marianum (L.) Gaertn. Silybum marianum (L.) (Compositae) Gaertn. Fruct. Sem. Pl. 2:378 (1791). Carduus marianum

Names Arabic: Qortom , Harshaf barri Shouk el-diman , Shouk el-nasara Berber: Tatoura Doujnilourman. English: Carduus marianus L. (botanical synonym), Milk , Holy thistle. French: Chardon marie, Chardon argente, Artichaut sauvage.

Compiled by: Prof. F. M. Hammouda, Prof. S. I. Ismail, Dr. N. S. Abdel-Azim and Dr. K. A. Shams Edited by: Prof. K. H. Batanouny Photo by Prof. K. H. Batanouny occurs in two types, the most abundant has purple flowers while the least abundant has white flowers Morphological Description (v. albiflora). It is indigenous to Europe. Silybum marianum is an annual to biennial herb, up to 2m high. It has a stem 20-150 cm high, rarely Status shorter, glabrous or slightly downy, erect and The is common in the Nile Delta. It is not seri- branched in the upper part. The leaves are alter- ously endangered. Trials to cultivate it in Egypt have nate, large, white veined, glabrous with strongly been carried out. spiny margins. The inflorescences are large and round capitula, solitary at the apex of the stem or Part(s) used its branches, surrounded by thorny bracts. The Fruits (seeds) and herb. florets are hermaphrodite, tubular in shape with a red-purple corolla. The fruits are hard skinned Collection achenes 6 to 8 mm long, generally brownish in are cut when flowering and seeds are color with a white silk like pappus at the apex. The collected when ripe. The fruits are dried for use in fruits are harvested in May - June, after blooming. infusions and tincture or for extraction of silymarin.

Geographical Distribution Preparation Local: Nile region, including the Delta, the Valley, Infusion, decoction, tincture. the Faiyum, Oases, Western Mediterranean Coastal Region, and the Isthmic desert, i.e. El-Tih and the Use region North of Wadi Tumilat. Oral, external. Regional: All North African countries. Global: Silybum marianum is native to Central and Constituents Southern Europe, Southern Russia, Asia minor, The fruits: A flavonolignan complex, silymarin, was North and South America and South Australia. first isolated from the seeds in 1968. Silymarin (4- 6% in ripe fruits) consists primarily of three flavono- Ecology lignans: silybin (silibinin), silychristin (silichristin), The plant grows wild in Egypt on canal banks and and silidianin. Other flavonolignans include dehy- in wet ground regions in the Nile Valley. The soil drosilybin, 3-desoxysilichristin, deoxysilydianin (sily- supporting this plant is fine-textured and moist. It monin), siliandrin, silybinome, silyhermin, and neosi-

A Guide to Medicinal Plants in North Africa 255 lyhermin. Fixed oil (20-30%), flavonoids, taxifolin, Even in large doses silymarin is safe, with practically sterols. no side effects, as well as no embryo toxic effect. The herb: Flavonoids: apigenin and its 7-O-gluco- Also, silymarin is used as a reference standard to side, 7-O-glucuronide and 4`,7-diglucoside, evaluate the efficacy of new substances found. kaempferol and its 7/-glucoside and 3-sulphate, luteolin and its 7-glucoside, Sitosterol and its gluco- Pharmacopoeias side, a triterpene acetate, polyacetylenes, and Deutsches Arzneibuch 10.1991. fumaric acid. The very young leaves of the herb Rote liste, Germany, 1987. contain only traces of silymarin. Dictionnaire vidal, France, 1986. Silybum marianum is covered by a positive Commis- Pharmacological Action and sion E monograph and has the following applica- Toxicity tions: Milk Thistle effectively acts as a hepatoprotective i) Crude drug: Dyspeptic disorders. and/or antihepatotoxic. It protects the liver from the ii) Preparations: For toxic liver damage; as poisonous effects of alcohol and other toxic chemi- supportive treatment in chronic inflammatory liver cals and heavy metals. The silymarin compounds in conditions and liver cirrhosis. Milk Thistle actually accelerate protein synthesis in the liver, which stimulates the production of new Pharmaceutical Products healthy liver cells. Legalon tablets (CID under licence from Madaus , The flavonoids present in Milk Thistle act as effec- Köln, Germany) tive free radical scavengers, which also protect the Silymarin granules “Instant” (SEDECO, Egypt) liver from damage. Milk Thistle helps to block Hepanox Capsules (Technopharma Egypt For: certain inflammatory reactions and is an anti-aller- National Pharmaceuticals Co. Under licence from: genic substance. Tishcon Corporation USA) Certain chemical constituents of Milk Thistle help to Hepaticum Capsules (Medical Union Pharmaceuti- increase the flow and solubility of bile which is cals Abu- Sultan, Ismailia, Egypt) beneficial for both the liver and the gallbladder. Hepamarin Capsules (UNI PHARMA – EL Obour Increased bile flow helps to prevent the formation City, Cairo –Egypt) of gallstones. Hepadox Capsules (Arab Caps – Alamreya – Milk Thistle can effectively treat jaundice, cirrhosis, Alexandria, Egypt) hepatitis, and fatty infiltration of the liver. Silymarin Mariagon Capsules (Alpha Chem Advanced Phar- is considered a spleen, and gallbladder tonic. maceutical Industries Co. – Badr City, Third Indus- Milk Thistle may be helpful in treating psoriasis, trial Zone – Cairo, Egypt) chronic fatigue syndrome, diabetes and oestrogen- Levatone Capsules (Under licence from Pan Phar- related disorders. maceuticals Australia for Golden Queen Co.) German research suggests that silybin, a flavonoid Levanox Capsules (Tiba Pharmaceutical Industries) component of the seed, is clinically useful in Liver Albumin Plus Capsules (Sigma Pharmaceutical treating severe Amanita mushroom poisoning. The Industries) antihepatoxic effect of silymarin was found to Silipex Capsules (PHARO PHARM pharmaceuticals depend on the time interval in which poisoning and for EMA pharm) therapy took place as well as the degree of liver Simepar Capsules (MINAPHARM – EGYPT Under damage. licence from Mepha Ltd. Basel, Switzerland Mepha The most recent clinical investigations have demon- pharma Egypt S.A.E) strated that the flavonolignan silibinin is the most Seralon-E Capsules (TIBA Pharmaceutical Indus- effective compound, used as an adjunct to current tries) methods, and has lowered the mortality rate below Cyncholine Plus Capsules (The Arab Company for any levels previously achieved. Future breeding Pharmaceuticals and Medicinal Plants, Egypt) activities should be directed to the production of Mepacure Capsules (The Arab Company for Phar- genotypes and lines that produce silibinin. maceuticals and Medicinal Plants, Egypt)

256 A Guide to Medicinal Plants in North Africa Traditional Medicinal and eaten as salsify. Flowers are boiled and eaten as Indigenous Knowledge Artichoke. Roasted seeds are used as a coffee History: The plant is a medicinal plant widely used substitute. in traditional European medicine. In France the roots, leaves and fruit are thought to be effective in References the treatment of chronic constipation and of various DiMario, F. R. Farini, L. Okolicasanyi, and R. hepatic diseases such as jaundice, bile stones, hepa- Naccarato. (1981). “The Effect of Silymarin on titis and steatosis. In addition, decoctions and tinc- the Liver Function Parameters of Patients with tures of the fruits, due to their cholagogic, anti- Alcohol-induced Liver Disease: A Double Blind allergic and decongestant activity on the circulatory Study” In: F. de Ritis, G. Csomos and R. Braatz system, are used in the treatment of haemorrhoids, (eds.). Der Toxisch-metabolische varicose ulcers, hay fever, asthma and nettlerash. In Leberschaden.Hans.Verl.-Kontor, Lubeek, pp. Italy, the fruits are used in the treatment of hepatic 54-58. diseases of various origins, oliguresis and hypoten- Foster, S. (1996). "Milk Thistle Silybum marianum" sion, thanks to their detoxicating action on the liver, Botanical Series No. 305, 2nd ed. American and their diuretic, hypertensive, cardiotonic and Botanical Council, Austin, Texas. temperature reducing properties. In Germany, the Morazzoni P. amd Bombardelli E. (1994). Silybum fruits find applications as decoctions and tinctures marianum (Carduus marianus), Fitotrapia vol. in the treatment of bile stones, hepato- and cholan- LXVI, No.1, p 3-42. giopathies, thanks to their cholagogic, stimulant of Salmi, H. A. and Sarna, S. (1982). “Effect of portal circulation and liver protective actions. Similar Silymarin on Chemical, Functional, and applications, above all of the fruits, are found in Morphological Alterations of The Liver: A traditional medicine in Hungary. In Greece, it is used Double Blind Controlled Study ” Scad. J. in the treatment of varicose veins, cholelithiasis, Gastroenterol. 17: 517- 21. duodenal ulcer and forms of amenorrhea. Homeo- Wagner, H. and Seligman, O. (1985). “Liver pathic medicine also makes use of tinctures of the Therapeutic Drugs from Silybum marianum (L.) fruits in the treatment of disorders of the liver, ” In H. M. Chang, H. W. Yeung, W. W. Tso and icterus, and cholelithiasis, as well as in peritonitis, A. Koo (eds.) "Advances in Chinese Medicinal pleuritis, bronchial coughs and congestion of the Materials Research", Singapore: World Scientific uterus and varices. Publ. Co. Wagner, H. Hrhammer, L. and Munster, R. (1968). Traditional Medicinal Uses “The Chemistry of Silymarin (Silybin), the active • Anorexia principle of the fruits of Silybum marianum (L.) • Cancer Gaertn. (Carduus marianus L.)” Arzneim-Forsch. • Demulcent in catarrh and pleurisy 18: 688-696. • Diabetes Wissemann, A. and D. Lorenz et al., (1990). eds., • Oestrogen-related diseases Aktuelle Hepatologie, Hansiches Verlagskontor, • Haemorrhoids Lubek, p. 55. • Hydrophaints • Liver diseases (toxic liver diseases, chronic General References inflammatory hepatic disease and liver cirrhosis) Batanouny, K. H., (1999). "Wild Medicinal Plants in • Malaria Egypt". (With contribution of: E. Aboutabl, M. • Spleen disease Shabana & F. Soliman). With support of the Swiss Development Co-operation (SDC). Other uses of the plant: For improving appetite Academy of Scientific Research and Technology, as a food. Young leaves are eaten as a spinach Egypt. The World Conservation Union (IUCN), substitute.Young stalks are peeled, soaked and Switzerland. pp. 86-90. Boulos, L. (2000). eaten as Asparagus. "Flora of Egypt", volume three, pp. 158-159, Roots soaked overnight to remove bitterness are printed by Al Hadara Publishing, Cairo, Egypt.

A Guide to Medicinal Plants in North Africa 257 Grieve, M. (1971). Modern Herbal, vol. 2. Hildesheim, pp 830-836. Dover Publications, New York, 797. Wagner H. and Seligmann O. in H. M. Change et Hikino, H. and Kiso, Y. in Wagner, H., Hikino, H. and al. (1985), eds. "Advances in Chinese Medicinal Farnsworth, N. R. (1968). eds., "Economic and Materials Research", World Scientific Publ. Co., Medicinal Plant Research", Vol. 2. Acdemic Singapore, p. 247. Press, New York, p. 39. Weiss, R. F. (1988). "Herbal Medicine" (translated Madaus, G. (1976). "Lehrbuch der biologischen from German by A. R. Meuss). Beaconsfield, Heilmettel", Band I. Georg Olms Verlag, England: Beaconsfield Publishers Ltd.

258 A Guide to Medicinal Plants in North Africa