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"Trademarks of lndena S.p.A. ©1004.1ndenaS.pA ' ON THE COVER Red Clover Trifolium pratense L. Family: Fabaceae

OVERVIEW Another trial demonstrated a significant increase in the cortical D ed clover (RC) is a short-lived perennial herb growing 1 to bone of the proximal radius and ulna after 6 months of use.I2 ~ feet that produces purplish-pink tubular flowers. I N ative RC isofl avones have numerous potential benefits for cardio­ to Europe, Asia, and Africa,2 the herb is widely cultivated for vascular health. One clinical trial res ted rhe effects of purified RC isoflavones on total cholesterol, concluding rhar these isofla­ its flowers and as a green manure and nitrogen-rich crop. I The vones provided no significant benefits on LDL (low-density lipo­ genus name TrifoLium is derived from the Latin tres meaning proteins, "cholesterol"), HDL (hifh-density lipoprotei ns, "good three and foLium for Leaf, the species pratense is Latin for growing cholesterol") , or total cholesterol. 3 Several other trials suggest in meadows.3 that RC isoflavones have beneficial effects on lipid levels in men HISTORY AND CULTURAL SIGNIFICANCE and women.I 2, 14, 15, 16 These include the following: a significant increase in HDL cholesterol in post-menopausal women,I 2 a In Greek and Roman mythology, the three-leaf clover repre­ significant decrease in triglyceride levels among women raking 2 sents the triad goddesses) The rare four-leaf clover became a standardized RC ex tracts compared to placebo, 14 and a lowered popular C hristi an symbol due to the cross shape. In medieva l folk LDL cholesterol in men usi ng biochanin A enriched isoflavone rhyme, the four-leaf clover symbolizes complete happiness. Each ex tract from RC .I5 A previous trial showed an increase in arterial leaf is thought to represent a different as pect of happiness includ­ compliance (a marker for potential hypertension) bur no reduc­ ing fame, wealth, faithful lover, and excellent health.3 tion of choles terol in menopausal women17 or menopausal women RC leaves are eaten as salad greens and the flowers are dried for with mild to moderately high cholesreroP B; a modest reduction use in teas. The Chinese have traditionally used an infusion of RC was shown in another triaJ.I 4 Another potential cardiovascular flowers internally as an expectorant, while Russians used an infu­ benefit of RC isoflavones is their apparent ability to reduce arte­ sion to treat bronchial asthma.2 European cultures also utilized rial stiffness and vascular resistance, thereby lowering rhe risk of RC as a medicinal herb to aid in liver and diges tive ailments. 2 cardiovascular disease. One clinical study suggests rhar dietary Various Native American cultures ate the leaves as food and used supplementation with RC isofl avones significantly lowers blood the plant for sore eyes and in a salve for burns,2 as well as for pressure and may benefit endothelial function in postmenopausal whooping cough, fevers, menopause, and cancers.4 type-2 diabetic women.19 Another showed that RC isoflavones RC is an excellent forage crop for hay, silage, and livestock graz­ reduced arterial stiffness and vascular resistance in normotensive ing, and ir is also recognized for its importance in soil conserva­ men and postmenopausal women.20 tion and crop rotation due to its ability to fi x nitrogen in soiJ.5 In clinical tri als invo lving over 1,000 women, standardized RECENT RESEARCH RC extracts were wel l tolerated and resulted in no reported Recent research on RC has focused on its isoflavone content, adverse events. The mildly estrogenic activity of RC isoflavones as RC is a rich source of four dietary isoflavones-formonone­ is many rimes less than thar of steroid al es trogen. One study in tin, daidzein, genistein, and biochanin A. High dietary intake pre-menopausal women demonstrated an anti-estrogenic effect of these phytoes trogens (mainly as found in soy foods) has been by relieving breast pain associated with cyclical mastalgia.21 implicated in buffering the effect of reduced estrogen in meno­ Another trial on the long-term effect of an RC-derived isoflavone pausal women. supplement taken daily for I year concluded that (u nlike conven­ In a systematic review of herbs used to treat menopausal symp­ tional hormone replacement therapy) rhe RC supplement did not toms, 4 studies focused on RC. The review's authors concluded increase mammographic breast densiry.22,23 rhar RC may poss ibly be beneficial for certain menopausal sy mp­ RC extracts have also shown potential for men in prostate toms.6 In 2 of the reviewed trials, an RC extract standardized to health. Epidemiological evidence (i.e., from population stud­ 40 mg of isoflavones reduced the frequency and severity of hot ies) suggests that a high dietary intake of isoflavones reduces the fl ashes by about 50% compared to placebo.7·8 A subsequent trial risk of prostate cancer and promotes general prostate health. 24 showed no statistically significant benefits of 2 red clover prepa­ In a clinical trial, isoflavones induced apoptosis (programmed rations over placebo in reducing hot flashes.9 However, despite cell death) in moderate-grade tumors; this related data suggests a growing body of clinical data suggesting benefits in the treat­ rhar RC may help slow or stop growth of prostate cancer25 ment of various menopause symptoms, a systematic review of 5 Another review of phytorherapies for men with benign prostatic randomized trials on RC in menopausal women found no statisti­ hyperplasia (BPH) concludes that isofl avones, particularly RC cally significant effect of RC on hot flash frequency.IO extract, are potential therapies for promoting prostate health in Two other trials suggest that the isoflavones in RC may slow men with the non-cancerous prostate growth associated with the rate of bone loss and may even help build bone in post-meno­ advancing age. 26 pausal women. One study showed decreased bone loss over 12 While rhere is growing clinical evidence for rhe benefits months compared to placebo, concluding rhat RC isoflavones of RC extracts, most trials have been relatively small. Larger may have a protective effect on the lumbar spine in women.! I Continues on page 6 Cover photo by Steven Foster. ©2006 stevenfoster.com

www.herbalgram.org 2006 HerbaiGram 69 I 1 2006 Metnbership Benefits frotn the Atnerican Botanical Council

oin thousands of individuals, organizations, and businesses around the Jworld who provide critical support for ABC's educational programs through annual Membership, and in exchange, you'll receive tremendous value through a variety of benefits. You'll have access to extensive resources offering scientific information from an independent source on hundreds of herbs and medicinal plants through a variety of printed and online formats.

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©2006 American Botanical Council • Photos ©2006 jesse Sommerlatt Burgundy Botanical Extr cts

For NUTRACEUTICALS and PHARMACEUTICALS A BRAND NEW PLANT For FOOD &BEVERAGES • Located near Macon (100 kms north of Lyon, France) • Food-Grade solvents only • Batch records for registration purpose CUSTOMS EXTRACTION • More than 1,000 tons I year as capacity GRAPEMAF" Grape Seed Extracts GRAPEMAX Extra-Pure 95 % Polyphenols (Falin) GUARAMAr' Guarana Extracts EXTRACTION FACILmEs GUARAMAF" W • Solid-Uquid Extraction : 24,000 liters capacity Water Extraction of Guarana for Extraction Operating from 50 kg to more than 100 tons as Plant (raw material) • Uquid-Uquid purification equipment SOYMAF" • Multi-stage spray-dryer : enables microgranulation, combining Soy lsoflavones 2 extracts as one powder, using freeze-grinded plant as carrier, adjusting the particle size to your needs, etc. TEAMAF"·W • Blender Green Tea Extract (water extraction) YERBAMAX Mate Extracts BMSRange Blends of Formulated Plant Extracts for Beverages And many others : DEVIL'S CLAW, OLIVE TREE LEAVES, • Pilot : 1,000 liters Extraction Vessel PROPOLIS, BLACKCURRANT, ROOIBOS TEA ... 250 1/h Concentration Vessel • Pilot Spray-dryer • Semi-pilot : 7 liters Extraction vessel • Laboratory extraction Burgundy Botanieal Extraets Actiparc de Pont de Vaux For further information, please contact our U.S. Distributor : Les Chapelles Sud F~1190 REYSSOUZE PHARMUNE Inc. Greg Berthomieu at (845) 651 4443 TeL: +33(0)492082600- Fax: +33(0)492082601 E-mail : [email protected] • www.burgundy-extracts.com 41 , Bridge Street • PO Box 291 • FLORIDA New York 10921 • USA www.phannllneinc.com advisory board dear reader Each issue of Herba/Gram is peer reviewed by members of our Advisory Board and other qualified experts before publication. Self-Regulation by Cindy K. Angerhofer, PhD Steven Oentali, PhD Director of Botanical Research, Aveda Institute, Vice President of Scientific and Technical Affairs, the Herb Industry Minneapolis, Minnesota American Herbal Products Association, Silver Spring, Maryland John Thor Arnason, PhD his iss ue contains a Gues t Edito­ Professor of Biology, Department of Biology, Hardy Eshbaugh, PhD ri al dea ling with the relative safety University of Ottawa, Ontario, Canada Professor of Botany &Assistant Curator, Willard of dietary supplements contai ning Sherman Turrell Herbarium, Miami University, T Dennis V. C. Awang, PhD, FCIC Oxford, Ohio bitter orange. M ichael McGuffin, president MediPiant Natural Products Consulting Services, of America n H erbal Products Association White Rock, B.C., Canada Trish Flaster, MS (A H PA), the national trade association of the Executive Director, Botanical Liaisons, LLC, Boulder, CO Bruce Barrett, MD, PhD herb industry, expresses Assistant Professor of Family Medicine, Joe Graedon, MS his concerns about the University of Wisconsin-Madison Medical School Author, syndicated columnist, radio host, FDA's releasing of raw Durham, North Carolina Marilyn Barrett, PhD data from its adverse Pharmacognosy Consulting Service, Charlotte Gyllenhaal, PhD event report (AER) San Carlos, California Research Assistant Professor, College of Pharmacy, database to members University of Illinois at Chicago; Research Program Ezra Bejar, Ph.D. of the media, who, in Manager, Block Center for Integrative Cancer Care, Director oflechnical Sciences, Herbalife International, turn, have published Evanston, IL Inc., Los Angeles, CA what has turned out Mary Hardy, MD Bradley C. Bennett, PhD to be erroneous and Director, Cedars-Sinai Integrative Medicine Medical Associate Professor of Biology, Florida International misleading informa­ Group, Los Angeles, California Un iversity, Miami tion on the safety of Christopher Hobbs, LAc, AHG Josef Brinckmann these supplements. VP of Research and Development, Traditional Herbalist, botanist, licensed acupuncturist, Articles in the New York Times and later Davis, California Medicinals, Inc., Sebastopol, CA the Los Angeles Times misreported that bitter David Hoffmann BSc, FNIMH Francis Brinker, ND orange has been associated with numerous Medical Herbalist, Author, and Research Associate Clinical Assistant Professor, Department of Medicines, adverse events, even some deaths. McGuffin's Program in Integrative Medicine, University of Arizona, Traditional Medicinals, Sebastopol, California analys is shows that the FDA's data incl uded Tucson Maurice M. lwu, PhD many duplicate reports, plus many AERs Bioresources Development and Conservation Donald J. Brown, NO related to supplements containing the now­ Director, Natural Products Research Consultants, Program, Senior Research Associate at the Division of banned and controversial herb ephedra. We Experimental Therapeutics, Walter Reed Army Institute Seattle, Washington invited officials at the FDA to review the of Research, Washington, D.C. Thomas J.S. Carlson, MS, MD editorial and provide us any corrections and/ Timothy Johns, PhD Associate Adjunct Professor, or comments, including a possible rebuttal Professor, School of Dietetics and Human Nutrition; Department of Integrative Biology; Director, Center for for publicati on. After at least six communica­ Centre for Indigenous People's Nutrition and the Health, Ecology, Biodiversity, & Ethnobiology; tions with FDA, we have received no res ponse Environment, McGill University, Montreal, Canada Curator of Ethnobotany, University and Jepson Herbaria; at press time. University of California, Berkeley Kenneth Jones T here has been considerable interes t in President and Medical Writer, Armana Research, Inc, Jean Carper the level of regul ati on of herbs and related Halfmoon Bay, BC, Canada Author and syndicated columnist, Washington, D.C. dietary supplemenrs. We support the imple­ Edward Kennelly, PhD Jerry Cott, PhD mentati on of rational regulations as well as Associate Professor and Chair, Department of Biological Pharmacologist, U.S. Food and Drug Administration, self- regulation by the industry. Self-regu­ Sciences, Lehman College, City University of New York, Center for Drug Evaluation and Research, latory initiatives are usually the optimal Bronx, NY Rockville, Maryland way to regulate any product category and Paul Alan Cox, PhD lkhlas Khan, PhD industry, but this requires a wide degree Associate Professor of Pharmacognosy, Assistant Executive Director, Institute for Ethnomedicine of voluntary compliance, often difficult Director, National Center for Natural Products Research, Jackson, Wyoming to affect. AH PA has taken leadership in University of Mississippi, Oxford, MS Lyle E. Craker, PhD numerous areas of self-regulation, including Professor, Department of Plant and Soil Sciences, Steven King, PhD three "trade recommendations" that it has Vice President, PS Pharmaceuticals, Inc., University of Massachusetts, Amherst recently enacted and/or revised regarding South San Francisco, California Edward M. Croom, Jr., PhD the presence of heavy metals in some herbal Adjunct Associate Professor of Pharmacognosy, Richard Kingston, PharmD, CSPI materials, prohibitions against drug- mas k­ President, Regulatory and Scientific Affairs, Safety Call'" University of Mississippi, Oxford, Mississippi ing claims, and pesticide/fungicide analy­ International Poison Center; Professor, Department of sis for cultivated ginseng, as we report. We Wade Davis, PhD Experimental and Clinical Pharmacology, College of Explorer-in-Residence, National Geographic Society, Pharmacy, University of Minnesota, Minneapolis, MN . also include a story on FDA's recogn ition of Washington, D.C. AHPA's self-regulatory guidelines for estab­ Thomas l. Kurt, MD, MPH lishing common names for herbs used in Clinical Professor, Department of Internal Medicine, University oflexas Southwestern, Dallas, Texas commerce, as published in AHPA's book

4 I HerbaiGram 69 2006 www. herbalgram.org Herbs of Commerce, 2nd edition, which has become federal law as of January 1, 2006. advisory board If it appears that there is a lor of cover­ age of AHPA and its work in this issue, with (continued) three articles about AHPA initiatives, yo u're correct. AHPA has done some laudable self­ Roberta A. lee, MD Holly Shimizu regulatory work and deserves recognition. Medical Director, Co-Director Integrative Medicine, Executive Director, US Botanic Garden, Washington, DC In addition, we were also planning to run an Continuum Center for Health and Healing; Director of Victor Sierpina, MD ex tensive article on new guidelines by rhe US Medical Education and Integrative Fellowship, Beth Associate Professor of Family Practice Medicine, Fish and Wildlife Service (FWS) regarding Israel Medical Center, New York, NY University ofTexas Medical Branch, Galveston the harvest of wild American ginseng, issued Martha M. libster, PhD, RN, CNS in August 2005 in accordance with FWS's James E. Simon, PhD Associate Professor of Nurs ing and History, Purdue Professor of New Use Ag riculture, Director of the Center responsibilities to monitor threatened and University, West lafayette, IN for New Use Agriculture and Natural Plant Products, endangered species for C ITES (the Conven­ Tieraona Low Dog, MD Rutgers University, New Brunswick, New Jersey tion on International Trade in Endangered Clinical Asst. Professor, Director of Botanical Studies, Species of Wild Fauna and Flora); however, Beryl Simpson, PhD Program in Integrative Medicine, University of Arizona C. L. Lundell Professor of Botany, Department of Botany, we did not have adequate space for all rhe School of Medicine, Tucson, Arizona University ofTexas at Austin regulatory articles initially slated for this Tom Mabry, PhD issue. S. H. Sohmer, PhD Professor of Plant Biochemistry, Department of Botany, President and Director, Botanical Research Institute of One of our features profiles some of the University ofTexas at Austin Texas, Fort Worth historical and modern literature on jimson­ Gail B. Mahady, PhD Barbara N. Timmermann, PhD weed (Datura), a plant with a long but some­ Research Assistant Professor, Department of Medical what speckled tradition in folklore, shaman­ Chairperson-Professor of Medicinal Chemistry, Chemistry & Pharmacognosy, College of Pharmacy, University of Kansas, Lawrence, Kansas ism, and medicine. Kofi Busia and Fiona University of Illinois, Chicago Arthur 0. Tucker, PhD Heckels write char chis interesting medic­ Robin J. Maries, PhD inal plant and irs documented psychoac­ Research Professor of Agriculture and Natural Director of the Bureau of Research and Science, Natural Resources, Delaware State University, Dover tive effects may have some yet unrealized Health Products Directorate, Health Products and Food va lue for psychiatric medicine, under prop­ Branch, Health Canada, Ottawa Nancy Turner, PhD Professor and Ethnobotanist, Environmental Studies erl y controlled conditions-a proposal that Dennis J. McKenna, PhD we find interesting and worthy of future Program, University of Victoria, British Columbia, Executive Director, Institute for Natural Products Canada research. HG Research; Senior Lecturer, Center for Spirituality and Healing, University of Minnesota, Minneapolis Daniel T. Wagner, RPh, MBA, PharmD Owner, Nutri-Farmacy, Wildwood, Pennsylvania Marc S. Micoui, MD, PhD Executive Director for Integrative Medicine, Andrew T. Weil, MD Thomas Jefferson University Hospital, Philadelphia, PA; Author, Director of the Program in Integrative Director, Policy Institute for Integrative Medicine, Medicine and Associate Director of the Divisio n of Washington, DC Social Perspectives in Medicine, College of Medicine, board of trustees University of Arizona, Tucson Daniel E. Moerman, PhD Michael J. Balick, PhD William E. Stirton Professor of Anthropology, Bernd Wollschlaeger, MD Director and Philecology Curator, New York Botanical University of Michigan/Dearborn Family practice physician; Clinical Assistant Professor Garden, Bronx, New York of Medicine and Family Practice, University of Miami, William Obermeyer, PhD School of Medicine, Florida Peggy Brevoort Vice President of Research and Technology, President, Brevoort, llC, Kapa'au, Hawaii Consumerlab.com, Annapolis, Maryland Jacqueline C. Wootton, MEd President, Alternative Medicine Foundation, Inc. James A. Duke, PhD Samuel W. Page, PhD Director, HerbMed• HerbMedPro™, Potomac, MD Botanical Consultant, Economic Botanist (U SDA, ret.), Scientist, International Programme on Chemical Safety, Herbal Vineya rd Inc. I Green Farmacy Garden, Fulton, World Health Organization, Geneva, Switzerland Maryland Joseph E. Pizzorno, Jr., NO ad hoc advisor: Norman R. Farnsworth, PhD President Emeritus, Bastyr University, Seattle, David M. Eisenberg, MD Research Professor of Pharmacognosy, Senior University Washington, and Editor, Integrative Medicine: A Director, Osher Institute, Scholar, University of Clinician 's Journal Division for Research and Education in Complementary Illinois at Chicago MarkJ. Plotkin, PhD and Integrative Medical Therapies, Steven Foster Author, Executive Director, Amazon Conservation Team, Harvard Medical School, Boston, Massachusetts President, Steven Foster Group, Inc., Brixey, Missouri Arlington, Virginia Fredi Kronenberg, PhD John M. Riddle, PhD Director, Rosenthal Center for Complementary and Professor of History, Department of History, Alternative Medicine, Columbia University College of North Carolina State University, Raleigh Physicians and Surgeons, New York Eloy Rodriguez, PhD Morris Shriftman James Perkins Professor of Environmental Studies, CEO, Mozart, Inc., San Rafael, California School of Agriculture & Life Sciences, Cornell University, Ithaca, New York Mark Blumenthal Founder and Executive Director (ex officio member) www.herbalgram.org 2006 HerbaiGram 69 I 5 RED CLOVER 2003;89:467 -47 4. Schult TM, Ensrud KE, Blackwell T, Continued from page 1 14. Ettinger B, Wallace R, Tice JA. Effect of studies are needed for conclusive evidence isoflavones on lipids and bone turnover American Botanical Council markers in menopausal women. Maturitas. on RC and/or RC-derived isoflavones for Mark Blumenthal July 15, 2004;48(3):209-218. the potential benefits of lowering choles- Founder and Executive Director 15. Neste! P, Cehun M, Chronopoulos A, terol and blood-pressure or the manage- DaSilva L, Teede H, McGrath B. A Wayne Silverman, PhD ment of menopausal symptoms. Potential biochanin-enriched isoflavone from red Chief Administrative Officer also exists for RC extracts as a source clover lowers LDL cholesterol in men.Eur J of dietary isoflavones for prostate and Clin Nutr. March 2004;58(3):403-408. Sean Barnes cardiovascular health in men. HG 16. Campbell M, Woodside JV, Honour JW, Art Director Morton MS, Leathem AJ . Effect of red Kathleen Coyne REFERENCES dover-derived isoflavone supplementa- Sales Coordinator I. Bown D. The Herb Society ofAmerica New tion on insulin-like growth factor, lipid Gayle Engels Encyclopedia ofHerbs & Their Uses. New and antioxidant status in healthy female Education Coordinator York: DK Publishing, Inc; 2001. volunteers: a pilot study. Eur J Clin Nutr. 2. Kelly G, Husband A, Waring M. Standard- 2004:58; 173-179. Michael Finney ized red clover extract clinical monograph. 17. Neste! PJ, Pomeroy S, Kay S, et al. lsofla- Herba/Gram Managing Ed itor Natural Products Research Consultants; vones from red clover improve systemic Lori Glenn 1998. arterial compliance but not plasma lipids HerbCiip Managing Editor 3. Onstad D. Whole Foods Companion. in menopausal women. J Clin Endocrinol Tara Hall White River Junction, VA: Chelsea Green Metab. March 1999;84(3):895-898. Special Projects Coordinator Publishing Co; 1996. 18. Howes JB, Sullivan D, LaiN, et al. Cassandra Johnson 4. Moerman DE. Native American T he effects of dietary supplementation Administrative Assistant Ethnobotany. Portland, OR: Timber Press; with isoflavones from red clover on the 1998. lipoprotein profiles of post menopausal Nancy Moon 5. Smith R. Red Clover in the "Twenty-First" women with mild to moderate hypercho- Executive Assistant Century; 2000. Available at: http://www. lesterolaemia. Atherosclerosis. September Ellyn Polis uwex.edu/ces/forage/wfc/proceedings2000/ 2000;152(1): 143-147. Receptionist/Administrative Assistant smith.htm. Accessed December 26, 2005. 19. Howes JB, Tran D, Brillante D, Howes George Solis AL, 6. Huntley Ernst E. A systematic LG. Effects of dietary supplementation HerbCiip Production Assistant review of herbal medicinal products with isoflavones from red clover on for the treatment of menopausal symp- ambulatory blood pressure and endothe- Nathanael Sponseller toms. Menopause. September-October lial function in postmenopausal type 2 Gardener 2003; I 0(5):465-476. diabetes. Diabetes Obes Metab. September Cecelia Thompson 7. Van de Weijer P, Barentsen R. lsoflavones 2003;5(5):325-332. Finance Coordinator from red clover (Promensil) significantly 20. Teede HJ, McGrath BP, DeSilva L, Cehun Aileen Truax reduce menopausal hot flush symptoms M, Fassoulakis A, Neste! PJ. lsoflavones Development/Marketing Coordinator compared with placebo. Maturitas. reduce arterial stiffness: a placebo-control- 2002;42: 187-193. led study in men and postmenopausal Margaret Wright 8. Jeri, A. The use of isoflavone supplement women.Arterioscler Thromb Vase Bioi. June Accounting Coordinator to relieve hot flushes. The Female Patient. I, 2003;23(6):1066-1071. 2002;27:45-50. 21. Ingram D, Hickling C, West L, Mahe L, 9. Tice JA, Ettinger B, Ensrud K, Wallace Dunbar P. A double-blind randomized R, Blackwell T, Cummings SR. Phytoes- controlled trial of isoflavones in the treat- trogen supplements for the treatment of ment of cyclical mastalgia. Breast. April hot flashes: the isoflavone clover extract 2002;11(2);170-174. (ICE) study: a randomized controlled trial. 22. Powles T. Isoflavones and Women's Health. ]AMA. July 9, 2003;290(2):207-214. Breast Cancer Res. 2004;6(3):140-142. 10. Krebs EE, Ensrud KE, MacDonald R, Wilt 23. Atkinson C, Warren RM, Sala E, Dowsett lJ. Phytoestrogens for treatment of meno- M, Dunning AM, Healey CS, et al . Red pausal symptoms: a systematic review. Obstet dover-derived isoflavones and mammogra- Gynecol. October 2004;104(4):824-836. phic breast density: a double-blind, rando- II. Atkinson C, Compston JE, Day NE, mized, placebo-controlled trial. Breast Dowsett M, Bingham SA. The effects of Cancer Res. 2004;6(3):170-179. phytoestrogen isoflavones on bone density 24. Griffiths K, Denis L, Turkes A, Morton in women: a double-blind, randomized, MS. Phytoestrogens and diseases of the placebo-controlled trial. Am J Clin Nutr. prostate gland. Bailliere's Clin Endrocrinol ~ERICAN 2004: 79;326-333. Metab. December 1998; 12(4):625-647. BoTf'NICAL 12. Clifton-Bligh P, Baber R, Fulcher G, Nery 25. Jarred RA, Keikha M, Dowling C, et al. M, Moreton T. The effect of isoflavones Induction of apoptosis in low to moderate- COUNCIL extracted from red clover (Rimostil) on grade human prostate carcinoma by red lipid and bone metabolism. Menopause. dover-derived dietary isoflavones. Cancer July-August 200 I ;8(4):259-265. Epidemiol Biomarkers Prev. December Mission: Provide education 13. Blakesmith S, Lyons-Wall P, George C, 2002; 11 (I 2): 1689-1696. using science-based and traditional Joannou G, Petocz P, Samman S. Effects 26. Katz, A. Flavonoid and botanical appro- information to promote responsible of supplementation with purified red aches to prostate health. J Altern Comple- use of herbal medicine-serving clover (Trifolium pratense) isoflavones on ment Med. December 2002;8(6):813-821. the public, researchers, educators, healthcare plasma lipids and insulin resistance in professionals, indusrry, and media. healthy premenopausal women. Br J Nutr.

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Winter 2006

The Journal of the American Botanical Council

Contributors Kofi Busia J.C. Callaway Courtney Cavaliere features Becky Costello Herbal Medicine in Belarus Ivan Darashkevich Subhuti Dharmananda By Jolie Lonner and Ivan Darashkevich Cascade Anderson Geller Belarus, previously part of the former Soviet Union, has Fiona Heckels 3 6 retained its strong traditions Nirmal Joshee of gathering and cultivating Jolie Lonner medicinal herbs, both at the household level and on large, commercial farms. Belarusians Michael McGuffin have traditionally employed medicinal Brenda Milot plants to treat most ailments. However, the John Neustadt Soviet legacy has kept herbal medicine institutionalized and thoroughly regulated Heather S. Oliff by the government. This article describes the Colleen Ostlund current state of herbal medicine in Belarus as Katherine Purcell it makes the slow transition to a free market Cathleen Rapp and struggles to maintain the values of healthcare and safety over business interests. Codi Scarbrough Triesch David Winston JimsonWeed: History, Perceptions, Traditional Uses, and Potential Herba/Gram Staff Therapeutic Benefits of the Genus Mark Blumenthal Datura Editor I Publisher by Kofi Busia and Fiona Heckels Native peoples and tribes in Michael Finney various parts of the world Managing Editor 40 have used intoxicating plants Sean Barnes from the genus Datura in Art Director religious rituals, divination, witchcraft, and healing ceremonies. These plants also Steven Foster have a long history in both traditional Associate Editor and modern medicine as treatments for mental illness, tumors, infections, and even Jimson weed Datura stramonium L. from Medical botany : containing Rakesh Amin as aphrodisiacs. This paper examines this systematic and general descriptions, with plates, of all the medicinal Legal & Regulatory Editor history, highlighting differing attitudes toward plants, indigenous and exotic, comprehended in the catalogues of the materia medica, as published by the Royal Colleges of Physicians of Maureen Jablinske Datura's hallucinogenic effects and describing London and Edinburgh: accompanied with a circumstantial detail of Proofreader traditional, therapeutic, and recreational uses in Europe and other cultures. Research aimed their medicinal effects, and of the diseases in which they have been most Nancy Dennis at explaining possible correlations between successfully employed by William Woodville Volume 2 of 4 (originally Editorial Assistant altered states of consciousness and activity in published in 1792). ©1995-2006 Missouri Botanical Garden http//www. the brain is also reviewed. Throughout these illustratedgarden.org Courtney Cavaliere descriptions, potential benefits and promising Editorial Intern areas for further research are suggested. Lance Lawhon Guest Editorial: Media Spins Numbers on Bitter Orange AERs Based on Erroneous Advertising Sales Information from FDA 877-832-1881 [email protected] by Michael McGuffin After the publication of a New York Times article citing a large number of adverse reactions to products containing bitter orange, the American Herbal Products Association filed with the US Food and Drug 52 Administration (FDA) a request under the Freedom of Information Act for copies of all adverse event reports (AERs) regarding products containing bitter orange or its extracts. This editorial provides background detail Herba/Gram• is printed on and a thorough analysis of the contents of these AERs, not for the purpose of making a case for the safety of bitter orange, recycled paper at Branch-Smith but to raise important and troubling questions about the way the FDA tallies AERs and disseminates the resulting erroneous Printing, Ft. Worth, Texas information to the media and the public. departments

10 ABC News Safety and Efficacy of Remifemin® Black Cohosh Extract in Alleviating Symptoms of Menopause Confirmed in Large A Future Pharmacist Shares Her Experience of the Peruvian Clinical Trial Amazon Study in New -England Journal of Medicine Tests Efficacy of ABC Develops "Healthy Ingredients" Database Low-Dose Echinacea Extracts in the Treatment of Rhinovirus Planned Giving Programs Support ABC and Provide Personal Infections Financial Advantages Sativex® Cannabis-Based Medicine Reduces Pain in MS Patients ABC Launches Second Online Herbal Information Course Peppermint Oil May Reduce Daytime Sleepiness Garlic Galore from the Gardens ABC Employee Profile: Nate Sponseller 56 Legal & Regulatory American Botanical Council Recejves Inaugural Weil AHPA Adopts New and Revised Trade Recommendations for ~ Foundation Groqnt , ' Herb Industry Self-Regulation ABC to Host "American Botanical Celebration" in Anaheim Herb Industry Self-Regulation Initiative on Common Names for Herbal Ingredients Becomes Federal Law in January 17 Organization News , 62 Market Report OCOM Gives First <;:linical Doctoral Degrees in Acupuncture and 1 Oriental Medicine,, , .[ ' A ,. • ' China Projected to Become Top Tea Exporter 1 ' & IJ HerbDay 2006 Scheduled ~.or October 14th Tata Tea Buys Good Earth Tea , I Dan Church Selected as Bastyr University's New President 64 Conference Report 19 Grants & Awards Second Annual Nutrition and Health Conference: The State of the Science and Clinical Applications Farnsworth Honof7d with ASP Achievement Award 1 Resea~ch 0 / ~ L ' Ftrst European Ayurveda Congress CRN Honors Industry Experts at Annual Conference NIH Holds Conference on Dietary Supplement s, Coagulation, and f Aloe Leaders Honored with International Aloe Science Council Antithrombotic Therapies Hall of Fame Award I , Brian Berman Receives ,200S BravewE?II Leadership Award 68 Book Reviews I I o I I I 1 The Medicinal Uses of Cannabis and Cannabinoids 22 Research & World News The Healing Power of Chinese HJ::rbs and Medicin~ (Recipes Mount Diablo Buckwheat Rediscovered Plants of Haida Gwaii: Kaadaa Gwaay gud gina !s.'aws (Skidegate) American Ginseng Root Smugglers Caught Off China Shores Kaadaa Gwaayee guu giin }{qws (Massett) {l / Organic Bouquet Initiates Bio-Friendly Flower Trend The Pharmacopoeia of the United States of America- Facsimile of Gates Foundation Invests $42.6 Million in Malaria Drug Research (he First Edition (7820 ) .:;. Experts Recommend More Funding to Develop Traditional New Book Profiles Herbal Medicines to Treat Malarl

Subscriptions to Herba/Gram are a benefit bf ABC membership at every level. One year memberships: Individual $50; Academic $100; Professional $150; Organization $250; Retailer $250; HerbCiip Service $500; Co(porate; Sponsor. Add $20 for memberships outside of the U.S. Student and Senior discounts are available. For informatiof) about Corporate or Sponsor Mernb rships, contactWayne Silverman, Ph(), at [email protected] or 512-926-4900. tO 2006 American Botanical Councn.1sSN .#0899-5648. Printed in the U.S.A. The information in HerbaiGram• is inten(\ed for educational purposes only and is not a substitution for tne advice of a qualified healthcare professional. Although we attempt to en~ure that advertising in Herba/Gram:is truthful and not misleading, the publication of an ad for a product or-company in HerbaiGram does not constitute an endorsement by AB<; of the product or the company being advertised. Publication of qn ad that makes a health claim or structure-function claim does not necessarily conStitute an approval of that claim by ABC Further, ABC has not reviewed any manufacturer's ~ Manufqe,turing Practices. ------4l ABC News J~------A Future Pharmacist Shares Her Experience of the Peruvian Amazon by Codi Sca rbrough Triesch uring my pharmacy doctorate internship at the American Botanical Council (ABC) in October, I took advantage of the fantastic opportunity to go on their annual trip to the Peruvian Amazon and Machu Picchu. ABC has teamed up with D the Amazon Center for Environmental Education and Research (ACEER) to offer this unique educational experience that focuses on medicinal plants from the Peruvian Amazon and Andes. People who sign up for the ABC/ACEER tour come from a vari­ ety of backgrounds, including physicians, pharmacists, nurses, chiropractors, students, herbalists, and anyone interested in learning about the medicinal uses of plants.

I first heard about the Amazon trip 10 During our stay we saw amazing wildlife sources. Examples ofplant sources currently years ago when my father, a pharmacist, and plants that cannot be seen anywhere used in prescription medications include and my mother went on the trip. They else. The ecosystem and species in the digoxin (foxglove, Digitalis purpurea L., came back raving about how wonderful rainforest are unlike any other. Reserva Scrophulariaceae), scopolamine (Jimson and educational the experience had been. Amazonica has built a series of hang­ weed, Datura stramonium L., Solanaceae), Ever since then I have wanted to experi­ ing bridges and towers called the Inkat­ and colchicine (autumn crocus, Colchicum ence the rainforest, but I did not know erra Canopy Walkway. Located 100 feet autumnale L., Li liaceae). 1 Due to patent at the time that I would also become a above the forest floor, the walkway spa ns regulations and ease of production, most pharmacist. I grew up around pharmacy, the top of the rainforest, allowing us to prescription medications are made from alternative medicine, and the idea of using walk among the treetops. We were able synthetic material in a laboratory, a far cry foods and herbs to help treat disease states to learn about and see medicinal plants at from the origin of pharmacy, which was the top of the rainforest based on plant material. on the canopy walk­ The Peruvian Amazon trip gave me the way, as well as on the opportunity to observe some of the myriad rainforest floor below. ways in which the indigenous people of Considering the height the rainforest use plants and herbs to treat of the trees, it seems disease states. As a future pharmacist, I logical that the animals can also appreciate how these same plants and plants on the floor and herbs could be used in the future to of the rainforest would treat diseases around the world. A good differ greatly from life example is the medium-sized tree called found in the canopy. sangre de drago (Croton lechleri Mull.Arg., During our canopy Euphorbiaceae), or dragon's blood, which tour we were lucky has been used for centuries by indig­ enough to see a group enous people for its wound healing, anti­ of Saddleback Tamarin inflammatory, antibacterial, anti-fungal, monkeys make their anti-diarrhea, 1 and antiviral properties. 2 way across the treetops Currently an American pharmaceutical Chuck Hughes, Codi Scarbrough Tri esc h, Lori Glenn, and Mehreen Hood a on the Sun Gate tra il above Machu Picc hu. Photo ©2005 Chuck Hughes against a background of company has filed patents on some prepa­ beautiful purple flow- rations made from the red sap of the sangre ers that grow only on de drago. T he company is also performing and promote well being. My parents own a vine at the top of the rainforest. These human clinical trials using oral prepara­ an independent compounding pharmacy flowers are easily seen as purple patches as tions to treat respiratory viral infections in Dallas ca ll ed Abrams Roya l Pharmacy, one flies over the Amazon. and persistent diarrhea, and using topical which specializes in natural products, Later we were taken to the ACEER preparation as an antiviral for herpes .2 A including herbs. Because of my back­ facility upriver where we met shaman multi-chemical drug from the sap is also ground in herbs and pharmacy, the trip to Don Antonio Montero Pisco, who walked being marketed in India and C hina for the Amazon was a must. us around the fac ility, pointing out the treatment of chronic diarrhea.3 O ur tour group arrived in Lima, Peru, different plants and local uses. He later Part of the accredited educational on the first day of our trip. On the second performed a traditional ceremony called portion of the trip included lectures about day we flew by local plane to Puerto the bath of tranquility, in which we all different aspects of medicinal herbs. An Maldonado near the Madre de D ios River, were able to participate. ex tremely interesting lecture was given by a major tributary of the Amazon in south­ As a pharmacy student at the University ABC's Founder and Executive Director ern Peru. T here we boarded a boat and of Texas in Austin, I learned about the Mark Blumenthal on the history of herbs traveled about an hour down river. We biochemistry, chemical structures, and in medicine and pharmacy. On another spent three nights at the beautiful Reserva medical uses of most prescription medica­ day we took a trip to a local fa rm on the Amazonica lodge located in the middle tions available. Most consumers are not Madre de Dios River and lea rned about of the rainfores t and on the banks of the aware of the fact that very few prescription Amazonian food and farming from James river. medications are made from natural plant Duke, PhD, an economic botanist retired

10 I HerbaiGram 69 2006 www. herbalgram.org ABC News ------~l------J~------from the United States Department of ABC Develops "Healthy Ingredients" Database Agriculture and a perennial workshop leader on ABC's trips. n keeping with its mission of providing education using science-based and tradi­ After our tour of the Amazon, we trav­ tional information on herbs and related ingredients, ABC has recently made avail­ eled to the sacred Urubamba Valley and I able a new online database called Healthy Ingredients. The database currently has the exciting Incan mountaintop citadel, 130 overviews of plants and related natural materials that are used in dietary supple­ Machu Picchu, a World Heritage site. We ments and natural cosmetics. Additional overviews will be added to the database over enjoyed two days exploring the Inca ruins, time. Access to this database is a new benefit for members of ABC at all levels. A few of including guided tours of the ruins and the overviews are available to the general public, including Eucalyptus, Frankincense, some of the surrounding areas. We had Sandalwood, and Wintergreen. The database can be viewed by clicking on the Healthy the choice of hiking up one of the two Ingredients link located on the left side of ABC's homepage at www.herbalgram.org. peaks, either the Sun Gate or the peak of Huayna Picchu (the needle-like spire often seen in photos of Machu Picchu). Both Each overview provides a Standard­ peaks provide a stunning view of the ruins ized Common Name per the respective below. To comprehend the beauty and awe herb's listing in the American Herbal of Machu Picchu, viewers must experience Products Association's Herbs of Commerce, it for themselves. 2nd edition (when available), a Cosmet­ For me this trip brought to life the vast ics, Toiletry, and Fragrance Association possibilities of herbs and plants in future (CTFA) name (when available), plant medicine. It also expanded my vision as a family, full references, and a color photo­ pharmacist to educate the public on the graph. The overviews begin with a short

introduction that describes the plant or ... ~ -----..... - ----·--~... , - --­ many medicinal benefits available from -----· ------~------·· ______.. -..._ .. _.. _ __ ..... _. ~------·- ...... herbs and plants. I am very fortunate other ingredient, its native habitat, where -·------·------".. --· ----~--- ·---·------to have had the opportunity to partici­ it is currently grown, and what plant pate in this wonderful experience, and I part or extract is used in commerce. This is followed by a section on the history would recommend it to everyone, espe­ outlook. This section will also be updated cially pharmacists wishing to expand their and cultural significance of the ingredi­ as information becomes available. ent, which includes internal and external knowledge of medicinal plants. HG Healthy Ingredients is available for uses, both historical and pres­ licensing as Web sire content. The infor­ ent, and any notable history (e.g., mation is written in consumer-friendly if it were traded on the Spice language and is appropriate for anyone Road, used in ceremonies or ritu­ interested in educating the public on als, or found in Egyptian tombs). herbal dietary supplements and natural Modern research is also included, cosmetic ingredients. This includes, but is but it is limited mainly to human not limited to manufacturers, distributors, clinical studies on the internal multilevel companies, online commerce and external uses of the item. sites, and educational organizations. The Occasionally, if there are no clin­ overviews will be updated on a regular ical studies, or in vitro in vivo basis, and ABC expects to have expanded studies are mentioned if they are versions for most of the overviews online especially significant. Frequently, by the end of 2005. at least with the ingredients Since there are many ingredients in Ethnobotanical tour group at Machu Picchu. Photo ©2005 completed rhus far, no clinical commerce that are nor included in rhe Chuck Hughes studies have been located. ABC database at this time, for a small fee ABC will check the scientific literature can write overviews of specific ingredi­ References on a regular basis and update this section ents for companies or individuals who I. Blumenthal M, Hall T, Goldberg A, when warranted. The final section of each request them. This is an opportunity for overview addresses the future outlook Kunz T, Dinda K, Brinckmann J, et al, companies to get information about their eds. The ABC Clinical Guide to Herbs. of the ingredient. This section attempts ingredients published. For more informa­ Austin, TX: American Botanical Council; to synthesize the commercial produc­ tion on li censing Healthy Ingredients as 2003. tion, market statistics, sustainable growth 2. Taylor L. The Healing Power ofRainfor­ Web content or having an overview on and harvesting, and any other factor that est Herbs: A Guide to Understanding and a specific herb written, contact Wayne might influence the future of each item. Using Herbal Medicinals. Garden City Silverman, PhD, at 512/926-4900 ext. For some of rhe ingredients, especially Park, NY: Square One Publishers; 2005. 120 or [email protected]. HG 3. Purcell K. New Anti-Diarrhea Medica­ those that are relatively new to the market, little used, or obscure for some other tion Produced from Amazonian Tree. -Gayle Engels HerbalGram. 2005;No. 68:20. reason, there is little or no information currently available regarding their future www.herbalgram.org 2006 HerbaiGram 69 I 11 ------~l__ A _B_CN_e_ws__ J~------Planned Giving Programs Support ABC and Provide Personal Financial Advantages a non-profit organization, ABC values and appreciates the support of our donors, but we also want to ensure that your gift s the right choice for you. Planned giving, deferred giving, or estate giving are some of the names that describe a process A f managing your financial affairs so that you can make a charitable gift that will provide the greatest benefits to you, your heirs, and ABC. To help you balance yo ur goals for the older the annuitant, the larger the Good plans shape your current financial interests, retire­ annuity. ment, your family and your charitable good decisions. interests, we invite you to please consider C h aritable Remaind er Trusts supporting ABC through one of these Similar to a charitable gift annuity, a That's why good planning many planned giving options: charitable remainder trust makes periodic helps to make elusive • An outright gift of cash or stock. payments to one or more individuals of • The creation of a charitable gift your choosing for life or for a term of years dreams come true. annuity or a charitable trust. and provides a tax deduction. Upon termi­ • The purchase or assignment of a life nation of the trust, the property remain­ -Lester R. Bittel, insurance policy naming ABC as a ing will be used for the charitable purpose beneficiary. you have specified. Charitable remainder The Nine Master Keys • A bequest or legacy gift. trusts can be created in two ways: A unitrust provides income that fluc­ ofManagement Gift of Cash or Stock tuates annually as a fixed percentage of Gifts of stock provide an immediate tax the fair market value of the trust. This ABC as a beneficiary. We would greatly deduction and allow yo u to minimize or type is more suited to donors who want to appreciate these kinds of actions. In addi­ avoid capital gains tax on the gift. This is participate in market gains and can toler­ tion, if you make the assignment to ABC especially helpful when donating appreci­ ate some risk. irrevocable, yo u can combine charitable ated securities because your cost basis is An annuity trust provides fi xed income goals with tax advantages by receiving low and you may be able to deduct the payments, determined when the gift is a calculated deduction, up-front for the full fair market value. You can also use made. This type is more appropriate for assignment. appreciated stock to se t up a charitable individuals who wish to avoid the risk of gift annuity or charitable trust, described market fluctuations. Bequ est or Legacy G ift in more detail below. Through a bequest or legacy in your Charitable Lead Trusts will, you can make a generous gift with­ Charitable Gift Annuity Unlike the charitable remainder trust, out reducing your current income. The You can make a significant contribu­ the charitable lead trust provides initial bequest could take the form of a special tion to ABC and receive cash flow and tax benefits to the charity and then makes fund in your name or in memory of loved benefits by creating a charitable gift annu­ periodic payments to one or more individ­ ones. Charitable bequests are usually fully ity. With as little as $10,000, you can start uals of your choosing for life or for a term deductible from estate taxes. Perhaps you a charitable gift annuity using cash, secu­ of years. Upon termination of the trust, participate in a local or regional founda­ rities, real property, or personal property. the remainder goes back to your estate. tion to assist you with your charitable Through a transfer of yo ur assets, you or a giving. Please consider making ABC one Life Insurance Policy Assign ment beneficiary receive income from the annu­ of your designated charities. ity for a fixed period of time or for your (partial or complete) or Purchase lifetime. Your tax incentives include: A simple way to make a significant gift Contact Financial Profession als • A charitable income tax deduction to ABC is to include us as a beneficiary on and A BC for a portion of the initial gift. your life insurance or to purchase a sepa­ These are just a few creative ways you • A partial or complete bypass of capi­ rate policy for ABC. You can choose to can combine your financial management tal gains tax when you fund the gift purchase a li fe insurance policy and name with yo ur philanthropic goals. Many of with appreciated property. ABC as the beneficiary. For relatively low these allow you to maximize your gift to • An exemption from estate taxes for premiums, you can make a substantial gift ABC while at the same time providing the asset. to ABC in the future. Another possibil­ you with tax savings, income, and other However, there are also certain res tric­ ity is that the growth of your assets or the benefits. For more information, contact tions. Generally, the minimum age for the changing needs of your dependents has your estate planner, tax advisor, or ABC's donor to begin receiving annuity payments left you with an unnecessa ry life insur­ Chief Administrative Officer Wayne is 60. The annuity is determined by using ance policy. If you do have a life insurance Silverman, PhD, at 512-926-4900 ext 120 a percentage payout associated with the policy that you no longer need, please or [email protected]. HG age of the donor (or income beneficiary); consider assigning it to ABC or including -Aileen Truax

12 I Herba iGram 69 2006 www.herbalgram .org ABC News

ABC Launches Second Online Herbal Information Course n October 2005, ABC launched Course Two of its Herbal Information Course. This online training and certification program is available at www.herbtraining.com. The new course is designed for retailers of dietary supplements, multi-level marketing I distributors, anyone who sells herbal products, and those who advise patients. Course Two expands upon the knowledge gained in Course One, which provides an overview of key issues and concepts in the field of herbal medicine. Course Two also serves as a recer­ tification for those who have already taken Course One. (Completion of Course One is the prerequisite for taking Course Two.)

Course Two contains three modules and on specific herbs in to conversations takes approximately six hours to complete...... ,._ -,___ '-~~a _ with customers/clients so they can be Upon completion of all three modules in better informed on what is stated in Course Two, the participant receives a the scientific and medical literature. new certificate identifying him or her as H erbal In fo rmation Courses are $69.95

...,._dda-fnal•okoo)-llk .... - ... ~ . S...... Aha. an Herbal Info rmation Specialist (HIS) -.:IW.-..IIIIIIl.-a!Aww.. olalcllloDy

Retail operations that participate in the Priounl~ or money order or for bulk discounts, online course for its employees may also ·--~-...c~·· contact Janet McCombs at 800-452- I ...... ,... request a formatted press release, which · FC'\~~1••...... ,._1 6854. ABC sponsor members who wa nt can be used to inform the local commu­ to purchase bul k quantities of the course -o-u-c·-~...., ...... "' __ ' should contact Wayne Silve rman, PhD, at nity that qualified providers of credible I'U~lActiMt information on medicinal herbs are avail­ 800-373-7105 or [email protected]. able on premises. H ea lth practitioners can Upon completion of Course Two, T he online course is prov ided by ABC use the program as an additional certifica­ participants will be able to: in conjuncti on with the National Train­ tion to their own professional training and • Eva luate safety informati on on ing Institute (NTI), a division of Virgo continuing education. specific herbs in order to articul ate Publishing. NTI develops and provides "In the current climate of consumers what is stated in the scientific and online traini ng and certi ficati on programs taking more res ponsibility for their own clinical literature. in a variety of industries. Virgo Publishing health, it is imperative that those who • Appreciate the history of the regula­ produces the trade magazines HSR: Health discuss herbs as part of their work be tion of dietary supplements, FDA Supplement Retailer and Natural Products knowledgeable when res ponding to their enforcement, consumer protection, Industry Insider, as we ll as the Suppl yS ide customers and patients regarding science­ and the importance of good manu­ shows and the Focus on the Future trade based information on the herbs that are fac turing practi ces (GMPs). shows and conferences. HG currently being sold in the US market," • Integrate current clinical research -Gayle Engels sa id Mark Blumenthal, ABC Founder and Executive Director. "These courses are designed to help fill that need and help businesses es tablish credibility, build consumer confidence in these products, and help ensure that they will be used Plants, People, and Culture responsibly." The course also clarifies the PLANTS, PEOPLE , AND CULTURE limitations that should be used when The Sc1ence of Ethnobotany The Science of Ethnobotany speaking about herbs in a non-clinical by Michael J. Balick & Paul Alan Cox environment. Part One of Course Two prov ides more Explore how peoples of the Americas, Caribbean, and in-depth information than Course One Southeast Asia used plants for m edicinal and recreational regarding safety, standardization, and purposes, their influence on modern pharmacology, market trends, as well as the legal and and the dangers of destruction of communities and regulatory iss ues that affect consumers environments. Based on the authors' experiences of and the herbal products industry. Part living with these indigenous peoples. ---..,_ Two of Course Two presents additional information on the 29 herbs covered in Course One, as well as information on Call +1-800-373-7107 Elder Berry, which was not covered in Course One. Parr Three of Course Two or email to [email protected] provides sa fety information on many of or order online at the herbs that were addressed in Course www.herbalgram.org One, plus some additional herbs.

www.herbalgram.org 2006 HerbaiGram 69 I 13 ABC News

Garlic Galore from the Gardens by Gayle Engels

n the autumn of 2004, when garl ic was still the International Herb of the Year, ABC staff and interns planted 22 varieties of Allium sativum (see Table 1) that were donated to ABC by Gourmet Garlic Gardens in Bangs, Texas (www.gourmetgarlicgardens. I com). [Related article appears in Herba/Gram #65.] In the summer of2005, when all the garlic tops had turned brown except for a few leaves, staff and interns harvested the garlic and recorded how each species performed in ABC's gardens. For the most part, it was a great harvest and it seemed that soil preparation, sunlight, and proper watering were more important than variety planted, and that harvesting at the correct time is imperative.

Of the two subspecies of ga rlic, the usually has a stronger flavor, stores for a over centuries from the hard-necked type hard-necked type, Allium sativum subsp. shorter period of time, and grows better in through a process of selection. It has a ophioscorodon, is the origi nal ga rl ic from colder climates. Soft-necked garlic, Allium mi lder flavor, stores longer, and grows which all others have hybridized. 1 It sativum subsp. sativum, was developed better in warmer climates. Soft-necked varieties, especially the Artichoke group, are the garl ic most often available at ABC Employee Profile: Nate Sponseller grocery stores because they are easy to grow, make large heads with numerous ne of the most unique aspects of ABC is the beautiful 150-year-old home­ cloves, and store well. I stead, located on a 2.5 acre hillside that is the remnant of what once was Austin, Texas, where ABC is located, 0 a 451-acre land grant from the Republic of Texas in the early 1840s, when is in USDA Hardiness Zone 8b where Texas was a fledgling country {some people think it still is!) . the average minimum winter tempera­ This historic homestead contains 13 herbal theme gardens as well as native, fruit, rure is between 15"F and 20"F. Austin has and medicinal trees, plus a fountain, pond, state-of-the-art greenhouse, rainwa­ relatively mild winters most years and it ter collection system, and more. Obviously, someone has to tenderly manage these rarely gets below freezing, so we expected gardens and trees. ABC is indeed fortunate to have Nathanael (Nate) Sponseller the soft-necked varieties to produce much serving as the chief gardener, responsible for coordinating all major aspects of garden better than the hard-necks; this did not and grounds maintenance. prove true. When harvested, the bu lbs Nate's primary job priorities are to keep the were smaller and had fewer cloves than plants alive and help them thrive, and to keep the expected. We suspect that there were a property as safe and tidy as possible at all times. couple of reasons for this. First, the cu li ­ Nate's critical responsibilities include the following nary and human systems gardens, in tasks: producing compost, fertilizing and water­ which the soft-neck garl ic was planted, ing all plants, trimming and pruning the plants, do not get as much direct sun for as mowing and trimming grassy areas, maintain­ long a period as do some of ABC's other ing all garden tools and equipment, maintaining gardens. Also, the soil in these gardens is the rainwater collection system including pumps not as loose and rich in organic matter and filters, and maintaining all greenhouse equip­ as some of the other gardens. In prepara­ Sponseller ment. Nate also maintains relations with the local tion for planting garlic in fa ll 2006, we community through his participation in the annual trimmed the trees and added compost to Sunshine Community Garden Sale, which is co-sponsored by ABC. these gardens. Nate is also the key interface and instructor between ABC and the volunteers and We planted many more hard-necked interns who work in ABC's extensive herb gardens. Many of ABC's dietitian and phar­ varieties of garlic than we did soft-necked macy interns, along with AmeriCorps and other community service volunteers, have (see Table I). Some were planted in gardens never grown plants, including many common vegetables, until they work with Nate. with similar soil and su n conditions as Nate's job requires a working knowledge of the special care needed for many differ­ the soft-necked varieties discussed above. ent types of plants (some like lots of water and some don't; some need lots of sun and Of the varieties planted in ABC's culi­ some prefer shade, etc.). His job also requires him to be exposed to the elements. He nary gardens, the Persian Star, Xian, and is outside in the blistering Texas summer sun, and during those few days or weeks of Sonoran varieties produced best with large potentially bitter cold in the winters, he is outside to ensure the protection of many firm bulbs, and the Shantung Purple and of the tropical and temperate plants (many are potted and brought into the New Chinese Pink were second with medium­ Hope Greenhouse to weather the winter, but obviously those rooted in the ground sized bulbs. require special care). Garlic production in the ABC vegeta­ Nate is a gifted and skilled person, covering many different tasks. He approaches ble garden supports our theory regarding his job with an attitude of cheerfulness and flexibility that makes him not only a the importance of soil composition and great asset to ABC but also a fun and friendly co-worker. HG sunlight. The soi l in this garden is very -Mark Blumenthal loose as it has been intensively worked by the method of double digging, has

14 I Herbai Gra m 69 2006 www. herba lgram.org ------~l__ A_B_CN_e_ws __ J~------been amended multiple times with good as they wanted. We set aside some to Reference compost and manure, and gets close to plant this fall. We lea rned some impor­ I. Anderso n R. A Garlic O verview. Gourmet eight hours of direct sun each day. All tant lessons. If Mother Nature cooperates, Garlic Gardens. Ava il abl e at: www.gourmer­ fo ur varieties of ga rlic planted in this next summer should witness an even more ga rlicgardens.com. Accessed November 30, 2005. garden (Metechi, Siberi an, C hes nok Red bountiful harvest for one of our favorite and Romanian Red) did very well and healthy, fl avorful crops. HG produced large heads with many cloves. Romanian Red was also planted in the Fi rst Aid G arden where the soil has not Table 1. Allium sativum Varieties Planted in ABC Gardens been worked as intensively and which only Subspecies ophioscorodon (Hard-necked) Artichoke varieties (Asiatic and Turban gets afternoon sun. It produced very small Purple Stripe varieties groups) scallion-like plants with no heads or indi­ Metechi (Vegetable Garden) Shantung Purple (Chinese Culinary Garden) vidual cloves. Siberian (Vegetable Garden) Xi an (Southeast Asian Culinary Garden) O ne las t thing that did not affec t the Chesnok Red (Vegetable Garden) Chinese Pink (Chinese Culinary Garden) Persian Star (Middle Eastern Culinary Garden) size or number of ga rli c heads that we Sonoran (Southeast Asian Culinary Garden) Purple Glazer (French Culinary Garden) harves ted, but did affect its storage ti me, Silverskin varieties (Creole group) Vekak (Antioxidant Garden) Burgundy (Antioxidant Garden) was the time of harvest. Garl ic should be Porcelain varieties Ajo Rojo (Mexican Culinary Garden) harves ted when all but a few of the leaves Romanian Red (First Aid and Vegetable Creole Red (French Garden) have turned brown. We didn't harvest Gardens) Spanish Morado (Mediterranean Garden) some of the garlic until all the tops had Georgian Crystal (Circulatory System Garden) Subspecies sativum (Soft-necked) died down. This res ulted in ga rl ic heads German Extra Hardy (Respiratory System Artichoke varieties with no protective papery husks and dirt Garden) California Early (Circulatory System Garden) Music (Excretory System Garden) between the cloves, which shortens the Inchelium Red (Indian Culinary Garden) amount of time that it will store well. Silverskin varieties Nootka Rose (Excretory System Garden) O verall, we were satisfied with our Mother of Pearl (Respiratory System Garden) harves t. We had plenty of garlic for staff, volunteers, and interns to have as much

www.herbalgram.org 2006 HerbaiGram 69 I 15 ABC News ------~l------J~------American Botanical Council Receives Inaugural Weil Foundation Grant he American Botanical Council (ABC) has been selected to receive one of the inaugural grants by the newly-formed Wei! Foundation. The Wei! Foundation was established earlier this year by Andrew Wei!, MD, best-selling author and pioneering T educator in integrative medicine. The other three grants went to university programs and teaching hospitals. "We are pleased to be able to provide this support to fo ur outs tand ing organizations," sa id D r. Wei! , chairman of the Foundation board. "Their pioneering wo rk will help to create a healrhcare sys tem that fully recogni zes the natural hea ling capacity of human beings, emphas izes prevention above trea tment, ensures appropriate use of both conventional and altern ative therapies, and makes doctors and patie nts true working partners."

ABC received $5,000 toward the cost and are honored to receive its support, rive medicine through grant-making and of completing H ealrhy Ingredients, an sa id Wayne Silverman, PhD, ABC's C hief other activities. T he Foundation seeks to online database of plants and other ingre­ Administrative Officer. "Healrhy Ingredi­ improve the training of phys icians, nurses, dients used in supplements, cosmetics, and ents is a pri me example of ABC respond­ pharmacists, and allied hea lth profession­ body care products. T here are currently ing to the needs of the natural product als; educate the public about hea lth, heal­ 130 ingredient overviews in the database. community to present simple ye t science­ ing, and lifestyle; reform public poli­ H ea lthy Ingredients, based information," Silverman continued. cies governing hea lthcare and the prac­ geared to consumers T he Wei! Foundation is a nonprofit tice of medicine; and expand and deepen and hea lrhca re and 50l (c)(3) organization supporting integra- resea rch in integrative medicine. HG industry profession­ als alike, provides an overview of each ingre­ dient, including: ABC to Host ''American Botanical Celebration" • Descriptions of in Anaheim pla nts, incl uding native growth Weil by Aileen Truax regions; n the evening of March 23, 2006, the American Botanical Council • Historical and (ABC) will host the first ''American Botanical Celebration" in ·appre­ current uses of plants and parts used; ciation of its Sponsor Members and Advisory Board Members. These • Clinical studies and other scientific 0 members provide critical support for ABC's non-profit educational programs. research; and The Sponsor Members are among the leading companies and organizations from • Market outlook, sustainabiliry, and future commercial growing. around the world in the herb, phytomedicine, dietary supplement, and natural The Wei! Grant will also be used to products industries, and the Advisory Board members represent some of the lead­ continue the development of ABC's Li tera­ ing experts in the various scientific fields related to herbal medicine, phytotherapy, ture Database, a searchable reference cata­ ethnobotany, and allied disciplines. log of journal articles and other printed Featured speakers at the banquet will include two world­ materials pertaining to medicinal plants renowned experts in herbal medicine: Dr. James A. Duke, and the science behind their use. T he an economic botanist and author formerly with the United system is used internally fo r ABC staff States Department of Agriculture for over 30 years, and Profes­ members and writers. Support will permit sor Norman R. Farnsworth, a distinguished pharmacognosist the system to be updated and will improve and Senior University Scholar at the University of Illinois at the functionality of the system. Chicago. Dr. Duke and Dr. Farnsworth are both founding "ABC deeply appreciates the Wei! Foun­ board members of ABC. ABC will present its first annual Botan­ dation's confidence in and support of ical Excellence Awards to a key researcher or herbal educator for contributions to herbal medicine and to the author or authors of our nonprofit educational ac tivities ," sa id Duke ABC Founder and Executive Director a distinguished book on herbal medicine. ABC Board of Trustee Mark Blumenthal. "For ove r 30 years D r. members will also convene in Anaheim for their regular quarterly meeting. Wei! has been a pioneer in educating the The banquet will be held in Anaheim, CA, in conjunction with New Hope Natu,. public in the role that natural foods and ral Media's Natural Products Expo West, Nutracon, and Supply Expo conferences. beneficial herbs can play in modern self­ The American Botanical Celebration is being sponsored by Spectrum Organic ca re and healthcare, and his work clea rly Products·, Unigen Pharmaceuticals, and New Hope Natural Media. ABC attends refl ects the miss ion of ABC." and exhibits at Expo West each year and is grateful to New Hope for assistance in ''ABC has had a long relationship with organizing this event. Drs. Farnsworth and Duke will also be featured speakers at Andrew Wei! , his colleagues, and one the Nutracon conference. of the programs that he founded, the For more information about the event or Sponsor Membership, please contact Program in Integrative Medicine at the ABC Chief Administrative Officer Wayne Silverman, PhD, at 512-926-4900 (ext. University of Ari zo na. We applaud the 120) or via e-mail at [email protected]. HG formation of this chari table foundation

16 I HerbaiGram 69 2006 www.herbalgram.org ------~~rganization New~~------

OCOM Gives First Clinical Doctoral Degrees in Acupuncture and Oriental Medicine by Courtney Cavaliere he Oregon College of Oriental Medicine (OCOM) conferred the first clinical doctoral degrees of acupuncture and Oriental medicine ever awarded in the United States. The degrees were given to 19 students on July 10, 2005, at the college in Port­ T land, OR.1 OCOM offers its 1,228-hour doctoral students into such a prog ram. not require the prior acquisition of lower­ program in a unique modular format Bigg said more institutions are li kely level degrees. HG over ex tended weekends every 4 to 5 to offer post-graduate doctoral programs weeks, enabling students to complete the in acupuncture and Oriental medicine in References 26-month program while maintaining the nea r future. "We have more and more I . Oregon College of Oriental Medicine ro ac upuncture practices either in or outside schools that are seeking approva l for the grad uate first cli nica l docrors of ac upun c­ of Portland. T he teaching modules fea ture post-graduate cl inica l doctoral program," ture and Oriental medi cine in rhe United Stares; first nineteen students to receive th eir didactic and cl inica l materi al, whic h Bigg said. "T here are a number of schools degrees July I 0, 200 5 in Portl and [press students supplement with outside cl ini­ that have doctoral programs in develop­ release] . Portla nd: Business Wire Web sire ; cal experience, profess ional development ment." June 28, 2005. Ava il abl e at: http://home. courses, and capstone research projects. Bigg said ACAOM is now developing busi nesswire.com /portal/s ire/home/index . The program also includes a manda­ sta ndards fo r a fi rst-professional doctoral jsp. Accessed July 25 , 2005. tory 6-week internship at university-affili­ degree in acupuncture and Oriental med i­ 2. Doctoral Program. Oregon College of ated hospitals and outpatient clinics m ci ne. First-professional doctorates diffe r Oriental Medi cine Web sire. Avail abl e ar: C hina. 2 fro m post-graduate clinical doctorates in http: / /www.oco m.edu/ doctoralptogram/ index.hrml. Accessed September 15, 2005 . "We hope that our graduates will be that they are the firs t and only degrees even better equipped to treat complex, needed for practice of a profession and do chronic cond itions after completing the program," sa id Kimberly Schauer, communications director of O COM (e­ HerbDay 2006 Scheduled for October 14th mail, August 31, 2005). "Students receive advanced instructi on in ac upuncture tech­ Events Planned to "Celebrate Herbs and Herbalism'' niques and additional training in C hinese group of five national nonprofit herb organizations has formed a coali­ herbal medicine. Also, the program is ion to present the first annual HerbDay. The HerbDay Coalition is designed to provide tools for practitioners omposed of the American Botanical Council (ABC), the American who wa nt more involvement in resea rch Herbalists Guild (AHG), American Herbal Pharmacopoeia (AHP), American and teaching of Chinese medicine. We are Herbal Products Association (AHPA), and United Plant Savers (UpS). The five training the future leaders of the indus­ try." organizations are working together to present the first annual HerbDay on According to D on Bigg, executive Saturday, October 14, 2006-and you are invited! director of the Accred itation Commis­ HerbDay is a coordinated series of public educational events celebrating the sion for Acupuncture and O riental Medi­ importance of herbs and herbalism through harmonized, independently planned cine (ACAOM), the post-graduate clini­ activities that will occur on October 14, 2006, or during the week leading up to cal doctorate in ac upuncture and O rien­ that date. The activities will occur at botanical gardens, parks, and retail srores tal medicine is a brand new degree, and throughout North America. HerbDay activities will be designed by each host­ standards fo r such doctoral programs ing venue, which will have broad latitude in selecting its own events, such as the were only recently developed by ACAOM following: lectures and workshops by well-known herbalists; herb walks; in-store (D. Bigg, oral communication, Septem­ cooking demonstrations featuring herbs and spices; seasonal herbal handcrafts; in­ ber 2005). Schools have to go through store herbal beauty product demonstrations; presentations by herb company repre­ a lengthy process proving they have the sentatives; and activities with herbal themes for children. in fras tructure in place to support such Members of ABC, AHG, AHP, AHPA, and UpS who want to participate in doctoral programs before they ca n offer HerbDay are invited to visit www.herbday.org to review the initial menu of ideas them, wh ich is why O COM is 1 of only that the HerbDay Coalition has developed. This Web sire will be utilized as the 6 colleges currently approved by ACAOM primary location for organizing and disseminating information about HerbDay to offer pos t- graduate clinical doctoral activities and for downloading educational resources. A registration feature will be programs in acupuncture and O riental added in the near future, so that you will have an opportunity to tell others what medicine. Schauer said OCOM was one you are planning to do to join the herbal celebration! Contact any of the offices of the first colleges approved by ACAOM of the Coalition partners to participate or contact ABC at [email protected] or to begin a doctoral program in 2002, 512-926-4900. HG and it was the firs t coll ege to matriculate www.herbalgram .org 2006 HerbaiGram 69 I 17 Organization News

Dan Church Selected as Bastyr University's New President by Courtney Cavaliere

astyr University, the nation's largest accredited teaching facility for natural medicine, located in Kenmore, WA, has selected Daniel K. C hurch, Ph D, to serve as the university's new president. Church began his tenure as president on September 1, B2005. 1 "I was drawn ro Bastyr University Church served as General Secretary and According to Daley, Church's background because of its unique mission and its excel­ CEO of the General Council on Minis­ and skills strongly qualify him for the job lent faculty and staff," Church stated (e­ tries of the United Methodist Church as university president. "He's very bright mail, August 30, 2005). "Bastyr Univer­ before joining Bastyr. His previous career and articulate," D aley said. "I think he'll sity is not content to experiences also include leadership of the work well with faculty and others at the merely pass on the nonprofit Edwin Shaw Hospital in Akron, institution. I think he was a very good accumulated knowl­ Ohio; 10 years as a tenured professor choice." edge of earlier genera­ .t ii. at Seattle Pacific University; and several Bastyr, founded in 1978, offers academic tions but is committed ~,,' ~~~ ...- years on the executive administration degree programs in naturopathic medi­ ro credible research team at Malone College in Ohio. 1 cine, acupuncture and Oriental medicine, which tests the efficacy Church replaced Thomas Shepherd, nutrition, herbal sciences, hea lth psychol­ of natural health inter­ DHA (Doctor of Health Administration), ogy, exercise science and wellness, and ventions and pioneers ~ ' as Bastyr University president. Shepherd applied behavioral science.3 Students can the development of Churc h left Bastyr University in the fall of 2004 earn bachelors, masters, and/or docroral new approaches." and moved to the East Coast ro be closer degrees in various fields or participate in Kathleen Warren, direcror of media ro his family. 1 He is now serving as execu­ certificate programs.4 Statistics for 2002- and community relations at Bastyr, said tive vice president of DeVry Inc. and presi­ 2003 show over 1,000 students attend­ the university's selection committee chose dent of Ross University, which has admin­ ing Bas tyr,S which occupies 50 acres of Church because they wanted a new presi­ istrative offices in Edison, New Jersey.2 land on the shore of Lake Washington, dent with experience as a CEO, as well While Bastyr University searched for 10 miles north of Seattle. The 186,000 as experience in the fields of health care Shepherd's replacement, John Daley, PhD, square-foot facility, built in 1959 as a and academia (oral communication, July acted as interim president (]. Daley, oral Catholic seminary, includes classrooms, 2005). "He had all of those in his back­ communication, August 2005). Daley was lab and research facilities, an extensive ground," Warren said. "He also has Seat­ the university's executive vice-president library, and dormirory space.G HG de roots, which is important for a small for 10 years and executive vice-president/ community like Bastyr, especially when provost for one year. Daley postponed it comes to fundraising. That was sort of his retirement to serve as the universi­ References icing on the cake." ty's temporary president for nine months. I. New President of Bastyr University Brings CEO, Higher Education and Healrh Care Experience [press release]. Kenmore: Bastyr ,___,_ University; July IS, 2005. ___ 2. Ross University Administration page. Ross n."-'t.- ...... C_. TH£ ABC FREE! Continuing University Web site. Available at: hrrp:/ I CLINICAL www.rossver.edu/Vererinary _School/ Admin­ education credits isrra rion/adminisrrarion.hrml. Accessed 1iERBS September I, 2005. 3. Bastyr University: Academic Progra ms. for Physicians through Bastyr Un iversity Web sire. Available at: hrrp: / /www.bastyr.edu/academic/ profiles/. Accessed September 9, 2005. The ABC Clinical 4. Bastyr University: Core Programs. Bastyr University Web sire. Available ar: hrrp:// www.bastyr.ed u/abour/co reprograms.as p. Guide to Herbs Accessed September 9, 2005. 5. Bastyr University: Viral Statistics. Bastyr Regularly $69·95 ecently updated, this indispensable reference book also University Web sire. Available ar: hrrp:// Member Price Roffers CE credits for Dietitans, Nurses, Naturopathic www.bastyr.edu/a bour/viral_srars.asp. Physicians and Pharmacists. Accessed September 9, 2005. $34·98 6. Bastyr University Admissions: Student Join ABC as a member today and receive 50% off the regular Life. Bastyr University Web sire. Available price of the Guide and other publications from ABC. at: hrrp:/ /www.bastyr.edu/admissions/ www.herbalgram.org srudendife/. Accessed September 9, 2005. 800-373-7105 ext. 118 or 512-926-4900 ext. 118

18 I Herbal Gram 69 2006 www.herbalgram .org ------4l Grants & Awards J~------Farnsworth Honored with ASP Research Achievement Award by Courtney Cavaliere orm an R. Farnsworth, PhD, was recently awarded the American Society of Pharmacognosy's (AS P) Research Achievement Award. T he award was bestowed upon D r. Farnsworth during ASP's 46th annual meeting, held July 23-27, 2005, in Corval­ N lis, O R.1 Professor Farnsworth is a world­ he is rhe director. Dr. Farnsworth's speech can Sociery of Pharmacognosy Web renowned pharmacognosist and director will likely be published in rhe March 2006 sire. Ava il able ar: h rrp: / /wW\v. ph cog. of rhe Program for Colla bora rive Research iss ue of ASP's official journal, rhe journal org/A nnuaiM rg/2005/Highlighrs.hrml. in the Pharmaceutical Sciences ar rhe ofNatural Products.4 Accessed October 7, 2005. 2. Hunr L. Farnsworrh named distin­ University of Illinois ar Chicago (UIC), According to Or. guished professor ar University of Illinois. a multidisciplinary program he es tab­ Farnsworth, one of HerbalCram. 2001;No. 53: 16. lished in 1982 . He is also a UIC distin­ rhe benefits of work­ 3. ASP Research Achievemenr Award. guished professor, research professor ing wirh narural prod­ American Sociery of Pharmacognosy Web of pharmacognosy, and senior resea rch ucts is rhe relative sire. Ava il able ar: hrrp://www.phcog.org/ scholar ar UIC. 2 speed ar which trear­ awards/res_ach.html. Accessed October 7, "When yo u receive an honor from yo ur menrs can be devel­ 2005. 4. Farnsworrh N. A New Paradigm in peers like rhis one, it's much more mea n­ oped, in comparison Pharmacognosy Research- Botani- ingful than other things," Dr. Farnsworth to pharmaceutical Farn sworth cal Dietary Supplemenrs. Power-poinr said of rhe award (o ral communication, drugs. "Most research- presenred ar: 46rh Annual Meering of the September, 2005). "Also, rhis wi ll be rhe ers wi ll never see rhei r work pur inro use American Sociery of Pharmacognosy; July first rime a pharmacognosist has gorren in humans," he sa id (o ral communication, 23-27, 200 5; Corvalli s, OR. rhe award after 18 years. That was kind September 2005). "In rhe work we do, we of nice." He was referr ing to rhe facr rhar ger to complete all rhis research and ir's in alrhough ASP was originally founded (by the cli nics now, already helpi ng people." Farnsworth, rhe !are Varro E. Tyler, and Dr. Farnsworth sa id one of his proud­ Save the Date! several others) to promote pharmacognosy, est accomplishmenrs is rhe invenrion of Thursday, March 23, 2006 in recent years much of ASP's focus has NAPRALERT in 1975. NAPRALERT 7:00 to 10:00 pm drifted towards natural products chem is­ is rhe world's largest database on natural Anaheim, California try and marine biology, borh important products, featuring information on rhe sources of new medicinal agents. erhnomedical or rradirional uses, chem­ ASP has selected a recipient for irs istry, and pharmacology of medicinal research awa rd annually since 1985. Candi­ pl anrs, microbes, marine organisms, and dates for the award-which includes an fungi. Prof. Farnsworth is also co-found­ honorarium of$5,000-must be members ing editor of rhe journal Phytomedicine of the society who have made signifi­ and a fo unding member of rhe American cant contributions to research on natural Botanical Council's Board of Trusrees. 2 producrs.3 The ASP Research Achieve­ He has received honorary doctorates from ment Award has been renamed in honor rhe University of Paris, Upsalla University, of Dr. Farnsworth, who is also a former and the Massachusetts College of Phar­ president of ASP. All subsequent awa rds macy and Alli ed Health Sciences. will be titled rhe Norman R. Farnsworth "Norman Farnsworth is like a force Resea rch Achievement Award in Natural of nature," sa id ABC Fo under and Exec­ Products ( . Farnsworth, e-mail, Octo­ utive D irector Mark Blumenrhal. "His ber 11 , 2005). vast volume of work is known and he is Dr. Farnsworth delivered a speech respected by almost every medicinal planr ar ASP's awards banquet titl ed "A New researcher in rhe world. Not only has Paradigm in Pharmacognosy Research­ he prolifically authored or co-authored Botani cal Dietary Supplements." In hi s over 1,600 research papers, he has also speech, he encouraged further research produced over 90 doctorates and 20 post­ and resting of natural products, particu­ doctoral fellows in his career. There is larly botanical dietary supplements, as no one in rhe medicinal pl anr research Featured speakers include Dr. James Duke trearmenr for a wide variety of medical community-anywhere-who is more & Or. Norman Farnsworth conditions. H e spoke of recenr clinical deserving of rhis recognition," Blumenrhal For more information about the event trials in rhis field, as well as rhe various added. HG or Sponsor Membership, please contact ABC Chief Administrative Officer works being performed by such groups Wayne Silverman, PhD, at 512-926-4900 or as rhe U IC/NIH Cenrer for Botanical References [email protected] Dietary Supplemenrs Research, of which 1. ASP 2005 Meeting High li ghts. Ameri- www.herbalgram.org 2006 HerbaiGram 69 I 19 ------il Grants & Awards J~------

CRN Honors Industry Experts at Annual Conference he Council for Responsible Nutrition (CRN), a leading trade association in the dietary supplement industry, awarded its prestigious "CRN (Steuben) Apple" to three prominent dietary supplement executives during a ceremony on September 25, T 2005, at CRN's annual symposium on dietary supplements in Indian Wells, California. The 2005 "CRN Apple" recipients are Edward Croom, PhD, consultant for scientific and regulatory affairs at lndena; Joy Joseph, formerly of Pharmavite LLC; and John Hathcock, PhD, of CRN. The "CRN Apple" award is presented annually by CRN in recognition of an individual's dedication, commitment, and service to the organization and the dietary supplement industry.

Dr. C room, an erhnoboranisr and one of the industry's lead ing forces in creat­ and develops C RN policy positions, and pharmacognosist, began working with ing standards by which all dietary supple­ spea ks on international regulations and CRN as an independent scientific advi­ ments are now measured. She intends to issues, including those pertaining to the sor and was instrumental in helping C RN remain active in industry affairs, main­ Codex Alimentarius and the European form a botanicals committee by se rving as taining a consultancy with Pharmavite, Commiss ion. He se rves as staff liaison for committee chair. As manager of scientific and serving as chair of the Dietary Supple­ the CRN International Trade and Marker and regulatory affairs for lndena USA (a mems, Nonbotanicals Ex pert Committee, Development Committee, and is well ­ division of lndena, the large Milan, Italy­ and as a member of the Council of Experts known for his opinions on the "precau­ based worldwide supplier of standardized Executive Committee. tionary principle." Prior to joining C RN, botanical extracts), he was also elected For the past 10 years, John Hathcock, Dr. H athcock served at the Food and to the CRN Board of Directors. A long­ PhD, has served as vice president for scien­ Drug Administration where he worked in rime advocate of improved quality control tific and international affairs at CRN. areas related to food safety. for botanicals as well as more ri gorous He is responsible for scientific review More information about CRN is ava il­ substamiation of claims, Dr. Croom is an and regulatory interpretation, specializ­ able on its Web sire at www.crnusa.org. HG expert in applying the science of natural ing in safety and international iss ues. In -Mark Blumenthal products to enhance human health. Dr. addition to publishing numerous peer­ Croom has served as an advisor for many reviewed scientific articles, he is the author Source: Industry expertS honored at CRN government agencies in the United States of CRN's Vitamin and Mineral Safety. 2005 Annual Co nference [p ress release]. and Canada, including the N IH Office Dr. Hathcock regularly presents at major Washington, DC: Council for Respo nsibl e Nutrition, September 26, 2005 . of Dietary Supplements, the US Food national and international conferences on and Drug Administration, the Cana­ foo d sa fety and regulatory iss ues, analyzes dian Natural Health Products Director­ ate, and the World Health Organiza­ tion. He was a research scientist with Aloe Leaders Honored with International Aloe the Resea rch Institute of Pharmaceutical Sciences and Pharmacognosy Department Science Council Hall of Fame Award in the School of Pharmacy at the Univer­ by Courtney Cavaliere sity of M iss iss ippi from 1982-2000. He currently is an adjunct associate profes­ prominent aloe researcher and a distinguished aloe industry professional were sor of Pharmacognosy at the University of Mississippi, consultant for scientific and both honored with Hall of Fame awards from the International Aloe Science regulatory affairs for Indena, a member A Council (IASC) during IASC's 24th Annual Scientific Seminar, held Septem­ of the CR Senior Scientific Adviso ry ber 10-11, 2005, in South Padre Island, Texas. Akira Yagi, PhD, research director at Council, and a longtime member of the the Placenta-Aloe Research Institute of the Japan Bioproducts Industry Co., Ltd, and Advisory Board of the American Botani­ Gene Hale, managing director of IASC, both received the award. 1 The modern aloe cal Council. industry is based on the gel of the aloe vera plant (Aloe vera [L.] Burm. f. , Liliaceae, After 25 yea rs with Pharmavite, a lead­ syn. Aloe barbadensis Mill.) and should not be confused with "drug aloe," the latex ing producer of dietary supplements in the from the insides (parenchym) of the leaf of A. ferox, used traditionally as a stimulant mainstrea m market, Ms. Joseph recently laxative ingredient. retired from her position as vice president of quality, technical operations, and prod­ Dr. Yagi, who is also an emeritus erties of verectin (a glycoprotein fraction uct development where she directed and professor at Fukuya ma University in of aloe vera), a name coined by Dr. Yag i. supervised the company's quality contro l Japan, sa id rhe H all of Fame award is Verecrin acts li ke a lectin, stimulating laboratori es, research and development of particularly meaningful to him because the production of human dermal cells, test methods, and new product develop­ he is one of the few academic researchers anti-oxygen activity, and cyclo-oxgenase ment. She has been involved with CRN working outside an aloe company to have activity (COX-1). H e is currently study­ for more than 20 years and has worked on received the recognition (A. Yagi, e-mail, ing hi gh molecular weight polysaccha­ numerous committees, including Quality November 3, 2005). Dr. Yagi received ride fractions of aloe vera gel, which have Standards and GMP Readiness Working IASC's Yun Ho Lee award in 1997 for his demonstrated strong activity in treating Group. C RN believes that Ms. Joseph is research on the immune- boosting prop- burns and wounds.

20 I HerbaiGram 69 2006 www. herbalgram .org ------~l Grants & Awards J~------

"Dr. Yagi has devo ted much of his life's beverages, which are regulated in Japan in Reference work to significant aloe research and a special category called FOSHU, "foods I. lASC Hall of Fame awards issued at 24th has been influential in helping represent with other special health uses ." HG annual scientific seminar [press release]. the International Aloe Science Council Boulder, CO: Westfall Communications, throughout the world with his unprec­ In c; October 13 , 2005 . edented dedication and education on the medicinal value of aloe," said Mick Ander­ Brian Berman Receives 2005 Bravewell son, vice president of business develop­ ment at Aloecorp (the world's largest Leadership Award supplier of aloe vera ingredients) and IASC Chairman of the Board.1 "He has by Courtney Cavaliere grearly assisted the IASC and the aloe industry in propelling this exceptional rian Berman, MD, founder and director of the Center for Integrative Medicine ingredient to the forefront of science." at the University of Maryland, was awarded the 2005 Bravewell Leadership Hale's distinguished career in the aloe BAward from the Bravewell Collaborative on November 10,2005. The $100,000 industry spans over 36 years and includes award was presented to Dr. Berman at a benefit dinner in New York City, hosted by positions at Aloecorp, AVA Cosmet­ Sarah Ferguson, Duchess ofYork.1 ics, Aloecorp's subsidiary company Dr. Berman, who was 1 of 5 finalists Dr. Berman's team is also conduct­ Naturchem, and IASC (G. Hale, oral nominated for the award, sa id he was ing a long-term, follow-up study on the communication, November 2005). "I surprised and honored to be the chosen cost-benefits of acupuncture, utilizing the was absolutely taken aback," Hale said of recipient (oral communication, Novem­ same cohort of 570 patients featured in receiving the Hall of Fame award. "I was ber 2005). "I think integrative medicine is his groundbreaking study of acupunc­ very honored to be given that recognition finally starring to get recognized, and for ture efficacy published in the December and pleasanrly surprised." me to be recognized in this field is a great 2004 issue of the Annals of Internal Medi­ According to the American Botani­ boost," he said. cine.2 H e is also pursuing a study on the cal Council's Founder and Executive The Bravewell Collaborative, estab­ treatment of rheumatoid arthritis through Director Mark Blumenthal, the award lished in 2002, is a group of 29 philan­ mindfulness-based stress reduction. is well-deserved: "Gene is synonymous thropists committed to supporting the "I think we all reali ze that conventional with the development of the modern aloe growth of integrative medicine.1 The medicine does n't have all the answers," vera industry, having served for over two Bravewell Leadership Award is given bian­ Dr. Berman sa id. Many people are turn­ decades as the main source for science and nually to a recipient chosen by the group's ing instead to integrative medicine, he market information on this commercially selection committee. explained, which offers a variety of ca re important herb" (M. Blumenthal, e-mail, Dr. Berman is renowned for his dedica­ options and reaffirms the relationship October 14, 2005). tion to and promotion of integrative care, between doctor and patient. "It involves Both award recipients commented on his influential research studies, and his looking at mind, body, and spirit-the the growing importance of aloe research clinical work with patients. He is currently whole person-and purring the patient at and of the aloe industry. "The aloe indus­ pursuing several research interests, many the center of care. The Bravewell Collab­ try is perhaps one of the most unique of which have recently received major orative reall y wants to promote this type industries around," said Hale. "Aloe vera funding (B. Berman, oral communica­ of approach and make it the mainstay of has been known for a long time but only tion, November 2005). He was awarded care in this country," Dr. Berman sa id. over the past 15 to 20 years has it come a grant from the National Center for More information on the Bravewell into its own." According to Hale, it was Complementary and Alternative Medicine Collaborative can be found at http://www. during these pas t several years that infor­ (NCCAM) of the National Institutes of bravewell.org/. HG mation on the effectiveness of aloe began Health in October, totaling approximately to be linked to clinical studies, rather than $4 million, to support an International References to anecdotal stories and folkloric evidence. Cemer for Research of Complementary I. Brian Berman, MD, named recipient of "On our Web site, iasc.org, there are some and Alternative Medicine. This center $100,000 Bravewell Leadership Award for 4,000 pages of referenced studies of what integrative medicine at benefit dinner on intends to study alternative treatments aloe can do," Hale said. Aloe now ranks November 10 in New York City hosted by for irritable bowel syndrome, including among the top ingredients in natural Sarah Ferguson, the Duchess ofYork [press a special 20-herb formula and acupunc­ product formulations, he continued. release]. Pleasa ntville, NY: Kelly & Salerno ture. A second grant from NCCAM, also Dr. Yagi, meanwhile, pointed to aloe's Communications; November II, 2005 . awarded in October and totaling nearly growing significance within Japan. 2. Berman BM, Lao L, Langenberg P, Lee $6 million, is funding the study of an 11 - WL, Gilpin AM, Hochberg MC. Effective­ General acknowledgment of aloe vera's herb formula known as HLXL, which is ness of acupuncture as adjunctive therapy health benefits has encouraged many intended to treat arthritic conditions. The in osteoarthritis of the knee: a randomized, American aloe vera companies to open gram also allows Dr. Berman's team to controlled trial. AnnaLs of InternaL Medicine. branches in Japan, and some Japanese 2004; 141: 12:901-10. Available at: http:/ I further explore the mechanism of action citizens have even begun to incorporate www.a nnals.o rg/cgi/reprint/141/12/90 !.pdf of acupuncture. aloe vera daily into their diets via health Accessed November 30, 2005.

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Mount Diablo Buckwheat Rediscovered American Ginseng by Courtney Cavaliere Root Smugglers are wildflower, last spotted in 1936 and long considered extinct, was cedis­ Caught Off China overed on May 10, 2005, in a remote corner of California's Mount Diablo tate Park.l The flower Eriogonum truncatum, Torr. & A. Gray, Polygonaceae, Shores commonly known as Mt. Diablo buckwheat, is an annual herb that California conser­ peedboat smuggling kg of vationists struggled to locate for decades. There are only seven prior recorded sightings 1,800 of the plant, which is endemic to the Mt. Diablo region in Northern California. Mt. ' high-quality" American ginseng Diablo buckwheat measures 10-70 em in height and is characterized by white or rose A oots and heading for the Chinese colored flowers, resembling the baby's breath used in floral arrangements. 1 mainland was intercepted by marine police on August 24, 2005. Michael Park, a botanist and graduate Diablo," Park sa id . "We're hoping to raise student at the University of California at the plant in cultivation and find out more According to an article in The Stan­ Berkeley, found the Mr. Diablo buckwheat about it." dard of Hong Kong, the police pursued while compiling an inventory of plants in Mr. Diablo contains 29 rare or endan­ a convoy of 7 speedboats and intercepted a previously unrecorded section of Mt. gered plant species, 11 of which are one carrying 36 drums full of the highly Diablo State Park for a research project. endemic (limited to a certain region) ­ prized American ginseng (Panax quin­ Park said he was active ly looking for the including the Mr. Diablo buckwheat. Mt. quefolius L., Araliaceae). The value of the buckwheat but did not expect to find it Diablo buckwheat's rarity is generally roots was es timated at $2.4 million in (oral communication, July 2005). "Some­ attributed to competition with introduced Hong Kong dollars (equivalent to about thing attracted my attention-! don't non-native plants. Moreover, its historic $300,000 in US dollars). exactly remember what-but I put down habitat has been threatened by develop­ Although the article does not specifi­ my backpack and realized I was standing ment pressures in recent yea rs. 1 cally describe the ginseng, presumabl y near Mt. Diablo buckwheat," Park said. Seth Adams, director of land programs the roots were wild American roots, the "My heart leapt because it was so early in for the non-profit organization Save value of which is several hundred dollars the season that I immediately suspected it Mount Diablo, said the rediscovery of Mr. per pound. (Cultivated American ginseng might be the Mr. Diablo buckwheat." Diablo buckwheat has generated increased sells for less than $20 US per pound in the attention to areas where such development United States and is now grown in China, is being considered. Save Mount Diablo where its price is probably lower.) helped preserve the piece of property on There is a fairly high incentive for which the Mr. Diablo buckwheat was the smugglers to try to slip the ginseng found (S. Adams, oral communication, into mainland China, as the quantity of July 2005). "Rare species give us regula­ ginseng seized by the police would have tory support in affecting development been subject to a tax of $580,000 (HK) proposals," Adams said. "This little plant on the mainland, equivalent to about is already affecting development applica­ $75,000 (US). tions in this area." According to the article, smugglers "It's been a highly educational experi­ recently have shifted from electrical ence," Park said of the rediscovery (oral appliances and automobiles to high-cost communication, July 2005). "''m learn­ seafood and herbs. Superintendent Jackie ing a little bit about practical conserva­ Ling, the head of the Police's Small Boat tion-beyond academics now. It's been Division, was reported to have sa id that very exciting!" After graduating from UC the task of intercepting smugglers is diffi­ Mt. Diablo buckwheat Eriogonum truncatum. Berkeley with a doctorate in integrative cult because the smugglers often employ Photo ©2005 Michael Park biology, Park plans to continue working sampans as lookouts. HG as a California botanist. He said the state's -Mark Blumenthal The discovered population consists of interesting geography has led to the gener­ Reference approximately a dozen plants. A small ation of many new species and unique management team was formed to monitor plants worthy of study. HG Ng D. Sea chase nets $2.4m ginseng haul. The Standard (Hong Kong). August 26, 2005. the site, protect the flowers, and collect Reference Available at: http://www.thestandard.com. seeds for future propagation. hk/a rchive_news_detail .as p?pp_cat=&arr_ Park, who serves on the management I. Mr. Diablo Buckwheat Red iscovered id =1 9157&s id =&co n_type= 1&archive _d_ team, said the group is optimistic that it [press release]. Walnut Creek, CA: Save str=20050826. Accessed August 28 , 2005. will achieve some percentage of germina­ Mount Diab lo; May 24, 2005. Avai lab le at: http://www.savemounrdiablo.org/wild­ tion from the collected seeds and success­ flower_rediscovered.htm. Accessed June fully protect the population in the wild. 13, 2005 . "It gives us one more chance to under­ stand a plant that is only found at Mr.

22 I HerbaiGram 69 2006 www.herbalgram.org ------~~esearch &World Ne~~------

Organic Bouquet Initiates Bio-Friendly Flower Trend by Courtney Cavaliere

n 2001, Organic Bouquet pioneered a new segment of the natural products market by becoming the world's first wholesale distributor and online retailer of organically-grown flowers (G. Prolman, e-mail, August 30, 2005). Si nce then, the company, I based in Mill Valley, CA, has catered to a rapidly growing sector of the floral industry1 and served as the official florist of the 2005 United Nations World Environment Day, held in San Francisco from June 1-5, 2005.2

Founder and CEO Gerald Prolman said and the American Humane Association.5 ence, Organic Bouquet organized a his goal in developing Organic Bouquet Holly Givens, communications director symposium, titled "Eco-Flower Power: was to establish a market for high-qual­ of OTA, stressed that all forms of organic Sustainabiliry Trends for rhe Floral Indus­ ity flowers produced through environ­ farming benefit the land and workers try," to educate and engage world-leaders, mentally-sound and socially-responsi ble through nonuse of toxic and persistent journalists, and florists about rhe environ­ methods (G. Prolman, e-mail, June 15, pes ticides. She added that organic flowers mental and social impacts of organic floral 2005). "Consumers have enthusiasti­ positively impact consu mers, as well {ora l producrion.6 cally embraced organic foods, making it communication, June 2005). "What's the "The future of agriculture exists in rhe the fastest growing segment of the retail first thing most people do when they see utilization of sustainable farming practices grocery business," Prolman said. "Now a beautiful rose? " Givens said. "They put that are environmentally sound," Prolman the same environmentally friendly and said. "Organic production systems clearly sustainable approach is being used to lead rhe way to this new standard." grow and sell flowers. Organic Bouquet Prior to initiating Organic Bouquet, is the leader in the new orga nic flower Prolman spent 26 years working in the category." organic foods industry, including service as According to statistics supplied by the president and co-founder of rhe company Organic Trade Association (OTA), sales Made in Nature. Made in Nature, which of organic flowers in the United States Pro! man claims introduced the first line of reached $8 million in 2003, demonstrat­ branded organic fresh produce into super­ ing a 52 o/o increase over the previous year. markets, was sold to Dole Food Company Further, the OTA expects organic flower in 1994 (G. Prolman, e-mail, June 15, sales to grow approximately 13 o/o annu­ 2005) . HG all y through 2008. 1 To meet such expand­ ing market demands, Organic Bouquet contracts with growers in several coun­ References tries, including Holland, Colombia, Ecua­ I. Organic Bouquet. Fast Facts. Organic dor, Mexico, and the United States, for Bouquet press room [Web site]. Available their supply {G. Prolman, e-mail, June 15 , at: www.organicbouquet.com/i_56/Press­ room/OrganicNews/OrganicFastFacts. html. 2005). All of the company's flowers are Accessed July 8, 2005. produced either organically or through 2. United Nations, Together We Can [Web similar sustainable farming methods, si te]. Available at: www.rogerherwecanthe­ such as biodynamic agriculture, green song.org/abour.hrml. Accessed November 7, label practices, or wildcrafting.3 Organic Peru vian Lili es. Photo ©2006 Organic Bouquet 2005. Bouquet's flowers and products are certi­ 3. Organic Bouquet. Organic Bouquet certifi­ fied under various regulating agencies their noses ri ght in it and breathe deeply. cation [Web sire] . Available at: WW\v.organ­ or third-party inspection programs; the It gives me confidence when I know that icbouquet.com/Producr/Cerrificarion.aspx. Accessed July 8, 2005. company's organic products are certified such flowers [e.g., like those produced by 4. Organic Bouquet. Organic Bouquet homep­ by Quality Assurance International, its Organic Bouquet] were grown organica lly, age [Web site] . Available at: www.organ­ biodynamic-labeled products are certi­ and it also gives me comfort to know the icbouquet.com. Accessed July 8, 2005. fied by the Demeter Association, and workers are nor being exposed to pesti­ 5. Organic Bouquet. Organic Bouquet charita­ its sustainable-label products are certi­ cides." ble bouquets [Web site]. Available at: www. fied under the Veriflora Certification According to Prolman, most commer­ organicbouquet.com/ c_2llcharirable_gifrs. Program. cial flowers are grown with a variety of hrml. Accessed November 7 , 2005. In addition to floral arrangements, strong chemical fertilizers, insecticides, 6. Organic Bouquet. Eco-Flower Power: Sustainabiliry Trends for rhe Floral Indus­ the company sells wreaths, chocolates, fu ngicides, nematocides, and plant growth try [press release]. Available at: WW\V. and gifts through its Web site at www. regulators, and these flowers are typically organicbouquer.com/i_l 06/Flower_power_ organicbouquet.com.4 A percentage of the nor inspected for pesticide residues before symposium.hrml. Accessed November 7, proceeds from specific bouquets are even being delivered to consumers {G. Prol­ 2005. donated to charitable nonprofit organiza­ man, e-mail, June 15, 2005). tions, including the World Wildlife Fund At the World Environment Day confer- www. herbalgram.org 2006 HerbaiGram 69 I 23 ------~~esearch & World NewjP------

Gates Foundation Invests $42.6 Million in Malaria Drug Research by Katherine Purcell

n December 2004, the Bill and Melinda Gates Foundation of Seattle, Washington, awarded a $42.6 million, 5-year grant to develop a semi-synthetic form of artemisinin, a highly effective anti-malarial drug. Currently, artemisinin is derived from I the leaves of a traditional Chinese medicinal plant that Westerners often call sweet Annie (Artemisia annua L. , Asteraceae) .1 The Gates Foundation awarded the grant to the Institute for OneWorld Health to fund a partnership among Amyris Biotech­ nologies, OneWorld Health, and the University of California at Berkeley. The goal of the partnership is to create a more afford­ able and accessible semi-synthetic version of the anti-malarial drug artemisinin. The partners are collaborating to manufacture microbes: single-celled bacteria that produce a semi-synthetic version of artemisinin, which is a purified bioactive substance from sweet Annie.

Malaria is a deadly, ye t preventable Development of Semi-Synthetic create artem1Sll1 ln. "We're taking what disease that infects between 300-500 Artemisinin nature does best and linking it to what million people annually, and it claims the chemistry does best. It's the best of both Artemisinin is part of the new class lives of one million Africans each yea r. worlds," Reiling said (oral communica­ of anti-malarial drugs known as Arte­ Most of the malaria-related deaths occur tion, July 2005). misinin-based Combination Therapies to children under the age of five. Accord­ Jack Newman, PhD, co-founder of (ACTs) . 2 ACTs are significant because ing to the most recent World H ealth Amyris Biotechnologies, said that the they have been approved by various inter­ Organization (WHO) figures, 3.2 billion partnership hopes to have this bioequiva­ people living in 107 countries or territo­ national health organizations such as the lent, microbi all y-produced artemisi nin ri es are at ri sk for contracting the illness. 2 WHO and the United Nations C hildren's ava il able for di stribution within 5 yea rs In Afri ca, the countries with the highes t Fund (UNICEF) as the first-line treat­ (o ral communication, February 2005). disease burden also ex perience a 1. 3 % ment for malaria in Africa According to Joanne Hasegawa, associ­ annual reduction in economic growth.3 "It Kinkead Reiling, PhD, co-founder of ate director of communications for the is unacceptable that 3,000 African chil­ Amyris Biotechnologies, sa id that research­ Institute for OneWorld H ealth, "If we dren die every day from a largely prevent­ ers are genetically engi neering microbes to meet our miles tones within that time­ able disease," sa id Mr. Gates in his press produce a chemical precursor of arte­ frame, we will have a regulatory package, release. "Malaria is robbing Afri ca of its misinin, which is then purified from the which includes all the studies necessary people and its potentiaJ."4 microbe and chemically manipulated to to satisfy an FDA or European regul atory

Experts Recommend More Funding to Develop Traditional Herbal Medicines to Treat Malaria n response to an article published in Chemical & Engineering News, 1 botanical expert and ABC Trustee Jim Duke wrote a letter-to-the-editor2 that proposes an innovative approach to mitigate the problems associated with the artemisinin shortages I and the high cost of supplying artemisinin as the first-line drug for treating malaria. In this letter, Duke points out that the Artemisia herb grows abundantly in Maryland, Virginia, and West Virginia, and that the tea of Artemisia would cost less than 20 cents per dose. However, clinical trials are needed to determine the safety and efficacy of the tea. According to Duke, "Any clini­ cal trials for malaria comparing pure artemisinin with placebo should include a third arm, a tea of Artemisia annua (also known as Qing Hao or Sweet Annie), which has been used effectively for millennia for fevers. Until the tea is clinically compared, we cannot be sure that it isn't better or equal or only slightly inferior."2

Duke's letter commended the Gates Foundation for its including: investment in anti-malarial drugs, but asked that the founda­ • Mike Benge, Senior Ago-Forestry Officer USAlD/USDA tion, public health officials, and the pharmaceutical industry Forest Service International Programs; also consider pharmacological and clinical trials of standard­ • Gordon Cragg, PhD, a retired chemist from the natural ized teas and other extract formulas from Artemisia annua. 2 products branch of the National Cancer Institute; "Given the current shortage of artemisinin and the difficulties • Jorge Ferreira, PhD, a horticulturist from the Agricultural that many countries with high malarial incidence face in being Research Service of the USDA; able to afford treatment, exploring a plant-based therapeutic • Janel Hopper, vice-president of the Simeus Foundation; option within a modern scientific and clinical approach pres­ • Jules Janick, PhD, professor in the horticulture and land­ ents a compelling strategy," Duke wrote in his letter. scape architecture department of Purdue University; Duke's recommendation has been endorsed by a wide range • W John Kress, PhD, chair of the department of botany of botanical medicine advocates and other health professionals in the United States National Herbarium in the National

24 I HerbaiGra m 69 2006 www.herbalgram .org body with other requirements for safety," (ora l communica tion, June 2005).

Shortage of Plant-Based Artemisinin An artemisi nin shortage became apparent shortly after inter­ national hea lth orga nizations, such as rhe Global Fund, WHO, UNICEF, and rhe United Stares Agency for lnrernational Devel­ opment, decided ro phase our the older less-effective conven­ tional d rugs, such as chloroquine, amodiaquine, or sulfadoxine­ pyrimerhamine,5 and officially adopt ACT combinations, which use artemisinin and irs derivares arthemerher and artesunare.6 Conference : March 3-5, 2006 Exhibits: March 4 & 5, 2006 "It is unacceptable that 3,000 African New York, NY children die every day from a largely Marriott Ma rquis preventable disease. Malaria is robbing Africa of its people and its potential." Enhance Your Practice Over rhe years, rhe inappropri ate use, poor management, Improve Patient Care Via and continued use of conventional anti-malarial drugs have all Integrative & Complementary Medicine conrribured ro increased resistance ro these drugs, which has increased mortali ty and morbidiry.5 he International Complementary and Natural Healthcare "W hen you don't ra ke the full dosage of an antibiotic, it can TConference and Expo (CAM Expo East) is the premier contribute ro resistance so rhar the drugs don't work. We want event designed to bring information , products and services ro make rhe semi-symheric drug so inexpensive rhar it rakes to the com plementary and integrative healthcare community. away the incemive ro not take the pills, save them, or se ll them," says Reili ng, referring ro the resistance problems associated with The conference features the most recent trends , research , clinical trials and protocols and the exhibition provides buyers of natural healthcare products and services with a dedicated marketplace. Museum of Narural History of the Smithsonian Insti­ tution; Learn from top medical & healthcare industry leaders. • Jim Simon, PhD, professor of new use agriculture and natural plant products at Rutgers University; Meet & source the highest quality products in the natural healthcare industry. • Gary Strobel, PhD, department of plant sciences and plant pathology at Montana State University; Network with your peers & colleagues at the • Andrew Weil, M D , leading author and director of the industry's most important event. Program in Integrative Medicine at the University of Arizona; and For complete event details visit www.camexpoeast.com • Merlin L. Willcox, MD, the honorary secretary of RITAM (Research Initiative on Traditional Antima­ larial Methods) and a general medical practitioner in Register Now & Save Buckingham, United Kingdom. For more information on Artemisinin, please refer to the Register online at www.camexpoeast.com article, WHO Approves Artemisinin for M alaria in Africa, Use priority code ABC and save an additional 15% off the published in HerbalGram 64. HG full conference rate. References 1. Marx V. Bootstrapping via philanthropy: A California start-up For exhibiting, press or attendee questions email chooses a zero profit project: helping to develop a malaria drug. info@camexpo. com Chemical & Engineering News. 2005;83(1): 18. 2. Duke J. An herbal solution? Letters. Chemical & Engineering Platinum Media Sponsors: News Web site. May 2, 2005 . Available at: http:/ /pubs.acs.org/ A LTERNAT I VE THERAP I ES INTEGRATIVEMEDICINE email/cen/hunl0502051 30203.hrml. Accessed August 3, 2005.

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chloroquine-type anti-malarial drugs rhar in 2003, will produce and sell the anti­ brought on by endorsement of interna­ pre-dared artemisinin. malarial drug at its cost.? "If we create a tional health organizations, coupled with In November 2004, rhe New York Times bigger volume, we can lower the price. It's the supply shortages, have caused the price reported that until early 2004, the total an economy of sca le," Reiling continued of sweet Annie to quadruple.G annual consumption of raw artemisinin (oral communication, February 2005). Finally, Reiling ex plains that another was about 30 tons. The price of artemis­ ancillary benefit of developing a consis­ inin had remained constant for several tent, affordable supply of bioequivalent years at $1 15 per pound. In April 2004, artemisinin is that this new technol­ when the WHO forecasted that the total "If we are able to reach ogy would have less of an environmen­ world requirements for 2005 would be our production goals, tal impact than traditional planting and between 130 to 220 tons, the price of cultivation (oral communication, Febru­ artemisinin jumped to $180 dollars per our artemisinin will be ary 2005). HG pound, then to $365, and later to $455 per pound.6 To combat the shortage and less expensive than the References steep price increases, each member of the current price for the l. Hasegawa J. Coll aboration of biotech, partnership is taking specific steps to help academia, and nonprofit pharma could ensure the affordabiliry of artemisinin. For plant-derived product" significan rl y reduce cost, boost supplies of antimalarial drug [press release]. San Fran­ example, UC-Berkeley gave Amyris and cisco, CA: Institute for OneWorld Health; OneWorld royalty-free licenses to develop Benefits of Semi-Synthetic December 13, 2004. irs technology for the anti-malarial drug.? 2. WHO and UNICEF. Malaria World Artemisinin "Our goal is to cut the total price of the Report 2005. Available at: http://rbm.who. drug by 10 times, down to about 25 cents The Gates grant to develop a semi­ int/wmr2005/index.html. Accessed May 25, per dosing," Reiling said (oral communi­ synthetic form of arremisinin is significant 2005. cation, February 2005) . for several compelling reasons. First, an 3. WHO and UNICEF. Malaria Burden. affordable, effective bioequivalent of arte­ World Malaria Report 2005. Available at: http:// rbm.who.inr/wmr2005/html/ l- misinin is important because the artemis­ 2.htm. Accessed May 27, 2005. inin derived from sweet Annie is extremely 4. Fuller]. Funding Commitmenr to acceler­ expensive. The plant-derived ACTs, which ate malaria resea rch [press release]. Seattle, are available for $.75 and $2.75 per treat­ WA: Bill and Melinda Gates Foundation; ment,2 cost more than 10 rimes as much as September 21, 2004. the older more conventional anti-malarial 5. The World Health Organization. Roll drugs, such as chloroquine and su lfadox­ Back Malaria lnfosheet. Facts on ACTs ine-pyrimethamine.6,8 If the grant work (Artemisin in -based Combination Thera­ pies), An Update on Recent Progress in is successful, this new bioequivalent drug Policy and Access to Treatmenr. Avail­ will be less expensive than the artemisinin able at: http://www.rbm.who.int/cmc_ derived from the plant. "If we are able to upload/0/000/0 15/364/RBM!nfosheet_ reach our production goa ls, our artemis­ 9.htm. Accessed June 6, 2005. inin will be less expensive than the current 6. McNeil DG Jr. Plant shortage leaves price for the plant-derived product, whi ch campaigns aga in st malaria at risk. New York is currently $2.40 per treatment. W hile Times. November 14, 2004. Available at: this number is small by Western stan­ h ttp:l /www. nytimes.com/2004/ 1 1I 14/in ter­ national/asia/14malaria.html?ex= 11 3445000 dards, it is prohibitive for those living in O&en=7ce7c3af52873986&ei=5 070. much of Africa," Reiling sa id (e-mail, June 7. Hasegawa J, Sa nders R, Melis C. $42.6 16, 2005). million five-year gram from Gates Founda­ Second, there is a growi ng shortage of tion for anrimalarial drug brings together the plant-derived artemisinin as the drug unique collaboration of biotech, academia transitions to the first-li ne treatment in and nonprofit pharma [press release]. Sweet Annie Artemisia annua Photo ©2006 most affected countries. Amyris scientists San Francisco, California: Institute for stevenfoster.com believe that the semi-synthetic drug will OneWorld Health, UC Berkeley, Amyris Biotechnologies; December 13, 2004. help with shortage problems because, "our 8. WHO and UNICEF. Global Financing, OneWorld, a non-profit pharmaceuti­ process will be very scalable, and rhus will Commodities and Service Delivery. World cal, is performing the necessary regulatory be able to meet world demand," Reiling Malaria Report 2005. Available: http://rbm. and non-clinical work required by health said (e-mail, June 16, 2005). who.int/wmr2005/html/3-1.hrm. Accessed: agencies in the United States and Europe, Third, the shortage of sweet Annie May 27, 2005. so interested pharmaceutical manufac­ plants and the rising costs of production turers will be able to substitute the semi­ create considerable concern for the WHO synthetic version of arremisinin for the and other international public health offi­ plant-derived product. Amyris, working cials. According to a New York Times on irs first project since incorporation article, the rising demand for the drug,

26 I HerbaiGram 69 2006 www.herbalgram.org ------1lResearch ReviewJ..,.______

Indian Tinospora Shows Positive Results in Treating Allergic Rhinitis

D evie~ed:. Badar V, Thawani V, Wakode P, et al. Efficacy of Tinospora cordifolia in allergic rhinitis. J Ethnopharmacol. ftloos,%.445-449.

Allergic rhinitis (AR) is rhe sixth most the safety and efficacy oflndian rinospora improvement whereas 88% of those in prevalent medical condition in rhe United as a single ingredient in rhe treatment of the placebo group had no relief from this Stares, outranking cardiac disease. It is AR. symptom. On an overal l comparison, the characterized by sneezing, runny nose, Patients diagnosed to be suffering from difference between Indian rinospora and nasal congestion, and itchy, watery eyes. AR were recruited from a hospital in placebo treated groups in all the symp­ Conventional treatment for AR generally Nagpur, India; 75 patients were random­ toms of AR was found to be highly signif­ includes antihistamines, decongestants, ized into the study. They received either icant (P< 0.00001 ). These findings corre­ and cromolyn sodium. However, many placebo or Indian rinospora (Tinofend•; lated well with clinical findings from the of the conventional therapies produce rhe Geni Herbs, Noblesvill e, IN) (300 mg nasal smears and white blood cell count unwanted side effect of drowsiness. Hence, tablet, M/s Pharmanza, India) 3 rimes a rhar demonstrated a significant decrease there is a search for a natural alternative day for 8 weeks. Throughout the trial, in inflammation (P<0.001) and all ergic rhar is effective and better tolerated. participants recorded rhe incidence of response (P

Join ABC & Save 50% on All ABC Publications Members of the American Botanical ~ Council receive a 50% discount on all books " published by ABC- including The ABC Clinical Guide to Herbs, HerbalMedicine: Adding value through science to Expanded Commission E Monographs, botanicals used in complementary and The Complete German Commission E MRICJ'.N alternative medicine Monographs: Therapeutic Guide to Herbal PgTI'NlCA.L Medicines, back issues of HerbalGram, the OJNCIL Quick Access series and more. www.phytosynergy.com Join online today at www.herbalgram.org c/o Missouri Innovation Center. Inc. [email protected] or calll-800-373-7105 University of Missouri-Columbia CELL (573) 356-7372 www.herbalgram.org 2006 HerbaiGram 69 I 27 ------~lResearch ReviewJ~------

Study Shows No Neuropsychological Efficacy for Cranberry Juice in Cognitively Intact Older Adults iewed: Crews WD, Harrison D, Griffin M, et al. A double-blinded, placebo-controlled, randomized trial of the neuropsy­ ologic efficacy of cranberry juice in a sample of cognitively intact older adults: pilot study findings. j Altern Complement llied. 2005 ;11 (2):305-309. The use of cranberry (Vaccinium macro­ University, and Virginia Neuropsychol­ size that likely decreased the power of carpon Aiton, Ericaceae) juice and related ogy Associates, Inc. the statistical measures to detect modest cranberry preparations to prevent and At the trial's end, 21 males and 26 differences between the two groups; the even treat urinary tract infections is well­ females had completed the study's proto­ relatively short duration of the study; the documented with over 18 clinical trials col and comributed data for analysis. relatively low quantity/concentration of published to date.1 This is the first known Three participants were excluded from the cranberry product used in the treatment clinical tri al to examine the effect of analysis due to noncompliance. No partic­ protocol, as compared to the study by cranberry juice on the neuropsychologi­ ipants withdrew from the study due to Joseph et al2 (i.e., the aged rats received cal functioning of cognitively intact (Cl) adverse events. T here were no sign ificam 18.6 grams of dried aqueous blueberry older adults. differences between the cranberry group extract per kilogram of diet for 8 weeks); The rationale for the study is based and the placebo group with respect to age, the relatively high mean educational level on previous research demonstrating that education, Mini-Mental State Examina­ of participants which may have enabled antioxidant and phytochemical supple­ tion, and treatment regime compliance. them to optimize their test performance ments have beneficial effects on neuro­ Data for the study was based on a battery to an extem that masked modest differ­ logical processes in animals and humans. of sta ndardized neuropsychological tests, ences between groups; and the possi­ In studies with aging rats, strawberry administered to the participants at base­ bility that the placebo drink may have (Fragaria spp., Rosaceae), spinach (Spina­ line and at the end of treatment. Analysis provided nutritional benefits (e.g., vitamin cia oleracea L., Chenopodiaceae), and of the imeraction effects using the fixed C) and thus was nor a truly inert placebo. bl ueberry ( Vaccinium spp., Ericaceae) factor of group and repeated measure of The authors ca ll for further research on extracts effectively reversed age-related trial (i.e., pretreatment and end-of-treat­ cranberry juice in two types of studies: deficits in neuronal and behavioral indi­ ment assessments) revealed no significant large, heterogeneous groups of Cl subjects, ces. 2 The blueberry supplement was the differences between the cranberry group and longitudinal studies that more closely most effective. Cranberries, like blue­ and the placebo group for any of the neuro­ parallel previous research with Vaccinium berries, are high in antioxidants, includ­ psychological variables. The only positive species in aged laboratory animals. HG ing f!avonoids, phenols, and vitamin C. result in this study was a non-significant -Cathleen Rapp, ND This randomized, double-blind, placebo­ trend for one aspect on a Follow-Up Self­ controlled, fixed-dose, parallel-group Report Questionnaire (FSRQ), namely, References rrial was conducted on 50 panici­ the question pertaining to the "partic­ 1. Blumenthal M , Hall T, Goldberg A, Kunz pams aged 60 years or older, with no ipams' overall abi lities to remember." T, Dinda K, Brinckmann J, et al, eds. The history of dememia or cognitive impair­ Specifically, more than twice as many ABC Clinical Guide to Herbs. Austin, TX: American Botanical Council; 2003. mems. Panicipams were screened with participants in the cranberry group (n = 2. Joseph JA, Shukitt-Hale B, Denisova NA, the Mini-Mental State Examination (a 9, 37.5%) rated their overall abilities to et al. Reversals of age-related declines in brief screening of the following cognitive remember by treatmem end as "improved" neuronal signal transduction, cognitive, and areas: ori entation, registration, attemion, as compared to controls (n = 4, 17.4%). motor behavioral deficits with blueberry, calculation, recall, and language). All The authors discuss a variety of factors spinach, or strawberry dietary supplementa­ cranberry products were discominued that may have contributed to the null tion. j Neurosci. 1999; 19:8 114-8121. prior to pretreatment assessmems. The findings in this trial. They point out that 3. Mix JA, Crews WD Jr. An examination of length of the trial (6 weeks) was based on this result appears to be contrary to a the efficacy of Ginkgo biloba extract EGb 761 on the neuropsychologic functioning the authors' prior research with ginkgo growing body of research. Dietary/herbal of cognitively intact older adults. J Altern (Ginkgo biloba L., Ginkgoaceae) extract products with high antioxidant activity Complement Med. 2000;6:2 19-229. in Cl older adults.3A Panicipams were have been shown to benefit neuropsy­ 4. Mix JA, Crews WD Jr. A double-blind, randomized to receive either cranberry chological functioning in Cl older adults placebo-conrrolled randomized rrial of juice (n = 25) or placebo (n = 25). T he (ginkgo extracr)3,4,5 and to improve neuro­ Ginkgo biloba extract EGb 761 in a sample cranberry juice was a low calorie prod­ nal/behavioral indices in aged rats (blue­ of cognitively intact older adults: neuropsy­ uct (27% juice/volume), sweetened by berry extract). 2 (Note: it is quire possible chologica l findings. Hum Psychopharmacol sucralose. The placebo was a marching that some of the cognitive functions of Clin Experiment. 2002; 17: 1-1 I . 5. Crews WD Jr, Harrison DW, Griffin ML, product with similar taste, smell, appear­ the ginkgo are due to the presence of the et al. The Neuropsychological Efficacy ance, and vitamin C content (Ocean unique terpene lactones, e.g., ginkgolides of Ginkgo: Preparations in H ealthy and Spray Cranberries, Inc., Lakeville, MA). and bilobalide, and not the flavonoids.) Cognitively Intact Adults. HerbalGram. The trial was conducted by researchers at Potential limitations in this study include 2005;No. 68:42-62. Virginia Polytechnic Institute and State the following: the relatively small sample

28 I Herbal Gram 69 2006 www.herbalgram.org Research Reviews

Liv.52®Ayurvedic Herb Combination Shows Benefit for Liver Cirrhosis in Small Trial 0 eviewed: Huseini H , Alavian S, Heshmat R, Heydari M, Abolmaali K. The efficacy of Liv.52 on liver cirrhotic patients: A ftrandomized, double-blind, placebo-controlled first approach. Phytomed. 2005;12:619-624. H epatic cirrhosis (liver fibrosis) is most total amount of Liv.52 prescribed was of hepatic disease by measuring 5 param­ frequently caused by alcoholism, viral 2,331 mg per day. Liv.52 is manufac­ eters: degree of ascites, encephalopathy, hepatitis, hepatotoxic drugs, and heredi­ tured by Himalaya Herbal Hea lrhcare, serum levels of albumin and bilirubin, and tary conditions. T he liver is one of the Bangalore, India, and is sold in the blood prothrombin time. Each param­ most important organs in the body and United States as LiverCare®, Himalaya eter scored on a 3-point scale, from 1 to is involved in more than 300 3. Scores for all parameters were processes. It is necessary for added together to create a total proper blood clotting, absorp­ child-pugh score: 5-6 = A, 7-9 = tion of fats , blood pressure B, and 9+ = C. The lower scores regu lation, and metabolism of were considered better. Ascites was endogenous (from inside the ranked as none, mild, moderate, body) and exogenous (outside and severe based on the amount the body) substances. It is also of flu id accumulation. Outcomes one of the largest immune were determined at baseline, and sys tem organs in the body. after 3 and 6 months of the herbal H epatic cirrhosis is one of the su pplemen rati on. most se rious hepatic diseases. Ascites severity significantly The live r graduall y loses its decreased in the Liv.52 group from many functions, contracts in baseline ro 6 months of treat­ size, and becomes hard and ment (P < 0.032). C hild-pugh leathery. scores significa nrly improved in This 6-monrh, random­ the treatment group during the ized, double-blind, placebo­ study period compared to baseline controlled clinical trial was (P < 0.001). Our of 18 subjects conducted on 36 subjects, 32 in the treatment group, 4 had no men and 4 women, ages 21 Ca per bush Capparis spinosa. Photo ©2006 stevenfoster.com ascites at baseline vs. 6 after treat­ to 76 years (approximate aver- ment, 6 had mild ascites at base­ age age was 49 yea rs). All volunteers had USA, Houston, Texas. Over 300 scien­ line vs. 10 after treatment, 5 had moder­ liver cirrhosis confirmed by liver biopsy, tific papers have been conducted on this ate ascites at baseline vs. 2 after treatment, biochemical, pathological, and abdomi­ proprietary formulation since its introduc­ and 3 had severe ascites at baseline vs. nal examinations. Subj ects were registered tion into the Indian marker in 1954, with none wirh severe ascites after treatment. patients at the Tehran H epatic Center 6 clinical trials published on it in recent Average se rum ALT and AST significanrly in Tehran, Iran; had no history of alco­ yea rs. 1 decreased in the Liv.52 group (89.0 ± 24.56 hol addiction; and did not have variceal Outcome measures included serum at baseline vs. 38.5 ± 3.79 after treatment bleeding (bleeding from the networks of alanine aminotransferase (ALT, a liver for ALT, P < 0.044, and 89.2 ± 14.24 at veins). enzyme, · the increased levels of which baseline vs. 57.2 ± 5.60 after treatment for Subjects were randomized to receive is an indicator of liver cell damage), AST, P < 0.029). None of the outcome either 3 tablets of a combination of tradi­ serum as partate aminotransferase (AST, measures significantl y changed in the tional Ayurvedic herbs ca ll ed Liv.52® or 3 another li ver enzyme whose increased placebo group during the trial. placebo tablets 3 rimes daily. Each Liv.52 level is an indicator of li ve r cell damage), T hi s study showed that 3 tablets of tablet contains 65 mg caper bush (Cappa­ total bilirubin, prothrombin time, plate­ Liv.52 taken 3 times dail y improved ris spinosa L., Capparaceae) root, 65 mg let, and white blood cells. Bi li rubin and measures of ascites and liver damage. chicory ( Cichorium intybus L. , Asteraceae) prothrombin are produced by the li ve r as Since significant improvements were seen seed, 32 mg black ni ghtshade (Solanum are the enzymes ALT and AST. Abnormal­ in the active group, but not the placebo nigrum L., Solanaceae) (w hole plant), 32 ities in these measurements can indicate group, these results indicate that Liv.52 is mg arjuna (Terminalia arjuna [Roxb. ex severe li ver pathology. Platelets and white superi or to placebo. HG DC.] Wight & Arn., Combretaceae) bark, blood cells are manufactured in bone -John Neustadt, NO 16 mg negro coffee (Cassia occidentalis L., marrow. D ecreased levels of platelets or Fabaceae), 16 mg yarrow (Achillea mille­ white blood cells could indicate immune Reference folium L., Asreraceae) aerial pans, 16 mg suppression. Additional outcomes were Blumenthal M, Hall T, Goldberg A, Kunz tamarisk (Tamarix gallica L. , Tamarica­ the child-pugh score and ascites (accu­ T, Dinda K, Brinck.mann J, er al, eds. The ceae) (whole plant), and 33 mg Mandur mulation of fluid in the abdomen). The ABC Clinical Guide to Herbs. Ausrin , TX American Botanical Coun cil ; 2003. bhasma (Calcinared Ferric Oxide). The child-pugh score determines rhe degree

www. herbalgram .org 2006 Herba iGram 69 I 29 Research Reviews

Special Butterbur Leaf Extract (Ze 339) as Effective as Antihistamine for Intermittent Allergic Rhinitis D eviewed: Schapowal A. Treating Intermittent Allergic Rhinitis: A Prospective, Randomized, Placebo and Antihistamine­ .ft.controlled Study of Butterbur Extract Ze 339. Phytotherapy Research 2005;19(6):530-537.

T his clinical trial demonstrates the and the conventional drug demonstrated clinical trials on Ze 339, demonstrat­ safety and efficacy of a special extract of about equal efficacy (P = 0.037). Superi­ ing its efficacy compared to placebo in butterbur leaf for treating intermittent ority of both treatments to placebo was a dose-ranging triaP and in another trial allergic rhinitis (IAR), commonly referred demonstrated during the evening/night favorably comparing it ro the conven­ ro as hay fever. (P < 0.001), according to the attending tional pharmaceutical IAR drug, cetiri­ In the largest clinical trial ro date on physicians' own assessment and by patient zine (Zyrrec®, Pfizer).2 butterbur leaf, the randomized, double­ responder rates. Butterbur (Petasites hybridus [L.] P. blind, placebo- and reference-controlled, Although both the butterbur prepa­ Gaertn. et al. , Asteraceae) is native ro three-arm, multi-cemer trial was based ration and the fe xofenadine were both Europe. All parts of the plant are known on 330 our-patiems in 11 centers in well tolerated, the butterbur showed a ro contain potentially heparoroxic PAs, Switzerland and Germany. (A reference­ predictably safer profile than the conven­ although the PAs are found in higher controlled trial compares a medication tional drug as butterbur did not produce concentrations in the root than in the directly against a medication known to the sleepy, drowsy effect that is char­ leaves and other aerial parts. Ze 339 be ac tive, in this case, the antihistamine acteristic of antihistamine medications. is made from specially grown butterbur fexofenadine, se rving as an active control.) There were few adverse events reported plants that have been bred to produce a T he trial was conducted according to US in any of the groups, although symptoms low amount of PAs in the leaves, with Food and Drug Administration G uidance related to sedation accounted for three­ the PAs then removed to virtually almos t for Industry on clinical trials for allergic quarters of all events reported in patients undetectable levels by a special carbon rhinitis. dioxide-based ex traction process . Study medications were a special carbon Note: A significantly different butterbur dioxide extract of butterbur leaf (Ze 339, preparation, a standardized extract made aka Tesalin®, produced by Max Zeller from butterbur roots, called Petadolex® Sohne AG of Romanshorn, Switze r­ (Weber & Weber GmbH & Co, KG, land) and fexofenadine (Telfas t® 180 aka Germany, imported by Weber & Weber All egra®, Ave ntis), a conventional anti­ International, Windermere, FL) has histamine drug. Daily dosages used in recently shown potential benefit for treat­ the trial were 3 tablets of Ze 339 (stan­ ing asthma in a non-controlled observa­ dardized to 8 mg petasine each) versus tional srudy3 as well as some evidence for one tablet of fexofenadine (180 mg), or treating migraine headaches in recently placebo, using a double dummy technique published clinical trials.4,5 HG for complete blinding. -Mark Blumenthal All patienrs were 18 yea rs of age or older and had a history of seasonal aller­ References gic rhinitis for at least two seasons in I. Schapowal A. Bunerbur Ze339 for the consecutive years. The primary measure­ treatment of interminent all ergic rhinitis: ment was a change in IAR symproms dose-dependent efficacy in a prospec- tive, randomized, double-blind, pl acebo­ during the day. These symproms include Butterbur Petasites hybridus. Photo ©2006 stevenfoster.com co ntrolled study. Arch Otolaryngol Head sneezing, watery eyes, itching eyes and Neck Surg. December 2004;130(12): 138 1- nose, and nasal congestion. Researchers 1386. also meas ured changes ex peri enced in 2. Schapowa l A. Randomized conrroll ed the evening and at night, based on the on fexofenadine and just over one-third trial of bunerbur and cetirizin e for treat­ phys icians' assessments and the rates of of all events in the butterbur and placebo ing seaso nal all ergic rhin iti s. BM}. January patienrs' responses. groups. There was no evidence suggest­ 2002; 19;324(7330): 144-146. Patients were randomized to the ing an adverse event that might be associ­ 3. Danesch U. Petasites hybridus (Butterbur root) ex tract in the treatment of asthma- an butterbur (n = 110), fexofenadine (n = ated with generic butterbur preparations open trial. Altern Med Rev. 2004;9(1):54-62. 11 3) , or placebo (n = 107) group. Based (e.g., potential liver problems associated 4. Lipton RB , Go bel H , Einhaupl KM , on changes in the rota! symprom score with pyrrolizidine alkaloids [PAs]), as liver Wil ks K, Mauskop A. Petasites hybridus and other measuremenrs, the trial results enzyme levels were monitored and did not root (bunerbur) is an effective preven­ concluded that both the special butterbur show an increase. tive treatment for migraine. Neurology. leaf extract and the anrihistamine drug The research team was led by principal 2004;63:2240-2244. were equally and significantly superior investigator Dr. Andreas Schapowal of the 5. Pothmann R, Danesh U. Migraine preven­ tion in children and adolescents: Res ults of ro the placebo (P < 0.001) in reduc­ Allergy Clinic in Landquart, Switzerland. an open trial with a special bunerbur root ing IAR symproms. The phytomedicine Dr. Schapowal has previously published extract. Headache 2005;45: 1-8. 30 I HerbaiGram 69 2006 www.herbalgram .org Research Reviews

Safety and Efficacy of Remifemin®Black Cohosh Extract in Alleviating Symptoms of Menopause Confirmed in Large Clinical Trial eviewed: Osmers R, Friede M , Liske E, et a!. Efficacy and safety of isopropanolic black cohosh extract for climacteric symptoms. RObstet Gyneco!. 2005;105:1074-1083. Black cohosh (Actaea racemosa L., of rhe MRS: hot flashes (hot flashes, and heparoroxiciry, although these cases Ranunculaceae, syn. Cimicifuga racemosa swearing, and sleep disorders), psyche have been evaluated and deemed ro lack [L.] Nutt) has a long hisrory of medici­ (depress ion, nervo usness, irritability, and evidence of causality. After moniroring nal use for a variety of gynecologic condi­ memory), soma (heart, joint, and muscle liver enzymes during rhe trial, rhe authors tions, and numerous clinical rrials suggest symptoms), and atrophy (sex ual disorders, wrote, "Our study does nor show clinically irs efficacy in alleviating the climacteric vaginal dryness, and urinary complaints). relevant changes in the primarily impor­ (i.e., the period of rime between the end The black cohosh extract was signifi­ tant hepatic enzymes [GGT, AST, ALT] of reproductive capacity in women and cantly more effective than was placebo in comparison ro placebo." the completion of menopause) symproms in decreasing the MRS associated with menopause. Most of the score (P < 0.001), clinical trials were conducted in the 1980s and treatment had and 1990s, and, since that rime, clini­ the greatest effect in cal research methods have continued ro women who had just improve. Therefore, rhe present study was begun menopause. The conducted ro obtain new evidence of the effect size was similar safety and efficacy of black cohosh by ro rhar of conventional evaluating rhe leading and most clinically hormone replacement tested product, a proprietary isopropa­ therapy and there­ nolic extract of black cohosh root srock fore clinically rele­ and rhizome, Remifemin® (Remifemin is vant. Four of the MRS manufactured by Schaper & Brummer, subscores decreased Salzgirrer, Germany). (At the rime of the significandy in the publication of this trial, Remifemin was black cohosh group imported and marketed in the United (relative ro the pl acebo Stares by GlaxoSmirhKiine; as of June group): P = 0.007 for 20, 2005, the importation and market­ hot flashes, P = 0.012 ing of Remifemin reverted ro Enzymatic for atrophy, and P = Therapy of Green Bay, WI, the company 0.019 for psyche. No that initially introduced Remifemin ro the significant treatment US marker.) effect was observed In this trial, 304 postmenopausal women for heart, joint, and Black cohosh Actaea racemosa . Photo ©2006 stevenfoster.com (with ei ther 6 months or more since rhe muscle symproms. last regular menstruation) were randomly Adverse events were assigned ro I of 2 treatments in a random­ reported by 50 (32.7%) ized, double-blind, placebo-controlled, subjects in the black cohosh group and by The results of this study confirm multi-center trial. For 12 weeks, 1 group 47 (3 1.1 %) subjects in the placebo group; the findings of previous studies, which (n = 153) received I Remifemin tablet (2.5 the difference in number of reported demonstrate the efficacy and rolerabil­ mg isopropanolic extract of black cohosh adverse events was nor significantly differ­ ir y of this particular proprietary black [20 mg of root srock]) 2 rimes daily, ent between groups. Most of the adverse cohosh extract (Remifemin) in alleviat­ and the other group (n = 151 ) received a effects in the black cohosh group were ing climacteric symproms, especially hot placebo. Clinica l examinations and inter­ determined ro be "mild and transient" fl as hes. Remifemin appears ro be most views were conducted before treatment and were deemed consistent with the data effective during early menopausal yea rs. and at 4 and 12 weeks. Climacteric symp­ found in numerous other studies. A causal The authors conclude that Remifemin rom intensity was evaluated on rhe basis relation between black cohosh and adverse has "a favorable benefit-risk ratio." The of the Menopause Raring Scale (MRS)-a events was suspected ro be "possible" in authors conclude that further randomized scale comprising 10 items, each of which is only 6 cases (3 .9%) as compared ro 7 controlled trials ro direcdy compare the rated from 0 (no complaints) ro I (severe cases (4.6%) in the placebo group. The effects of black cohosh preparations with symproms) in increments of 0.1. researchers also evaluated the "putative those of conventional hormone replace­ The primary outcome was the change heparoroxic potential" of black cohosh in ment therapy would be valuable. HG from baseline in the MRS score. Second­ re sponse ro a few published case reports -Brenda Milot, ELS, ary outcomes were safety (evaluated on suggesting a poss ible relationsh ip between and Mark Blumenthal the basis of adverse events and clinical ingestion of various black cohosh prepa­ measures) and changes in rhe 4 subscores rations (none have involved Remifemin)

www.herbalgram .org 2006 HerbaiGram 69 I 31 ------~~esearch ReviewJ~------

Study in New England journal ofMedic ine Tests Efficacy of Low-Dose Echinacea Extracts in the Treatment of Rhinovirus Infections D eviewed: Turner RB, Bauer R, Woelkart K, Hulsey TC, Gangemi JD. An evaluation of Echinacea angustifolia in experimental .ftrhinovirus infections. N Englj Med. 2005;353(4):341-348.

As has been documented in the pages and treatment phases, and placebo during Canada's Natural Health Products Direc­ of this publication in the past few years, both phases. torate) This WHO recommended dosage the outcomes of recent clinical trials All echinacea preparations were from equivalent is about 330% greater than the testing the efficacy of various types of a single lot of E. angustifolia root. These one used in this trial (i.e., calculated on preparations made from echinacea (from echinacea preparations concentrated a dry weight basis). The significance of Echinacea spp., Asteraceae) have been on the alkamide fraction, a group of this dosage differential was the subject of conflicting. These variable results are compounds known to contribute to echi­ a letter to the editor written by the first likely due, in part, to the wide variation in nacea's immunomodulatory activity, and author of this review (Mark Blumenthal) phytochemical composition of echinacea were designed by the highly esteemed and Prof. Norman R. Farnsworth, preparations due to differences in the Prof. Rudolf Bauer of the Karl-Franzens Research Professor of Pharmacognosy and species used (E. angustifolia, E. pallida, University in Graz, Austria, acknowl­ Senior University Scholar at the College E. purpurea), the part of the plant used edged by many scientists as the world 's of Pharmacy at the University of Illinois (root and/or aerial parts), and the different leading researcher on echinacea chem­ at Chicago; the letter was published in the types of methods used to make the prepa­ istry and pharmacology. The carbon New England journal ofMedicine (NEJM) rations (e.g., dried leaves or roots, erhano­ dioxide extract had a 73.8% alkamide in November.4 lic or hydroethanolic extracts of leaves or concentration and no polysaccharides The assigned medications were taken roots, fresh-pressed juice of aerial parts, (complex sugars also known to contribute at the dosage noted above on days -7 to and/or mixtures of these). Other variables to immune function) , while the ethanolic 0. On day 0, all asymptomatic subjects affecting outcomes include trial design, extracts contained both polysaccharides were challenged with rhinovirus type 39 e.g., dosage used, initial application of and a significantly lower level of alkamides and were then isolated in individual hotel dosage and/or duration of dosage, subject (60% extract: 48.9% polysaccharides and rooms for the duration of the study. The selection, endpoints measured, etc. 2.3% alkamides; 20% extract: 42.1% and subjects rated their symptoms (sneezing, 0.1%). The extracts were produced by a nasal discharge or obstruction, sore throat, Study Review leading European extract manufacturer cough, headache, malaise, and chilliness) Efforts are being made by numerous (Finzelberg GmbH & Co., KG , Andern­ from days 0 to 5 on a scale of 0 to 4, researchers in an attempt to standardize ach, Germany). with 0 representing no symptoms and 4 the plant materials used in clinical stud­ Each dose of 1.5 ml (mill iliters) of the representing very severe symptoms. lnter­ ies so that the results of multiple stud­ liquid extracts was stated to be equivalent leukin-8 and polymorphonuclear leuko­ ies can be compared more readily. The to 300 mg of dried powdered root. Each cyte concentrations were measured in objective of this study by Turner et al was subject received 3 doses per day, for a total nasal-lavage specimens collected from the to use the well-established experimental daily dose of 4.5 ml, equivalent to approx­ subjects on day 0 (before the virus chal­ model for colds caused by rhinoviruses imately 900 mg dry root per day. The lenge) and on days 1-5 (after the virus and 3 "carefully defined preparations" to control group received placebo through­ challenge). The primary outcome measure assess systematically the effects of differ­ out both phases of the study. The placebo for the prophylaxis phase was the number ent echinacea constituents on rhinovirus contained "alcoholic beverages," denato­ of subjects treated with the echinacea infections and symptoms of such. nium benzoate, and tap water. preparations who became infected with This randomized, double-blind, placebo­ This dosage level was selected because it the rhinovirus, relative to the number controlled, 7-arm study was conducted at is recommended by the German Commis­ of placebo-treated subjects. The primary the University of Virginia, Charlottesville, sion E for E. pallida root. 1 However, the outcome measure for the treatment phase between March 2002 and March 2004 in Commission E did nor approve the thera­ was the comparison of total symptom 6 cohorts (n = 45-84 per cohort) of healthy peutic use of E. angustifolia root prepara­ scores between the echinacea-treated and young adult students (mean plus/minus SD tions due to the lack of adequate clinical placebo-treated subjects. age: 20.8 plus/minus 3.3 yea rs). The study data on this specific species and plant part Of the 437 students who began the was divided into 2 phases: a prophylaxis during the early 1990s when the echinacea trial, the results were calculated for 399 phase (for 7 days [day -7] to the time of the monographs were being developed by the subjects. No significant effect of echinacea virus challenge on day 0) and a treatment Commission and subsequently published prophylaxis on rhinovirus infection was phase (from day 0 to day 5). Within each in 1992. However, the World Health observed, and no effect on the infec­ cohort, there were 7 possible treatment Organization (WHO) recommended a tion rate was observed in the echina­ assignments: carbon dioxide extract of E. dosage of 3000 mg of dried root for teas, caea-rreated subjects during the treatment angustifolia root, E. angustifolia root with or equivalent preparations, per day in its phase. On the basis of the total symptom 60% ethanol, or a 20% ethanolic extract of 1999 monograph on E. angustifolia root, 2 score and on the proportion of subjects E. angustifolia root during the prophylaxis and this dosage was also later adopted by with colds, treatment with the echinacea

32 I Herba iGram 69 2006 www.herbalgram.org ------~~esearch ReviewJ~------preparations had no effect on rhinovirus­ for this [in this trial] ....1 do think that a the liquid extract (I :5, [sic] 45% ethanol) related symptoms. Neither prophylaxis second trial wirh a higher dose is needed 3 doses per day of 0.5-1 ml each are nor treatment wirh echinacea had a signif­ ro answer rhe question on echinacea's recommended, and for rhe tincture ( I :5; 45% eth anol) 3 doses of 2-5 ml per dose icant effect on interleukin-8 or polymor­ effectiveness in limiting rhe symptoms per day. The WHO dosage is based on phonuclear leukocyte concentrations. resulting from rhinovirus infect ion" (D. the dosage recommended in th e British The results of rhis study conclude that ]. Gangemi e-mail to M . Blumenthal, HerbaL Compendium VoLume 1, ed ited by the specific extracts of rhe roots of E. ovember 18, 2005). Peter R. Brad ley (Bournemomh, Doresr, angustifolia rested at rhe doses admin­ T he National Center for Complemen­ UK: British Herbal Medicine Association; istered within the design of rhe trial tary and Alternative Medicine (NCCAM ) 1992). Howeve r, rhis characterization of produced no clinically significant effects has stared that it will continue w ith irs the liqu id ext ract as a" I :5 " co ncentrat ion on the prevention of rhinovirus infection research on Echinacea: "NCCAM wi ll (the same as for rh e tincture) is appar­ entl y a typographi ca l error in the Brad ley or treatment of its symptoms. T he authors continue to support research on Echinacea. book rhar was repeated in the WHO suggest, however, that it is conceivable that A number of preclinical, Phase I, and monograph. T he Bradley vol um e is based "other chemical constituents or combina­ Phase II studies of Echinacea products on the British HerbaL Pharmacopoeia of tions of constituents rhat were nor rested are currently under way. T his research 1983 (Bournemourh, Doresr, UK: Bri t­ in this study have important biologic is being done both because of rhe public ish Herbal Medicine Association), which effects." The authors further suggest that health burden of the common cold and correctly characterizes the srrengrh of the because of rhe wide variety of available rhe public's widespread use of this natural liquid extract as I : I , rhar is, a preparation echinacea preparations, it will be difficult product. A recent survey of complemen­ 5 rimes more co nce ntrated than the 1:5 tincture. ro provide conclusive evidence that vari­ tary and alternative medicine use by adults 3. Echinacea. Natural Health Products ous other preparations made from species in the United Stares found that, among Directorate. Health Canada. Draft Janu­ in this genus would have no role in treat­ those who reported using natural prod­ ary 2004. Ava il able ar: hrrp: //www.hc­ ing the common cold. ucts , Echinacea was rhe most commonly sc. gc.ca/h pfb-dgpsa/ nh pd -d psn/ mono_ used ." 7 NCCAM was citing a survey of echinacea_e.pdf. Accessed July 27, 2005. Media Coverage Complementary a nd A lternative Medicine 4. Blumenthal M, Farnsworth NR. C uriously, despite this last statement use in adults in 2002.8 Echinacea angustifo!ia rhinovirus in rhe NE]M paper, rhe principal author In anticipation that the trial might be infections [letter to editor] . N EngLJ Med. November 3, 2005;353(18):197 1-1972. of rhe trial (Ronald B. Turner, MD), reported as a "definitive" study showing Available at: hrrp:!/conrent.nejm.org/cgi/ who reportedly has never used echinacea that "echinacea is ineffective," the Amer­ content/short/35311 81197 1. Accessed himself, has made numerous statements ican Botanical Council (ABC) iss ued December 13, 2005. in the media suggesting rhar rhis is the a press release in an attempt to clar­ 5. Kaplan K. Cold relief from echinacea "definitive" study on echinacea and that ify the dosage iss ue.9 Information from might be all in yo ur head. Los Angeles no future trials testing irs potential bene­ ABC's releases and the subsequent media Times. July 27, 2005. firs for prevention or treatment of upper interviews were carried in stories in rhe 6. Gangemi OJ . Eval uation of Chemically respiratory tract infections related ro colds Associated Press (appearing in literally Defined Preparations of Echinacea in Prevention and Treatment of Expe rimen­ or f1u should be necessary. "We find no thousands of newspapers and Web sires tal Rhinovirus Infection. Black Moun­ evidence that it actually does anything to around the United States and interna­ rain, NC: Med icin es from rh e Earth common cold symptoms," he is quoted tionally), the Los Angeles Times, The New Conference; June 5, 2005. as saying in a Los Angeles Times story. "If York Times, Bloomberg Business News, 7. Echinacea for th e prevention and rrear­ that's rhe reason you're buying it, then NBC Nightly News with Brian Williams, ment of colds in ad ults: Research results you're wasting your money." And this: Wolf Blitzer Reports on CNN, a nd numer­ and implicati ons for future studies. "Do I think it's likely rhar other echinacea o us radio imerviews and m any other Bethesda, MD: Na ti onal Center for preparations will have an effect give n media outlets. HG Complementary and Alternative Medi­ cine. Avai labl e ar: http://ncca m.nih.gov/ rhe results here and in other studies? -Mark Blumenthal cl ini cal rrials/echinacea_rr. hrm. Accessed No. There's an almost infinite number and Brenda Milot, ELS December I 0, 2005. of possibilities for these things, bur at References and Notes 8. Barnes P, Powell -Griner E, McFann K, some point you've gor to say, 'Enough is Na hin R. CDC Advance Data Report enough."'5 I . Blumenthal M, Busse WR, Goldberg #343. Complementary and alternative David ]. Gangemi, PhD, a professor A, Gruenwald J, Hall T, Ri ggins CW, medicine use among adults: United ar C lemson University, and a co-author Rister RS , eds. Klein S, Rister RS , trans. Stares, 2002. May 27, 2004. The CompLete German Commission E of rhis trial, stared in June at the Medi­ 9. Herbal science group says dosage roo Monographs- Therapeutic Guide to Herbal cines from the Earth Conference in Black low in new echinacea trial [press release]. Medicines . Austin, TX: American Botani­ Austi n, TX: American Botanica l Council ; Mountain, North Carolina, "I think we're cal Council ; Boston: Integrative Medicine July 27, 2005. missing rhe boar with dose and timing."6 Communications; 1998. Further, in an e-mail he reiterated his view 2. Echinacea Rad ix. In: WHO monographs rhar a higher dose may have produced on seLected medicinaL pLants. Vol I. Geneva: different results: "I would like to see re­ World Health Organization; 1999. sults from a higher dosage group, bur Note: The WHO recommendatio n is for dry weight of E. paL/ida for rea prepara­ NIH funding limitations didn't allow tions or equivalents. WHO stares that for

www.herbalgram.org 2006 Herba/Gram 69 I 33 Research Reviews '~~~~~~~.·~;;tt~·-~-~.-~ Sativex®Cannabis- Based Medicine Reduces Pain in MS Patients D eviewed: Rog OJ, Nurmikko TJ, Friede T, and Young CA. Randomized, controlled trial of cannabis-based medicine in central .1.~ ain in multiple sclerosis. Neurology. 2005;65:812-819.

This clinical trial published in late tion containing 2 major components of were 3.9 times more likely to rate them­ September 2005 demonstrates that the cannabis: the cannabinoids delra-9-retra­ selves in any improved category than those cannabis-based medicine Sativex® is effec­ hydrocannabinol (THC) and cannabi­ on placebo (P = 0.005). tive in reducing central neuropathic pain diol (CBD). 1 The final preparation Sativex was generally well tolerated in and sleep disturbance in people with also contains a range of phytocannab­ the study, producing relatively mild adverse multiple sclerosis (MS). Sativex is an oral­ inoids, terpenoids, and flavonoids (E. side effects. In the Sativex group, 30 of 34 mucosal spray produced from cannabis, Russo, personal communication to M. patients (88.2%) experienced at least one aka medical marijuana (Cannabis sativa Blumenthal, October 30, 2005). Sativex adverse event (AE), compared with 22 of L., subssp. sativa, Cannabaceae) and is thus significanrly distinct in its chem­ 32 patients (68.8%) on placebo. Nervous manufactured by GW Pharmaceuticals ical composition from the only other system AEs included dizziness (18 Sativex, PLC in the United Kingdom (UK). currently approved cannabis-related medi­ 5 placebo), somnolence (3,0), disturbance In the randomized, placebo-controlled cation, Marino!® (aka dronabinol, Solvay in attention (2,0), and headache (1,3). trial conducted in the UK, Sativex was Pharmaceuticals Inc., Marrietta, GA), a Psychiatric AEs included disassociation shown to be significantly superior to synthetic form ofTHC which is approved (3,0) and euphoria (2,0). Several of the placebo in reducing the mean intensity for chemotherapy-induced nausea. psychiatric AEs occurred in the same In this trial Sativex patient. was administered as an oromucosal (mouth) Sativex was shown pump spray des igned for self-administration to be significantly superior by the pati ent, allow­ ing flexible dosing (i.e., to placebo in reducing the patients can rake the mean intensity of pain ·as little or [a lmost] as much as they deem and sleep disturbance necessary, based on in people with MS. their own assessment of pain). GW Pharma­ ceuticals stares rhat this Two women patients withdrew from is ideally suited to the the trial, both on Sativex. One developed variable nature of MS.l an AE of agitation with tachycardia (rapid Each spray of Sativex heartbeat) and hypertension after 4 sprays, delivers a fixed dose of which settled with conservative manage­ Cannabis Cannabis sativa. Photo ©2006 stevenfoster.com 2.7mg THC and 2.5mg ment within 3 hours. She declined further CBD. To ensure safety, use of the medication and withdrew 7 days the patients were advised later without completing further scores. of pain (P=0.005) and sleep disturbance to take no more than 8 sprays (a total of The second patient developed paranoid (P=0.003) in people with MS. The study 21.6 mg THC, 20 mg CBD) within any ideation and was withdrawn from study was conducted in 66 patients, 65% of 3-hour interval and refrain from increas­ medication at the investigator's discretion whom required support to walk or were ing the daily dose by more rhan 50% from in the second treatment week but subse­ wheelchair-bound and suffering from the previous day. If the parienrs experi­ quently completed all study diaries and moderate to severe central neuropathic enced an intoxicating effect, they were assessments (her scores are included in the pain which had not been alleviated by told to reduce or omit a dose. The mean final results) . currently available conventional pharma­ daily dose achieved in the trial was 25.9 Carolyn Young, MD, principal investi­ ceutical pain medications. In this trial mg THC, and 24 mg CBD. gator and Consultant Neurologist based design, the patients continued to take The proportion of patients raring them­ at the Walton Centre for Neurology and their existing medication (i.e., the medi­ selves as "much" or "very much improved" Neurosurgery in Liverpool, explained, cation prescribed prior to the onset of in the Sativex group (9 of 34; 26.5%) was "Cenrral neuropathic pain occurs the trial) throughout the duration of the more than twice that of patients receiving frequently in people with MS. It can be study. placebo (4 of 32; 12.5%). In the patients' tremendously debilitating and unrespon­ Sativex is derived from whole plant Clinical Global Impression of Change sive to existing therapies. Our findings extracts of 2 specifically bred cannabis (CGIC, a self-assessment of changes from demonstrate that Sativex was effective in plant varieties. The extracts are combined rhe baseline, either improvement or wors­ reducing both central pain in MS and to produce a standardized formula- ening of conditions), patients on Sativex pain-related sleep disturbance in a popula-

34 I HerbaiGram 69 2006 www. herbalgram.org ------~LResearch ReviewJ~------tion with moderate to severe central pain Peppermint Oil May Reduce Daytime Sleepiness inadequately relieved by existing medica­ tion."' viewed: Norrish M, D wyer K. Preliminary investigation of the effect of Neuropathic pain is caused by damage epp~r~int oil on an objective measure of daytime sleepiness. Int j Psychophysiol. to or dysfunction of the nervous system. 005,55.291-298. It is usually chronic and accompanied by unpleasant burning or shooting sensa­ The oil from peppermint (Mentha x baseline sleepiness between groups. In tions, or extreme sensitivity to touch. piperita L., Lamiaceae) leaf is thought conditions rhar favor an increase in sleepi­ It is estimated rhar at least 2.4% of rhe to be stimulating and invigorating and ness, both groups had an increase in world's population suffers from neuro­ may reduce sleepiness. This elegant and sleepiness. However, according to pupil­ pathic pain,2 including over 1.4 million unique study measured the invigorating lary oscillations, the increase in sleepiness patients in the UK and 350,000 in the effects of peppermint o il on an objective was significantly lower with pepperminr US.3 It is estimated that central neuro­ measure of daytime sleepiness-pupillary exposure (P = 0.011). The authors believe pathic pain (pain initiated or caused by oscillations. In darkness, the pupils of the that the affect was not due to differences damage to the central nervous system, eyes oscillate (move back and forth) with in pupil size or an orienting response to i.e., the brain or spinal cord) occurs in up increasing amplitude when a person is to 52% of people with multiple sclerosis.4 sleepy; in contrast, the pupils are relatively Up to 32% of patients with MS regard stable when alert. Most norma l healthy pain among their most severe symptoms,5 people become increasingly sleepy during describing it as frequent, disabling, and an 11 minute recording of daytime sleepi­ inadequately managed.6 ness. The goal of this study was to ascer­ Sativex has been developed by UK­ tain whether peppermint o il limits this based GW Pharmaceuticals PLC (www. increase in sleepiness. gwpharm.com) and has been approved This randomized controlled trial tested recently as a prescription medicine in 20 undergraduate students from Coven­ Canada for the symptomatic relief of try University, Coventry, United King­ neuropathic pain in adults with MS. dom, who were randomly assigned to 2 Sativex is marketed in Canada by Bayer groups: experimental group (peppermint Pep permint Mentha x piperita. Photo ©2006 HealrhCare. According to GW, an ongo­ oil) and control group (no fragrance). An stevenfoster.com ing clinical trial program is currently being eye tracking computer system was used to conducted by the company to support measure pupilla ry oscillations. The experi­ regulatory approval in the UK. Upon memal group received a fixed low concen­ the presentation of an olfactory stimu­ approval in the UK, GW has a licensing tration of pepperminr oil. T he pepperminr lus. The authors state that they cannot agreement that Sarivex will be exclusively oil was placed on a pad near each subject's rule our the possibility rhar the subjects marketed by Bayer HealrhCare. HG nostrils prior to each subject enrering exposed to the peppermint oil "expected" -Mark Blumenthal rhe room. The fixed concenrration was to be invigorated a nd as a result were more determined in another study. To conrrol invigorated. Also, it cannot be said with References for the subjects' initia l subjective level of certainty that the peppermint oil caused I. Sarivex•, a Cannabis-Based Medicine, sleepiness, they completed the Stanford an invigorating effect or rather the pres­ Significantly Reduces Central Neuropathic Sleepiness Scale, which is routinely used ence of an odor (i.e., any odor) produced Pain in People with Multiple Sclerosis [press to assess feelings of sleepiness. Following the effect. release]. London: GW Pharmaceuticals, a brief adaptation to the darkness, rhe !!­ The goal of this srudy was ro ascertain September 27, 2005. minute recording was initiated. Subjects the accuracy of the claim rhar pepperminr 2. Neuropathy Trust Web sire. Ava ilable at: were asked not to smoke, drink coffee, or h rrp://www. neurocen rre.com/. Accessed oil can ward off sleepiness. The authors December 2, 2005. wear strong perfume/aftershave one hour believe that this study can support the 3. Perro OJ. Cannabis in multiple sclerosis: prior to participation. claim. However, further investigations are Women's heal rh concerns. journal ofCanna ­ According to the Stanford Sleepiness needed to confirm rhar the effect is indeed bis Therapeutics. 2002;2(3-4):161- 175. Scale, participams in both groups were attributable to the pepperminr oil a nd to 4. Biovie J. Central Pain. In: Wall PO, fairly alert but relaxed prior to the test. determine the mechanisms of action. HG Melzack R, eds. Textbook ofPain , 4th ed. There were no significanr differences in -Heather S. Oliff, PhD Hong Kong: Harcourt Publishers Ltd; 1999:879-914. 5. Srenager E, Knudsen L, Jensen K. Acute and chronic pain syndromes in multiple HerbClip™ sclerosis. Acta Neural Scand. 1991 ;84: 197- The preceding Research Reviews are drawn from more than 2,700 HerbClip critical reviews 200. available online to members of ABC at the Academic level and above. The full HerbClip G. Thompson AJ. Symptomatic treatment in Educational Mailing Service is distributed bimonthly and includes 12 critical reviews along multiple sclerosis. Curr Opin Neural. August with many of the original articles drawn from a variety of professional and mainstream 1998;4:305-309. sources. To receive the full service, contact Wayne Silverman, PhD, at 512-926-4900 ext. 120, or via e-mail at [email protected]. www.herbalgram.org 2006 Herba!Gram 69 I 35 arus, also known as Byelorussia or "White Russia," is breaking into the free arket-slowly. Previously part of Great Duchy Lithuania, Poland, Russia, and most recently, the former Soviet Union, Belarus is now 15 years into its independence. This small country, approximately the size of Kansas, borders Russia to the east, Poland to the west, and Ukraine to the south. Resembling Wisconsin in latitude and climate, its corn and wheat fields are surrounded by birch and spruce forests.

Citizens of Belarus are nature-loving people, who, like past generations, retain a strong tradition of gathering herbs, berries, and mushrooms from the forest. Consequently, it is particu­ larly tragic that a people so rooted in their natural environment have suffered more than 60% of the high-level radioactive fall- out from the 1986 explosion of the Chernobyl nuclear power plant. The most-contaminated areas have been closed off and the government closely Belarus has one foot monitors radiation in relation to all aspects of in the Soviet past daily life, including the herb industry. and one foot in contemporary Since the breakup of the Soviet Union in the early 1990s, words like "socialism" Western Europe, have been traded for terms like "social evidenced by the oriented market economy." However, predominance of casinos the Soviet influence remains strong with 80% of the people working for the state. juxtaposed with Over 8S% of families own their own flats statues of Lenin. (apartments), with an overwhelming majority having summer houses or dachas where they grow medicinal plants as well as fruits and vegeta­ bles for food. Traditionally, Belarusians employ medicinal herbs to treat most ailments. Herbal medicine is institutionalized and thoroughly regulated by the government. Phytomedicines

36 I HerbaiGram 69 2006 www.herbalgram.org are available exclusively through about 2500 pharma­ Ericaceae), and everlasting (Helichrysum arenarium (L.] cies located throughout the country. Licensed herbal Moench, Asteraceae). Additionally, Belarus is a party pharmacists with years of medical and herbal training to the Convention on International Trade in Endan­ staff many of the larger pharmacies. Herbal consulta­ gered Species (CITES) . tions are free, courtesy of the state. While a significant portion of cultivated herbs reach­ Belarus follows the Pharmacopoeia of the People's ing the market is grown by thousands of home farm­ Republic of the Soviet Union, 11th edition. Last issued ers at their summer dachas, the bulk of raw cultivated in 1987, this pharmacopeia contains about 60 plant product equaling an estimated 250 tons is produced species and only these plants are permitted for use as on a single 600 hectare state-run farm. Additionally, commercial herbal medicines in Belarus. Many of the about 20 state-licensed commercial farms contrib­ leading herbs in the American herb market such as ute minimally to black cohosh (Actaea racemosa L., Ranunculaceae, syn. the market. Each Cimicifuga racemosa [L.] Nutt) and goldenseal (Hydrastis licensed herb farm canadensis L., Ranunculaceae) are not included in the must consult a state- Belarus values healthcare Soviet Pharmacopoeia. If a pharmacy wishes to sell registered agrono­ and safety over business herbs not listed in the pharmacopeia, it must hire an mist as well as an herbal specialist, package the products according to herbal pharmacist. interests, yet government government standards, and provide a separate room Growing herbs in to sell the products. Because the government regu­ Belarus is heavily regulation effectively lates alcoholic substances stringently, tinctures are regulated and few limits alternative herbal produced solely by one state-owned enterprise. Only if any chemicals are 10 tinctures are widely ava ilable from pharmacies permitted for appli­ remedies and local throughout the country (see Table 1 on page 38). cation to cultivated companies. According to the Belarus Herbal Producer and herbs. Processors Association, herbs accounted for 10% of all lnallstepsofgrow­ Belarusian pharmaceutical sales in 2002, up from 1% ing and processing, in 1999. Five major herb companies in Belarus collec­ herbs are exten- tively generate about 2 million (US) dollars in annual sively tested by the State. Every shipment a processor revenue from the sale of approximately 200 tons of purchases from an individual harvester or grower must processed material in the form of bulk tea, teas bags, be analyzed for radioactive contamination, heavy tinctures, and tablets. The overwhelming majority of metals, chemical residue, moisture content, weed tablets and tinctures produced and sold in Belarus in content (i.e., foreign plant material), and microbiologi­ 2002 were valerian preparations. Currently, a handful cal properties (i.e., presence of microorganisms, such of Belarusian companies manufacture capsules and as mold and bacteria). This service is mandatory and syrups in very small quantities. Domestic companies provided for free by the State. After the herbs are cut have yet to meet the country's herb demand with and sifted, they are put through the same regimen of respect to quality and quantity, and consequently tests. In order to further track the process, each most products are imported from Russia and Ukraine. individual box of tea must identify Belarus, consistent with its position as an environ­ mentally-minded nation, restricts harvest of sensi­ tive species such as uva-ursi (Arctostaphylos uva­ ursi [L.] Spreng, Ericaceae), lingon- berry (Vaccinium vitis­ idaea L,

www.herbalgram.org 2006 HerbaiGram 69 I 37 the person responsible for packaging the product. in subsidies to state farms per year. The association's BioTest, the country's largest private herb processor, is failure is partly a result of its inability to serve private in the process of developing new tea blends; because herb manufacturers due to non-competitive pricing, all herb-based treatments are rigorously analyzed a limited number of targeted herbs, and an inatten­ by the State, employing animal tests, clinical trials, tion to quality. Like almost everything in Belarus, the and reference to compendia! standards, the approval herb market is slowly moving from a state-run model process for each formula takes about one year. to a free-market model and the BHPPA did !10t adjust Belarus has one foot in the Soviet past and one foot accordingly. in contemporary Western Europe, evidenced by the Belarus, with its long-standing reliance upon herbs, predominance of casinos juxtaposed with statues of socialized medicine, and an administrative economy, Lenin. The uneasy balance between social needs and provides a glimpse into another world of herbal medi­ business is played out in all aspects of the society and cine. Currently, Belarus values healthcare and safety economy. For example, BioTest experienced signifi­ over business interests, yet government regulation cant issues with quality control over raw materials effectively limits alternative herbal remedies and local because its buyer was on a three-year maternity leave, companies. Questions remain-what will be cut and with pay, and Biotest was barred from filling her posi­ sifted, what will be packaged and consumed, and tion for the entirety of her leave. by whom? How will the shift to a capitalist economy The Belarus Herbal Producer and Processors Asso­ affect the herbal industry and the nation's healthcare ciation (BHPPA) was founded in 1999 but is now as a whole? And finally, as business interests become defunct. While its mission was to meet business needs a higher priority, will regulation of herbal quality and and satisfy state regulations, it failed in merging environmental sustainability give way? Ten years is soviet models with the needs of private enterprises. a lifetime to the country of Belarus, and by the year Through the association, members pooled the costs 2015, the landscape of the herbal industry will surely of hiring an herbal pharmacist and an agronomist. be pruned and trained. HG The organization managed the supply of raw materi­ als to processors, facilitated the distribution of prod­ Jolie Lonner, MS (Natural Resources), is the founder ucts through a regional network of pharmacies, and and director of GoWild! Consulting, whose mission is negotiated with suppliers of agricultural inputs. The to foster and protect healthy ecosystems that include BHPPA acted as a liaison with the Ministries of Agri­ sustainable and traditional uses by humans. Ms. Lonner culture and Health. The association was started by is a forest ecologist and field botanist and has completed the government primarily to help state-run collective several herbal training programs. She has consulted in farms increase production for state-run processors, Belarus, rural California, Ghana, India, and the former and to that end they distributed about $50,000 (US) Yugoslav republic of Kosovo on issues of conserva­ tion, sustainability, and development of medicinal and Table 1. Widely Available Herbal Tinctures in Belarus aromatic plants. E-mail: [email protected]. Common Name Latin Binomial Family More information is available at www.gowildconsulting. &Authority com. Asian ginseng Panax ginseng C.A. Araliaceae Ivan Darashkevich, MS (Economics-Agriculture), is a Meyer tutor and research worker at Grodno State Agricultural Calendula Calendula officina/is L. Asteraceae University, Belarus. He completed economics programs at Chamomile Matricaria recutita L. Asteraceae the Agricultural University (Belarus) and pharmacognosy Echinacea leaf & root Echinacea purpurea (L.) Asteraceae courses in St. Petersburg Chemical-Pharmacology Acad­ Moench emy (Russia). His activities include ecological rural devel­ Eleuthero* Eleuthercoccus senticosus Araliaceae opment, pharmacognosy, natural pharmaceutical indus­ (Rupr. & Maxim.) Maxim try, and medicinal herb supply, and he provides consult­ Motherwort Leonurus cardiaca L. Lamiaceae ing for local growers, producers, and manufacturers Peppermint Mentha x piperita L. Lamiaceae of medicinal plants and spices. He is a co-owner of the Ononis Ononis arvensis L. Fabaceae country's largest herb-company, BioTest. Valerian Valeriano officina/is L. Valerianaceae Yarrow Achillea millefolium L. Asteraceae * Formerly called "Siberian ginseng" in the US

38 I HerbaiGram 69 2006 www.herbalgram.org

There are numerous reports in which people experiencing hallucination have gained great insight that may not have been attained otherwise. JimsonWeed History, Perceptions, Traditional Uses, and Potential Therapeutic Benefits of the Genus Datura

or many years, native peoples and tribes in various parts of the world have taken intoxicating plant preparations in religious rituals, divination, witchcraft, and healing ceremonies.1 "Western" interest in hallucinogenic plants or drugs has focused mainly on either the potential for psychother~peutic appli­ cations or their use to induce "controlled psychosis" to understand psychotic disorders such as schizo­ phrenia. Studies on ritual psychoactive plants could provide further insights into their proper use or misuse, improve clinical management of intoxication with herbal "highs," and perhaps also help in the discovery of therapeutically beneficial chemical compounds. The solanaceous plants such as those from the genus Datura have been used in both traditional and modern medicine as treatments for mental illness, tumors, infections, and even as aphrodisiacs. This paper examines attitudes toward Datura's hallucinogenic effects, its potential benefits, and describes traditional, therapeutic, and recreational uses in Europe and other cultures. Research on mecha­ nisms is also described to highlight the scientific rationale for Datura's use among indigenous peoples.

Introduction From the years 1330 to 1700, solanaceous plants were thought of as "diabolic incarnations."6 Hence Datura became known by For centuries various species of Datura have been revered as names such as "devil's apple," "mad apple," and "devil's work."5 sacred visionary plants by virtually all peoples who experience This is reflected over 300 years later in an English newspaper them. Datura is a member of the family Solanaceae (deadly night­ headline, which read thus: "Hooked! On the Devil's Weed."7 shade family), which also includes edible plants like tomatoes, The name "Jimson weed," the preferred common name estab­ potatoes, eggplant, and peppers (i.e., fruits of the genus Capsi­ lished by the herb industry in the United States, 8 is a corruption cum). The genus is widely distributed in the warm and tropical of "Jamestown weed" in reference to the experience of Captain regions of the world and consists of potent hallucinogenic plants John Smith and his band of English colonizers in their eventu­ such as D. inoxia, D. stramonium, D. mete!, D. wrightii, D. cerato­ ally unsuccessful attempt to establish a colony at what was called caula, D. quercifolia, D . tatula, D. discolor, and D. fostuosa .2 (The Jamestown in the Virginia colony in 1607. British soldiers were so-called "tree Daturas," which are significant in various South reportedly given boiled Jamestown weed (Jimson weed) for inclu­ American shamanistic practices and ethnomedicine, formerly sion in a salad, which the soldiers readily ate and then experienced belonged to this genus but now have been reclassified into the several days of erratic behavior. Several contradictory accounts are genus Brugmanisa.) given, but the most reliable appears to be that the soldiers may The name Datura comes from the early Sanskrit dustura3 or have been served this accidentally.9 (See sidebar on page 50 for dahatura, meaning "divine inebriation."4 The plants usually grow details.) as herbaceous annuals or perennials and are strikingly charac­ The origins of Datura are shrouded in uncertainty due to terised by beautifully colored (white to pinkish) trumpet-like the species' wide distribution, but Mexico and Central America flowers, which typically exude a fragrant odor nocturnally. They appear to have the largest concentration. This has led to sugges­ also bear walnut-sized seed capsules covered with spiky thorns, tions that it was probably introduced into Europe by the explorers hence the English common name "thorn apple" and the German of the New World. Others believe that Datura originated from the StechapfeJ.3.4,5 Caspian Sea, spreading south to Africa and east to Asia, from where it was brought to Europe by travelers during the Middle-Ages.IO It is probable that the Roma (aka "gypsies") brought Datura from India to Europe in the early 15th century,2 although Gerard claims to have been the distributor of the first seeds of D. stramonium (which he refers to as D. inoxia) in England. 11 Datura's usage was subsequently integrated into the sophisticated cultural belief systems associated with "witchcrafr."2 Whatever the origin, Datura appears to have played an important role as a "culture plant," particularly in Asia and the New World, for many years. Throughout these pans of the world, the species was particularly valued for its abil­ ity to induce visionary dreams, to help in foretelling the future, and to reveal the causes of disease and misfortune. Records indicate that the Aztecs knew the genus Datura. A particular species, which was then referred to as toloache, was used as an enema or suppository for pain relief in initiation rituals; it was also administered as a hallucino­ gen. Another species, D. ceratocaula, called atlinan by the Aztecs, was so revered that only the priests were allowed to use it. It supposedly enabled them to hold counsel with the gods and to foretell the future. In addition, it was used to find stolen objects and even to make prognosis of black magic associated illness. Datura ceratocaula was also used in an ointment to treat cracked soles, sores, bruises, pustules, as plasters for ulcers, and as a poultice for rheu­ matic pains.12, 13 Western Attitudes towards Datura: Pleasure and Intoxication In Medieval Europe and England, solanaceous plants such as Datura were utilized for their mind-altering propenies.14 It appears that in European and other native religions, witches and shamans originally held the sacred knowledge required to utilize these power­ ful plants safely. They were used in pagan rituals and as components of the infamous flying "green ointments" in witchcraft practices.5 A Renaissance record indicates that these applications were applied to the armpits and deli­ cate mucous membranes of the vagina with a broomstick or like-shaped implement.15, l6 Andres Laguna (1499- 1560), a physician to Pope Julius III, investigated these controversial religious practices and showed that the green ointments containing Datura took the women on "journeys" by producing dream-like states, rather than on physical flights as was widely believed.l7, 18 Existing evidence suggests that during the Spanish Inquisition, use of Datura could lead to persecution for witchcraft and sorcery.6 The executioners of the Inquisition recorded numerous accounts of "journeys to the Sabbath" during which the accused "danced with the deviJ."IO The pros­ ecution reportedly believed the accounts of the "witches" and subsequently may have condemned them to death on the basis of forced confession. But given that these accounts were usually obtained by severe torture, it is difficult to ascertain their veracity. It is now apparent that the experiences of "flying through the sky, dancing with the devil, and partaking in orgiastic feasts and rituals"6 were connected to tropane alkaloid-induced hatlucina­ tions.I9,ZO

Jim son weed Datura stramonium. Photo ©2006 stevenfoster.com

www.herbalgram.org The growth of European monotheism, instigated by dange r. 23 There were several reports of irs intoxicating rhe Inquisition, resulred in the eradication of pagan effecrs24 and consequently Datura use beca me synony­ beliefs and practices and the persecution of those who mous with negative terms such as "overd ose" and "drug practised them.G The Catholic C hurch condemned addicts."? even the research on "natural magic," so that the likes Although the American National Drug Intelligence of G iovan Battista Della Porta, who had worked with Center (ANDIC) recognized in rhe 1990s that there natural hea lers and recorded folklores, was threatened had been a dramatic increase in incidents of Datura for recording these beliefs and practices. Witch-hums exposure nationwide, encouraging awareness of its during the Renaissance period further marginalized "dangers" was seen as key to preventing Datura fro m "folk " groups, leading to widespread persecution and ever becoming a significant "rhrear."25 an even greater skepticism towards solanaceous plants and their use. 15 Attitudes outside Western Society It is debatable whether some of the so-call ed pagan Datura was more revered in societi es whose medi­ rituals of the medieval era were merely recreational, cal paradigm differed from the Western biomedical "diabolically" intended, or designed for so me well­ system in Europe. References to the sacred uses of considered medical purpose. Piomelli and Pollio's Datura (s pecifically D. mete/) ex ist in ancient records account ofCardano and Della Porta's famiarum unguen­ from Euras ia (e.g., C hina and India). For example, in tum seem to suggest rhar at least the inclusion of some India, rhe sadhus and yogis smoked the leaves and seeds excipienrs (e.g., soot) in this preparation, probably had mixed with ganja (Cannabis indica L. , Cannabinaceae) . 1 an indirect pharmacological rarionale. 5 lr has been T he plant was highly revered as a powerful aphrodi­ observed that on topical application, tropane alkaloids siac.16.1 7 The Indians mixed the powdered seeds with are slowly absorbed through the skin and that absorp­ buuer and ingested it orally for impotence or applied it tion is enhanced by induc- topically to invigorate the ing inflammation, creat­ male genitalia. The leaves ing abrasions, or by using In spite of its reputation as we re also smoked to reli eve a substance that would a witch's herb, Datura was asthma 16 and were one of create an alkaline envi­ the primary in gredients in ronment. It seems there­ commonly used for medicinal an ami-asthmatic product. fore that the addition of purposes even in Europe. In C hina a Taoist legend the soot to the famiarum refers to the plant as the unguentum produced flower of one of the pole the alkalinity needed for stars. The C hinese customarily mixed Datura with 1 diffusion into the blood stream. 5 T he records also cannabis and wine, and legend had it rhar if the person show that an aqueous extract of the roxie Aconitum spp. gathering rhe plant had a pleasant disposition at the (fa mily Ranunculaceae) was among the pl ant ingre­ rime, this would be reflected in the behavior of all 1 dients contained in the salve. Piomelli and Pollio 5 who drank from it, bur if the gatherer had been sad, suggest that the soot's alkalinity could have affected the so would be all who drank the wine.13 Datura was also hydrolytic cleavage of the roxie constituent aconitine to used to treat colds and nervous condirions. 17 the less harmful derivative aconine, thereby reducing In parts of South America, Datura was taken as a the potential toxicity of the salve. rea or smoked to induce visions. Apart from irs sacred Interestingly, the complexity of these preparations has significance, it was also regarded as one of the most been compared with the shamanic use of halluci nogens ancient healing herbs. It is thought that rhe ancient 14 in Mesoamerica and the Amazon basin. It could be Peruvian healers and shamans employed Datura's hallu­ inferred that the intentions for use in this context were cinogenic properties when performing rituals or medi­ of a more complex magico-spirirual or even pharmaco­ cal operations (e.g., skull trepanations-the process of logical nature. Most current reports, if they include any cutting a hole in the skull). 2G In what is present day notes on preparation, describe ingestion of si mple infu­ Chile, the Auruks still use Datura as a shamanic plant sions or smoking and do not refl ect the erhnoboranical and as med icine in much the sa me way as their ances­ sophistication of the "green ointments." tors. The leaves of the species D. ferox are brewed and It is probable that Datura was used recrearionally up give n to unruly ch ildren to "teac h the children a good to rhe witch-hunts of the 17th century at a rime when measu re of respecr."1 2 alcohol was expensive.14 During the Middle Ages, the Among rhe C humash people of Cali forn ia, D. practice of combining Datura seeds with alcoholic mete! played an important role in their initiati on ritu­ drinks was popularized in Europe. In Catholi c Bavaria, als. To them Datura was the single most important henbane (Hyoscyamus niger L., Solanaceae) was labeled medicinal plant and was taken in a ritualistic fra me­ a "crazy-making thing" and the practi ce of mixing it work.27 According to Baker, reasons for raking Datura 1 with beer was banned in 1507.2 included, aiding the acquisition of "dream helpers," T he use of Datura in a modern context peaked in ascertaining the caus e or cure of an illness, or gaining the 1960s and 70s with an upsurge in interest of pagan a specific skill , such as fishing. They used Datura to 2 and shamanic practices. 2 Linked with adolescents empower rhem to manipulate rhe "supernatural forces" and the growth in "youth culture" during this period that control nature and influence human acti vity. All of social transformation, Datura and other psychorro­ young males and fema les of puberty age were given pics quickly became associated with rebelliousness and extracts of the root to invoke some form of spiritual

www.herbalgram.org 2006 protection throughout thei r earthly and non-earthly that assemble this are disrupted, the notion of the self endeavours. A person experienced in Datura would be may be dissolved.33 T his could be likened to the state present during intoxication and would teach "moral that often occurs during dreaming. values" in the period after inebriation.27 Similar Experience of consciousness is highly influenced by accounts can be found from across South and Cenrral the combination of connections between the thalamus America, including Diegueno shamanism, the Algon­ and the cortex, which are modulated at the relevant quin tribe of North America, and the Qichaus of regions by neurotransmitters.31 Consequently, inter­ Peru.l3,28 The effects and the dosage were considered ference with the transmission of neurotransmitters according to both pre-session preparation and envi­ across the synapses will affect the conscious experi ence ronmental factors. As in many other tribes, Chumash of an individual. preparations included abstinence from certain foods One of the major neuromodulatory systems involved and sexual activity for up to 21 days before inges­ in relaying information between these importanr brain tion. The degree of adherence to these rules corre­ strucrures is the cholinergic system. The neurotrans­ sponded with the amount of power a person wanted mitter acetylcholine (ACh) has been postulated as to acquire. a major correlate to consciousness; the cholinergic The Chumash also used Datura as an anaesthetic for neural pathway, specifically fro m the basal forebrain to "bone setting," to treat wounds, bruises, and hemor­ the cortex and thalamus, is thought to be an essential rhoids, and to "freshen the blood." In some cases the afferent regul atory system to the cerebral cortex.32 plant was used to induce a quasi-comatose state in a person experiencing severe trauma, in the belief that Tropane Alkaloids and Anticholinergic the psychoactive properties of the plant would desen­ Activity sitize the pain receptors to reduce stress in the patient, The tropane alkaloids present in Datura include thereby promoting speedy healing. 27 Among the atropine, hyoscyamine, and hyoscine (scopolamine). Navajo, the dried roots were chewed in ceremonies as a Research suggests that there is little diffe rence in the febrifuge (to stop fever), while a leaf infusion was used quantities of these alkaloids found across species .3 4 as a vulnerary (wound-healing agent) "to wash the Although hyoscyamine has been found to be the major wounds of castration in sheep."29 "Possession inebria­ alkaloid, with atropine and hyosci ne being consider­ tion" began in Africa before being inrroduced to the ably less,34 the principal CNS effects are created by Mediterranean and Indonesian islands. It "invaded" hyoscine, which can cross the blood brain barrier more America with the slave trade and became known as effi cienrly.35 voodoo, candomble, or mandinga. Datura was one of The tropane alkaloids are thought to act as competi­ the main plants used to induce this kind of inebria­ tive inhibitors of ACh via the muscarinic receptors at tion, causing raprures of "bodily frenzy" in which the autonomic ganglia and at the myoneural junc­ conscious awareness disappears) tion. 23.36 During the 1970s, the action of scopolamine Not only are these uses outside the realms of general in reducing inhibitory impulses was investigated for understanding in Western society, they also incorpo­ use as a possible "truth drug."9,12 It is thought that rate a different attitude toward the plant itself. The solanaceous alka loids trigger hallucinations through long period of preparation before ingestion of the blocking chol inergic activity. ACh, an excitatory plant may be for physical protection or as a symbol neurotransmitter, is widely distributed in the brain of respect for the forces that were to be encountered and is important for the sleep-wake-cycle.37 By block­ (psychological preparation) or a combination of the ing cholinergic activity, the alkaloids cause intrusions two. Additionally, it is worthy of note that the partici­ of rapid eye movement (REM) sleep into the waking pant was permitted the space and time ro prepare; state.32 therefore the rirual did not isolate them from the It has been shown by electroencephalography social group. Communication took place between (EEG) studies that humans have the potential to be the participant and the group, suggesting a social consciously attending during REM sleep.32 Similar "dialogue." In other words, the plant was used in these wave patterns to those of REM were recorded when instances to achieve culturally desirable altered states brain activity was measured in 10 cases of Datura of consciousness. intoxication.18 EEG recordings immediately after Neurotransmitters and Conscious hospitalization revealed slow wave activity and bizarre rhythmical bursts of high-voltage sharp wave activity Perception in 6 of the 10 patients, indicating that Datura may Attempts have been made in recent years to explain lower the threshold for dream and hypnagogic (i.e., a possible physical correlation between altered states that state between being awake and falling as leep) of consciousness and activity in the central nervous imagery. IS system (CNS), specifically the brain.30 It is thought Dreams have long been associated with elements that different strucrures of the brain are associ­ of the unconscious mind_38 ,39 There are numerous ated with different levels of consciousness and that reports in which people experiencing hallucination conscious perception occurs only when the associative have gained great insight that may not have been cortex is active. T his type of perception is involved attained otherwise. One such case was that of a 74- with identity of self, in the planning of movement, year-old male who became intoxicated after hav ing orientation, and imagination_3l,32 Consciousness gives received atropine sulphate for bradycardia (slow heart a sense of rea lity to stimuli and hence if mechanisms beat). He experienced visual hallucinations, which

2006 www.herbalgram.org revealed detailed knowledge about an area of his field (business) which he claimed to have had no previous knowledge.l9 Hallucinations in degenerative brain disorders are thought to be due to alterations in consciousness and are associated with regional deficits in the cholinergic system. Those occurring in some diseases, such as dementia with Lewy bodies, coupled with disturbances in REM sleep have been likened to experi ences following solanaceous plant ingestion.32 (Lewy bodies disease is a neurodegen­ erative disorder characterized by distinct loss of ability to process, learn, and remember information, with fluctuat­ ing confusion, visual hallucinations, fantasy, and signifi­ cant parkinsonism.) Datura intoxication could therefore represent a useful model for understanding brain organiza­ tion, memory, and emotional behavior.40 Hyoscine in the form of scopolamine hydrobromide in combination with morphine was formerly used to produce "twilight sleep" and amnesia in obstetrics, a practice which has since ceased because of the associated risk.9 A study that sought to investigate the visual eyes-closed hallucinations associated with the toxicity of another muscarinic ACh receptor, atropine, may provide an alter­ native hypothesis for the hallucinogenic effect of Datura. It was observed from the study that the visual eyes-closed hallucinations observed resembled hypnagogic hallucina­ tions and may therefore originate in the brain stem.18 It is thought that there is a correlation between the number of receptor sites (and their affinity to the psycho­ tropic subsrance) and the type of hallucination expe­ rienced by an individual as well as the idiosyncratic responses observed.3 2 Therapeutic Potential of Datura In spite of its reputation as a witch 's herb, Datura was commonly used for medicinal purposes even in Europe. Datura cigarettes have been prescribed to asthma sufferers for the anti-spasmodic/bronchodilating effect of atropine on the respiratory sysrem .41 Both atropine and scopolamine have interesting phar­ macological actions. Atropine suppresses ni cotinergic activity (i .e., activity of agents that act to enhance the action of ACh at nicotinic receptor sites) more than cholin­ ergic activity (i .e. , activity of agents that directly m imic the action of ACh at receptor sites or block acetylcholines ter­ ase). Therefore, atropine is a parasympatholytic (inhibits the physiological effects generated by stimulation of the sympathetic nervous system). It is mainly used as a mydri­ atic (dilates the pupils) before surgery, although a newer drug, rropocamide, is now the drug of choice due to atro­ pine's slow degradation. Atropine is also used in the treat­ ment of bradycardia (slow heart beat). It reduces bronchial and salivary secretions and also serves as an antidote for poisoning by organophosphate insecticides and nerves.9 Like atropine, scopolamine is also used as an antidote for the roxie effects of phosphate insecticides and "nerve gases."9, 12 Both scopolamine/hyoscine and atropine have been used to treat motion sickness.42,43 T he mechanism is as yet unclear, bur it is thought to involve inhibition of vestibular input to the CNS, thereby inhibiting the vomit­ ing reflex.43

Jim son weed Datura stramonium. Photo ©2006 stevenfoster.com

www.herbalgram .org In addition, hyoscine was formerly used together with morphine just before childbirth to produce "twilight sleep and amnesia"9,12 whereby the expect­ ant mother remains semi-conscious but forgets the pain associated with delivery afterwards. Besides the unpleasant adverse effects of the hyoscine-morphine combination, it was also found that pain was not really reduced. The side effects included neona­ tal depression, drug transfer via the placenta to the fetus, which caused respiratory distress, teratogenesis, and in rare cases, death of the mother and/or child. Hyoscine has also been used as an anaesthetic and, more dubiously, in narcoanalysis (as a "truth drug"). In the 1950s, various intelligence agencies such as the US Central Intelligence Agency investigated the effectiveness of scopolamine as a "truth drug," but the possibility that findings could be distorted by the compound's hallucinogenic side effects resu lted in the project being abandoned.9 The tropane alkaloids also cause paralysis of the muscles of light accommodation (cycloplegia) and pupil dilation (mydriasis) .1 2 One of the first medical investigations to uncover the therapeutic potential of Datura in mental health was undertaken in 1762 by Anton Storck. His inves­ tigations led him to report that Datura had the abil ­ ity to make "unsound minds sane and sane minds mad."43 In 1886, August Sohrt of Torry is said to have utilized Datura isolates for the "mentally ill," possibly on the recommendation of one of hi s teach­ ers who claimed that hyoscine was an extremely valu­ able medicine for psychiatric treatmenr.21 It has been suggested that the period following the comatose state induced by Datura may be ideal for psychotherapeu­ tic efforts,27 comparable with the teaching of "moral values" by the Chum ash tribe after inebriation. 27 However, it has been shown that small doses of some Datura constituents such as atropine may impair learning and memory functions in dementia.44 Set and Setting T he effects of Datura depend not only on the type of species and dose used, but also on the "set and setting" of the user. An interesting study in which two volun­ teers were given "scientifically calculated " doses of henbane to investigate whether the archetypal mental image of"the witch" as a "f1ying hag" can be ex plained by the use of solanaceous plants was conducted in comfortable and attractive surroundings. The volun­ teers had previously been introduced to the research panel to create some degree of familiarity. One of the volunteers had previous experience with these plants and subsequently reported visions of a dream-like state in which he was conscious and over which he had control once he allowed his "body to relax and drift off over landscapes." In contrast, the less experienced volunteer had vivid dreams and f1ashes in his peripheral vision but reported no "f1ight" or conscious awareness during the dreaming state. 20,45 In another study the patient experienced hallucina­ tions for 12 days and was able to describe his experi-

Jimsonweed Datura stramonium. Photo ©2006 stevenfoster.com

www. herbalgram .org Table 1. Central and peripheral effects of anticholinergic syndrome induced by Datura stramonium intoxication in 4 cases. Central nervous system effects Peripheral effects (begins 30-60 minutes after ingestion) Co nfu sio n Red appearance Disorientati on Warm, dry sk in and mucous me mbranes Atax ia slu rred speech Dysphasia (d ue to mucosal dryness) Fluctuati ng luci dity and hyperactive agitated state Elevated body temperature (for 8 to 12 hours) Staring into space Tachycardia (in 3 patients) La bile state (of laughter and crying) Pupillary di lation with poor reaction to light Sensitiv ity to peripheral activity Blu rred vis ion Misident ifi catio n of peopl e Auditory hallu cin ations (voices of close fri ends) Vi sual hallu ci nati ons (beetl es or insects) ences ro his attendants, including his wife. T his could nology could be because reports of am nesia, anxiety, be considered a rel atively long peri od of time ro be in and paranoia would inevitably discourage abuse of a hallucinatory state-yet there was no reported anxi­ these preparations. ety or fearl9 - probably a refl ection of the impact of In some of these cases, behavior comparable to a secure environment and the opportunity to express that of "possession inebriation" was described here as his ex periences as they occurred . T his could also be a "violent" or "aggressive" (Table 2 describes as hyper­ refl ection of the complete estrangement from reality activity or combative ness). Similarly, what m ight be that these agents induce. deemed "hallucinati on" in orthodox medical terms T hese studies suggest, as is the case with the admin­ may in another context be referred to as a "vision." istrati on of other psychotropic agents, that if there is Although the outcome of Datura intoxication is sa id the potential to utilize Datura as a therapeutic tool, to be favo rable and "treatment" bes t confined to protec­ the context (e.g., surroundings , attitudes , and rhe ti ve measures, prolonged use of scopolamine may res ult social climate) in which it is taken may influence the in withdrawa l symptoms including dizziness, nausea, res ults. vomiting, headache, and disorientation.43 Symptoms of Datura Intoxication Conclusion M any of the cases of Datura intox ication reported It is evident that contemporary attitudes toward in the 1960s and 1970s occurred in hospitals and often halluci nati on have influenced the general perception fea tured quite severe sympro ms.21 ,4 6,47 These cases of Datura and that the socially-driven bias toward the may have involved people ingesting large (potentiall y plant may have diminished interest in its therapeutic roxie) amounts of the alkaloids with virtuall y little potential. It appears that in societi es in which the use knowledge of the potential effects and dosages. of Datura is an integral pa rt of the socio-cultural and Symptoms such as increased heart rare, drying up of rel igious belief sys tems, there is emphasis on personal the mucous membranes, dry throat and cramps, rest­ growth, preparati on, and healing. Moreover, the ri sks lessness, giddiness, disorientation, constipation, and (both phys ical and psychosocial) invo lved in the inges- confusion have been observed. Uncontroll ed talking or laughing, memory disturbances, and repetitive acts, as well as hallucinations and elated fa ntas ies are also Table 2. Symptoms of Datura stramonium common features. T hese effects are often followed by intoxication in 212 cases a deep prolonged sleep during which sexually inclined Symptom No. of drea ms and hallucinations ca n be experienced. 23,48 O n people "recovery" from this state of altered consciousness, a Hallucinati ons 99 characteristic "hang over" and amnesia are fel t. In 1968, DiG iacomo reported the symproms Di sorientatio n 45 presented in Table 1 as hav ing occurred in four cases Dilated pupils 36 of Datura intox ication in reenagers.47 Dryness of ski n and mucous membranes 32 In Table 2, Gowdy46 provides a more represenra­ rive picture in a review of 212 cases of D. stramonium Ataxia 31 intoxication (mentioning both seed pod and in gestion Hyperactivity or combativeness 29 of as thma powder containing dried Datura) . Amnesia 21 In his review, Gowdy46 points out that 99 our of the 212 cases actuall y ex perienced hallucination. Since Fever 20 this was the ex pressed intention by most of the inebri­ Rapid pulse 18 ated, nearly half achieved what they had se t out to do Flu sh 13 and only a reported 8 out of 212 experienced anxiety. Paranoia 10 Gowdy also states that negative or biased reporting of symptoms and the omission of positive effects or termi-

www. herbalgram .o rg 2006 References 1. Furst PT. Hallucinogens and Culture. ova to, CA: Chandler and Sharp; 1976. 2. Preissel U, Preissel HG. Brugrnansia and Datura-Angel's Trum­ pets and Thorn Apples. Aukland, New Zealand: David Bateman; 2001 :107-118. 3. Mann J. Murder, Magic and Medicine. Oxford: Oxford Univers ity Press; 1996:82-84. 4. Rarsch C. Plants of Love: The Histo ry ofAphrodisiacs and a Guide to Their Identification and Use. Berkley, California: Ten Speed Press; 1997:55. 5. Mascord G. T he hi sto ry and uses of Datura (Thornapple). The Herbal Review. 1984;9(2): 11-13. 6. Escohorado A. Drugs, Lust, and Saran. In: A Brief H istory of Drugs-From the Stone Age to the Stoned Age. Rochester, Vermont: Park Street Press; 1999:39. 7. Associated New Media. Hooked! O n the Devil's weed: A plant which can send yo u on a halluci nation "rrip" is growing wi ld in th e West Country. Daily Mail [serial online]. January 8, 1979:9. 8. McGuffin M, Karresz JT, Leun g AY, Tucker AO. 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Photo ©2006 stevenfoster.com ology of alrered stares. Addiction. February 1995;90(2): 163- 164. tion of Datura-while appearing m anifold-may in part be 15. Piomelli D, Pollio A. In upupa o srrige. A study in Ren aissa nce a product of socially driven perceptions. In these societies, the plant ointments. History and Philosophy of the Life Sciences. London: Taylor and Francis; 1994; 16(2):24 1-273. " hardships" undergone during intoxication may be considered 8 16. Lewis WH, Elvin-Lewis MPF. Medical Botany: Plants Afficting worth enduring and are socially supported4 as opposed to W es t­ Man 's Health. USA: John W il ey; 1977:330-420. ern societies where a type of social isolatio n is often imposed on 17. Grieves M. Thornapple. Boranical. co m- A Modern Herbal [data­ those who partake in such activities, (e.g. , "drug addicts"). Profes­ base online]. Avai lable ar: rrp: //botanical. co m/boranicallmgmhlr/ sional hechiceros (Native American medicine men), for example, rhorna12.hrml. Accessed November 8, 2005. were persecuted by the church for using Datura for purposes 18. Rothman T. De Laguna's co mmentaries on hallucinogenic drugs of "witchcraft,"I3 paralleling the action taken in Europe and and witchcraft in Diosco rides Materia Medica. Bulletin of the England during the 1960s a nd 70s. History ofMedic ine. 1972;46(6):562-567. 19. Fisher CM. Visual hallu cin ations on eye closure associated with A review of the potential benefits a nd uses of this plant species atropine toxicity. A neurological analysis and comparison with outside Western societies suggests that the negative publicity that or her visual hallucinations. The Can j Neural Sciences. February is often given to it may be undeserved. The mechanisms proposed 1991;18(1) :1 8-27. so far suggest that the species has therapeutic benefits that can be 20. Marris S. Sacred Weeds: Henbane [Video]. London: Channel 4; utilized to further the understanding of hallucination. This there­ 1998. fore calls for new research that views hallucination in a positive 21. Miiller JL. Love porions and rhe ointment of witches: histori­ light and extends outside the confines of culturally determined ca l aspects of rhe Nightshade alkaloids. J Toxicol Clin Toxicol. bias, that is, in the right professional setting. There may be a need 1998;36(6):617-627. 22. Bye RA. Shorr Communications: Datura and Casreneda. j Ethno­ to learn from societies in which the pl ant is still utilized in order biol. 1987;7(1):121-122. to fully understand its therapeutic potential. However, experi­ 23. Hall RC , Popkin MK, McHenry E. Angel's trumpet psychosis: a ences may not be directly transferable as most research is bound ce ntral nervous system anticholinergic syndrome. Am j Psychiatry. up in cultural mores. 1977; 134(3):312-314. Moreover, research must m ove away from the emphasis on 24. Mahler DA. The jimso n-weed hi gh. JAMA. January 13, 1975; generating awareness of dangers (which may be seen as instilling 231 (2): 138. fear into people) toward understanding of the experience of hallu­ 25. arional Drugs Intelligence Centre (N DIC) for United Stares cination. Further studies could provide the miss ing link in the Deparrment of Justice. Jimso nweed (Datura stramonium): current understanding of these pla nts, including keys to the more Right: Jimsonweed Datura stramonium L. from Kohler's Medizinai-Pflanzen religious or spiritual aspects, and those differences that personal­ in naturgetreuen Abbildungen mit kurz erlauterndem Texte: Atlas zur Pharma­ ity and preconceived ideas may bring to the experience. HG copoea germanica, Volume 1 of 3 (origina lly published in 1887). 1995-2006 Missouri Botanical Garden http://www.illustratedgarden.org

48 I HerbaiGram 69 2006 www.herbalgram.org Solaneae .

1

7

8 • 6

na lura ~tram onium l. W iJl CTl. i.Jhl.

l3 Analyst Commenrs [onl ine]. September 1998. Available ar: hn p:/ /64.233. 183. 10 4/search?q=cache: b27W6ddof5MJ :www. usdoj.gov/ ndic/pubs/5 79/co mmenrs.hrm+J imso nweed+is+a +da ngerous,+bur+legal+hallucinogen& hl=e n . Accessed on November II , 2005. 26. H eiser CB Jr. Nightshades: The Paradoxical Plants. Sa n Fran­ cisco: WH Freeman and Company; 1969:I 36- I4 1. 27. Baker JR. T he Old Woman and H er Gifrs: Pharmacologica l Bases of rhe Chumash use of Datura. Curare. I994; I7(2):253- 276. 28. Romanucci-Ross L, Moerman D E, Tabcredi LR, eds. The Anthropology ofMedicine: From Culture to Method. 3rd ed. Wesrporr, CT: Bergin and Garvey; I997: 2I5-220. 29. Kluckhohn C. Navaho Witchcraft. Bosron: Beacon Press; I944:2. 30. Perr ine DM. The Chemistry ofMind Altering Drugs. H istory, Pharmacology, and Cultural Context. Washi ngton DC: Ameri ­ ca n C hemical Sociery; 1996: 14- I 5,34. 3 1. Rorh G. T he ques t to fi nd consciousness. Sci Am Mind. 2004; 14( 1):32-39. 32. Perry E, Walker M , Grace J, Perry R. Acerylcholine in mind: a neurorransminer co rrel ate of consciousness? Trends in Neuro­ sci. June 1999;22(6):273-280. 33. Beyersrei n BL. Believing is seeing: organi c and psychological reasons for hal lucinations and orher anomalous psychiatric symproms. Medscape Psychiatry & Mental Health ej ournal. 1996; I : l -I 2. 34. Schul res RE, H ofmann A. The Botany of Hallucinogens. Springfield, IL: Charles C. T homas; 1980:286-287. 35. Spinella M. The Psychopharmacology of Herbal Medicine: Plant Drugs That Alter Mind, Brain and Behaviour. London: T he M IT Press; 2001. 36. Hall RCW, Pfefferbaum B, Gardner ER, Stickn ey SK, Pe rl M. Imoxicarion wirh angel's rrumper: amicholinergic del ir ium and hall ucinosis. J Psychedelic Drugs. July-September, I978; I 0(3):25 1-253. 37. Schneck), RuprehrJ. Cenrral anticholinergic synd ro me (CAS) in anes thes ia and inrensive care. Acta An£sthesiol Jim son weed Datura stramonium L. from Plantarum se/ectarum icones pictae I Belgica. I989;40(3):2 19-227. editae a Nico/ao Meerburg Vol ume 1 of 1 (originally published in 1798). ©1995- 38. Mikolich JR, Paulson GW, Cross C] . Acure am icholinergic 2006 Missouri Bota nical Garden httpJ/www.illustratedgarden.org synd rome d ue to jimson seed ingestion: cli nical and laborarory observation in six cases . Ann Intern Med. 1975;83(3):321-325. 39. Myers DG. Psychology. 6rh ed. New York: Worrh Publishers; Jimson weed- A Jamestown Story 200 I :258. n 1676, British soldiers were sent to stop the Rebellion of 40. Ardila A, Moreno C. Scopolamine in toxicati on as a model of Bacon, a protest led by a resident of Jamestown, Nathan­ rransienr global amnesia. Brain and Cognition. 1991; 15:236- iel Bacon, against policies of the governor of Virginia. The 245. I 4 1. C harpi n D, O rehek J, Vela rdocchio JM. Bronchodilator soldiers failed in their mission because of the hallucinogenic prop­ effecrs of anriasrhmaric cigarene smoke (Datura stramonium). erties of the Jamestown weed (Jimson weed), which was boiled Thorax. Ap ril 1979;34(2):259-261. for inclusion in a salad the soldiers readily ate. Robert Beverly 42. Q uigley EMM, H asler WL, Parkman HP. AGA techni­ describes their resulting behavior in The History and Present State cal review on nausea and vo miting. Gastroenterol. January of Virginia (1705): "... some of the soldiers sent thither to quell the 200 I; 120:263-286. rebillion of Bacon (1676); and some of them ate plentifully of it, 43. Wood, C D. Pharmacological counte rmeas ures against motion the effect of which was a very pleasant comedy, for they turned sickness. In: Crampton GH , ed. Motion and Space Sickness. natural fools upon it for several days: one would blow up a feather Boca Raton, CRC Press; 1990:344. 44. Srorck AF. An Essay on the Internal Use ofThorn-apple, in the air; another would dart straws at it with much fury; and Henbane, and Monkshood; Which Are Shown to be Safe and another, stark naked, was sitting up in a corner like a monkey, Efficacious Remedies in the Cure ofMany Obstinate Diseases grinning and making mows at them; a fourth would fondly kiss [Translation from Larin]. London: Becker and H ondr; 1762. and paw his companions, and sneer in their faces with a counte­ 45. lnzelberg R, Shapira T, Korczyn AD. Effects of atropine on nance more antic than any in a Dutch droll. lea rn ing and memory functi ons in dememia. Clin Neurophar­ In this frantic condition they were confi ned, lest they should, macol. June I990;13(3):241-247. in their folly, destroy themselves - though it was observed that 46. Gowdy JM. Stramonium imoxicarion: Review of symptomato­ all their actions were full of innocence and good nature. Indeed logy in 212 cases.]AMA. August 7, 1972;221(6):585-587. 47. DiGiacomo JN . Toxic effect of Stramonium simulating LSD they were not very cleanly; for they would have wallowed in their rrip. JAMA. Ap ril 15, 1968;204(3):265-266. own excrements, if they had not been prevented. A thousand such 48. Zaehner RC. Mysticism, Sacred and Profane. Oxford: O xford simple tricks they played, and after 11 days returned themselves Unive rsiry Press; 196 I. In: Eva ns DM. H allucinogenic planrs. again, not remembering anything that had passed." HG Br J Phytother. 1990; I (2):23-28.

50 I HerbaiGram 69 2006 www. herbalg ram.org A leading company on the Brazilian pharmaceutical market, Catarinense has been producing quality herbal medicines for 6 decades. Our concern for the cultivation of medicinal plants, the preservation of endangered species , the quality and safety of our products, our constant search for scientific innovation and our sense of ethics are core values at Catarinense. If you need anything from raw materials to finished products, especially those based on native Brazilian medicinal plants, consider Catarinense as a partner for your next projects. For further information , call+ 55-47-451-9143 or e-mail us at [email protected] .br.

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U.S. Partners: ABKIT, INC. and Markan Global Enterprises, Inc. GuEsT EDITORIAL

Media Spins Numbers on Bitter Orange AERs Based on Erroneous Information from FDA

Review Finds All But One "Report" Associated with Ephedrine or Caffeine

BY MICHAEL McGuFFIN

ditor's note: A previous version of this article was published in September 2004 in the AHPA Report, 1 the monthly newsletter ofthe American Herbal Products Association, the herb industry trade association. Because we comidered the Esubject so significant, we invited the author to submit the article for publication in HerbalGram. This version contaim new information and additional references and has undergone peer review. In essence, the author is commenting on the prac­ tice ofthe Food and Drug Administration to release adverse event reports (AERs) to the media without qualifying each report and/or clarifying the overall significance ofthe data being released. The author is not attempting to provide a thorough review or evaluation of the AERs on bitter orange dietary supplements. The opiniom expressed herein are those ofthe author and do not necessarily reflect the opinions or policy ofHerbaiGram or the American Botanical Council. HerbalGram provided a copy ofthis editorial to officials at the FDA for comment in this issue, but at press time FDA had not yet responded.

Many marketers of dietary supplements contammg contains ephedrine alkaloids. The combination products bitter orange (Citrus x aurantium L., Ruraceae) were containing both bitter orange, ephedra, and other ingre­ surprised when an April 11, 2004 article in the New York dients had been sold, and adverse event reports related to Times2 stated that, according to an unidentified Food them had been filed prior to the ephedra ban on April 12, and Drug Administration (FDA, or the Agency) spokes­ 2004.3 Consequently, AHPA's legal counsel, Anthony L. woman, there had been 85 adverse reactions-and 7 Young, filed a request with the FDA under the Freedom deaths-associated with this increasingly popular ingre­ oflnformation Act (FOIA) for copies of any adverse event dient. As is often the case with such articles, other media reports (AERs) regarding dietary supplements containing picked up on the story, and bitter orange and/or its extracts.4 it appeared in other papers In early June, AHPA received from FDA two CDs around the country, includ­ containing files for 147 AERs to fulfill Young's request. It was difficult to ing the Seattle Times, the York As is typical of FDA's AER files, these reports varied Sunday News (PA), the Kansas greatly in content and completeness of documentation believe that reports City Star, the Arizona Repub­ of the details of the cases. Some of them provided thor­ of such a serious lic, the Akron Beacon journal ough descriptions of the subject patient, extensive medical (OH), San jose Mercury News records, and a copy of the label of the product associated nature could have (citing the New York Daily with the report. Others consisted of only one- or two-page News) , and others. e-mails from one FDA employee to another and lacked passed unnoticed. None of the primary suppli­ basic information such as the name of the product. A ers of bitter orange extracts, quick review showed that the many of these reports were as well as various other herb associated with products that also contained ephedrine experts in the industry and alkaloids. academia, had heard of any such cases, and it was difficult to believe that reports of such a serious nature could have The Number Keeps Going Up passed unnoticed. Even as AHPA's staff worked to organize all of these This author, as president of AHPA, contacted the records and wondered how the number had suddenly Agency and engaged in frustrating conversations in which jumped from the 85 reported in April to the 147 received it became clear that FDA personnel knew that the Times two months later under the FOIA request, the number of report was not accurate and that these officials had abso­ allegedAERs jumped again. An article in the July 5, 2004 lutely no intention of issuing a retraction or correction, or edition of Food Chemical News5 reported that Barbara at the least, a clarification. It was later learned that FDA Schneeman, PhD, the new director of the FDA's Office of officials knew that many of these reported adverse reac­ Nutritional Products, Labeling, and Dietary Supplements tions were associated with dietary supplement products (ONPLDS), had then tallied 169 bitter orange AERs. that also contained the controversial and now banned To her credit, Dr. Schneeman was also quoted as saying, herb ephedra (Ephedra sinica Stapf., Ephedraceae), which "One has to look at the quality of the data that's in those

52 I HerbaiGram 69 2006 www.herbalgram.org reports," and that just because FDA receives a report "doesn't automatically mean that the product itself has caused the problem."5 But when the Los Angeles Times ran a story on July 19,6 it cited a "spokeswoman for [FDA]"as its source for reporting that 169 "reactions" had now been "linked" to bitter orange. In preparing this article, AHPA was informed by the LA Times writer Shari Roan that this number had been provided by FDA's press office in response to her request that specifically asked that only "ephedra-free" products be counted. AHPA's concerns about FDA's failure to reveal that these cases were based on products that also contained ephedrine alkaloids esca­ lated to concerns that FDA was simply misstating the facts, whether intentionally or through negligence. AHPA's Analysis, Part 1: How Many Bitter Orange AERs Are There? When AHPA completed its analysis of the 147 AERs received in June, some truly remarkable facts and figures were found (see Table 1). In summary, AHPA was provided with 110 unique AERs and with information about 17 others for which no report numbers were assigned. The total of 127 cases Bitter orange Citrus x aurantium. Photo ©2006 stevenfoster.com represents 42 more than the amount revealed by the NY Times' anonymous source at FDA in April and 42 fewer than what Dr. Schneeman (FDA's Director of ONPLDS) providing the public-in this case AHPA- with the kind believed to exist in early July. Any competently rational of accurate information that assures transparency of the person who reviews this data must assume that something operation of government agencies. is seriously flawed at the Agency. Either FDA's manage­ ment is receiving erroneous information from irs AER Why Were the Incomplete Cases Included? staff, or the FDA (via the FOIA system) is not actually It is difficult to understand how FDA decided to consider each of the cases identified by Cytodyne LLC (in Table 1. Quantification of AERs in Freedom of the information submitted by Cyrodyne's consultant and Information Act Response listed in Table I) as a unique adverse event. (Cytodyne TOTAL quantity of AERs identified by FDA with 147 markers Xenadrine• EFX, a dietary supplement containing unique case numbers. bitter orange extract.) T he Cytodyne tables were provided Duplicate numbers (i.e., more than one case 1 as a reference to support a statement made by a consul­ number for a single AER). tant to the company that one described event (in which a seizure was reported) represented a unique report for Quantity of case numbers included in FDA's Free- 79 the company's product. The information included in the dom of Information Act (FOIA) response that were Cytodyne tables consisted only of an internally assigned assigned to events identified in tables sent to FDA number, the date of the report, a reported outcome (each by a consultant to Cytodyne LLC* related to inter- stated in nor more than three words (e.g., "hair loss" or nal records on 2 of the company's products. "loss of consciousness"), and the frequency of the reported Apparent duplicates included in the above identi- 36 outcome. All additional relevant and necessary informa­ fied "79 cases." tion was lacking; for example, there was no age or gender Quantity of unique AERs identified by FDA in its 11Qt identified for the subjects, nor were dosage and duration FOIA response. of use discussed. Also missing was any information on the medical history and the possibility of concomitant use Events that were included in the above-refer- 17 of prescription or nonprescription drugs or other dietary enced Cytodyne tables but apparently not supplements. It is impossible to view these cases as mean­ counted in the above identified "79 cases ." ingful submissions to a federally managed adverse event Actual quantity of unique AERs identified in FDA's 127t reporting system. FOIA response. * A marketer of dietary supplements under the Xenadrine• AHPA Analysis, Part 2: Where's the Bitter Orange? brand. Further analysis of the 127 unique cases identified in t Calculations are: 147- 1-36 = 110; 110 +1 7 = 127. the data provided to AHPA by FDA was undertaken to

www.herbalgram.org 2006 HerbaiGram 69 I 53 answer an important question-How many of these cases osteoarthritis, hypertension, and diabetes. Concomitant were related to products that were labeled or reported to prescription drugs were identified as DiaBeta" (a blood contain bitter orange (or bitter orange extract) but no sugar-lowering drug for diabetics), Norvasc" (a blood pres­ other source of a stimulant alkaloid? Of particular inter­ sure-lowering drug), Zocor" (a cholesterol-lowering drug), est is another question-How many of these AERs were and a thyroid drug. And the recorded adverse experience: associated with products that were labeled or reported "Felt very unwell, weak," and later, "lower extremity to contain both bitter orange and a source of the now­ swelling (2+ edema)." banned ephedrine alkaloids? (See Table 2.) This review has narrowed the focus of these AERs to What is most outrageous in this single incident to call attention to concerns about the Table 2 is that the agency has way that FDA provides safety information about herbs What is most not in any way differentiated to the media. Bur those reports that are associated with the 82 AERs purportedly asso­ products that combine bitter orange and a caffeine-source outrageous is that ciated with bitter orange that ingredient should not be overlooked, as there are numer­ the agency has are also products with ephed­ ous such products available in the market. rine-containing ingredients. not in any way In fulfilling AHPA's FOIA What Next? Will FDA or the Media Set the Record request, FDA simply lumped Straight? differentiated the these together with other AHPA has verbally communicated the information 82AERs cases. Nor has the Agency contained in this article to FDA by forwarding the previ­ separated these AERs in its ous version of this article published in the AHPA Report1 purportedly statements to the media, even to them as well as to the writers of the articles cited above associated with when the media has reportedly in the New York Times and the Los Angeles Times. 2,6 AHPA requested information only for has also requested that FDA amend its flawed communi­ bitter orange that products that did not contain cation policy that currently provides inaccurate informa­ ephedrine. In its recent ban tion to the public on the agency's own AER records for are also products on ephedra, the government bitter orange, and, presumably, for all dietary supplement with ephedrine- branded any amount of ephed­ products. AHPA believes that FDA should establish a rine in a dietary supplement policy wherein it always provides clarifying information containing as presenting an unreason­ whenever it releases reports about AERs it has received. ingredients. able risk of illness or injury.3 Such information should include, for example, a break- Has not FDA already assigned ephedrine as the "associated" ingredient for each of these 82 cases and utilized that Table 2. Quantification of AERs information as part of the basis on which it has banned Uniquely Associated with Bitter Orange ephedrine alkaloids from dietary supplements? ACTUAL quantity of unique AERs provided by 127 FDA. The One Case Still Standing Quantity of AERs that did not identify a bitter 82* The above calculations leave a single case remain­ orange ingredient in the associated product. ing where FDA received a report, in late 1998, of an adverse event associated with a product that was labeled Quantity of AERs that did identify a bitter orange 41 to contain bitter orange but that did not contain either ingredient but did not include any ephedrine- caffeine or ephedrine. It is, of course, useful to examine containing ingredients. this case in derail in light of the pressing question. Could Quantity of AERs that did identify a bitter orange 40 this incident have been a "signal"? Did the symptoms and ingredient, did not include an ephedrine ingredi- other factors rise to the level of a "sentinel event"? (The ent, but also included a source of caffeine. term "sentinel event" was used in the 2003 report by the Quantity of AERs that identified only a bitter 1 RAND Corporation on its safety evaluation of ephedra, orange ingredient (i.e., did not include either an under contract by the Agency for Healthcare Research ephedrine or a caffeine ingredient). Quality.? This report defined such an event to be one that met certain criteria, including exclusion of alternative * Includes one case for a product with a label that identi- fied Sida cordifolia L., Malvaceae as an ingredient with no explanations for the adverse event.) mention of ephedrine, but that also stated the product was In fact, this report recorded an adverse experience in not for sale in numerous states, consisting of those states where ephedrine was not allowed to be sold (but where sida a 74-year-old woman who had been prescribed three was presumably legal); one case for the same product for separate herbal formulas, in the form of imported small which no label was provided; and a third case for this same black pills, from a Chinese herbalist. One of the prod­ product with a label that listed an extract of 5. cordifolia as ucts contained as an ingredient "immature bitter orange." an ingredient and that also identified and quantified ephed- rine as a constituent of the product. The woman's prior medical history was noted to include

54 I HerbaiGram 69 2006 www.herbalgram.org Bitter orange Citrus x aurantium. Photo ©2006 stevenfoster.com

down of adverse events by dosage; breakdown of adverse References events by severity; identification of other contained ingre­ 1. McGuffin M. FDA spins numbers on bitter orange AERs: dients (especially if such ingredients might also be consid­ AHPA analysis finds only 1 actual report associated with ered to be associated with any reported events); informa­ bitter orange. AHPA Report. September 2004;19(9):2-4. tion on age and gender; and any other data needed to 2. Hurley D. As ephedra ban nears, a race co sell the last ensure a clear understanding of any such reports. supplies. New York Times. April 11, 2004. It has now been reported in trade journals that, in 3. US Food and Drug Administration. Final Rule Declaring Dietary Supplements Containing Ephedrine Alkaloids Adul­ response to AHPA's identification of errors and misrep­ terated Because They Present an Unreasonable Risk, 69 Fed. resentations in FDA's record of adverse events report­ Reg. 6788 (February 11 , 2004). Available at: http://www.fda. edly associated with bitter orange, FDA's press office gov/ohrms/dockets/98fr/1995n-0304-nfr000 1.pd£ will no longer provide quantitative responses to inquiries 4. Young AL. Letter (via facsimile) to Food and Drug Adminis­ about adverse events associated with dietary supplements tration, Freedom oflnformation Staff, April 14, 2004. submitted to FDA. 8,9 However, FDA has not made any 5. Wallace P. FDA taking cautious approach co AERs, bitter public statement to acknowledge that the next time an orange safety. Food Chemical News. July 5, 2004;46(21): 1,20. enterprising writer calls the Agency, he or she will receive 6. Roan S. Ephedra-free weight-loss supplements scrutinized. any more accurate information than was provided to the Los Angeles Times. July 19, 2004:Fl. 7. Shekelle P, MortonS, Maglione M, et al. Ephedra and reporters for the New York Times and the LA Times last Ephedrine for Weight Loss and Athletic Performance spring. HG Enhancement: Clinical Efficacy and Side Effects. Evidence Reporc/Technology Assessment No. 76 (Prepared by South­ Michael McGuffin is president of the American Herbal ern California Evidence-based Practice Center, RAND, under Products Association, the national trade association and Contract No. 290-97-0001, Task Order No.9). AHRQ voice ofthe herbal supplement industry. He is also the senior Publication No. 03-E022. Rockville, MD: Agency for author/editor of several books that provide self-regulatory Healthcare Research and Quality. February 2003. Available guidance for the herb industry in the areas of safety and at: http://www.fda.gov/OHRMS/DOCKETS/98fr/95n- 0304-bkg0003-ref-07 -0 1-index.hrm. nomenclature, The American Herbal Product Associa­ 8. Wallace P. Herbal group challenges adverse event numbers tion's Botanical Safety Handbook (1997) and Herbs of for birrer orange. Food Chemical News. September 13, Commerce, 2nd ed. (2000). Founded in 1983, AHPA 2004;46(31): 17-18. represents the responsible core of the botanical products 9. CFSAN examines AER reporting following bitter industry, and comprises growers, processors, manufacturers, orange miscalculation. The Tan Sheet. September 20, and marketers ofherbal products. Web site: www. ahpa. org. 2004;12(38): 11.

www.herbalgram.org 2006 HerbaiGram 69 I 55 Legal & Regulatory

AHPA Adopts New and Revised Trade Recommendations for Herb Industry Self-Regulation New policies affect traditional herbs processed with heavy metals, prohibitions against drug-masking claims, and pesticide analysis for cultivated ginseng by Mark Blumenthal

he American Herbal Products Association (AHPA), the national trade association and voice of the herbal products industry, has issued new trade recommendations for its members. 1 The first recommendation deals with herbal preparations made T with heavy metals according to traditional processing methods; the second two are revisions of two previously issued recom­ mendations regarding herbal products that might be sold to mask drug tests and pesticide levels in cultivated ginseng. The new and revised policies were approved by the AHPA Board of Trustees at its meeting on July 15, 2005. T he primary purpose of a u ade associa­ It is in the interests of the surro unding this article has increased the tion like AHPA is to protect and promote public's awareness of this problem. T he the interes ts of its members. O ne of the industry association(s) AHPA Board has thus adopted the follow­ bes t ways this ca n be achieved is through ing u ade recommendation dealing with indusu y sel f-regulation. In the case of the to provide leadership this issue, as recommended by the AHPA herb industry, whenever problems regard­ to its members to help Standards Committee: ing quality, sa fety, and claims for product W hereas traditional Ayurvedic benefits arise, it is in the interests of the improve conditions in the formulas may include ingredients that indusuy association(s) to provide leader­ industry, eventually for consist of herbs that are processed ship w its members to help improve condi­ with metals; and whereas the pres­ tions in the industry, eventually for the the presumed benefit for ence of several of these metals in pres umed benefit for the general public. the general public. herbal dietary supplements sold in T hroughout its 22-year history AHPA has the United States may cause such taken the initiative in a variety of labeling, products to be adulterated under the quality, and safety issues affecting the herb Traditional Metal-Processed Herbs Federal Food, Drug and Cosmetic trade by iss uing policies and "trade recom­ O ver the pas t several decades there have Act; therefore, AHPA recommends mendati ons" designed to help prevent or been reports of va ri ous heavy metals that that manufac turers and marketers remedy va ri ous problems.2 AHPA's self­ have been detected in specific "herbal" of herbal products that are based regulatory initiatives are often produced formulations from both C hina and India. on Ay urvedic traditions refr ain from well ahead of any guidelines or regulations According to some traditional methods of the inclusion in such products of by state or federal regulatory agencies, if processing herb and other materia medica any ingredient that is processed with any such regul ati ons are ever iss ued. in traditional Chinese medicine (T CM ) metals if the resultant presence of AHPA's trade recommendations become and the Ayurvedic herbal tradition in heavy metal(s) would cause the prod­ incumbent upon all AHPA members as India, some herbs are processed with heavy uct containing the ingredient(s) to be a requirement of membership. AHPA's metals (e.g., arsenic, lead, mercury) for adulterated under labeled or ordinary Association By-Laws defines "Obliga ti ons their pres umed health benefits. Although conditions of use. I of Membership" to include ". .. adher­ TCM and Ayurvedic formulations sold in T he presence of heavy metals in any ence to all poli cies and principles of busi­ the United States in the dietary supple­ herbal pro duct detected at levels which ness as outlined in the Code of Erhics ."3 ment indusu y normally do not contain may render it injurious to health consti ­ T he AHPA Code of Ethics and Busi­ these heavy metals in any appreciable levels tutes an adulterated or co ntaminated ness Conduct established that a trade that would cause health concerns, there product and the product is thus illega l. recommendation of the Board of T rustees have been reports of their illegal presence Thus, unlike the two recommendations co nstitutes an amendment to the Code. in T C M or Ayurvedic products, many of below, AHPA has made this recommen­ T he new and recently revised trade recom­ which are imported and sold directly in dation effective immediately when issued mendations described below rhus consti­ ethnic markets in the United States. For las t July. tute amendments to the C ode of Ethics example, an article published December and are incumbent on all AHPA members. 2004 in the j ournal ofthe American Medi­ Prohibition Against Drug-Masking According to AHPA policy all newly cal Association4 containing an analysis of Claims adopted or substantively amended trade Ayurvedic herbal products from India In the mid 1980s, with the advent of recommendations are effective six months that were purchased in ethnic Indian urine res ting for metabolites of mari­ fro m their dare of adoption, unless other­ grocery stores in the Boston area demon­ juana and other illicit drugs, some aggres­ wise noted. (In the case of the recommen­ sn ared that there are excessive levels of sive marketers began promoting herbal dations below, the effective date is Decem­ some toxic heavy metals in some of these formulati ons claiming to be able to assist ber 15, 2005.) Indian products. The res ulting publicity persons in masking a test for marijuana.

56 I HerbaiGram 69 2006 www.herbalgram.org legal & Regulatory

One of the herbs most often promoted labeling or marketing any dietary agricultural extension agents have encour­ for this purpose was goldenseal (Hydrastis supplement in any manner that aged Ameri can ginseng farmers to employ canadensis L. , Ranunculaceae) root, even sugges ts that the product masks or a variety of fungicides and other pesti­ though there is no rational basis for the defrauds drug tes ting. I cides* on their ginseng ro prevent root rot misguided belief that goldenseal prepara­ and related problems. This practice is now tions can produce this effect-the myth Pesticide Analysis for Cultivated also employed in C hina in the produc­ having been derived from a novel written Ginseng tion of both Asian gi nse ng (Panax ginseng in 1900 by the renowned herbal pharma­ In 1998 the issue of pesticide and C.A. Meyer) and American ginseng grown cist John Uri Lloyd.5 fungicide residues in cultivated Amer­ in C hina from seeds imported from the AHPA has a long-standing policy, origi­ ican ginseng (Panax quinquefolius L., United States. nally published in March 1998, against Araliaceae) roots came In November 1999 labeling dietary supplements and teas to the fore in the US AHPA published a containing goldenseal root or aerial parts herbal industry. Because policy which included as agents to assist in masking the results ginseng must be grown in a specific analysis for of drug tests that are required by many conditions that approxi­ pesticides used in culti­ employers and the military. In May 2005, a mate the light conditions vated ginseng, including Congressional hearing was held to discuss of the forest canopy, it all members of the genus various products, including some that are is grown under shade Panax. In April 2005 labeled as dietary supplements, which are cloth that allows only when AHPA's vice presi- marketed with the deliberate intention of about 25% of the avail- dent for scientific and masking drug testing.6 The AHPA Board able light through to the technical affairs, Steven decided therefore to extend the current plant. Plus , the soil must be moist and the Denrali, PhD, lea rned that the Food and AHPA policy beyond goldenseal, and the ginseng roots must be at least four yea rs of Drug Administration (FDA) was usi ng a ex isting policy published in 1998 was age before harves ted. All this creates ideal different analytical method, he conferred revised as follows: conditions for opportunistic fungi and a with the AHPA Analytical Labs Commit­ AHPA recommends that marketers fungal pathology called "root rot"-the tee for review of the FDA method and of dietary supplements refrain from bane of ginseng farmers. For many years a recommendation on its potential use

www.herbalgram.org 2006 HerbaiGram 69 I 57 legal & Regulatory

by indusrry. Based on that committee's ity of consuming a relatively high level due Dentali, PhD, Vice-President of Scientific review and recommendations, the AHPA to its use on many different food crops.B and Technical Affairs, at AHPA to iden­ Board in July amended AHPA's current The World Health Organization's Inter­ tify an appropriately validated analytical rrade recommendation on ginseng pesti­ national Programme on Chemical Safety method for testing their ginseng material cides, removing the identification of a states that quintozene is "unlikely to be for this purpose. He can be reached at specific analytical method for pesticide hazardous" and that it is a weak skin sensi­ 301-588-1171 ext.l03 or sdentali@a hpa. analysis. The revised policy, which went tizer, but not an irritant.9 The US Envi­ org. HG into effect immediately, follows: ronmental Protection Agency classifies it AHPA recommends that processor as a Group C, possible human carcino­ References and manufacturer members analyze gen, and that "No information is available 1. AHPA Board Adopts New and Revised cultivated ginseng (Panax spp.) by on the chronic (long-term), reproductive, Trade Reco mmendations [press release]. an appropriately validated analytical developmental, or carcinogenic effects of Silver Spring, MD: American Herbal Products Association. July 26, 2005. method at an appropriate and relevant pentachloronitrobenzene in humans." IO 2. McGuffin M. Self Regulatory Initiatives limit of detection for the presence of Quintozene is approved for use in by the Herbal Industry. Herba!Gram. quintozene and related compounds, ginseng in Canada but it has not been 2000;No. 48:42-43. including known degradants and registered for such use in the United 3. AHPA Code of Ethics and Business impurities of quintozene,* and also States. It has reportedly been used in Asian Conduct. Silver Spring, MD: Ameri­ for the presence of difenoconazole; ginseng cultivation for the past 30 years. 11 can Herbal Products Association; July and further, that the analyses iden­ Generally, only a relatively small amount 2005. Available at: http://www.ahpa. tified herein be performed by quali­ of quintozene remains on ginseng roots org/05_0700_CodeOfEthics_july2005. pdf. Accessed December 13 , 2005. fied analytical labs using validated after they are harvested, so the amount of 4. Saper RB , Kales SN, Paquin J, et al. analytical methods; and further, that quintozene ingested by a ginseng supple­ Heavy Metal Content of Ayurvedic bulk lots of ginseng be accompanied ment or tea consumer is low, due to the low Herbal Medicine Products. JAMA. by a certificate that provides actual level of the quintozene in the material and 2004;292:2868-2873. tes t results for quintozene and its because of the relatively small amount of 5. FosterS. Go ld ensea l masking of drug degradants, and for difenoconazole; herb material usually ingested as teas and tests: From fiction to fallacy, an historical and further, that in lieu of analysis dietary supplements, i.e., compared with anomaly. Herba!Gram. 1989:No. 21:7,35. by the processor or manufacturer, conventional foods consumed as vegeta­ 6. House committee calls for federal legisla­ tion to ban drug test masking products. the accompanying certificate identi­ bles, with the most likely human intake of The AHPA Report. June 2005:4-5. fied above may be accepted from a quintozene coming from peanuts and leafy 7. American Conference of Governmental supplier provided that the proces­ green vegetables. The current FDA stan­ Industrial Hygienists. Documentation of sor or manufacturer establishes the dard is for ginseng to be quintoze ne free; the threshold limit values and biologi­ reliability of the supplier's analysis; this is defined as containing a level less cal exposure indices. 7th ed. Cincinnati, provided that, any cultivated ginseng than 0.01 parts per million, the current OH; 2001:6. [Note: Abstract available at that is produced in a manner that limit of analytical detection.11 There is a toxnet.nlm.nih.gov.] assures that the ginseng is free of small but growing movement in North 8. Pesticide Action Network. Toxicity Infor­ mation for PCNB. Available at http:/ I quintozene and related compounds America to produce pesticide-free and/ www.pesticideinfo.org/Detail_Chemical. and of difenoconazole is exempted or organically-grown American ginseng. jsp?Rec_Id=PC35123#Toxicity. Accessed from this recommendation.! Further, some herb suppliers have devel­ December 10, 2005. *PCNB, quintozene; PCA, penta­ oped methods to remove pesticides from 9. International Program on Chemical chloroaniline; PCTA, pentachloro­ cultivated ginseng roots before they are Safety. Environmental Health Criteria thioanisol; HCB, hexachloroben­ sold to manufacturers for further process­ 41. Quintozene. Geneva: United Nations zene; PCB, pentachlorobenzene; ing into dietary supplements and other Environment Programme, International alpha-BHC, alpha-benzenehexachlo­ consumer products. The acceptable level Labo r Organization, and World Health Organization, 1984. Available at: http:/ I ride; beta-BHC, beta-benzenehexa­ for these pesticides according to the FDA www.inchem.org/documenrs/ehc/ehc/ chloride; delta-BHC, delta-benzene­ is the current limit of analytical detection ehc4 1.htm#SubSecrionNumber: 1.1.5. hexachloride; gamma-BHC, gamma­ (lOppb or 0.001ppm). In the European Accessed December 10, 2005. benzenehexachloride (lindane); TCA, Union the legal limit for such pesticides 10. EPA. Technology Transfer Network Air tetrachloroaniline; and TCZ, tech­ is 1 ppm (part per million), according Toxics Website. Hazard Summary. Penta­ nazene. to Volker Wypyszyk, CEO, MB North chloronitrobenzene (Quintozene). US Quintozene (pentachloronitrobenzene, America, a supplier of quintoze ne-free Environmental Protection Agency. Janu­ PCNB) is rated by American and inter­ ginseng material through the affiliated ary 2000. Available at: http://www.epa. gov/ttn/atw/hlrhef/ quintoze.hrml#refl. national organizations as a relatively mild company Finzelberg GmBH & Co. KG of Accessed December 10, 2005. toxic agent, a fungicide. It is not classi­ the Martin Bauer Group (W. Wypyszyk e­ 11. Dharmananda S. The source of quin­ fied as a human carcinogen according mail toM. Blumenthal, July 28, 2005). tozene residues in ginseng. Portland, to the American Conference of Govern­ An extensive article on quintozene is OR: Institute for Traditional Medicine; mental Industrial Hygienists.? The Pesti­ available on the Web site of the Institute November 2001. Available at: http:// cide Action Network rates quintozene as for Traditional Medicine.l 1 Members of www.itmonline.org/ans/quintozene.hrm. having "slight toxicity" due to the possibil- the herb industry can contact Steven Accessed November 29, 2005.

58 I HerbaiGram 69 2006 www.herbalgram.org

Herb Industry Self-Regulation Initiative on Common Names for Herbal Ingredients Becomes Federal Law in January by Mark Blumenthal

n most cases, the ideal way to regulate an industry is for that industry to regulate itself. Since 1992 the American Herbal Products Association (AHPA) has taken the initiative for self-regulation in one of the most important areas of the herb trade, the names I used for herb materials used in teas, dietary supplements, and other commercial products. In 1992 AHPA published Herbs of ing to implement as pects of the Dietary dardized in the second edition of Herbs of Commerce, a listing of about 550 of the Supplement Health and Education Act of Commerce. 2 T he rules also allow dietary most widely used herbs in the North 1994 (DSHEA). 2 supplement product labels to omit the American market with their "standardized In 2000, AHPA revised this list to Latin binomial of herbal ingredients listed common name" (SCN) and the corre­ more than 2,000 species found in the US in H erbs of Commerce, 2nd edition when sponding Latin binomial for each entry. 1 marketplace with its Herbs of Commerce, the AHPA SCN is used; otherwise, the T he intention was to develop uniform 2nd edition) Effective January 1, 2006, Latin name is required to identify all other common names used for herb materials the second edition will be inco rporated herbal ingredients. In addition, when and finished products. The first edition officially into federal regulations dealing Larin names are used, they must conform was published as self-governing guidance with the labeling of botanical ingredi­ to internationally accepted nomenclature for AHPA members to reduce confusion ents in dietary supplements. This official rules; the 2000 edition of the International associated with labeling botanical ingre­ recognition was originally announced by Code of Botanical Nomenclature (IC BN, or dients. This standardization of common the FDA in the Federal Register in 2003.4 St. Louis Code) is identified as an authori­ names is at the root of efforts to ensure Titl e 21 of the Code of Federal Regula­ tative reference.5 quality and safety of botanical products. tions, Part 101.4(h) (2 1 CFR 101.4(h)) The second ed ition of Herbs ofCommerce T he 1992 document was incorporated by requires that the common or usual name contains almost 1,5 00 more species than reference in 1997 as the Food and Drug of botanical ingredients in dietary supple­ the original 1992 edition (2,048 separate Administration (FDA) initiated rulemak- ments be consistent with the names stan- species as opposed to 550). Thus, accord-

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60 I HerbaiGram 69 2006 www.h erbalgram.org Legal &Regulatory

ing to AHPA, "m any ingrediem s presenrly (The A merican Botanical Cou ncil [A BC] 3. McGuffin M, Karresz JT, Leung AY, Tu cker used on labels w ill now be able to be iden­ also independently suggested to FDA that AO. American Herbal Products Association's ti fied by their com mon names instead of H erbs of Commerce, as well as some lists of Herbs of Commerce, 2nd ed. Silver Spring, MD: American Herbal Prod ucts Associa­ their Latin binomials."6 old d ietary ingred ients compiled by other tio n, 2000. AHPA's presidem Michael M cGuffin ind ustry groups, be recognized as an offi ­ 4. FDA. Food label ing: Ingredient labeling stated , "It's gratifying that FDA incorpo­ cial list of old dietary ingred ients, the lack of dietary supplements thar contain bota­ rated AH PA's good work to set standards of which causes con fusion in the industry nicals. Docker no. 2003N-0346. (Food fo r labeling. We strive to work in th is as to whether a potentially novel botanical and Dru g Administration). Federal Register way with the regularory agencies : credible ingrediem must undergo a n N O! review.) 68 ( 167) :51693-51704. August 28 , 2003. experts in the fi eld provide valuable and ABC published a n a rticle on this Available ar: hnp://www.ahpa.org/03_ authoritative information to the regula­ subject in H erba!Gram in 2003 after 0828_DirecrFinaiRule_HoC2.pdf. Accessed December 2, 2005 . tor, and the regulator then adopts and FDA announced the new policy.? The 5. Greurer W, ed. International Code of Bota­ endorses this information as policy."6 direct final rule fro m the Federal Regis­ nical Nomenclature (St. Louis Code) 2000, AHPA has also urged FDA to recog­ ter is posted on AHPA's Web site: http:// adopred by rhe International Association for nize H erbs of Commerce, 2nd ed ition, as www. a h pa .o rg/ 03 _ 0 82 8 _ Direct F i na i­ Plant Taxonomy ar rhe XVI Intern at ional an authoritative resource to differentiate Rule_HoC2.pdf. H erbs of Commerce, 2nd Bora ni ca l Congress. Kon igsre in , Germany: between old d ietary ingredients a nd new edition, is avail able to AHPA members Koelrz Scientific Books; 2000. Available ar: dietary ingredients (NDis, i.e., dietary from the AHPA online bookstore, http:// h np:/ /www.bgbm . fu-berl in.de/iapr/ nomen­ ingredients that were not sold as fo ods or www.ahpa.org/bookstore.htm, fo r $39.95. clature/ code/Sai n tLouis/OOOOSr. Lu isri de. hrm. Accessed December 2, 2005. dietary supplements prior to the passage of Non-A HPA members ca n purchase the G. AH PA. Herbs of Commerce, 2nd edition, OSH EA on O ctober 15, 1994). N D!s are book from the A BC H erbal Education Becomes Law of rhe Land for Labeling required to be subject to a safety review by Catalog on ABC's Web site at http://www. (press release]. Silver Spring, MD: American FDA with the prospective seller submit­ h erba lg ra m. o rg/b ookca ta log/ p roduc t . Herbal Producrs Associat ion; November 7, ting documentation of safety at least 75 as p ?p =l 36 (item # B475) fo r $95.00. HG 2005. days before the date of the proposed initial 7. Blumenthal M. FDA publishes rule ro sale of the NDI. AHPA asked the FDA References incorporate AH PA's Herbs of Commerce to recognize the second ed ition of H erbs 1. Fos ter S. Herbs of Commerce. Austin TX: in herb label ing. HerbalGram. 2003;60:66. Ava il ab le ar: hnp://www. herbalgram.org/ of Commerce in its Public C ommem s to American Herbal Prod ucts Association; herbalgram/arricleview.asp?a=260 I. Accessed FDA regarding FDA's proposed regula­ 1992. 2. Tide 2 1. Code of Federal Regulations, Parr December 2, 2005. tions on N Dis on February 1, 2005. I 0 1.4(h).

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BC is now offering the second compone nt of this training and certification course, desig ned to assist the natural products reta il employee, sa les and marketi ng staff members of manufacturers, customer service Arepresentatives, di stributors in multilevel marketing compani es, and a nyone who talks to customers about herbs as part of their work. Course Two expands on the information offered in Co urse One, which provid es an ove rvi ew of key issues and concepts in the field of herbal medicine along with basic scie nce-based information on 29 herbs commonly sold in the U.S. market. Course Two teaches you to: Evaluate safety information on specific he rbs in o rd e r to a rticulate what is stated in the scie ntific literature, Appreciate the history of the regulation of di etary supplements, FDA enforcement, consumer protecti on, and the importance of good manufacturing practices (GMPs), and Integrate curre nt clinical research on specific herbs into your conversations with customers/clients so they can be better informed on what is stated in the scie nt ific li terature. www.herbtraining.com Single Course $69.95 Quantity discounts available. Contact 800-373-7105 or 512-926-4900 www.herb algram .org 2006 HerbaiGram 69 I 61 ------ll Market Report J.------China Projected to Become Top Tea Exporter by Courtney Cavaliere

ea exports from China have risen dramatically over the past few years and are forecast to increase further, which is a cause for concern in many developing countries that depend on tea sales, according to a recent front-page article in the New York T Times.1 According to the article, Chinese sands of workers in southern India alone. Tea consumption in China, on the other figures indicate that the production of rea China's preeminence in the tea indus­ hand, has grown only 2% a year. Young (Camellia sinensis [L.] Kuntze, Theaceae) try, however, seems to reflect its history Chinese citizens, in particular, have been increased 8.7% in 2004. Tea produc­ with the beverage. The British East India showing a preference for other bever­ tion is accelerating due to newly planted Company, which acquired its tea from ages, including coffee and Coca-Cola. rea bushes reaching maturity, ineffi­ China, held a monopoly on tea supply The abundance of Chinese tea entering cient state-owned farms transferring to to Britain until 1834, after which other global markers wi ll likely continue only if output-conscious entrepreneurs, Chinese people keep switching to and favorable government policies these other beverages. Other chal­ promoting tea industry growth. It lenges, including unpredictable is now estimated that China will weather patterns, land erosion, and soon become the world's largest the increasing demand for certi­ rea exporter by tonnage, overtak­ fied organic teas, could also affect ing Sri Lanka in 2005 and Kenya the future of China's currently in 2006. M eanwhile, the tea bright tea business. Furthermore, super-producing country of India the near stagnation of the global continues to battle aggressive market has caused reluctance competitors including China­ among some Chinese officials Indian tea exports continued to to comment about future levels plummet from 200 million kg in of tea production. On a brighter 2002 to 145 million kg in 2004. note, exports of Chinese green A kilogram of good quality Assam tea to Japan-much of it used black tea that fetched $1.69 in the to manufacture ready-to-drink tea auctions in 1998 is now selling beverages-and the United States, for $1.28.2 According to informa­ where higher-grade Chinese teas tion presented at the Intergovern­ are becoming increasingly popular, mental Group on Tea meeting in are accelerating. China, like much Bali (July 20-22, 2005), global Tea Camellia sinensis Photo ©2006 stevenfoster.com of the global tea producing indus- tea production continued to reach try, is viewing the United States as new highs in 2004, when output an emerging market for better qual­ grew by 2% over 2003 volumes to reach countries finally became big exporters. ity specialty teas, which command signifi­ an estimated 3.2 million metric tons. The Times article states that the origins of cantly higher dollar volumes than their Experts at this consortium agreed that tea itself are often traced back to ancient conventional counterparts.3 HG tea consumption is generally flat with China. The earliest literary reference, few exceptions. dating back nearly 5,000 years, tells of Referen ces China's success in the tea market, mean­ how Chinese Emperor Shen Nung discov­ I. Bradsher, Keith. Read the tea leaves: China while, could threaten the economies of ered the drink after tea leaves accidentally will be top exporter. The New York Times. various developing countries. Tea produc­ dropped into his hot water. October II, 2005:AI, C4. Available at: http:/ /www.nytimes.com/2005/ I 0/ 11 /busi­ tion is a huge employer in such areas as According to the article, government ness/worldbusiness/11 tea.html. Accessed Bangladesh, India, Sri Lanka, Indonesia, support encouraged the 18 .9% jump in December 5, 2005. and various East African nations. Accord­ Chinese tea exports in 2004, which totaled 2. Indian tea will soon wake up Japanese. ing to the Times article, countries that $437 million. In Beijing, for instance, Times of India [Web sire]. October 27, suffered from the tsunami of Decem­ municipal and provincial governments 2005. Available at: http://www.plenrea.com/ ber 2004 are particularly vulnerable to offered subsidies to the tea industry to news/latest_tea_news/indian_tea_for_japan. Chinese competition in the tea industry. alleviate lingering poverty and unemploy­ hrml. Accessed December 2, 2005. In Sri Lanka, the tea business helps feed ment in the countryside, and they paid 3. Tea Is "Hot" Report, 5th ed. (rev. 3/2005). Seattle, WA; Sage Group Inrernational. nearly a tenth of the population. Four up to half the cost of planting new tea dozen large farms producing black tea farms and building tea-processing facto­ leaves in these threatened countries have ries. Beijing has also eliminated an 8% already shut down over the past 2 years, tax on tea production as a way to increase causing the displacement of tens of thou- rural incomes.

62 I HerbaiGram 69 2006 www.herba lgram.org Market Report ------~l------J~------Tata Tea Buys Good Earth Tea Herb Industry Pioneers Sell to World's Second Largest Tea Company by Mark Blumemhal etley Tea Group/Tara Tea, the second largest tea company in the world, has purchased Good Earth® Teas and its parent company, Fmali Herb Co. of Santa Cruz, California. The terms of the sale were not disclosed but reliable sources indicate T it was less than $50 million dollars. According to Reuters, Tara, the parem Zaricor e-mail to M. Blumenthal, Octo­ United Stares in 80 yea rs. In 1976 they company to Tetley Tea Group of the ber 27, 2005). At that time Fmali was also wrote and published Goldenseal Etc. , UK (TTTE.BO), purchased Good Earth one of the major bulk and specialty herb a handbook on the wi ldcrafting of impor­ and Fmali through Tara's US subsidiary, suppliers to the then emerging herbal tea tant medicinal pl ants native to the United Tetley Teas.1 Good Earth Teas are sold in trade in the United States. Fmali began States. They were co-founders of the H erb grocery, gourmet, and natural food stores shifting irs marker focus toward produc­ Trade Association, the predecessor to the across the United States, with a strong tion and marketing of the branded rea line American Herbal Products Association. In presence in the Western US. Good Earth when it became Good Earth Tea's comrac r 1977 they were co-founders of Botanical markets herbal, fr uit-flavored, medicinal, packer. International of Long Beach, California, and specialty green and black teas with Zaricor and his wife Louise Veninga which at rhar time was a major state-of­ reportedly a 3.7% national market share. started the Fmali Co. in 1971, sell­ the-art supplier of botanical ingredients. The company's annual sales are estimated ing C hinese herb special ties like Asian One of the las ting and most signi ficant to be more than $16 million.1 ginseng roots (Panax ginseng C.A. Mey., contributions of Yeninga and Zaricor to Good Earth will continue to blend and Araliaceae) and T ige r Balm, the well­ the modern herb industry occurred on rhe pack the Good Earth teas in Santa C ruz known Chinese analgesic rub. Fmali was lega l-regul atory level. In 1983 Fmali sued and ex pand the brand in selected world in the vanguard of the developing natu­ the US Food and Drug Administration markets, emphasizing its California roots, ral food and specialty product companies, on a point of law in what is now consid­ according to a statement from Tara cited which first started proliferating in the San ered a landmark case, Fmali vs. Heckler2 by Reuters. Francisco Bay area in the 1970s. From (Marga ret Heckl er was FDA Commis­ Tara Tea acquired Tetley of the UK for those entrepreneurial beginnings, Fmali sioner at that time). Prior to the passage $432 million in 2000, according to the was the first American herb company to of the Dietary Supplement H ea lth and Reuters article. Reuters also states that es tablish the trade of importing Chinese Education Act of 1994 (OSHEA), which Tara and other major tea companies in herbs directly from the People's Repub­ states that herbs and other dietary supple­ India have been dives ting their tea planta­ li c of China after President Richard M. ment ingredients are not food additives, tions to fo cus on promoting their brands. Nixon began to normalize trade relation­ FDA often rook the position that an "We were only a marginal player in the ships with China in 1971. herbal or other natural ingredient was a US tea market (with Tetley) with a pres­ The Fmali Co. has operated continu­ food additive, requiring pre-marker proof ence in black tea and a small presence ously since 1972 in Santa C ruz, begin­ of safety. FDA also contended that such in specialty," sa id Tara Tea Managing ning in the founders' home and then proof should include a history of safe use Director Percy Siganporia. 1 "What this expanding to the old "Fog Kist" arti­ within the United States. acquisition does is give us critical mass in choke warehouse where Fmali first began Fmali's attorney, William R. Pender­ specialt y, which is very fa st-growing. It the milling, processing, and blending gast, an attorney specializing in FDA gives us not just the brand, but also knowl­ of herbs, teas, and spices fo r resale to law, persuaded the 9th Circuit Court of edge of the US marker," he continued. companies such as Celes ti al Seasonings, Appeals to find that in 1958 when the The original Good Earth tea is a Sweet Lipton, and Bigelow, among many others food additives provision was passed by and Spicy rea that was the "house tea" in rhe emerging specialty rea trade in Congress, its term "common use in food" of the Good Earth restaurant chain, a America. The company was especially never intended to limit the evidence of concept res taurant that featured all natu­ noted in the early days of rhe herb trade use as a food solely to history of use in rhe ral ingredients with menu items that were for its development of C hinese specialties, United States, i.e., that foreign marketing prepared fresh daily. Good Earth was es pecially Chinese ginse ng and "Siberian experience was allowable to help es tabli sh started in California in the early 1970s gi nseng" (Eleutherococcus senticosus [Rupr. the safety of a food ingredient. The res ult by its founder Bill Gault. The chain was & Maxim.] Maxim ., Arali aceae), plus of the Fmali case was to all ow the rel ative ly purchased in 1979 by General Mills and wild native American herbs, and other free importation of herbal ingredients as expanded to over 55 units until sold in botanical materi als. foods, thereby not requiring pre-market 1986 to one of the franchisees. According Zaricor and Yeninga were significant safety approval. If the FDA had prevailed, to Ben Zaricor, CEO of Good Earth/ players in the emerging herb marker in rhe the result would have stunted rhe growth Fmali, his family purchased the trademark United States. They helped to popularize and development of the modern herb trade and trade secrets in 1992 after founding ginseng in the 1970s with the publica­ at a pivotal rime in its history, and would the Good Earth tea products under li cense tion of Yeninga's beautiful coffee table­ from the restaurant chain with the Fmali style book, The Ginseng Book (1973), the name beginning in the ea rly 1980s (B. first book on ginseng published in the Continues on page 77 www.herbalgram .org 2006 HerbaiGram 69 I 63 ------~~onference ReporJ~------

Second Annual Nutrition and Health Conference: The State of the Science and Clinical Applications by Colleen Ostlund, CH

ver the past 30 years, healthcare professionals have had to respond to the growing interest in nutrition and alternative healthcare. Patients are asking for and seeking alternative therapies in huge numbers. This growing interest in favor of alter­ 0 native therapies was obvious at the Second Annual Nutrition and Health Conference held in Tucson, Arizona, on March 6-9, 2005. This conference was sponsored by the University of Arizona's Program in Integrative Medicine (PIM) and the Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine at the Columbia University College of Physicians & Surgeons. Course directors were Andrew Wei!, MD (University of Arizona) and Fredi Kronenberg, PhD (Columbia University).

Twelve hundred people attended the His remarks included the obesity prob­ about the supplementary need for new Public Forum portion of the conference, lem and irs signal to a bad diet, which direction in the education of healrhcare which included opening remarks from then leads to an increase of prevent­ professionals and medical schools so that Andrew Wei!, M D, founder of PlM and a able diseases. T he discuss ion fo cused on all patients can benefit. Throughout his nationally recognized author and author­ refined and processed foo ds being the remarks, Dr. Wei! indicated that it was the ity on integrati ve medicine, a term he main culprit to rhe increasing obesity res ponsibility of both government and the ori ginall y coined to denote the integration problem and the increase in infectious individual to take charge of making sure of so-ca ll ed complementary and alterna­ diseases . H e also discussed new research that high quality, natural food is accessible tive medicine into modern conve ntional on trans-fats and how this resea rch has to everyone. His remarks created a clear medica l practice. shown that trans-fats intake has increased understanding of the role of food and how T he conference was well attended by rype-2 diabetes and inflammatory disor­ many modern foods can actuall y cause doctors, pharmacists, nurses, registered ders such as arthritis. Water was discussed more harm than good. H e stressed that dietitians, dietetic technicians, clinic for irs benefits to prevent inflammation it is time for people to move from being directors, and numerous other health ca re and irs aid in diges ti on. In his discuss ion, victims of food to making healthy choices providers. another food/disease indicator included for greater preventative health care. This Accreditation was given for all those the increase of dairy consumption and can only occur through education. professionals attending. pros tate cancer and increases in breas t One session of particular interes t was Dr. Wei! described the PIM curricu­ ca ncer, chronic in fec tions, and stress on "The Role of Herbs in the Diet," presented lum, which includes the fo ll owing modali­ the digestive tract. by T ieraona Low Dog, MD. Dr. Low ties : botani cal medicine, nutrition and T his overview of the current state D og focused on the role of whole herbs diet, spirituality, homeopathy, traditional of nutrition leads to a bigger discussion versus isolated fractions in a few specific C hinese medicine, motivational inter­ herbs. She discussed the role of synergy viewing, clinical conditions, leadership (the increased activity of an herb based on program, mind-body medicine, energy the additive effects of the herb 's constitu­ medicine, manual medicine, healing envi­ Food and Health Facts ents), potentiati on (the increased effect of ro nment, philosophy of medicine, medi­ • Total estimated cost of obesity in the herb by providing an additional herb cine and culture, and the art of medi­ 2000: $117 billion simultaneously), stabilization (the process cine. T he d isc ussion then shi fted to the • Dollars Spent by Consumers in of ensuring that herbal constituents do not dramatic change in human bodies and the 2003 on natural products: $42.5 change or degrade), and how herbal prepa­ direction of food and diet in the United billion rations influence health. Stares and the world. • Percentage of overweight Dr. Low Dog explained that once Dr. Weil's remarks focused on the food Americans: 66% understood, these herbs would become produced in the United States and how the • Percentage of cancer patients the foundation for better health. The first systems for food refinement and process­ using at least one form of herb she discussed was turmeric (Curcuma ing lead to dramatic changes in bodies by alternative therapy: 64.5% longa L. , Z ingiberaceae). Turmeric has changing how the food is directed into • Average length of conventional­ antioxidant, antimutagenic, antimicro­ bodies . According to D r. Wei! , nearly medicine office visits: 7-15 bial, hepatoprotective, anti-inflamma­ all the obesity, diabetes , and narrowing minutes tory, and choleretic activities. Other herbs of time between sickness and decline, • Average length of alternative discussed were chamomile (Matricaria come as a direct res ult of influences from medicine treatment: 50 minutes recutita L. , Asteraceae), rea (Camel­ the food industry. Dr. Wei! believes that to 2 hours lia sinensis L. , Theaceae), and red clover medicine must influence social change • Number of consumers using (Trifolium pratense L. , Fabaceae). Dr. Low and become the cornerstone and a key herbal remedies instead of Dog discussed the flavones in each of player in the movement for better health prescriptions: 22.8 million these herbs and how they can provide and hea lrhca re. relief for many common disorders. Cham-

64 I HerbaiGram 69 2006 www.herbalgram.org ------1~onference ReporJ~------omile can be useful for colic and dysmen­ orrhea and has anti-inflammatory activity. First European Ayurveda Congress Tea provides antioxidant benefits and has By Nirmal Joshee, PhD been associated with slowing of aggressive breast tumors. She also spoke of the poten­ out 300 scientists, medical doctors, journalists, government officers, lawyer~ , tial benefits of the isoflavones in red clover nd policy makers participated in the First European Ayurved Congress on April in the treatment of certain cancers. 3-24, 2005, in the city of Castrop-Rauxel in western Germany. The theme So much information is still being A of the congress was based on the idea that the time has come to establish Ayurved discovered on many herbs that it is a chal­ (aka Ayurveda) in a proper way and to regulate its practice in Europe, especially in lenge to educate the public with accurate Germany. information that can be used for health benefits. Herbs continue to offer a rich The major concern expressed by many to become an Ayurved doctor and an addi­ source of biologically active compounds arrendees related to the misrepresentation tional 2 years for specialization. To carry and, of course, when consumed as part of of Ayurved as a massage/wellness system out further research and earn a PhD degree a wholesome diet, can become a source of that is being promoted as an extension of requires at least 3 more years. He empha­ medicinal compounds that may be used cosmetology. Currently, virtually anyone sized the willingness of the Indian govern­ to relieve symptoms or even to prevent or can practice Ayurved, and no restriction ment to train qualified individuals overseas treat disease. on irs practice has been established by any for these programs in a bilateral manner. The conference also showcased the professional group or government agency. D. Jobst, PhD (University of Dussel­ University of Arizona's Online Educa­ Most of the arrendees agreed that the time dorf & Bonn), presented a paper on the tion Courses for continuing education for has come to establish Ayurved as a healing "State of Naturopathy in Germany." G. healrhcare professionals. One example is science, to integrate it with modern medi­ Merzenich, PhD (University of Bonn), a Botanical and Health Series. These on­ cine, and to develop rules and regulations gave a presentation on "Indication based line courses include Botanical Founda­ for its practice in Europe. clinical studies of rheumatoid arthritis in tions, Botanical and Women's Health, and Kerala Ayurveda Academy in Castrop­ Ayurveda." Mr. Stephan von Bandemar Botanical and the Gastroinrestinal System Rauxel is the first Ayurvedic institution (Institute for Work and Technology in course. These programs can be viewed at in Germany working to achieve this goal. Gelsenkirchen) suggested that "The mini­ www.integrativemedicine.arizona.edu. Kerala Ayurveda Academy was one of the mum would be to meet the Indian stan­ In many of the lectures the current major supporters of the congress, along dards in Germany" and discussed issues state of nutritional education for health with the State Government and Bonn related to "Quality management of Indian care professionals was discussed. Medical University. Ayurvedic medicine." doctors typically receive either substan­ The inaugural address was given by P. In numerous speeches it became clear dard training or in some cases receive no K. Wartier, MD (Ay), chief physician of that Ayurved is composed of complex and training. One reoccurring theme addressed Kottakkal Arya Vaidya Sala, an Ayurvedic highly customized treatment concepts that the need for the medical profession to act Hospital and Research Centre in Kottak­ comprise what is considered a proper way of socially and politically as a force to coun­ kal, Kerala, India. (Note: The abbreviation life and nutrition, plus a variety of different teract commercial pressures in hospitals, "Ay" refers to a doctorate in Ayurvedic medi­ therapies, combined with the all-embracing schools, medical centers, and the fast food cine.) Dr. Warrier stressed the potential fo r concept of phytopharmacology (i.e., the use and conventional food industries. Indo-German collaborations in Ayurvedic of herbal medicines). Costs of our current health care systems medicine. Mr. Thomas Vallomtharayil, the There were presentations related to were given so attendees could view the Director of Kerala Ayurveda Academy in multiple facets of Ayurved. Prof. H. P. impact of the currenr systems on health and Germany, gave the welcome speech. He T. Ammon (University of Tubingen) the dollars involved (see sidebar). emphasized the Academy's present aims presented his biochemistry- and cell physi­ The overall objectives of the program and objectives, as well as its future proj­ ology-based research on "Sallai Guggul" were well covered. Participants came away ects and plans. The inaugural function was (Boswellia serrata Roxb., Burseraceae). G.G. with key understandings of the nutritional presided over by the Mayor of Castrop­ Gangadharan, PhD (FRLHT, Bangalore), values of antioxidants, micronutrients, Rauxel. presented a paper on "Globalization of protective phytochemicals, use of dietary There were a variety of presentations Ayurveda-Issues and Perspectives." Dr. change and its role in therapeutic interven­ dealing with both policy issues and clinical C. Suresh, Bachelor in Ayurvedic Medi­ tion, interaction between genes and diet, matters. S. K. Sharma, MD, PhD, attended cine and Surgery (BAMS), MD (Ay) , PhD health implications for various cultural and the meeting as a represenrative from the (Triveni Hospital, TVM, Kerala, India), racial groups, and recognition of the social, Indian Government. Dr. Sharma is a gave a presentation on "Osteoporosis-An political, and behavioral aspects of diet and member of the advisory board for the India Ayurvedic Approach," which was based on health. HG Government's Department of Ayurveda, patients he has treated over the years in his Yoga and Naturopathy, Unani, Siddha and hospital. (Note: The BAMS degree requires H omoeoparhy (AYUS H ). He explained rhe 5.5 years of study and is the basic qualifica­ rules and regulations for rhe education and tion to practice Ayurvedic medicine.) The practice of Ayurved in Europe, pointing writer of this conference report (from Fort out rhat it takes more than 5 years in India Valley State University, Georgia, USA)

www.herbalgram.org 2006 HerbaiGram 69 I 65 ------l~onference ReporJ~------

presented a paper on "Traditional medici­ herbal products"; and (3) "Present poten­ in Germany. Two research projects are nal plants in the light of modern medi­ tials and limits of Ayurvedic treatments soon to begin at the University of Bonn. cine," which used the example of Scutei­ in the EU." T he projects will be supported by the Laria research being carried out in the State Government of North Rhine-West­ university labs. Dr. Syal Kumar, BAMS, Outcome phalia, the Institute for Work and Tech­ MD (Ay), with the Kerala Ayurveda A key point made at the congress was nology scientific center, and the city of Academy, spoke on "Osteoarthritis and that the German government is interested Castrop-Rauxel, wh ich intends to position Ayurvedic Management." Dr. Madhavan in establishing and promoting health itself as a European center of excellence in Kutty, BAMS, MD (Ay), Superintendent tourism locally and in collaboration with Ayurved. of the Arya Vaidya Sala in Kottakal, India, India. The German government is keenly Traditional C hinese medicine (TCM) gave a presentation on "Panchakarma," a interested in joint projects that collabo­ has been established in Germany during key traditional practice in Ayurved. Prof. rate with the appropriate parties in the the past 10 years and continues to receive L. M . Singh, PhD (Tribhuvan Univer­ Indian government within the area of acceptance. T his popularity has caused sity, Nepal), talked about "Ayurvedic Ayurvedic medicine. T hese activities will many Europeans to visit China and learn management of urinary diseases," and help to upgrade the status of Ayurved in more about T CM . As a result of this activ­ Dr. E.P. Jeevan, BAMS (Kerala Ayurveda Germany to establish its rightful place. ity many TCM medicines are now avail­ Academy) spoke about "New trends in These efforts will also encourage people able in Europe, triggering the export of Ayurvedic research methodology." Many to visit genuine Ayurvedic hospitals in TCM medicines and boosting the econ­ physicians from Germany also presented India. All the speakers agreed that inte­ omy. In the same manner, congress attend­ papers on cancer, gastroenterology, diabe­ grating the modern Western conventional ees agreed that a similar program needs to tes polyneuropathy, etc. medical system with Ayurved offers great be developed to promote Ayurvedic medi­ Panel discussions on relevant topics opportunities for both patients and profes­ cine. HG were also conducted . T he subjects of these sionals. d iscussions were as follows: (1) Qual­ In the recent past, a two-year train­ ity control of Ayurvedic education and ing course for Ayurved therapists, which Ayurvedic practice in Germany; (2) "New follows the Indian example, has shown European d irectives on the medical use of satisfactory results in providing services

NIH Holds Conference on Dietary Supplements, Coagulation, and Antithrombotic Therapies by Becky Costello he National Heart, Lung, and Blood Institute (N HLBI), in collaboration with the O ffice of Dietary Supplements (O DS) and other Institutes and C enters of the National Institutes of H ealth (NIH), convened a national workshop on January 13- 14, T 2005, in Bethesda, MD. The goal of the two-day meeting was to gain greater understanding of the complex issues of dietary supplement use by patients receiving antithrombotic therapies. T he Chairperson for the con ference was Victor Marder, MD, Profes­ sor of Medicine & Neurosurgery and D irector of the Vascular Med icine Program at Los Angeles Orthopaedic Hospital, UCLA. Invited faculty included individuals with scientific and medical expertise along with interested parties from academia, industry, patient-advocacy groups, and representative government agencies.

Conference Goals Introduction to the Problem reported to interact with antithrombotic therapies, although relatively little data Participants were charged with review­ To manage or treat their disease condi­ are available concerning the scope of the ing the available evidence concerning the tion, an estimated 4 million patients are problem. M any misconceptions exist in the effects of dietary supplements on hemostasis receiving long-term antithrombotic thera­ literature concerning the presumed antico­ (blood coagulation) and antith rombotic pies (anticoagulants, drugs that prevent agulant effects of "coumarins" present in therapies (medications used to prevent or the coagulation of procoagulant plasma botanical dietary supplements.3 treat thrombi or blood clots formed within proteins in the blood and/or anti-plate­ the blood vessel). Furthermore, they were to let agents, d rugs that alter a number of Current Antithrombotic T herapies identify and discuss public health concerns biochemical pathways to prevent platelets and H emostasis about the use of these supplements and from aggregating and initiating the process T he conference began with an over­ conceptualize a framework for developing of hemostasis) . Some surveys suggest that view of normal hemostasis and current clinical guidelines concerning the use of dietary supplements are used by approxi­ antithrombotic therapies, followed by a dietary supplements in patients who are mately 52% of the general population 1 review of the avail able evidence on interac­ either taking antithrombotic medications and consumed concurrently with prescrip­ tions between selected dietary supplements or who may be at risk for increased bleeding tion drugs by approximately 16% of the and antithrombotic therapy. Most of the due to other medical factors. population.2 Many supplements have been evidence consists of individual case reports

66 I HerbaiGram 69 2006 www.herbalgram.org Conference Report

or small case se ri es, with inconsistent and setting to clinical prac ti ce would still spokes people from va nous pati ent advo ­ frequently incomplete data reported . In require we ll -designed , pros pective cl inical cacy groups, pati ent care organiza ti ons, addition, many supplements are not avail­ trials, of which few have been conducted and representati ves from the Ameri can able in standardized preparations. These in this area. Capturing dietary supple­ H erbal Products Association. More infor­ factors make it difficult to compare the ment interac tions in free-living individu­ mation about the conference is avai lable res ults from one report to another. The als would require a ve ry well -defined and at www.nhlbi.nih.gov/mee tings/coagula­ need for a more systemati c approach to ac ti ve surve ill ance system. ti on/index .htm. A C onference Bibliog­ documenting and reporting the impact Conference participants identi fied a raphy has been prepared and is avai lable of dietary supplements on antithrombotic se ri es of potential research topics and strat­ in electronic format at: http://ods.od .nih. therapy was advocated . egies to address these iss ues, including the gov. T he proceedings will be published in T he impact of dietary supplements on need fo r in vitro studies to evalu ate mech­ Thrombosis Research. HG normal hemostasis and antithro mbotic anism of ac tion/interaction, in vivo stud­ therapy was also considered. Supplements ies to inves tigate interaction synergy and/ References that have been reported to affect normal or antagoni sm, the use of whole animal I. Radimer K, Bindewald B, Hughes J, Ervin coagul ation and pl atelet ac tivity and/or models for interaction tes ting, the use of B, Swanson C , Pi cciano M F. Dietary have been reported to possibly interact with national registries and epidemiologic stud­ Supplement Use by US Adults: Data fro m the National Health and Nutrition coumarin anticoagulants include danshen ies , and the development of educati onal Examination Survey, 1999-2000. Am J Epi. (Salvia miltiorrhiza Bunge, Lamiaceae), programs for pati ents and providers. Also 2004; 160:339-349. ga rlic (A llium sativum L., Lilliaceae), highlighted was the need to encourage 2. Kaufman OW, Ke ll y JP, Rosenberg L, ginkgo (Ginkgo biloba L. , Ginkgoaceae), botanists, plant phys iologists, and phar­ Anderson T E, M itchell AA. Recem patterns American ginseng (Panax quinquefolius L., macognosists to contribute to this research of medicati on use in the ambulatory adult Araliaceae), Asian ginseng (P.ginseng C. A. on herb-drug interac tions. Foll owing this population of the United States: the Slone Meyer), and St. John's wort (Hypericum panel disc ussion, a se ries of presenta­ Survey. JAMA . 2002;287:337-344. perforatum L., C lusiaceae). H owever, most tions provided an assess ment of public 3. Booth N L, iko li c D, van Breemen RB , et al. Confusion regarding anticoagulam of these reports are either theoreti cal or health concerns from the perspectives of coumarins in dietary supplements. Clin consist of individual cases. In addition academia, the Food and Drug Admin­ Pharmacol Ther. 2004;76: 5 11 -5 16. to supplement heterogeneity, individ­ istrati on, and industry. The confe rence ual patient responses also refl ect specific also included a panel sess ion fea turing ge neti c polymorphisms in the cytochrome P450 enzyme system and other metabolic pathways that can alter metabolism of wa rfa rin (a synthetic dicoumarol , often sold under the trade name Coumadin") and/or dietary supplements. Give n the va ri ety of dietary supplements available, an important aspect in the management of patients on oral anticoagulant therapy remains a regular assessment of supple­ ment use and making sure that pati ents are awa re of the potential ri sks and bene­ fits of taking supplements in conjunction with their prescribed medications.

Research for the Future Several new resea rch tools and analytic strategies we re also reviewed. For example, the pregnane X receptor (PXR), a member of the nuclear receptor family of li gand­ acti va ted transcription factors, mediates the interacti on between St. John's wort and va rious prescription drugs, including wa rfa rin. This obse rva tion has stimulated additional research to eva luate interac­ tions of other prescription drugs, herbal supplements, and xe nobiotics (a foreign substance introduced to the body that has pharmacologic or toxicologic effects) on the PXR receptor. Translating herb­ drug interactions identified in the in vitro

www.herbalgram.org 2006 HerbaiGram 69 I 67 Book Reviews

he M edicinal Uses of Cannabis multiple sclerosis, emesis in chemother­ by simply re movi ng patients fro m more T and Cannabinoids. Geoffrey W. apy, and appetite stimulation in patients rox ie medications and on to safer and G uy, Brian A. W hittle, and Philip ]. with AIDS. Imminently useful informa­ more efficacious cannabis-based medi­ Robson, eds. Chicago, IL: Pharmaceuti­ tion is also presented in other chapters cines for some indications, in addition cal Press; 2004. 488 pp, hardcover. ISBN on the subject of cannabis and driving a to the fact that such plant derivatives 0853695172. $65.00. motor vehicle, along wi th international are simply less costly to produce than Every now and then there comes a good perspectives on law and public policy. synthetic analogues. As incredible as it book at the ri ght time. The Medicinal Uses O n the surface, it seems as if legislators seems, this vision is not on some distant of Cannabis and Cannabinoids, edited by may have been able to see some signi ficant academic hori zon. Quite recently, Sativex D rs. Guy, W hittle, and Robson is such difference between the synthetic T H C was approved in Canada for treating neuro­ a book, and now is such a rime. T his (i.e., Marino!) and plant-derived T H C pathic pai n in patients with multiple scle­ book presents evidence of past, present, (e.g. , marij uana and its deriva tives). But of rosis. In the EU, however, the ava il ability and even future medical util i­ course, the iss ue here has been of Sarivex has been put on hold until addi­ zations of both cannabis (i.e., one of control and not medi­ tional clinical trials have been completed, medical marijuana, Cannabis cal utility. This is where Sativex much to the consternation of GW Phar­ sativa L. , Cannabaceae) and the begins to enter the historica l maceuticals, va rio us patient groups, and herb's primary active constitu­ rime line of medicinal canna­ compassionate medical doctors. ents, the ca nnabi noids. T his bis. Moreover, the recent success Although Marino! remains available, information is timely because of Sarivex in clinical trials has this oral formulation has intractable limi­ the matter of medici nal canna­ clearly demonstrated that the tations, which have been recognized over bis has entered the modern medical utility of ca nnabis is nor the years, and its monopolized marker pharmacopeia. Although a gel limited to THC, a fact that has share can only exist because the legal avail ­ capsule of synthetic T H C in been known to those involved in ability of more efficacious forms of ca nna­ sesame seed oil has been avail­ the medicinal use of marijuana binoid delive ry continue to be delayed or able fo r quire some rime as over the last 30-plus years, in proscribed by law. And, after all , Marino! dronabinol (Marino[•, Solvay Pharmaceu­ addition to historic medical documents is only T H C (and does not incl ude any ticals, Inc., Marietta, GA, USA) , there that go back over several thousand years. of the other interes ting "impurities" of are considerable limitations with the oral So, aga in it seems, there is nothing new a whole plant extract). Specifically, the administration of cannabinoids. And of than what has been fo rgotten. desired effects of THC begin to develop course, the medicinal use of ca nnabi­ Some inevitable overlap exists between quire slowly after oral delive ry. Moreover, noids in both Europe and North America a few of these chapters, bur these are a potent psychoactive metabolite is formed runs parall el to decades of clandes tine complex iss ues that are presented by 16 by the liver, which makes the patient production, distribution, and oppression authors, and many of these topics are "higher" than if he/she had simply taken of both ca nnabis and cannabis users in worth saying two and even three times . It the spray, sucked on a lozenge, or smoked these countries. Also, there seems to be is also no great secret that the editors do a joint. A T HC suppository is also avail­ no clear distinction between the medici­ have a financial interest in both editing able, and even though this ro ute of admin­ nal and recreational uses of cannabis. In and contributing to this effort. T hus, one istration is relatively fast and does bypass other words, the desired "side effect" of could argue a potential bias, as many of the the liver, who really wants this inconve­ psychoacrivi ry may be inextricably linked other authors are also intimately involved nient method of drug delivery when a to therapeutic effects. in the continuing development and even­ spray, or a puff, will do? T he wealth of scientific information in tual distribution of cannabis medicines No! Enough already! We have finally this vo lume will be an important resource for profit. O n the other hand, all authors arrived at a new plateau for medici­ for years to come, especially as new deriv­ are well informed and in exactl y the ri ght nal cannabis, in a world of sophisti­ atives and formulations are introduced. positions to know their subject matter. In cated medical delivery systems for the sa fe T his thoroughly referenced academic text any event, this volume is a refreshing step and rapid administration of standardized is well written and we ll organized, and away from past decades of emotion-based ca nnabinoids in dose-controlled, patient­ covers the history, botany, phytochemistry, rationales that have shaped both political titratable sprays of liquid bliss. T his is human pharmacology, metabolism, and opinion and public policy. the obvious quantum leap forward from pharmacokinetics of both exogenous and In particular, this book is about the inhaling the vapors of burned fl owers, endogenous cannabinoids in 14 chapters difference between the development and at bes t, and popping hot seeds on the (i ncluding an index and glossary). T here delive ry of a pharmaceutical product (i .e., patients' bedspread with gratuitous pieces is also a good amount of info rmation on doing it) and pre-clinical applications (i.e., of "lumber" at worst. Finally, we can various cannabis derivatives, including still just talking about it). T his roughly enj oy the benefits of modern technology whole plant extracts. To complete the corresponds to the difference between to deliver cannabinoids in the same ways medical perspective, res ults are presented actually knowing and just guessing about already enj oyed by so many other medica­ from recent clinical trials on Sarivex•, an the potential implications of ca nnabis­ ments, mos t of which have only recently oral spray developed by GW Pharmaceuti­ based medicines , both medically and been introduced to our species. Imagine cal in the UK from a whole plant extract, economically. The economic aspect is also how effective wide-spread cannabis use for treating chronic pai n, symptoms of expected to include the savings achieved might be with the sudden introduction of

68 I Herbai Gram 69 2006 www.herbalgram.org Book Reviews ------~l------J~------such a device or formulation; as if both the motivations of earlier toxicological inves ti­ tics, and medical fact, one must occa­ actual political risks and potential hea lth gations, the recent discovery of an endog­ sionall y wonder why a planr would even concerns from smoked marijuana suddenly enous cannabinoid system has come out want to produce a cannabinoid, as canna­ and simultaneously diss ipated into a waft of pure scientific interest and not through bis is the only living species known to of thin air, leaving just the patient and the a stated political agenda. This is the stage do so. As a form of protection, perhaps, medicine to work it our under the gentle where the matters of medical cannabis against ionizing UV-B radiation from the supervision of an informed phys ician. Bur have developed over the years, where time sun, or simply a highly specified gooey are we really there yet? Well, yes and no. and cool logic have been the producer and resin that makes it difficult for insects to Smoking marijuana is still the most director, respectively. The audience has chew? And why do humans and so many efficient and effe ctive way to administer been patient. More u agedy than comedy, other eukaryoti c organisms have discreet the natural components of cannabis, and it is ironic to realize that all this hys teri a receptors for botanical cannabinoids, let millions of people wi ll continue to use this has been about THC, the sole component alone our own systems for producing the form of delivery for a long time to come and of Marino!, or so it seems. And yet we endo-cannabinoids from linoleic acid, a for a wide variety of reasons . However, the still need more scientific evidence to show common omega-6 dietary fatty acid? And, inhalation of any burnt offering may not what? Again, the authors help us put these could it be any coincidence at all that the ever be more widely acceptable to modern matters into perspective. seed oil of cannabis typically contains over medicine than it is now, and most medical T his book also describes the tedious 50% linoleic acid, the essential precursor patients should probably not be smoking process that has led to the successful regis­ to our endo-cannabinoids, as wel l as the something anyway. Eating cannabis can n ation of Sativex. These efforts coincide entire arachidonic acid cascade? The mind also be effective, but quality control and with the simultaneous unfolding of bas ic begins to reel at the evolutionary implica­ dose titration are obvious and complex medical research into phyto-cannabi­ tions, and there is discussion in this book drawbacks, as with Marino!. T hus, a stan­ noids, endo-cannabinoids, and the discov­ of these matters as well. dardized plant ex u act, delivered by a ery of a complex endogenous network of This authoritative, well-referenced book septic inhalation device, a lozenge, or a ligands and cannabinoid receptors within is recommended to anyone who has even a spray under the tongue, wi ll be the obvi­ us all. The wide range of potential medi­ passing interest in the medical significance ous ways forward in the modern world of cal indications for cannabis and cannabi­ of cannabis, and it is a valuable resource to acceptable pharmaceuticals. noids, and the potential economic savings either the studenr, scientist, or physician The lingering issues around cannabis to both priva te and governmental health who has any desire to learn more about prohibition are also complex, and the over­ systems are striking. Again, the overused this fascinating topic. It may even help all result of this dubious effort has been an term "panacea" comes to mind. alleviate the symptoms of cannabiphobia incredibly huge and effective propaganda On a more practical level, this book also in some. W ithout a doubt, this literary machine over the las t 70-plus yea rs, where includes important chapters on the genetic effort by Guy et al has accomplished its political uuths and opinions have become pedigree of existing cannabis varieties, and purpose. T he only thing lacking, in my deeply entrenched as hard wired "facts." it demonstrates the pharmacologic impor­ opinion, was a complimentary sample of T hese topics are also discussed in this tance of cannabinoid profiles ; i.e ., some Sativex. Rapid progress will continue in book. Realistically, most of the recent lines producing just THC while some the field of medicinal cannabis, particu­ change concerning the politics of canna­ others reliably produce various combina­ larly as the remaining obstacle of regressive bis has basica lly come through political tions of THC and other useful cannabi­ politics continues to melt away with time, attrition during the last decade; i.e., the noids, along with the usual terpenes and and especially as more legislators begin to ideological resistance is simply retiring other minor components of a whole plant fill the void with matters more important and dying at a sure and steady rate, in extract. Established lines of genetica ll y than u ying to control the personal use of addition to recent realizations that there se t cannabinoid profiles, reproduced as flowers. HG may be more important things for law cloned fields of green under a matrix of -].C. Callaway, PhD, Adjunct Profes­ enforcement and military resources to high press ure sodium lamps, standardized sor of Ethnopharmacology, do than bully peaceful pot smokers and/ extraction methods, and a final delivery Dept. of Pharmaceutical Chemistry, or medical marijuana patients. Another device are exactl y the features required University of Kuopio, Finland. important component of change has also of a modern medicament to fit seam­ come from the efforts of politics, albeit lessly into the pharmacy without all the he Healing Power of Chinese Herbs more indirectly; i.e., through the public emotional baggage and pyrolys is of "mari­ T and Medicinal Recipes by Joseph P. funding of various scientific efforts to juana." Such an approach is yet another Hou and Youyu Jin. Binghamton, NY: establish the putative toxicity of cannabis positive force that runs counter to 70-plus Haworth Integrative Healing Press; 2005. and cannabinoids over the last 40-plus years of fear, ignorance, and faith-based 812 pages , soft cover. ISBN 0-7890-2202- years. Of course, these efforts have only testimony on matters of cannabis, and it 8. $69.95. revealed new medicines (s uch as Marino!/ runs parallel to the wel l-established medi­ Writing a text on Chinese herbal medi­ THC) and have firmly es tablished that, in cal marijuana movements in those coun­ ci ne is always a challenging task. The fact, the natural cannabinoids are surpris­ tries where cannabiphobia has reached traditional Chinese approach to healing ingly lacking in either acute or chronic epidemic proportions. involves a comprehensive medical sys tem, toxicity, even under the most determined Digressing just a bit from this heady not just a collection of healing plants; it experimental designs. And, unlike the collection of radical science, ignorant poli- is based on a foreign culture, an ancienr

www.herbalgram .org 2006 HerbaiGram 69 I 69 ------~l Book Reviews J~---- 8 chromaDex ------setting THE standard rime, and a different language; the method trained in thi s area, they study a M ateria of using herbs has changed over time Medica (typica ll y with over 300 herbs) NEW ChromaDex and continues to change rapidly today. divided up by a system that has been used Books on this subject can be written with in C hina for several decades. For this new 2006/2007 Catalo rhe full Chinese medicine jargon, relying book, the authors have effectively rear­ on minimal ex planatory text, to provide ranged several of the categories to help the Available April 2006 information for hea lth professionals who reader better understand the applicati ons • Hundreds of NEW standards have attended extensive formal training of the herbs. programs, or they can be writ­ T he monographs foll ow a • Many new KITs ten in simplified terminology set format: a ge neral introduc­ for the general reader with addi­ tory paragraph to the herb (the With over 3500 standards available, tional explanations to fill in for plant identification, where it we are the most comprehensive their lack of specific training. grows, how it is collected and supplier of phytochemical reference It is not easy to write a book processed, and what it was tradi­ standards. that falls in between. tionally used for) ; followed by a Hou and Jin have managed list of the properties as desig­ our product line includes: to deal with these diffi culties nated in the Chinese system ; • Primary Standards in an admirable way and have the medicinal uses (includ­ • Secondary Standards produced a text that falls in ing typical combinations with between the professional and other herbs for those specific • Reagent Grade Standards popular approaches. T hey first actions); the dosage, precau­ • AHP-Verified'" Standards-NEW defined their audience by saying that tions, side-effects, toxicity, and ve ry brief • Snap-n-Shoof" Standards-NEW the book is a "sel f- help manual. .. directed statements about research findings. toward the general public who are actu­ These monographs are mainly deri ved • Botanical Reference M~ltP.1ri r~ I~- F'\RIM !=i ally seeking help with C hinese herbs .. . from four sources: The Encyclopedia of • Reference Standard Kits and those who want to try herbs for their Chinese M ateria Medica from the Ji angs u • Complete Analytical Kits illnesses ... " Although they also mention New Medical College; Contemporary Clin­ health care practitioners and students who ical Chinese Materia M edica by D ong may want to add herbal prescribing to their KS, Wang XQ, and Dong YF ; Manual of Contact ChromaDex to get your practices as potential readers, it is clear Commonly Used Chinese Medicine Herbs by 2006/2007 copy now. that those individuals will have access to Wang JH (all three in Chinese), and the tel. 949.419.0288 professional educati on that the other read­ English language book Chinese Materia fax. 949.419.0294 ers won't easil y find, so this book has to Medica-Chemistry, Pharmacology, and email. [email protected] take care of the needs of the former group. Applicatio ns (1998) by Zhu. These books The text has plenty of C hinese medicine are considered authoritative presentations; jargon, but there is an attempt to explain they are produced by reviewing and collat­ it in terms the general reader can under­ ing information from prior works, mainly stand. C hinese documents from the 1950s In the introductory chapters, the authors thro ugh the 1980s. make it clear that Chinese medicine has a T here is also a section on traditional long history and is quite complex, which herbal formulations and patent reme­ should actually direct the readers to rely dies (101 recipes). The explanations are on health professionals rather than trying necessarily limited. In keeping with my to obtain and use the herbs on their comments about turning to a health own. Thus, the main self-help aspect of professional to actually get the treatments, this book is that it lets these readers I'll relay a typical description of using one know more about Chinese medicine before of the formulas: Huo Xiang Z heng Qi deciding to embark on a therapeutic regi­ Wan (page 610). The directions for use are men through a local practitioner (licensed as follows: " .. . grind the ingredients into a to practice Oriental medicine). The book fine powder and either mix with honey for can also be a means by which the readers honey boluses or cook the powder for oral learn more about the treatments that have administrati on. Take 6 g each time with been prescribed to them. a decoction of fresh ginge r and Chinese The main part of this book, nearly dares. Available commercially in pills or 500 pages, is a "Materi a Medica"- a set soft capsules." The grinding to a fine of monographs on 138 individual herbs, powder is something done in C hinese divided into therapeutic categories with factori es and difficult for the reader to explanations of each category as an intro­ do without special equipment (a coffee duction. When health professionals are grinder will not work). While the formula

70 I HerbaiGram 69 2006 www.herbalgram.org Book Reviews

is available commercially, the dosage to be References used, the timing, and other aspects are nor I. Shebek], Rindone JP. A pi lor srudy explor­ defined here, and rhe package instructions ing rhe effect of kudzu root on rhe drinking are often not sufficiently clear to help the habits of parienrs wirh chronic alcoholi sm. j user. T his is where the practitioner can Aft Compl Med. 2000;6:45-48. • •• 2. Lukas SE, Penerar 0, Berko J, er al. An • help the reader acquire rhe materials and • •• describe their use to get the best results. exrracr of the Chinese herbal roar kudzu T he down-side of the book is related to reduces alcohol drinking by heavy drink­ •••• ers in a nawralisric serring. Clin Exp Res. rhe attempt that has been made ro pur so bic:luminex 2005;29 (5):756-762. much into a single vo lume (even one of Bioluminex~ a revolutionary new 800 pages). T he supporting evidence from analytical bioassay studies (many of them conducted decades !ants ofHaida Gwaii: X.aadaa Gwaay ago under poor conditions) gives no hint Pgud gina k.'aws (Skidegate) }{aadaa Bioluminex~ is a new assay for as to how the study was conducted and Gwaayee guu giin k.'aws (Massett) by biological actMty and toxicity what were the details of the outcomes, so Nancy ]. Turner, PhD. Winlaw, British screening of complex sample mixtures such as foods, beverages, that it is easy to misinterpret the state­ Columbia: Sono N is Press; 2004. 264 pp., hardcover. ISBN 1-55039-144-5. $38.95 . dietary supplements and waste water. ments provided. As an example, for puer­ This unique and effective technology aria root (aka kudzu, Pueraria !obata), Every ethnoboranical work rhar bears w as invented by Bayer to combine there is a section headed "clinical find­ Nancy ]. Turner's name-and there are Thin Layer Chromatography (TLC) ings" where only a laboratory study is many-may be fo und to be a trustwor­ with the use of bioluminescent marine bacteria, Vibrio fischeri, as a bioassay relayed about this herb's seeming abil­ thy companion to those who crave knowl­ edge about people's relation­ detector. BioluminexN is fast, reliable ity to reduce drinking of alco­ and economic tool for quality control, ship to plants. Her new book, hol. H owever, a clinical study research and manufacturing of food published in 20001 and not Plants ofHaida Gwaii: ){aadaa related products or water. reported in the book had shown Gwaay gud gina B. 'aws (Skide­ that it doesn't have this effect in gate) ){aadaa Gwaayee guu giin Key Benefits of Bioluminex:· humans (a more recent study,2 k.'aws (Massett) is an excep­ tional work and was recently • Greatly enhances TLC with a published after the book, indi­ biological detector cated a modest positive outcome the recipient of British Colum­ on reducing alcohol consump­ bia's Lieutenant-Governor's • Rapid results tion in an informal setting). It Medal for Historical Writing. is also reported in this clinical Her careful attentiveness to • Easy-to-use findings section that the herb detail allows the reader to shift • Works with almost and sample type has been used for alcohol detox- from the ordinary viewpoint ification, but doesn't describe what that of botanical interest to an extraordinary • Wide application base means (in fact, the herb is mainly used perspective of wholeness as understood by to treat hangover symptoms). Another people deeply rooted to the land and sea, • Determination of both "active" potential problem is that the informa­ specifically the Haida Nation. and "toxic" compounds tion provided about comraindications and The many excellent photographs enliven • Cost effective (low cost per assay) side-effects for the herbs usually applies the book. Most are in color and many only to the high doses used in C hina that were taken by the author and her husband. most Westerners will not encounter, and They cover rhe plants and the people in so may concern herb users unnecessarily. native communities-people busy with In all, this book does a very good job bark, root, or pitch. Also included are of presenting traditional C hinese medi­ wonderful illustrations by Giitsxaa (Ron cine and the commonly used herbs and W ilson) that portray scenes from tradi­ formulas so that a well-educated and tional H aida stories. T hese illustrations motivated reader can gain a reasonable and photos, combined with the thought­ ful and thought-provoking text, allow the level of understanding. It should help To leam more about Bioluminex ~or people to decide whether or not to pursue reader to experience the landscape, the for a detailed brochure of applications this method of therapy with professional people, and their culture, as well as many please contact us at: assistance and help them to better under­ of the individual plants harbored on this stand what has been prescribed to them. archipelago known as the Queen Char­ ChromaDex It may also encourage some readers to lotte Islands. consider a professional career in Chinese Located off the northern mainland 2952 S. Daimler St. Santa Ana, CA 02705 medicine. HG coast of British Columbia just south of the panhandle of Alaska, these islands tel. 949.419.0288 -Subhuti Dharmananda, PhD, fax. 949.419.0294 Director, Institute for Traditional are botanically and culturally rich. The email. [email protected] Medicine, Portland, OR preferred traditional name of the land is web. www.chrornadex.com www.he rb algram .org 2006 HerbaiGram 69 I 71 Book Reviews

Haida Gwaii. (Recently, the Canadian her passing at nearly 100 years of age. British Columbia. Her early works, such as government recognized Haida Gwaii as The book represents a milestone In the 1970s series from the British Colum­ the accepted official name of the islands.) a life dedicated to the new ethics of bia Provincial Museum, including Food The title of the book speaks of the archi­ ethnobiology, a field in which Turner Plants ofBritish Columbia Indians, Parts 1 pelago as well as two specific Haida Nation has been a catalyst as a member of the and 2, along with Plants in British Colum­ settlements on the large northern island ethical standards working group of the bia Indian Technology, remain nor only known as Graham Island. Throughout, International Society of Eth no biology. excellent sources of information about the Turner references traditional names of Deep concern for bioerhics has grown plants but illustrate her acknowledgment plants, animals, places and objects using our of a generation of people signifi­ of her indebtedness to the indigenous the two different dialects represented by cantly touched by nor simply the bounty people who were integral in her educa­ rhe Skidegare and Massett peoples. of the green earth and how to utilize it, tion. But in Plants of Haida Gwaii, the Though it has grown common for but by the acknowledgement that living interloping scientist is rather thoroughly authors to acknowledge by name local requires reciprocity. In seeking models for replaced by an acceptance of the Haida informants in the foreword, Turner takes a this act of giving back, indigenous people as the experts, while still acknowledg­ giant step beyond by putting rhe concerns offer not just historical guides but current ing those researchers, and their written of the Haida people in the forefront of inspiration as Plants of Haida Gwaii so work, in whose academic paths she has this entire work. Written with collabora­ aptl y illustrates. Though for centuries followed. Whereas in her writings of three tion and cooperation of the Haida, this white researchers have lamented the loss of decades ago, Turner categorized the indig­ book represents a strong sense of account­ indigenous wisdom and know-how to the enous peoples of British Columbia using ability to the "first people" and the land, crush of industriali za tion, native peoples the government's accepted classification as well as rhe deep relationship rhar exists have managed to maintain themselves and system, in this current book she unabash­ between them. Plants of Haida Gwaii, the knowledge that is essential to their edly utilizes the Haida's languages and in essence, is a gift from Nancy]. Turn­ unique worldviews. viewpoints. er's mid-life to a people and a place that The dedication to the concerns of the This makes for complications that she once inspired a youthful graduate student. Haida people in this new book is noth­ willingly tackles. She gently helps the Luckily, she was able to reconnect with ing new for Turner, who is a distinguished reader to grasp concepts that may be unfa­ people like Florence Davidson, one of her professor of botany at the School of Envi­ miliar and have been certainly regarded as earlier informants from rhe 1970s, before ronmental Studies, University of Victoria, unscientific. Because of the Haida's broad

72 I HerbaiGram 69 2006 www.herbalgram.org Book Reviews ------~l------J~------concept of medicine, rheir relationship stories rhar are esse mial fo r a more thor­ European migrati on had on rhe H aida ro rhe "whole", and, more imporranrly, ough understanding of rhe H aida Nation's arion. By doing her best to truly listen due ro rhei r desire for privacy and protec­ viewpoim. Some of these narratives are to and record whar rhe H aida people tion of rhe planrs wirh whom rhey share brought forward from ea rli er rimes , bur wa nred to share about rheir relati onship rheir lives, specific appli cations of medici­ rhere are plenry from rhe local people of to rhe pl anrs, Nancy J. Turner reveres rheir nal informati on are nor give n. As Turner today. knowledge and wisdom along wirh rhe puts ir, "Each individual has her or his Plants of Haida Gwaii is a handsome re markable land rhar sustains rheir lush, own particular connection wirh nature. and unique book rhar goes far in bridging green worl d. T he ripples of rhis rype of Ir is imporranr for all of us ro under­ rhe gap between races rhar view rhe world work, es peciall y from a hi ghly acclai med stand rhar rhis relationship ex isrs and rhar in very differenr ways. Ten useful appen­ author and erhnoboranisr like Turner, ir has a profound influence on rhe way dices include rhose on H aida language; travel fa r ro ser a precedenr for truly traditionally trained H aida perceive rheir li sts of food and utilitarian plams such honoring rhe asronishing dive rsity of rhe lands, bur equally imporranr ro res pect irs as rhose used fo r build ing, dyeing, and ea rrh we all share. HG sacredness and essenrially private nature." weaving; medici nal plam s; plams associ­ -Cascade Anderson Geller This emphasis on rhe individual's rela­ ated wirh srories and animals; inrroduced Herbalist, Portland, OR tionship ro nature sers a tone far differenr vegetables; and others. True to her own rhan rhar of currenr prorocols for scienrific training in botany, Turner also incl udes he Pharmacopoeia of the United categorization and creates complications excellenr indices rhar reference nor only T States of America-Facsimile of for rhe lerrered researcher, like Turner, English and scienrific names bur also rhe the First Edition (1820). M adiso n, W I: who chooses ro work within rhese param­ H aida plam names. Throughout rhe rex r, American Institute of rhe History of Phar­ eters . Turner has included Larin binomi als and macy; 2005. 272 pages, sofr cover. ISBN Turner appea rs to accept willingly such fa mily names for each planr , rendering ir 0-931292-41-7. $25.00. parameters and ex plains rhar, "Iris impos­ a ve ry professional work rhar belongs in Early Ameri can pharmacy and rhe prac­ sible to separate rhe concepts of healing every library, public or priva te. tice of medicine we re, for rhe mosr parr, from rhe concepts of spirituality and rhe Plants of Haida Gwaii se rves as a literary based on 17rh and 18rh cenrury British power invested in natural rhings within mitigation for rhe devastatingly disrup­ or European pharmacy and med icine. rhe H aida culture. M edicinal plams, along ti ve and des tructive influences rhar rhe Virrually all of rhe literature and most of wirh orher natural obj ects, are treated wirh deep res pect and rheir porenria l fo r affect­ ing peoples' lives and healrh is acknowl­ edged from rhe ourse r by rhose practicing traditional medicine." Whar replaces rhe Earn a Master of Science usual review of rhis planr for rhar condi­ tion is probably of more imporrance ro those outside the H aida community; rhat in Herbal Medicine is, a glimpse imo a culrure rhar believes rhar rhe relationship between individual Now enrolling ADVANCED STANDING NOW AVAI LABLE planrs and people is rhe medicine. for the FOR EXPERIENCED HERBALISTS Turner masterfully negori ares orher Fall2006 Class cultural hurdles srimulared by rhis funda­ 800 HOURS OF EXTENSIVE CLINICAL mental belief rhar knowledge is born of a TRAINING & PRACTICUM private, individual relationship between people and plams. She lers rhe H aida RENOWNED FACULTY MEMBERS themselves ex plain why, for example, rhey SIMON MILLS, M.A., F.N.I.M .H., M.C.P.P. lac k a general rerm for plant. As one of rhe & JAMES DUKE, PH .D. informam s ex plained, "ir is because all planrs are living beings, individuals, jusr as individual humans are beings. Therefore, each individual rype of plam has irs own 800-735-2968 x6647 name, jusr as an individual H aida; rhere [email protected] is no need to use a broader name." These www.tai.edu rypes of iss ues have always confo unded Tai Sophia ethnobiologisrs and ethnoboranisrs. 7750 Montpelier Rd., Laurel, MD 20723 A paramoum consideration for erhno­ Institute biologisrs has always been, and remains, Tai Sophia In st itute . a leader in well ness education. offers grJduate degrees in Acu puncture. rhe issue of arrempring to capture oral Ht: rlJal Medicine and the Applied Healing Arts-along w ith an arrJy of wellness n::sourees fo r the traditions in rhe enrrapmenrs of rhe wrir­ general public including a booksto re/ cafe. clinical services. community workshops, li brary. meditation and herb gardens. We invite you to \·isit our cam p us and become a part of our ren word. Plants of Haida Gwaii helps ro learning com munity. allay rhis conundrum by recording rhe www.herbalgram.org 2006 HerbaiGram 69 I 73 ------~l__ Bo _o_k_R_ev_ie_w_s_J~------the medicines used by phys icians, mmis­ Essay toward a Materia Medica for the conventions. T hese conventions rook ters, and others who dispensed med i­ United States," clearly stared rhe need for place in Boston, Philadelphia, C harleston, cines were of European origin. By the late a "pharmacopoeia of this counrry." T he and Lex ington, Kentucky. Many of the 1700s there was a definite need for profes­ publication of regional works such as rhe most highly rega rded physicians of the day sional texts that recognized the unique Pharmacopoeia of the Massachusetts Medi­ rook part, including Jacob Bigelow, James conditions and diseases facing physicians cal Society (1808) and the Pharmacopoeia T hatcher, William Tully, Joseph Parrish, in the Americas. Diseases and climati c Nosocomii Neo-Eboracensis, The Pharma­ Samuel L. Mitchell, and David Hosack. conditions rarely seen in Europe were copoeia of the New York Hospital (1816), This cumulative effort led to the publi­ common in rhe burgeoning towns and further stimulated inreres r in a uniform cation of the first Pharmacopoeia of the vi llages of the now former Colonies. Many national pharmacopeia. Phys icians and United States in December of 1820. commonly used plant medicines (ginger, pharmacists understood that there was T his groundbreaking work not only rhubarb, li corice, senna) did nor grow in a desperate need for pure, unadulterated included the well-known medicines of the North America, and foreign medicines medicines with uniform potency, clearly time- mercury, antimony, senna, arsenic, were expensive and not always ava il able defined formulas, and standardized reci­ opium, aloes, lead, sulphur, and jalap-it outside of the more heavily populated pes so that Vinegar of Opium, prepared in also made officinal new medicines such as cities on the eastern seaboard. Boston, was the same medicine prepared ether and many uniquely American reme­ Early attempts at creating an indigenous in Charleston, South Carolina. dies. Through the earlier publications of pharmaceutical literature were published Dr. Lyman Spalding, a physician from Manasseh Curler, Samuel Stearns, Samuel bur they had a limited use and scope. One New York, is credited with advancing and Henry, Benjamin Smith Barron, William such publication, written for the Conti­ promoting the idea of a national stan­ Barron, and Jacob Bigelow, native Ameri­ nental Army, was rhe Lititz Pharmacopoeia dard text for medicines and is considered ca n plants were becoming better known (1778), bur ir included only O ld World the originator of the first US Pharmaco­ and more frequently used in medicine. remedies and was intended for army poeia. In 1817 he proposed rhis under­ The fi rst edition of the Pharmacopoeia of surgeons. In 1798 and agai n in 1804, ea rly raking ro the New York Medical Soci­ the Un ited States ofAmerica includes many medical botanist and physician Benjamin ety and suggested medica l societies from New World botanicals such as Sassafras, Sm ith Barron, in his "Collections for an each state send delegates ro fo ur regional Sarsaparilla, Peruvian Bark (Cinchona),

New Book Profiles Understanding Medicinal Plants: Their plants. Details usage, dosage, modes of formulas, references, index. $99.95. ISBN Chemistry and Therapeutic Action. action, use res trictions, characteristics, 0-415-30830-5. Bryan A. Hanson, PhD. Binghamton, indications, and references of more than An overview of the current use of NY: Haworth Herbal Press; 2005. 307 1,200 plant drugs. Search criteria avail­ Juzen-taiho-ro, a formulation of herbs pp., softcover, contents, 7 color photos, able for scientific names and synonyms, used in Kampo, a traditional Japanese woodblock illustrations, tables, notes, vernacular names, substances, indica­ herbal approach to healing. Describes glossary, bibliography, index. $44.95. tions, and pharmacopeias containing Juzen-taiho-to in detail, including its ISBN 0-7890-1552-8. monographs for the plant drugs. formula, cultivation, uses, pharmacologi­ Explains the chemistry behind medici­ The Complete Revised and Updated cal actions, and latest research of its use in nal herbs in a user-friendly, technical Cancer Survival Guide. Peter Teeley and cancer treatment. Also discusses the place manner geared towards individuals with­ Philip Bashe. New York, NY: Broadway of Kampo in modern Japanese medicine. out an intensive chemistry background. Books; 2005. 988 pp., soft cover, charts, Viral Immunity: A 10-Step Plan to Covers medicinal molecules found in diagrams, cancer resource appendices, Enhance Your Immunity Against Viral plants and the pharmacology behind their index. $21.95. ISBN 0-7679-1989-0. Disease Using Natural Medicines. ] .E. actions on the human body. Includes An exhaustive reference of state-of-the­ Williams, OMD. Charlottesville, VA: three case studies for reinforcement and art treatment options for 25 of the most H ampton Roads; 2002. 465 pp., soft application of concepts and principles. common types of cancer. Contains orga­ cover, charts, diagrams, lab tests, thera­ Herbal Remedies on CD-ROM. nized explanation of cancers, diagnosis pies, glossary, notes, references, index. T homas Brendler, Joerg Gruenwald, and prognosis, rationale of current treat­ $19.95. ISBN 1-57174-265-4. and Christof Jaenicke, eds. Stuttgart, ment options and detailed contact infor­ A guide to improving viral immu­ Germany: Medpharm GmbH Scientific mation for leading national cancer centers nity with natural remedies. Explains Publishers; 2003. CD-ROM, English/ and professional organizations. the importance of viral immunity, how German language, reference list, glos­ juzen-taiho-to (Shi-Quan-Bu-Tang): the immune system succumbs to viral sary, substance list, color photos. $88.95. Scientific Evaluation and Clinical Appli­ infections, and natural techniques in ISBN 3-88763-102-1. cations. Haruki Yamada and Ikuo Saiki, building a strong immune system includ­ Covers general and botanical descrip­ eds. Boca Raton, FL: Taylor & Francis; ing lifestyle, detoxification, antioxidants tions, etymology, habitat, toxicity, and 2005. 242 pp., hardcover, charts, graphs, and oxidative therapies, enzymes, and protection status of more than 1,100 b&w illustrations and pictures, medicinal herbs.

74 I Herba iG ram 69 2006 www.herbalgram.org Book Reviews

Tobacco, Slippery Elm, Carolina Pink readable than any original copy of this Collection of the Native Medicinal Plants of (Spigelia), Virginia Snake Root, Ameri­ pharmacopeia that I have ever seen. This the United States. Boston: C ummings & can Hellebore (Veratrum viride), Indian allows this viral piece of early American Hilliard; 18 18. England J, ed . The First Century of the Phila­ robacco (Lobelia), and Seneca Snake root. hisrory ro become an easily accessible delphia College of Pharmacy, 182 1-1 92 1. Many of these herbs later found wide primary document for historians, physi­ Ph iladelphia: Philadelphia College of Phar­ acceptance in orthodox practice (Spige­ cians, pharmacists, or herbalists looking macy and Science; 1922:82-96. lia, Sarsaparilla, Cinchona); T homsonian ro understand the beginnings of Ameri can HenryS. A New and Complete American Medi­ practice (Boneset, Lobelia, Slippery Elm, medicine and its materi a medica. HG cal Family Herbal. New York; 18 14. Cayenne); and Eclectic practi ce (Vera­ -David Winston, RH (AHG) Kremers E. Documenrs Pertaining ro T he trum viride, Phyrolacca, Bloodroot, and Washington, NJ Medicinal Supplies Within the North Xanthoxylum). Most of these remedies American Coloni es from 1643- 1780. Madi­ are still used by herbalists and/or naturo­ Bibliography so n, WI: Ameri ca n Institute of the Hisrory of Pharmacy; 1944. pathic physicians ro this day. An Account of So me of the Vegetabl e Products Ll oyd JU, Just T, Simons CM. Catalogue of Naturally Growing in This Parr of Ameri ca Original copies of the first pharmaco­ The Pharmacopoeias, Dispensatories, Formu ­ (Botanically Arranged by M . C urler). In : peia are scarce and expensive (often in the laries, and Allied Publications (I 493-1957). Memoirs of the American Academy of Arts $600-$1000 range). In addition, these C in cinnati : Ll oyd Library; 1957 . & Sciences, Volu me I. Bosron; 1785:396- The Pharmacopoeia of the Massachusetts Medical copies often have extensive foxing (brown­ 493. Society. Bosron: E&J La rkin; 1808. ing of the paper due ro acidification of Barron BS. Coll ections for An Essay Toward a Spalding JA. Dr. Lyman Spalding, The Origi­ the paper), making them very fragile and Materi a Medica for The United States. In: nator of the United States Pharmacopoeia. often difficult ro read. Bulletin of the Lloyd Library# I (reproduc­ Bosron: WM Leo nard; 1916. tion of 1798 and 1804 editions) . Ci ncin­ The American Institute of the Hisrory Stearns S. The American Herbal or Materia nati ; 1900. of Pharmacy (AIHP) has provided a great Medica . Walpole, N H: David Carli sle; Barro n W. Vegetabl e. Materia Medica of the service in reprinting this book. It is ava il­ 1801 . United States or Medical Botany. Philadel­ able as an inexpensive paperback or a phia: M. Carey & Sons; 18 17. hardcover edition, and it is more easily Bi gelow J. American Medical Botany, Being a

Herbal Medicine ofthe American South­ root, wild ginger, and ramps. Topeka, KS: Red Otter Graphics & west. Charles Kane. Tucson, AZ: Lincoln Optimal Digestive Health: A Complete Media Services. 2005. 61 pp., spiral­ Town Press; 2006. 307 pp., soft cover, Guide. Trent Nichols, MD, and Nancy bound, b&w photographs, drawings and therapeutic index, color pictures, glos­ Faass, MSW, MPH, eds. Rochester, VT: diagrams, herb lists, references. $39.95. sary, references, index. $29.95. ISBN 0- Healing Arts Press; 2005. 598 pp., soft No ISBN. 9771333-0-3. cover, charts, references, index. $19.95. Details the life of John Jacob "Indian A reference work of more than 200 ISBN 159477036-0. John" Derringer, an herbalist in the 1800s plants native ro the southwest United Details 30 digestive diseases and disor­ and early 1900s. Pictures and stories States and how they are used in herbal ders. Collected information and research collected from various sources piece medicine. Plant profiles include descrip­ from 25 top physicians. Up-to-date treat­ together his healing career and cross­ tion, geographical distribution, chem­ ment options from both mainstream and country journeys. Contains numerous istry, medicinal and other uses, indica­ alternative medicine, including herbs, herbal remedies, methods of diagnosis, tions, preparations, dosage, and cautions. homeopathy, acupuncture, biofeedback and plant collection lists that Derringer Many of the profiles include plant illus­ and Ayurveda. used in his practice. trations and color phoros for ease in Complementary and Alternative Thera­ Traditional Chinese Medicine: An identification. pies for Epilepsy. Orrin Devinsky, MD, Authoritative and Comprehensive Guide. Ginseng, Goldenseal & Other Woodland Steven Schachter, MD, and Steven Pacia, Henry Lu, PhD. Laguna Beach, CA: Medicinals. W. Scott Persons and Jeanine MD, eds. New York, NY: Demos Medi­ Basic Health Publications, Inc.; 2005. Davis. Fairview, NC: Bright Mountain cal Publishing; 2005. 330 pp., hardcover, 207 pp., soft cover, charts, diagrams, Books, Inc; 2005. 466 pp., soft cover, commentary, tables, index. $79.95. ISBN b&w illustrations, index. $19.95. ISBN b&w pictures and photos, charts, refer­ 1-888799-89-7. 978-159120-132-2. ences, statistics, resource directory, index. Integrates complementary and alter­ Discusses the 13 syndromes in tradi­ $25.00. ISBN 0-914875-42-6. native medicine (CAM) into Western tional Chinese medicine that are thought Recommended methods for grow­ medicine for the treatment of epilepsy. to cause disease and treatments for a wide ing and marketing of Eastern wood­ Contains stress-reduction, nutrmon, range of diseases and disorders, including land botanicals. Detailed information herbs, music, art, and pet therapies. Pres­ those that are specific to men or women. on botany and usage, management prac­ ents scientific evidence to support its Food and herbal cures are detailed. How, tices and present market conditions. approaches and rationale of treatment. when, and why to use acupuncture is Includes sections on history, cultivation, The Legacy ofthe Talking Crow. Volumes discussed. Exercise and self-massage are and testimonials for 14 plants including I, 2 and 3 of Indian john, Medicine also addressed. HG American ginseng, goldenseal, blood- Man to the Settlers. Gale Wollenberg. www.herbalgram.org 2006 HerbaiGram 69 I 75 In Memoriam

D ay on April 22, 1970, in which an esti­ es t honor given to civilians in the United mated 20 million people participated. 2 States, for hi s public service and work fo r "Earth day worked because of the spon­ the environment. Clinton explained his taneous response at the gras sroots level. choice to the honorees, their families, and We had neither the time nor the resources friends: "In the 1970s, when a ri ver was to orga nize 20 million demonstrators and so polluted that it actually caught on fire, the thousands of school and local commu­ Gaylord Nelson spoke up. He insisted that nities that participated . T hat was the Americans deserved the safety that comes remarkable thing about Ea rth Day. It from knowing the world we live in will not organized itsel f, " said elson. 2 make us sick. H e wa rned that our leaders "It was an immense thrill to see that should never let partisan politics divert us breakthrough, and to see it culminate from responsibility to our shared environ­ Gaylord A. Nelson with Earth D ay. I think that he rega rded ment. He inspired us to remember that 1916- 2005 it as the highlight of his li fe, although he the stewardship of our natural resources is was not a person to brag about his achieve­ the stewardship of the Ameri can Drea m. aylord Anton Nelson, former US ments," said Senator George McG overn, H e is the worthy heir of the tradition of Senator and governor of W iscon­ the former South D akota Senator and T heodore Roosevelr."5 Gsin, as well as an internationally 1972 D emocratic Pres idential nomi­ Nelson received his BA in 1939 from recogn ized leader of the enviro nmental nee (oral communicati on, September 8, Sa n Jose State College (California) and movement, died on July 3, 2005, in Kens­ 2005) . graduated fro m the University ofW iscon­ ington, MD. Nelson was 89. T he cause of After the first Earth D ay, Nelson contin­ sin Law School in 1942. H e served during 1 death was cardiovascular failure. ued to work on his enviro nmental agenda. World War II as a First Lieutenant in the Nelson distinguished himself ea rly as Within the first 10 yea rs of the first Earth United States Army during the Okinawa an environmentalist with his first Senate Day, 23 major enviro nmental legislations ca mpaign.6 Nelson began his ca reer as speech on March 25 , 1963: "We need a became law. In 2000 an estimated 500 a public se rva nt in 1948 as a Wisconsin comprehensive and nationwide program million people from 174 countries partici­ State Senator, serving from 1949-1959. H e to save the national resources of Ameri ca," pated in Earth D ay activities } se rved as the Wisconsin Governor (1 959- he said . "O ur soil, our water and our air "I regarded him as the leading envi­ 1963) and United States Senator (1963 - are becoming more polluted every day. ronmentalist in the Senate," sa id McGov­ 1981) .7 Senator Nelson is survived by his O ur most priceless natural resources­ ern. "We both came to the Senate on the wife Carrie Lee Nelson, his two sons, trees, lakes, rive rs, wildlife habitats, scenic same day in 1962, and left on the same Gaylord Nelson Jr. and Jeffrey Nelson, landscapes- are being destroyed."! day in 1982. We were seatmates all those his daughter T ia Nelson, and three grand­ Senator Nelson is bes t known as the yea rs ... I sat nex t to him in the Senate children .1 fo under of Ea rth Day. T he momentum fo r for 18 years. H e was my closest fri end." McGovern ex plained that Nelson had Earth Day began in 1962 when the newly­ McGovern sa id their departure from the a wide range of interests, listing his work elected W isconsin Senator convinced then Senate was not an accident. He sa id a with the Wilderness Society, his inter­ President John F. Kennedy to help make group of right-wing extremist organiza­ est in soil conservation, as well as wild­ the environment an important political tions conducted a campaign to oust liberal life preserves, fl ora, and fauna. "H e had iss ue. To that end, Kennedy embarked on Senators. "Gaylord and I were targeted, a total interes t in all growing and living a five-day, eleven-s tate conservation tour and 5 out of 6 were defeated. They used things. I'd give him an A-plus fo r his 1 in September 1963. the word 'targets' for the people that they service as a US Senator and as the Gover­ In 1964 Senator Nelson joined a group went after. I always thought it was a stag­ nor of Wisconsin. He loved that state, and of lawmakers to sponsor the Wilderness ge ring blow to the good side of the Senate, America, and he was just thrilled with Act, permanently sa feguarding millions of the people working for progress and social the landscape of this country," McGovern acres of fe deral land. In 1968 he worked change. I don't think the Senate has ever told HerbaLGram. "H e was a person with with the Johnson administration to pass been the same since." a remarkable sense of humor, one of the the federal Wild and Scenic Rivers Act. Prior to his electi on to the Senate, witties t people I ever knew, and I think it Working with the Interior Department, during his tenure as Governor of Wiscon­ helped him soften up his opponents," sa id N elson helped to es tablish national scenic sin, Nelson created the O utdoor Recre­ McGovern. "I miss him terribly." HG 1 seashores and lakeshores. ation Acquisition Program. T he $50- -Katherine Purcell In 1969 Nelson began a grassroots million program worked to acquire and ca mpaign to draw attention to the increas­ conse rve one million acres of Wisconsin References ing pollution and degradation of the envi­ park land, and it was funded by a one-cent 1. Schneider K. Gaylord A. Nelson, fo under ro nment. His efforts were modeled after tax on cigarettes. T his land conse rvation of Earth Day, is dead ar 89. New York anti-Vietnam War pro tes ts called "teach and acquisition program became a model Times. July 4, 2005:Al2. 2. Gaylord Nelson. The History of Ea rth­ ins." T he Senator held a press conference for other states. 3.4 in September 1969 to announce a major day. The Wilderness Sociery [Web sire] . On September 29, 1995, former Presi­ Available ar: h rrp:/ I earth day. wilderness. pro test and to invite public participation. dent Bill Clinton presented Nelson with the org/ history/ hi story.pdf. Accessed August T hese effo rts culminated in the first Earth Presidential Medal of Freedom, the high- 29, 2005.

76 I HerbaiGram 69 2006 www.herbalgram.org In Memoriam

3. Environmentalist Gaylord A. Nelson dies contributions speak for themselves." he guided our scientists and helped open at age 89; Earth Day founder, Wiscon­ Dr. Pang was born in Hong Kong in doors for success in science and busi­ sin governor, U.S. senator. Wispolitics. 194 1. He earned two bachelor degrees ness. As a world renowned scientist and com [Web site]. Available at: http: // in science from the University of Hong enthusiastic entrepreneur, his ground­ www.wispolitics.com/printerfriendly. Kong, a masters in science and doctor­ imi ?Article=40035. Accessed August 29, breaking work and keen vision shaped our 2005. are from Yale University, then returned to company's scientific and business fo unda­ 4. Profile of Gaylord A. elso n. The the University of Hong Kong to achieve tion. Even after his retirement from CV Wilderness Society [We b site]. Ava ilable a Doctor of Science. He taught at Yale, Technologies in ea rl y 2000 his dream at: http: //www.wilderness.org/ About Us/ Columbia University, the City University had continued to inspire us to pursue Nelson_Bio.cfm . Accessed August 29, of New York, and Texas Tech University. evidence-based natural medicine and will 2005. In 1986, he began serving as chair of the continue to motivate us in the furure."3 5. Clinton W. Rem arks by the President in physiology department of the University After leavi ng CV Technologies, Dr. presentation of th e Presidential Medal of of Alberta's School of Medicinel Freedom. The Wilderness Society [Web Pang hel ped found another Edmonton­ site] . Availab le at: http://earthday.wilder­ based botanical product development firm, ness. org/hi storylremarks.pdf Accessed "He was always C P Drug Developmenr. H e was working August 29, 2005. to develop another research-based herb­ 6. Nelson , Gaylord Anton (1916- 2005). a great research ally and, derived products company at the time of The Biograp hical Directory of th e I'd say, one of the his death.1 HG United States Congress: 1774-Present -Courtney Cavaliere [Web page]. Available at: http://biogu­ most intuitive scientists id e.congress.gov/scripts/biodisp lay. References pl?index=N000033. Accessed August 29 , I've ever known." 200 5. I. Farrell J. Cold -fX creator Dr. Peter Pang 7. Wisconsin Public Television. Gaylord -Christina Benishin, PhD remembered for friendship, fun . Edmon­ Amon Nelso n. Wisconsin Public Televi­ ton journal. May 14, 2005:81. 2. Cold-fX: number one selling cold remedy sion [Web site]. Available at: http: //www. Dr. Benishin said Dr. Pang was always in Canada [press release] . Edmonton, wpt.org/nelso n/. Accessed August 29 , anxious to initiate and encourage research 2005. Alberta: CV Tec hnologies; May 24, 2005 . efforts within the department, and he 3. CV Tec hn ologies. In memory of Dr. Peter Pang actively recruited minority students and Peter Pang. Edmonton j ournal. May 17, research colleagues to the U niversity of 2005: B2. 1941-2005 Alberta. "He was a great friend," said Dr. Benishin. "He was always a great research TATA lEA eter Pang, PhD, DSc, an accom­ ally and, I'd say, one of the most intui­ plished researcher and academic CCNUNUHJ liD\! !'ACE 63 tive scientists I've ever known. He will be who helped initiate the development P really missed by everyone around here." have adversely affected the importation of of various herbal product companies, died The University of Alberta has es tabli shed m any common foreign botanica l ingredi­ May 9, 2005, from injuries sustained in a a graduate student award in Dr. Pang's ents that constitute much of today's mulri­ traffic accident in China.1 name (C. Cheeseman, e-mail, September billion dollar herb industry. Dr. Pang contributed to multiple 6, 2005). Reached for comment for this article, research projects throughout his career, In 1992, Dr. Pang co-founded CV Louise Veninga and Ben Zaricor empha­ including investi gations into the causes Technologies, a science-based herbal prod­ sized that this acquisition wi ll ensure that of hypertension and a study regarding the uct development firm based in Edmonton, the Good Earth line under the new lead­ effects of calcium on various diseases. Dr. Alberta, Canada. While working at CV ership of the Tetley Tea Group/Tara Teas Pang also published two books, a treatise Technologies, Dr. Pang contributed to w ill now have the resources to become of five volumes, and more than 300 scien­ the development of the all-natural immu­ 1 a n international brand leader in the tific papers during his lifetime. 8 nostimulant, Cold-fX , based on isolated special ty tea trade. Veninga and Zaricor His former colleague Christina ginsenosides from American ginseng wi ll continue in their role in the foresee­ Benishin, PhD, associate professor of (Panax quinquefolius L., Araliaceae). able future to lead the company in Santa physiology at the University of Alberta, Cold-fX is the best-selling cold remedy C ruz. They have also retained the rights said Dr. Pang significantly contributed in Canada according to statistics analyzed to the Good Earth Res taurants and intend to the field of comparative endocrinol­ by marketing information company to develop a plan ro "re-launch the unique ogy and to research in traditional C hinese ACNielsen over a 52-week period ending concept of the restaurants ro its former medicines (C. Benishin, oral communi­ in April of2005.2 leadership in healthy dining." cation, September 2005). "He was very HG CV Technologies published a tribute to proactive, early on, in bringing rigorous Dr. Pang in the Edmonton journal, which References scientific studies to the field [of herbs included the following statements: "Dr. I. Tara Tea buys U.S. brand Good Earth . and nutraceutical ingredients] to help us Pang, in addition to being our company's Reuters. Thursday, October 13, 2005. understand the mechanisms of action in a founder, was a fri end, reacher, mentor, 2. Fmali Herb In c. v Heckler, 715 F. 2d 1385 number of products used in herbal medi­ and leader to many of our former and (9 th Cir 1983). cine," said Dr. Benishin. "His scientific current employees. In his role as a mentor,

www.herbalgram .org 2006 HerbaiGram 69 I 77 understanding of these techniques. Web site: Bill Mitchell, NO; Kenneth Proefrock, ND; 2006 http:/ /www.genom ics .uic.edu. Jill Stansbury, NO; and Donald Yance. Topics March 22-24. Nutracon. Anaheim, CA. This include botanical therapies for headaches, February 16- 18. Health Strategy Network evenr is intended for product developers, R&D managing leukemia, allergies, respiratory Executive Conference Series. Marco Island, scienrists, formulators, brand managers, and disease, inflammation using botanical COX-2 Florida. We create a global learning connec­ executives of the healrh and nutrition industry. inhibitors, irritable bowel syndrome, declining tion using perrinent, facilitated business case Nutracon presenrs emerging scientific infor­ cognition at any age, and rhe Ia rest research for studies in the areas of retail, branded market­ mation, product strategies, case studies, and cancer prevention and treatment. Herb wa lks ing, and ingredienr manufacturing. Together marker data of the food and beve rages sector at the Desert Botanical Garden. CE credits for with our attendees, we challenge the issues and the dietary supplemenrs/bioactives sector. health professionals. Phone: 800-252-0688. that face companies as they compete in global Attendees can lea rn about the next genera­ Web sire: www.boranicalmedicine.org. markers-sharing diverse knowledge, back­ tion of ingredients to improve product offer­ April 9-10. Natural Products Europe/ grounds, and perspectives to collectively ings, rrack emergin g markers and trends, and Organic Products Europe 2006. London, formulate new ideas and alternative solutions. get the lares r consumer data and regulatory England. This event enables manufacturers, Our program will provide the bes t environ­ information. Phone: 303-939-8440. Web sire: producers, and distributors from different ment for learning and sharing among industry http: I lwww. n u rracon ference .com I. countries to showcase rheir latest natural and leaders. We invite decision makers throughout March 23-26 (exhibits March 24-26). organic products. This wi ll be rhe IO• h year of the natural products va lu e chain to participate Natural Products Expo West. Anaheim, CA. the rrades how. Fax: 011-44-(0)-1903-817310. and share their experience and insight. Web This event features informational sessions and Web site: hrrp://www.naruralproducts. eo.uk/ sire: http: I /www.hea It h-straregy.com/news/ ex hibitions of natural and organic products. op_europe/index.shrml. conferences.php. Visitors can attend educational presentations April 26-28. LOHAS 10 Forum. Los Ange­ February 26-27. 2006 Spa & Resort on such topics as nutrition, marketing, organic les, CA. LOHAS 10 is a three-day business and Medical Spa Expo and Conference. production, i nternarional commerce, and conference chat wi ll bring together leaders Los Angeles, CA. This event is des igned related interests. Attendees ca n also browse from Fortune 500 companies, LOHAS busi­ for all medical and spa professionals includ­ nearly 2,500 ex hibits regarding organic, nesses, the entertainment industry, and celeb­ ing dermatologists, plastic surgeons, chiro­ specialty, and vegetarian foods, natural home rities to focus on how businesses, media, and practors, demises, massage therapists, nurses, and textile irems, healrhcare and personal enrertainmenr can be leveraged to educate, acupuncturists, narutopaths, es rhericians, and care products, supplements, and pet products. shape, and influence consumer behavior and medical spa and spa owners and/or managers. Phone: 303-939-8440. Web sire: http://www. purchasing decisions while promoting life­ For more information about the Spa & Resort expowesr.com/. styles of hea lth and susrainabiliry. If yo u and Medical Spa Expo & Conference, srory March 24-26. Supply Expo. Anaheim, CA. or your busin ess is involved in conscious ideas, or inrerviews with key industry spokes­ This show ex hibits materials for health and commerce, this is an evenr rhar should not people, please conracr Pam Wadler or Nancy nutrition product development. Featured be missed. Phone: 303-222-8283. Web sire: Trent at 212-966-0024. Web sire: http://www. items include in gredienrs, raw materials, http://www. lohas.com/forum/. medica !spa ex pol a .com I a pp/ ho mepage.c fm 'a p and finished products of functional foods, May 1-3. SupplySide East. Secaucus, NJ. pname; I 00324&moduleid ;42. dietary supplements, nurraceurica ls, personal This evem features educational sessions, March 3-5. International Complemen ­ care items, and cosmeceuticals. Phone: 303- speaker presenrarions, and exhibits regarding tary and Natural Healthcare Conference 939-8440. Web site: http://www.supplyexpo. healthy and botanical ingredients. SupplySide and Expo. New York, NY. This evenr is com/. East is designed for executives of the dietary inrended for licensed practitioners and their March 27-29. World Tea Expo. Las Vegas, supplemenr, functional food s, pharmaceuti­ suppliers. More chan 20 speakers wi ll pres­ NV. The World Tea Expo is the only trade cal, and cosmetic sectors. Phone: 480-990- ent at the conference, which features rhe latest show and educational symposium based in 1101. Web sire: http://www.supplysideshow. trends, research, clinical trials, and protocols rhe United Srares and dedicated exclusively com/easr/. in the field of complementary and integra­ to the tea trade. This 4rh annual expo wi ll May 6-7. Healthy Products Expo Retailer tive medicine. The exhibition showcases the feature over 200 booths, in-depth seminars, Show. Secaucus, NJ. Healthy Product Expo is laresr natural healthcare products. E-mail: and presentations from over 35 speakers , ideal for retail decision-makers across all cate­ info@ca mexpo.com. Web sire: http://www. geared toward companies in vo lved in retailing, gories including independenr retailers, chain camexpoeasr.com/index.asp. wholesaling, manufacturing, and merchandis­ health retailers, natural food retailers, herb/ March 11-12. Quail Botanical Garden's ing specialty teas. Attendees wil l also partici­ botanical reta ilers, independent and chain lOth A nnual Herb Festival. Encinitas, CA. pate in daily tea samplings and various prod­ pharmacies, supermarkets, grocery stores, More rhan 20 speakers wi ll discuss unique uct competiti ons. Phone: 702-253-1893. Web wholesalers, and distributors. Phone: 480- aspects of herbalism, including herb growing sire: www.worldreaex po.com. 990-1101. Web sire: http://www.healthypro­ and landscaping, skin care products, native April 4. NNFA Natural Foods Day (Lobby­ ducrexpo.com/. medicinal plants, and cooking with herbs. ing Effort). Washington, DC. This wi ll be May 6-9 (exhibits May 7-9). Organic Trade The spring Planr Sale and Tomatomania-a the National Nutritional Foods Association's Association (OTA) All T hings Organic. celebration of all things tomato-will also be 9th annual lobbyi ng event on Capitol Hill. Chicago, IL. All Things Organic is Norrh occurring at rhe herb festival. Several evenrs Concerned natural products stakeholders wi ll America's only all-organic trade show. Over are geared toward children and vendors will visit congress members and government staff 450 booths of organic products are expected be offering an array of plants, crafts, and herb to promote NNFA's legislative and regulatory for this 6th annual event. Phone: 412-774- products. Phone: 760-436-3036. Web sire: priorities, which involve increasing consumers' 75 11 . Web site: hrrp://www.organicexpo. www.qbgardens.com. access to and awa reness of natural products. com/. March 15 (deadline). United Soybean Board Phone: 800-966-6632. Web sire: http://www. May 24-27. North American Research Grant. The United Soybean Board invites top nnfa.org/. Conference on Complementary and Inte­ US researchers to apply for I 0 ince ntive grants April 6-8. Texas Dietetic Association grative Medicine. Edmonton, Canada. This of $ 10,000 each for grant proposals on soy and Conference. The Woodlands, TX. This conference wil l feature presenrarions of origi­ human hea lrh for evenrual submission to rhe food and nurririon conference and exhibi­ nal scientific CAM research in such areas as National Institutes of H ea lth. The appli cation tion wil l focus on the truth about func­ basic science, clinical, methodological, health deadline is March 15, 2006. For more infor­ tional foods, supplements, a nd biotechnology. services, and education. CAM researchers, mation visit www.talksoy.com/shrp. Phone: 972-755-2530. Web sire: http://www. educators, and practitioners, as well as conven­ March 20-21. T he "Omics" Revolution. nurririon4 rexas.org/ index. h r m. tional practitioners, are invited to attend the Lihue (Kaua' i), HI. This scienrific confer­ April 8-9. Southwest Conference on Botan­ evenr, which is sponsored by the Consortium ence will provide state-of-rhe-arr informa­ ical Medicine. Tempe, AZ. The eleventh tion about current advances and applications annual conference. Speakers: Paul Bergner; of genomics, proreomics, merabolomics, and Ryan Drum, PhD; Deborah Frances, NO; More calendar listings at data mining to dietary supplements and natu­ Cascade Anderson Geller; Rose mary G ladstar; ral products research based on our growing Phyllis Hogan; Mimi Kamp; Michael Moore; www.HerbalGram.org

HerbaiG ram 69 2006 www.herbalgram.org of Academic H ealth Centers for Integrati ve activator; botanicals for pain associated with ing of rhe sociery. Abstracts of presentations Medicine. Web sire: hnp://www.imconsor­ cancer; iridology intensives; essential oils for and posrers will be published in the confer­ ri u m -conference 2006 .com/. immunity; and botanical therapies for rhe ence program and distributed to all registered June 3-5. Medicines from the Earth Herb newest health challenges (drug-resisranr TB, anendees. For primary consideration, submir Symposium. Black Mountain, NC. Annual avian viruses, and hepatitis C). CE credits for absrracrs as soon as possible. The deadline symposium on herbal medicine at Blue Ridge health professionals. Phone: 800-252-0688. for submission is April I, 2006. All absrracrs Assembly near Ashev ille, NC. Workshops Web sire: hrrp://www.boranicalmedicine.org /. should be submined via rhe online Call for include the following: pre-conference inten­ June 5-8. 48th Annual Meeting of the Papers submiss ion. For submission derai ls sive on case studies with Bill Mitchell, ND; Society for Economic Botany. Chiang Mai, and registration information visir hrrp://www. Artemisia for ca ncer and malaria; therapeuric Thailand. The Society for Economic Barany seb2006.com. uses of medicinal mushrooms; making medic­ is calling for submission of oral presentation inal honey; St. John's wort as a xenosensory or posrer abstracts for rhe 48th annual meer-

In this deparrmenr of HerbalGram, we li st resources such as publications, organizations, seminars, and networking for our readers. A li sting in this section does not constitute any endorsemenr or approval by HerbalGram, ABC, or irs Advisory Board.

Medicine Hunter TV- new program high­ ized flax lignan ingredient producers Acarris copies may also be requested via e-mail at li ghting medicinal pl ants premieres w ith a Inc. Membership is open ro other interested, [email protected], or by writing to ODS, National !-hour special in March 2006 on rhe Healthy qualified flax li gnan manufacturers. For more Institutes of Health, 6100 Execurive Blvd, Living C hannel. The special will focus on rhe information or to join, contact Laura Keidan Rm. 3BO I , MSC 7517. Bethesda, Maryland traditional lncan pl anr maca (Lepidium meye­ Marrin. Phone: 312-902-5487. 20892-7517, USA. nii), from rhe hi ghlands of Peru, and feature Annual Bibliography of Significant GlycoScience.org Web sire provides educa­ footage of shamanic rituals, interviews wirh Advances in Dietary Supplement Research tional material about nutritional effects of maca experts, and scenes of maca harvest­ 2004. The Office of Dietary Supplements dietary supplement ingredients and is intended ing and festivals. Subsequent programs in (ODS) ar rhe National Institutes of H ealth for health professionals, research scientists, rhe series, hosted by widely known herbalist compiled rhe 6th issue of this bibliography, and rhe general public. Users can access infor­ and author Chris Kilham and produced by rel eased October 2005. Includes absrracrs of mational pages regarding nurririon and nutri­ HQ Productions of New York, are planned rhe 25 most noteworthy dietary supplement tional supplements, as we ll as reviews of indi­ for future distribution in the US and abroad. research papers published in 2004, as selected vidual food and dietary supplement ingre­ Exact air-dares of rhe maca special to be ava il­ by an inrernarional rea m of 49 expert review­ dients. News releases rega rding glycoscience able at: www.medicinehunter.com. ers from 325 nominated articles. Bibliography and health are posted, and articles from rhe Flax Lignan Association has been formed to features papers on phenolics and flavonoids, journal ClycoScience & Nutrition are avai l­ promote rhe health benefits of flax lignans, as antioxidants, vitamins, minerals, botanicals, able to readers. The sire is maintained by well as rhe responsible labeling and market­ farry acid s, and other ingredients contained the Research and Development Deparrmenr ing of fl ax lignan ingredients. Other goals in dietary supplements. I r is intended for use of Mannatech Inc., a US-based multilevel are to support clinical studies, help develop by srudenrs, nutrition and health profess ion­ marketing company devored to glyconurrient a cenrral resource regarding safety data and als, educators, and scientists who conduct research and development. Portions of the sire allergens, and encourage standardized meth­ such research. Copies can be downloaded are translated into Chinese, French, Japanese, ods for analys is of flax lignan ingredients. The from ODS Web site: lmp://ods.od.nih.gov/ Korean, and Spanish. association was founded by leading standard- Research / Annuai_ Bibl iographies.aspx. Single

announcing "Herbal Information Specialist Publications Other On Staff". Renewable annually. $69.95 Bulk pricing avai lable. www.herbtraining.com. American Herb Association Quarterly Not enough time to read all of the latest Newsletter: $20/yr. AHA, P.O. Box 1673, journal articles? ABC makes ir easier for Stock Photography that doesn't look like Nevada C ity, CA 95959. yo u to sray up-to-dare. Twice monthl y, ABC Stock: Steven Fosrer Group, Inc. Phorog­ raphy, Consulting, Publica tions. Specializ­ Australian journal of Medical Herbalism: publishes a doze n summaries and critical ing in medicinal and aromatic plants, along quarterly publication of the National H erbal­ reviews of important articles drawn from w irh rhe places rhey grow, our srock phoro ists Association of Australia (fou nded in 1920). mainstream media, scientific journals, files incl ude more than 120,000 images shor Deals wirh all aspects of Medical H erbalism, newslerrers, governmenr documents and around rhe world for over 30 years. Contact including laresr medicinal planr research find­ specia l reports. Receive hard copies of these us ar our NEW location in rhe hearr of rhe in gs . Regular features include Australian reviews, accompanied by rhe origina l arti­ Ozarks in Eureka Springs, Arkansas. Vi sir medicinal planrs, conferences, conference cle (when permission is granred), through our website: www.srevenfosrer.com emai l: reports, book reviews, rare books, case srudies, rhe HerbCiip'" Educational Mailing Service. sfosrer@s reven fosrer.com and medicinal plant reviews. AUD/$95 plus Available when yo u join as an H erbC iip AUD/$ 15 if required by ai rmai l. National Service Member. Or access more rhan 2700 ABC £-Newsletter: ABC's HerbaiEGram Herbali sts Association of Australia, 33 Reserve reviews through H erbCiip'" Online, a search­ electronic newslener for members features Street, Annandale, NSW 2038, Australi a. able database updated twice monthly. Ava il ­ up-to-dare information on ABC and herb news, legal & regulatory iss ues, upcom­ HerbalGram: Quarterly journal published able when you join ar designated Member­ ing articl es in Herba!Cram, rhe laresr dozen by the American Botanical Council. A benefit ship levels. To receive rhe fu ll service, contact HerbC iips, upcoming events & ABC appear­ at all levels of membership in ABC. See page Wayne Sil verman, PhD, ar 512/926-4900 ances, and much more. Don't m iss our. 2 for membership information or join online exr. 120, or via e-mail ar wayne@herbalgram. Contact us roday ro make sure we have your ar www.herbalgram.org. P.O. Box 144345, or g. correcr email address or ro become a member: Austin, TX 78714. 800-373-7105 or fax 512- Get Certified with ABC's Herbal Informa­ [email protected] or 800-373-7 105. 926-2345. E-mail [email protected]. tion Course. This self-paced online course is Medical Herbalism: Subtided "A C lini­ designed to help retail employees and multi­ cal Newslener for rhe Herbal Practitioner." level distributors communicate knowledg­ Edited by Paul Bergner. $36/yr, $60/2 yrs. ably w irh customers about herbs and dietary Canada $39/yr. Overseas $45/yr. Sample/$6. supplements. After successfully completing Medical Herbalism, P. 0. Box 20512, Boulder, rhe course, you' ll receive an Herbal Informa­ co 80308. tion Speciali st Certificate and a window decal www.herbalgram.org 2006 HerbaiGram 69 I Health& Nutrition Product D~-

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