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HerbalGram 75 • Aug - Sept - Oct 2007 Allegations of Biopiracy • Chocolate’s Health Benefits • Hibiscus Lowers Blood Pressure • Protecting Wisconsin Ginseng • Safeguarding Seeds www.herbalgram.org Ginseng • Safeguarding Wisconsin • Protecting Blood Pressure Health Benefits • Hibiscus Lowers - Sept - Oct 75 • Aug HerbalGram of Biopiracy 2007 Allegations • Chocolate’s Chocolate’s Health Benefits • Hibiscus Lowers Blood Pressure • Protecting Wisconsin Ginseng The Journal of the American Botanical Council Number 75 | USA $6.95 | CAN $7.95 Peruvian Display until Nov. 1, 2007 Allegations of Biopiracy www.herbalgram.org www.herbalgram.org 2007 HerbalGram 75 | 1 2 | HerbalGram 75 2007 www.herbalgram.org Herb Profile Marshmallow Althaea officinalis Family: Malvaceae INTRODUCTION A perennial herb, marshmallow is native throughout damp The sweet confection known as “marshmallow” is related to the areas of Europe and Western Asia. Marshmallow is naturalized in plant through history. In 2000 BCE, ancient Egyptians reportedly North America in salt marshes from Massachusetts to Virginia, made a candy of marshmallow root and honey, which was reserved and it’s cultivated from Western Europe to Russia.1,2,3 Its material for gods and royalty.14 In the more recent past (circa mid-17th of commerce consists of both the whole or cut dried leaves and the century CE), French druggists made a meringue of marshmallow peeled or unpeeled, whole or cut, dried roots.4 These materials are root extract, egg white, and sugar called Pâté de Guimauve to treat harvested from cultivated plants mainly from Belgium, Bulgaria, chest complaints.10 By the late 19th century, marshmallow confec- Croatia, Hungary, Russian Federation, and Serbia.3,5 The thera- tions were easily available to the public, mass-produced, and no peutic activity of high-mucilage-containing materials, like marsh- longer contained marshmallow extract.14 mallow, can be predicted in part by volumetrically measuring their Continues on page 2 swelling index. This quality indicating test directly corresponds to the demulcent action (i.e., the soothing of mucous membranes caused by the expansion of mucilage polysaccharides when they absorb moisture, swell, and form a demulcent gel that has bioadhe- sive properties). Pharmacopeial quality marshmallow root should have a swelling index of not-less-than 10, and for marshmallow leaf, not-less-than 12.4 The material used in the traditional systems of medicine in India, the mature dried seeds and roots, are often cultivated in Punjab and Kashmir.6,7 The plant should be at least two years old before harvesting its roots.8 The seeds are collected when they are mature, before the dried fruits fall to the ground.6 HISTORY AND CULTURAL SIGNIFICANCE Reportedly, marshmallow has been used in traditional European medicine for over 2000 years.2 Its therapeutic use was first recorded in the 9th century BCE, and it was used widely in Greek medicine.9 Its genus name Althaea comes from the Greek altho, meaning to cure, and its family name, Malvaceae, is derived from the Greek malake, meaning soft.10 The root is often used as a component of preparations intended for the treatment of coughs (e.g., teas and syrups).11 Marshmallow’s use in traditional Greek medicine spread to Arabian medicine and to traditional Indian Ayurvedic and Unani medicines.1 Early Arab physicians prepared a poultice with the leaves to suppress inflammation. The Ayurvedic Pharmacopoeia of India (2006) reports the therapeutic uses of the roots and/or seeds for treating coughs and bronchitis, coryza (runny nose), and throat disorders, among other conditions. An important formulation that contains both marshmallow seed and root, “Gojihvadi Kvath,” indicated for cough, is listed in the Government of India’s Essen- tial Ayurveda Drugs for Dispensaries and Hospitals.12 In the Unani system of medicine, marshmallow seed is used for treatment of bronchitis, pleurisy, pneumonia, and kidney stones.6 The Unani formulation, “Lauq-e-Sapistan,” is indicated for dry and irritative cough, scanty sputum, chronic bronchitis, and chronic catarrh. Lauq-e-Sapistan is a soft, honey-based compound medicine with powdered marshmallow seed, snap melon seed (Cucumis melo, var. momordica, Cucurbitaceae), jujube fruit (Ziziphus jujuba, Rhamna- ceae), and quince fruit (Cydonia oblonga, Rosaceae), among other Marshmallow Althaea officinalis 13 herbs. Photo by Steven Foster. ©2007 stevenfoster.com www.herbalgram.org 2007 HerbalGram 75 | 1 MARSHMALLOW Continued from page 1 In 1989, the German Commission E approved both marshmal- group showed a significant reduction in cough score compared to low leaf and root for irritation of the oral and pharyngeal (throat) placebo.22 mucosa and associated dry cough.15 The root was also approved An open-label clinical study containing 42 patients with chronic for mild inflammation of the gastric mucosa (stomach lining). cutaneous leishmaniasis (CCL) involved the application of an The German Standard License for marshmallow leaf or root teas herbal paste to lesions. The herbal paste was prepared from a indicates their use to alleviate irritation of the mucous membranes special extract designated as “Z-HE,” which was modified from a of the mouth and throat accompanied by dry irritated cough, traditional Iranian medicine formula. The Z-HE extract contained and for mild inflammation of the gastric mucosa.3 As all national extractives of marshmallow and the related hollyhock (A. rosea) pharmacopeias and formularies of European Community member (plant parts not specified in study), as well as other herbs. The states are in the process of harmonization, a European Community study reported that 69% had a complete cure, 12% had partial Herbal Monograph for marshmallow root is in development. This cure, and 19% failed to respond to the therapy. In a subsequent monograph will eventually become official in all 27 member states open-label trial, the authors concluded that although the active for the purpose of uniform product licensing and labeling for drug ingredient(s) and the mechanism(s) of action of Z-HE are not preparations containing marshmallow root.16 known, its ease of preparation, topical application, lack of adverse The non-official British Herbal Compendium, 1st edition, indi- effects, low cost, and satisfactory cosmetic effects make it a promis- cates marshmallow root internally for soothing the stomach and ing drug for use in the treatment of lesions of CCL.23 intestinal tract.8 Topically, liquid preparations made from marsh- An open-label clinical study containing 62 patients with irri- mallow root are indicated as a mouthwash or gargle for soothing tating cough used a combination syrup (Weleda Hustenelixier, inflammations in the mouth and throat.8 Weleda, Schwäbisch Gmünd, Germany) containing extracts of For marshmallow leaf, the British Herbal Compendium, 2nd English ivy leaf (Hedera helix, Araliaceae), thyme leaf and wild edition, states that no indications are adequately substantiated by thyme leaf (Thymus vulgaris and T. serpyllum, Lamiaceae), anise pharmacological or clinical studies. However, uses based on expe- fruit (Pimpinella anisum, Apiaceae), and marshmallow root. The rience or tradition include internal use of the tea infusion or liquid syrup alleviated coughs resulting from the common cold, bronchi- extract for irritation and inflammation of the oral and pharyngeal tis, and respiratory tract diseases that formed mucous.24 mucosa, dry irritating coughs, respiratory catarrh and bronchitis, A double-blind, placebo-controlled study contained 60 patients digestive tract disorders (peptic ulcer), and urinary tract disorders diagnosed with acute pharyngitis. The patients were treated with (cystitis).17 an herbal tea (Throat Coat®, Traditional Medicinals, Sebastopol, Similarly, the European Scientific Cooperative on Phytotherapy CA) that contained marshmallow root, licorice root (Glycyrrhiza (ESCOP) indicates marshmallow aqueous cold macerate or syrup glabra, Fabaceae), slippery elm bark (Ulmus rubra, Ulmaceae), and for dry cough and irritation of the oral or pharyngeal (throat), and wild cherry bark (Prunus serotina, Rosaceae), among others. The the cold macerate form for gastrointestinal irritation.18 However, tea was found to be significantly superior to placebo and provided the World Health Organization (WHO) monograph states that a rapid, temporary relief of sore throat pain.25 medicinal uses for marshmallow root are not supported by clini- cal data. For uses described in pharmacopeias and in traditional FUTURE OUTLOOK systems of medicine, the WHO lists the same aforementioned indications citing the monographs of the British Herbal Compen- Wild marshmallow is considered a threatened plant in Germany dium, ESCOP, and the German Commission E.19 and is listed in the German Federal Ordinance on the Conserva- 26 In the United States, marshmallow leaves and roots are used as tion of Species. A permit is necessary for import or export of components of herbal teas, dietary supplement products, and topi- any wild-collected material. Marshmallow is also listed as “nation- 27 cal demulcent preparations.11 Marshmallow flower and root, and ally scarce” in the United Kingdom, and due to its scarcity in 28 extracts thereof, are also classified by the Food and Drug Admin- Bulgaria, it is prohibited from collection in the wild. Commer- istration (FDA) as generally recognized as safe (GRAS) natural cial marshmallow is, and should continue to be, harvested only flavoring substances when used in the