WMMII-Lesson10

Western Materia Medica Anemone pulsatilla By Terry Willard ClH, PhD and Todd Caldecott ClH RANUNCULACEAE

Botanical Name: Anemone pulsatilla, Ranunculaceae

Common names: Anemone, Pulsatilla, Paqueflower, Passeflower, Windflower, Old Man in the Mountain.

Similar species: A. occidentalis (Western Pasqueflower), A. patens (Prairie Crocus)

Plant description: Pasqueflower is a perennial plant, with a simple, erect, rounded stem 8-15 cm in height. The leaves are characteristically feathery, with many lobes, covered in a soft, silvery pubescence. The flowers are solitary, terminal and pendulous, deep- purple to violet-brown, with 6 sepals and no petals, surrounding a cluster of yellow-tipped stamens and numerous pistils. The flower appears early in spring, typically as the snow is melting. The flowers give way to an elongated cluster of seeds that looks rather like a mop-head, with long, silky drooping plumes that allow the seed to be carried by the wind when mature. The sepals of A. occidentalis are white.

Habitat, ecology and distribution: Various species of Anemone are found throughout Eurasia, from the British Isles, through Europe into Asia Minor and Russia, and into the Orient. In North America the Anemones (spp. pulsatilla, patens, and occidentalis) prefer high elevations and full sun, often in sub-alpine or alpine regions, but also in open fields and grasslands east of the Rocky Mountains, preferring drier, well-drained sandy soils.

Part used: Aerial parts, fresh plant.

History: The genus name Anemone is derived from the Greek word anemos, meaning ‘wind,’ in obvious reference to the method of seed dispersal. According to Greek mythology the Anemone sprang from the tears shed by Aphrodite as her lover Adonis lay dying. The older common name of Passeflower is derived from a Latin term that refers to the use of the roots in preparing passum, or ‘raisin-wine.’ The name ‘Pasque’ flower is derived from the French word for the original Hebrew term pesach (‘Passover’), in reference to the fact that the plant flowers early in spring.

Constituents: Anemone contains the glycoside ranunculin (2.8%) that hydrolyzes into the unstable lactone protoanemonin (1%), which dimerises into the comparatively inert anemonim upon drying. The extent to which protoanemonin degrades and how quickly in fresh plant preparations is not entirely known, but the product may be only about half as potent one year later as it was upon harvest. Dry plant preparations probably contain little or no protoanemonin and are avoided. Other constituents include the flavonoids delphinidin and pelargonidin, the saponin glycoside hederagenin, triterpenes, beta-sitosterol, and carbohydrates (Newall et al, 1996; Bradley 1992, 179; Martin et al 1988).

Medical Research: Anemone is a poorly understood plant among medical researchers and thus there is little evidence to support its traditional usage. In support of its usage as an analgesic, sedative and antidepressant, one study demonstrated that both anemonin and protoanemonin have a sedative effect in experimental animal models (Martin et al 1988), but this is about the extent of the supporting data. The British Herbal Compendium describes a series of studies in which protoanemonin was shown to stimulate and then paralyze the central nervous system in experimental animals (Bradley 1992, 180). •Antifungal: Protoanemonin has demonstrated in vitro activity against fungal growth and development (Martin et al 1990; Mares 1987). •Anti-mutagen: Protoanemonin has been shown to have an anti-mutagenic activity against UV- and N-methyl-N'-nitro-N-nitrosoguanidine-induced mutations in E. coli B/r WP2 trp (Minakata et al 1983).

Toxicity: The toxicity data on Anemone is unclear. The toxic principle is usually attributed to protoanemonin, an acrid constituent found in many different members of the Ranunculaceae, including the medicinal Actaea rubra and the Buttercup (Ranunculus spp.). The British Herbal Compendium states that fresh plant materials have been observed to cause severe skin irritation and mucosal inflammation (“Ranunculaceae dermatitis”), and that irritation of the kidneys and urinary tract may occur through the alkylating activity of protoanemonin. Dry plant preparations, or the dried herbaceous material found in animal feed (i.e. hay) is usually not considered to be problematic because of the degradation of protoanemonin. King’s states that in higher doses Anemone can cause a violent gastritis, accompanied by a sense of constriction and tightness of the chest, with chilliness and weakness, followed by a depressant activity upon cardiac function, lowered arterial tension, and reduced body temperature (Felter and Lloyd 1893). King’s states further that sensory and motor paralysis may also occur, and in toxic doses Anemone will produce mydriasis (pupil dilation), stupor, coma, and convulsions (Felter and Lloyd 1893).

Herbal action: antidepressant, anxiolytic, analgesic, antispasmodic

Indications: nervousness, depression, anxiety, sadness, grief, pain, insomnia, amenorrhea, dysmenorrhea, orchitis, otitis, neuralgia

Contraindications and cautions: Anemone is avoided in sthenic conditions with symptoms of heat and inflammation. Given its irritant effects Anemone is best avoided in gastrointestinal or urinary tract inflammation, and because it exerts a depressant effect upon cardiac function it is avoided in bradycardia. Anemone is also best avoided during pregnancy and lactation.

Medicinal uses: Anemone is among the most useful antidepressants and anxiolytics in the material medica, but is used primarily for those conditions that are marked by coldness and nervous debility. Anemone is often the first plant to flower, rising out of the melting snow, and because of this is seen by many cultures as representing the rejuvenating power of rebirth, even in hardship. Thus Anemone is indicated whenever there are apparent obstructions to happiness, helping to provide courage and strength to move to the next level. The ragged, mop-like appearance of the seeds heads suggests a disorganized consciousness that is easily swayed by influences (i.e. the wind). Although not trophorestorative per se, Anemone exerts its influence by pacifying undue excitement, lifting the spirits, and providing the ability to rest and relax. It is best used along with trophorestoratives in full doses, such as Avena or American Ginseng. Anemone is indicated in a weak, open and soft pulse, sometimes irregular, sometimes thin, with a creamy, thick, whitish coating upon the tongue. The mood will be gloomy, with a tendency to weep, brood and worry, imagining only desperate scenarios and seeing only the negative. It is often used in times of acute crisis of in patients that have just received bad news and cannot cope, as in patients who have a just received a difficult diagnosis (e.g. cancer). In insomnia Anemone is particularly indicated in patients that think too much and worry while lying in bed, and have a difficult time getting warm. Anemone has also earned a prominent reputation in the treatment of reproductive disorders in both men and women. It acts as an emmenagogue, used in the treatment of amenorrhea in nervous and anemic patients, with coldness as the prominent symptom (Felter and Lloyd 1893). It is used in digestive disorders, particularly from overindulgence in fats and pastries, in bilious conditions and in constipation caused by dietary indiscretions and from anxiety. In dysmenorrhea Anemone is helpful as an antispasmodic, with similar indications as in amenorrhea, and also in leucorrhoea, “…with a free, thick, milky, or yellow, bland discharge and pain in the loins” (Felter and Lloyd). The patient may also complain of poor libido, expressing some anxiety around the sexual act, with pain upon intercourse and poor vaginal lubrication. Anemone is indicated in epididymitis and orchitis from an STD infection or from viral parotitis, indicated by “…a dark-red, congested, enlarged, and sensitive testicle” (Felter and Lloyd 1893). Similarly, Anemone may be helpful in orchitis and varicoceles secondary to venous congestion “…which stops short of inflammation” (Felter and Lloyd 1893). Anemone is also used in urethritis, spermatorrhea and

prostatorrhea, and in incontinence from nervous debility. Anemone is an important remedy in headache, particularly in menstrual headaches and migraines associated with anemia and decreased cerebral blood blow. It is also stated to be a helpful remedy in acute upper respiratory tract viral infection, with a thick, abundant nasal catarrh, and a dry, tight, painful cough. In children Anemone is helpful in nightmares, given before bed, and also in enuresis that occurs with or without a disturbed, frightful sleep. Anemone is used in both herbal medicine and in homeopathy in otitis media, especially with a thick, yellow non-bacterial discharge, impaired hearing and tinnitus. Anemone is also indicated in the treatment of hordeolum (sty), chronic conjunctivitis, glaucoma, or eyestrain with orbital pain. Anemone is similarly used for dental pain, primarily caused by decaying teeth and nerve inflammation.

Pharmacy and dosage: Although Anemone can be found in both dry and fresh plant form, tradition and empiricism indicates that the fresh plant preparation is the most active. The dosage ranges depending upon the recentness of the preparation: if relatively fresh only very small dosages should be used. As the preparation ages however, the doses may need to be increased, but doses should also be administered at the low end and then increased to obtain an effective dose. •Fresh Plant Tincture: fresh herb, 1:2, 95% alcohol, 1-10 drops

REFERENCES

Bradley, Peter R. ed. 1992. British Herbal Compendium. Bournemouth, UK: British Herbal Medicine Association. Felter, HW and JU Lloyd. 1893. King’s American Dispensatory. Digitized version available from http://www.ibiblio.org/herbmed/eclectic/kings/main.html. Grieve, Maude. 1971. A Modern Herbal. New York: Dover Publications. Mares D. 1987. Antimicrobial activity of protoanemonin, a lactone from ranunculaceous plants. Mycopathologia. Jun;98(3):133-40 Martin ML, San Roman L, Dominguez A. 1990. In vitro activity of protoanemonin, an antifungal agent. Planta Med. Feb;56(1):66-9 Martin ML, Ortiz de Urbina AV, Montero MJ, Carron R, San Roman L. 1988. Pharmacologic effects of lactones isolated from Pulsatilla alpina subsp. apiifolia. J Ethnopharmacol. Dec;24(2-3):185-91 Minakata H, Komura H, Nakanishi K, Kada T. 1983. Protoanemonin, an antimutagen isolated from plants. Mutat Res. Mar;116(3-4):317-22

Moore, Michael. 1993. Medicinal Plants of the Pacific West. Santa Fe: Red Crane. Newall, Carol A., Linda A. Anderson and J.D. Phillipson. 1996. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press.

Botanical Name: Bryonia alba, Cucurbitaceae

Common names: Bryonia, White Bryony, English Mandrake, Wild Vine, Wild Hops, Wild Nep, Tamus, Ladies' Seal, Tetterbury, Snakeweed, Devil's Turnip, Bastard Turnip.

Plant description: Bryonia is a perennial climbing vine with tuberous roots, growing up to 4 meters in length. The stems climb by means of unbranched tendrils, the leaves cordate and five-lobed, the terminal lobe being larger that the others. The flowers are whitish-green with distinct green veins, borne in axillary racemose panicles or sub-umbellate fascicles (bundles). Bryonia alba is monoecious, the calyx as long as corolla, stigmas glabrous, giving way to black fruits. Bryonia dioica is dioecious, the calyx only about half the size of the corolla, the stigmas with short hairs and the fruits red.

Habitat, ecology and distribution: Bryonia is native to temperate Europe southwards into the Mediterranean and Balkans, extending eastwards into Russia, Turkey and Iran. In North America it is an introduced species, occurring only sporadically. It prefers moist alkaline soils, in full sun or semi-shaded.

Part used: Fresh or dried root.

History: Bryonia was well known to the ancient Greeks and Romans, described by both Dioscorides and Galen, in which it was commonly used as a purgative. The Franciscan Bartholomew Anglicus (c. 13th cent.) states that Augustus Caesar wore a wreath of Bryony during a thunderstorm to protect himself from lightning (Grieve 1971, 133). According to Culpepper Bryonia “…are furious martial plants…the root purges the belly with great violence, troubling the stomach and burning the liver, and therefore not rashly to be taken; but being corrected, is very profitable for the diseases of the head, as falling sickness, giddiness, and swimmings, by drawing away much phlegm and rheumatic humours that oppress the head, as also the joints and sinews; and is therefore good for palsies, convulsions, cramps, and stitches in the sides, and the dropsy, and for

provoking urine; it cleanses the reins and kidneys from gravel and stone, by opening the obstructions of the spleen, and consume, the hardness and swelling thereof.”

Constituents: The earliest isolated constituent in Bryonia was a bitter glycoside called bryonin. Since then several other glycosides have been isolated, including bryoamaride, bryoniosides A-G, bryodulcoside, cucurbitacins, dihydrocucurbitacins, bryoioside, cabenoside and chrysophanic acid. Included as well are the alkaloids bryonicine and bryonine, trihydroxyoctadecadienoic acids, ribosome-inactivating proteins (RIPs, bryodin 1-2), as well as resin, tannin, volatile oil and carbohydrates (Ukiya et al 2002; Karageuzyan et al 1998; Duke 2003).

Medical Research: •Adaptogenic: The increases in the content of nitric oxide and cortisol in blood and saliva is a marker of strenuous physical exercise. An extract of Bryonia alba root purified from its tetracyclic tripterpenes (called “Loshtak”) was applied to several groups of athletes in a placebo-controlled double-blind study. The extract was found to decrease salivary NO and cortisol in athletes, compared to placebo (Panossian et al 1999). •Antioxidant: The effect of aqueous and methanol extracts of “Loshtak” preparation (purified Bryonia alba roots) on exogenous and endogenous oxidative DNA damage was studied on human lymphocytes using the comet assay with endonuclease III and formamidopyrimidine DNA glycosylase. Extracts of Loshtak protected human cells against endogenous DNA oxidative damage (Nersesyan 2001). The intragastric administration of Loshtak was shown to promote a statistically significant decrease in the clastogenic effect of cyclophosphamide injected 48 h after the end of treatment in experimental animals (Mkrtchian et al 1995). •Anti-inflammatory: The triterpene glycosides, bryoniosides A-G, as well as cabenoside D, and bryoamaride, isolated from a methanol extract of the roots of Bryonia dioica demonstrated marked anti-inflammatory effects in experimental animals (Ukiya et al). •Anti-diabetic: Trihydroxyoctadecadienoic acids obtained from the roots of Bryonia alba, administered in doses of 0.05 mg/kg/day for 15 days. i.m., was shown to restore disordered lipid metabolism in alloxan induced diabetic rats, dose-dependently reducing thromboxane B2 generation, with a corresponding increase in prostaglandin E2 release. Researchers concluded that the trihydroxyoctadecadienoic acids from B. alba may correct major metabolic abnormalities in severe diabetes mellitus, and that they can influence the profile of the formation of stable prostaglandins by actions downstream of prostaglandin endoperoxides (Karageuzyan et al 1998). Researchers examined the action of Bryonia alba root extract on lipid peroxidation in microsomes and on fatty acid composition of individual lipid fractions in the liver of rats with alloxan diabetes. Administration of the extract was found to produce an appreciably normalizing effect on the biochemical indices of liver function (Karageuzyan et al 1981).

Toxicity: The fresh root of Bryonia is a powerful irritant and caustic agent, promoting blistering of the skin with topical exposure. Taken in too large a dose both fresh and dry Bryonia preparations will promote a violent gastro-enteritis, with uncontrollable diarrhea and vomiting, severe abdominal pain, dizziness, lowered temperature, dilated pupils, and perspiration, and cardiopulmonary collapse. Large but less than fatal doses may cause

bronchial irritation, hepatomegaly, profound diuresis with tenesmus, and cardiac depression. Tannins are stated to counteract the toxic effects of Bryonia (Felter and Lloyd 1893; Felter 1922).

Herbal action: febrifuge, anti-inflammatory, analgesic, anodyne

Indications: fever, pleuritis, pleurisy, pericarditis, peritonitis, hepatitis, rheumatoid arthritis, rheumatism, neuralgia, neuritis, headaches, chronic constipation

Contraindications and cautions: diarrhea, mucosal inflammation, respiratory congestion; pregnancy, lactation

Medicinal uses: Bryonia is above all a remedy for serosal inflammation, equally effective in peritonitis, pleuritis, and synovitis and in inflammation of the serosal tissues of the viscera. These tissues will be extremely tender upon palpation. Its use is indicated wherever there is severe bruising pain in these parts, accompanied by fever, a hard and rapid pulse, and flushed cheeks (particularly on the right cheek). Bryonia is indicated in diseases of the lung where there is a “…sharp, cutting, and lancinating pain… the cough is dry, rasping, hacking or explosive, and always attended with more or less tensive or sharp pain. Little secretion is present, unless it be a small quantity of white or brown, blood-streaked or clotted, frothy mucus” (Felter and Lloyd 1893). The patient feels cold but perspires easily, and often the symptoms are “…aggravated by motion,” having “…little inclination to go about” (Felter and Lloyd 1893). In cases of pleuritis Ellingwood states that the action of Bryonia is best facilitated by alternating the dose with Ascplepius tuberosa (1919). Bryonia is also frequently mentioned in pericarditis. Bryonia is similarly indicated in abdominal disorders, recommended by Ellingwood in acute appendicitis and acute pancreatitis, and in “…chronic disorders of the liver or spleen with deep-seated soreness and quick, shooting pains, especially if there be some elevation of the temperature” (1919). In constipation, Eli Jones recommends Bryonia when the bowels are inactive, the stools large, hard and dry, “…as if burnt,” three drops thrice daily (1911). In cirrhosis of the liver with chronic constipation, with a whitish tongue and dry hard stools Jones recommends Bryonia, five drops thrice daily (1911). Ellingwood used Bryonia in acute neuritis and neuralgia, and provided a few examples of successful treatment in particularly severe cases. In spinal inflammation the pain comes on from exposure to cold or from a draft, and is experienced as sharp catching pain upon inhalation (1919). As a topical remedy for neuralgia and inflammation Bryonia tincture can be added with Calendula succus or tincture, one part Bryonia to ten parts Calendula, in a hypoallergenic cream base, 15% v/v, apply as needed. Bryonia is an important remedy in acute rheumatoid arthritis and in muscular rheumatism, where the joints are swollen and feel stiff, given in small frequent doses, together with or in alternating doses with Cimicifuga. Several Eclectic practitioners felt that Bryonia was particularly helpful in acute rheumatism finger joints and hand (Felter and Lloyd 1893; Ellingwood 1919). In severe headaches, the pain sharp and cutting such that the head feels like it might split open, made worse by bending over, coughing or eye movement, with nausea and faintness, Eli Jones recommends Bryonia in doses of 5 drops to 4 ounces (120 ml) of water, one teaspoonful every hour

(1911). Bryonia is an important remedy to eliminate excess heat, opposing dryness of the mucous membranes induced by inflammation tenderness on pressure, tiny shooting pains, or pain increased by motion. Bryonia is considered to be helpful in acute fever, as well as in chronic states, the latter marked by dry mucous membranes, cracked lips, excessive thirst, constipation, with hard, dry stools and scanty, dark colored urine (Ellingwood 1919).

Pharmacy and dosage: •Fresh Plant Tincture: fresh root, 1:2, 95% alcohol, 1-10 gtt •Dry Plant Tincture: recently dried root, 1:5, 50% alcohol, 1-10 gtt.

REFERENCES Duke, James. 2003. Dr. Duke's Phytochemical and Ethnobotanical Databases. Agricultural Research Services. Available from http://www.ars-grin.gov/duke/ Ellingwood, Finley. 1919. The American Materia Medica, Therapeutics and Pharmacognosy. Digitized version available from: http://www.ibiblio.org/herbmed/eclectic/ellingwood/main.html Felter, HW. 1922. The Eclectic Materia Medica, Pharmacology and Therapeutics. Digitized version available from: http://www.ibiblio.org/herbmed/eclectic/felter/main.html Felter, HW and JU Lloyd. 1893. King’s American Dispensatory. Digitized version available from http://www.ibiblio.org/herbmed/eclectic/kings/main.html. Grieve, Maude. 1971. A Modern Herbal. New York: Dover Publications. Karageuzyan KG, Vartanyan GS, Agadjanov MI, Panossian AG, Hoult JR. 1998. Restoration of the disordered glucose-fatty acid cycle in alloxan-diabetic rats by trihydroxyoctadecadienoic acids from Bryonia alba, a native Armenian medicinal plant. Planta Med. Jun;64(5):417-22 Karagezian KG, Vartanian GS, Panosian AG. 1981 Effect of an extract from the roots of bryony (Bryonia alba) on lipid peroxidation in the liver of rats with alloxan diabetes. Biull Eksp Biol Med. Aug;92(8):35-7 Mkrtchian LN, Nersesian AK, Panosian AG. 1995. Effect of the preparation "Loshtak" on the clastogenic activity cyclophosphamide. Genetika. May;31(5):729-31 Nersesyan, Armen K. 2001. The Effect of Bryonia alba root Extracts on Exogenous and Endogenous Oxidative DNA Damage in Human Lymphocytes. CEJOEM. Vol.7. Nos.3- 4.:209-216 Panossian AG, Oganessian AS, Ambartsumian M, Gabrielian ES, Wagner H, Wikman G. 1999. Effects of heavy physical exercise and adaptogens on nitric oxide content in human saliva. Phytomedicine. Mar;6(1):17-26 Suganda AG, Amoros M, Girre L, Fauconnier B. 1983. Inhibitory effects of some crude and semi-purified extracts of indigenous French plants on the multiplication of human herpesvirus 1 and poliovirus 2 in cell culture. J Nat Prod Sep-Oct;46(5):626-32 Ukiya M, Akihisa T, Yasukawa K, Tokuda H, Toriumi M, Koike K, Kimura Y, Nikaido T, Aoi W, Nishino H, Takido M. 2002. Anti-inflammatory and anti-tumor-promoting effects of cucurbitane glycosides from the roots of Bryonia dioica. J Nat Prod Feb;65(2):179-83

! !

Gelsemium sempervirens, Loganiaceae

Common names: Yellow Jasmine, Yellow Jessamine, False Jasmine, Jessamine, Carolina Jessamine, Wild Woodbine, White Poison Vine, White Jessamine

Similar species: G. nitidum, G. elegans, G. lucidum

Plant description: Gelsemium is an evergreen, woody vine, often climbing in the higher branches of trees, often moving from one tree into the next. It has a smooth slender stem, the immature bark dark brown to reddish brown and shining, exuding a milky-white juice when broken. The leaves are opposite, simple, lanceolate, the apex acute to acuminate, the base acute to rounded, glossy green on upper surface, margin entire, with a short petiole. The axillary flowers are bright yellow and highly fragrant, reminiscent of the true Jasmine. Each flower is between 3-5 cm long, the petals fused in to a trumpet-shaped corolla with five lobes, and five stamens surrounding a central four-clefted style. The fruit is composed of two separable, jointed pods that contain numerous, flattened winged seeds.

Habitat, ecology and distribution: Gelsemium is found in thickets and woodlands, often weedy in disturbed areas along roadsides and fences, in moist areas of the southern United States, from Virginia south to Florida and westwards into Texas, extending down into Mexico and Guatemala. Some species (e.g. G. elegans) occur in south- east Asia. Yellow Jasmine is also cultivated as an ornamental.

Part used: Fresh root and rhizome; dried plant preparations are stated to be inferior (Felter and Lloyd 1893).

! ! History: The use of Gelsemium in herbal medicine is stated to have begun with an anonymous plantation owner from Mississippi, who, while suffering an attack of the “bilious fever,” sent a servant into his garden to find a certain medicinal root to prepare an infusion of it for him to drink. The servant however collected another root by mistake, and when the infusion was given, the patient was seized with a sudden paralysis, and could not even open his eyelids, although he was otherwise lucid, and could hear the voices about him. His condition caused great anxiety amongst his friends who all gathered around him expecting him to die. After a few hours however the patient gradually recovered, and found that his fever had completely abated. The plantation owner then determined which plant it was that his servant had mistakenly harvested, and then began to use it among his workers and shared it with his neighbors as a treatment for fever. It eventually attracted the interest of a local physician who prepared an extract and marketed it under the name “Electrical Febrifuge” (Felter and Lloyd 1893).

Constituents: Gelsemium contains a variety of unique, highly toxic indole alkaloids including gelsemine, gelsemicine, sempervirine, 1-methoxyoxogelsemine, 21- oxogelsemine, 14-hydroxygelsemicine, gelsedine and 14-hydroxygelsedine. Other constituents noted in Gelsemium include scopoletin (which gives the drug a bluish glow in ultraviolet light), iridoid glycosides, an essential oil and tannin (Evans 1988, 615; Duke 2003).

Medical Research: Researchers observed an inhibitory activity upon HepG2 hepatoma cells with the in vitro administration of Gelsemium alkaloids. The result was thought to be related to an ability of these alkaloids to induce apoptosis (Wang et al 2001). Low doses of G. sempervirens were determined to have significant neurotropic, immunological, and protective effects on stress-induced behavioral, immunological and gastric alterations in experimental mice (Bousta et al 2001).

Toxicity: The toxicity of Gelsemium root and rhizome is undeniable, but to what extent

! ! is largely a matter of dosage. The alkaloids appear to be responsible for a profound depressant effect upon the central nervous system, appearing to act as both muscarinic and nicotinic acetylcholine antagonists, promoting a marked weakness and muscular paralysis. Toxic symptoms include drooping of the eyelids (ptosis) and jaw, double- vision (diplopia), pupil dilation, profuse sweating and muscle paralysis. The pulse rate drops dramatically as does the core body temperature. Respiration is initially quickened but then slowed, becoming quite shallow, the slowing of cardiac activity proportional to the respiratory effects. Consciousness is usually maintained throughout, and although the patient can hear he or she will not be able to react to stimuli. Death is from cerebral hypoxia from the accumulation of CO2. Treatment consists of emetics or gastric lavage, the hypodermic administration of morphine, artificial respiration, vigorous massage, and external heat. Poisoning can occur from the use of honey made from the nectar of Gelsemium, and as little as 2-3 g can be fatal in an adult, although there are reports in the literature of people consuming much more without any permanent effect (note the entry under History). The effects of a moderate dose typically resolve within a few hours. Apart from its ability to paralyze the lungs Gelsemium is otherwise non-toxic and non- irritating, evidenced by the fact that Gelsemium was as one time used in surgery as a kind of anesthetic, in which the patient was kept alive by artificial respiration until the effects wore off (Felter and Lloyd 1893; Potter 1902).

Herbal action: febrifuge, sedative, analgesic, anodyne

Indications: fever, inflammation, pain, neuralgia, insomnia; all characterized by extreme heat, burning sensations and inflammation

Contraindications and cautions: symptoms of coldness; weak, slow, thin pulse; bradycardia, congestive heart failure, senile heart, emphysema, myasthenia gravis, multiple sclerosis; pregnancy, lactation

Medicinal uses: Gelsemium is a powerful herbal agent to diminish muscular spasm and irritation, indicated in inflammatory conditions, evidenced by a “…flushed face, bright eye, contracted pupils, increased heat of head, great restlessness, and excitation” (Felter and Lloyd). The prototypical Gelsemium patient has a muscular build and a florid complexion, and “…is grouchy, touchy, every impulse and feeling, whether painful or pleasant, is magnified or accelerated” (Felter and Lloyd). The pulse will be full, tense and bounding, and the tongue red and pointed. In insomnia Gelsemium is useful, particularly when characterized by complaints of being too hot and emotional irritability, classic Type A personalities that have difficulty letting go and relaxing. To this end Gelsemium may

! ! be combined with Passiflora. Specifically, Gelsemium is used in severe fever, especially in children where convulsion may occur, or in cerebro-spinal meningitis. It is an important remedy in smooth muscle spasm that accompanies diarrhea and dysentery, particularly when accompanied by fever, or in renal colic from the passing of stones. In gynecological disorders it finds utility in dysmenorrhea, pelvic inflammation, post- partum pain, ovaritis, and severe cystitis. Similarly, Gelsemium is indicated in neuralgia, such as that of the trigeminal nerve, as well as in toothaches and almost any kind of pain that is characterized by burning sensations. Gelsemium is also indicated in active states of joint inflammation, such as rheumatoid arthritis. Historically Gelsemium was considered a powerful remedy in epilepsy, palsy, chorea and tetanus. Weiss recommends Gelsemium is irritability of the heart in extra-systole and functional heart disease (1988, 151). In psychiatric disorders Gelsemium is used in manic conditions, and in delirium tremens from sudden abstinence in alcoholics.

Pharmacy and dosage: Doses should be administered cautiously, beginning with diluted doses up to full drop doses, administered 1 drop per dose until the effects are noted. Although some texts state that doses can be administered until diplopia occurs, this is an indication of toxicity and should be avoided.

• Fresh Plant Tincture: fresh green root, 1:2, 95% alcohol, 1/10-10 drop. • Dry Plant Tincture: recently dried root, 1:10, 50% alcohol, 1/10-10 drop.

Botanical Name: Hyocyamus niger, Solanaceae

Common names: Henbane, Black Henbane

Similar species: H. albus, H. muticus, H. reitculatus, H. aureus, H. pusillus; allied species include Datura stramonium (Datura), Atropa belladonna (Belladonna).

Plant description: Black henbane is an annual (var. beta- annua) or biennial (var. alpha- biennis). The annual plant has a simple stem, attaining a height of between 25 and 50, with sessile ovate-oblong to triangular ovate leaves. The biennial stem is very short in the first year, with large hairy ovate-lanceolate leaves arranged in a basal rosette. The second year the branched stem rises up to 1.5 meters tall, the sessile leaves ovate-oblong to triangular ovate, with coarsely toothed edges, covered in a pubescence, especially along the mid-rib and veins. The leaves of both varietals have a pungent, unpleasant odor. The flowers in the second year biennial or in the annual appear by summer, carried on long racemes in axils of upper leaves, brownish-yellow with a purple center and purple veins. The pineapple-shaped fruits are arranged in two rows, approximately 2-3 cm long, with five lobes, containing hundreds of tiny black seeds.

Habitat, ecology and distribution: Henbane is native to Eurasia, and has since naturalized in the Americas. It can be found wild as a weed, growing in pastures, along roadsides, and in waste areas, but is also under cultivation as a herb of commerce, and can be found as a garden ornamental.

Part used: Leaf.

History: Henbane has long been known to herbalists all over the world, and figured importantly in the practices of Ayurvedic, Chinese and Unani medicine, used as an analgesic and sedative. In ancient and medieval Europe henbane was considered to have magical properties, serving as the base of a ‘flying’ ointment used by female shamans to induce a state of altered consciousness. This ointment was prepared as a salve and then introduced intra-vaginally, sometimes by smearing it onto the end of a broomstick – hence the myth of witches flying on their brooms. Henbane also found its way as an ingredient in the manufacture of beer, and was observed to promote states of altered consciousness. Often these recipes were closely guarded family secrets, with the women

Western Materia Medica Hyocyamus niger By Terry Willard ClH, PhD, Todd Caldecott ClH SOLANACEAE

of the household responsible for gathering the herbs and mixing them for use in the preparation of beer. With the advent of Christianity the altered states of consciousness induced by the henbane beer became increasingly associated with the malignant effects of devilish influences. In this respect the witches cauldron, another archetype of satanic influences, was probably more correctly the brewer’s kettle. The toxic effects of henbane also finds its way into the works of Shakespeare, where Hamlet states: “Sleeping within mine orchard, My custom always of the afternoon, Upon my secure hour thy uncle stole, With juice of cursed hebenon (Henbane) in a vial, And in the porches of mine ear did pour the leprous distillment.” Occasionally the fruit of henbane was mistaken for hazelnuts, with disastrous consequences. Gerard states that “…the leaves, the seeds and the juice, when taken internally cause an unquiet sleep, like unto the sleep of drunkenness, which continueth long and is deadly to the patient.” Culpepper adds that henbane is under the dominion of Saturn because it tends to grow in high nutrient areas in and around outhouses, sewer outfalls and ditches.

Constituents: Henbane, like datura and belladonna, is noted for its tropane alkaloids (0.03-0.15%), including hyoscyamine, hyoscine (scopolamine), and atropine. Atropine is derived from the racemization of hyoscyamine, a process that occurs upon drying (when the L-amino acid group gradually changes to D [right-handed] conformation). The difference between these three plants is the amount of tropane alkaloids found in each, and the ratio of hyoscyamine to hyoscine. Henbane is generally considered to be the weakest of the three because it has slightly less of the alkaloids, up to 0.15%, whereas Datura contains upwards of 0.45%, and Belladonna 0.6% (0.8% in the root). Henbane also contains an almost equal ratio of hyoscine to hyoscyamine, whereas Datura contains a ratio of 1:2 for hyoscine and hyoscyamine, respectively. Belladonna contains upwards of 20 parts hyoscyamine for every part hyoscine. Thus Datura is mildly stronger than Henbane, with Belladonna being the most potent among the three, and therefore the most toxic. Other alkaloids found in Henbane include the N-oxides of hyoscyamine and hyoscine, with small amounts of atropamine (apoatropine) and cuscohygrine. Henbane is also stated to contain the flavonoid glycosides quercetin, rutin and kaempferol, and volatile amines such as choline, methylpyrroline and pyridine (Bradley 1992, 31, 131; Evans 1988, 545-562).

Medical Research: The physiological effect of the tropane alkaloids is well- established. Both hyoscyamine and hyoscine have a parasympatholytic effect, competing with and inhibiting the activity of the neurotransmitter acetylcholine,

Western Materia Medica Hyocyamus niger By Terry Willard ClH, PhD, Todd Caldecott ClH SOLANACEAE

decreasing parasympathetic responses such as sweating, salivation, gastric secretion and smooth muscle contraction in the urinary, respiratory and gastrointestinal tracts. Vagal stimulation is inhibited, leading to tachycardia and possible fibrillation. In larger doses the patient’s pulse will be quickened and the pupils dilated. This later effect is the source of the name Belladonna, which means ‘beautiful woman’ in Italian, referring its former usage to make the eyes more appealing. To this end atropine in commonly used as a topical solution by opththamologists to dilate the pupil when examining the retina. The biological activity of hyoscyamine is dependent upon its isomeric conformation: L- hyoscyamine is much more potent than D-hyoscyamine (i.e. atropine), and thus dried plant preparations are less potent than fresh. Furthermore, unlike hyoscyamine, which has potent effects upon both the central and peripheral nervous systems, hyoscine acts primarily upon the PNS, and thus Henbane lacks the same degree of cerebral effects as Belladonna (Bradley 1992, 131).

Toxicity: Unlike most medical plants all the tropane alkaloid-containing plants have a fairly narrow therapeutic window. This is to say, the therapeutic dose is very close to symptoms of toxicity, and thus the dose and the patient’s response needs to be carefully monitored. Some practitioners will prescribe Henbane, Belladonna or Datura until the first initial symptoms of toxicity appear, such as a dry mouth. Beyond this, a dose too large will cause pupil dilation, difficulty swallowing, cardiac excitement, restlessness, hallucinations, delirium and coma. In most cases these herbs can be administered at a threshold below that at which any symptoms of toxicity appear. A dry mouth and visual disturbances are indications that the dose should be lowered.

Herbal action: anodyne, hypnotic, sedative, antispasmodic

Indications: smooth muscle spasm, with irritation and inflammation, in the digestive, respiratory or urinary tracts; Parkinsonim, epilepsy, cerebral palsy; neuralgia

Contraindications and cautions: glaucoma, obstructive uropathies (e.g. benign prostatic hypertrophy), obstructive disease of the gastrointestinal tract (e.g. pyloric stenosis), intestinal atony, hypertension, toxic megacolon (complicating ulcerative colitis), myasthenia gravis, pregnancy, lactation. Henbane, Belladonna and Datura should not be used with medications that have an anticholinergic action, including tricyclic antidepressants, MAO inhibitors, quinidine, antiepileptics, anticonvulsants, anti-psychotics, antihistamines and amantadine.

Western Materia Medica Hyocyamus niger By Terry Willard ClH, PhD, Todd Caldecott ClH SOLANACEAE

Medicinal uses: Henbane is used principally whenever there is smooth muscle spasm that cannot be controlled by less potent methods. It acts quickly to reduce chronic and acute spasm in the gastrointestinal, respiratory and urinary tracts, checking excessive secretion and inflammation. In digestive disorders it is particularly valued with symptoms of hyperacidity, and in spasms of the stomach, intestine, gall bladder and colon. It is particularly helpful when used in formulation to treat colitis and inflammatory bowel disease when immunological triggers in the diet have been removed, the gut ecology corrected, and metabolic causes of inflammation have been addressed (e.g. omega-3 fatty acid supplementation), but the bowel remains in a state of hyperactivity. To this end Henbane is used along with other antispasmodics (e.g. Humulus, Dioscorea), cholagogues to correct bile excretion (e.g. Berberis) and vulneraries to heal the inflamed mucosa (e.g. Quercus, Calendula). In the treatment of asthma, Henbane is an exceptional remedy to reduce spasm, used along with expectorants such as Prunus (Wild Cherry bark), Inula (Elecampane). At one time Henbane, or more commonly Datura, was smoked or burned as incense for this purpose. In the treatment of urinary spasm secondary to a severe urinary tract infection Henbane is an exceptionally helpful remedy when combined along with antimicrobials (e.g. Chimaphila, Arctostaphylos) and urinary demulcents (e.g. Zea, Althaea). Henbane also finds use in the treatment of Parkinsonism and epilepsy, although extreme care should be taken when used along with conventional drug therapies. In Parkinson’s disease Henbane is used along with trophorestoratives (e.g. Avena, Withania) and herbs that naturally contain high levels of natural L-dopa (e.g. Mucuna pruriens, Astragalus), to control symptoms and delay the usage of synthetic L-dopa (Carbidopa). Many patients will find that their symptoms are well-controlled by such treatment, and while it is not a cure per se, they can remain free of the side-effects that occur with conventional anticholinergic and L-dopa therapies. Henbane can be similarly used for senile tremor that has not been diagnosed as Parkinsonism, in cerebral palsy and in other spasmodic afflictions. In the treatment of epilepsy Henbane is an important remedy in grand mal seizure. Combined with antispasmodic herbs such as Cimicifuga and Lobelia, as well as nervine trophorestoratives such as Avena and Turnera, the use of Henbane can be very helpful to limit the effect or duration of seizure, as well as significantly increase the duration between episodes. Applied topically, Henbane tincture or oil is an effective analgesic in neuralgia.

Pharmacy and dosage: In many cases the dosage of Henbane should be begun at the lower end of the dosage range and then gradually increased in drop doses until symptoms such as a dry mouth appear. The dose can then be reduced gradually until these symptoms disappear: this is the optimal dosage range. Otherwise, Henbane can be dosed as follows: •Dry Plant Tincture: 1:10, dried herb, 40-70% alcohol, 1-10 drops., up to 20 ml per week. The British Herbal Compendium allows a dose of the 1:10 tincture up to 2-5 ml (1992, 131).

Western Materia Medica Hyocyamus niger By Terry Willard ClH, PhD, Todd Caldecott ClH SOLANACEAE

REFERENCES

Bradley, Peter R. ed. 1992. British Herbal Compendium. Bournemouth, UK: British Herbal Medicine Association. Evans, W.C. 1989. Trease and Evans Pharmacognosy London: Baillière Tindall. Felter, HW and JU Lloyd. 1893. King’s American Dispensatory. Digitized version available from http://www.ibiblio.org/herbmed/eclectic/kings/main.html. Weiss, Rudolf. 1988. Herbal Medicine. Translated by A.R. Meuss. Beaconsfield, England: Beaconsfield Publishers

Western Materia Medica Hyocyamus niger By Terry Willard ClH, PhD, Todd Caldecott ClH SOLANACEAE

Western Materia Medica Veratrum viride By Terry Willard ClH, PhD; Todd Caldecott ClH LILIACEAE

Botanical Name: Veratrum viride, Liliaceae

Common names: Veratrum, False Hellebore, Indian Hellebore, Indian poke, Skookum root, Corn Lily

Similar species: V. californicum, V. album

Plant description: Veratrum is an erect herb, 1- 2 meters tall, with short perennial rootstalks. The leaves are smooth, alternate, parallel veined, broadly oval to lanceolate, 12-30 cm long, 12 cm wide, in three ranks and clasping at the base. The inflorescence is a panicle of very numerous, small, greenish-white star-shaped flowers, dark green in the middle, the lower ones often staminate and the upper ones perfect. The fruit is an oblong or oval shaped capsule, straw colored to dark brown, containing flattish, broadly winged, brown papery seeds.

Habitat, ecology and distribution: Veratrum is found in moist areas, along stream banks and in thickets, meadows, bogs and swamps. It is abundant in sub-alpine elevations or in areas with a late snowmelt, found from the Yukon and NWT southwards into Idaho and Montana. Along the north coast of British Columbia it can be found at lower elevations.

Part used: Rhizome.

History: The genus name Veratrum is derived from the Latin term vera, meaning ‘true,’ and atrum, meaning ‘black,’ probably in reference to the dark flowers or the blackish rhizome. The origin of the common name Hellebore is obscure, although it may be because some of Veratrum’s medicinal properties are similar to that of the European Hellebore, which was used in nervous disorders and hysteria. Veratrum was carefully used by almost all First Nations groups, used in colds, fever, rheumatism, sprains, bruises and many other conditions. Its name “skookum root” is derived from a Chinook term that means ‘powerful,’ or ‘strong.’ Veratrum is sometimes prepared as a tea and used as an insecticide by gardeners.

Constituents: The primary constituents of interest in Veratrum are the very toxic alkaloids, some of which have demonstrated antihypertensive properties in experimental models. They are organized into three groups: group A, including the alkamines (esters of organic steroidal bases) with organic acids, such as germidine and germitrine, as well as cevadine, neogermitrine, neoprotoveratrine, protoveratrine and veratridine; group B,

Western Materia Medica Veratrum viride By Terry Willard ClH, PhD; Todd Caldecott ClH LILIACEAE

the glucosides of the alkamines, primarily as pseudojervine and veratrosine; and group C, the alkamines germine, jervine, rubijervine, and veratramine (Duke 1985, 507).

Medical Research: •Antihypertensive: In six chloralose-anesthetized dogs an injection of cryptenamine alkaloids derived from Veratrum into the circumflex coronary artery resulted in a significant fall in arterial pressure. Despite these hypotension changes and the presence of intact arterial baroreflexes, there was no change in plasma ADH. Overall, the data showed that the stimulation of cardiac receptors with vagal afferents by intra-coronary injection of the Veratrum alkaloids inhibits ADH secretion (Thames et al 1980). •Nervous system: Researchers examined the influence of the sodium channel toxins veratrine and veratridine on mu-opioid ([3H]-DAGO), muscarinic ([3H] NMS) and beta- adrenergic ([3H] CGP) receptors in rat brain slices. These compounds were found to reduce opioid and muscarinic binding, leaving beta-receptors unaffected. The data suggests that some factor contained in the mixture of drugs (veratrine) can block opioid and muscarinic receptors independently of depolarization (Van Huizen et al 1988). •Anti-tumor: Veratrum alkaloids and their derivatives exhibited an in vitro cytotoxic effect on leukemia P388 cells (Fuska et al 1981).

Toxicity: There have been a few reported cases of Veratrum poisoning over the last 10- 15 years, typically because the plant is misidentified as edible (e.g. “leeks) or medicinal (e.g. Gentian). Upon ingestion a moderate dose Veratrum may cause dizziness, fainting, hypothermia, pupil dilation, shallow breathing, sleepiness, hypotension and bradycardia. In toxic doses Veratrum causes significant bradycardia and severe hypotension, severe vomiting, coma and unconsciousness. Treatment begins with emetics or gastric lavage, with the internal administration of atropine and pressors such as dopamine. All recent reported cases of poisoning recover over a 24 to 48 hour period with appropriate treatment (Prince and Stork 2000; Jaffe et al 1990). Death from Veratrum is caused by asphyxia from cardiac and respiratory depression. Nausea is the most prominent indication for the immediate discontinuation of therapy.

Herbal action: febrifuge, antihypertensive, cardiac sedative, anodyne

Indications: fever, hypertension, bronchitis, pleurisy, meningitis, neuralgia, mania, hyperthyroidism; all the above associated with hyperthermia and a rapid, bounding pulse

Contraindications and cautions: pregnancy, lactation, children, elderly; bradycardia, hypotension, hypothyroidism, asthenic conditions, gastric irritability, nausea; a long pointed tongue with a red tip

Medicinal uses: Veratrum is indicated in sthenic conditions, with a full, bounding pulse and fullness of the capillary circulation, used primarily to diminish the activity of the heart and arteries and lower the body temperature. The tongue is coated white or yellow with a red streak down the middle. Michael Moore provides the term

Western Materia Medica Veratrum viride By Terry Willard ClH, PhD; Todd Caldecott ClH LILIACEAE

“incredible Hulk syndrome” when he describes the specific indication for Veratrum, with arterial tension and bloodshot eyes, insomnia, a flushed face and throbbing carotid arteries (1994). To this extent, Veratrum is indicated, whatever the cause, given the proper indications, be it inflammation from infection, or from endogenous sources. Veratrum was formerly used in high fever, and serous inflammation. It cannot however be used for any considerable length of time, and only in small doses, by which it gradually “…lessens the frequency and hardness of the pulse, and promotes a uniform and equal circulation” (Felter and Lloyd 1893). It is used in pulmonary afflictions, once again always indicated by the full, bounding pulse, used as a sedative in acute pneumonia, in pleurisy (with Bryonia), and in acute and chronic bronchitis, where it acts as powerful expectorant. It is also mentioned in King’s for septic peritonitis, and for nephritis, cystitis, hepatitis, ovaritis, and orchitis. It is mentioned as useful anodyne in acute injury, “…arising from blows or kicks upon the abdomen” (Felter and Lloyd 1893). Veratrum is indication for irritation of the nervous system, cerebro-spinal meningitis, convulsions, neuralgia and headache all associated with a febrile or hyperemic stare. It is similarly used in delirium tremens, insomnia, and acute manic states. Used in small doses, “…and progressively increasing to 12 drops of the tincture, and again reducing the dose, Veratrum has been accredited with favorably influencing exophthalmic goiter” (hyperthyroidism) (Felter and Lloyd 1893). Veratrum may also be of benefit in acute exacerbations of rheumatoid arthritis and inflammatory arthropathies, with fever and nervous irritation, but should be avoided in patients that have gastric involvement (i.e. colitis, Crohn’s disease). Whenever Veratrum is administered, it is advised the patient lie down and relax as not to burden the heart. The pulse rate and blood pressure should be cautiously observed. Applied externally as an unguent or salve (4% v/v), Veratrum is stated to be helpful in boils, carbuncles, abscesses, inflamed acne, cellulitis, and other local inflammations, acting to ease pain and promote resolution. It is similarly used in acute inflamed herpetic lesions and in the dermatitis of poison ivy (Rhus radicans), western poison oak (Rhus diversiloba) and poison sumac (Rhus vernix) (Ellingwood 1919).

Pharmacy and dosage: •Dry Plant Tincture: dried rhizome, 1:10, 50% alcohol, 1-10 drops •Medicated oil: dried rhizome tincture, 4%v/v in a hypoallergenic cream base

REFERENCES

Duke, James. 1985. CRC Handbook of Medicinal Herbs. Boca Raton: CRC Press. Ellingwood, Finley. 1919. The American Materia Medica, Therapeutics and Pharmacognosy. Digitized version available from: http://www.ibiblio.org/herbmed/eclectic/ellingwood/main.html Felter, HW and JU Lloyd. 1893. King’s American Dispensatory. Digitized version available from http://www.ibiblio.org/herbmed/eclectic/kings/main.html.

Western Materia Medica Veratrum viride By Terry Willard ClH, PhD; Todd Caldecott ClH LILIACEAE

Fuska J Fuskova A Vassova A Voticky Z New substances with cytotoxic and antitumor effects. IV. In vitro effect of some veratrum alkaloids and their derivatives on leukemia P388 cells. Neoplasma. 28(6):709-14 Jaffe AM, Gephardt D, Courtemanche L. 1990. Poisoning due to ingestion of Veratrum viride (false hellebore). J Emerg Med. Mar-Apr;8(2):161-7 Moore, Michael. 1994. Specific Indications in Clinical Practice. Self-published. Available online from: http://www.swsbm.com/ManualsMM/MansMM.html Prince LA, Stork CM. 2000. Prolonged cardiotoxicity from poison lilly (Veratrum viride). Vet Hum Toxicol. Oct;42(5):282-5 Thames MD Peterson MG Schmid PG. 1980. Stimulation of cardiac receptors with veratrum alkaloids inhibits ADH secretion. Am J Physiol. 239(6):H784-8 Van Huizen F Wilkinson M Cynader M Shaw C. 1988. Sodium channel toxins veratrine and veratridine modify opioid and muscarinic but not beta-adrenergic binding sites in brain slices. Brain Res Bull. 21(1):129-32