SPASMA

Holy Basil

Immuno-modulating activity

Pharmacological studies in rats have indicated that both aqueous and methanolic extracts of sacred basil leaves stimulate humoral and cellular immunity.6; 13 Increased humoral immune response was demonstrated by increased antibody titre in response to challenge with typhoid antigen, while raised cellular immunity was evidenced by increased lymphocyte count.6 A steam distilled oil from the fresh leaves modulated various aspects of humoral immunity in vitro and in vivo.13

Antibody titre, including IgE titre was enhanced in vivo, and the oil also significantly inhibited histamine release from peritoneal mast cells and antagonised the spasmogenic effects of histamine, serotonin and acetylcholine in vitro. The authors of this study suggested that sacred basil might have an anti-allergic action resembling that of sodium chromoglycate, a widely used anti-allergic drug that suppresses the release of histamine.

Piperine

Long Pepper and Black Pepper contains the alkaloid piperine which is known to increase the bioavailability of a number of drugs such as vasicine (a.k.a. peganine) an antiasthmatic alkaloid from Adhatoda vasica (Johri et al 1992). In 1928, Bose, while studying the anti-asthmatic properties of Adhatoda vasica, noted that Long pepper, when added to Adhatoda leaves, would increase their efficacy (in Atal et al. 1981).

Effects on bioavailability

Several studies have demonstrated that Trikatu (as well as some of its ingredients, see below) can significantly affect the bioavailability of other compounds, including herbal and pharmaceutical drugs. Most of these studies appear to suggest that Trikatu and its components can increase the bioavailability of other substances.

The constituent responsible for this bioavailability enhancing effect is piperine..2;34

As mentioned above, an early study found that adding Long pepper to Adhatoda vasica leaves increased their efficacy in asthma (in Atal et al. 1981).

Enhanced bioavailability as a result of co-administration with either piperine, Black pepper or Long pepper, or Trikatu has been observed for several drugs including vasicine (from Adhatoda vasica), sparteine (from Spartium junceum but also found in broom, Cytisus scoparius), phenytoin, propranolol, theophylline, pentobarbitone, sulphadiazine and tetracycline.1;2;34;35

For example, piperine administered at a dose of 30 mg/kg together with sparteine to rats more than doubled the bioavailability of sparteine.2

The primary mechanism by which piperine (and Trikatu) affects the bioavailability of other compounds seems to be via the nonspecific and noncompetitive inhibition of microsomal liver metabolism involving the cytochrome P-450 enzyme system.1;13;16;34;36;3

Clinical References

Long Pepper has been used in the treatment of asthma and chronic bronchitis in Ayurvedic and Unani medicine.10 In a study involving 240 children of different age groups suffering from frequent asthma attacks, long term administration of Long Pepper fruits significantly reduced the severity of asthma attacks.15 25 patients in the study group showed no occurrence of asthma attacks, 161 showed clinical improvement, 47 did not benefit from the treatment, and 7 patients deteriorated.

In another study 20 pediatric patients with asthma received Long Pepper in dosages of 9.35 to 15.75 grams daily for several weeks. As a result of this treatment all patients showed clinical improvement.

Adhatoda vasica

Several alkaloids are present in the leaves and the chief principle is a quinazoline alkaloid, vasicine; the yield of the alkaloid from different samples in India ranged from 0.541 to 1.105 per cent on dry basis. Vasicine is accompanied by l- vasicinone., deoxyvasicine and maiontone, some minor alkaloids viz. Vasicol,adhatodinine and vasicinol also present. Adathoda vasica known in Ayurveda by its Sanskrit name Vasaka has been traditionally included in preparations for the relief of cough, asthma and bronchitis.22 The properties of alkaloid vasicine has been utilized in the development of the drug with brand name Bisolvon® which chemically is a synthetic derivative of alkaloid vasicine. The clinical evaluation of Bisolvon® (administered intravenously) confirmed that this drug can be useful in clearing the airways by decreasing the mucus secretion and opening the air passages. 23

Antiasthmatic, antispasmodic (respiratory tract), bronchodilator, expectorant (relaxing), oxytocic.

The pharmacological activities of vasicine and vasicinone are well known. The /-forms of vasicine and vasicinone are more active than their racemic forms. Recent investigations on vasicine showed bronchodilatory activity (comparable to theophylline) both in vitro and in vivo. Vasicinone showed bronchodilatory activity in vitro but bronchoconstrictory activity in vivo; it is probably biotransformed in vivo, causing bronchoconstriction. Both the alkaloids in combination (1:1) showed pronounced bronchodilatory activity in vivo and in vitro. Vasicine also exhibited strong respiratory stimulant activity, moderate hypotensive activity and cardiac-depressant effect; vasicinone was devoid of these activities. The cardiac-depressant effect was significantly reduced when a mixture of vasicine and vasicinone was used. Vasicinone (dl-form) showed no effect on the isolated heart, but probably the l-form is a weak cardiac stimulant. Clinical trials of a commercial drug containing vasicinone and vasicinone have not revealed any side effects while treating bronchial asthma. The drug is known to possess abortifacient activity and hence should not be used during pregnancy. The widely used mucolytics namely benzylamines (bromhexine and ambroxol) are the semisynthetic derivatives of vasicine extracted from

Adhatoda vasica, and these benzylamines enhance lysozyme levels in respiratory tract secretions and clear bacilli-laden mucus65. Chakraborty et al., reported the potent anti-inflammatory activity of Adhatoda vasica to be equivalent to that of hydrocortisone66. Paliwa et al., documented the potent antiallergic activity of “Compound 73/602 (AA)” (a structural analogue of vasicinone, an alkaloid of Adhatoda vasica) 67. Dhuley et al., reported the antitussive activity of Adhatoda vasica to be similar to that of codeine in vitro68.

Licorice

Licorice root has been used therapeutically for several thousand years in both Western and Eastern systems of medicine (Bradley, 1992; Leung and Foster, 1996). A chronological, documented summary of its medical uses since 2100 B.C.E. to the present, with correlations to modern pharmacological research, has been published (Gibson, 1978). Its use is first documented in Assyrian clay tablets (ca. 2500 B.C.E.) and Egyptian papyri. It was used in ancient Arabia to treat coughs and to relieve the unwanted effects of laxatives (Bruneton, 1995). Its use in ancient Scythia spread to Greece. Greek natural scientist Theophrastus (ca. 372–287 B.C.E.) reported its use for dry cough, asthma, and all pectoral diseases (Grieve, 1979). Pliny the Elder (ca. 23–79 C.E.) reported licorice cleared the voice and had expectorant and carminative actions (Der Marderosian, 1999). In China, licorice is first mentioned in the Shen Nong Ben Cao Jing (ca. 25 C.E.), reconstructed "materia medica" from lost text attributed to Shen Nong Shi (ca. 3000 B.C.E.) (Foster and Yue, 1992). According to the Chinese pharmacopeia, licorice, either aqueous dry extract or hydroalcoholic fluid extract, is an irritant, often used in combination with expectorants and antitussives to diminish irritation of the mucous membrane of the pharynx. It also relieves spasms of the gastrointestinal smooth muscle and shows desoxycorticosterone-like action (Tu, 1992). In India, licorice is used in traditional Ayurvedic, Siddha, and Unani medicines (Nadkarni, 1976). The present-day Ayurvedic Pharmacopoeia reports it is expectorant, demulcent, spasmolytic, antinflammatory, an adrenal agent, and a mild laxative (Karnick, 1994). It is also official in the Indian Pharmacopoeia as a demulcent (IP, 1996).

In Germany, licorice root is licensed as a standard medicinal tea for bronchitis and for chronic gastritis. It is also used in bronchial teas, stomach teas, and laxative teas available only in the pharmacy. Aqueous and alcoholic extracts of licorice root are used in many bronchial, gastrointestinal, liver and bile, and urological preparations. In the United States, licorice root is often a component of demulcent, expectorant, or laxative preparations (dietary supplement and OTC drug) in aqueous infusion, hydroalcoholic fluidextract and tincture, and solid dosage forms. Licorice root and extracts, fluid and solid, are official in the U.S. National Formulary (NF, 1985).

Chemistry and Pharmacology

Licorice root contains triterpenoid saponins (4–24%), mostly glycyrrhizin, a mixture of the potassium and calcium salts of glycyrrhizic acid; flavonoids (1%), mainly the flavanones liquiritin and liquiritigenin, chalcones isoliquiritin, isoliquiritigenin and isoflavonoids (formononetin); amines (1–2%) asparagine, betaine, and choline; amino acids; 3–15% glucose and sucrose; starch (2–30%); polysaccharides (arabinogalactans); sterols (b-sitosterol); coumarins (glycerin); resin; and volatile oils (0.047%) (Bruneton, 1995; Bradley, 1992; Budavari, 1996; Leung and Foster, 1996; List and Hrhammer, 1973–1979; Newall et al., 1996; Wichtl and Bisset, 1994). An

extensive review of licorice chemistry has been published recently (Tang and Eisenbrand, 1992).

The Commission E reported that, according to controlled clinical studies, glycyrrhizic acid and the aglycone of glycyrrhizic acid accelerate the healing of gastric ulcers. Secretolytic and expectorant effects have been confirmed in tests on rabbits. In the isolated rabbit ileum, an antispasmodic action has been observed at concentrations of 1:2500–1:5000.

The British Herbal Compendium reported its actions as anti-inflammatory, expectorant, demulcent, and adrenocorticotropic (Bradley, 1992).

The pseudo-aldesterone-like effects are generally attributed to the glycyrrhizic acid. New research suggests that the glycyrrhetenic acid, the hydrolytic metabolite of glycyrrhizic acid, is the primary active component that causes inhibition of peripheral metabolism of corticol, which binds to mineralocorticoid receptors in the same way as aldosterone (Heikens et al., 1995).

The main constituent found in the root is glycyrrhizin. The plant also contains various sugars (to 14%), starches (30%), flavonoids, saponoids, sterols, amino acids, gums, and essential oil. Glycyrrhizin, stimulates the secretion of the adrenal cortex hormone aldosterone.

It can be as effective as codeine, and safer, when used as a cough suppressant. Rhizomes in the plant have a high mucilage content which, when mixed with water or used in cough drops, sooths irritated mucous membranes. The drug also has an expectorant effect which increases the secretion of the bronchial glands. It is an effective remedy for throat irritations, lung congestion, and bronchitis.

Glycyrrhizin also encourages the production of hormones such as hydrocortisone which give it anti-inflammatory properties. Like cortisone it can relieve arthritic and allergy symptoms, without the side effects.

Uses

The Commission E approved the internal use of licorice root for catarrhs of the upper respiratory tract and gastric or duodenal ulcers.

The British Herbal Compendium indicates its use for bronchitis, peptic ulcer, chronic gastritis, rheumatism and arthritis, and adrenocorticoid insufficiency (Bradley, 1992). The German Standard License approves licorice root infusions for loosening mucus, alleviating discharge in bronchitis, and as an adjuvant in treating spasmodic pains of chronic gastritis (Bradley, 1992; Braun et al., 1997; Wichtl and Bisset, 1994). In France, licorice preparations may be used to treat epigastric bloating, impaired digestion, and flatulence (Bruneton, 1995).

The World Health Organization recognizes no uses for licorice as being supported by clinical data; WHO recognizes the following uses as being described in pharmacopeias and in traditional systems of medicine: demulcent for sore throats; expectorant in treatment of coughs and bronchial catarrh; prophylaxis and treatment of gastric and duodenal ulcers; used in dyspepsia; anti-inflammatory in treating allergic reactions, rheumatism, and arthritis; to prevent liver toxicity; and to treat tuberculosis and adrenocorticoid insufficiency (WHO, 1999).

The Glycyrrhiza glabra root component Glycyrrhizin induces potassium excretion in conjunction with sodium and water re-absorption in the kidneys, resulting in hypokalemia and hypertension, if used in large amounts for prolonged periods (Brinker, 2001). However, licorice extracts are safer than consuming an equivalent amount of pure glycyrrhizin, due to modified intestinal absorption and bioavailability of the glycyrrhizin when it is combined with other licorice components (Cantelli-Fort et al 1994).

Licorice is added to so many mixtures in Chinese medicine as a synergistic agent, both as a potentiator and detoxifier. These effects are now becoming better understood, and it is known that licorice potentiates compounds such as paeoniflorin as a neuromuscular blocking agent, while affecting intestinal absorption of toxic substances such as the aconite alkaloids (Miaorong and Jing, 1996).

Solanum xanthocarpum

The yellow berried nightshade or Solanum xanthocarpum is one of the members of the dasamula or ten important medicinal roots of the Ayurveda.

Different parts of this plant such as its fruits, roots are used in making specific medicines. Its roots are used in the preparation of expectorant to treat coughs. Roots of solanum xanthocarpum possess the ability to heal asthma, sore throat and bronchial spasm.

The juice of the yellow berries is used to relieve sore throat. Roots and seeds are administered as an expectorant in asthma, cough and pain in the chest. Stem flowers and fruits are bitter and carminative and are prescribed for relief in burning sensation in the feet. Leaves are applied locally to relieve pain. The drug is collected mainly from the wild plants, as there is very minimal systematic cultivation of this herb.

The juice of the leaves mixed with black pepper is advised for rheumatism. The leaves juice is externally applied to relieve body or muscle pain. Pharmacological studies on this herb have shown that aqueous and alcoholic extracts of the plant possess hypotensive effect, which is partly inhibited by atropine.

The clinical efficacy of two herbs Solanum xanthocarpum and Solanum trilobatum in a dose of 300 mg tds for 3 days was investigated in mild to moderate bronchial asthma. Their effect was compared with standard bronchodilator drugs, salbutamol (4 mg) and deriphylline (200 mg). The improvement in PEFR and the reduction in other symptom scores clearly indicate a bronchodilator effect, a decrease of oedema and secretions in the airway lumen. The response to these herbs can be considered to be equivalent to that of deriphylline but less than salbutamol. No untoward effects were reported during the study. The present study further confirms the traditional use of these herbs in bronchial asthma (Govindan et al., 2004).

Ammonium Chloride

Expectorant

Expectorants are remedies which facilitate the expulsion of mucus from the respiratory organs. They do this largely by increasing the fluidity or the rate of the secretion. Most of them act reflexively from an irritant (nauseant) action in the stomach. Henderson and Taylor (1910) believed this to be the case with ammonium compounds, antimony, ipecac, and senega. Coleman holds that ammonium chloride fluidifies by increasing the water in the bronchi, which it carries out as the medium of its own excretion.Ammonium chloride also has been used as an expectorant, usually in combination with other expectorants and cough mixtures; its expectorant action is caused by irritative action on the bronchial mucosa. This causes the production of excess respiratory tract fluid which presumably is easier to cough up. (See The American Journal of the Medical Sciences: October 1916 - Volume 152 - Issue 4 - ppg 569-581 - The Expectorant Action of Ammonium Chloride by Coleman, Warren M.D.)Note: Main Ingredient of DIPHENHYDRAMINE EXPECTORANT SYRUP.

10. Dymock, W., Warden, C.J.H., Hooper, D. (l 972) Piper nigrum: Pharmacographia Indica.Published by The Institute of Health & Tibbi Research under auspices of Hamdard NationalFoundation. Pakistan. Vol.III. 372-374

15. Athavale VB (1978) Piper longum in asdbronchitis. Paper presented at International Pediatric Conference in New Dehli, India.16. Dahanukar, S. et al. (1984) Efficacy of Piper longum in childhood asthma. Indian Drugs. 384-388.22. Gupta OP et al. Pharmacological investigations of vasicine and vasicone - the alkaloids of Adhatoda vasica. Indian J Med Res 1977; 66(4):680-691.23. Racle JP et al. Clinical and anatomopathological effect of Bisolvon in respiratory resuscitation. Ann Anesth Francaise 1976; 17(1):51-58.65. Grange JM, Snell NJ. Activity of bromhexine and ambroxol, semi-synthetic derivatives ofvasicine from the Indian shrub Adhatoda vasica, against mycobacterium tuberculosis in vitro. J.Ethnopharmacol. 1996; 50(1): 49-53.66. Chakraborty A, Brantner AH. Study of alkaloids from Adhatoda vasica Nees. on their anti-inflammatory activity. Phytother. Res. 2001; 15(6): 532-544.67. Paliwa JK, Dwivedi AK, Singh, S, Gutpa RC. Pharmacokinetics and in-situ absorption studiesof a new anti-allergic compound 73/602 in rats. Int. J. Pharm. 2000; 197(1-2): 213-220.68. Dhuley JN. Antitussive effect of Adhatoda vasica extract on mechanical or chemicalstimulation-induced coughing in animals. J. Ethnopharmacol. 1999; 67(3): 361-365.

Ephedra Gerardiana

Overview

In Oriental medicines, ephedra is the chief drug for treatment of asthma and bronchitis. It has been used for thousands of years in traditional Chinese medicine (TCM) as a primary component of multi-herb formulas prescribed to treat bronchial asthma, cold and flu, cough and wheezing, fever, chills, lack of perspiration, headache, and nasal congestion. It is listed in the oldest comprehensive materia medica, Shen Nong Ben Cao Jing, among the "middle class" herbs, used to induce perspiration and as an anti-allergy agent (Blumenthal and King, 1995; Bruneton, 1995; Der Marderosian, 1999; Huang, 1999; Leung and Foster, 1996; Weiss, 1988). Today, ephedra is official in the national pharmacopeias of China, Germany, and Japan. In India, ephedra herb is listed in the Ayurvedic pharmacopoeia. Only its isolated derivatives ephedrine and ephedrine hydrochloride are official in the Indian Pharmacopoeia (DAB 1998; IP, 1996; JP XII, 1993; Karnick, 1994; Tu, 1992). The Chinese pharmacopoeia indicates its use for common cold with wind-cold syndrome (marked by chilliness and mild fever, headache, stuffy and runny nose, general aching, but no sweating), and for bronchial asthma (Tu, 1992). The Ayurvedic pharmacopeia lists ephedra for asthma, spasms, hay fever, and allergic symptoms (Karnick, 1994). In China, ephedra is a major component of a cold medication used to relieve headache, body ache, coughing, and to lower fever by increasing perspiration. The formula is an aqueous decoction containing ephedra herb, cinnamon twig, licorice root, and almond (Huang, 1999).

In Germany,ephedra is official in the German Pharmacopoeia and is an approved herb in the Commission E monographs. It is used as a primary component of licensed prepared respiratory medicines (BAnz, 1998; DAB 1998). In the United States, the herb ephedra is regulated as a dietary supplement under the Dietary Supplement Health and Education Act of 1994 (DSHEA) in aqueous infusion, alcoholic tincture, and dry extract in capsules or tablets. Ephedra is used in TCM herbal teas and prepared professional products prescribed to patients by licensed acupuncturists and naturopathic physicians. The alkaloids (and their salts) from ephedra—i.e., ephedrine and pseudoephedrine—are approved by the Food and Drug Administration (FDA) as over-the-counter (OTC) drug ingredients for common cold, flu, and allergies.

Modern human studies in China have investigated its clinical uses for treatment of bronchial asthma, chronic bronchitis, pneumonia of children, and whooping cough (Chang and But, 1986; Liu, 1989). Human studies in the West have focused on its pharmacokinetics (Gurley et al., 1998; Pickup et al., 1976), cardiovascular effects in healthy adults (White et al., 1997), and potential in weight loss (Nasser et al., 1999).

One clinical study reported that therapeutic effects were achieved in patients suffering from chronic asthmatic bronchitis who were treated with TCM formula "San Ao Decoction" [ephedra stem (Ephedra sinica Stapf.), bitter apricot seed (Prunus armeniaca L. var. ansu Maxim.), licorice root (Glycyrrhiza uralensis Fisch.), perilla fruit (Perilla frutescens (L.) Britt.), and ground dragon body (Pheretima aspergillum (Perier) or Allolobophora caliginosa (Savigny) trapezoides (Ant. Duges)] modified to suit individual manifestations (Chang and But, 1986). Another clinical study reported that satisfactory results were obtained in 288 cases of whooping cough in children, mostly between 3 and 5 years old, treated with the TCM formula "Ephedra-Prunus-

Gypsum-Glycyrrhiza Decoction" [ephedra stem (Ephedra sinica Stapf.), bitter apricot seed (Prunus armeniaca L. var. ansu Maxim.), gypsum plaster stone (hydrated calcium sulfate), Chinese licorice root (Glycyrrhiza uralensis Fisch.), stemona root tuber (Stemona sessilifolia (Miq.) Miq., pepperweed seed (Descurainia sophia (L.) Webb ex Prantl.), Chinese date fruit (Ziziphus jujuba Mill.), and maltose (malt sugar)]. The authors reported it to be effective in catarrhal and spastic stages (Chang and But, 1986).

The approved modern therapeutic applications for ephedra are supportable based on its history of clinical use in well established systems of traditional and conventional medicines,extensive phytochemical investigations,pharmacological studies in animals, and human clinical studies.

Recent research suggests that ephedra as a single herb can be used safely in persons with normal blood pressure levels. A small clinical study of 12 healthy men and women between the ages of 23 and 40 employed four capsules twice daily, each containing 375 mg of powdered ephedra herb (Solaray brand, Ogden, Utah) (White et al., 1997). After blood pressure baselines were recorded, during the treatment phase four capsules were taken with breakfast and again nine hours later, with dinner. No additional herbal ingredients were present in the capsules, nor did they contain added ephedra extracts. Alkaloid levels of the capsules were measured by high-performance liquid chromatography (HPLC); the average level for each four-capsule dose was 19.4 mg ephedrine, 4.9 mg pseudoephedrine, and 1.2 mg methylephedrine. (By comparison, an over-the-counter cold capsule or tablet contains 25 mg ephedrine in the hydrochloride or sulfate forms.) Blood pressure was monitored every 15 minutes during the treatment phase. None of the 12 subjects experienced adverse effects during the study. Six experienced statistically significant increases in mean 12-hour heart rate after taking the herb, three had minor increases, and three showed no change. During the first three hours of treatment, four had significant increases in systolic pressure and two had significant decreases in diastolic pressure. The authors did not consider these effects clinically significant. They concluded that "pharmacodynamic aspects of ingestion of ma-huang in a normotensive, young population were fairly benign." They cautioned about the use of ephedra with other stimulants or in high doses. The weakness of this trial is the obvious small sample and lack of data on how the weight of each subject may have affected the results (Leigh, 1998).

Chinese pharmacopeial grade ephedra must be composed of the dried herbaceous stem collected in autumn, containing not less than 0.8% total alkaloids, calculated as ephedrine. Botanical identity must be confirmed by thin-layer chromatography (TLC) as well as by macroscopic and microscopic examinations (Tu, 1992). The Japanese Pharmacopoeia requires a minimum of only 0.6% total alkaloids but has additional purity requirements, including not more than 5% woody stems and the absence of stems of Equisetaceae or Gramineae plants (JP XII, 1993).The German Pharmacopoeia requires not less than 1% total alkaloids as well as identity, purity, and quality requirements comparable to those of the Chinese and Japanese monographs (DAB, 1997; DAB, 1998).

Description

Ephedra consists of the dried, young branchlets, harvested in the fall, of Ephedra sinica Stapf, E. shennungiana Tang [Fam. Ephedraceae], or other equivalent Ephedra species, and their equivalent preparations in effective dosage. The herb contains alkaloids; main alkaloids are ephedrine and pseudoephedrine. Ed. Note: The species listed by the Commission E are quite rare in U.S. commerce. Many species of ephedra are used in commerce, including E. equisetina Bge (Leung, 1999).

Chemistry and Pharmacology

Ephedra herb contains alkaloids (approx. 1.3%) mostly composed of l-ephedrine (50–90%), d-pseudoephedrine, l-norephedrine, d-norpseudoephedrine, l-N-methylephedrine and d-N-methylpseudoephedrine; flavonoid glycosides; glycans (ephedrans); citric, malic, and oxalic acids; proanthocyanidins (condensed tannins); and tannins and volatile oils (l-a-terpineol, limonene, and linalool) (Bruneton, 1995; Budavari, 1996; Leung and Foster, 1996).

The Commission E reported antitussive actions in animal experiments. Ephedrine acts by indirectly stimulating the sympathomimetic and central nervous systems. Bacteriostatic activity is also reported.

A diaphoretic action in humans has been reported for the aqueous decoction and volatile oil forms, and antiallergic effects in vitro have been demonstrated for the decoction and alcoholic extract forms of ephedra herb (Leung and Foster, 1996).

The pure alkaloid ephedrine acts as an indirect sympathomimetic. It is structurally similar to adrenaline. It stimulates cardiac automaticity with a positive inotropic action. It accelerates and increases the intensity of respiration and functions as a bronchodilator (Bruneton, 1995; Robbers and Tyler, 1999). The Merck Index lists the therapeutic category of l-ephedrine as bronchodilator and d-pseudoephedrine as decongestant (Budavari, 1996).

Uses

The Commission E approved the internal use of ephedra herb for diseases of the respiratory tract with mild bronchospasms in adults and children over the age of 6.

The World Health Organization has found the following uses of ephedra preparations to be supported by clinical data: treatment of nasal congestion due to hay fever, allergic rhinitis, acute coryza (rhinitis), common cold, sinusitis, and as a bronchodilator in treatment of bronchial asthma (WHO, 1999).

In Oriental medicine, ephedra herb, known as mahuang, is the primary drug used in treatment of asthma and bronchitis (Bruneton, 1995). Mahuang has been used for more than two thousand years to treat bronchial asthma, cold and flu, fever, chills, lack of perspiration, headache, nasal congestion, aching joints and bones, and cough and wheezing (Leung and Foster, 1996; Morton, 1977).

Main Ingredients: ephedrine and pseudo-ephedrine. Ephedra gerardiana contains 1.22% total alkaloids and 0.68% ephedrine.

Medicinal usesUses supported by clinical data

Herba Ephedrae preparations are used in the treatment of nasal congestion due to hay fever, allergic rhinitis, acute coryza, common cold, and sinusitis. The drug is further used as a bronchodilator in the treatment of bronchial asthma (4, 8, 10, 21–23).

Uses described in pharmacopoeias and in traditional systems ofMedicine

Herba Ephedrae has been used for the treatment of urticaria, enuresis, narcolepsy, myasthenia gravis, and chronic postural hypotension (4, 8, 22, 23).

Uses described in folk medicine, not supported by experimental or clinical data

Other medical uses claimed for Herba Ephedrae preparations include its use as an analgesic, an antiviral agent, an antitussive and expectorant, an antibacterial, and an immune stimulant (10, 24, 25).

Clinical pharmacology

Two of the main active constituents of Herba Ephedrae, ephedrine andpseudoephedrine, are potent sympathomimetic drugs that stimulate α-, _1- and _2- adrenoceptors (22, 23). Pseudoephedrine’s activity is similar to ephedrine, but its hypertensive effects and stimulation of the central nervous system are somewhat weaker. Part of ephedrine’s peripheral action is due to the release of norepinephrine, but the drug also directly affects receptors. Tachyphylaxis develops to its peripheral actions, and rapidly repeated doses become less effective owing to the depletion of norepinephrine stores (22).

Effects

ACTION _ Circulatory stimulant, bronchodilator, vasodilator, antiallergic, antiasthmatic (usualy given with expectorants), diaphoretic. Not prescribed with antidepressants.

KEY APPLICATION _ Ephedra sinica—in diseases of the respiratory tract and mild bronchospasms. Also in acute coryza, allergic rhinitis and sinusitis. (German Commission E.) In the treatment of nasal congestion due to hay fever, allergic rhinitis, acute coryza, cold, sinusitis and as a bronchodilator. (WHO.)

Contraindicated in anxiety, restlessness, high blood pressure, glaucoma, impaired circulation of the cerebrum, adenoma of prostate with residual urine accumulation, pheochromocytoma, thyrotoxicosis. (German Commission E.)

The level of the active principles can fluctuate drastically. Ephedrine acts by indirectly stimulating the sympathomimetic and central nervous system. The herb is bacteriostatic, positively inotropic and positively chronotropic. In animal tests ephedrine acts as an antitussive.

INDICATIONS AND USAGEApproved by Commission E:• Cough/bronchitis

The dried twigs which form the official drug are used in asthma, hay fever and rashes of allergic origin. Liquid extract of the plant is used for controlling asthmatic paroxysms. Juice of berries is used in affections of respiratory passages. Nasal spray prepared from the drug is used in asthmatic attacks and inflammation of mucus membranes.

Contraindications

Anxiety and restlessness, high blood pressure, glaucoma, impaired circulation of the cerebrum, adenoma of prostate with residual urine accumulation, pheochromo–cytoma, thyrotoxicosis.

Side Effects

Insomnia, motor restlessness, irritability, headaches, nausea, vomiting, disturbances of urination, tachycardia.

In higher dosage: Drastic increase in blood pressure, cardiac arrhythmia, development of dependency.

Use During Pregnancy and Lactation

Not recommended (McGuffin et al., 1997).

Interactions with Other Drugs

In combination with:

Cardiac glycosides or halothane: Disturbance of heart rhythm.

Guanethidine: Enhancement of the sympathomimetic effect.

MAO-inhibitors: Greatly raising the sympathomimetic action of ephedrine.

Secale alkaloid derivatives or oxytocin: Development of hypertension.

Dosage and Administration

Unless otherwise prescribed:

Adults: 1.2-2.3 g of cut herb containing approximately 1.3% (13 mg/g) total alkaloids.

Children: 0.04 g (40 mg) of cut herb per kg of body weight (Single dose for a 30 kg child, 1.2 g of cut herb).

Single dosage:

Adults: Herb preparations corresponding to 15-30 mg total alkaloid (=1.2-2.3 g of cut herb), calculated as ephedrine.

Children: Herb preparations corresponding to 0.5 mg total alkaloid (=0.04 g of cut herb) per kg of body weight.

Infusion or decoction: 1.2-2.3 g in 150 ml water.

Fluidextract 1:1 (g/ml): 1.2-2.3 ml.

Tincture 1:5 (g/ml): 5.75-11.5 ml.

Native extract 3.5-4.5:1 (w/w): 0.25-0.65 g.

Maximum daily dosage:

Adults: Herb preparations corresponding to 300 mg total alkaloid (=23 g of cut herb), calculated as ephedrine.

Children: 2 mg total alkaloid (=0.15 g of cut herb) per kg of body weight.

Duration of administration: Commission E recommended that ephedra preparations should only be used short-term because of tachyphylaxis and danger of addiction.

Note: When the monograph was published in January, 1991, the Commission E stated that ephedrine-containing preparations are listed as addictive by the International Olympic Committee and the German Sports Association. However, a more recent analysis of the available U.S. health and safety data compiled by Edgar H. Adams, M.S., Sc.D., former Director of the Division of Epidemiology and Statistical Analysis at the U.S. National Institute on Drug Abuse, indicates that there is no evidence of significant abuse of, or addiction to, ephedra, despite decades of widespread use, establishing that any potential for addiction is low and does not rise to the level of regulatory concern to the extent that it warrants scheduling (as is done with addictive narcotic drugs) (Adams, 1999).

References

Adams, E.H. 1999. Statement to U.S. FDA. FDA Docket No. 98N-0148, cmt. 28, tab A. Feb 10.

Astrup, A., S. Toubro, S. Cannon, P. Hein, J. Madsen. 1997.Thermogenic synergism between ephedrine and caffeine in healthy volunteers: A double-blind, placebo-controlled study. Metabolism 40(3):323329.

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General Accounting Office (GAO). 1999. Dietary Supplements: Uncertainties in Analyses Underlying FDA's Proposed Rule on Ephedrine Alkaloids. Washington, DC: United States General Accounting Office; July.

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This material was adapted from The Complete German Commission E MonographsTherapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.

1) The Overview section is new information.

2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.

3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:

Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]

Infusion: 2 g in 150 ml of water

Fluidextract 1:1 (g/ml): 2 ml

Tincture 1:5 (g/ml): 10 ml

4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.

This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.

Excerpt from Herbal Medicine: Expanded Commission E MonographsCopyright 2000 American Botanical Council

Turmeric

Published by Integrative Medicine Communications of turmeric powder and in turmeric used in cooking – more on this in Section D Medical Qualities of Turmeric below. Mark Pederson also includes a chart indicating that turmeric is very high in fat, magnesium, and silicon and high in calories, iron, manganese, niacin, potassium, selenium, and sodium. (33)

In his book Dr. Dukes Essential Herbs, Dr. James Duke discusses “turmeric’s medicinal power” emphasizing certain constituents including the following:

Antioxidants including vitamins C and E, several carotenoids, curcumin, and related compounds called curcuminoids.

Cyclooxygenase-2 (COX 2) inhibitors, effective at blocking inflammation, especially inflammation caused by arthritis and gout. However, unlike aspirin and certain other anti-inflammatory drugs turmeric doesn’t contain COX-1 which inhibits necessary body functions including clotting of blood.

Curcumin is one of the above mentioned antioxidants. It neutralizes some cancer causing substances and acts as an anti-mutagenic stopping very early changes in cells that can turn to cancer. Curcumin also protects the heart, is antiviral (and thus may be useful to HIV patients), and is a cell growth generator speeding up the healing of wounds.

Cineole also known as Eucalyptol which stimulates the central nervous system, is antiseptic, is expectorant, and eliminates gas. Studies show that cineole has both expectorant and decongestant activity when ingested.

Dr. Duke'sPhytochemical and Ethnobotanical DatabasesChemicals and their Biological Activities in: Curcuma longa L. (Zingiberaceae) – Indian Saffron, Turmeric

1,8-CINEOLE (also known as Eucalyptol) Rhizome 30 - 720 ppm Allelopathic; Allergenic; Anesthetic; Anthelminthic; Antiacetylcholinesterase IC50=41 ug/ml; Antiallergic; Antibacterial 50 ppm; Antibronchitic; Anticatarrh; Anticholinesterase; Antifatigue; Antihalitosic; Antilaryngitic; Antipharyngitic; Antirhinitic; Antiseptic; Antispasmodic; Antistaphylococcic; Antitussive; Candidicide; Choleretic; CNS-Stimulant; Convulsant; Counterirritant; Cytochrome-P450-Inducer; Degranulant 0.3 ul/ml; Dentifrice;Edemagenic inj; Expectorant; FLavor FEMA 1-200; Fungicide; Gram(+)icide; Gram(-)icide; Hepatotonic; Herbicide IC50=78 uM; Hypotensive; Inflammatory inj; Insectifuge; Irritant; Myorelaxant; Nematicide; Neurotoxic; P450-Inducer; Perfume; Pesticide; Rubefacient; Secretogogue; Sedative; Spasmogenic; Surfactant; Testosterone-Hydroxylase-Inducer; Trichomonicide LD100=1,000 ug/ml

Eucalyptol is an ingredient in many brands of mouthwash and cough suppressant. It controls airway mucus hypersecretion and asthma via anti-inflammatory cytokine inhibition. Eucalyptol is an effective treatment for nonpurulent rhinosinusitis. Research showed that treated subjects experienced fewer headaches on bending, frontal headache, and sensitivity of pressure points of trigeminal nerve, impairment of general condition, nasal obstruction, and rhinological secretion. Side effects from treatment were minimal.

Action of Turmeric - Anti-inflammatory, cholagogue, hepatoprotective, blood-purifier, antioxidant, detoxifier and regenerator of liver tissue, antiasthmatic, anti-tumour, anticutaneous, antiprotozoal, stomachic, carminative. Reduces high plasma cholesterol. Antiplatelet activity offers protection to heart and vessels. Also protects against DNA damage in lymphocytes.

Key application - In dyspeptic conditions. (German Commission E, ESCOP, WHO.) As antiinflammatory, stomachic. (Indian Herbal Pharmacopoeia.) The rhizomes gave curcuminoids, the mixture known as curcumin, consisting of at least four phenolic diarylheptanoids, including curcumin and monodesmethoxycurcumin; volatile oil (3-5%), containing about 60% of turmerones which are sesquiterpene ketones, and bitter principles, sugars, starch, resin. Curcumin related phenolics possess antioxidant, anti-inflammatory, gastroprotective and hepatoprotective activities. The antioxidant activity of curcumin is comparable to standard antioxidants—vitamin C and E, BHA and BHT. The volatile oil, also curcumin, exhibited anti-inflammatory activity in a variety of experimental models (the effects were comparable to those

of cortisone and phenylbutazone). Used orally, curcumin prevents the release of inflammatory mediators. It depletes nerve endings of substance P, the neurotransmitter of pain receptors.

Hedychium spicatum (Ginger Lily)

Any ornamental plant of the genus Hedychium, of the ginger family (Zingiberaceae). About 50 species occur in tropical and subtropical regions (e.g., India, southwestern China). The rhizomes (underground stems) are ginger-like (i.e., fleshy with a yellow or bluish interior).

Phytochemistry:The dried rhizome of the plant contains essential oil, starch, resins, organic acids and a glycoside; albumen and saccharine are also present. The essential oil has ethyl ester of p-methoxy cinnamic acid, d-sabirene cineole, sesquiterpenes and pentadecane methyl paracumarine acetate. It contain, ß-sitosterol and its ß-D-glycoside.

Pharmacology: In preliminary pharmacological studies the drug is found to have a vasodilatory effect on coronary vessels, mild hy-potensive property and a non-specific antispasmodic effect on smooth muscles. Studies on the essential oil of the rhizomes of Hedychium spicatum reveal that these oils possess a mild tranquilizing effect of short duration. They depressed the conditioned avoidance response, rotarod performance and potentiated pento-barbitone hypnosis and morphine analgesia in rats. The crude ethanolic extract of rhizomes possesses anti-inflammatory and analgesic activity. The anti-inflammatory activity was mainly localised in the hexane fraction from which 1% of pure active constituent was isolated. The analgesic activity was more prominent in the benzene fraction. Some other minor active constituents were also present which may contribute to the total activity of rhizomes.

The root stalk is useful in local inflammations, nausea, asthma, bronchitis, hiccups and in pain. The rhizome of the plant is said to be carminative, stimulant and a tonic. It has been described as useful, especially as an anti-asthmatic agent. Clinical trials have been conducted in tropical eosinophilia, with promising results. It counteracts had mouth taste and smell.

In the doses commonly used, no adverse reactions have been reported.

Action _ Rhizome—carminative, spasmolytic, hepatoprotective, anti-inflammatory, antiemetic,antidiarrhoeal, analgesic, expectorant, antiasthmatic, emmenagogue, hypoglycaemic, hypotensive, antimicrobial, anthelmintic, insectrepellent.

EtOH (50%) extract—anti-inflammatory and hypoglycaemic; gave encouraging results in tropical pulmonary eosinophilia in clinical studies. Alcoholic extract of the plant—vasodilator, mild hypotensive and antiseptic in animals. Essential oil from rhizome—mild tranquilizer in male albino rats; antimicrobial. Rhizome gave sitosterol and its glucoside, a furanoid diterpene—hedychenone and 7-hydroxyhedychenone. The therapeutic activity of the rhizome is due to its essential oil which contains cineole, gamma-terpinene, limonene, betaphellandrene, p-cymene, linalool and beta-terpineol as major constituents. The oil inhibits the growth of several fungi. The ethanol (95%) extract showed antibacterial activity. The 50% extract showed antimalarial activity in vitro against Plasmodium berghei strain.

Traditionally used in India to treat asthma and with saw dust of Cedrus deodar used in tuberculosis.

The drug is valued for treatment of bronchial asthma in Ayurveda. Soothing, expectorant, anti-tussive, anti-asthmatic (Chaturvedi and Sharma, 1975) [79] .In a clinical study powdered rhizome of the plant was administered to 25 patients with bronchial asthma for a period of 4 weeks and the result was considered satisfactory [80] .

79. G.N Chaturvedi, B.D Sharma. Ethnobotanical survey of plants used to treat asthma in Andhra Pradesh. Journal of Research in Indian Medicine. 10(2) : 6 (1975).  

80. V. Sekhar, D. N. Gandhi, N. Mohan Rao and U. D. Rawal. An Experimental and Clinical Evaluation of Anti-Asthmatic Potentialities of Devadaru Compound (Dc) Indian Journal of Physiology and Pharmacology. January 47(1) (2003).  

Nardostachys jatamansi DC.

Action - Used as a substitute for Valerian. Tranquilizer, sedative, hypotensive. Used for the treatment of epilepsy, hysteria, convulsive affections, palpitation of heart and in intestinal colic. A decoction of powdered roots is prescribed as a home remedy for high blood pressure. It is used in dysmenorrhoea for pain relief and smooth menstrual flow. It is used in hair oil for arresting hair loss and greying of hair.

The Ayurvedic Pharmacopoeia of India recommends dry rhizomes in obstinate skin diseases, erysipelas, disturbed mental state and insomnia. The rhizome is rich in sesquiterpenoids.The crude drug gave an oil (yield 2.5% v/w), which contains dnardostachone, valeranone and jatamansone as the major ketonic sesquiterpenes. The oil potentiated Phenobarbital narcosis in rats, reduced brain serotonin content and decreased the conditioned avoidance performance in cats.

Jatamansone was shown to exert tranquilizing effect in mice and monkeys. In rabbits, jatamansone was found to impair biosynthesis of serotonin in the brain leading to a reduction in brain level of 5- hydroxytryptamine. The degradation of serotonin was unaffected. The mode of action of jatamansone was thus in variance with that of reserpine which has direct action on the cell to liberate serotonin.

On the other hand, the alcoholic extract of the roots of Indian Nard caused an overall increase in the levels of central monamines, 5-hydroxy indole acetic acid and the inhibitory amino acids, gamma-aminobutyric acid, norepinephrine, dopamine and serotonin in rat brain.

In a clinical trial on hyperkinetic children, jatamansone showed significant reduction in hyperactivity and improvement in restlessness and aggressiveness, almost at par with Damphetamine. The volatile oil was found to be less active than quinidine in several tests.It did not counteract digitalis induced ventricular arrhythmias.

Abies Webbiana (Himalyan Fir)

Action _ Expectorant, bronchial sedative, decongestant, anticatarrhal, antiseptic, carminative.

Key application _ Fir (Abies alba Miller) needle oil—in catarrhal illness of upper and lower respiratory tract (internally and externally); externally in rheumatic and neuralgic pains. Contraindicated in bronchial asthma and whooping cough. (German Commission E.)

A bioflavonoid, abiesin, n-triacontanol, beta-sitosterol and betuloside are present in the leaves.The essential oil from leaves contains alpha-pinene, l-limonene, deltacarene, dipentene, l-bornyl acetate and l-cardinene as major constituents. A crystalline alkaloid called known as taxine essential oil.

Antitussive activity of Abies webbiana Lindl. leaf extract against sulphur dioxide-induced cough reflex in mice.

The methanol extract of A. webbiana Lindl was evaluated for its effect on a cough model induced by sulphur dioxide gas in mice. When administered orally it exhibited significant antitussive activity compared with the control in a dose dependent manner. The antitussive activity of the extract was compared with that of codeine phosphate, a prototype antitussive agent. The A. webbiana leaf extract (400 and 600 mg/kg) showed maximum inhibition of cough frequency by 71.69% and 78.67%, respectively, when compared with the control group and was comparable in effect to codeine phosphate. Medicinal UsesThe buds are antibiotic, antiseptic and balsamic[7]. The leaves are expectorant and a bronchial sedative[7]. They are best harvested in the spring and can be dried for later use[238]. The bark is antiseptic and astringent[7]. It can be harvested as required throughout the year[238]. The resin is antiseptic, balsamic, diuretic, eupeptic, expectorant, vasoconstrictor and vulnerary[7]. Both the leaves and the resin are common ingredients in remedies for colds and coughs, either taken internallly or used as an inhalent[238]. The resin is also used externally in bath extracts, rubbing oils etc for treating rheumatic pains and neuralgia[238].

Parts used: leaves

Preparations – Tincture, Infusion, Powder and Confection

Traditional Uses – Tincture or decoction (1 in 8) in doses of half to one drachma or infusion (1 to 20) in doses of 4 to 12 drachma of the dried terebinthinous leaves are useful in cases of cough, asthma, chronic bronchitis and catarrh of the bladder and other pulmonary infections. Juice of the fresh leaves is administered in fevers of infants during teething and infections of the chest, the dose being 5 to 10 drops in water or mother’s milk. Powder of the leaves in doses of half to one drachma is given with the juice of Adhotoda vasica and honey in cough, asthma and haemoptysis. A confection called Talisadi churna is prepared with Black pepper, Long pepper, Ginger, bamboo-manna, cardamoms, cinnamon and sugar is used in cough, asthma and haemoptysis. It is used in a wide variety of breaqthing problems, common cols, coughing, asthma and to liquefy phlegm for expectorationDose: 20 to 40 grains in water

Clerodendrum serratum

ACTION: - Root—Antiasthmatic, antihistaminic, antispasmodic, antitussive carminative, febrifuge.Leaf—febrifuge.

The Ayurvedic Pharmacopoeia of India indicated the use of the dried roots in cough, bronchitis, dyspnoea, chest diseases and sinusitis.

CHEMICAL COMPOSITION:

The bark contains triterpenoids — serratagenic, oleanolic and queretaric acids; leaves contain alpha-spinasteroland flavonoids, including luteolin, apigenin, baicalein, scutellarein, phenolic acids—caffeic and ferulic acids.

EtOH (50%) extract of the plant exhibited hypotensive and spasmolytic activity. Polyhydric property on isolated guinea pig ileum. Antiasthmatic effect was also observed pharmacologically. The root bark yields a glycoside material, phenolic in nature. D – Mannitol is isolated from the bark with a yield of 10.9 %. The powdered stem contains D- mannitol, D- glucoside of sitosterol, sitosterol and cetyl alcohol. Alcoholic extract and saponin isolated from root bark caused release of histamine from lung tissue.

PHYTOCHEMISTRY:

1..Clerodendrum serratum (Bharangi-Mul) Anti asthmatic roleIts tastes are bitter, pungent and astringent; it’s an excellent anti-histaminic agent and on prolonged administration causes protection against anaphylaxis. It is anti-inflammatory and an immunomodulator. It is commonly recommended in bronchial asthma, fevers, chronic conditions, e.g. sinusitis.

MEDICINAL USES:It is anti-inflammatory, anti-allergic and anti-nociceptive. Clerodendrum is the most valuable herb to take internally in respiratory ailments and for all fevers in general respiratory infections. Traditionally in Asthma, the leaves are used as mucolytic agent. As bharngi effectively liquefies the mucous, it is salutary in respiratory problems like colds, bronchitis, bronchial asthma and tuberculosis. In such conditions, varied combinations of bharngi are recommended. The juice of its roots and ginger relieves bronchospasms in asthma. In cough due to kapha and vata, the jam prepared of sesame oil, jaggery, bharngi and sunthi is beneficial. It works well with pippali, sunthi and jaggery to curb the spasms and bouts of cough. In hiccup, the root powder is given along with sugar, or its jam. The combination of bharngi and pippali (2: 1) wih honey, is also an effective remedy for hiccup.

ELEPHANTOPUS SCABER (ELEPHANT’S FOOT)

ACTION:

Plant—astringent, cardiac tonic, diuretic, mucilaginous, emmolient (used in dysuria, diarrhoea, dysentery. Roots—given to patients with heart and liver affections; topically in rheumatism. Root and leaf — used in dysuria and other urethral complaints. An infusion of the whole plant is used to stimulate diuresis, reduce fever and to eliminate bladder stones. The decoction is also used in peptic ulcers, swelling or pain in stomach. Plant is also used in piles and scabies.

The plant contains germacranolide dilactones. Hydroxylated germacanolides, molephantin and molephantinin, exhibited cytotoxic and antitumour properties. The plant also gave epifriedelanol, lupeol, stigmasterol, triacontan-l-ol and dotriacontan-l-ol. Elephantopus scaber L. is known to contain a large number of bioactive compounds such as lipids, phytochemicals, pharmaceutics and pigments. For example, ethyl hexadecanoate, ethyl-9, 12-octadecadienoate, ethyl-(Z)-9-octadecenoate, ethyl octadecanoate, lupeol, stigmasterol, stigmasterol glucoside, deoxyelephantopin (1) and two new germacranolide sesquiterpene lactones named 17, 19-dihydrodeoxyelephantopin (2) and iso-17,19-dihydrodeoxyelephantopin.

The whole plant of Elephantopus scaber L. is a perennial herb and is well known as a Chinese folk medicine which is widely used in the treatment of nephritis, edema, dampness, pain in the chest, fever and cough of pneumonia, scabies, and arthralgia due to wounding (Peer, L. M., 1980 & Tsai, C. C, 1999). It is also commonly used as a remedy for the treatment of gastropathy, hepatitis, nephritis, edema, chest pain, fever and cough of pneumonia, bronchitis, arthritis, and carbuncle in China.

Pistacia integerrima

ACTION:

- Gall—astringent, expectorant, antiasthmatic, antidysenteric, styptic.

Key application - In cough, bronchitis and dyspnoea. (The Ayurvedic Pharmacopoeia of India.)

ACTIVE PRINCIPLES AND PHARMACOLOGY:

The tetracyclic triterpenes, pistacigerrimones A, B and C have been isolated from the galls produced on the leaves.

Alpha-pinene 21.8 (expectorant and anti-inflammatory), beta-pinene 16.2, alpha-phellandrene 15.5 and delta-carene 11% are major constituents of the essential oil extracted from galls. The oil is reported to exhibit CNS depressant, antispasmodic, carminative and antibacterial, antiprotozoal, antiamoebic, anthelmintic activities.

Essential oil: The essential oil obtained by steam-distillation of Kakra Singi, the indigenous drug prepared from P. integerrima contains: alpha -pinene (25%.), camphene (27%.), di-limonene (4-5%), 1:8-cineole (10%.), alpha –terpineol (20%.), and aromadendrene (4-5 per cent.); also a small percentage of a lactonic stearoptene. 15% by volume of the oil is caprylic acid.

Other constituents of the galls are beta-sitosterol and the triterpene acids pistacienoic acids A and B.

The oil, in moderate doses, exhibits antispasmodic action on involuntary muscles inhibiting excessive peristaltic movements of the intestine. It showed a depressant action on the central nervous system of guinea-pigs and white rats when given in sub-lethal doses. The animals became deeply unconscious in about an hour. (Lethal dose: 0.1 cc/100 g body weight) The oil showed a slight irritant action on mucous membrane.

Essential oil from galls is antibacterial, antiprotozoal, anthelmintic, antiamoebic, antimicrobial; stem-bark spasmolytic. Galls possess antiasthmatic, astringent and expectorant properties. (CIMAP)

Medicine: P. integgerima galls are used in traditional medicine to treat coughs, asthma, diarrhoea, dysentery, fever, vomiting, appetite loss, nose bleeding, snake bites and scorpion stings. The plant extracts are used in treating livestock diseases.

Other products:Pistacigerrimones C and D from P. integerrima have significant analgesic and anti-inflammatory activity.

Holy Basil

Active Compounds

Leading Phytichemical compounds in holy basil leaf include eugenol (volatile oil), ursolic acid (triterpenoid), and rosemarinic acid (phenylpropanoid). Other active compounds include careyophellene and oleanolic acid. Seeds contain fixed oils having linoleic acid and linolenic acid.

Nutritional components include vitamins A and C; minerals calcium, iron and zinc; as well as chlorophyll.

Holy Basil contains no caffeine or other stimulants. Duke cites a study by Gupta et al. that reports three newly identified phytochemical

components of holy basil with antistress activity (ocimumosides A and B and ocimarin) and several other bioactive substances, including the cyclo-oxygenase-2 (COX-2) inhibitor apigenin, which shows anxiolytic properties. Oxidative and inflammatory agents are potent sources of bodily stress.

Gupta P, Yadav DK, Siripurapu KB, et al. Constituents of Ocimum sanctum with antistress activity. J Nat Prod. 2007;70:1410-1416.

Holy Basil is highly aromatic and different varieties may smell and taste of peppermint, cloves , licorice, or lemon. The clove-like odour comes from its high eugenol content. The plant grows abundantly in India, Malaysia, Australia, Central and South America and Western Asia. It also grows in Jamaica and Puerto Rico.

The Ayurvedic Pharmacopoeia of India recommends the use of the leaf and seed in rhinitis and influenza; the seed in psychological disorders, including fear-psychosis and obsessions.Major components of the essential oil are eugenol, carvacrol, nerol and eugenolmethylether. Leaves have been reported to contain ursolic acid, apigenin, luteolin, apigenin-7-O-glucuronide,luteolin-7-O-glucuronide, orientin and molludistin. Ursolic acid, isolated from leaves, exhibited significant protection of mast cell membrane by preventing granulation and decreased histamine release.

Most of the modern research on Holy Basil has been on animals. These animal studies have tended to corroborate and confirm the related claims in Ayurvedic literature. This research has confirmed dozens of its traditionally known actions and therapeutic uses including its remarkable adaptogenic and anti-stress activities as well as its powerful support to the immune system. Modern clinical studies are also in agreement with claims from Ayurvedic literature. Clinical studies were also undertaken in cases of bronchial asthma, viral encephalitis, stress-related arterial hypertension, compounded states of the humoral and cellular immune system, gastric ulcers, arthritis and chronic fatigue syndrome.

Today herbalists are beginning to classify HB as a primary adaptogen and are finding that HB modulates the “stress response” and increases adaptive energy.

Uses & Benefits Relating to Various Human Body Systems – based on observations made by practitioners and modern scientific research

IMMUNE SYSTEM

Strengthens and modulates the immune system - Immuno-modulatory effects Improves immune response – enhances humoral (bodily fluids) and cellular immunity. Increased cell-mediated immunity – both in the number of immune defense cells and

also in their activity; increased T-cell activity. Anti-inflammatory activity – reduces the painful and dangerous inflammation that plays a

key role in various forms of arthritis, cancer and degenerative neurological disorders (COX-2 inhibition)

Anti-inflammatory similar to aspirin and ibuprofen, but unlike aspirin and ibuprofen it is not irritating to the stomach. Modulates inflammation (COX-2 inhibition).

Immunostimulant properties – inhibits antigen-induced (allergic) histamine Reduces asthmatic and other adverse immune reactions Used in the treatment of colds and flu Antiviral properties – success with viral hepatitis, viral encephalitis and AIDS virus Contains eugenol – known to be anti-viral and one of the best herbal antibiotics Antioxidant – reduces oxidative stress Anti-allergic – management of immunological disorders including allergies and asthma Antibiotic protection – offers significant antibacterial, antiviral and antifungal properties

thereby helpful in treating many serious systemic diseases, as well as localized infections

Relieves canker sores and useful in pyorrhea (gum infection)

RESPIRATORY SYSTEM

Contributes generally to respiratory health – supports healthy pulmonary function; provides lung and bronchial support

Helpful in the treatment of a variety of serious allergic, inflammatory and infectious disorders affecting the lungs and related tissues

Used to strengthen the respiratory system – one of the main herbs for coughs and colds Used for bronchial asthma; expectorant and bronchodilator effects Used against respiratory ailments including bronchitis and tuberculosis Anti-catarrh (inflammation of mucus membranes) and anti-phlegm (mucus) Used for rhinitis (inflammation of nasal mucus membrane( AYURVEDA: can serve as a cure and a prophylactic as well as for the severe acute

respiratory syndrome (SARS) – the root of the tulsi plant should be crushed and boiled with turmeric powder for a few minutes, after which it should be filtered. Consuming two spoonfuls of this remedy twice daily will cure SARS and prevent contracting the disease

AYURVEDA: tulsi tea with honey is a good expectorant especially in cases where fever is involved

AYURVEDA: the juice of the leaves is given in catarrh and bronchitis in children. AYURVEDA: chewing the leaves relieves colds and flu. A decoction of the leaves,

cloves and common salt also gives immediate relief to cases of influenza.

Excerpted from the Maimes Report on Holy Basil, by Steven Maimes,SALAM Research

Whole Plant:

Ascorbic-Acid Leaf 830 ppm: Antiallergic, Antiasthmatic 1,000 mg/day, Antibacterial, Anticold 1-2 g/man/day, Antihistaminic 2 g/day orl man, Antiinflammatory, Antioxidant 100 ppm, Antipneumonic, Antipyretic , Antirhinitic 1,000 mg 3x/day, Antiseptic 4-8 g/day, Antistress 500-1,000 mg; Asthma-preventive 1,000 mg/day/orl, Cold-preventive 1-2 g/day, Immunostimulant, Mucolytic 1 g/woman/day

Carvacrol Leaf 180 - 210 ppm: Allergenic; Anthelmintic; Antibacterial, Antiinflammatory (11 uM) IC~97=1,000 uM, Antioxidant (LDL) IC50=5.53 uM; Antiseptic 1.5 x phenol; Antitussive; Cyclooxygenase-Inhibitor =indomethacin ; Expectorant; Tracheorelaxant; Vermifuge

EUGENOL Leaf 4,200 - 4,970 ppm: Allergenic; Antibacterial 500 ppm MBC=400 ug/ml; Antiinflammatory, Antioxidant 10 uM IC65=30 ppm; Antipyretic 3 ml/man/day; Antisalmonella MIC=400 ug/ml ; Antiseptic 3 ml/man/day 400 ug/ml; Antiviral IC50=16.2-25.6 ug/ml; COX-1-Inhibitor IC97=1,000 uM; COX-2-Inhibitor IC50=129 uM; Cytotoxic 25 ug/ml; Fungicide; Larvicide; Nematicide MLC=2,000 ug/ml; Trichomonicide LD100=300 ug/ml; Trichomonistat IC50=10 ug/ml; Vasodilator; Vermifuge

LINOLEIC-ACID Seed 102,455 ppm: Antihistaminic; Antiinflammatory IC50=21 uM; Immunomodulator

Oleic-Acid: Allergenic; Antiinflammatory

Source: Multiple Activities Menus: Dr. Duke’s Phytochemical & Ethnobotanical Database

There has been a significant amount of both animal studies and human clinical research on the benefits of holy basil. Today, we know this versatile plant is an adaptogen with antioxidant, neuroprotective, stress reducing, and radioprotective (protects against the damaging effects of ionizing radiation) effects. Clinical studies have shown significant anti-stress activity when the herb is taken as an alcohol extract, as it seems to prevent increased corticosterone levels that indicate elevated stress. Tulsi extract was administered to 20 patients with shortness of breath secondary to tropical eosinophia in an oral dosage of 500 mg TID and an improvement in breathing was noted. Animal studies have found that extracts of holy basil (Ocimim sanctum) inhibit constriction of the bronchial airway passages. Two preliminary clinical trials treated asthma patients with 500 mg of holy basil three times daily for one month. Breathing function

improved and the frequency of attacks was reduced. Placebo-controlled research is needed to validate these results. More recent research has shown it reduces excess immune response in allergic asthma and allergies while enhancing normal immune function.

Asthma

In a study without controls, oral administration of an aqueous extract of dried Folium Ocimi Sancti to 20 patients with asthma increased lung vital capacity and relieved laboured breathing (7).

4. Palit G, Singh SP, Singh N, et al. An experimental evaluation of antiasthmatic plant drugs

from the ancient ayurvedic medicine. Asp Aller Appl Immunol 1983;16:36–41.

5. Singh SP, Sinha KN, Singh N, Kohli RP. Inula racemosa (Puskarmal), Terminalia belerica

(Vibhitaki) and Ocimum sanctum (Tulsi) – a preliminary clinical trial in asthma patients. Proc Int

Sem Clin Pharmacol Devel Count 1986;1:18–21.

6. Dixit KS, Singh SP, Sinha KN, et al. Inula racemosa (puskarmal), Terminalia belerica

(Bibhitaka) and Ocimum sanctum (Tulsi) – a preliminary clinical trial in asthma patients. Proc Int

Sem Clin Pharmacol Devel Count 1986;2:22–27.

7. Sharma G. Antiasthmatic effect of Ocimum sanctum. Sacitra Ayurveda, 1983, 35:665-668.

Dr. Narendra Singh:

Dosage and Usage

Holy Basil is generally effective in a single dose of 300mg to 600mg of dried leaves daily for preventive therapy, and in 600mg to 1800mg in divided doses daily for curative therapy. Holy basil scientist Dr. Narendra Singh of Lucknow recommends a dose of 2 grams of the freshly dried herb twice daily for several months. Herbal extracts and supercritical extracts should be used as directed.

Holy basil can also be taken as tea (2 grams a cup). A cup of Tulsi tea simply from an infused tea bag is an excellent prophylactic and a good direct medicine for many mild therapies. 

Dr. Narendra Singh in his book on Tulsi reports that after three decades of clinical research that the adaptogenic/antistress activity of Holy Basil (including an increase in stamina and immunological resistance) is likely to take one week to one month to develop and gives appreciable improvements in health lasting for a month of more after discontinuation.

Safety and Contraindications

Sacred basil has a long history of safe traditional use in India.

Anti-fertility effects, including abortifacient and anti-spermatogenic effects, have been described in rats, but only following the inclusion of sacred basil leaf in the diet at high levels.33;34 The doses producing these effects are in the order of 1000 mg per kilo bodyweight or more daily, equivalent to a daily dose of 50 g or more in humans.

There is no indication of safety concerns about sacred basil in the literature.The LD50 for the oral administration of an ethanolic extract of the whole plant is 4508±80 mg in mice.16 This very high value supports the innocuous nature of the extract.

HB is available as a dietary supplement in the United States under the Dietary Supplement Health & Education Act of 1994 (DSHEA).

HB is synergistic with other herbs.

UK – HB is on the general sales list.

Canada – approved as an over-the-counter drug.

France – considered Traditional Medicine

Are there any side effects or interactions?

Two animal studies suggested that large amounts of holy basil might negatively affect fertility,19 20 but no adverse reactions have been reported in human clinical trials. Safety during pregnancy and lactation has not been investigated; until more is known, holy basil should probably be avoided at those times.21

At the time of writing, there were no well-known drug interactions with holy basil.

19. Seth SD, Johri N, Sundaram KR. Antispermatogenic effect of Ocimum sanctum. Indian J Exp Biol 1981;19:975–6.

20. Kasinathan S, Ramakrishnan S, Basu SL. Antifertility effect of Ocimum sanctum L. Indian J Exp Biol 1972;10:23–5.

21. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Medical Publications, 1998, 33–4.

Achyranthes aspera (devil’s horsewhip)

Traditional Uses

Devil's Horsewhip (Achyranthes aspera)  The plant is highly esteemed by traditional healers and used in treatment of asthma, bleeding, in facilitating delivery, boils, bronchitis, cold, cough, colic, debility, dropsy, dog bite, dysentery, ear complications, headache, leucoderma, pneumonia, renal complications, scorpion bite, snake bite and skin diseases etc. Traditional healers claim that addition of A. aspera would enhance the efficacy of any drug of plant origin. Prevents infection and tetanus.  Used to treat circumcision wounds, cuts.  Also used for improving lymphatic circulation, strengthens musculatured, improves blood circulation; Cold with fever, heat stoke with headache, malaria, dysentery; Urinary tract lithiasis, chronic nephritis, edema; Rheumatic arthralgia (joint pain). Used traditionally for infertility in women: Two ml decoction of root and stem is administered orally thrice a day for three months. Younger women respond better to this therapy.

Habitat _ Throughout the tropical and subtropical regions, up to an altitude of 2,100 m, in the southern Andaman Islands.

English _ Prickly Chaff Flower.

Action _ Astringent, pectoral (ashes of the plant used in asthma and cough), diuretic, hepatoprotective, emmenagogue. Benzene extract of the plant exhibited abortifacient activity. The flowers, ground and mixed with sugar, are given for menorrhagia. Roots—astringent,haemostatic. Seeds—emetic; used for biliousness. Essential oil—antifungal.

Key application _ As astringent, emetic. (Indian Herbal Pharmacopoeia.)

Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicates the use of the whole plant in lipid disorders and obesity, the root for its blood-purifying property.

The plant juice and ash are used for treating bleeding piles. An alkaline powder of the plant is used in preparing Kshaarasutra of Ayurvedic medicine, which is recommended for treating fistula-in-ano.

The whole plant contains the alkaloids achyranthine and betaine. Achyranthine, a water-soluble alkaloid, is reported to dilate blood vessels, lower blood pressure, decrease heart rate and increase the rate and amplitude of respiration.

The presence of ecdysterone and oleanolic acid is also reported in the root.

The ashes of the plant yield large quantities of potash. The seeds yield saponins and oleanolic acid and its ester.

The presence of tannins and glycosides is also reported in the plant.

Achyranthine Plant: Respirostimulant, Vasodilator

Betaine Root: ExpectorantDatura metel

Habitat _ Throughout India, particularly in waste place.

English _ Thornapple, Downy Datura.

Action _ Various plant parts are used in headache, hemiplegia, epilepsy, delirium, convulsions, cramps, rigid thigh muscles, rheumatism. Leaf— antitumour, antirheumatic. Leaf and corolla—anti-inflammatory. Flower—antiasthmatic. Seed, leaf and root—anticatarrhal, febrifuge,antidiarrhoeal, antidermatosis; also used in cerebral complications. Seeds—used in asthma.

Ascorbic-Acid Leaf 2,220 ppm: Antiallergic, Antiasthmatic 1,000 mg/day, Antibacterial, Anticold 1-2 g/man/day, Antihistaminic 2 g/day orl man, Antiinflammatory, Antioxidant 100 ppm, Antipneumonic, Antipyretic , Antirhinitic 1,000 mg 3x/day, Antiseptic 4-8 g/day, Antistress 500-1,000 mg; Asthma-preventive 1,000 mg/day/orl, Cold-preventive 1-2 g/day, Immunostimulant, Mucolytic 1 g/woman/day

Scopolomine Leaf 1,750 ppm: Antiasthmatic, Antispasmodic, Antiviral, Bronchodilator, Sedative 0.5-1 mg/orl/man

Terminalia belerica

(Terminalia belerica), is a gentle bowel tonic excellent for chronic constipation and IBS and for clearing toxins from the bowel. It can be taken in powder or capsule form at bedtime.Among the Ayurvedic medicines available for treatment of constipation.

Habitat _ Throughout deciduous forests of India.

English _ Belleric Myrobalan, Bastard Myrobalan.

Action _ Fruit—purgative when half ripe, astringent when ripe; antipyretic; used in prescriptions for diarrhoea, dyspepsia, biliousness; cough, bronchitis and upper respiratory tract infections, tropical pulmonary eosinophilia and allergic eruptions.

The Ayurvedic Pharmacopoeia of India recommends the drug in powder form in emesis and worm infestation, in addition to other therapeutic applications.

The fruits contain beta-sitosterol, gallic and ellagic acids, ethyl gallate, galloyl glucose, chebulagic acid and a cardiac glycoside, bellaricanin. The fruits produce hepato-protective effect in CCl4-induced liver injury in mice. Alcoholic extract of the fruit exerted a negative chrono-and inotropic and hypotensive effect of varying magnitude in a dose dependent fashion on isolated rat and frog atria and rabbit heart. The fruit contains all components of Chebulicmyrobalan (T. chebula) except corilagin and chebulic acid. The fleshy fruit pulp contains 21.4% tannin, both condensed and hydrolysable types.

Piper longum

Habitat _ Warmer parts of India, from Central Himalayas to Assam, lower hills of West Bengal; Uttar Pradesh, Andhra Pradesh, Western Ghats from Konkan southwards to Trivandrum. Often cultivated.

Action _ Fruits—used for diseases of the respiratory tract (cough, bronchitis, asthma); as sedative (in insomnia and epilepsy); as cholagogue (in obstruction of bile duct and bladder), as emmenagogue, as digestive, appetizer and carminative (in indigestion); as general tonic andhaematinic (in anaemia, chronic fevers and for improving intellect). Applied locally on muscular pains and inflammations.

Several aristolactams and dioxoaporphines have been isolated from Indian long pepper. It also contains the long chain isobutyl amide, longamide, besides guineensine and the lignans,pluviatilol, methyl pluviatilol (fargesin), sesamin and asarinine.

Piperine is the major alkaloid of peppers.

Piperine is antipyretic, hypotensive, analeptic, CNS stimulant. It has been reported to exert significant protection against CCl-induced hepatotoxicity in mice. It improves drug availability in experimental animals, and is used for enhancing the efficacy of coadministered medicaments.

Piperine enhanced bioavailability of hexobarbital, phenytoin, propranolol and theophylline. (Sharon M. Herr.) (Piperine is also a component of Piper nigrum.)

N-isobutyl-deca-trans-2-trans-4-dienamide, isolated from the fruit, exhibited antitubercular property.

Milk extract of the fruit effectively reduced passive cutaneous anaphylaxis in rats. It protected guinea-pigs against antigen-induced bronchospasm.

PIPer nigrum or black pepper

Habitat _ Native of the Indo- Malaysian region; cultivated in Western Ghats, Karnataka,Maharashtra, Assam and Kerala.

Action _ Stimulant, carminative, diuretic, anticholerin, sialagogue, bechic, antiasthmatic. Used in fevers, dyspepsia, flatulence, indigestion, and as mucous membrane and gastro-intestinal stimulant. Used as a gargle for sore throat. Used with ginger and Piper longum for viral hepatitis.

The fruit yielded piperine, piperatine and piperidine; amides, piperyline, piperoleins A and B, and N-isobutyl- cicosa-trans-2-trans-4-dienamide.