Cordyceps Medicinal Fungus: Harvest and Use in Tibet

Home , Amomum, Armana, Cordyceps, Kangding, Litang County, Mandragora (genus)

HerbalGram 83 • August 2009 – October

Kew’s 250th Anniversary • Reviving Graeco-Arabic Medicine • St. John’s Wort and Birth Control

The Journal of the American Botanical Council Number 83 | August – October 2009 Kew’s • Lemongrass Graeco-Arabic • Reviving Medicine 250th Anniversary for Oral forThrush • Hibiscus Blood Pressure • St. John’s ControlWort and Birth

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www.herbalgram.org 2009 HerbalGram 83 | 1 STILL HERBAL AFTER ALL THESE YEARS Celebrating 30 Years of Supporting America’s Health

The year 2009 marks Herb Pharm’s 30th anniversary as a leading producer and distributor of therapeutic herbal extracts. During this time we have continually emphasized the importance of using the best quality certified organically cultivated and sustainably-wildcrafted herbs to produce our herbal healthcare products.

This is why we created the “Pharm Farm” – our certified organic herb farm, and the “Plant Plant” – our modern, FDA-audited production facility. It is here that we integrate the centuries-old, time-proven knowledge and wisdom of traditional herbal medicine with the herbal sciences and technology of the 21st Century.

Equally important, Herb Pharm has taken a leadership role in social and environmental responsibility through projects like our use of the Blue Sky renewable energy program, our farm’s streams and Supporting America’s Health creeks conservation program, and the Botanical Sanctuary program Since 1979 whereby we research and develop practical methods for the conservation and organic cultivation of endangered wild medicinal herbs.

Thirty years and millions of bottles later, Herb Pharm remains America’s best-selling brand of liquid herbal extracts.We thank all our loyal customers for making our many years of work such a success.

2 | HerbalGramYou 83’l l find Herb Pharm at fine natural produ2009cts stores or online at www.herb-phawww.herbalgram.orgrm.com Herb Profile Skullcap Scutellaria lateriflora Family: Lamiaceae

Introduction rabies in both humans and animals, claiming to have prevented Skullcap, sometimes spelled scullcap, is a perennial in the mint 4,000 people and 1,000 cattle from being infected after having 3 family that grows to 3 feet and is native to the eastern United been bitten by rabid dogs. A number of scientists and doctors States.1 It can be found in moist woodland areas throughout North of the era questioned the validity of this treatment, and by 1852, America and its blue flowers appear from July through Septem- the Eclectic physicans Drs. John King and Robert Newton had 3 ber.1,2 The aerial (above-ground) parts of the plant are harvested dismissed skullcap as a treatment for rabies. th th during the flowering period and are used in herbal preparations During the late 19 and early 20 centuries, the Eclectic in western herbal medicine. The root of an Asian species (S. physicians prescribed skullcap for nervousness caused by illness, baicalensis) is frequently employed in Traditional Chinese Medi- teething, and mental or physical exhaustion; nervousness with cine (TCM).1 muscular spasms; heart disorders of the nervous type with intermittent pulse; hysteria accompanied by uncontrollable muscular action; tremors; and subsultus tendinum (twitching of the History and Cultural Significance tendons, notably the wrist, during low fevers).7,8 King’s American Skullcap’s genus name, Scutellaria, comes from the Latin scutella, Dispensatory also recommended skullcap for convulsions, delir- a small dish or tray, which refers to the appearance of the sepals ium tremens, intermittent fever, neuralgia, tremors, and chorea during the fruiting period.3 The (involuntary, rapid, jerky, force- species name, lateriflora, means ful movements).8 The Ameri- “flowering on the side,” which can Materia Medica, Therapeu- is how the flowers appear on the tics and Pharmacognosy includes one-sided racemes. Skullcap’s the following additional uses common name comes from the for skullcap: twitching, nervous helmet-like shape of the flow- tics, epilepsy, paralysis agitans (a ers.3 progressive, degenerative neuro- Traditionally, the leaves logic disease), and irritability of this herb were steeped to and restlessness with nervous produce a tea or tonic.1 Utilized excitability and sleeplessness.9 by the Cherokee and other Throughout the 20th century tribes of North America to and into the 21st, American and promote menstruation, skullcap Canadian herbalists and natu- was employed in the ceremo- ropaths continue to use skullcap nial transition of young girls as an effective antispasmodic, to womanhood.1,2 The Cher- nervine tonic and sedative.3 okee also used infusions and Skullcap fluid extract was decoctions of skullcap roots for listed in the United States Phar- treating diarrhea, kidney prob- macopoeias from 1860 until lems and breast pains, and to 1900 and was included in the help expel the afterbirth.4 The National Formulary from 1916- Iroquois used an infusion of 1942.3 The Health Canada the powdered roots to prevent Natural Health Products Direc- smallpox and to keep the throat torate approved the oral tradi- clean.4 In North American folk tional medicinal use of skull- medicine, skullcap was used as cap preparations equivalent to a sedative and nerve tonic, or 0.25-12 g dried aerial parts per “nervine,” and skullcap tea was day to help relieve nervous- drunk for anxiety.5 ness, as a sleep aid, and to help Due to its gentle relaxing relieve the pain associated with effects, skullcap became a popu- menstruation.10 While not offi- lar treatment in the 1700s for cial, monographs published in hydrophobia or rabies, resulting both the British Herbal Phar- in one of its common names, macopoeia (BHP) and the Brit- mad-dog weed.1,2,6 A Dr. Van ish Herbal Compendium (BHC) Derveer (or Vandesveer) used address S. lateriflora. The BHP skullcap to prevent and treat lists skullcap as a mild sedative Skullcap Scutellaria lateriflora ©2009 Stevenfoster.com www.herbalgram.org 2009 HerbalGram 83 | 3 and the BHC recognizes the use of skullcap for nervous disorders flora been adulterated with Teucrium species over the past decades, due to anxiety, tension or stress; headaches; migraine; neurasthenia but more recent reports suggest that some seed stock sold as S. (a mental disorder characterized by chronic fatigue and concomi- lateriflora may be another species entirely.3 tant physiologic symptoms); neuralgia; panic attacks; restlessness; Other than reports of the susceptibility of skullcap to 2 virus sleep disorders; premenstrual tension and period pain; and to assist pathogens—tomato spotted wilt virus and another necrotic spot withdrawal from benzodiazepines.11,12 virus—major problems with diseases or insects have not been Several cases of hepatotoxicity were attributed to skullcap in reported.2,17 Ever-present threats to natural growth areas include the late 1980s.13 Unfortunately, none of the multi-herb products urban growth and development. However, it is unclear what impact implicated were tested to see if they actually contained skull- this population pressure may have on the production of skullcap. cap.3 The herb germander (Teucrium canadense, Lamiaceae), also known as wood sage or wild basil, and the species in the whole- —Gayle Engels sale herb trade known as pink skullcap (T. chamaedrys) are known hepatotoxins. They have been common skullcap adulterants for decades.3,14 The toxicity in the case reports is associated with References diterpenes that are contained in germander but not skullcap.3 This 1. DerMarderosian A, Beutler JA, eds. The Review of Natural Products. adulteration persists today and is addressed in the recent American 3rd ed. St. Louis, MO: Facts and Comparisons; 2002. Herbal Pharmacopoeia standards monograph on skullcap, along 2. Joshee N, Patrick TS, Mentreddy RS, Yadav AK. Skullcap: Potential with questionable published research supposedly on S. lateriflora Medicinal Crop. Trends in New Crops and New Uses. Alexandria, VA: 3 ASHS Press; 2002. but actually done on inaccurately named species. 3. Upton R, ed. American Herbal Pharmacopoeia and Therapeutic Compendium: Skullcap Aerial Parts. Scotts Valley, CA: American Modern Research Herbal Pharmacopoeia; 2009. 4. Moerman DE. Native American Ethnobotany. Portland, OR: Timber While Western herbalists remain convinced that skullcap is Press Inc.; 1998. an effective sedative, antispasmodic and nervine tonic, very little 5. Foster S, Duke JA. A Field Guide to Medicinal Plants and Herbs: East- scientific research has been done on this species. One small single- ern and Central North America. 2nd ed. Boston: Houghton Mifflin dose study was performed in 2003 on 19 healthy subjects. The Co; 2000. effects were subjectively evaluated at 30, 60, 90 and 120 minutes 6. Foster S, Tyler VE. Tyler’s Honest Herbal. 4th ed. Binghamton, NY: after oral administration of one of 4 preparations: 1 capsule Haworth Herbal Press; 1999. The Eclectic Materia Medica, Pharmacology and Thera- containing 350 mg of freeze-dried aerial parts of skullcap (Eclec- 7. Felter HW. peutics. Cincinnati, OH: John K. Scudder; 1922. Available at: http:// tic Institute, Sandy, OR); 1 capsule containing 100 mg of freeze- www.henriettesherbal.com/eclectic/felter/intro.html. Accessed June 1, dried skullcap extract; 2 capsules containing 100 mg of freeze- 2009. dried skullcap extract; or 2 capsules of placebo. While there was 8. Felter HW, Lloyd JU. King’s American Dispensatory. Cincinnati, OH: little effect on cognition or overall energy, participants reported a Ohio Valley Co.; 1898. Available at: http://www.henriettesherbal. noticeable decrease in anxiety.15 The value of this study is limited com/eclectic/kings/scutellaria.html. Accessed June 1, 2009. due to size, duration, subjective assessment scale used for measure- 9. Ellingwood F. The American Materia Medica, Therapeutics and ment, and the fact that the participants were not suffering from Pharmacognosy. Evanston, IL: Ellingwood’s Therapeutist; 1919. Avail- anxiety, the condition being addressed in the study.3,15 able at: http://www.henriettesherbal.com/eclectic/ellingwood/index. html. Accessed June 1, 2009. There are a small number of animal and in vitro studies on 10. Health Canada Natural Health Products Directorate (NHPD). skullcap, none of which are conclusive in their results. One of the Skullcap. In: NHPD Compendium of Monographs. Ottawa, Ontario: animal studies involved a combination product, so the efficacy Natural Health Products Directorate. January 18, 2008. Available of skullcap alone cannot be determined.16 Some pharmacological at: http://www.hc-sc.gc.ca/dhp-mps/prodnatur/applications/licen- data suggest that the flavones in skullcap may be involved in its prod/monograph/mono_scullcap-scutellaire-eng.php. Accessed June mechanism of action.3 Also, one animal study with very limited 1, 2009. data suggests that skullcap may have some anti-inflammatory 11. British Herbal Medicine Association. British Herbal Pharmacopoeia. effects.3 4th ed. Exeter, UK: British Herbal Medicine Association; 1996. 12. Bradley P. British Herbal Compendium: A Handbook of Scientific Infor- Although there is more published research on the beneficial mation on Widely Used Plant Drugs. Vol. 1. Bournemouth, UK: Brit- effects of preparations made from the root of Chinese skullcap (S. ish Herbal Medicine Association; 2006. baicalensis), it would be unwise to assume that the same therapeu- 13. DeSmet PSGM, Keller K, Hänsel R, Chandler RF, eds. Adverse Effects tic effects are achievable with S. lateriflora. Clearly more scientific of Herbal Drugs. Vol. 3. Berlin: Springer Verlag; 1997. investigation is warranted on this species to support its well-estab- 14. Foster S. Scullcap substitution. HerbalGram. Fall 1985;3. lished empirical evidence of efficacy and continued clinical use. 15. Wolfson P, Hoffmann DL. An investigation into the efficacy of Scutel- laria lateriflora in healthy volunteers. Alternative Therapies in Health and Medicine. 2003;2:74-78. Future Outlook 16. Peredery O, Persinger MA. Herbal treatment following post-seizure Skullcap grows in the wild and commercial cultivation efforts induction in rat by lithium pilocarpine: Scutellaria lateriflora (skull- have been developed.2 One source estimates that 85% of the total cap), Gelsemium serpervirens (gelsemium) and Datura stramonium 2001 harvest was from cultivated sources.17 While wild material (jimson weed) may prevent development of spontaneous seizures. in the United States is harvested sporadically throughout its native Phytother Res. 2004;18:700-705. Cited by: Upton R, ed. American Herbal Pharmacopoeia and Therapeutic Compendium: Skullcap Aerial habitat, in 2001, approximately 70% of cultivated skullcap in the Parts. Scotts Valley, CA: American Herbal Pharmacopoeia; 2009. US market was imported from small growers outside of North 17. Greenfield J, Davis JM. Medicinal Herb Production Guide: Skullcap 17 America. (Scutellaria lateriflora L.). 2004. Natural Medicines of North Caro- Manufacturers of skullcap products who do not grow their own lina Web site. Available at: http://www.naturalmedicinesofnc.org/ material should take care to ensure that the dried material they Growers%20Guides/Skullcap-gg.pdf. Accessed June 2, 2009. purchase is tested and correctly identified. Not only has S. lateri-

4 | HerbalGram 83 2009 www.herbalgram.org Every Herbal Library Starts with ABC

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Cindy K. Angerhofer, PhD Lyle E. Craker, PhD Steven King, PhD Director of Botanical Research, Aveda Institute, Professor, Department of Plant and Soil Sciences, Vice President, Sustainable Supply and Ethnobotanical Minneapolis, Minnesota University of Massachusetts, Amherst Research, Napo Pharmaceuticals Inc., South San Francisco, California John Thor Arnason, PhD Edward M. Croom, Jr., PhD Professor of Biology, Department of Biology, Adjunct Associate Professor of Pharmacognosy, Richard Kingston, PharmD, CSPI University of Ottawa, Ontario, Canada University of Mississippi, Oxford, Mississippi President, Regulatory and Scientific Affairs, Safety Call™ International Poison Center; Professor, Department of Dennis V. C. Awang, PhD, FCIC Wade Davis, PhD Experimental and Clinical Pharmacology, College of MediPlant Natural Products Consulting Services, Explorer-in-Residence, National Geographic Society, Pharmacy, University of Minnesota, Minneapolis, MN Surrey, B.C., Canada Washington, D.C. Uwe Koetter, PhD Bruce Barrett, MD, PhD Steven Dentali, PhD Principal and Founder, Dr. Koetter Consulting Services Associate Professor of Family Medicine, Chief Science Officer, American Herbal Products Association, Switzerland University of Wisconsin-Madison Medical School Silver Spring, Maryland Thomas L. Kurt, MD, MPH Marilyn Barrett, PhD Hardy Eshbaugh, PhD Clinical Professor, Department of Internal Medicine, University Pharmacognosy Consulting Service, Professor of Botany & Assistant Curator, Willard Sherman of Texas Southwestern, Dallas, Texas San Carlos, California Turrell Herbarium, Miami University, Oxford, Ohio Martha M. Libster, PhD, RN, CNS Ezra Bejar, PhD Trish Flaster, MS Associate Professor of Nursing, East Carolina University, Director Vice President of Scientific Affairs, Herbalife Executive Director, Botanical Liaisons, LLC, Boulder, Colorado Greenville, North Carolina International, Inc., Torrance, California Paula M. Gardiner, MD, MPH Tieraona Low Dog, MD Assistant Professor, Department of Family Medicine, Boston Stacey J. Bell, DSc Director of the Fellowship, Arizona Center for Integrative University Medical School, Boston, Massachusetts Nutritional Consultant Medicine, Clinical Asst. Professor, Department of Medicine, Belmont, Massachusetts Joe Graedon, MS University of Arizona Health Sciences Center, Bradley C. Bennett, PhD Author, syndicated columnist, radio host, Tucson, Arizona Durham, North Carolina Associate Professor of Biology, Florida International Gail B. Mahady, PhD University, Miami Bill J. Gurley, PhD Research Assistant Professor, Department of Medical John A. 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www.herbalgram.org 2009 HerbalGram 83 | 7 American Botanical Council Mark Blumenthal Founder and Executive Director dear reader Lucy Bruno Executive Assistant Probably the most famous and respected botani- Janie Carter cal garden in the world is the Royal Botanic Gardens Membership Coordinator at Kew, just outside of London, England. Kew, as it Courtney Cavaliere is known among botanists, is celebrating its 250th HerbalGram & HerbalEGram birthday this year, and as an acknowledgement of Managing Editor its innumerable contributions to botanical research Gayle Engels and conservation, we are including a feature article Special Projects Director on its glorious history. We have previously published Holly Ferguson a profile on the world’s oldest medicinal plant garden Education Director in Padua, Italy, and we hope to profile other leading botanical garden institutions in future issues. Lori Glenn On an admittedly much lesser scale, we also high- HerbClip Managing Editor light our own modest attempts here at ABC to grow Kelly Saxton Lindner numerous medicinal plants for display and educa- Writer/Assistant Editor tional purposes. One of the key elements of ABC’s pharmacy and dietetic Matthew Magruder internship program is that each intern is encouraged to spend one day per week Art Director in our gardens, learning how to make compost, cultivate medicinal plants, Denise Meikel collect seeds, or perform various other gardening techniques, as well as create Development Director simple herbal remedies. Some interns state that the opportunity to work and Tamarind Reaves learn in the gardens is one of the most unique and rewarding aspects of the Receptionist/Administrative Assistant ABC rotation. Elsewhere in this issue of HerbalGram, we explore the history of Graeco- Perry Sauls Customer Service Coordinator Arabic medicine and a project that has been initiated to revitalize this medicinal tradition in the Middle East. The origins of Western medicine are based, George Solis in large part, on the development of Graeco-Roman medicine, much of which HerbClip Production Assistant is still practiced today as part of the Graeco-Arabic traditional medicine system Lindsay Stafford in the Near East (and in India, where it is called Unani Tibb). We welcome Writer/Assistant Editor our old friend Steven Fulder and his colleague Omar Said to the pages of Cecelia Thompson HerbalGram with their article about Graeco-Arabic medicine and the project Finance Coordinator that they helped to initiate, which involves growing and conducting scientific Margaret Wright research on traditional medicinal plants in the Galilee area with the ultimate Accounting Coordinator goal of commercializing herbal preparations. Past HerbalGram contributors Alessandro Boesi and Francesca Cardi, meanwhile, provide a review of the highly-prized fungus cordyceps in Tibet, where the ingredient is primarily harvested to supply the Traditional Chinese Medi- cine (TCM) market. Cordyceps is a key adaptogenic ingredient in TCM. Drs. Boesi and Cardi wrote the cover story on Tibetan herbal medicine in HerbalGram issue 71 in 2006. In the Research Review section, we present a few summaries of recent clinical trials and studies of herbs demonstrating relatively novel uses. For example, we cover a recent clinical trial on a special Swiss butterbur root extract showing potential uses for anxiety. This is a relatively new use for most American herbalists and industry members, as butterbur is not widely used for such conditions in the United States. As we note in our review, extracts of butterbur are demonstrating considerable versatility. A different butter root extract from Germany has shown efficacy in treating migraine headaches, and an extract of butterbur leaf effectively treats seasonal allergic rhinitis. We present another review of a clinical trial on the popular herb hibiscus, showing its hypotensive benefits, this time as a tea. Previous clinical research has documented the hypotensive effect of a standardized hibiscus extract. These and other Research Review articles are based on summaries from Mission: Provide education ABC’s extensive HerbClip database. More information on recent herbal using science-based and traditional research is available in the HerbClip database on the ABC Web site. information to promote responsible use of herbal medicine—serving the public, researchers, educators, healthcare professionals, industry, and media.

8 | HerbalGram 83 2009 www.herbalgram.org

The Journal of the American Botanical Council

Number 83 • August – October 2009

Steps Towards Revival of Graeco-Arabic 36 Medicine in the Middle East: A New Project By Stephen Fulder, PhD, and Omar Said, PhD Graeco-Arabic medicine is an ancient medical system that greatly influenced the development of both West- features ern herbalism and conventional medicine. There has been a decline in knowledge and use of herbs in some parts of the Arab world, such as the Middle East, and a medicinal plant project administered under the Galilee Society has been established to preserve medicinal species, revive regional interest in herbal medicine, and create economic benefits for the project’s developers and the Galilee Arab community. In addition to exploring the historical roots of Graeco-Arabic medicine, this article explores research and new product development conducted through this medicinal plant project.

England’s Kew Gardens Celebrates 250 46 Years By Kelly Saxton Lindner In honor of its 250th anniversary, the United Kingdom’s Royal Botanic Gardens, Kew, is celebrating throughout 2009 with special events and presentations. Kew is considered one of the world’s premier botanical gardens. This article details some of the activities and developments that have been arranged to mark the Gardens’ anniversary, and it highlights the Gardens’ historical importance and on-going conservation efforts.

Cordyceps sinensis Medicinal Fungus: Traditional Use among Tibetan People, 52 Harvesting Techniques, and Modern Uses By Alessandro Boesi, PhD, and Francesca Cardi, PhD Cordyceps sinensis is a fungus that attacks, kills, and grows on caterpillars, primarily found in Tibet, certain Chinese provinces, and a few other regions of Southeast Asia. Cordyceps is a popular tonic and aphrodisiac in Traditional Chinese Medicine. Although it is primarily important for Tibetan people as an export item, cordyceps is also included in the materia medica of traditional Tibetan medicine and is used in some Tibetan medicinal formulations. This article explores the techniques and sustainability of cordyceps harvesting, the popular and clinical medicinal uses of cordyceps in Tibet, and descrip- tions of cordyceps within Tibetan medical texts.

On the Cover A monk from Lithang Roses from the Kew 250th Anniversary Rose Garden. monastery scans the ground Charlotte Rose Rosa spp. looking for cordyceps. Photo ©2009 David Austen Roses Photo ©2009 Alessandro Boesi departments Contributing Writers 10 ABC News 62 Legal & Regulatory Stacey J. Bell ABC’s Green Garden Practices and Community GAO Calls for More Dietary Supplement Jenö Bernáth Outreach Programs Regulation Alessandro Boesi Employee Profile: Holly Ferguson Francesca Cardi Donna Chesner Meet ABC Board Member Morris Shriftman: 64 Conference Report Subhuti Dharmananda Groundbreaking Marketer for the Natural and W. Hardy Eshbaugh Organic Industries Late Herbalist Michael Moore’s Life and Legacy Celebrated at Conference Stephen Fulder Creating HerbMed® -- A Combination of Mariann Garner-Wizard Expert Curation and Automatic Generation Rakesh Kapoor 65 Book Reviews Thomas L. Kurt 17 Organization News Michael McGuffin Nutraceuticals: A Guide for Healthcare Brenda Milot USP Withdraws Proposed Caution Statement Professionals Will Morris for Decaffeinated Green Tea Extract Western Herbs According to Traditional Chinese Heather Oliff Medicine: A Practitioner’s Guide Marissa Oppel Herbal Pearls: Traditional Chinese Folk Wisdom Omar Said 18 World News Shelley Torgove Herb, Nutrient and Drug Interactions: Clinical Jacqueline C. Wootton Project BudBurst: Observing Plant Life Cycle Implications and Therapeutic Strategies Events to Track the Effects of Climate Change Stevia: The Genus Stevia Prince of Wales’ UK Company Launches Herbal Line African-American Slave Medicine: Herbal and HerbalGram Staff Non-Herbal Treatments Egyptian Herbal Wine: A 5,000-Year-Old Mark Blumenthal Vintage Handbook of Poisonous and Injurious Plants Editor / Publisher WHO Congress Passes Beijing Declaration on Dietary Supplements Pocket Companion Courtney Cavaliere Managing Editor Traditional Medicine Chia: Rediscovering a Forgotten Crop of the Aztecs Matthew Magruder Art Director New Book Profiles 26 Conservation Kelly Saxton Lindner CITES Plants Committee Meeting—Report Writer/Assistant Editor from Buenos Aires 75 In Memoriam Lindsay Stafford Writer/Assistant Editor Juliette de Bairacli Levy Steven Foster 29 Research Reviews Péter Tétényi Associate Editor Survey: Newspapers Under-report Herbal Victor Siaulys Rakesh Amin Clinical Trials and Tend to Show Negative Bias Legal & Regulatory Editor Ivy Leaf Extract Found Safe and Possibly Maureen Jablinske Effective for Bronchitis in Open, Multicenter 78 Calendar Proofreader Study Lance Lawhon Pilot Study Finds Low-Hyperforin St. John’s 79 Access Advertising Sales Wort Extract Does Not Interact with Oral 877-832-1883 Contraceptive 80 Classifieds [email protected] Herbal Formula with Butterbur Root Extract Improves Psychological Outcomes in Psychosomatic Disorders Correction Lemon Juice and Lemongrass Infusion The article “The Expanding Market and Regulatory Challenges of Supple- Beneficial for Treating Oral Thrush in HIV/AIDS ments for Pets in the United States,” published in HerbalGram 82, incorrectly Patients stated that the company Standard Process is not a member of the National Hibiscus Tea Lowers Blood Pressure in Patients Animal Supplement Council (NASC); Standard Process is, in fact, an NASC with Type 2 Diabetes member.

Published by the American Botanical Council, P.O. Box 144345, Austin, TX 78714-4345. Subscriptions to HerbalGram are a benefit of ABC membership at every level. One year memberships: Individual $50; Academic $100; Professional $150; Organization $250; Retailer $250; HerbClip Service $600; Corporate; Sponsor. Add $20 for memberships outside of the U.S. Student and Senior discounts are HerbalGram® is printed available. For information about Corporate or Sponsor Memberships, contact Denise Meikel at [email protected] or 512-926-4900. on recycled paper at © 2009 American Botanical Council. ISSN #0899-5648. Printed in the U.S.A. Branch-Smith Printing, The information in HerbalGram® is intended for educational purposes only and is not a substitution for the advice of a qualified healthcare professional. Although Ft. Worth, Texas we attempt to ensure that advertising in HerbalGram is truthful and not misleading, the publication of an ad for a product or company in HerbalGram does not constitute an endorsement by ABC of the product or the company being advertised. Publication of an 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 Good Manufacturing Practices. ABC News

ABC’s Green Garden Practices and Community Outreach Programs The American Botanical Council’s (ABC) 2.5-acre herbal oasis, hidden in what some might consider an atypical urban area of Austin, Texas, contains 30 gardens that beautify the landscape and provide educational benefits to the public and others. But are ABC’s gardens “green”? Holly Ferguson, ABC’s education coordinator, says “Abso- lutely.” Although some may assume that all gardens contribute to a healthy environment, as the plants grown in gardens pull harmful carbon dioxide (CO2) from the atmosphere during photosynthesis, this is not necessarily true in all cases. The amount of energy used to construct and maintain some gardens can actually generate large levels of CO2 emissions, such as those produced through the use of gas-powered gardening equipment, water irrigation, and pesticides, fungicides, artificial fertilizers, and other agricultural chemicals. The ABC gardens, however, are designed to have greater environmental benefits through the use of so-called green gardening practices.1 For instance, the majority of the labor for the ABC gardens is done by hand, including weeding, and ABC only uses organic pesticides and fertilizer. The property also utilizes a rainwater collection system that is based loosely on a Roman aqueduct system.2 Gutters along the roofs of 3 ABC buildings—the main building, the annex, and the greenhouse—trap rainwater and run it underground to a filtration system, which cleans out large and small particulate matter and then sends it to storage tanks on the ABC property. These tanks collectively hold a total of 12,700 gallons. If there’s a large amount of precipitation in a particular month, ABC can maintain all of its gardens with rainwater alone. The rainwater system can limit city water usage, furthering ABC’s efforts to support sustain- Musculoskeletal and Central Nervous System Garden. able gardening and permaculture. (The gardens were originally designed Photo ©2009 Matthew Magruder through consultation with the famous horticulturalist and botanist Sage Salvia officinalis Photo ©2009 Matthew Magruder

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Gabriel Howearth Landeros. He specialized in permaculture and biodynamic ABC Demonstration Gardens gardening techniques.3) 1. Fragrance According to Gayle Engels, special projects director for ABC, the last time someone checked (a botany intern in 2004), there were 246 different plant species 2. Children’s in the ABC gardens. Some of the species that the gardens contain are ayahuasca 3. Mexican and South American Cuisine (Banisteriopsis caapi, Malpighiaceae), used by shamans in the traditional medi- 4. Mediterranean Cuisine cine of South America; curry leaf (Murraya koenigii, Rutaceae), much-loved in 5. Southeast Asian Cuisine India for its use in flavoring foods but also used medicinally and studied for its 6. Indian Cuisine hypoglycemic effects; and numerous species that act as forage plants for butterfly 7. French Cuisine larva and nectar plants for adult butterflies, bees, and hummingbirds. Various other species 8. Cattail Pond in the gardens include 9. Chinese Cuisine the following herbs: 10. Middle Eastern Cuisine comfrey (Symphytum 11. Ginger/ Gotu Kola officinale, Boragina- 12. Antioxidant ceae), traditionally used 13. Tea to heal tissue injuries; 14. Male/ Female Reproductive Garden passionflower (Passi- flora incarnata, Passi- 15. Vegetable floraceae), traditionally 16. Oriental used as a sedative; lemon 17. Tree Garden balm (Melissa officinalis, 18. Tropical 2 Lamiaceae), which has 19. Vicki Adams Rose Garden demonstrated both seda- 20. Musculoskeletal System and Central tive and antiviral activity; Nervous System Madalene Hill double- Mentha graci- 21. Digestive and Excretory System mint ( x lis cv ‘Madalene Hill,’ 22. Respiratory System Lamiaceae), a mint that 23. Cardiovascular System has both peppermint 24. Eye, Ear, Nose, Throat and Immune and spearmint proper- 25. Guava Garden ties, named for the late 26. Phytocosmetic Texas herbalist; and 27. Southwest Pollinator yerba mansa (Anemopsis californica, Saururaceae), 28. Native Wildlife Garden and Pond which could be used for 29. First Aid mouth sores, sinus prob- 30. Endocrine System lems, and rheumatoid Passionflower Passiflora incarnata arthritis, according to Photo ©2009 Matthew Magruder late herbalist and author Michael Moore. Some of the 30 herbal garden themes include: Asian, antioxidant, fragrance, children’s herbs, human systems (including digestive, respiratory, musculoskeletal, excretory, cardiovascular, reproductive, central nervous and immune), Southwest pollinator, international cuisine (including Mexican, Mediterranean, Southeast Asian, French, Chinese, and Middle Eastern), and first aid. The ABC New Hope greenhouse (donated by New Hope Natural Media) is where plants are born and housed during unfavorable weather. (For a full list of gardens see the ABC Demonstration Gardens sidebar.) One of the greatest ways that the gardens contribute to ABC’s mission of educating the public about medicinal herbs is through ABC’s internship program with pharmacy and dietetic students. Many of these students connect with ABC through the University of Texas and Texas State University, although some travel from other states to intern with ABC. Ferguson primarily uses these gardens to teach interns how to make medicinal teas, tinctures, salves, and lotions. Students are also able to view the natural sources of some pharmaceutical ingredients through their work in the gardens. “This is an especially valuable lesson to the pharmacy students who, before ABC, Fennel Foeniculum vulgare Photo ©2009 Matthew Magruder may have made no connection between the pills they know and the plants they www.herbalgram.org 2009 HerbalGram 83 | 13 ABC News

may be derived from,” said Ferguson. “The dietetic interns also learn numerous aspects about plants as food and sources of nutrition.” ABC hopes that this instruction can help bring more balance to the understanding of natural products to those who are taught primarily conventional medicine. Also it will possibly encourage students to incorporate the use of herbs in their work along with conventional pharmaceuticals, bringing more of an integrative approach to the medicine field. “The gardens were conceived over 10 years ago as a prime public-facing project designed to promote ABC’s educational mission on a local basis as well as through its internship program,” said Engels. “We try to reach the public, not only through educating their future healthcare professionals but by showing them, through classes and tours of ABC’s gardens, how they can incorporate the healthy herbs into their own lifestyles.” Ferguson has also implemented various community outreach programs. She frequently attends a local farmer’s market on Wednesdays and sells medicinal and culinary herbs from the ABC gardens to spread awareness of herbs and increase the visibility of ABC. Often she accepts the services of those wishing to fulfill community service hours, allowing them to volunteer in the gardens. Recently, she and Denise Meikel, ABC’s development director, have been exploring the possibilities of creating an herbal health education program for disadvantaged youth. Various local organizations, such as LifeWorks, a local nonprofit homeless shelter for youths, and Southwest Key Programs, Inc., a national nonprofit that specializes in community-based treatment programs for troubled youths, have brought groups of students to the gardens where they get a chance to experience nature and learn about Monterrey Oak Quercus polymorpha. medicinal herbs. This fall, there will also be workshops on the ABC grounds Photo ©2009 Matthew Magruder that consist of lectures coupled with in-garden experience. The ABC gardens will become a demonstration area for those who want to volunteer their time ABC Memorial Trees and Benches while gaining garden and medicinal plant education. Several gardens on the ABC property have resulted from the ABC Garden • There is a bur oak (Quercus macrocarpa, Dedication Program, in which ABC creates or names an existing medici- Fagaceae) and southern magnolia (Magnolia nal herb garden (usually 10 feet square) of a donor’s choice that displays a grandiflora, Magnoliaceae) dedicated to Alfred desired theme. Gardens that have been dedicated in this manner include the Blumenthal, father of ABC Founder and Execu- planned Ayurvedic garden, adopted by Nature’s Formulary and Organix- tive Director Mark Blumenthal; • 3 redbuds (Cercis canadensis, Fabaceae) and a bench dedicated to Finance Coordina- tor Cecelia Thompson’s mother, father, and brother; • a Lacey oak (Q. laceyi) dedicated to Accounting Coordinator Margaret Wright’s mother; • a Monterrey oak (Q. polymorpha) and a Chin- quapin oak (Q. muehlenbergii,) dedicated to Engels’s father and mother; • a Mexican plum (Prunus mexicana, Rosaceae) dedicated to the step-father of Wayne Silverman, former administrative and development director; • a desert willow (Chilopsis linearis, Bignonia- ceae) dedicated to Steve Allen, a friend of Blumenthal and ABC; • a pomegranate (Punica granatum, Lythraceae) dedicated to Joyce Fletcher, wife of Ed Fletcher, COO of the Botanical Division of Strategic Sourcing, Inc; • and a Texas Red Oak (Q. texana) dedicated to Roberta Roland Weeks, mother of Board of Trustees Member John Weeks.

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South, and the Oriental garden, created in collaboration with Holly Ferguson the Academy of Oriental Medicine at Austin (AOMA) and Employee Profile: made possible by a grant from High Falls Gardens.4 (Parties ABC is most fortunate to have Holly Ferguson as our educa- interested in helping ABC build a new garden or dedicating an tion coordinator and garden manager. Holly came to ABC in the existing garden should contact Denise Meikel at ABC.) fall of 2008 after moving to Austin from her native Arkansas. One particularly unique garden at ABC is the Vicki Adams Holly is a perfect fit here at ABC. She has a background in Rose Garden, in memory of a former employee of ABC. Vicki herbal medicine, having studied with the late herbalist/author Adams initially volunteered and later did part-time work for Michael Moore. An avowed naturalist, she grew up in the ABC until just before her death at age 93.5 Engels explained Ozarks on the side of a moun- that ABC does not normally establish memorial gardens, but tain—literally in the woods, i.e., Adams was a special case: “We already had a rose garden, with no running water other than and she loved the roses, so we dedicated it to her memory a nearby stream and no electric- because she was so special to us.” There are also some memo- ity. Her family collected rainwater rial trees and benches dedicated to those personally connected long before rainwater harvesting to ABC staff members. (For a current list of dedicated trees became one of the new “green” and benches, please see the ABC Memorial Trees and Benches trends. She drives a Volkswagen sidebar.) Beetle with a diesel engine, which More information on the ABC gardens and how to donate she feeds with biofuel. As much to them is available at http://abc.herbalgram.org/site/PageServ as possible, Holly eats food from er?pagename=Support_ABC#Donate. local gardens and makes her own herbal remedies. —Kelly Saxton Lindner Here at ABC, Holly supervises the pharmacy and dietetic interns, References which includes finding interest- 1. Marinelli J. How green is your garden. National Wildlife. April/ ing and unusual field trips for Ferguson May 2009; 47(3):46–50. them (e.g., visits to herb gardens other than those here at ABC, 2. Silverman W. Creating an herbal legacy: protecting and preserving etc.). She also instructs interns on how to make their own simple healthy herb solutions. HerbalGram. 2007;74:12–13. herbal remedies. She has energized ABC’s volunteer program and 3. Engels G. Renowned horticulturist designs ABC gardens. HerbalGram. 1999;47:12 handles numerous research questions sent by ABC members. 4. ABC collaborates with Academy of Oriental Medicine at Austin to Holly’s responsibilities also include managing the ABC gardens, create Chinese medicinal herb garden. HerbalGram. 2007;73:10 where she supervises volunteer and intern activities. (All interns 5. Engels G. ABC loses beloved staff member, Vicki Adams. at ABC get to spend 1 day per week working in the gardens.) HerbalGram. 2003;57:8. Holly is also in charge of maintaining ABC’s library and electronic literature database. She coordinates community outreach, Jimson Weed Datura stramonium. Photo ©2009 Matthew Magruder as well as visitor support, including educational programs and garden tours for the general public, garden clubs, student groups, and others. Holly sums up her philosophy as follows: “I believe that education is power, and that it is going to take immense power to remedy the collective human impact on the environment. My hope is to teach and inspire people to live a healthy lifestyle that is in balance with the environment at large. In particular, I hope that our interns and volunteers will learn to appreciate herbs and learn how to use them for their personal health and for the health of their patients or families. I hope that some will be inspired to grow their own medicine by creating herb gardens at home. I hope that they will develop an appreciation for plants as a whole.” Holly is the kind of person who is well-suited for her role at ABC. Her deep and vibrant passion for all things natural, her love of plants, her keen interest in natural healing, and her sensitivity to environmental issues, as well as her many other interests and passions, have created a new level of positive energy for all of us here at ABC, as well as for our local, regional, and other stakeholders with whom she comes into contact.

—Mark Blumenthal

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Meet ABC Board Member Morris Shriftman: Groundbreaking Marketer for the Natural and Organic Industries Deep in thought, often with opera or Spanish music filling his ears, Morris “Mo” Shriftman tackles marketing projects as an artist with a blank canvas. Using his creative mind, Shriftman creates visually-stimulating graphics and innovative marketing campaigns that truthfully inform the public about the virtues of natural and organic companies and their products.

“I decided to focus on these “Morris has been one of the industries because it has been key marketing influences in my most satisfying work,” said this business for as long as I can Shriftman (oral communica- remember. He’s one of the few tion, April 14, 2009). “It is nice, true artists in our business. Art as a marketing guy, not to have is at the core of everything he to lie in order to build brands does,” said Greene. for my clients.” Working with Whole Foods Shriftman’s 3-decade long Market (Austin, TX) in the career in marketing for the 1980s and 1990s, Shriftman “natural space” has been charac- helped the company open a terized by his artistic approach dozen new stores with a direct to effecting positive change. By mail video campaign, which building upon client compa- gave Whole Foods name recog- nies’ sense of purpose, purity of nition in untapped commu- ingredients, product differentia- nities.5 He later created team tion, or their higher mission of member orientation videos, social importance, his work has which Peter Roy, former presi- helped establish many brands as dent of Whole Foods, said were industry staples, such as Hori- instrumental in orienting new zon Organic Dairy (Boulder, team members on the culture, CO) and Traditional Medic- Morris Shriftman history, and expectations of the inals (Sebastopol, CA).1,2 He company (oral communication, is also the CEO of marketing April 21, 2009). communications firm Mozart, Inc., which specializes in natural “The videos were very effective, used for many years, and were and organic products and herbal and alternative medicine. eventually re-edited to become an investor presentation,” Roy Doug Greene, founder of New Hope Natural Media, has said. known and worked with Shriftman for 30 years. Greene said that Quite possibly the most groundbreaking point of Shriftman’s Shriftman does not approach marketing from a “market manipula- career has been his time as senior vice president of marketing for tion point of view—he comes at it from a service and social justice Avalon Natural Products. There he helped build the company’s point of view” (oral communication, May 11, 2009). brands, including Avalon Organics and Alba, into major lines. He Shriftman became involved with his first natural products further created the Consciousness in Cosmetics campaign, a platform client, Tree of Life, during the early 1970s, when the company was for personal care products based on the absence of “objectionable still a small neighborhood grocery store.3 Shriftman helped turn ingredients.”6 Tree of Life into a major retail brand and successful distributor of Shriftman wanted to encourage consumers to think more natural and organic products deeply about what they put by creating retailer-oriented onto their skin, so he helped programs and by launching the Shriftman creates visually- create the campaign to guide company’s new image with the the creation and reformation creation of a logo, catalogs, and stimulating graphics and of all Avalon Organics prod- marketing literature.4 ucts by focusing on the elimi- Recalling the bright green innovative marketing nation of ingredients such as blurred tree insignia that parabens, petro-chemical based Shriftman created for Tree campaigns that truthfully ingredients, sulfates, and any of Life, Greene said that animal-based ingredients, while Shriftman profoundly influ- inform the public about the instead promoting the use of enced packaging for the organic botanicals and oils and entire natural products indus- virtues of natural and organic on ensuring non-animal test- try, taking it from “brown, ing. crunchy, granola” to vibrant Shriftman’s initial desire to quality graphics. companies and their products. remove potentially toxic ingre-

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dients from Avalon’s products was spurred when the European Union banned about 1,100 potentially harmful chemicals from References cosmetics and body care products in 2003.7 The US Food and 1. Horizon Organic Dairy. Mozart, Inc. Web site. Available at: http:// Drug Administration (FDA), meanwhile, has only banned 11 www.mozartinc.com/. Accessed April 20, 2009. ingredients from cosmetic products.8 2. Traditional Medicinals: the natural pharmacy of plants. Mozart, Inc. Web site. Available at: http://www.mozartinc.com/. Accessed April 20, “That was a real eye-opener for me,” said Shriftman. 2009. “Many at Avalon worked hard to make this change, but Morris 3. About Us. Tree of Life Web site. Available at: http://www.treeoflife. led the way by conceptualizing and driving the campaign,” said com/MainCategoryTemplate.aspx?ParentCategoryId=5. Accessed April Gil Pritchard, former president of Avalon Natural Products (oral 21, 2009. communication, April 16, 2009). “Shriftman initially encountered 4. Health Sciences Group adds prominent industry leader to its manage- criticism and hesitation from within the natural products indus- ment team; Morris Shriftman to lead marketing effort for product try. But he all the while remembered that we were doing the right launch initiatives [press release]. Los Angeles, CA: Health Sciences thing. Group, Inc.; November 10, 2003. 5. Whole Foods. Mozart, Inc. Web site. Available at: http://www. “[The campaign] is a legacy. And quite frankly, we owe it to mozartinc.com/. Accessed April 20, 2009. Morris. It ultimately changed the ingredient structure of health 6. Five Elements of Consciousness. Avalon Organics Web site. Available and beauty aids sold as natural products.” at: http://avalonorganics.com/?id=30. Accessed May 11, 2009. Similarly, Mo has been an invaluable asset to the American 7. Directive 2003/15/EC of the European Parliament and of the Council Botanical Council (ABC) Board of Trustees, said ABC Founder of February 27, 2003 amending Council Directive 76/768/EEC on the and Executive Director Mark Blumenthal. approximation of the laws of the Member States relating to cosmetic “His artistic talents permeate his every word. Mo speaks in such products. Official Journal of the European Union. 2003;11(3);26-35. an eloquent way that it’s almost like listening to poetry. He has a 8. Electronic Code of Federal Regulations: Title 21: Food and Drugs, Part 700–General, Subpart B—Requirements for Specific Cosmetic Prod- phenomenally broad sense of vision and heart, and these qualities ucts. Available at: http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr;rgn have helped propel and expand ABC’s sense of our role in chang- =div6;view=text;node=21%3A7.0.1.2.10.2;idno=21;sid=11932eedf179 ing our culture to be more accepting of natural medicine,” said 169919a4f92bf2ebd207;cc=ecfr. Accessed May 11, 2009. Blumenthal. Despite his years of experience and success in the field, Shriftman didn’t initially plan on a marketing career. He received his bachelor’s degree in labor relations from Cornell University, then attended law school for a year before deciding that it was not for him. He went on to earn his master’s degree in British and American literature from New York University and completed BASTYR all the exams and coursework required for his doctorate. Prior to beginning his dissertation, however, he landed a job writing TV CHANGES LIVES commercials and print ads, where he developed a sense of what marketing was about and began to make more money than many of his professors. This led Shriftman to create his own graphic design company, Century Expanded, which worked with compa- “The demand for nies like the American Broadcasting Company (ABC) and Dow Jones. Century Expanded eventually became involved with Tree of herbal experts Life, and since then, Shriftman has not left the “natural space.” “There’s a lot of love in this industry, and that feels good,” is increasing.” Shriftman said, noting that the natural and organic industries Jennifer Perez, Alumna, have a sense of compassion and caring that he has not encountered BS, herbal sciences elsewhere. Aside from marketing, Shriftman enjoys numerous activities, including yoga, painting, playing music, and traveling. Longtime friend Greene recalled that Shriftman is also a fantastic whistler (especially to Van Morrison tunes), and Pritchard noted his great sense of humor. “There aren’t many dull dinner conversations when Morris is around,” said Pritchard. Greene added that Shriftman is also a “phenomenal” father of 2 daughters and a son, as well as a very loyal and generous friend. “As good as [Morris] is at marketing, he’s also just as good at the art of friendship.” Earn a BS in Herbal Sciences: —Lindsay Stafford herbmed.bastyr.edu www.herbalgram.org 2009 HerbalGram 83 | 17 ABC News

Creating HerbMed® — A Combination of Expert Curation and Automatic Generation By Jacqueline C. Wootton, MEd An article in a previous issue of HerbalGram provided a brief history of the HerbMedPro database and the exclusive arrangement that the database’s originator, the Alternative Medicine Foundation, has with the American Botanical Council.1 This new column will high- light features of the database and provide news on development of basic content and extra functionality. One fundamental characteristic of hyperlink it directly to the source data. ability of the document. The goal is to state HerbMedPro, and the underlying HerbMed Expert compilers must be thoroughly simply and briefly the findings of the origi- database, is that it is built incrementally as conversant with the scientific literature on nal article. a structured, scientific database. It combines medical herbs and need to be scientists, The neutral presentation of research infor- the power of expert curation (the process usually PhD pharmacologists or pharmacog- mation in HerbMed means that it is avail- of organizing and supervising the compi- nosists, and have an unusually broad knowl- able for a variety of uses and interpreta- lation of data) and automatic compilation edge of the field so that they can correctly tions by companies, researchers, educators, of data from multiple electronic resources. identify relevant literature and other research government bodies, health science librar- Although much of the scientific research resources and allocate data to the correct ies, and other similar organizations. Access data is drawn from the US National Library category or subcategory. They all work within through HerbMedPro provides clear catego- of Medicine’s PubMed database, searching the strictly impartial framework of presenting rized medicinal plant data on which users HerbMedPro yields creative cross-referencing neutral, categorized data. can base their own judgments and policy, and new information that cannot be obtained Each herb is identified by scientific, family, based on their own organizational priorities from PubMed alone. The records viewed and common names, and the research infor- and goals. in HerbMedPro may look like static files or mation that has been identified is sorted into ABC’s HerbMedPro team is continually documents, but they are frequently updated clear categories and subcategories, as follows: updating the database by building new herb by expert compilers and can be automatically • Evidence for Efficacy: Human Data records and updating existing ones, particu- enhanced by the user when clicking on the from Clinical Trials; Case Reports; larly those that have been “adopted” through “Live Links to PubMed” search feature. Traditional/Empirical Use; ABC’s new Adopt-An-Herb program. This The tasks of the expert compilers of the • Safety Data: Adverse Events; Interac- is quite an intensive process. Continuous database are the following: tions; Contraindications; comprehensive coverage for users is facili- 1. To research the literature from various • Evidence of Activity: Animal Studies; tated by the unique and powerful Dynamic online published sources; Pharmacodynamics; Analytical Chem- Updates feature, where search terms are 2. To categorize and sub-categorize the istry; Pharmacokinetics; Genetics & provided to automatically pull up all the most data; Molecular Biology; recent publications for any specific category 3. To summarize briefly each item and • Formulas and Blends: Modern Meth- of research and information for each herb. ods of Preparation; Patents; and where Due to the combination of expert-curated HERBMEDPRO ADDITIONS AND UPDATES appropriate, whether the herb is used as categorization and summaries and dynami- (From January - June 2009) a component in a Folk Blend or Contem- cally generated data, HerbMed has a breadth porary Mixture; and comprehensiveness that enables creative New Herb Records • Other Information: Pictures & Distribu- cross-referencing and unexpected links that Common Name Latin Binomial tion Maps; Cultivation, Conservation, provide fresh insights for a variety of users Sceletium Sceletium tortuosum and Ecology; Related Links; and needs. • Dynamic/Live Search Updates. The HerbMedPro database is available Updated Herb Records Common Name Latin Binomial Finally, the expert compiler writes a brief, to all ABC members at the Academic level one-sentence summary for each database item. and higher. Information on how to set up Artichoke Cynara scolymus Essentially, this is a one-sentence “bottom- a subscription, license the content, or use Basil Ocimum spp. line” statement of the main findings of the the Pay-Per-Day feature is available at www. Chaste tree Vitex agnus-castus published research or trial, whether positive, herbalgram.org. Echinacea Echinacea spp. negative, or inconclusive. The compiler does Elderberry Sambucus nigra not make a judgment on the quality or reli- Jacqueline C. Wootton, MEd, is Ginger Zingiber officinale founder and president of the Alter- Horse chestnut Aesculus hippocastanum native Medicine Foundation, Inc, Adopt-an-Herb Update Jujube Ziziphus spp. in Potomac, Maryland and director Common Name Latin Binomial Adopter Neem Azadirachta indica of the HerbMed® and HerbMedPro Arnica Arnica montana Naturopathica Onion Allium cepa databases. Chocolate Theobroma cacao Mars Botanicals Prickly ash Zanthoxylum spp. Neem Azadirachta indica Organix South Reference Rooibos Aspalathus linearis Sceletium Sceletium tortuosum HL Hall & Sons 1. Wootton J. ABC acquires the Tea, Camellia sinensis Tea, green/black Camellia sinensis Tea Dragon Films popular herbal database HerbMed. green/black HerbalGram. 2008:78:14.

18 | HerbalGram 83 2009 www.herbalgram.org Organization News

USP Withdraws Proposed Caution Statement for

DecaffeinatedThe United States Pharmacopeia Green (USP) Tea announced Extract in April 2009 that it had canceled the proposed caution statement for its powdered decaffeinated green tea (Camellia sinensis, Theaceae) extract monograph, a change from previous USP assessments of green tea extract (GTE).*1 USP’s decision resulted from an updated safety review that quality monograph.4 Also, it does not require a caution or warning considered feedback on the proposed caution, recent literature that statement in the labeling section of the USP-NF powdered decaf- did not show new cases of liver toxicity associated with GTE, and feinated GTE monograph. adverse event reports that did not show the same toxicity signal Powdered decaffeinated GTE was previously classified, under previously observed, said Dandapantula Sarma, PhD, scientific USP’s old classification system, as Class 2, which meant that the liaison for USP’s Dietary Supplements Information (DSI) Expert Committee was unaware of significant safety issues present when Committee (e-mail, May 2, 2009). the article is used and formulated appropriately, provided there is “It seemed that there was increasing evidence leaning toward a warning statement in the labeling section.1 The Expert Commit- safety rather than toxicity,” said Marilyn Barrett, PhD, a consult- tee designated GTE as Class 2 following reports of liver damage ing pharmacognosist and member of the DSI Expert Committee that may have been associated with the ingestion of dietary supple- (oral communication, May 1, 2009). “There was a lack of clar- ments containing green tea, as documented in a 2008 article in ity regarding the potential for liver toxicity. The usefulness of a Drug Safety.5 cautionary statement was questioned due to the variety of green tea After announcing GTE’s Class 2 designation, the USP Commit- products on the market and the range of serving sizes.” tee held a public comment period before adopting a caution Founded in 1820, USP is an official public standards-setting statement for the monograph’s labeling section in the USP’s authority for all prescription and over–the–counter medicines Pharmacopeial Forum 33(6),6 said Dr. Sarma. If approved, this and other healthcare products manufactured or sold in the United proposal would have required all dietary supplement products States.2 USP also sets widely recognized standards for food ingre- claiming to meet USP standards and for USP-certified dietary dients and dietary supplements. supplements containing the ingredient to feature a caution state- USP’s Dietary Supplement Information Expert Committee ment on their labels. reviews safety profiles of ingredients being considered for a mono- Following the proposal, some industry companies and organi- graph to be published in the USP-NF (National Formulary), a zations voiced opposition to a caution statement. The American book of public pharmacopeial standards. The committee uses Herbal Products Association (AHPA), for example, issued a press its safety classification system to determine whether a USP-NF release in which it disregarded USP’s premise of GTE toxicology, monograph should be developed and if it should require a warn- saying the proposed labeling would be required for instances where ing/cautionary statement in its labeling section. The organization’s it is clearly not warranted and that USP failed to describe needed dietary supplement monographs serve as official pharmacopeial additional research that would adequately address uncertainties.7 standards for products claiming to meet USP standards and for The powdered decaffeinated GTE monograph was published on USP-verified ingredients marketed as dietary supplement products December 1, 2008, in the Second Supplement to USP 31-NF 26 in the United States.3 (Compliance with USP dietary supplement without a cautionary labeling statement.6 GTE was still considered monograph standards is voluntary, while compliance with USP a Class 2 ingredient at that time, but the final caution decision had prescription drug monograph standards is mandatory). been delayed to allow for public comment and the USP’s classifica- After proposing the caution statement for powdered decaffeinated GTE, the Committee considered public feedback and updated the comprehensive safety evidence. This also included information from the US Food and Drug Administration’s (FDA) MedWatch, the Canada Vigilance Program, and the Australian Adverse Drug Reactions Advisory Committee (ADRAC), said Dr. Sarma. Much of the feedback USP received from industry groups said USP did not have the authority to issue these proposed cautionary statements, as that is the job of the FDA, Dr. Barrett added. After reviewing all of the information, the Commit- tee reclassified powdered decaffeinated GTE as Class A under USP’s new safety classification system.1 This classification signifies that the article is admitted into the USP-NF and the available evidence does not indicate a serious health risk that precludes the creation of a Green Tea Camellia sinensis Photo ©2009 Steven Foster * Green Tea Extract (GTE) is a general term referring to a wide range of articles in commerce that vary in quality, all of which are derived from unfermented green tea (Camellia sinensis). Powdered Decaffeinated Green Tea Extract is the title of the only monograph for GTE currently in the USP-NF and identifies one GTE with definitive quality specifications (D. Sarma, e-mail, May 2, 2009). www.herbalgram.org 2009 HerbalGram 83 | 19 Organization News World News tion system review. As the most recent classification of powdered decaffeinated GTE—as Class A—does not require a warning or caution state- Project BudBurst: Observing ment, no updates are necessary, and the ingredient’s December 2008 monograph is currently official. Though no new informa- Plant Life Cycle Events to Track tion has been received that would require implementing any caution statements or reclassifications, the Committee still has the Effects of Climate Change concerns about the safety of some GTEs, as discussed in the On April 1, 2009, Kay Havens, PhD, strolled through the Drug Safety article.5 Therefore, it is continuing to monitor aris- Chicago Botanic Garden (CBG), where she works as director ing evidence, such as clinical case reports, and might change its of plant science and conservation. As Dr. Havens passed by the position accordingly, said Dr. Sarma. deciduous shrub forsythia (Forsythia x intermedia, Oleaceae), If any GTE safety concerns (or concerns for other dietary she noticed several bright yellow flowers peeking out through supplement ingredients for which USP has a safety review) do the plant’s branches and leaves. surface, the Committee could decide to communicate findings and recommendations through publications in peer–reviewed As these colorful blooms were appearing 2 weeks earlier than journals, public communications, Pharmacopeial Forum notices, last year’s forsythia blooms in the Chicago area (and more than or other appropriate means, Dr. Sarma added. 3 weeks earlier than 2007’s blooms), Dr. Havens was a little The newly-revised safety classification system for dietary surprised with these rather early signs of spring.1 Later, she ingredients, under which powdered decaffeinated GTE was reported her observation to the online national database for Proj- recently reclassified, was approved and implemented on Febru- ect BudBurst, an organization for which she is lead botanist. ary 5, 2009.4 After reviewing the classification system’s progress, Created in 2007, Project BudBurst aims to use years of plant challenges, and public feedback, the Committee decided that the phenophase observations, just like Dr. Haven’s forsythia find- system did not allow enough flexibility to communicate safety ing, in order to measure climate change and its effects on plants.2 concerns and that the “Class 2” designation was overly rigid as it Though some observers, like Dr. Havens, are scientists, the proj- required safety concerns to be expressed by a warning statement ect is rooted in the participation of non-scientists, or citizen scien- in the labeling section of the ingredient’s monograph. Detailed tists, who monitor plants’ phenophases (the timing of life cycle information on the newly revised classification system and its events such as the first leafing, first flower, and first fruit ripen- differences from the previous system are available from the USP ing). A collaboration of CBG, the University Corporation for Web site, at www.usp.org/USPNF/notices/USPRevisedAdmis- Atmospheric Research (UCAR), and University of Montana, the sionCriteria.html. project is now in its second full year. About 4,700 participants from all 50 states have been out and —Lindsay Stafford about in gardens and in nature observing plants (including many medicinal species) for the 2009 project, and about 1,400 of them References just joined this year, said Kirsten Meymaris, lead technologist for 1. Update on the USP green tea extract monograph [press release]. Project BudBurst (e-mail, May 16, 2009). Participants begin to Compendial Notices: United States Pharmacopeia Web site; April observe their plant about a week before the average budburst (when 10, 2009. Available at: http://www.usp.org/USPNF/notices/upda- the buds have opened and leaves are visible), and upon noticing teUSPGreenTeaExtractMonograph.html. Accessed April 22, 2009. 2. About USP—An Overview. United States Pharmacopeia Web site. this life cycle change, they report their findings to the project’s 3 Available at: http://www.usp.org/aboutUSP/. Accessed April 22, online database. Throughout the growing season, participants 2009. continue to look for and report phenophase information. Since 3. Understanding USP–NF. United States Pharmacopeia Web site. Project BudBurst’s creation, more than 7,500 observations have Available at: http://www.usp.org/USPNF/understandingUSPNF. been amassed, including almost 5,000 from 2008’s project and html. Accessed April 22, 2009. 2,600 observations received in early 2009, said Meymaris. 4. USP revises admission criteria and safety classification for dietary The observations that Project BudBurst has collected so far supplements [press release]. Compendial Notices: United States Phar- provide valuable baseline data and make possible contemporary macopeia Web site; April 10, 2009. Available at: http://www.usp. org/USPNF/notices/USPRevisedAdmissionCriteria.html. Accessed data comparisons, such as the finding that flowering dogwood April 22, 2009. (Cornus florida, Cornaceae) fully bloomed 2 weeks earlier in 2008 5. Sarma, D. N., Barrett, M. L., Chavez, M. L., et al. Safety of green than it did in 2007.3 Additionally, the project might begin to tea extracts: a systematic review by the US Pharmacopeia. Drug accept historical datasets from participants in the future, said Dr. Safety. 2008; 31:469–484 Havens. The observations are collected from a wide range of site 6. USP to defer decision on green tea extract cautionary labeling [press conditions and geographical areas, making it possible to look at release]. Rockville, Maryland: United States Pharmacopeia. June 23, patterns of climate change across the whole country and in much 2008. Available at: http://www.usp.org/pdf/EN/fcc/uspGreenTeaSt- greater detail than was possible in the past, said Paul Alaback, atement2008-06-23.pdf 7. AHPA urges USP to drop label cautions on black cohosh and green PhD, lead scientist of Project BudBurst (e-mail, May 21, 2009). tea [press release]. American Herbal Products Association. January Both Dr. Havens and Dr. Alaback noted that in order to have 11, 2008. Available at: http://www.ahpa.org/Default.aspx?tabid=69& enough information to document climate change trends, Project aId=445&zId=1. Accessed April 28, 2009. BudBurst will need many more years of data. “Every year of data helps, but even after 2009, we’ll only have 2 full years of data and 3 months of observations from our pilot

20 | HerbalGram 83 2009 www.herbalgram.org World News project in 2007,” said Dr. Havens. “It is still too early to say much dogwood, 9 and red maple (Acer rubrum, Aceraceae).10 The citizen about what is happening in any one location.” scientists can choose one or more plants from the list of 75, or they As climate change can affect temperature, day length, and can follow any plant of their choosing. weather, it can in turn affect plants’ phenophases.4 Some plants are These additions should make it easier for Project BudBurst responding to climate change with earlier and/or longer growing participants, many of whom are school children, to correctly iden- seasons, and others are shifting their growing ranges toward the tify the phenological events of their plant, said Dr. Havens. Other poles or higher elevations.3,5 features also help to ensure quality, such as a review of the dataset “This is what we would expect as temperatures warm,” Dr. by scientists and comparison of the BudBurst dataset to observa- Havens said in a CBG press release.3 “Many people may welcome tions collected by professionals. an earlier spring, but plants could be in trouble if they bloom “Public participation allows a much greater level of data collec- before their pollinators are present.” tion—both in geographic span and number of observations—than Many plants depend upon pollinators such as bees and other could be done by scientists alone,” said Dr. Havens. “In addi- insects, or bats, for survival. While some pollinators will learn to tion, another goal of the project is to raise public awareness about adapt, many others breed and disperse based on sunlight cycles climate change and its effects on plants.” instead of temperatures and could have mismatched behavior with flowers that are blooming earlier.3 Also, pollinators who spend —Lindsay Stafford winters in the tropics don’t receive the same signals of spring temperature change and will need to evolve to migrate early, said References Dr. Havens. 1. Monday, April 20, 2009: Spring is finally here... Project BudBurst “Over time, natural selection will favor early migration, but we Scientist Blog. Available at: http://projectbudburst.blogspot.com/. aren’t sure if this will happen fast enough to prevent species extinc- Accessed May 21, 2009. 2. About Us. Project BudBurst Web site. Available at: http://www. tion or severe decline,” she said. windows.ucar.edu/citizen_science/budburst/aboutus.php. Accessed May Species other than plants can also experience potentially damag- 14, 2009. ing ecological consequences. For example, oak trees (Quercus spp., 3. Citizen-scientists watch flowers for clues about climate: Chicago Fagaceae) in Europe are leafing earlier, and in response, the larvae Botanic Garden’s Project BudBurst in second full year [press release]. of a moth that eats young oak leaves is hatching earlier, said Dr. Glencoe, IL; Chicago Botanic Garden. March 24, 2009. Havens. “But the pied flycatcher that migrates back to Europe 4. Phenology and Climate Change. Project BudBurst Web site. Available from more southerly wintering grounds has not altered its migra- at: http://www.windows.ucar.edu/citizen_science/budburst/climat- tion time,” she added. “By the time it arrives and nests, moth echange_pheno.php. Accessed May 15, 2009. 5. Cavaliere C. The effects of climate change on medicinal and aromatic larvae are too old to feed to the flycatcher chicks and many chicks plants. HerbalGram. 2009;81:44-57. are starving as a result and the pied flycatcher is in decline.” 6. Taxon: Taraxacum officinale F. H. Wigg. aggr. GRIN Database. Avail- Project BudBurst introduced several new features this year, able at: http://www.ars-grin.gov/cgi-bin/npgs/html/taxon.pl?80051. including photographic guides to the different phenophases Accessed May 18, 2009. of target species, a simple blog written by Dr. Havens and Dr. 7. Taxon: Syringa vulgaris L. GRIN Database. Available at: http://www. Alaback, and “real-time” Google maps that display the latest ars-grin.gov/cgi-bin/npgs/html/taxon.pl?36122. Accessed May 18, phenophase observations for each species. 2009. Cornus florida To obtain an expanded geographical representation of plants, 8. Taxon: L. GRIN Database. Available at: http://www.ars- grin.gov/cgi-bin/npgs/html/taxon.pl?11551. Accessed May 18, 2009. Project BudBurst increased the number of plants that it encour- 9. Taxon: Forsythia suspensa (Thunb.) Vahl. GRIN Database. Available at: ages participants to follow from 60 to 75, said Dr. Havens. Many http://www.ars-grin.gov/cgi-bin/npgs/html/taxon.pl?231. Accessed May of these targeted species have medicinal properties, including last 18, 2009. year’s most observed plants: common lilac (Syringa vulgaris, Olea- 10. Taxon: Acer rubrum L. GRIN Database. Available at: http://www.ars- ceae),6 common dandelion (Taraxacum officinale, T. mongolicum, grin.gov/cgi-bin/npgs/html/taxon.pl?1220. Accessed May 18, 2009. Asteraceae),7 forsythia (Forsythia suspensa, Oleaceae),8 flowering

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Prince of Wales’ UK Company Launches Herbal Line Prince Charles’ Duchy Originals, a company that produces organic food products, launched a line of herbal remedies in January of 2009.1 The company was founded by Prince Charles in 1990 and is owned by the Prince’s Charities Foundation, to which all profits from Duchy are donated.

So far, Duchy Herbals includes an Echina-Relief tincture Blumenthal said.3 (containing the root of Echinacea purpurea, Asteraceae), a Hyperi- Roberta Lee, MD, medical director at the Continuum Center Lift tincture (containing St. John’s wort [Hypericum perforatum, for Health and Healing in New York City, and a member of Clusiaceae]), and a Detox tincture (containing artichoke [Cynara ABC’s Board of Trustees, was also quoted in the article, agreeing scolymus, Asteraceae] leaf and dandelion [Taraxacum officinale, that detoxification as a concept may be getting an undeserved, Asteraceae] root). negative reputation. “Detoxification is a natural process that Involved in the development of Duchy’s traditional herbal occurs in the body, though it is not labeled as such in the medical medicines is Michael McIntyre, a practicing herbalist in Oxford- profession,” Dr. Lee said.3 “The idea shire and consultant for Asanté Academy of Chinese Medicine. that detox is a silly notion, I think, is McIntyre is the former president of the National Institute of Medi- a fallacy.” cal Herbalists and founder of the European Journal The Echina-Relief and Hyperi-Lift of Herbal Medicine. According to McIntyre, his role tinctures are the first herbal tinctures so far has involved supplying expert advice; writ- produced in the United Kingdom to ing the products’ data sheets on traditional use, be registered under the THMPD.1 safety, and relevant pharmacology; and discuss- According to McIntyre, the European ing which products Duchy should attempt to Union passed the Directive in 2004, register* under the European Union’s Tradi- and each Member State has to fully tional Herbal Products Directive (THMPD) implement it by passing national laws (e-mail, March 3, 2009). Although he helped by April 2011. The THMPD allows in obtaining registration for the Echina- herbal products to be registered under Relief and Hyperi-Lift tinctures, he was not medicines law. To earn a registration, a involved in the development of the Duchy company must submit a complete file Detox tincture, which was the focus of to the Medicines and Healthcare prod- some media attention in the United King- ucts Regulatory Agency (MHRA), dom in early 2009. containing extensive evidence of a Professor Edzard Ernst, PhD, MD, product’s traditional use, safety, and director of complementary medicine quality. According to one source, cost at the University of Exeter University’s estimates for putting together the scien- Peninsula Medical School, was quoted in tific dossier and other related costs to BBC News as stating that detox products meet these standards are as high as do not work, and he further argued that €100,000 (about US $140,000), if not the product was based on “outright quak- higher.4 ery.”2 He added that Prince Charles and Though McIntyre could not discuss his advisers were deliberately ignoring the cost of Duchy’s registrations, he science and relying on “make-believe” and did add, “Perhaps as the process gets “superstition.”2 bedded in, the costs of licensing[*] may come down. We certainly “Many people—rationally or irrationally, correctly or not— hope so!” believe strongly that they must detoxify their bodies to give Products that are registered can provide more information on themselves that extra edge to get rid of [undesirable chemicals],” their labels, including medicinal claims about traditional uses. said ABC’s Founder and Executive Director Mark Blumenthal, For instance, in May 2009, an arnica homeopathic product was according to an article from ABCNews.com.3 “There is probably registered under the THMPD, and it can now include label a healthy and rational basis for some of this, though some people claims about arnica’s traditional use relieving sprains, muscle take it a bit too far.” aches, and bruises within the homeopathic tradition.5 However, Blumenthal also pointed out that the basic notion of expelling these claims are limited to mild or moderate self-limiting condi- unhealthy substances from the body goes back 150 years or more. tions and cannot address more serious conditions that require a However, he noted that detox shouldn’t be treated as a free pass to physician’s care, such as cancer. indulge in unhealthy behavior, and some extreme forms of detox Although Duchy’s Echina-Relief and Hyperi-Lift tinctures could be even more unhealthy than indulgence and should be are registered with the MHRA, the company’s Detox tincture avoided: “People need to apply these things with common sense,” requires no such registration since it is classified as a food supple-

*This article refers to registration of THMPs. According to McIntyre, the MHRA uses the term “traditional herbal registration” for THMPs to avoid confusion with other more rigorous forms of approval known as licensing. A license requires proof of safety, quality and efficacy, whereas a traditional use registration requires evidence of safety, quality and tradition of use. More information about this can be accessed at the MHRA Web site: http://www.mhra.gov.uk/index.htm.

22 | HerbalGram 83 2009 www.herbalgram.org World News

ment. By 2011, every herbal product that is judged as medicinal by 5. Rose D. Medicines regulator grants first ever license to homeopathic the MHRA will require a registration. (The criteria used to deter- remedy. Times Online. May 15, 2009. Available at: http://www.timeson- mine whether a product is a medicine or not are set out in the main line.co.uk/tol/life_and_style/health/article6294395.ece. Accessed May EU Medicines Directive 2001/83/EC). A product may be deemed 18, 2009. 6. Frean A. Universities drop degree courses in alternative medicines. Times medicinal by function or by presentation. Thus an herbal product Online. January 30, 2009. Available at: http://www.timesonline.co.uk/ can be deemed a medicine by the claims it makes or the way it is tol/life_and_style/education/article5614896.ece. Accessed January 30, marketed, i.e., its intended use.) 2009. “The herbal medicines in the Duchy range are manufactured 7. Jones A. Prince’s firm told to amend ads. The Guardian. March 21, to exact standards and to provide popular herbal remedies over 2009. Available at: http://www.guardian.co.uk/uk/2009/mar/21/prince- the counter that the public can be certain are quality assured with charles-duchy-originals. Accessed March 21, 2009. all necessary safety information,” said McIntyre. “The launch of 8. Devlin K. Prince Charles’ Duchy Originals ordered to remove Duchy Originals herbal tinctures reflects the Prince’s passion for ‘misleading’ herbal remedy claims. Telegraph.co.uk. March 21, 2009. Available at: http://www.telegraph.co.uk/news/newstopics/theroyalfa- adopting an integrated approach to health.” mily/5024341/Prince-Charles-Duchy-Originals-ordered-to-remove- That the Prince of Wales is involved with a company getting misleading-herbal-remedy-claims.html. Accessed April 3, 2009. herbal products registered as medicines stands out in the United Kingdom, where schools like the University of Salford and the University of Central Lancashire have either dropped their home- opathy and complementary medicine degrees or stopped recruiting new students for them.6 In March 2009, the MHRA upheld a complaint about the online advertising of Duchy’s Echina- Relief and Hyperi-Lift tinctures. Duchy Herbals has We believe in… since changed the wording of its online advertising and removed previous claims of efficacy about the 2 products.7,8 nature’s Healing Power The modified statement on the Duchy Web site • 93 single herbs regarding Echina-Relief reads: “traditional herbal medicinal product used to relieve the symptoms of • 170 unique herbal the common cold and influenza type infections;” formulations the modified statement on Hyperi-Lift reads: “tradi- • Over 600 botanical tional herbal medicinal product used to relieve the symptoms of slightly low mood and mild anxiety, ingredients based on traditional use only.”8 More information about Duchy Herbals is avail- Uncompromising Quality able at www.duchyoriginals.com. • Over 600 tests developed —Kelly Saxton Lindner for quality assurance

References • 5 resident Ph.D.s 1. Duchy Originals encourages consumers to adopt an • 1 NSF- and cGMP- integrated approach to healthcare with launch of duchy herbals [press release]. East Twickenham, London, certified facility England: Duchy Originals. January 22, 2009. 2. BBC News. Prince Charles detox ‘quackery.’ BBC News. March 10, 2009. Available at http://news.bbc. Sharing our Message co.uk/1/hi/health/7934568.stm. Accessed March 11, • Over 700,000 2009. 3. Childs D. Prince Charles’ herbal products stir contro- distributors worldwide versy. ABCNews.com. March 13, 2009. Available at: http://abcnews.go.com/Health/WellnessNews/ story?id=7071267&page=1. Accessed March 16, 2009. 4. Starling S. Can the EU traditional herbal medicines directive be amended? NutraIngredients.com Europe. November 20, 2008. Available at: http://www.nutraingredients.com/Regulation/Can-the-EU-traditional- Let the Sunshine in. herbal-medicines-directive-be-amended. Accessed www.NaturesSunshine.com February 9, 2009. www.herbalgram.org 2009 HerbalGram 83 | 23 World News

Egyptian Herbal Wine: A 5,000-Year-Old Vintage Researchers from the University of Pennsylvania have found evidence of wine dating back to 3150 BCE (5,100 years ago) that may have been used for medicinal purposes.1,2 In one of the 700 jars buried with Scorpion I—also known as the Scorpion King, one of the first Egyptian pharaohs—was a jar with a residue that experts chemically analyzed and identified as wine.3

The new research was published which has not yet been fully iden- online in April 2009 in the pres- tified. tigious journal Proceedings of the “There were a lot of additives National Academy of Sciences.1,2 in [the Abydos sample] wine, According to this paper, the and it fits very well with the later wine residue, called the Abydos Egyptian pharmacology texts, the sample, possibly contains tree resin medical papyri that describe simi- (perhaps from pine [Pinus spp., lar kinds of alcoholic beverages Pinaceae] as a preservative), mint with herbs in them,” said Patrick (Mentha spp., Lamiaceae), corian- McGovern, PhD, according to an der (Coriandrum spp., Apiaceae), article by the Associated Press.4 “So savory (Satureja spp., Lamiaceae), the assumption is that, although senna (Senna spp., Fabaceae), balm we’re 1500 years before the earli- (Melissa spp., Lamiaceae), thyme est medical papyrus, in fact we’re (Thymus spp., Lamiaceae) and sage looking at medicinal wine.” Dr. (Salvia spp., Lamiaceae).1 However, McGovern is the lead author of further testing is needed to estab- the study and senior research scien- lish the exact ingredients. tist and adjunct associate professor Another residue sample from a for the Museum Applied Science different tomb was also analyzed Center for Archaeology (MASCA) by the researchers and found to be within the University of Pennsylva- wine. This wine sample, called the nia Museum. Gebel Adda sample—taken from Osama Kandil, PhD, chairman the tomb of Gebel Adda and dated and CEO of Biopharm Group Inter- approximately 3,500 years after national and an expert on Egyptian the Abydos sample—is thought to herbs, said he also believes that the contain only pine resin, rosemary wine was created for medicinal (Rosmarinus officinalis, Lamiaceae), purposes (e-mail, May 18, 2009). and a member of the mint family, Dr. Kandil noted that Egyptians

Right photo: The inside of this wine vessel shard contains a yellowish residue, the accumulation of organic materials from the upper surface of the wine that once filled the inside of jar no. 50 from the tomb of Scorpion I at Abydos (Egypt), ca. 3150 B.C.E. The residue, forming a circle around the vessel’s interior, is slanted off from the horizontal because the jar with its liquid was tilted in antiquity. Analyses showed that herbs including balm, coriander, mint, sage and many more were steeped in the wine, to which pine resin and fig were also added. Photo courtesy of German Archaeological Institute in Above photo: Amphora containing wine residues laced with rose- Cairo. mary and pine resin, from tomb 217 of cemetery 4 at Gebel Adda (Egypt), dated to early Byzantine times (4th-early 6th c. CE). With permission of the Royal Ontario Museum © ROM; photograph courtesy of W. Pratt.

24 | HerbalGram 83 2009 www.herbalgram.org World News have a history of using medicinal plants, and other medicinal This information can be useful for a variety of reasons: “We’re herbs have been found in Egyptian tombs, such as the discovery of trying to rediscover why ancient people thought these particular black seed (Nigella sativa, Ranunculaceae) in King Tutankhamun’s herbs were medically useful and seeing if they are effective for the tomb. Therefore, these new discoveries add to evidence that medic- treatment of cancer or other modern diseases,” Dr. McGovern told inal wine and medicinal herbs were fairly common in Egypt. National Geographic.5 Dr. Kandil added that, although he believes that medicinal wine isn’t common today (Egypt is a predominantly Muslim country —Kelly Saxton Lindner and intake of alcohol is forbidden in Islam), this may not remain the case: “They may become more common because of this article References if it is developed commercially by a company in the functional 1. McGovern P, Mirzoian A, Hall G. Ancient Egyptian herbal wines. Proceed- ings of the National Academy of Sciences. beverage segment that is thinking of being a pioneer,” said Dr. 2009;106(18):7361–7366. 2. 5,100 year old chemical evidence for ancient medicinal remedies—discov- Kandil. ered in ancient Egyptian wine jars [press release]. Philadelphia, PA: Univer- Currently, the co-authors of the study are collaborating with sity of Pennsylvania Museum; April 14, 2009. Penn Medicine’s Abramson Cancer Center to reconstruct the 3. Viegas J. Herbal wines healed ancient Egyptians. Discovery News. April ancient medicinal wine recipes, hoping to utilize their possible 14, 2009. Available at: http://dsc.dicoverycom/news/2009/04/14/egyptian- health benefits.5 wine-print.html. Accessed April 15, 2009. According to Dr. Kandil, possible health benefits for the discov- 4. Todt R. Study: herbs added to 5,100-year-old Egyptian wine. Associate ered wines include antimicrobial effects from thyme and rose- Press. April 13, 2009. Available at: http://www.ldnews.com/news/ci_ mary, in addition to antioxidant benefits from rosemary through 12133696. Accessed April 14, 2009. 5. Handwerk B. Scorpion King’s wines—Egypt’s Oldest—spiked with meds. its rosmarinic acid. “Mint could have provided a calming effect on National Geographic News. April 13, 2009. Available at: http://news. the digestive system,” said Dr. Kandil. “Senna provides laxative nationalgeographic.com/news/2009/04/090413-scorpion-king-wine.html. benefits. Coriander is an antimicrobial agent.” Accessed April 28, 2009.

Below photo: A selection of wine jars from Scorpion I’s tomb at Abydos, laid out on the desert sand. Photograph courtesy of German Institute of Archaeology, Cairo.

www.herbalgram.org 2009 HerbalGram 83 | 25 World News

WHO Congress Passes Beijing Declaration on Traditional Medicine In November 2008, attendees at the first-ever World Health Organization (WHO) Congress on Traditional Medicine adopted the Beijing Declaration. Heralded as the most significant outcome of the Congress, the Declaration promotes the safe and effective use of traditional medicine (TM), while guiding and supporting its integration into national healthcare systems around the world.1

“The Declaration may be World Health Organization’s most 2008;2 significant initiative on traditional medicine to date,” said Ryan • establish systems for the qualification, accreditation, or Abbott, a researcher at the University of California at Los Ange- licensing of TM practitioners; les (UCLA) Center for East–West Medicine, who attended the • strengthen communication between conventional medicine Congress as a member of the WHO Secretariat and is a former and TM providers and establish training programs for health member of WHO’s TM team (oral communication, May 8, professionals, medical students, and researchers. 2009). “More than ever now, many countries are promoting progressive policies towards alternative medicine. I don’t think Six months after the Beijing Declaration was adopted, a reso- you would have seen something like the Declaration 10 years lution on TM was passed by the 62nd World Health Assembly ago.” (WHA), the supreme decision-making body for WHO.3 The The Declaration suggests for the governments of WHO resolution is heavily based on the Beijing Declaration, acknowl- Member States to do the following:1 edges the Declaration in its text, and calls for Member States to • respect, preserve, promote, and communicate TM; consider adopting and implementing the Declaration in accor- • create national policies, regulations, and standards within dance with their own national capacities, priorities, relevant national health systems to ensure safe and effective use of legislation, and circumstances, said Xiaorui Zhang, MD, the TM; coordinator of WHO’s TM Program (oral communication, June • integrate TM into national health systems; 8, 2009). • further develop TM based on the “Global Strategy and Plan “Since the resolution was adopted by all Member States during of Action on Public Health, Innovation, and Intellectual the WHO Health Assembly in May 2009, it is more powerful Property,” adopted at the 61st World Health Assembly in than the Declaration, which was agreed upon by the representatives of 74 countries,” Dr. Zhang added. WHO has a 3-decade history with TM, including the historic 1978 Alma-Ata Declaration, which was the organization’s first recognition of TM’s importance and how it affects primary healthcare.4 WHO has claimed that up to 70-80% of the population in developed and developing countries have used TM or complementary and alternative medicine (CAM).5 The organization has also published various guidelines and monographs concerning quality, safety, and efficacy of medicinal plants and herbal preparations.6,7 Still, the Beijing Declaration stands out among other components of WHO’s TM history, said Gerry Bodeker, EdD, a senior clinical lecturer in public health at Oxford University, chair of the ExpErtisE Oxford-based Global Initiative For Traditional Systems (GIFTS) of Health, and co-editor of the 2005 WHO Global Atlas of Tradi- ExpEriEncE tional, Complementary and Alternative Medicine (e-mail, June 2, 2009). The 2008 Beijing Declaration advances the most compre- ExcEllEncE hensive set of policy recommendations that go beyond the clinical emphasis of previous positions, he said. n n Loose Herbs Bulk and Bag Teas In order for the Declaration’s policies and practices to become n n Antioxidants Beauty Care entrenched and endure, further actions are needed, such as the n n Essential Oils Herbal Supplements regulation of TM practices and practitioners, adequate financ- n Liquid Extracts n Private Label ing, and TM economic research, said Dr. Bodeker. Though FREE CATALOG WHO has great influence, it does not have authoritative powers, requiring any outcomes of the Declaration to result from a range Indiana Botanic Gardens, Inc® Since 1910 of actions from governments, non-governmental organizations, b b 3401 West 37th Avenue, Hobart, IN 46342 TM practitioners and associations, and international networks, Tel: 800-644-8327 Fax: 219-947-4148 he added. www.BotanicChoice.com “Ultimately, the ball is back in the court of national govern- HG-1 (Code: HG9XX) ments to make the big decisions to mainstream and fast track—or

herb26 gram | HerbalGram ad.indd 1 83 6/29/2009 12:45:37 PM2009 www.herbalgram.org World News

not—traditional medicine and integrative healthcare,” said Dr. at WHO, said UCLA’s Abbott. Abbott added that he expects it Bodeker. “What is certain is that the Declaration urges those might take years before WHO would require member countries governments that are lagging in their development of this field to to commit themselves to certain activities. move ahead to catch up with the rest of the world.” “This may be the first step to something like a legally-binding Some nations are taking the initiative to proceed. On April 21, agreement.” 2009, the State Council of China released its “Guidance to Sup- A compulsory agreement would call for great motivation and port and Promote the Development of Traditional Chinese Medi- initiative from Member States, and as far as he knows, there cine (TCM),” which requests that TCM services be included in is no push for such a commitment, said Abbott. Part of this is all levels of health services due to complicated issues, and covered by all kinds such as TM regulation, of health insurance.8 The “The Declaration may be World groups’ rights to protect State Council also requested their natural resources, and that the country’s TCM Health Organization’s most intellectual property rights, pharmaceutical indus- on which developed and try be improved and that underdeveloped countries all levels of local govern- significant initiative on traditional tend to disagree, he contin- ment increase investment ued.10 in TCM public hospitals medicine to date” Future promotion of TM and support research and by WHO, however, will training of TCM doctors, have to come about under said Zhu Haidong, who works in the Department of Interna- new leadership. Dr. Zhang, who has been the leader of WHO’s tional Cooperation of State Administration of TCM (e-mail, June TM program for nearly 20 years, will soon retire. Dr. Zhang 11, 2009). maintains her strong belief in TM and the importance of an inte- Other entities have not necessarily changed their actions as a grative relationship between TM and Western medicine. direct response to the Declaration but are continuing with TM- “I was a ‘barefoot doctor’ in a rural area for 5 years. I used herbs related programs already in place or being planned. The Japan- and acupuncture on the patients and I’ve seen it work,” Dr. Zhang based Nippon Foundation, for example, is an important partner said. “I have big hopes for traditional medicine because the people of WHO’s TM department and has several TM-related projects need it and it works. We need to do more research on its safety, underway, such as its collaboration with governments of countries efficacy, and quality to ensure that the patient benefits.” like Myanmar and Thailand to distribute TM kits.9 Nippon’s future projects include a 5-year collaboration with the Associa- —Lindsay Stafford tion of Southeast Asian Nations (ASEAN) Secretariat for the promotion of TM throughout the region, as well as the creation References of curriculum and funding for Cambodia’s first TM school. 1. Beijing Declaration. World Health Organization Web site. Available “The Declaration itself does not affect our projects,” said at: http://www.who.int/medicines/areas/traditional/congress/beijing_ Tatsuki Nakajima, who oversees Nippon’s TM program (e-mail, declaration/en/index.html. Accessed April 29, 2009. 2. World Health Organization. Sixty-first World Health Assembly. May 11, 2009). “Instead, the Declaration could prove to be Global strategy and plan of action on public health, innovation and intel- the meaning of our projects.” lectual property. WHA 61.21. Agenda Item 11.6. May 24, 2008. Additionally, for the African Region of WHO, which is mid- 3. World Health Organization. Sixty-second World Health Assembly. way through the African Decade for the Development of Tradi- Traditional Medicine. WHA 62.13. Agenda Item 12.4. May 22, 2009. tional Medicine, the Beijing Declaration further reinforces their 4. Background of WHO Congress on Traditional Medicine. World commitment to make TM a priority within the context of ratio- Health Organization Web site. Available at: http://www.who.int/ nal use, safety, and professional development, said Dr. Bodeker. medicines/areas/traditional/congress/congress_background_info/en/ The National Center for Complementary and Alternative index.html. Accessed April 29, 2009. 5. Traditional Medicine. World Health Organization Web site. Avail- Medicine (NCCAM), a division of the National Institutes of able at: www.who.int/mediacentre/factsheets/fs134/en/index.html. Health in the United States and a WHO collaborating center for Accessed July 6, 2009. TM, also feels that its projects are in accordance with the Decla- 6. Akerele O. Summary of WHO guidelines for the assessment of herbal ration. Jack Killen, Jr., MD, deputy director of NCCAM, noted medicines. HerbalGram. 1994;28:13. that the Declaration calls for research to develop an evidence base 7. Blumenthal M. Herbal monographs. HerbalGram. 1997;40;30. for complementary, alternative, and traditional medicine (e-mail, 8. China introduces traditional medicine into basic healthcare program. May 22, 2009). Xinhua News Agency. May 7, 2009. Available at: http://news.xinhua- “In this regard, the Declaration is entirely consistent with the net.com/english/2009-05/07/content_11332281.htm. Accessed May 11, 2009. existing mission, programs, and operations of NCCAM,” said 9. Sasakawa Y. World Congress speech. Lecture presented at: World Dr. Killen, adding that NCCAM’s research informs policy and Health Organization Congress on Traditional Medicine; November healthcare coverage decisions made by governmental and corpo- 7–9, 2008; Beijing, China. rate entities. 10. Abbott R. The Beijing Declaration: A landmark for traditional Though the Declaration is an advocacy document and cannot medicine. Bridges. International Centre for Trade and Sustainable require countries to act, it will influence future TM negotiations Development. 13(1); March 2009. www.herbalgram.org 2009 HerbalGram 83 | 27 Conservation

EXTRACTS OF CITES Plants Committee Meeting – QUALITY Report from Buenos Aires

TM AHPA Continues its Involvement in CITES Policy Development ORAC 15,000 Michael McGuffin, president of the American Herbal Products Association (AHPA), attended the 18th meeting of the Plants Committee of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) in Buenos Aires, Argentina from March 16-22, 2009. His account of that meeting was published in the May 2009 issue of the AHPA Report, and a slightly edited version of the article is reprinted below. Background on CITES have been meeting over the past several The Convention on International Trade years to consider whether to expand the use Patent Pending in Endangered Species of Wild Fauna and of an exemption from CITES trade controls Deﬁ ned Flora (CITES) is an international agree- for finished products that contain certain Antioxidant Power ment that originated in 1975 and currently Appendix II-listed species. The precedent involves 175 countries. Specific requirements for this exemption was established when have been established for international trade the introduction of the cancer drug Taxol® in plant and animal species that are listed (paclitaxel) led to the listing in 1995 of Bilberry by CITES, and these requirements differ Taxus wallichiana (Taxaceae) with an annotation to except “finished pharmaceutical for each of 3 defined CITES Appendices. 1 Appendix I includes all species threatened products.” CITES subsequently considered with extinction that are or may be affected extending this exemption to other plants by trade; Appendix II includes species that traditionally used as medicines, at which may not be currently threatened with extinc- time AHPA requested that it be acknowl- tion but could become so unless trade in edged that these plants are not marketed those species is subject to strict regulation; as medicines in many countries. AHPA’s and Appendix III includes species that any request was accepted and this annotation

EuroBilberryTM party regulates within its jurisdiction to has now been modified to exempt “finished 25% Anthocyanins prevent or restrict exploitation and needs products packaged and ready for retail cooperation of other parties to control such trade” and extended to several other plant trade. species identified by CITES as “medicinal” A number of AHPA’s members market (i.e., Adonis vernalis, Ranunculaceae; Guaia- Ginkgo products that contain as ingredients plant, cum spp., Fabaceae; Hydrastis canadensis, and in some cases animal, species that are Ranunculaceae; Nardostachys grandiflora, listed on one of the Appendices maintained Valerianaceae; Panax ginseng, Araliaceae; by CITES. AHPA and its members (as P. quinquefolius; Picrorhiza kurrooa, well as other parties involved in the trade Scrophulariaceae; Podophyllum hexan- of botanical materials) therefore have an drum, Berberidaceae; Rauvolfia serpentina, Apocynaceae; Taxus chinensis, Taxaceae; T. interest in CITES and need to understand 2 the processes and practices that must be fauna; T. cuspidata; and T. sumatrana). followed to be in conformity with CITES The focus of the most recent working Premium when importing and exporting CITES- group has been to consider whether the USP and Low Acid listed species. annotation is also appropriate for 3 other species: Cibotium barometz (Scythian lamb Issues before the 18th Meeting of the or jin mao gou ji, Dicksoniaceae), Cistanche TM NATURE VERIFIED BY SCIENCE CITES Plants Committee deserticola (desert broomrape or rou cong The CITES Plants Committee covers rong, Orobanchaceae) stem, and Dionaea many topics at each of its meetings and muscipula (Venus’ fly trap, Droseraceae). usually addresses several issues with direct The guiding principle for considering this relevance for marketers of herbal products finished product exemption was articulated that contain plants listed by CITES. At the at CITES’ 2004 Conference of the Parties Buenos Aires meeting these included the (CoP13), at which the Plants Commit- following subjects: tee was instructed to develop annotations that “focus on those commodities that first Annotations on Exclusion of Finished appear in international trade as exports Products from range States and on those that domi- www.ethicalnaturals.com Working groups of the Plants Committee nate the trade and the demand for the wild 866-459-4454 resource.”3 Based on a report from China [email protected] (on which AHPA has served as a member) 28 | HerbalGram 83 2009 www.herbalgram.org Conservation

(a range state for Cibotium barometz and of international trade in finished products Cistanche deserticola) that most specimens containing candelilla wax. Thus, Germany EXTRACTS OF exported from China are in the form of submitted a trade survey in which it stated QUALITY finished products, the Plants Committee that application of the finished product accepted the working group’s recommenda- annotation “will not be harmful and there- tion against applying the finished product fore could be supported.”5 Mexico also PolyPhlor 70TM annotation to these species. And because submitted a document that described the of the low volume of international trade in collection and processing of candelilla wax D. muscipula, the committee also recom- and clarified that it is the wax itself that is mended that the annotation should not the article of export.6 And AHPA provided apply to this species.4 These recommen- a document to suggest that finished product dations will be reported to the next CoP, exemptions be considered for plants that are scheduled for 2010. not defined by CITES as medicinal and that exemptions also be considered for finished Import Controls on International products that are not yet packaged.7 Trade in Lipstick with CITES-listed After considerable discussion in working 40% Phloridzin Ingredients groups and in the full committee’s plenary 30% Polyphenols The above report would thus have sessions, it was agreed that “finished prod- concluded that the working group assigned ucts of E. antisyphilitica packaged and ready TM itself a task which, after numerous e-mails for retail trade” should be exempted from ResVinol-25 and discussions to consider input provided CITES controls.4 This decision will be by the range states of these 3 species, resulted presented to the 2010 CoP and, if adopted, in recommendations by the Plants Commit- would come into effect 90 days later. It is yet tee to do nothing. But enterprising inspec- to be seen whether the cosmetic companies tors in Germany and Switzerland threw a that use candelilla wax will exhibit patience wrinkle in the Plants Committee’s consid- for this process to be completed or whether eration of finished products exemptions by they will find a replacement ingredient that initiating enforcement policies late last year will result in a loss of income in northern for imported lipstick and other cosmetics Mexico at a time when other employment containing less than a milligram of candel- options there are rare or unattractive. Resveratrol-plus illa wax to comply with all relevant CITES import and export requirements. Review of Significant Trade in Euphorbia antisyphilitica Medicinal Plants (Euphorbiaceae)—the source of this natu- CITES includes as one of its processes an Milk Thistle ral wax—has been on CITES Appendix II opportunity “to review the biological, trade since 1975. Its range states are limited to and other relevant information on Appen- the United States and Mexico, and commer- dix-II species subject to significant levels cial production of the wax occurs only of trade, to identify problems and solutions in Mexico. The species has never been concerning the implementation of Article annotated to exclude finished products, but IV, paragraphs 2 (a), 3 and 6 (a).”8 The until the recent European actions, finished cited paragraphs are related to the require- cosmetics that contain candelilla wax have ments for the exporting country to certify not been subjected to enforcement. The that export “will not be detrimental” to the emergence of this new policy has been quite species’ survival (paragraph 2 (a)), and to Acetone-free disruptive to several international cosmetic monitor permit issuance and actual exports companies and has threatened to undermine and to propose quantitative harvest limits if TM Mexico’s commercial operations as their needed (paragraph 3); paragraph 6 (a) is rele- NATURE VERIFIED BY SCIENCE cosmetic customers consider short- and long- vant just to articles introduced from the sea. term responses. At its 12th meeting in 2002, the Plants CITES’ processes are consultative in Committee selected several species for review, nature and generally rely on informed and including Prunus africana (pygeum, syn. thorough consideration of extensive back- Pygeum africanum, Rosaceae). This review ground information about any topic under is ongoing, and it has included a decision review. This sort of process is not designed by the Committee to categorize harvest of to respond to issues in which a need for this species as of “urgent concern” in several immediate decisions is presented. But it of its range states (i.e., Burundi, Cameroon, became quite clear at the Plants Commit- Democratic Republic of the Congo, Equato- tee meeting that something needed to be rial Guinea, Kenya, Madagascar, and United www.ethicalnaturals.com done—and quickly—to address the issue Republic of Tanzania).9 Each of these coun- 866-459-4454 [email protected] www.herbalgram.org 2009 HerbalGram 83 | 29 Conservation tries has now either voluntarily set a zero export quota or has been on regular monitoring is an important consideration in the NDF identified in a notification from the CITES Secretariat recommending evaluation process. suspension of trade in P. africana from these countries.10 This review • “The NDF is based on resource assessment methodologies. has included an extensive evaluation of harvest of the species on Bioko • “The NDF employs appropriate broad-scale assessment, such as Island (in Equatorial Guinea),11 at a cost of about €60,000 (in 2004), total harvest assessments.” which was contributed by Spain. The chair of the Plants Committee and observers from Germany and Mexico were recorded as describing In addition, each working group recommended that an NDF- the project as “a good example of how to make sound non-detriment specific resolution be considered at the next CoP and that such resolu- findings for a species included in Appendix II,” and noting that it tion recommend that Parties to CITES consider the above principles “could be used as a model.”9 in making non-detriment findings, as well as consider other guidance The significant trade review process has also been extended to other contained in the several reports submitted by the various working plants used medicinally. In a document submitted at the 15th meet- groups. ing of the Plants Committee in 2005, Germany expressed concern that “action to address gaps in CITES implementation” in regard to a Conclusions variety of Asian medicinal plants had been “limited.”12 The Commit- As should be apparent, either from this report or from the experi- tee has, at each of its subsequent meetings, revisited this topic and has ences that individual companies have already gained, the listing on included 4 species in the review of significant trade: Cistanche deserti- a CITES Appendix of any plant used in a commercialized product cola; Pterocarpus santalinus (red saunders, red sandalwood, Fabaceae); has ramifications for manufacturers and marketers of such products. Rauvolfia serpentina (Indian snakeroot, Apocynaceae); and Taxus Although CITES processes can move quite slowly, it may also be inevi- wallichiana. In addition, a decision was adopted at CoP14 to direct table that regulatory controls associated with any CITES-listed species range states, the representative of Asia, and the CITES Secretariat to will move only in the direction of more stringency. To date some of the “ensure implementation of regionally coordinated actions” to improve wealthier Parties to the Convention have shown a willingness to bear management of and prevent illegal trade in these and 3 other species: expenses related to developing models for implementation of CITES Dioscorea deltoidea (Dioscoreaceae); Nardostachys grandiflora; and policies, but industry cannot assume that these expenses will always be Picrorhiza kurrooa. The CoP14 decision also requested submission of covered by others, even as the models become more complex. All that progress reports at the next 2 scheduled Plants Committee meetings.13 may be certain is that AHPA members (and non-member companies A progress report submitted at the Buenos Aires meeting of the Plants engaged in the trade of botanical products) should maintain attention Committee noted that very little progress has been made to date on on this long-established international agreement, and that AHPA itself review of these species.13 must continue to serve an active role as an observer to meetings of the Plants Committee and to Conferences of the Parties. Development of Standards for Determination of Non-detriment Findings —Michael McGuffin A central tenet of CITES is the requirement for range states of any Appendix II-listed species to issue an export certificate for each References 1. Amendments to Appendices I and II of the Convention. Adopted November 1994. exported quantity advising that such export “will not be detrimental to Available at: http://www.cites.org/eng/cop/09/E9-Amend-to-AppI-II.pdf. 14 the survival of that species.” In the decades in which CITES has been 2. Notification to the Parties. July 26, 2007. Available at: http://www.cites.org/eng/ in place, however, there has not been any standard approach estab- notif/2007/E022.pdf. lished for determination of such “non-detriment findings” (NDFs). 3. CoP13 Doc. 58: Annotations for medicinal plants in the Appendices. October 2004. Available at: http://www.cites.org/eng/cop/13/doc/E13-58.pdf. The Plants Committee has therefore developed an interest in estab- 4. PC18 WG4 Doc. 1: Cactaceae and Orchidaceae: Merging and amendment of Annota- lishing some standards to ensure consistency in making these essential tions #1 and #4; and Tree species: Annotations for species included in Appendices II determinations. and III. March 2009. Available at: http://www.cites.org/common/com/PC/18/wg/E- Numerous reports were addressed to this topic at the Buenos Aires PC18-WG04.pdf. 5. PC18 Inf. 6: Trade survey study on succulent Euphorbia species protected by CITES meeting, and several working groups took on the issue (one as a follow- and used as cosmetic, food and medicine, with special focus on candelilla wax. March up to an International Expert Workshop on NDFs held in Mexico last 2009. Available at: http://www.cites.org/common/com/PC/18/X-PC18-Inf06.pdf. November; one on Timber Species and Prunus africana; one on Agar- 6. PC18 Inf. 10: Evaluación de estatus de Euphorbia antisyphilitica en México dentro de wood-producing Species (Aquilaria malaccensis, Thymelaeaceae); and los apéndices de la CITES. March 2009. Available at: http://www.cites.org/common/ com/PC/18/X-PC18-Inf10.pdf. one on Medicinal Plants, in which AHPA was included). A common 7. PC18 Inf. 17: International commerce and annotation for finished products containing theme was established among the various groups, such that each iden- candelilla wax derived from Euphorbia antisyphilitica. March 2009. Available at: http:// tified “generic principles applicable to the NDF process in CITES www.cites.org/common/com/PC/18/X-PC18-Inf17.pdf. regardless of the taxa being considered,” and including: 8. Conf. 12.8 (Rev. CoP13): Review of significant trade in specimens of Appendix-II species. Available at: http://www.cites.org/eng/res/12/12-08R13.shtml#FN0. • “The non-detriment finding (NDF) for Appendix I and II species 9. CITES Summary Record, Sixteenth Meeting of the Plants Committee. July 2006. verifies that traded volumes within the range state are not detri- Available at: http://www.cites.org/eng/com/pc/16/E-PC16_summary_record.pdf. mental to the survival of that species. 10.PC18 Doc. 8.3: Overview of the species based review of significant trade. March 2009. • “The NDF considers whether the species is maintained through- Available at: http://www.cites.org/eng/com/pc/18/E-PC18-08-03.pdf. 11.PC16 Doc. 10.2.1: Evaluation of the harvest of Prunus africana bark on the Bioko out its range at a level consistent with its role in the ecosystems in Island (Equatorial Guinea); Guidelines for a management plan. July 2006. which it occurs. 12.PC15 Doc. 10.2.2: Seven Asian medicinal species. May 2005. Available at: http://www. • “The data requirements for an NDF are tailored to appropriate cites.org/eng/com/PC/15/E-PC15-10-02-02.pdf. precision according to the resilience or vulnerability of the target 13.PC18 Doc. 8.5 (Rev. 1): Progress report on seven Asian species of medicinal plants. March 2009. Available at: http://www.cites.org/eng/com/PC/18/E-PC18-08-05.pdf. species. 14.CITES, Text of the Convention, Article IV, paragraph 2 (a). • “The implementation of an adaptive management scheme based

30 | HerbalGram 83 2009 www.herbalgram.org Research Reviews

Survey: Newspapers Under-report Herbal Clinical Trials and Tend to Show Negative Bias Reviewed: Bubela T, Boon H, Caulfield T. Herbal remedy clinical trials in the media: a comparison with the coverage of conventional pharmaceuticals. BMC Complement Altern Med. 2008;6:35. In a recent survey, researchers compared newspaper coverage of trial and the rest on medical conditions, uses for herbs, and/or risks clinical trials on herbal remedies with coverage of clinical trials on of herbs. Errors of omission were common: especially dose, sample conventional pharmaceutical medicines. size, and location and duration of clinical trials. Risks were under- Online database searches from the United Kingdom, United reported, especially for HCTs. However, 29% of articles on HCTs States, Australia/New Zealand, and Canada found 57 herbal vs. 4% on PCTs said the tested remedy had no benefit. Individuals remedy clinical trials (HCTs) referenced in 352 newspaper articles, quoted in articles about all trials were overwhelmingly university published between 1995 and 2005. After coding the HCTs and or hospital scientists or physicians not specializing in CAM; clearly media articles for content, conventional drugs were identified for identified CAM researchers or practitioners were quoted in only 8% each medical condition studied in the HCTs, and the corresponding of articles on HCTs. pharmaceutical clinical trials (PCTs) identified. Since “significantly Newspaper evaluations of PCTs were more likely to be positive or more [PCTs] received press coverage” than HCTs, up to 3 PCTs neutral; those of HCTs, negative—a result not entirely explained by were randomly chosen for each medical condition; 48 PCTs and 201 HCTs’ more frequent negative results. Overall tone was more likely newspaper articles about them were included in the survey. Those to be positive about PCTs. In fact, no article on PCTs was negative PCTs and newspaper articles were overall; 21.9% of those on HCTs similarly coded for content. were negative. This was so even Codes included specifics of clini- though significantly more risks, cal trials as reported in journals, Despite a vast increase primarily adverse effects, were presentation of tested treatments reported for conventional pharma- (i.e., controversial), tone in which in the number of HCTs ceutical drugs. A very large major- outcomes were discussed, and over- ity of newspaper stories failed to all tone. For newspaper articles, mention funding sources, involve- codes included whether and how in recent years, there has ment of funders, or other conflicts involvement of a funding agency of interest for PCTs. For all stories, and/or conflicts of interest were not been a corresponding there was a significant association reported, format in which the story between disease condition studied appeared, and whether the main and the article’s overall tone and claims in the story reflected the increase in newspaper tone of clinical trial assessment. findings reported in the clinical Stories with the most negative over- trials. articles about them. all tone concerned disorders associ- HCTs had similar Jadad scores* ated with diet and obesity, and the for design quality to PCTs, but most negative in assessing clinical most were significantly smaller and of shorter duration. Clinical trials were those featuring trials of the genitourinary system, mental trials covered in newspapers were mostly from Western countries disorders, and infectious diseases. and published in high-ranking journals (the Journal of the American Despite a vast increase in the number of HCTs in recent years, Medical Association, Lancet, New England Journal of Medicine, and there has not been a corresponding increase in newspaper articles British Medical Journal published 57 of the 105 clinical trials). Only about them. The media is not keeping up with the march towards one HCT reported in newspapers appeared in a complementary evidence-based herbal medicine. Results suggest high-profile jour- and alternative medicine (CAM) journal. Most clinical trials took nals publish a significant number of CAM studies with nega- place in public institutions. Two PCTs and 4 HCTs took place in tive results, although a general publications bias towards positive the private sector, but most PCTs (64%) and HCTs (53%) had some results applied to both types of clinical trials. The authors state private funds. Some had other conflicts of interest (46% of PCTs, that current newspapers are not providing the tools for informed 23% of HCTs). Of HCTs, 34% did not specify funding source. health choices. Also, lack of reported conflicts of interest may Of the analyzed stories, from 131 papers in 5 countries, most impact public trust and respect for medical researchers. Solu- reported news (60%), while one-third were features that just tions would include better reporting guidelines and training in happened to include information about a clinical trial. In regards health and science for journalists, training in media skills for clini- to framing, 43% of all articles had no controversial elements, 35% cal researchers, and scientific and media literacy programs for the were presented as balanced (i.e., both sides of a controversy were public that relies upon newspapers for health-related news. presented), and 22% as unbalanced (i.e., only one side of the story was provided). For PCTs, the theme of almost all articles was the —Mariann Garner-Wizard clinical trial itself; for HCTs, 63.6% of stories focused on the clinical

* Jadad scores refers to the system developed by Alex Jadad for evaluating the design quality of clinical trials. A review of a book by Dr. Jadad explaining this system was published in HerbalGram 81. www.herbalgram.org 2009 HerbalGram 83 | 31 Research Reviews

Ivy Leaf Extract Found Safe and Possibly Effective for Bronchitis in Open, Multicenter Study Reviewed: Fazio S, Pouso J, Dolinsky D, et al. Tolerance, safety and efficacy of Hedera helix extract in inflammatory bronchial diseases under clinical practice conditions: a prospective, open, multicenter postmarketing study in 9657 patients. Phytomed. 2009;16(1):17-24.

Ivy (Hedera helix, Araliaceae) leaf with symptoms including the hypersecre- extract has secretolytic and bronchodi- tion of mucus and a productive cough. lating effects linked to its constituent They were recruited at outpatient clinics saponins, notably alpha hederin. Clinical throughout Latin America. All patients trials on ivy extracts have shown safety received Prospan, a syrup containing and efficacy in the treatment of respira- an extract of dried ivy leaves (drug-to- tory illnesses, but their study designs and extract ratio 5-7.5:1, extraction solvent: objectives vary. Since 1988 the German ethanol 30% w/w). The main purported Commission E has approved the use active chemical constituents of Prospan of ivy leaf extracts for “Catarrhs of the are triterpene saponins, including a stan- respiratory passages [and] symptomatic dardized content of 30 mg/g hederaco- treatment of chronic inflammatory bron- side C in the dried leaves used to make chial conditions.”1 This uncontrolled, the extract. For 7 days, the patients multicenter, post-marketing study was received Prospan syrup containing 700 designed to investigate the efficacy and mg ivy extract at the manufacturer’s tolerance of ivy extract (Prospan®; Engel- recommended doses for each age group: hard Arzneimittel GmbH & Co.; Nieder- 2.5 ml/3 times daily for 0-5 years, 5 dorfelden, Germany) in the treatment of ml/3 times daily for 6-12 years, and 5-7.5 bronchitis-related symptoms. ml/3 times daily for those patients over The patients had physician-diag- 12 years of age. The patients’ physicians nosed bronchitis, defined as an acute or filled out a questionnaire on adverse chronic bronchial inflammatory disease effects (AEs), discontinuation of therapy, Ivy Hedera helix Photo ©2009 Steven Foster

32 | HerbalGram 83 2009 www.herbalgram.org Research Reviews and efficacy and tolerance. The research- (n=6). Other reported AEs included skin ers evaluated the overall change in the or other allergies (n=10), anxiety, restless- following symptoms: cough, expectora- ness or tremor (n=5), headache (n=6), and tion, dyspnea (shortness of breath), and drowsiness (n=4). There were 46 patients respiratory chest pain. (0.5%) who discontinued therapy due to The patients (n=9,657) were recruited AEs. A further 1.9% discontinued due to from 11 Latin American countries improvement or disappearance of symp- between January 2003 and November toms, while 0.9% discontinued due to 2004. The predominant populations therapeutic failure. were from Argentina, Mexico, Venezu- After treatment with Prospan syrup, ela, and Peru. The study group included 95.1% of patients (n=9,183, 95% CI: 5,181 children aged 0-14 years and 4,476 94.6-95.5%) experienced improvement or adults aged 15-98 years. The patients disappearance of their symptoms, 3.3% suffered from cough (100%), expectora- (n=318, 95% CI: 2.9-3.7%) experienced tion (74.5%), dyspnea (22.0%), and respi- no change, and 0.6% (n=62, 95% CI: 0.5- ratory-related chest pain (21.9%). The 0.8) reported worsening of their symp- average duration of symptoms was 4 days, toms. The authors judge that the efficacy and the average duration of treatment was of the Prospan syrup alone was compa- 7 days. About 60% of patients received rable to the efficacy of the syrup plus concomitant conventional drugs, includ- prescribed conventional drugs. The rela- ing antibiotics. tive risk (RR) of adverse events was lower In 96.6% of the patients, the tolerance in the group receiving Prospan, compared of Prospan was rated as good or very good to patients taking Prospan plus antibi- (no AEs). For 0.8% of patients, tolerance otics (RR: 1.26, 95% CI: 0.86-1.84). was rated as poor (presence of AEs that Similarly, the RR was lower for patients caused discontinuation of therapy). There taking Prospan alone, when compared were AEs reported by 2.1% of the patients to patients taking concomitant non-anti- (95% CI: 1.8-2.4%), including 112 AEs biotic medication (RR: 2.34, 95% CI: reported in children. The AEs were mild 1.66-3.28). and transient, and most were gastrointes- The results of this study indicate tinal complaints (n=149). They included primarily that Prospan syrup is safe and diarrhea (n=75), abdominal and epigastric is well-tolerated with few AEs when taken pain (n=38), nausea and vomiting (n=26), alone. The authors also conclude that it and dry mouth and thirst is an effective treatment in patients with bronchitis. It should be noted, however, that uncomplicated acute bronchitis generally resolves after 3-5 days, and the average duration of treatment in this study was 7 days. Thus, it is possible that the amelioration of symptoms that have been attributed to the action of the ivy leaf extract may be due to the time period at which the results were measured. The authors recommend further studies in order to determine the effects of Prospan in special patient groups, as well as in patients from different age groups, those taking concomitant therapies, and those with different baseline conditions.

—Marissa Oppel, MS

Reference 1. Blumenthal M, Busse W, Goldberg A, Gruenwald J, Hall T, Riggins CW , Klein S, Rister RS, trans. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin, TX: American Botanical Council;1998. www.herbalgram.org 2009 HerbalGram 83 | 33 Research Reviews

Pilot Study Finds Low-Hyperforin St. John’s Wort Extract Does Not Interact with Oral Contraceptive Reviewed: Will-Shahab L, Bauer S, Kunter U, Roots I, Brattström A. St. John’s wort extract (Ze 117) does not alter the pharmacokinetics of a low-dose oral contraceptive. Eur J Clin Pharmacol. 2009;65(3):287-294. St. John’s wort (SJW, Hypericum perforatum, Clusiaceae) is Germany) for at least 3 months were enrolled in the trial. Lovelle widely used in the treatment of mild to moderate depression. Previ- contains 0.02 mg ethinylestradiol and 0.15 mg desogestrel per ous studies have demonstrated that SJW interferes with the metab- tablet. The women were instructed to take 1 tablet of SJW twice olism of certain drugs when they are taken at the same time. SJW daily for 14 days (day 7 through day 21 of the Lovelle cycle). Each formulations can vary considerably in composition and dosage, and tablet contained 250 mg of Ze 117 extract, which is prepared using this variability may produce different effects on drug-metabolizing a 50% ethanol extraction and is standardized to 0.2% hypericin enzymes. SJW may interact with hormones found in oral contra- and less than 0.2% hyperforin. The daily dose of hypericin was ceptives, and this interaction could diminish the effectiveness of about 1 mg and the daily dose of hyperforin was less than 1 mg. the contraceptives. The purpose of this study was to investigate the Blood concentrations of hypericin were measured after taking effects of SJW extract Ze 117 (Zeller AG; Romanshorn, Switzer- Ze 117 for 7 days and 14 days to assess compliance with the tablets. land)—standardized to contain a low content of hyperforin—on Urine samples were collected before and after taking Ze 117 to the pharmacokinetics of 2 hormones after the administration of assess the effects of Ze 117 on the cytochrome P450 drug-metabo- oral contraceptives. lizing enzymes (CYP2D6, CYP2C19, and CYP3A4). The subjects The open-label, uncontrolled pilot trial was conducted at the were hospitalized for a 24-hour period before starting Ze 117 and University Medical Centre Benjamin Franklin, Free University after taking Ze 117 for 14 days. Blood samples were collected from of Berlin, Germany. Sixteen healthy women who had taken the an intravenous catheter 17 times over the 24-hour period to assess low-dose oral contraceptive Lovelle® (Organon; Oberschleissheim, the pharmacokinetics of ethinylestradiol and 3-ketodesogestrel. The average age of the subjects was 31.8 years, and all 16 subjects completed the study. No adverse events were reported, and none of the women experienced spotting or break-through bleeding during the trial. Blood concentrations of hypericin revealed that all subjects were compliant with the Ze 117 tablets. The ethinylestradiol and 3-ketodesogestrel pharmacokinetic parameters of area under the concentration time curve, maximum peak concentration, and peak time did not change significantly after 14 days of Ze 117 treatment, nor did Ze 117 influence the activity of the 3 cytochrome P450 enzymes. This is consistent with other studies of Ze 117 suggesting a lack of interaction with the immunosuppres- sant drug cyclosporin, the anti-anxiety drug alprazolam (Xanax®, Pfizer), or the cardiac medication digoxin. The authors conclude that SJW extracts with reduced hyperforin content, such as Ze 117, are less likely to interact with the hormones in oral contraceptives. The authors explain that previous studies suggesting an interaction between SJW and oral contraceptives used higher doses and methanolic extracts, leading to much higher intakes of hypericin and hyperforin. The authors suggest that results of this and other studies demonstrate that the known drug interactions of SJW are primarily due to the level of hyperforin content, and that use of reduced-hyperforin preparations may lower the risk of serious herb-drug interactions. Clinical trials have shown that Ze 117 appears to be as efficacious as other preparations of SJW at the same dose of 500mg/day, and some literature suggests that hyperforin is not necessary for the antidepressant effect of this herb. It is unclear if doses of Ze 117 larger than 500 mg per day might induce interactions with oral contraceptives and other drugs.

—Heather S. Oliff, PhD

34 | HerbalGram 83 2009 www.herbalgram.org Research Reviews

Herbal Formula with Butterbur Root Extract Improves Psychological Outcomes in Psychosomatic Disorders Reviewed: Melzer J, Schrader E, Brattström A, Schellenberg R, Saller R. Fixed herbal drug combination with and without butterbur (Ze 185) for the treatment of patients with somatoform disorders: randomized, placebo-controlled pharmaco-clinical trial. Phytother Res. March 9, 2009; [Epub ahead of print].

Somatoform disorders, also (P = 0.007) butterbur extract, known as psychosomatic disor- compared with placebo. Ze 185 ders, are a group of disorders with butterbur was significantly in which physical symptoms more effective than Ze 185 cannot be explained by a physi- without butterbur at improving cal disorder but are rather caused anxiety (P = 0.024) and depres- by psychological factors. Exam- sion (P = 0.012). More patients ples of somatoform disorders are using Ze 185 with butterbur body dysmorphic (malforma- reported complete and marked tion) disorder, conversion disor- improvement (49%) and der, hypochondriasis, and soma- reported that they would use tization disorder. Herbal prepa- the treatment again (73%) rations such as valerian (Vale- compared with patients using riana officinalis, Valerianaceae) Ze 185 without butterbur (14% root, passionflower (Passiflora and 67%, respectively) and incarnata, Passifloraceae), and placebo (2% and 24%, respec- lemon balm (Melissa officinalis, tively). No serious adverse side Lamiaceae) leaf are used for their effects occurred. One subject calming and anxiety-reducing treated with Ze 185 without effects. An herbal preparation butterbur had nausea leading to Ze 185 (Relaxane®; Max Zeller discontinuation of the interven- Söhne AG; Switzerland) contains tion that was possibly related extracts of these herbs along with to treatment. Cardiovascular butterbur (Petasites hybridus, and hepatic systems were not Asteraceae) root extract and is affected. used to treat anxiety disorders. The study shows that the The purpose of this study was to inclusion of butterbur signifi- evaluate Ze 185 in a randomized, Butterbur Petasites hybridus Photo ©2009 Steven Foster cantly improves efficacy of Ze placebo-controlled study in somatoform disorders and to evaluate 185 compared to its exclusion. However, it is debatable whether the benefit of butterbur in the product. the primary outcome measures evaluated in this study are appro- Patients (n = 167) with symptoms typical of somatization disor- priate clinical outcome measures. Another limitation is that this der and undifferentiated somatoform disorder according to ICD- study had a very short duration (2 weeks) and long-term efficacy 10 (International Statistical Classification of Diseases and Related was not determined. Typically treatment of somatoform disor- Health Problems - 10th Revision) criteria for at least 6 months ders varies with the type of somatoform disorder. This study did were enrolled from 2 German study centers. For 2 weeks, patients not differentiate the type of somatoform disorder. These limita- received placebo, Ze 185 (1 tablet, 3 times/day), or Ze 185 with- tions should be considered when examining the data. However, out butterbur extract (1 tablet, 3 times/day). One coated tablet of since there is no standard therapy for these types of disorders, this Ze 185 contains the dry extracts of 90 mg butterbur root (content formula offers an herbal pharmacotherapy option that could be of pyrrolizidine alkaloids below detection limit of 35 parts per incorporated into the clinical approach until a more specific treat- billion), 90 mg valerian root, 90 mg passionflower herb, and 60 mg ment is established. lemon balm leaf. Depression and anxiety, the most common symp- Extracts of the butterbur plant are proving to be versatile toms associated with somatoform disorders and typically used to phytomedicines. A different butter root extract, Petadolex®, made monitor treatment efficacy in clinical trials, were rated by Beck’s by Weber & Weber International GmbH & Co. KG, Germany, Depression Inventory and a visual analogue scale, respectively. has been shown to be safe and effective in treating migraine head- They served as the primary outcome parameters in this study. aches. Zeller, the Swiss manufacturer of the formula tested in this Clinical global impression was a secondary parameter. clinical trial, also produces an extract of butterbur leaf, which has At baseline, the groups were similar. At study’s end, compared been shown in published clinical trials to safely and effectively with placebo, Ze 185 with (P ≤ 0.0001) and without butterbur treat seasonal allergic rhinitis. extract (P ≤ 0.019) were significantly more effective at improving depression. Similarly, improvements in anxiety occurred —Heather S. Oliff, PhD with the herbal extract formulas with (P = 0.001) and without www.herbalgram.org 2009 HerbalGram 83 | 35 Research Reviews

Lemon Juice and Lemongrass Infusion Beneficial for Treating Oral Thrush in HIV/AIDS Patients Reviewed: Wright SC, Maree JE, Sibanyoni M. Treatment of oral thrush in HIV/AIDS patients with lemon juice and lemon grass (Cymbopogon citratus) and gentian violet. Phytomed. 2009;16:118-124. Oral thrush is an overgrowth of Candida albicans, a normal the mix was swished in the mouth and spit out; the remaining mix organism in the gastrointestinal tract and mouth. It commonly was kept in the mouth in the affected area for as long as possible occurs in people who are immunosuppressed, especially those with and then swallowed. Two to 3 drops of pure lemon juice 3 times/ HIV/AIDS. In severe cases of oral thrush, the person has difficulty day were then used for the next 10 days or until clinical cure; (3) swallowing, which limits the ability to consume nutritious meals 12.5 mL dried lemongrass was infused in 500 mL boiling water and take oral medicines. for 10 minutes and then cooled. On day 1, 125 mL of infusion was Sub-Saharan Africa has the highest number of people living with consumed, then at least 250 mL was consumed 2 times/day for 10 AIDS. First-line primary care treatment for oral thrush in such days. A fresh infusion was made every 24 hours. patients is gentian violet 0.5% solution, which is applied to the The maximum treatment period was 10 days. Patients could with- inside of the mouth 3 times a day. The problem with this treatment draw from the study if there was no improvement after 2 consecu- is that it must be applied at a clinic, which requires that the person tive days of treatment, if pain or difficulty swallowing increased be healthy enough for travel and that funds are available for trans- compared to day 1, or if the patient found any adverse effects unac- portation. Plus, gentian stains the mouth purple, which causes the ceptable. Adverse events (AEs) were recorded if patients spontane- person to be stigmatized as having HIV/AIDS. Due to financial ously reported them. constraints, the Moretele Hospice in South Africa routinely treats The 3 groups were similar at baseline, based on age, gender, body oral thrush with lemon (Citrus x limon, Rutaceae) juice applied mass index distribution, days with symptoms, and thrush scale of directly to the mouth or a lemongrass (Cymbopogon citratus, Poaceae) severity. The AEs for the gentian violet group were purple discol- infusion that is made from lemongrass plants grown and dried at oration (a predictable effect), cracked lips, and dry mouth. Many the hospice. According to the authors, the 2 remedies are reported of the 12 patients in the gentian violet group who withdrew did to be highly efficacious and have been used at the hospice since it not want to continue treatment because they were embarrassed opened in 1997. A randomized controlled study was conducted to about the color of their mouths. The lemon juice group reported a compare the efficacy of these natural products to standard first-line changed taste in mouth and abdominal cramps, and 12 withdrew. treatment (gentian). One patient in the lemongrass group had an increased appetite, but Ninety patients with oral thrush were recruited from the HIV/ 6 withdrew. One patient in the gentian violet group and 7 in the AIDS support group at the Moretele Hospice to participate in this lemongrass group were lost to the study due to incomplete docu- randomized, controlled, open-label comparative study. The patients mentation. In the intent-to-treat population, there was no signifi- were randomly assigned to receive 1 of 3 treatment schedules: (1) cant difference in the proportion of patients treated successfully Control treatment of gentian violet aqueous solution 0.5% (brand with gentian violet (n = 30) vs lemon juice (n = 30) or gentian violet not identified) applied topically 3 times/day and continued for 2 vs lemongrass (n = 30). In the participants who completed the trial, days after clinical cure; (2) Lemon juice was squeezed from a fresh those who were clinically cured included 16 using lemon juice (n = lemon and 20 mL of juice was mixed with 10 mL water. Half of 18) and 15 using lemongrass (n = 17), which is significantly more (P = 0.02 and P < 0.05, respectively) than the 9 who used gentian violet (n = 17). The authors conclude that both lemon juice and lemongrass are better than gentian violet at treating oral thrush in HIV/AIDS patients. Lemon juice stings but cures within a couple of days, and gentian violet had poor compliance due to the discoloration. The lemongrass infusion had the lowest number of AEs, and compliance was good. In South Africa, inadequate finances limit the use of effective therapies, so finding a cost-effective alternative is paramount. According to the authors, lemon trees and lemongrass can be grown in any garden in South Africa, so the results of this study may help these treatments become more widespread. A limitation of this study was that it had a small number of participants, and a large-scale study should be conducted. Also, the study should include multicenters, rather than just one.

—Heather S. Oliff, PhD

36 | HerbalGram 83 2009 www.herbalgram.org Research Reviews

Hibiscus Tea Lowers Blood Pressure in Patients with Type 2 Diabetes Reviewed: Mozaffari-Khosravi H, Jalali-Khanabadi B-A, Afkhami-Ardekani M, Fatehi F, Noori-Shadkam M. The effects of sour tea (Hibiscus sabdariffa) on hypertension in patients with type II diabetes. J Human Hypertension. 2009;23(1):48-54.

Hypertension and diabetes often coexist; hypertension is twice ± 5.79 mm Hg) in the hibiscus group and increased significantly as frequent in diabetic as in non-diabetic persons. Hypertension (P < 0.05) by 2.7% from baseline (118.6 ± 14.9 mm Hg) to day 15 contributes significantly to the morbidity and mortality of diabetic (120.7 ± 13.6 mm Hg) and by 6.2% from day 15 to day 30 (127.3 persons and accounts for as much as 75% of the cardiovascular ± 8.74 mm Hg) in the black tea group. Furthermore, SBP was disease risk in this population. Although hypertension is more significantly different between the hibiscus and black tea groups frequent in developed than in developing countries, its prevalence at baseline and on day 30 (P < 0.001). PP decreased significantly is rapidly increasing in many developing nations—particularly in (P < 0.001) from baseline (52 ± 12.2 mm Hg) to day 15 (34.5 ± Iran. Both animal and human studies have shown that extracts of 9.3 mm Hg) in the hibiscus group and increased significantly (P hibiscus (Hibiscus sabdariffa, Malva- = 0.01) from baseline (41.9 ± 11.7 mm ceae) calyces (outer coverings of the Hg) to day 30 (47.3 ± 9.6 mm Hg) in flower petals) beneficially affect lipid the black tea group. PP was signifi- profiles and reduce hypertension. cantly different between the hibis- This is especially true of extracts cus and black tea groups at baseline standardized to total anthocya- (P = 0.003) and day 30 (P < 0.001). nins.1,2 The mechanisms responsi- The therapeutic effectiveness of the ble for the blood pressure-lowering interventions (defined as a decrease effect are not proven; however, the of ≥10 mm Hg in the measured vari- antioxidative and diuretic effects of ables) over the 30-day study period hibiscus, which is also known as was calculated as 48.1% in the hibis- roselle and sour tea, are thought to cus group and as 15.4% in the black be primarily responsible for its bene- tea group (P = 0.01). Compliance was ficial effects. 95% in the black tea group and 92% The objective of the present study in the hibiscus group. was to compare the short-term effects A significant positive therapeutic of hibiscus tea with those of black effect of hibiscus ingestion on blood tea (Camellia sinensis, Theaceae) on pressure was observed in the diabetic blood pressure in patients with type patients in this study. The authors 2 diabetes. Sixty mildly hypertensive conclude that the present study (systolic blood pressure [SBP] not “supports the results of similar studies >160 mm Hg and diastolic blood in which antihypertensive effects have pressure [DBP] not >100 mm Hg) been shown” for hibiscus. patients with type 2 diabetes (dura- Hibiscus Hibiscus sabdariffa Photo ©2009 Steven Foster The safety of hibiscus as a widely tion: >5 years) were enrolled in this double-blind, randomized, consumed beverage is well established; previous short-term clini- controlled trial, which was conducted at the Yazd Diabetes cal trials measuring blood-pressure-lowering effects have not indi- Research Center in Yazd, Iran. cated any adverse effect. The authors note that the sustainability The patients were randomly assigned to consume a glass of either of effects on BP should be evaluated further. They also admit to hibiscus or black tea twice daily for 1 month. The hibiscus was 2 egregious shortcomings of their study, namely (1) the lack of a imported from Saudi Arabia and the black tea from Sri Lanka. placebo control group and (2) the lack of monitoring of changes Each tea sachet weighed 2 g and was steeped in 240 ml of boil- in blood chemicals such as sodium, potassium, and angiotensin ing water, to which 5 g of sugar was added, before ingestion. The converting enzyme (which causes an elevation of blood pressure). subjects were prohibited from drinking any other tea during the study. SBP, DBP, and pulse pressure (PP) were measured on days 1, 15, and 30. Fifty-three patients (45 women and 8 men), 27 in —Brenda Milot, ELS the hibiscus group and 26 in the black tea group, completed the study. References At baseline, no significant differences in weight, age, or body 1. Herrera-Arellano A, Flores-Romero S, Chavez-Soto MA, Tortoriello J. mass index were observed between the 2 groups; however, signifi- Effectiveness and tolerability of a standardized extract from Hibiscus sabdariffa cant differences in DBP (P = 0.01), SBP (P < 0.001), and PP (P = in patients with mild to moderate hypertension: a controlled and randomized clinical trial Phytomed. 2004;11:375-382. 0.003) were observed between groups. DBP did not change signif- 2. Herrera-Arellano A, Miranda-Sanchez J, Avila-Castro P, et al. Clinical icantly during the study and did not differ significantly between effects produced by a standardized herbal medicinal product of Hibiscus groups at any time point. In contrast, SBP decreased significantly sabdariffa on patients with hypertension. A randomized, double-blind, (P < 0.05) by 7.8% from baseline (134.4 ± 11.8 mm Hg) to day 15 lisinopril-controlled trial. Planta Med. 2007;73:6-12. (123.3 ± 10.9 mm Hg) and by 8.1% from day 15 to day 30 (112.7 www.herbalgram.org 2009 HerbalGram 83 | 37 STEPS TOWARDS REVIVAL OF GRAECO — MEDICINE IN THE MIDDLE E A ST: A NEW PROJECT By Stephen Fulder, PhD, and Omar Said, PhD

Ibn Sina (980-1037 CE), called Avicenna by the Western world, a prominent contributor to the sciences of pharmacy and medicine. ©Pfizer Corporation from the book Great Moments in Pharmacy: A History of Pharmacy in Pictures

38 | HerbalGram 83 2009 www.herbalgram.org Tucked away between plant nurseries and small family fields of olives and wheat near the Galilee village of Kafr Kanna* is a shaded greenhouse. This greenhouse contains a large collection of medicinal plants, with approximately 120 species.1 The building is surrounded by classrooms, offices, a laboratory, a permaculture herb garden, and animals important to local Arab village life. This site, termed Al-Maissam, is a project of the Galilee Society, the largest charity in Israel and Palestine devoted to improving the health and environment of the Arab/Palestinian population. The medicinal plant project began in 1995 as the brainchild of this article’s authors, Omar Said, PhD, a pharmacologist and a leader in research on Arab herbal medicine in the region, and Stephen Fulder, PhD, an international herbal expert and author of many books on herbs, as well as pioneering Arab herbalist Khaled Khalil and others. The project was based on the fact that herbs are of interest and value to all communities, being resources that cross boundaries and transcend conflict. It was hoped that it would also help to preserve threatened species of medicinal plants and sustain Arab herbal medicine as a cultural and economic resource. This project has grown enormously and is now the source of an initiative to bring both the herbs and the rich knowledge of traditional Arabian medicine to the United States, Europe, and elsewhere throughout the world. *Cana of Galilee, famous as the Christian pilgrimage site of Jesus’s miracle of changing water into wine.

The Greek physician Pedanios Dioscorides (first century CE) accompanied the Roman armies throughout the known world and recorded his scientific observations. He promulgated rules for the collection and use of herbs, and his texts are revered for representing the science of herbal drugs in antiquity. ©Pfizer Corporation from the book Great Moments in Pharmacy: A History of Pharmacy in Pictures

www.herbalgram.org 2009 HerbalGram 83 | 39 GRAECO-ARAB MEDICINE practitioners of modern herbal medicine. Such an assumption may not be valid. The herbal tradition of the Middle East is part of th th an ancient medical system that is still alive and well.2 From the 8 to the 13 century, the Arab The correct term for this medical system is Graeco- caliphates (successive kingdoms ruled by the caliph Arab medicine, sometimes also called Hippocratic- from Bhagdad) became the Western world’s great Arab medicine, acknowledging its roots mainly in center of learning and discovery. During this era, the ancient Greek medicine of Dioscorides (ca 40 the Greek and Roman texts and knowledge, as well –90 CE) and Galen (ca 130-200 CE). It is still a as those of Ayurveda and other medical systems, major healthcare resource for millions in a large were translated, incorporated, and hugely extended. part of the world, stretching from Pakistan to Hospitals, libraries, and pharmacies were estab- Morocco, with many therapists (hakims) practic- lished. Chemistry was applied to the processing ing in an informal manner alongside the conven- of medicines, and pharmacy became an independ- tional Western medical system. They are often the ent discipline from medicine. The approach was first choice for handling common daily-life health rational, experimental, exploratory, Hippocratic, problems. Though it is a major and intact medical and open, without the obsessive control by reli- system with its own literature, therapeutic princi- gious clergy that restricted medicine in Europe at ples and theory, specific materia medica, and meth- the time. ods of diagnosis and treatment, not much is known Great physicians included Abu Bakr Muham- about Arabic medicine in the West, nor is much mad ibn-Zakaria al-Razi (953-986 CE), known as effort made to bring its remedies into Western Rhazes in the West and author of 237 books (over markets. This may be based on an assumption that half of which were on medical subjects), and the Arabic materia medica, as a foundation of Western Andalusian genius scholar El Zahrawi (Albuca- herbal medicine, has nothing much left to teach sis 930 – 1013 CE), who is considered one of the greatest physicians-surgeons of all times. His work

Galen (ca 130-200 CE), who practiced and taught both pharmacy and medicine in Rome, is known for devising complex prescriptions. His treatises on the preparation and use of herbal drugs contain numerous formulas, termed “galenicals” in pharmacy today. ©Pfizer Corporation from the book Great Moments in Pharmacy: A History of Pharmacy in Pictures

40 | HerbalGram 83 2009 www.herbalgram.org At-Tassrif is a medical encyclopedia of 30 volumes. years after pharmacy became a distinct profession The most influential Arabic contributor to medicine in Persia, did it become so in Europe. At that time was the Persian physician abu-Ali al-Husayn ibn- there was great enthusiasm in European apothecar- Sina, known in the West by the Latinized version ies for the discovery of new remedies from the Arabs. of his name, Avicenna (980-1037 CE). Avicenna’s Avicenna and Galen became the leading authorities influence continues to the present time within tradi- guiding European medicine, and Arab herbal phar- tional Arabic medicine. His 5-volume text, al-Qanun macy was the source of European professional herbal fil-Tibb (the Canon or the Law of Medicine), was therapeutics (described as ‘Galenical’ medicine). used as the main medical text until the 17th century While pre-Arab European folk medicine contin- in Europe. Along with Galen’s works it dominated ued, especially in the countryside, based on single medical thinking. The Canon’s first 4 books were local herbs simply prepared (‘simples’), the Galenical devoted to hygiene, medicine, diseases, surgery, physicians and apothecaries found they could extend pathology, and contagious diseases. The fifth book their professional territory (and fill their pockets) by dealt with pharmacy and was the standard materia prescribing and formulating exotic mixtures from medica for centuries. Another well-known sage was Arabic medicine and giving them Latin names. the Spanish Jewish Talmudist and physician Moses Many new herbs were also introduced over time. ben Maimon (Maimonides, 1135-1204 CE). A list of those that probably were introduced from The knowledge of herbal remedies in Arabic medi- Arabic medicine, based on information from various cine was rational and vast. Pharmacy was devel- expert sources, is given in Table 1. oped as a separate discipline for the first time.3 Rhazes used animals in order to test the safety and efficacy of extracted active ingredients. The Ibn GREEK-ARABIAN MEDICINE TODAY Baytar Pharmacopoeia contained 1200 natural drugs There has been a decline in the great knowledge (including more than 250 medicinal plants consid- and use of herbs in the Arab world, mostly as a result ered completely new to the medicine of the time), of the increased availability of modern medicine. which were formulated and prescribed after differ- In some countries, such as Egypt, Syria, and Paki- ential diagnosis and according to a range of theories. stan, traditional medicine is very strong and widely These included the restorative and cleansing effects used. However, in certain areas, such as the Middle of bitters; the heating, drying, cooling nature of East, there is a real danger of much of indigenous remedies; elimination as a method for restoration of Arab medicinal practices and knowledge disap- immunity; analysis of tastes; pattern of humors; etc. pearing altogether, further weakening traditional This sophistication can be illustrated by the use of Arab culture and creating more insecurity, as well herbs for pain relief at the time. Arab chemists such as forsaking a resource of inestimable economic and as Ibn Hayan, Al-Kindi and others, who were found- healthcare importance. ers of chemical science, were able to prepare various In order to evaluate the current status of Arabic kinds of anaesthetic extracts from local herbs such medicine and indigenous medicine in the Middle as opium poppy (Papaver somniferum, Papaveraceae), Eastern region, the authors of this article have carried mandrake (Mandragora officinarum, Solanaceae), out an ethnopharmacological survey of practitioners henbane (Hyoscyamus niger, Solanaceae), hemlock in Israel and Palestine, including the Bedouin in the (Conium maculatum, Apiaceae), aconite (Aconitum desert regions.4 We were able to locate 31 therapists napellus, Ranunculaceae), and cannabis/marijuana who regarded themselves as practitioners of Arabian (Cannabis sativa, Cannabinaceae). They listed them herbal medicine. Among them, they used 150 plant in order of strength and duration of pain relief, and they further defined dosages and antidotes. Before initiating surgery at Table 1: Selected Herbs in Current Popular Use Derived that time, the physicians dipped a sponge from Graeco-Arabic Medicine in the plant extract and put it at the nose of the patient for general anesthetiza- 1. Milk Thistle (Silybum marianum, Asteraceae) tion or on the site of the surgery for local 2. Olive leaf (Olea europaea, Oleaceae) anesthesia. They also created oral and 3. Feverfew (Tanacetum parthenium, Asteraceae) rectal dosage forms and patches, pastes, or 4. Licorice (Glycyrrhiza glabra, Fabaceae) fillings to provide pain relief in dentistry. 5. Black seed (Nigella sativa, Ranunculaceae) 6. Bay leaf and fruit (Laurus nobilis, Lauraceae) ARABIC FOUNDATION OF 7. Carob (Ceratonia siliqua, Fabaceae) WESTERN HERBALISM 8. Myrrh (Commiphora myrrha, Burseraceae) 9. Myrtle (Myrtus communis, Myrtaceae) It was only in the 10th century that the 10. Senna (Senna alexandrina, Fabaceae) teachings of the Arab physicians, bring- 11. Chicory (Cichorium intybus, Asteraceae) ing with them Hippocrates (ca. 460–370 12. Pomegranate (Punica granatum, Punicaceae) BCE), Galen, and the Greeks, began to 13. Lemon balm (Melissa officinalis, Lamiaceae) slowly filter into Europe from the Arab 14. Indian spices such as pepper (Piper nigrum) and world via the bridge of the Salerno School ginger (Zingiber officinale) in Italy. Only in the 12th century, 400

www.herbalgram.org 2009 HerbalGram 83 | 41 species. The herbalists, on average aged 60, felt threatened and insecure. Very few passed on their knowl- A serious issue is that edge to others or to the next generation on the grounds that it would be ‘stolen.’ Whereas practitioners were many herbs used in some of the most revered and educated members of the community in the past, this is evidently no longer the Arabic traditional case today, particularly with the present dominance of medicine are now rare modern medicine in the Middle Eastern region. Various ethnopharmacological surveys have shown and that many have that around 200 herbs are sold or traded in market places in the Middle Eastern region.5-8 A 2000 report been eradicated from by the Arab Union for Agriculture and Development has indicated that 23 plants are utilized in the medici- the Middle East for the nal products industry, 55 are used in perfume and cosmetics, 34 are involved in the food industry, and 10 usual reasons: ongoing species are used as botanical pesticides.9 A 2003 survey conducted in Jordan, where more than 100 herbalists destruction of their were interviewed, revealed that there are around 150 plant remedies still in use as traditional substances.10 natural habitat, over- Preliminary data from the most recent and largest harvesting of wild species, ethnobotanical survey in the region, which is still in process, shows that some 300 plant medicines, and and detrimental climatic quite a few animal and mineral remedies, are sold in traditional apothecaries (ittara stores). Some 400 herbs and environmental are in use within the Arab population of Israel and Palestine.11 changes. A serious issue is that many herbs used in Arabic traditional medicine are now rare and that many have been eradicated from the Middle East for the usual reasons: ongoing destruction of their natural habitat, over-harvesting of wild species, and detrimental climatic and environmental changes. The hills, shore- line, and deserts of Israel and Palestine are extremely rich in plant diversity, with some 2700 species.12 Many of these are the progenitors of many important food crops of today, of which more than 700 are noted for their uses as medicinal plants used in Arabic traditional medicine.13 Some 30% of the flora are considered rare plants, and many of these are endangered.14 Some of these species, such as white wormwood (Artemisia herba alba, Asteraceae) and castor bean (Ricinus communis, Euphorbiaceae) are widely used throughout the Middle East and are also well known in European herbal medicine. Others, such as Judean wormwood (A. judaica) are used only locally. This was the background that encouraged the establishment of the Al-Maissam botanical garden. It is a place for collection and preservation of species, a location for research on agriculture and creation of herbal formulations, and above all, an educational project to revive interest in a great herbal medical system that was rapidly vanishing. Today, about 10,000 schoolchildren visit this site annually, mostly from the Israeli Arab community and some from the Jewish community. In addition, there is a laboratory where older children can make creams, concentrated and honey extracts, tinctures, soaps, and distilled oils in a way similar to the ancient apothecaries.

42 | HerbalGram 83 2009 www.herbalgram.org RESEARCH AND NEW PRODUCT with elders, healers, and practitioners, plus the accu- DEVELOPMENT mulated knowledge of the founders of this project. In Part of the aim of the project was to create return, extensive education within Israel and Pales- economic benefit for the Galilee Society charity, the tine was volunteered to restore credibility, legitimacy, team working on the project, and the Galilee Arab and interest in the herbal tradition, and to benefit the community. It was envisaged that a successful busi- whole community, including healers and clients. ness would be an invaluable way of raising the profile On the research front, potential candidates for and value of locally grown herbs as well as aid farm- herbal remedies have passed through an extensive ers, herbal experts, and all those involved in Arabic screening process. Some basic screening tests were medicine. For this purpose the company Antaki Ltd carried out on a very large number of plant extracts. was set up, taking its name from one of the last great Examples include in vitro toxicity testing by means scholars of Arabic medicine.15 (The blind Da’ud of lactate dehydrogenase assays (LDH), screening ibn Amar Al Antaki—‘David of Antioch’—was a for antioxidant activity, and toxicity studies in mice. renowned pharmacist, and his classic text Tadhkirah These tests were carried out at the Galilee Society contains many plant remedies.) The company’s first R&D Center, the Haifa Technion, and the Carmel task was to develop a library of tested formulations Hospital, Haifa. A thorough review of published for common health problems, which would embody literature was carried out for each herb to confirm the full power of Greek-Arab medicine and its novel the kind of activity that was described in the Greek- herbs. It was clear that many local remedies that are Arabic literature. in use throughout the Middle East have never been The literature search revealed many discrepan- properly researched, evaluated, or economically devel- cies, however. For example, Hypericum, the genus of oped, and many of the tradition’s herbs are still new to St. John’s wort (H. perforatum, Clusiaceae), is well Western countries. Moreover, we believed that many described as a very important remedy. It is called commercial herbal products have been developed by a halawa by the local Arab population and dathi in process of formulation that has lacked knowledge and the classical texts. Unlike the current accepted uses therapeutic logic. of Hypericum, in which anti-depressant effects take The main source of information for the creation priority and antiseptic activities are regarded as minor, of formulations is the vast written literature that still Greek-Arabic medicine recognizes its main use to be exists. Fortunately, as with Chinese and Indian medi- against burns and as an anti-inflammatory, anti-infec- cine, the Arab physicians wrote everything down, tive, and anti-parasitic herb, especially in skin treat- and much of this material is in homes and in librar- ment. It was also reported that it can be used to treat ies throughout the Arab world. The literature is fasci- anxiety and menstrual problems. It is likely that more nating and intriguing, particularly since the herbal than one species in different areas are identified under formulations are accompanied by a very clear descrip- the collective name of halawa (dathi). Being more tion of differential diagnosis from which many health indigenous to the Middle East region, the sources conditions widespread throughout the modern world probably meant H. triquetrifolium, not H. perforatum. can be precisely identified. For example, one useful According to our high-performance liquid chroma- ancient book is called The Nabatean Book of Agricul- tography (HPLC) analyses of H. triquetrifolium, it ture.16 In it one finds not only remedies for human contains less hypericin and more hyperforin than H. use but also a large number of veterinary prescrip- perforatum, and this may account for the differences tions, plus methods of preparing botanical pesticides, in therapeutic emphasis. fungicides, and crop treatments. However, literature Examples of Rationally Formulated Herbal alone is not enough, since there can be confusion Products: regarding identification and names of plants. In addition, herbal medicine consists of a very large aggregate 1. Saltbush Formulations for Blood Sugar Problems of overlapping information, which makes it difficult and Metabolic Syndrome to define the primary remedies and combinations for each specific health problem. In our case, we sought There are several well-known remedies for hyper- additional confirmation and support in current use glycemia, described in the Arab medical tradition from the various published ethnopharmacological as zihar, zaheer, zarab, diabeta, and diabatish. It surveys,17,18 and our own, as well as from discussions was diagnosed by such symptoms as frequent urination, thirst, dry mouth, tiredness, etc. We identi- Fortunately, as with Chinese and Indian medicine, the Arab physicians wrote everything down, and much of this material is in homes and in libraries throughout the Arab world.

fied the various herbs from traditional texts and then giving it saltbush, saltbush extract, or even the ash from cross-checked them in published research literature and saltbush.22 Saltbush apparently helps the animal by ethnobotany.19 restoring insulin sensitivity and reducing insulin resis- One of the herbs mentioned was saltbush (Atriplex tance.23 halimus, Chenopodiaceae). The Bedouin of the Negev A combination formula can be developed through desert pointed out the significant antidiabetic effect of the addition of further herbs to modify and slow sugar this plant.20 We were pleasantly surprised to learn that absorption from food to reduce cholesterol levels and to researchers at the Ben-Gurion University in the Negev, stimulate urination and removal of waste. For example, Israel had already studied this plant some years earlier. olive leaf (Olea europaea, Oleraceae) is added to reduce It was a remarkable story centered around a small desert sugar levels, cholesterol, and fats through metabolic rodent called the sand rat (Psammomys obesus). This mechanisms. This proprietary combination has been animal lives healthily in the wild, mostly on the leaves of tested pharmacologically and in a preliminary clini- the saltbush. As soon as it is given conventional rodent cal observation study with promising results.24 Atriplex food or taken into a laboratory environment, it develops together with other herbs is therefore an herbal combi- diabetes and metabolic syndrome (obesity, circulatory nation that is both scientifically and traditionally ratio- problems, etc.).21 Researchers found that this genetic nal. tendency to diabetes and metabolic syndrome comes from a disturbed insulin system and insulin resistance, 2. Zallouh in the Development of Sexual Potency which also seems to be a key factor in the develop- Formulations ment of diabetes and metabolic syndrome in humans. Another interesting example of a rationally studied The animal’s diabetes can be prevented and treated by herbal preparation is zallouh. Zallouh is the common The project is not just about marketing a radically new line of effective herbal combinations but the introduction of Arabic medicine itself as a whole new modality into Western markets.

44 | HerbalGram 83 2009 www.herbalgram.org name in the Middle East for the roots of the plant Preliminary research on this plant indicated that it Ferula hermonis (Apiaceae), so named because it grows may have a role in improving potency in sexual dysfunc- on the slopes of Mount Hermon in the Golan Heights. tion. For example, sexually potent and impotent male The plant grows in a relatively restricted area and is at rats were orally treated with extracts of F. hermonis. The risk of over-collection. It is also cultivated in certain acute administration stimulated libido in potent rats and countries such as Syria. It is botanically similar to F. improved copulatory performance in sluggish/impo- communis, the giant fennel. There are several species of tent rats. However, chronic administration of the higher Ferula that grow locally and around the world, includ- dose reduced testosterone and copulatory performance.26 ing the famous species F. asafetida, which is cultivated in There is similar evidence from researchers in Jordan Asia as a source of the spice resin asafetida. (The genus that may show that higher doses of F. hermonis extracts, name Ferula comes from the Latin word for “walking obtained using organic solvents and given over extended stick,” because its stem was used as such. It is mentioned periods of time,27 have apparent adverse effects in rats and in the Bible [The Book of Job, Chapter 30, verse 2] in mice28 such as reduced fertility and sexual activity, which that context.) are opposite to the extracts’ desired effects. A product was Zallouh has been used since ancient times as a mild formulated based on particular plant parts and extracts tonic remedy and an aid to fertility and sexual energy. of the closely related F. asafetida, the spice plant. For The Druze living in the Golan Heights, and also the local women, extracts derived from Capparis spinosa (Cappara- population of South Lebanon and Syria, appreciate the ceae), the common caper, known in Arabic medicine for value of the roots especially in the elderly or in cases of improving fertility in women, were also included. impotence.3 Local people usually sell it mixed with honey. A relatively large number of Arab patients at fertility Some of the great scholars of traditional Arabic medicine clinics in Israel have been administered these products (Ibn AlBeetar and Al-Antaki) suggested that zallouh is a as part of ongoing clinical research. Some of the male sexual tonic and described the plant and the ecological patients have had sperm counts and been motility tested range of F. hermonis.25 They called it Oud Alkerach Alga- before and after a 1- or 2-month course. The majority of bali (“stick from the mountains for the infirm,” or “walk- patients with low sperm count (5-15 million/ml) showed ing stick”) and also Aaqer qarha (“fertility aid”). Accord- a significant increase in sperm count during this period, ing to Dioscorides, this plant is used for the treatment of with most also showing improvements in sperm motil- fatigue and impotence.† He also pointed out that the root ity, microstructure, and white blood cell count. Those or the resin of the cut stem can be used to clear the air with very low or zero sperm count sometimes showed a passages and in cough or bronchial problems. Galen also modest increase in sperm count, though it never reached mentions this plant. normal levels.29

†In the Arabic translations of Dioscorides, of which there are many throughout the ages, impotence is described and recommended remedies included plants in the genus Ferula. This plant’s description as well as its specific Arabic name clearly identifies it as Ferula, but there is uncertainty concerning the exact species. One can never be sure of the precise botanical identification of an ancient common name. However, in the ethnopharmacological research in the Middle East that these authors have conducted, F. communis is known and used, but not once mentioned for treatment of impotence, whereas F. hermonis is widely known and used for impotence. Therefore it is reasonable to suggest it is this species.

www.herbalgram.org 2009 HerbalGram 83 | 45 3. Topical Formulas for Skin Conditions The above are synergistic combinations, rationally formu- Dermatology is another area that was investigated because lated according to both traditional Arabic medicine and skin problems are widespread in the Arab community and modern scientific research. They may have an advantage over because, according to Arabic medicine, herbs are very effec- the use of single herbs such as calendula (Calendula officinalis, tive for these conditions. A partnership was established with Asteraceae), tea tree (Melaleuca alternifolia, Myrtaceae) oil, the Dermatology Department of the Hebrew University under lavender (Lavandula angustifolia, Lamiaceae) oil, chamomile Professor Yoram Milner, supported by grants from the Israel (Matricaria recutita, Asteraceae), witch hazel (Hamamelis Ministry of Infrastructure and private investors under the virginiana, Hamamelidaceae) and Aloe vera (Liliaceae), which Technological Incubator process. may have a one-dimensional activity, such as anti-inflamma- (a) Psoriasis: In searching for potential topical remedies for tory, astringent, antiseptic, or antioxidant effect. psoriasis, we tested the ability of low doses of plant extracts to Conclusion inhibit cultured skin cell division, since skin thickening is one of the primary symptoms of psoriasis. We found that herbs Many of the herbal combinations for various common that are regarded as highly important in Arabic dermatologi- health problems have now been tested in clinical studies cal medicine performed very well in these assays, showing a among the Arab population of the Galilee, and there are a major difference between cytostatic and cytotoxic effects. series of scientific publications already out or on the way. In Black cumin or black seed (Nigella sativa, Ranunculaceae) addition, a major international company based in Denmark 32 was one such plant. Using the results from this research, as (Sprunk-Jansen Ltd.) has taken these product concepts and well as published data and extensive exploration of Arabian is marketing them internationally. They are already in 20 medicine texts and current traditional practice, a synergistic countries so far. The project is not just about marketing a radi- combination of specific plant parts of several herbs was devel- cally new line of effective herbal combinations but the intro- oped. Nigella not only acts against skin thickening, but it also duction of Arabic medicine itself as a whole new modality into has significant and well-documented anti-inflammatory and Western markets. This may have unexpected advantages. For antiseptic effects.30,31 Other herbs are added for anti-itching, example, according to current European regulations, herbs pain-relieving, and anti-inflammatory effects, and to support which have not previously been consumed in Europe cannot the tissues and skin condition. be sold as they are regarded as ‘novel foods.’ However, many (b) Acne: Acne vulgaris results from excess production herbs offered through Arabic medicine, such as black cumin/ of sebum in the sebaceous glands due to hormonal, envi- black seed, are already known, consumed by communities ronmental, or other factors. Anaerobic bacteria feed on the in the EU area, and though entirely novel as medicines, are sebum creating a local infection and associated inflammatory permitted. Arabic medicine can therefore help to return inno- response, which is seen as unsightly spots. We used a sophis- vation into the European herbal market. ticated screening method of measuring sebum production in How does all this help peace and co-existence? All proj- sebaceous glands isolated from human skin and maintained in ects in which Jewish and Arab professionals cooperate create organ culture in the laboratory. Accord- ing to some unpublished observations by Y. Nissimov and Y. Milner at the Meyer’s Skin Biochemistry Research Laboratory, Hebrew University in Jeru- salem, several herbs based on Arabic medicine treatments for spots were able to suppress sebum production, in some cases almost completely. In addition, we collaborated with Profes- sor Ali-Shteya in the Microbiology Department at An-Najah University in Nablus, Palestine to identify herbs with powerful antibacterial action on the anaerobic bacteria involved in acne, Propionibacterium acnes. We found at least 2 herbs, soapwort (Saponaria officinalis, Caryophyllaceae) and Inula viscosa (Asteraceae), which had powerful antimicrobial effects against this bacteria. Combinations were made from these herbs, in which one herb stopped sebum production and cleaned the skin, another prevented growth of anaerobic bacteria, and a third provided mild anti-inflammatory skin conditioning and astringent effects to support skin quality. Common Caper Capparis spinosa, growing in the hills of the Western Galilee. Photo ©2009 Simon Irgens 46 | HerbalGram 83 2009 www.herbalgram.org important precedents and a sense of normalization. But herbal Egypt. 2000. remedies do more than that. They carry an emotional message 10. Abu-Irmaileh BE, Afifi FU. Herbal medicine in Jordan with of cultural empowerment and community selfcare. When one special emphasis on commonly used herbs. Journal of Ethnophar- of us gave talks on Arabic herbs in the Palestinian town of macology. 2003;89:193–197. 11. Said O. (unpublished data, 2008) Nablus, the older women from the surrounding villages began 12. Department of Ecology at the Hebrew university of Jerusalem. to weep. They explained that under the Israeli occupation and Checklist and ecological data-base of the flora of Israel and with the pressures of modern life, their traditional cultural surroundings, Rotem. 1999. knowledge was disappearing. Violence and despair increased 13. Palevitch D, Yaniv Z. Medicinal Plants of the Holy Land. Tel Aviv, without this support. Teachings on herbs and family healthcare Israel: Modan Publishing House; 2000. skills restored a sense of ownership and legitimacy to their 14. Shmida A, Fragman A. Endangered and rare plant species of culture and their community. Israel. Ecology and Environment, Israel (Hebrew); December 1999. 15. Antaki Center for Herbal Medicine Ltd Web site. Available at: www.al-antaki.com. Stephen Fulder, PhD, has worked for 30 years as a consultant 16. Ibn Wahshiya, The Book of Nabatean Agriculture. (3 volumes). to companies in the herbal field and has lectured at universities (Edited by Prof. Tawfiq Fahd), Aljaffan and Al Jabi publisher, and many international conferences. He has written 14 books and Limassol, Cyprus, and Damascus, Syria,1993. (In Arabic) approximately 40 academic papers regarding herbs and natural 17. Bailey C, Danin A. Beduin plant utilization in Sinai and the medicine. He lives in Galilee, Israel in an environmental village Negev. Economic Botany. 1981;35:145–162. that he helped to found, and he is active in peace and environmen- 18. Dafni A, Yaniv Z, Palewitch D. Ethnobotanical survey of tal work. He earned his doctorate in the molecular biology of aging medicinal plants in northern Israel. Journal of Ethnopharmacology. from Oxford University. 1984;10:295–310. 19. Yaniv Z, Dafni A, Friedman J, Palewitch D. Plants used for the Omar Said, PhD, is the founder and CEO of Antaki Center treatment of diabetes in Israel. Journal of Ethnopharmacology. for Herbal Medicine Ltd, a company established in 1998 that 1987;19,145–151. develops a wide variety of medicinal herbal formulations based on 20. Friedman J, Yaniv Z, Dafni A, Palewitch D. A preliminary clas- traditional Arab medicine. He serves as the head of the medicinal sification of the healing potential of medicinal plants based on a plant project in the Galilee Society R&D regional center, as well rational analysis of an ethnopharmacological field survey among as the manager of Al-Maissam—The Medicinal Plant Center for Bedouins in the Negev desert, Israel. Journal of Ethnopharmacol- Research & Education. He obtained his doctorate in pharmacology ogy. 1986;16:275–287. from the Technion, Institute, Haifa, Israel. 21. Kalderon B, Gutman A, Levy F. et al. Characterisation of stages in development of obesity-diabetes syndrome in sand rat (Psammo- mys obesus). Diabetes. 1986;35: 717–724. Conflict of Interest Disclosure 22. Shani J, Ahronson Z, Sulman FG. et al. Insulin-potentiating effect of the salt bush (Atriplex halimus) ashes. Israel Journal of Medical Dr. Fulder is an independent consultant, author, and Sciences. 1972;8:757–8. researcher, with no interest in or ownership of the project and 23. Mertz W, Roginski EE, Gordon WA, et al. In vitro potentiation organizations mentioned and will have no benefit from any of insulin by ash from saltbush (Atriplex halimus) Arch. Int. Phar- interest generated by this article. Dr. Said is a part owner of the macodyn. Ther. 1973;206:121–128. Antaki Company, which is mentioned and could possibly bene- 24. Said O, Fulder S, Khalil K et al. Maintaining a physiological blood glucose level with ‘Glucolevel’, a combination of four anti- fit from interest generated by the article, but very indirectly, as diabetic plants used in Traditional Arabic Herbal Medicine. eCam. Antaki Ltd. does not market finished products outside Israel. 2008;5:421–8. 25. Ibn Albitar. In: Aljamea Limufradat Aladwiya Walaghdiya, p. 115–116. Dar Bulaaq, Cairo 1974. (Manuscript from 12th References Century). 1. Medicinal Plant Center page. The Galilee Society Web site. 26. Zanoli P, Benelli A, Rivasi M, et al. Opposite effect of acute and Available at: http://www.gal-soc.org/en/?s=Al-Maissam. Accessed subchronic treatments with Ferula hermonis on copulatory behav- May 4, 2009. ior of male rats. Int J Impot Res. 2003; 15(6):450–5. 2. Saad B, Azaizeh H, Said O. Tradition and perspectives of Arab 27. Homady MH, Khleifat KM, Tarawneh KA, et al. Reproductive herbal medicine: A review. eCam. 2005;2:475–479. toxicity and infertility effect of Ferula hermonis extracts in mice. 3. Levey N, Khaledy N. The Medical Formulary of al-Samarqandi. Theriogenology. 2002;57(9):2247–56. University of Pennsylvania Press; 1976. 28. Khleifat KM, Homady MH, Tarawneh KA, et al. Effect of 4. Said O, Khalil K, Fulder S, Azaizeh H. Ethnopharmacological Ferula hermonis extract on social aggression, fertility, and some survey of the medicinal herbs in Israel, the Golan Heights and the physiological parameters in prepubertal male mice. Endocr J. West Bank Region. Journal of Ethnopharmacology. 2002;83:251– 2001;48(4):473–82. 263. 29. Kassis E, Fulder S, Khalil K, et al. ‘Masculine’ is a proprietary 5. Ali-Shtayeh MS, Yaniv Z, Mahajna J. Ethnobotanical survey in extract of Ferula asafetida to enhance male sexual functioning in the Palestinian area: a classification of the healing potential of animals and man. (submitted). medicinal plants. Journal of Ethnopharmacology. 2000;73:221– 30. Khan M. Chemical composition and medicinal properties of 232. Nigella sativa Linn. Inflammopharmacol. 1999; 7: 15–35. 6. Lev E. Reconstructed materia medica of the Medieval and Otto- 31. Al-Ghamdi MS. The anti-inflammatory, analgesic and antipyretic man al-Sham. Journal of Ethnopharmacology. 2002;80:167–179. activity of Nigella sativa. J Ethnopharmacol. 2001; 76: 45–48. 7. Lev E, Amar Z. Ethnopharmacological survey of traditional drugs 32. Sprunk-Jansen Web site. Available at: www.sprunk-jansen.com. sold in Israel at the end of the 20th century. Journal of Ethnophar- Accessed May 4, 2009. macology. 2000;72:191–205. 8. Heneidy SZ, Bidak LM. Potential uses of plant species of the coastal Mediterranean region, Egypt. Pakistan Journal of Biological Sciences. 2004;7:1010–1023. 9. Arab Union for Agriculture and Development: The Neglect of Medicinal Plant Resources in the Arab World. A Report. Cairo, www.herbalgram.org 2009 HerbalGram 83 | 47 250th Anniversary Rose Garden. Photo ©2009 David Austen Roses England’s

By Kelly Saxton Lindner

48 | HerbalGram 83 2009 www.herbalgram.org The Royal Botanic Gardens, Kew, in Richmond, Surrey, of the United Kingdom, considered by most botanists as one of the world’s premier botanical gardens, is celebrating its 250th anniversary.1 An omission in Kew’s archives prevents anyone from knowing the exact date that Princess Augusta (mother of King George III) entrusted her 9-acre garden to William Aiton—the Gardens’ first official superinten- dent—meaning that Kew’s staff only knows the year that the Gardens was founded. So all year they’re going to party like it’s 1759. “The main goal of the year, besides the celebration of the 250 anniversary, is to educate the public about Kew’s global conservation efforts, the role plant-science has to play in dealing with the environmental challenges we are facing, plus remind people of our rich history and heritage,” said David Yard, the travel trade manager for Kew (oral communication, March 10, 2009). Historic color drawing of visitors at Kew Gardens with the Palm House in the background. Photo ©2009 Kew Royal Botanic Gardens Historically, it was Princess Augusta’s goal to create a garden that would “contain all the plants known on Earth,” according to The World of Kew (BBC Books, 2006) by Carolyn Fry.2 With advancements in the Interior view of the Temperate House. Photo ©2009 Kew Royal Botanic Gardens collection of various plants from all over the world made by past directors such as Sir Joseph Banks (1743– 1820) and Sir Joseph Hooker (1817–1911), Kew has certainly gotten a head-start on this goal.3 “Of course, neither Kew, nor any other botanic garden, is anywhere near to containing all the plants known on Earth. Many more plants are known since the days of Princess Augusta,” said Professor Sir Ghil- lean Prance, director of Kew from 1988–1999 (e-mail, April 17, 2009). “Nevertheless, Kew’s collection of some 40,000 taxa is probably one of the largest in the world.” The idea to celebrate the anniversary-year all year long was a collective decision of the Kew planning committee, which includes staff from various departments of the organization, according to Yard. This committee was also behind the creation of a smorgasbord of events, which can be attended at no additional cost outside the usual Gardens entry fee of £13 ($19.24 US dollars). This large array of events includes several art exhibits at the Shirley Sherwood Gallery of Botanical Art, 10 artistic sculptures of seeds added to the Main Gate entrance to symbolize the Gardens’ conservation efforts through Kew’s Millennium Seed Bank (MSB) partnership, and the restoration of the Marianne North Gallery (Mari- anne North was a Victorian artist who created botanical paintings inspired by her travels).1 “Kew is the leading botanical garden and institution of its type in the world. It was turned over to the Crown (made public) in 1841 and has had a huge influence on the conduct of botany throughout the world ever since,” said Peter Raven, PhD, director of the Missouri Botanical Garden (MoBot) in St. Louis (e-mail, May 1, 2009). Dr. Raven explained that MoBot’s founder, Henry Shaw, consulted Sir William Jackson Hooker, a previous director of Kew, in 1851 to get advice about how to organize MoBot. “It was that correspondence that changed our garden—the oldest that has operated continuously in the United States—to a partly scientific www.herbalgram.org 2009 HerbalGram 83 | 49 institution from pure display, and that’s the way Henry Shaw set it up in his will after operating it himself for 30 years, 1859–1889,” said Raven. He added that the 2 gardens closest in size and scope to Kew are the New York Botanical Garden, which was established in 1891, and MoBot. Though he said that MoBot doesn’t necessarily emulate Kew, since the 2 gardens specialize in different areas and have gone different directions, MoBot does often cooperate with Kew. “As a model, Kew has influenced all botanical gardens, and especially those for which science and conservation are components of their programs, and it continues to influence them now.”

Kew’s Conservation Efforts Conservation is one of the main focuses of Kew during its 250th year, just as it has been throughout much of Kew’s history. Currently, Kew is a leader in several efforts to conserve orchids native to the United Kingdom. Some of these endangered orchids include the fen orchid (Liparis loeselii, Orchidaceae) and the lady’s slipper orchid (Cypripedium calceolus, Orchidaceae), one of the UK’s rarest orchids, according to Bronwyn Friedlander of Kew public relations (e-mail, March 10, 2009). The event that kicked off the 250th anniversary celebrations was the Tropical Extravaganza—a celebration of orchids. This took place Febru- ary 7–March 8, 2009, in the Princess of Wales Conservatory, with a turn-out of 115,000 people for the 4 weeks it ran, according to Yard. This event featured various types and colors of hybrid orchids.1 Visitors also had an opportunity to view Kew’s species

50 | HerbalGram 83 2009 www.herbalgram.org orchid collection. Kew is involved in the conservation of orchids nal building, first built in 1877, has already been extended 7 in Madagascar4 as well as various other conservation projects, times, according to Bronwyn Friedlander. The new wing will including a venture to preserve the world’s meadows. According to extend the capacity of the herbarium by about 40 years, meaning Yard, a large color-coded map that pin-points the exact locations an additional 40 years-worth of herbs can be collected and stored of all of Kew’s conservation efforts around the world was installed in the new space. This area will also feature climate-controlled near the Victoria gate of Kew in April 2009. storage and adjacent study areas for an additional hundreds of “Conservation is the most important thing that a botanic garden thousands of plant specimens. This expansion will further provide can do today,” said Sir Ghillean Prance. “If we don’t, there will not a new space for Kew’s library, archives, and art collection. be plant species to study, to feed us, to decorate our gardens, and “The move is excellent as it will give us a further 30+ years of to supply medicines. We need to conserve all plants—not just storage space and also the opportunity to re-arrange the collec- orchids—and this is certainly what Kew is doing.” Prance was tions according to a modern system based on DNA studies,” said knighted in 1995 for his many services in conservation, many of David Mabberley, PhD, keeper of the herbarium, library, art, and which involved Kew. archives and author of the recently revised and world-renowned Mabberley’s Plant Book (e-mail, April 29, 2009). “We incorporate ca. 35,000 new herbarium specimens every year.” Kew’s Herbarium, Library, Art, and Kew also has the world’s largest and most Archives comprehensive library of botanical litera- Another exciting development is Kew also ture, said Christopher Mills, head the opening of a new wing to of the library, art, and archives the herbarium, scheduled for (e-mail, April 29, 2009). “It is 2010. This will add even has the world’s international in its coverage more dried specimens to and contains some 300,000 the herbarium, which is largest and most printed titles, over 4,000 already the largest in the journal runs, some going world with a current back over 200 years. It count of 7,000,000 comprehensive library holds 200,000 items specimens. The origi- of botanical literature in its Art and Illustra-

www.herbalgram.org 2009 HerbalGram 83 | 51 tions Collection and 7 million manuscript items in its Archives.”

Kew on BBC Another event to honor the Gardens’ anniversary was the creation of a television program by presenter Dan Cruickshank, titled “Cruickshank on Kew: The Garden That Changed the World,” which aired in the United Kingdom on BBC 2 on April 28, 2009, and was replayed on May 6, 2009.5 “The BBC Wales has a long association with Kew Gardens, thanks to several series about its work, including the acclaimed ‘A Year at Kew,’” said Jenny Walford, communications manager for BBC Wales (e-mail, March 16, 2009). “As the 250th anniversary was coming up, we thought it was time to tell the history of this fascinating place and how its purpose had changed through the years.” Directed by Sam Benstead, there are currently no plans to air this program outside of the United Kingdom, nor will it be available on DVD. The main theme of the film is to show that Kew Gardens is “more than a perfect picnic spot or place to browse through blooms,” according to a synopsis of the film.5 In fact, “Kew has shaped the course of Britain and its empire, playing its part in scientific discoveries, serving the economic cause, and continuing to push the boundaries of plant research into the 21st century.” Author Carolyn Fry contributed to the film by providing her opinion of Kew’s importance during the time of England’s far- reaching empire. Fry was asked to respond to the validity of the following comment from William Thiselton-Dyer, director of Kew from 1885–1905: “We at Kew feel the weight of the empire more than they do in Downing Street.”6 (Downing Street is the term frequently used to refer to the residence of the Prime Minister.) Fry confirmed that this estimation was not an exaggeration: “Towards the end of the 19th century Kew was acting as a hub, corresponding with some 30 or so gardens around the world— [with] the idea that these gardens could support the British empire by growing plants that could be of economic value in the places where the climate was most suitable,” said Fry. In fact, “the scale (of the operation) was immense. If you think when the British empire was at its great extent, it was holding sway over a quarter of the world’s population….At the beginning of the 19th century much of the world was untouched, with its plants unknown. By the end of the 19th century it had been pretty well ransacked.”6

The Millennium Seed Bank Today, as opposed to merely collecting plant species from all over the world, Kew focuses on preservation. A major event occurring during the 250th anniversary celebrations is an exhibition about Kew’s Millennium Seed Bank (MSB) partnership (which takes place April 4–September 13, 2009). This exhibition—Banking on Life—is housed in the Nash Conservatory and showcases the work of the MSB and its partners around the world.4 The MSB is located at Wakehurst Place, a 465-acre satellite of Kew. According to Sir Ghillean Prance, since Kew is on very poorly-drained sandy soil, Wakehurst Place is home to the seed bank as well as a useful horticultural addition, due to the area’s higher quality soil and roll- ing topography. Kew’s MSB was conceived and built at Wakehurst Place during Prance’s time as director and began in 2000 to collect seeds from plants that are (1) rare and endangered, (2) from areas of the world most impacted by climate change, and (3) medicinally and economically useful.7 Interior view of the Princess of Wales Conservatory. “The seeds are the answers to problems mankind has not yet Photo ©2009 Kew Royal Botanic Gardens

52 | HerbalGram 83 2009 www.herbalgram.org begun to encounter,” said Cruickshank in “Cruickshank on Kew.”6 “In time of mass habitat destruction and shifting weather patterns, this is the last ditch safeguard against extinction of all plants for the benefit of the future of mankind and the world.” According to the program, Kew’s MSB contains bomb-proof bunkers, with inside temperatures as low as 40° below Celsius, where a human cannot stay for more than 30 minutes without risking a slowing of his or her metabolism to a dangerous level.6 Twenty-three thousand plant species are housed inside these vaults, as 1.3 billion seeds. In October 2009, the MSB partnership conservation project, a combined collection effort of organizations all over the world, plans to celebrate hitting its target of collecting and banking seeds from 10% of the world’s ca. 300,000 wild plant species.7 “We believe that Kew’s MSB partnership has an important role to play in providing plant-based solutions to environmental problems and in enabling humanity to adapt and innovate,” said Paul Smith, PhD, head of Kew’s MSB partnership (e-mail, April 30, 2009). “We can do this only by working with plant scientists in both government and industry. Our next milestone is to collect and conserve 25% of the world’s plant species by 2020 and to do all we can to enable their use for the benefit of the planet and people.” “Ultimately, this work also contributes to the battle of miti- gation against climate change,” said Nigel Taylor, Kew’s curator (e-mail, April 29, 2009). “In the future it is clear that we are going to need to be the gardeners of nature, having modified it so comprehensively that it will not recover unaided. This will be Kew’s contribution as we enter the next 250 years of the Gardens.” At this rate of collection and preservation, one day Kew may indeed achieve the goal Princess Augusta set for it—to “contain all the plants known on Earth.”2 More information about Kew’s 250th anniversary is available on the Web site: www.kew.org. A full list of Kew’s 250th anniversary events is available at: www.kew.org/press/factsheets/Diary/ Kew’s_250th_year_ahead.pdf.

References 1. Kew celebrates 250 years [press release]. London, England: Kew Garden; January 27, 2009. 2. Fry C. The World of Kew. London, England: BBC Books. 2006. 3. Kew’s History and Heritage, People. Kew Garden Web site. Avail- able at: http://www.kew.org/heritage/people/directors.html. Accessed April 10, 2009. 4. Kew’s work with orchids. Kew Garden Web site. Available at: http:// www.kew.org/plants/orchids/kewswork.html. Accessed April 6, 2009. 5. Unpublished synopsis of Cruickshank on Kew: The Garden That Changed the World. BBC 2. May 22, 2009. 6. Cruickshank on Kew: The Garden That Changed the World. BBC 2. May 22, 2009. 7. Banking on Life: The story of RBG Kew’s Millennium Seed Bank partnership [press release]. London, England: Kew Garden; March 23, 2009.

Top photo: Millennium Seed Bank scientist examining a plant specimen. Middle photo: Interior view of the Millennium Seed Bank Visitor Centre at Wakehurst Place. Bottom photo: Orchids (Phalaenopsis hybrid) from the Tropical Extravaganza Exhibit. Photos ©2009 Kew Royal Botanic Gardens www.herbalgram.org 2009 HerbalGram 83 | 53 Cordyceps sinensis Medicinal Fungus Traditional Use among Tibetan People, Harvesting Techniques, and Modern Uses By Alessandro Boesi, PhD, and Francesca Cardi, PhD

Lithang Town with its Gelugpa monastery in the back. A few Cordyceps sinensis gathering areas are located beyond the ridge of Pomra (sPom ra), the mountain dominating Lithang. Photo ©2009 Alessandro Boesi 54 | HerbalGram 83 2009 www.herbalgram.org The fungus cordyceps (Cordyceps sinensis, Ophiocordycipita- ceae) has been known as an effective tonic and aphrodisiac in Traditional Chinese Medicine (TCM) and is increasingly used in China as a popular dietary supplement and/or medicine. Owing to the upsurge in consumer demand for this ingredient in the past few decades, Tibetan peoples have been gathering increased amounts of cordyceps over the high-altitude expanses of Tibetan regions, and this activity has become one of their most important sources of income in certain parts of the country. Prices rose significantly from the early 1980s until 2008,1,2 at which point they dropped due to the global economic crisis.* Cordyceps is also renowned within other international markets, and it is available in several countries around the world, where it is sold in different forms. Although not as highly prized in the Tibetan traditional system of medicine as in Chinese medicine, the fungal ingredient is included in the materia medica of Tibetan medicine. Its first citation in Tibetan medical treatises actually pre-dates its reference in Chinese texts by a few centuries. The present article analyzes the use of cordyceps among Tibet- ans with particular reference to its classification and therapeutic properties, gathering and processing, combination with other medicinal substances in Tibetan medicine, as well as its use on the popular level. Data in this article were obtained during several field-research trips conducted by the authors in different Tibetan cultural regions: Lithang and Dardo/Kangding Counties (Ganzi/Kandze Tibetan Autonomous Prefecture, Sichuan Province, China), where the authors spent 9 months during 2 consecutive vegeta- tive seasons in 1999 and 2000; the region of Baragaon located in Mustang District, central Nepal (2001); and Repkong/ Tongren County (Huangnan Tibetan Autonomous Prefecture) and Rushar, Huangzhong County (Xining Prefecture-level city) in Qinghai Province, China (2007). The methods used during fieldwork included participant observation and open-ended and structured interviews conducted with cordyceps gatherers, traders, users, and in particular with Tibetan medical practitioners—both independent and belonging to recognized medical institutions. Excerpts from Tibetan medical treatises have been thoroughly examined, particularly the Mennag chewa rinsel (Ten Millions of Instructions: a Relic), Above photo: The written by the famous Tibetan doctor Zurkhar Namnyi Dorje in weight of the dbyar th 3 the 15 century, the Tibetan materia medica that the Mongol rtswa dgun ‘bu is taken Jampal Dorje compiled in the 19th century,4 and a few modern using small scales. The treatises devoted to Tibetan pharmacopeias and medical prepa- measurement is quite rations.5,6,7 The botanical identifications presented in this article accurate, yet between are mainly those reported in modern Tibetan materia medica5,6 traders arguments often arise about the and those related to the specimens gathered on the field by the precision of the weight authors. We note that, because the botanical taxonomic identifi- or the quality and the cation of Tibetan materia medica may vary throughout Tibetan price of the produce. regions, the identification presented herein may represent only Those quarrels can one of the possible species to which a Tibetan designation corre- often become real sponds. fights. Photo ©2009 *According to Daniel Winkler, MSc, following economic liberalization in Alessandro Boesi the early 1980s, cordyceps prices increased dramatically from Chinese yuan (CNY) 1,800 (8 CNY = $1 USD in 2005) per kg in the Tibetan capital Lhasa, to Specimens of dry CNY 8,400 in 1997 (an increase of 366%), then to CNY 36,000 in 2004 (a further Cordyceps sinensis. Its increase of 1,900%). In June 2005, prices in Tibet ranged from CNY 10,000– length may span from 3 60,000 (USD 1,250–7,500) per kg. Yet in late 2008, due to the global crisis, prices to 10 centimeters. went down significantly. [References: Winkler D. Yartsa gunbu (Cordyceps Photo ©2009 sinensis) and the fungal commodification of Tibet’s rural economy. Economic Alessandro Boesi Botany. 2008;62(3):291-305 and Winkler D. Present and historic relevance of Yartsa Gunbu (Cordyceps sinensis). An ancient myco-medicinal in Tibet. Fungi. 2008;1(4):6-7.] www.herbalgram.org 2009 HerbalGram 83 | 55 The gathering of cordyceps represents the principal source of income for many Tibetans from Lithang and neighboring areas.

The Fungus Cordyceps sinensis bodies through the mouth or the respiratory pores (2 of them are Cordyceps is a genus of ascomycete fungi belonging to the present over each metamere). When C. sinensis attacks T. armori- family Ophiocordycipitaceae (formerly Clavicipitaceae), parasitic canus, its mycelium invades the caterpillar’s body, filling its cavity, mainly on insects and other arthropods. These type of fungi are killing the insect, and eventually completely replacing the host thus named entomophagous (feeding on insects) fungi. [Authors’ tissue. The dead caterpillar appears yellowish to brown in color. taxonomic note: According to the recent DNA review of the The cylindrical club-shaped fruiting body, 5-15 cm long and dark genus Cordyceps, the new name for Cordyceps sinensis is Ophio- brown to black in color, grows up from spring to early summer, cordyceps sinensis (Berk.) G.H. Sung, J.M. Sung, Hywel-Jones & protruding and developing out of the caterpillar’s forehead. The Spatafora.8] Cordyceps sinensis s.l. (in the broad sense) is a para- stroma (mass of fungus tissue) bears many small, flask-shaped sitic fungus living on lepidopterous (butterflies and moth) larvae. perithecia (fruiting bodies) that contain the asci (sacs in which the It attacks and grows on caterpillars, specifically on larvae from sexual spores are formed). According to Li et al., C. sinensis spores the genus Thitarodes (Hepialidae, Lepidoptera). Cordyceps sinensis disperse and break up into 30-60 propagules, which attach themselves to the larval state of the insect; usually 15 days pass between thrives from 3000 to 5000 meters above sea level, in cold, grassy, 10 alpine meadows of Tibet Autonomous Region (TAR, Chinese: spore dispersion and larval infection. Xizang), Sichuan, Gansu, Qinghai, and Yunnan Chinese prov- In the Lithang area, where most of the fieldwork was conducted, inces, and in a few Nepalese, Bhutanese, and Indian Himalayan the authors observed C. sinensis between 4000 and 4500 meters of areas. The infected hosts, of which T. armoricanus (Oberthür) altitude in the alpine grasslands on the northern slopes of the Shal- Ueda is the most commonly-mentioned species, live underground uli Shan Range mountains. The length of the larvae varies roughly on the Tibetan plateau and Himalayan regions in the same areas from 3 to 6 centimeters. The length of the dry mushroom spans where C. sinensis thrives, and they spend up to 5 years before from 3 to 10 centimeters. pupating. The spores of C. sinensis are spread by the wind over the soil and Cordyceps Harvesting onto plants, where they come into contact with Thitarodes larvae, particularly when the caterpillars emerge to feed on roots and During our fieldwork in east Tibet, we participated in the gath- herbaceous vegetation. Larvae were observed eating tender roots ering of cordyceps, both with Tibetan medical practitioners and of alpine meadow species such as Polygonum, Astragalus, Salix, professional gatherers. The season starts at the beginning of April Arenaria, and Rhododendron.9 The caterpillars may eat the spores and lasts until the end of June, although normally the harvesting or the spores lying on their bodies may germinate and enter their season spans from the beginning of May until the middle of June. After that period, according to a modern text of Tibetan materia

56 | HerbalGram 83 2009 www.herbalgram.org medica, “the body of the ‘worm,’ which is within the ground, our fieldwork, a few small bags full of cordyceps were hanging gets rotten… until its interior becomes hollow.”5 from the wooden ceiling of his home. He had decided to sell The gathering of cordyceps represents the principal source them the next winter when the price would be higher. of income for many Tibetans from Lithang and neighboring areas.11,12,13 Many people from Lithang—young and old, laymen and monks, men and women—walk everyday Cordyceps Use at the Popular Level along the steep path that leads to the collecting areas. A few Traditionally, Tibetan people perceive cordyceps as a single Chinese citizens, some of them coming from lowland regions, substance that undergoes a metamorphosis on passing from also participate in the gathering. According to our informants, spring to summer. They refer to it as yartsa gunbu, mean- most of the picking areas are located on the north-facing ing “summer-grass winter-worm,” although they frequently slopes of the mountains. shorten the name to bu (“worm”) at the popular level. All the Most of the gatherers lie on the ground over the high-alti- Tibetans with whom we spoke believe that, during winter, tude expanses, attentively scanning the terrain. The search cordyceps lives as a worm and that, after a metamorphosis for the tiny cordyceps in the high altitude grasslands, inter- occurring at the beginning of spring, it changes into a kind of spersed with small Rhododendron grass. In certain confined areas, bushes and various vegetation, such as a few sacred sites, cordy- still dormant at the beginning of ceps seems to have connections spring, is a difficult task, requir- with the local popular reli- ing concentration and patience. gion. Its gathering was banned, In fact, the height and thickness for example, in the Dzachuka of the fungus are so small that it (rDza chu kha) and Sertha (Se cannot be easily seen: in spring tha) regions (located in Sêrxü the ground is covered with short County and Sêrtar County, vegetation stumps as brownish as respectively, Ganzi Tibetan the tiny cordyceps. But Tibetan Autonomous Prefecture, Sich- people generally seem happy to uan Province).14 Animals that perform this work since it is not dwell underground in burrows, considered particularly strenuous, as Huber reports, “are nega- the enterprise is highly profitable, tively associated with the archaic and because they like spending cosmology. These species are their time together in the moun- considered to be too close to the tains. realm of the local subterranean The gatherers proceed slowly and sub-aquatic deities, who are on hands and knees, or bend- believed to be easily offended ing the body and leaning on a and also quick to cause harm to small hoe. They usually carefully humans and their livestock in scan the area in front of them, retribution for human encroach- keeping their faces close to the ment upon their realm.”15 ground. If they do not recognize The use of cordyceps is not any cordyceps, they take a few particularly common at the steps forwards and proceed in popular level in Lithang County the search to an adjacent area. The layer of earth encapsulating cordyceps specimens and in the other fieldwork areas. Cordyceps is extracted from the extracted from the soil has to be removed before utilization. Several Tibetan medical practi- soil with a hoe or a small knife. Photo ©2009 Alessandro Boesi tioners agree on the fact that, in It is important not to damage the general, this substance is seldom larva, because it would lose value. used as a medicine or diet supple- We have noticed many gatherers carrying thin sticks of wood ment among Tibetans, who essentially regard it as a trade (like toothpicks) that may be used to repair cut or broken item. larvae or to increase the weight of the product, once inserted The few people who consume the product typically do so as in them. a tonic in the form of a beverage that may be prepared in differ- Some gatherers claim that they may find 30 to 40 worms a ent ways. We have sometimes observed Tibetans sipping small day. Nawan Tashi, an independent doctor who often spends amounts of these potions from tiny bottles while conduct- a few days of the gathering season collecting cordyceps, says ing activities such as carving religious prayers on stones and that the average amount collected in that area does not usually gambling. Nearly 80 informants (i.e., gatherers of and traders exceed 20 specimens a day; the maximum specimen number in cordyceps, plus Tibetan traditional doctors) maintain that that he has found in one day has been 27. On the day that these potions are helpful to the body’s general health and for we met with him, he arrived home late in the afternoon with increasing strength and vigor, and that they are also a good only 14 specimens in his leather bag. After drying the amount aphrodisiac. Our informants from Lithang explain that these collected, Nawan Tashi saved some of it in his store room with potions are prepared by dipping a few cordyceps specimens other herbal materials. He generally sells most of the product into a container filled with arak (a rag), a local alcoholic spirit on the local market to make some money, with which he then processed from barley or rice. The number of specimens may buys other medicinal plants, usually manufactured Tibetan vary according to the quantity of a rag held in the container pills from the Derge Tibetan Medical Institute. At the time of and the potion strength required. Usually 3 to 5 speci- www.herbalgram.org 2009 HerbalGram 83 | 57 Distribution of cordyceps in Tibet. Map reprinted from Daniel Winkler’s article on Yartsa gunbu in Economic Botany 62.3 (2008). www.danielwinkler.com mens of cordyceps are used for each half-liter of a rag. The potion is ready after having been kept in a cool place for 2-3 months. Some people wait a year or more before consuming it, claiming that the long period of the drug permanence in the alcohol increases the potion potency and effectiveness. When the a rag is exhausted, some more may be added by filling the container again. Most informants state that the refilling can be done several times and are aware that, in from that same text. To our knowledge, apart from this occur- this case, the potion’s overall potency decreases. Some people may rence, the expression has never been mentioned to indicate yartsa add other ingredients, as is often done by traditional doctors. gunbu in classic or other modern Tibetan materia medica. A Winkler reports that “in Lithang there is already a distillery that modern Tibetan medical dictionary presents the entry tsatachi as produces liquor (qingke jiu) from regionally grown barley with a a synonym of yartsa gunbu.21 This designation has probably been few caterpillar fungi or fritillary bulbs floating in the bottle.”13 devised recently in connection to the drug named tachi, which A few scholars provide evidence that cordyceps is employed at according to Gawe Dorje, corresponds to a salamander (Batrachu- the popular level in other regions inhabited by populations of perus pinchonii).6 Zurkhar Namnyi Dorje, who devotes an entire Tibetan language and culture. In the Dolakha District (Central- chapter to describing the so-called tachi and its varieties, affirms east Nepal), the Sherpa people use cordyceps as an aphrodisiac that this term connotes several other substances from plants, and tonic: “One to two fruiting body are orally administered with minerals, and animals that share the same properties as yartsa milk, once a day.”16 According to Sacherer, in the Rolwaling Valley gunbu, although yartsa gunbu itself is never mentioned.3 Attribut- of the same District, the product is popularly used as a tonic and ing this new denomination to yartsa gunbu has possibly been done aphrodisiac and “it is eaten in its entirety, caterpillar and fungus, to include it in the same group as the most powerful aphrodisiacs mostly by middle aged men.”17 In Nar (Central Nepal, Manang and tonics, and it is probably due to Chinese influence: Aphrodi- District), it is said that “if a person mixes yertsagumbu with 13 siacs, notably cordyceps, represent highly praised drugs in Chinese other herbs and takes the mixture over a period of three years, he medicine. It seems that, only in the past few decades, the use of will become as thick as an elephant, quick as a horse and pretty as cordyceps has been spreading in modern Tibetan medical insti- a peacock,”18 and it has been assessed that “the product is ground, tutes located in Central Tibet. boiled in milk and drunk with honey or rock candy.”18 According The first Tibetan author who described yartsa gunbu seems to be to a publication by the Ministry of Forests and Soil Conservation the famous Tibetan doctor Zurkhar Nyamnyi Dorje (1439-1475) of Nepal, in the Thak areas (Central Nepal) cordyceps “is taken mentioned above, the practitioner who founded the so-called Zur orally in combination with Dactylorhiza hatagirea (Orchidaceae), medical tradition. In his treatise Ten Millions of Instructions: a honey and cow’s milk,” and it is also administered as a tonic to yak Relic (commonly and incorrectly also referred to as “Oral Instruc- and sheep.19 A similar use is attested also among the Tibetan prac- tions on a Myriad of Medicines”), he mentions yartsa gunbu among titioners of Dolpa District (West Nepal).20 According to Phuntsho the drugs that cure the rotsa (ro tsa) ailments—those concerning Namgyel, who has been conducting extensive survey in Bhutan sexual virility.3 on cordyceps as an economic resource for local people, in several The fundamental treatise of Tibetan medicine, The Four Tantras areas of this country the fungus is also known as a medicine at the (rGyud bzhi), of which the first edition dates between the 8th popular level (e-mail to A. Boesi, March 10, 2004). and the 12th century, does not mention this medicinal fungus.22 Also, The Crystal Rosary (Shel phreng), a text devoted to Tibetan materia medica, composed by the Tibetan doctor Deumar Geshe Cordyceps in Tibetan Medicine Tenzin Phuntsok in east Tibet in the 18th century and still consid- Cordyceps in Tibetan Medical Texts. In Gawe Dorje’s modern ered the fundamental reference for Tibetan practitioners owing text about Tibetan materia medica, the term tsa tachi (rtswa da to its completeness and details in medicinal substance descrip- byid, “grass da byid”) is given as the main name for yartsa gunbu.6† tion, surprisingly does not mention yartsa gunbu.23 Cordyceps is a We have never heard Tibetan doctors employing this designa- very common product in eastern Tibetan regions, and certainly at tion, although a few of them claim to have known of the term that time it already represented an important trade item as docu-

†Traditional treatises utilize the term “yartsa gunbu;” the notion of “cordyceps” is not known in such documents.

www.herbalgram.org 2009 HerbalGram 83 | 59 mented from several sources. For example, Rockhill reports that that time. It is also possible that among Tibetan peoples cordyceps “this mountain [in the valley called Lit’ang Golo] is famous as was already more famous as an item of trade than as a medicine, producing that curious worm-plant known as the Shar-tsa gong- exactly as it happens at the present time. Jampal Dorje describes bu (tung-chung hsia-ts’ao in Chinese), called by botanist Cordyceps yartsa gunbu as follows: “It grows on high mountains, during sinensis.”24 Yartsa gunbu is also not included in a Tibetan materia summer the root is similar to a worm, the leaves are similar to the medica describing the plants used at the Lhasa Medical and Astro- ones of the ‘mountain garlic’ rigok (ri sgog, Allium spp., Liliaceae), logical Institute in the first part of the 20th century.25 the flower is similar to that of the plant called Awa” (A wa, a plant The medicinal fungus is, however, described in the illustrated belonging to the Gramineae). Tibetan materia medica written by Jampal Dorje in the 19th Contrary to traditional treatises, in Chinese Tibetan cultural century, where it is mentioned among the “herbaceous medi- areas, all recently-published modern texts devoted to describing cines,” nomen (sngo sman), the so-called category that includes Tibetan materia medica give a large emphasis to cordyceps. The medicinal plants growing mostly in the higher zones of the moun- fungus is included in the first modern Tibetan materia medica tains, exhibiting an herbaceous aspect, slender stem, and tiny published at Lhasa in 1973.26 Certainly under Chinese influence, underground organs.4 The author provided an illustration of the in the modern pharmacopeia of Gawe Dorje, cordyceps has been fungus, in which he depicted some specimens already prepared in added to the so-called “essence medicines,” tsimen (rtsi sman) cate- bundles kept together by small strings, ready to be sold, exactly as gory, which includes peculiar medicinal substances coming from is customary today in some traditional Chinese pharmacies. This animals, minerals, and plants such as camphor (ga bur, Cinna- figure testifies to the importance of the product as a trade item at momum camphora, Lauraceae), cardamom (sug smel, Elettaria The few people who consume the product typically do so as a tonic in the form of a beverage that may be prepared in different ways.

A Khampa cordyceps trader waiting for customers in Lithang main street. There A Tibetan lady weighing some cordyceps specimens in Lithang main market. are several types of gatherers and traders, who may be distinguished in relation Many people, both men and women, both young and old, are involved in the to their activities and social status. Photo ©2009 Alessandro Boesi gathering and trading of this medicinal mushroom. Photo ©2009 Alessandro Boesi

60 | HerbalGram 83 2009 www.herbalgram.org cardamomum, Zingiberaceae), saffron (gur kum, Crocus sativus, given by several doctors at the 2000 Lhasa International Tibetan Iridaceae), musk, bear bile, and bitumen.6 Even a small amount Medicine Congress, who lamented that cordyceps had become of them is considered very powerful, and they share a particular rare in the last decades. As was noted earlier, it has been reported fragrance. Differently, Karma includes the product in the category that local Tibetan practitioners frequently use this product in the named tangmen (thang sman, “medicines of the plains”), which region of Dolpo (Nepal),27 and it is also employed in the Nepalese includes bulky herbaceous or sometimes tiny woody plants usually region of Manang.28 According to Phuntsho Namgyel, although not growing at high altitude, and reports that throughout Tibetan knowledge of cordyceps as an important medicinal plant exists regions there are 5 different varieties of it.5 We have never obtained in the Himalayan kingdom of Bhutan, the Bhutanese traditional this last piece of information during our fieldwork. medicine system, which is similar to Tibetan medicine, started Tibetan doctors from Lithang state that they do not frequently incorporating it in its formulations only a few years ago. employ and do not highly value cordyceps, claiming to know other herbs that, once mixed, have the same properties but give more The Energetics of Cordyceps in Tibetan Medicine. According effective results, particularly wang lag or wangpo lagpa (dbang po to the modern texts of Tibetan materia medica, the fungus must lag pa, Gymnadenia orchidis, Orchidaceae);6 G. crassinervis and be gathered between spring and summer (May-June).5,6 Both the G. conopsea;5 and Dactylorhiza hatagirea (Orchidaceae).20 The worm and the grass are used after removing the earth that encap- Gymnadenia species is also deemed a good tonic and aphrodisiac sulates the larva. Also the worm’s white-to-yellowish mycelium according to Tibetan medical treatises. that encapsulates the larva must be peeled off. The fungus is then The utilization of cordyceps was not very common also at cleaned and dried in a cool place at a constant temperature. The the Kumbum Medical Institute (Qinghai Province) and at the therapeutic properties mentioned in the texts are described accord- Lhasa Medical and Astrological Institute before the arrival of the ing to the pharmacological theory of Tibetan medicine. The taste Chinese. Today it seems that the product is utilized more frequently of the dbyar rtswa dgun ‘bu is sweet (mngar mo) and salty (lan in central Tibet (particularly at Lhasa) according to information tshwa ba), its post-digestive taste is sweet, its potency is unctu- ous (oily; snum) and hot (drod). The fungus has the properties of A Chinese cordyceps trader in Dardo (Kandging) town, located increasing the energy of the body, of restoring semen functionality, at the limit of Tibetan cultural areas. and of increasing its production. Furthermore, it increases kidney Photo ©2009 Alessandro Boesi strength and heat, it cures all the disorders caused by unbalance of the humor wind (rlung nad) and the disorders caused by unbalance of the humor bile (mkhris nad). It also prevents increasing of the humor phlegm (bad kan). Gawe Dorje reports that, according to a treatise compiled in the 19th century, cordyceps is among the 4 best plants to treat the ailments concerning sexual virility.6 Tibetan doctors from Lithang prepare 2 slightly different potions that contain cordyceps. These 2 recipes seem to be devised by mixing together medicinal herbal preparations deemed to be good tonics and aphrodisiacs in order to get a strong and effective preparation. Practitioners prepare both recipes by adding cordyceps and other materials to a container filled with a rag, which is then kept in a cool place for 2-3 months, as described earlier. The first recipe includes the following ingredients: cordyceps, dugme (dug med, Fritillaria cirrhosa, Liliaceae) bulbs, the root of a herbaceous plant not yet identified, and a fragment of shara (sha rwa, deer’s antler, probably Cervus albirostris, white-lipped deer, or C. elaphus macneilli, a red deer). The second recipe includes cordyceps, dugme bulbs, and dretserma (‘dre tsher ma, Lycium barbarum, Solanaceae; aka goji or wolf berries). These 2 medicines do not represent typical Tibetan medical preparations. They are not reported on written sources and most likely originate from oral transmitted knowledge influenced by Chinese tradition. A preparation aimed at improving physical strength and sexual virility,7 administered as a pill, includes as the main ingredient 50 grams of crushed cordyceps, to which the following powdered medicinal substances are added: aruserdog (a ru gser mdog, Terminalia chebula, Combretaceae); the so-called sanpodrug (bzang po drug), dzati (dzwa ti, Myristica fragrans, Myristicaceae; nutmeg), lishi (li shi, Eugenia caryophyllata, Myrtaceae; clove), chugan (cu gang, Bambusa textilis, Poaceae), gurkum (gur kum, Crocus sativus, Iridaceae; saffron), sukmel (sug smel, Elettaria cardamomum, Amomum compactum, Zingiberaceae; cardamom), and kakola (ka ko la, Amomum subulatum, A. tsao-ko, Zingiberaceae). The following substances are also added: powari (pho ba ris, Piper nigrum, Piperaceae; black pepper), giwan (gi wang, bezoar), tomtri (dom www.herbalgram.org 2009 HerbalGram 83 | 61 A Tibetan lady extracts cordyceps mushroom with a small hoe at 4300 meters in Lithang County. Photo ©2009 Alessandro Boesi

then 50,544 kg in 2004.”1 Unfortunately, at present no data regarding the long-term impact of this intensive collection are available. At the time of the fieldwork, Lithang gatherers and traders stated that they had not noticed a reduction in the abundance of cordyceps since they had come into the business, except for some seasonal decreases attributed to bad weather conditions in early spring. Collectors and dealers interviewed by Winkler reported the same data but complained about reduced harvesting rates per individual due to steadily-increasing competition.1 Winkler applied to this issue the “Rapid Vulnerability Assessment” (RVA) technique, as developed by ethnobotanist Tony Cunningham (after Wong 2000)36 and formalized for analysis by Wild mkhris, bear bile), tandromkarpo (thang phrom dkar po, Przewalskia and Mutebi.37 He obtained a score of 20, indicating a moderate tangutica, Solanaceae), and lantantse (lang thang rtse, Hyoscyamus degree of vulnerability. Namgyel, by applying the same technique, niger, Solanaceae; henbane). obtained a score of 26 for Bhutan’s cordyceps species, noting that Cordyceps is also employed in another preparation, named tachi the score would be slightly lower “if the traditional rights of the chusum (da byid bcu gsum, “tachi 13”), similarly administered as a 7 collectors are recognized and a community-based natural resources pill. This preparation’s main constituent is tachi, and it includes management system is put in place.”38 the following 13 ingredients, most of them coming from animal substances: tachi (da byid), wangpo lagpa, drekar (‘bras dkar, white rice), ghiacil gomar (rgya mchil mgo dmar, sparrow [meat]), samsha Conclusion (sram sha, otter meat), tsangnya (gtsang nya, river fish), tugdre (thug Since C. sinensis grows over much of the area traditionally inhab- ‘bras, ram testicles), ciwisha (‘phyi ba’i sha, marmot’s meat), pukron- ited by populations of Tibetan language and culture, and since sha (phug rong sha, pigeon’s meat), chilwisha (mchil ba’i sha, sparrow ‡ its citation in Tibetan medical treatises pre-dates by 2 centuries [meat]), kimchasha (khyim bya’i sha, cock’s meat), cordyceps, and its mentioning in Chinese medical texts, it may be assumed that gonmosha (gong mo’i sha, Tibetan partridge’s meat). The medicine, Tibetan people were probably the first to notice this fungus thriv- administered early in the morning with honey, has the property of ing on the high pasturelands, examine its morphological traits, boosting the body’s energy, supporting the 5 senses, and increas- understand its biological features, assess its qualities and thera- ing life span. peutic properties, and to attribute it a name. It is remarkable and Although the primary focus of this paper is not about review- difficult to explain that this medicinal fungus, so highly praised ing the modern pharmacological and clinical data on cordyceps, as a tonic and aphrodisiac by Zurkhar Namnyi Dorje in the 15th it is constructive to mention a few recent clinical studies that century,3 is not mentioned in many Tibetan materia medica. While have investigated the efficacy of cordyceps preparations. Human this interesting fungus is used in some Tibetan medicinal formula- clinical trials have demonstrated the effectiveness of C. sinensis 29,30 tions, it is certainly not employed as heavily as in Chinese culture. fermented mycelia in combating decreased libido and virility. Its popularity within Chinese medicine, however, has certainly In a clinical study of elderly patients with chronic fatigue, results made the fungus an important economic resource for Tibetan indicated that most of the subjects treated with C. sinensis pure people. mycelium reported a significant clinical improvement in the areas The recent drop in sales of cordyceps may therefore have seri- of fatigue, cold intolerance, dizziness, frequent nocturia, tinnitus, ous economic consequences for some Tibetan communities, and hypo sexuality, and amnesia, while no improvement was reported 31,32,33 it remains to be seen whether sales of cordyceps will rebound to in the placebo group. In recent years, C. sinensis has been or surpass previous levels as the global economy stabilizes. With investigated in animal and in vitro studies for anti-aging effects, further clinical investigation, it is possible that use of cordyceps activity on sexual function, and immune modulation, among other 34,35 may eventually spread to or increase within other cultures. As potential uses. Tibetan people continue to gather cordyceps for medicinal use Sustainability Issues and/or international markets, it will be important to occasionally reassess sustainability and environmental impact. The increased harvesting of cordyceps all over its distribution area certainly implies sustainability issues. Winkler reports that, Alessandro Boesi, Tibetologist, received his PhD in Biologi- “according to current official statistics, yartsa gunbu harvest was cal Anthropology in 2004 from the Université de la Méditerranée, below 40,000 kg for Tibet [Tibet Autonomous Region] between Marseille, France. He has conducted extensive fieldwork in Tibetan 1999 and 2001, reached nearly 44,000 kg in 2002 and 2003, and cultural regions, and his present research interests focus on the ethno-

‡Sparrow meat is listed twice with different names. The 2 different Tibetan designations indicate 2 species belonging to the genus Passer. The latter is identified as P. montanus; the identification of the former is not confirmed in modern Tibetan materia medica.

62 | HerbalGram 83 2009 www.herbalgram.org botany of Tibetan peoples and the materia medica of Tibetan medicine. 16. Bhattarai NK. Folk herbal medicines of Dolakha district, Nepal. Fitotera- His most recent publication is a translation from Tibetan into Italian pia. 1993;66:387-395. of a rare illustrated Tibetan materia medica handbook written about 17. Sacherer J. The high altitude ethnobotany of the Rolwaling Sherpas. Contributions to Nepalese Studies. Kathmandu: CNAS, Tribhuvan Univer- 2 centuries ago, which describes medicinal plants and their therapeutic sity. 1979;6(2):45-64. properties (www.shangdril.org). 18. Polhe P. Useful Plants of Manang District. Stuttgart: Franz Steiner Verlag Francesca Cardi obtained her PhD in Medical Anthropology in 2004 Wiesbaden GMBH, Nepal Research Centre Publications. 1990;16:37. at the Université de la Méditerranée, Marseille, France. For 10 years, she 19. Ministry of Forests and Soil Conservation. Medicinal Plants of Nepal. has conducted extensive research in Tibetan regions, focusing on phar- Kathmandu: 1970:116-117. macopeias, medical preparations, and traditional doctors’ practice. She is 20. Lama YC, Ghimire SK, Thomas YA. Medicinal Plants of Dolpo. Amchis’ a member of the research center Shangdril (Italy) and collaborates with Knowledge and Conservation. Kathmandu: People and Plants Initiative, WWF Nepal Program; 2001:56. scientific institutions on drug development and clinical research. She and 21. Byams pa ‘phrin las. Bod lugs gso rig tshig mdzod chen mo. Beijing: Mi Dr. Boesi co-wrote the article “Classification and Utilization of Natural rigs dpe skrun khang; 2006:707. [Champa Trinle. Great dictionary of Products Used as Materia Medica in Tibetan Traditional Medicine” in the Tibetan medical tradition. Beijing: Nationalities Languages Press; HerbalGram issue 71. 2006:707.] 22. Yu thog yon tan mgon po. bDud rtsi snying po yan lag brgyad pa gsang ba References man ngag gi rgyud. Lhasa: Bod ljongs mi dmangs dpe skrun khang; 1992. 1. Winkler D. Yartsa Gunbu (Cordyceps sinensis) and the fungal commodifi- [Yuthog Yonten Gonpo. Tantra of Secret Instructions on the Eight Branches, cation of Tibet’s rural economy. Economic Botany. 2008;62(3):291-305. the Essence of the Elixir of Immortality. Lhasa: Tibetan People Press; 1992.] 2. Winkler D. Present and historic relevance of Yartsa Gunbu (Cordyceps 23. De’u dmar dge shes bstan ‘dzin phun tshogs. Shel gong shel phreng. sinensis). An ancient myco-medicinal in Tibet. Fungi. 2008;1(4):6-7. Dharamsala: Tibetan Medical and Astro Institute; 1994. [Deumar Geshe 3. Zur mkhar ba mnyam nyid rdo rje. Man ngag bye ba ring bsrel. Beijing: Tenzin Phuntsok. The Crystal Block, The Crystal Rosary. Dharamsala: Mi rigs dpe khrung khang, 2005. [Zurkhar Namnyi Dorje. Ten Millions of Tibetan Medical and Astro Institute; 1994.] Instructions: a Relic. Beijing: Nationalities Languages Press; 2005.] 24. Rockhill WW. Diary of a Journey through Mongolia and Tibet in 1891 and 4. ‘Jam dpal rdo rje. An Illustrated Tibeto-Mongolian Materia Medica of 1892. City of Washington: Smithsonian Institute, 1894:361. Ayurveda. Chandra L, ed. New Delhi: International Academy of Indian 25. Gangs ljongs sman pa’i grong khyer lcags ri bai durya gling gi sngo’i sman gyi Culture; 1971. ‘khrungs dpe. 1971. Bod gzhung sman rtsi khang, Dharamsala. [Materia 5. Karma chos ‘phel. bDud rtsi sman gyi ‘khrungs dpe legs bshad nor bu’i Medica of Herbal Medicines of the Country of Beryl: The Iron Mountain City phreng mdzes. Lhasa: Bod ljongs mi dmangs dpe skrun khang; 1993. of the Doctors in the Land of Snow. Dharamsala: Medical and Astro Insti- [Karma Chopel. Beautiful Rosary of Precious and Elegant Teachings: a Mate- tute of the Tibetan Government; 1971.] ria Medica on the Medicines which are Elixir of Immortality. Lhasa: Tibetan 26. Bod ljongs rgyun spyod krung dbyi’i sman rigs. Bod ljongs mi dmangs dpe People Press; 1993.] skrun khang. 1973: 579. [A List of Chinese Traditional Medicines of Tibetan 6. dGa’ ba’i rdo rje. ‘Khrungs dpe dri med shel gyi me long. Beijing: Mi rigs Everyday Use. Lhasa: Tibetan People Press; 1973.] dpe skrun khang; 1998. [Gawe Dorje. The Immaculate Crystal Mirror of 27. Ghimire SK, Lama YC, Thomas YA. Medicinal Plant Management and Source and Identification. Beijing: Nationalities Languages Press; 1998.] Health Care Development in Shey Phoksumdo National Park, Dolpa. Kath- 7. Tshe ring nor bu. Bod kyi gso ba rig pa’i sman rdzas rnams spyod yul sman mandu: People and Plants Initiative, WWF Nepal Program, 2000. sbyor gang du gsal ba btso sbyang zhun thigs. Dharamsala: Bod gzhung sman 28. 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The Tibet Journal. 2003;27(3):29-42. with heart failure. J Admin Tradit Chin Med. 1995;5:40–43. 12. Winkler D. Forest Use and Implications of the 1998 Logging Ban in the 34. Ji DB, Ye J, Li CL. Antiaging effect of Cordyceps sinensis extract. Phytother Tibetan Prefectures of Sichuan: Case Study on Forestry, Reforestation And Res. 2009;23(1):116-22. NTFP in Litang County, Ganzi TAP, China. In: Jiang Z, Centritto M, 35. Park DK, Choi WS, Park PJ. Immunoglobulin and cytokine produc- Liu S, et al. The ecological basis and sustainable management of forest tion from mesenteric lymph node lymphocytes is regulated by extracts of resources. Informatore Botanico Italiano. 2003;35(2):116-125. Cordyceps sinensis in C57Bl/6N mice. J Med Food. 2008;11(4):784-8. 13. Winkler D. Yartsa gunbu—Cordyceps sinensis: economy, ecology & ethno- 36. Wong JLG. The biometrics of non-timber forest product resource assess- mycology of a fungus endemic to the Tibetan plateau. 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www.herbalgram.org 2009 HerbalGram 83 | 63 Legal & Regulatory

GAO Calls for More Dietary Supplement Regulation In March 2009, a Government Accountability Office (GAO) report was released to the public that called for the US Food and Drug Administration (FDA) to have more authoritative oversight of the dietary supplement industry.1 The 77-page report, titled “Dietary Supplements: FDA Should Take Further Actions to Improve Oversight and Consumer Understanding,” stemmed from a request of the House Energy and Commerce Committee, particularly Representatives Henry A. Waxman (D-CA) and Bart Stupak (D-MI), as well as Assistant Senate Majority Leader Richard J. Durbin (D-IL). For just over one year, GAO conducted a performance audit any complaint be dealt with by the agency does not make sense,” of FDA’s relationship and past actions with dietary supple- he continued. ments. Among several conclusions, GAO found that the agency NPA additionally disagreed that FDA doesn’t have enough cannot adequately identify safety concerns, dedicates relatively few information about individual dietary supplement products, citing resources to dietary supplement oversight, and has limited ability that the industry has registered all manufacturing facilities under to efficiently and effectively remove what the agency might deem bioterrorism regulations enacted 5 years ago. a contaminated or otherwise unsafe product from the market. An Steve Mister, president and CEO of the Council for Responsible article in the New York Times, for example, noted that because FDA Nutrition (CRN), stated in a press release that requiring all adverse cannot require manufacturers to remove tainted supplements from events to be reported would create more bureaucratic paperwork stores, only 3 out of 69 brands of weight-loss products deemed and would not result in true benefits for consumer safety.4 as harmful in a recent FDA “The adverse event report- report had been voluntarily ing law was carefully consid- recalled (as of early March Some industry organizations ered and supported by numer- 2009).2 ous stakeholders, including Based on its findings, GAO have voiced their opposition, consumer groups, and there recommended that the FDA is no need to revise a law that commissioner seek additional with most disagreement only recently went into effect authority to oversee dietary and appears to be working,” supplements and improve said Mister. consumer understanding surrounding the controversial FDA also recognized of such products. It specifi- this potential problem in cally called for the commis- recommendation that all its response to GAO.1 The sioner to require facilities and agency said that receiving an companies to provide more dietary supplement-related increased number of reports information about themselves on all adverse events could and their products, such as a adverse events be reported. make it more difficult to list of products and copies of recognize signals of potential their labels. It also suggested toxicity generated by reports that FDA issue a guidance to clarify what is considered a new of serious adverse events. This could delay the identification of dietary ingredient (NDI) and explain the difference between safety concerns, FDA said. dietary supplements and foods with added dietary ingredients. Not all of the response, however, was in disaccord with GAO. Furthermore, GAO called for the FDA commissioner to require FDA generally agreed with most recommendations, and NPA and reports of all adverse events, not just those that are serious. Though CRN also supported guidance that clarifies how the FDA deter- GAO recognized that the number of adverse event reports has mines NDIs and what evidence is needed to document safety of tripled since mandatory reporting for serious adverse events went NDIs. into effect in December 2007, it said underreporting remains a The Center for Science in the Public Interest (CSPI) agreed with concern and noted that FDA has estimated that a total of more the overall report, claiming in a press release that the supplement than 50,000 mild, moderate, and serious adverse events occur industry operates in a gray area where the law doesn’t always reign each year. supreme.5 In response to GAO’s recommendations, some industry orga- “Congress should close those loopholes by requiring that ingre- nizations have voiced their opposition, with most disagreement dients be reviewed for safety and effectiveness and that cautionary surrounding the controversial recommendation that all dietary information appear on product labels,” said CSPI Legal Affairs supplement-related adverse events be reported. Director Bruce Silverglade, in a press release. “While we supported legislation to establish mandatory adverse Representatives Waxman, Stupak, and John D. Dingell (D-MI), event reporting for dietary supplements and over-the-counter as well as Senator Durbin, said in response to the report that they drugs, we still believe that reporting should be limited to inci- will work with other lawmakers to ensure FDA has the regulatory dents that are serious,” said David Seckman, executive director and authority and resources that it needs.6 CEO of the Natural Products Association (NPA) at that time, in Two weeks after the report’s release, President Barack Obama a press release.3 “If the FDA’s resources are already stretched, as nominated Margaret Hamburg, MD, to be the new FDA commis- the report indicates, then adding to this burden by mandating that sioner and Joshua Sharfstein, MD, to be deputy commissioner.7

64 | HerbalGram 83 2009 www.herbalgram.org Legal & Regulatory

(Dr. Hamburg was approved for the position on May 18 after a GAO says [press release]. Washington, DC: Center for Science in the Senate voice vote8 and Dr. Sharfstein was appointed in March with Public Interest; March 2, 2009. no Senate confirmation necessary.) Obama’s choices for FDA lead- 6. Schiff D. Congress says GAO report supports increasing supplement ership, as well as increasing criticism of FDA’s performance on a oversight. The Tan Sheet: 17(10):10. March 9, 2009. 7. Harris G. President promises to bolster food safety. New York Times. number of food safety issues, initially caused speculation that the March 15, 2009;A24. agency might be separated into 2 entities—one focusing solely on 8. Alonso-Zaldivar R. Senate confirms Obama’s pick for FDA chief. The foods and the other focusing primarily on medicines and medical Associated Press. May 18, 2009. devices. 9. Hearing on the Nomination of Margaret A. Hamburg for Commis- Dr. Hamburg went through her Senate hearings in May, during sioner of the Food and Drug Administration before the Senate which she denied that any possible severing of the agency would Committee on Health, Education, Labor, and Pensions; May 7, 2009; take place and called reports of such “simply untrue.”9 Also during Washington, DC. her hearing, Senator Orrin Hatch (R-UT) asked Dr. Hamburg 10. Fiore K. Group calls for review of DSHEA in light of Hydroxycut. Medpage Today. May 7, 2009. if she thought the Dietary Supplement Health and Education 11. Scott-Thomas C. Record FDA budget proposed as Hamburg clears Act (DSHEA) and the Dietary Supplement and Non-prescrip- Senate. NutraIngredients-USA.com. May 12, 2009. tion Drug Consumer Protection Act are adequate at regulating 12. Editorial: Tighten up laws on diet supplements. Minneapolis-St. Paul the dietary supplement industry and protecting consumers, to Star Tribune. May 5, 2009. Available at: http://www.startribune.com/ which she responded that she currently lacks experience with these opinion/editorials/44325417.html?elr=KArksUUUU. Accessed May topics. 6, 2009. “This is really a complex issue and one that I haven’t been deeply involved in my other professional experiences—one that I want to take time to study and examine and work with you and others,” she said. Dr. Hamburg also recognized the GAO report and its recommendations, though she did not indicate if she would or would not implement any of its suggested changes. She ended her response by saying FDA oversight of the industry is important to ensure safety for the many American consumers who use these products. Several other recent incidents have also occurred that could potentially spur changes at FDA, including a recall of Hydroxycut® weight loss supplements in May that initiated numerous calls for a review and overhaul of alleged weaknesses of DSHEA,10 as well as the proposed 2010 fiscal year budget for FDA of $3.2 billion (a 19% increase, the largest in FDA history).11 These events’ influence on FDA’s relationship with the dietary supplements industry remains to be seen. If Congress or Dr. Hamburg do take the GAO’s advice, the dietary supplement and natural products industries could encounter some big changes. Some observers, however, say FDA currently has bigger issues on its plate.12

—Lindsay Stafford

References 1. United States Government Accountability Office. Dietary Supple- ments: FDA should take further actions to improve oversight and consumer understanding. GAO-09-250; January 2009. Available at: http://www.gao.gov/new.items/d09250.pdf. Accessed March 26, 2009. 2. Singer N. Study urges more oversight of dietary items. New York Times. March 3, 2009;B3. 3. Natural Products Association comments on new GAO report on regulation of dietary supplements [press release]. Washington, DC: Natural Products Association; March 2, 2009. 4. CRN responds to GAO report on dietary supplements [press release]. Washington, DC: Council for Responsible Nutrition; March 2, 2009. 5. FDA can’t protect Americans from dangerous dietary supplements, www.herbalgram.org 2009 HerbalGram 83 | 65 Conference Report

Late Herbalist Michael Moore’s Life and Legacy Celebrated at Conference By Shelley Torgove, Holly Ferguson, Donna Chesner, and Courtney Cavaliere The late herbalist, author, and teacher Michael Moore was a man who was brilliant in many ways. There has never been and will possibly never be another botanical medicine teacher like him. Michael, who passed away at the age of 68 in February of • Adam Seller, director of the Pacific School of Herbal Medi- 2009, taught hundreds of students about plant medicine, many of cine and one of Michael’s former students, gave a presen- whom have gone on to practice or teach herbal medicine. Many of tation on the historical roots of Michael’s contributions to these students, as well as friends and colleagues, recently gathered herbal medicine. He noted that Michael brought the clinical together to honor his life and work and to remember his spirit. insight of the Eclectic medical practitioners of the late 19th The conference “Michael Moore and American Herbalism” was and early 20th centuries into the current era, enlarging and held April 17-19, 2009, in Truth or Consequences, New Mexico updating John Scudder’s application of Darwinian episte- with around 200 dedicated plant lovers and friends of Michael in mology to modern herbal medicine in ways that respected attendance. Who could have chosen a more appropriately named and incorporated some of the richness of traditional biologi- town for a gathering of all who loved Michael? Throughout the cal knowledge of indigenous Southwestern cultures. He event, a common theme quickly emerged: herbalists must band believed that Michael’s work set the stage for a generation of together and assist one another, and great strength can come from American herbalists to respect indigenous knowledge and to such mutual support. acknowledge culturally-held intellectual property rights. • Shawn Sigstedt, a conservation biologist and ethnobotanist Some of the highlights of the conference include the follow- who learned from the Navajo and was mentored by Michael ing: Moore, led the workshop “Stalking the Wild Osha.” He • The documentary Just an Old Fashioned Herbalist, by began his presentation by declaring, “For 30 years, my whole Jessie Emerson, premiered before conference attendees, world has been circling around 1 plant.” Sigstedt has been some of whom openly wept during the viewing. Created to instrumental in growing and conserving osha (Ligusticum honor Michael Moore, the documentary contains footage of porteri, Apiaceae), which is also a plant that Michael Moore Michael collecting herbs, preparing tinctures, and teaching helped to make popular and protect. Sigstedt explained that about herb use, as well as interviews with Michael and with osha is an evolutionary bottleneck. The plant does not read- people who knew him well. The documentary gives viewers a ily reproduce by seed, even though each plant drops up to glimpse of Michael’s personality, humor, and wisdom. It also 300 seeds per year. He explained that osha must be collected provides viewers with the opportunity to learn of Michael’s in such a way that botanists replant the rootcrown with 6 introduction to the herbal scene, his knowledge of herbal inches of the root intact. Sigstedt instructed attendees to medicine, and his views on the importance of cultural back- embrace our invaluable plant medicines in order to preserve ground, folklore, ecological responsibility, etc., via his own them. words. The film further showcases images of the Southwest • Gabriel Howearth, one of Michael’s old friends, presented and its plants, and it incorporates Michael’s musical compo- at the conference despite having recently suffered serious sitions throughout the film. (The DVD may be purchased health problems that left him confined to a wheelchair. A for $30 by contacting Emerson at osoherbalsjessie@yahoo. great seedsman, botanist, and master gardener, Howearth com.) spoke of the importance of caring for the Earth. He advised • Daniel Gagnon (owner of Herbs, Etc.), Amanda McQuade attendees to think long-term rather than only about tomor- Crawford (a teacher and author), Mark Blumenthal (execu- row, and he said that they needed to be “moving mountains, tive director of the American Botanical Council), Phyllis not anthills.” He stressed that—like Michael Moore—people Hogan (ethnobotanist and owner of Winter Sun Trading are able to effect great changes within their lifetimes, and he Co.), and Shelley Torgove (practitioner and owner of Apoth- encouraged attendees to band together to create change. ecary Tinctura) led a discussion on “The Future of Ameri- In addition to such presentations, attendees were given the can Herbalism.” The discussion primarily raised ideas on opportunity to mingle and, in some cases, reconnect with friends how herbalists can band together and help each other. It and classmates during herb walks, social events, and between addressed the topic of how herbalists with small businesses— workshops. Not only did these gatherings allow attendees to people near and dear to Michael’s heart—can adjust to regu- openly reminisce with one another about Michael Moore, but lations such as the Good Manufacturing Practices (GMPs) they often led to engaging discussions of herbal, health, and other and survive within the larger herbal industry. Mitch Coven, topics. owner of Vitality Works, graciously offered to assemble A full list of the conference’s presentations and activities is information on GMPs and provide guidance on how these available at: www.mooreandmore2009.com. regulations could be implemented by small manufacturers, which could be an invaluable resource for the community.

66 | HerbalGram 83 2009 www.herbalgram.org Book Reviews

Nutraceuticals: A Guide for Healthcare mended dose range.” However, it was not on subjects drinking tea rather than taking Professionals, 2nd ed., by Brian Lock- clear how the references in that section led it as a capsule. In keeping with the scien- wood. Chicago, IL: Pharmaceutical Press; to these recommendations. It’s far better for tific rigor of the book, it is difficult to 2007. Hardcover; 426 pages. ISBN-13: the readers to go to the meat of the book match the dose of tea from cupfuls of liquid 978-0853696599. $75.00. Available in (i.e., condition-specific chapters), where the to a solid pill form. ABC online store. actual recommendations of nutraceutical Two chapters, on cancer and osteopo- What a treat it was to review such doses are supported by clinical studies. The rosis, were particularly thorough. The a scholarly book on the very important third chapter deals with sources and manu- first included an excellent review of how science behind nutraceuticals! Finally, a facturing. Even though this was not of keen commonly-known supplements (e.g., mela- nutraceuticals book on my shelf that is interest to me, the table included in this tonin, conjugated linoleic acids [CLA]) well-researched, timely, highly credible, chapter was worth the price of the whole affect cancer risk. For bone health, Dr. and well written. The author, Brian Lock- book. Dr. Lockwood listed commonly Lockwood presents the relevant science wood, PhD, a senior lecturer in pharmacy used nutraceuticals, their source (bovine, behind L-carnitine and CLA. The chap- at the University of Manchester, dedicated milk, conventional foods, etc.), manufac- ter on weight loss was the weakest of this book to his father, also a pharmacist, turing issues, their safety status (gener- the condition-specific chapters. It included who unfortunately died before the book ally recognized as safe or GRAS), and only a few of the plethora of nutraceuticals was published. This book would have made analytical techniques. The “source” and touted for weight loss. Reviewed are DHEA him proud. GRAS columns were most valuable. The (dehydroepiandrosterone), green tea, carni- The aim of the book was to “explore, fourth chapter deals again with pharmacy- tine and CLA. Surely others are available discuss, and possibly substantiate claims” type issues—more on bioavailability and (e.g., hydroxycitric acid [HCA], chromium, for a great many natural dietary ingredi- pharmacokinetics. For me, the outcome Hoodia gordonii [Asclepiadaceae], etc.) and ents, frequently referred to as nutraceuticals. of clinical studies reviewed in the remain- should have been included, even if data Hands down, Dr. Lockwood succeeded in ing chapters is more important than these weren’t favorable to promote weight loss. doing that. If one were to attempt to create a types of issues. Also missing was any substantial discus- new dietary supplement product and relied Now to the good stuff: chapters 5– sion of drug/supplement interactions. In solely on this book as a guide, one would 18 address specific conditions. Topics my view, this important subject belongs in need little else. The book is intended for include joint disease, heart-health, sleep, the chapter on synergies. pharmacists, medical practitioners, nurses, sports, bone health, and so forth. Each are There was some overlap, though that is and students of each discipline. Regretta- superbly researched and well presented. to be expected. Information on Omega-3s, bly, the author does not mention dietitians, Nearly every major study is cited for each soy, and tea appeared in many chapters, the category in which I belong, many of nutraceutical ingredient. The only two I but the author was careful to review only whom would also find it valuable. could not find were the age-related eye the relevant studies that relate to the chap- The first 4 chapters are the least interest- disease study (AREDS) for eye health ter theme. Similarly, a discussion of meta- ing to me. They provide a general overview and the GISSI-Prevenzione study for heart analysis—a statistical review of pooled of nutraceuticals and regulations. Unfortu- health. The only shortcoming is that each trials—has its own chapter devoted to it, nately, some information is too out-dated chapter does not end with a summary table but also such reviews appear elsewhere to be meaningful. For example, data from of the clinical trials and the effective dose when relevant. the late 1990s were used to determine of the nutraceuticals reviewed. Busy clini- In summary, to anyone who has anything the percentage of the population using cians may find it difficult to cull through to do with nutraceuticals—be it healthcare dietary supplements/ the dense material in provider, product developer, or regulator— nutraceuticals. Surely order to find the correct this book is a must-have. I look forward to newer data are avail- amount to recommend subsequent updates of this scholarly work. able. In this chapter and of a certain supplement. Reading such a fine book on the subject of many others, the data Dr. Lockwood consis- nutraceuticals makes me proud to work in presented were “Euro/ tently updates informa- this field. UK-centric.” Few statis- tion found in the previ- tics were germane to the ous edition and includes —Stacey J. Bell, DSc, RD markets or demograph- many more studies on Nutritional Consultant ics in the United States. tea (Camellia sinensis, Belmont, MA The second chapter felt Theaceae) and soy very “pharmacist-like” (Glycine max, Fabaceae), to me—it had several as publications on these Western Herbs According to Tradi- drawings and discus- 2 highly popular ingre- tional Chinese Medicine: A Practitio- sions about structure dients have increased ner’s Guide by Thomas Avery Garran. and pharmacokinetics. the most since the first Rochester, VT: Healing Arts Press; 2008. Two dozen or so ingre- edition published in Hardcover; 257 pages. ISBN-13: 978- dients were reviewed 2002. Unfortunately, 59477-191-0. $50.00. and each had a corre- many of the tea-related The author of this book, Thomas Garran, sponding “recom- studies were conducted comes by his credentials via mentorship www.herbalgram.org 2009 HerbalGram 83 | 67 Book Reviews with senior herbalists Michael Tierra and Felter, King, and Cook. He pulls further The appendices are useful and include Christopher Hobbs. As an acupuncturist information from contemporary greats of Western analogues of Chinese herbs, an with a master’s degree in Oriental Medicine Western herbalism, such as Simon Mills index of herbs by common name, an index from Pacific College of Oriental Medicine, and the late Michael Moore. of herbs by Latin name, and a glossary he has served as chair of the Department of The method Garran uses to develop the of Chinese medicine terms. I would have Herbal Medicine at the Institute of Clini- body of knowledge is both pragmatic and liked to have seen a glossary of Western cal Acupuncture and Oriental Medicine time honored: he triangulates personal herbal terms included, since practitioners in Honolulu, Hawaii. Garran’s roots are experience, literature, and oral teachings. of Chinese herbal medicine may not be in Western herbal medicine, which values This method can be considered a form familiar with technical terms of Western the use of herbs grown locally and region- of action research that employs cycles of herbal practice such as demulcent, vulner- ally. He has endeavored to categorize West- phenomenological observations and the ary, alterative, aperient, etc. ern herbs according to traditional Chinese clinic hermeneutic analysis of the literature. Garran photographed the images in the medical criteria, and admirably so. Included in this loop of knowledge build- book with the exception of the damiana Upon examining the table of contents ing is a participatory world view where the (Turnera diffusa, Turneraceae) image. His of Western Herbs According to Traditional dialogues among teachers, students, and images have a bright presence that is clear, Chinese Medicine: A Practitioner’s Guide, I peers are used to further establish the cred- with excellent color and relief. The images discover a well-organized setup, allowing ibility, dependability, and transferability of make the book a pleasure to explore, bring- immediate use in a clinical setting. There the knowledge about Western herbs and ing a touch of beauty to the pages. The are discussions about various herbal delivery Chinese medical thinking presented in the qualitative methods of building knowledge methods, including infusions, extracts, and book. used by Garran are employed well in terms decoctions, as well as poultices, suffused Fifty-eight herbal monographs and 40 of constructing a clinically useful collec- oils, suppositories, and briefs form the back- tion of monographs. special preparations. bone of the book; This book is a result of the best efforts of Looking further, they are constructed a mid-career professional herbalist. Garran I discover that the in a fashion simi- approaches his craft with mindfulness and materia medica lar to traditional heart, and it shows. While the book has section has 14 Chinese materia usefulness for the Chinese medical practi- Chinese herbal cate- medicas. From top tioner who is interested in Western herbs, gories based on the down, each mono- the Western herbalist who is interested professional language graph contains the in Chinese theory as a method of clinical of Chinese medicine, common, Latin thinking will also find this book useful. including herbs that binomial, plant As the world becomes more globalized, have the following family, Latin creolized, and cosmopolitan, so does the actions: resolve the pharmacopeial, and cultural application of the herbal agents of exterior, clear heat, other names that healing. This book is a strong step in that precipitate, drain can be commonly direction. dampness, dispel found in China or wind and dampness, the West. After the —Will Morris, PhD, DAOM transform phlegm naming conven- The Academy of Oriental Medicine and stop cough, tions, the flavor and Austin, TX aromatically trans- qi—which are essen- form damp, rectify tial to the Chinese qi, regulate blood, methods of organiz- Herbal Pearls: Traditional Chinese warm the interior and expel cold, supple- ing therapeutics—as well as the enter- Folk Wisdom collected by Miao Wen-wei, ment, stabilize and bind, calm the spirit ing channels, are described, which often translated by Yue Chong-xi, and edited and and extinguish wind. relate to the organ tropism but can also annotated by Steven Foster. Eureka Springs, The herbal categories relate directly to refer to tissue layers or anatomical zones. AR: Boian Books, LLC; 2008. Paperback; treatment principles that lead to formulas. The actions are described using Western 184 pages. ISBN-13: 978-0978601423. In the practice of Chinese medicine, the botanical language. After these brief forms $19.95. Available in ABC’s online store. clinical data is aggregated into patterns of information about the plant material Herbal Pearls is a fun and helpful book from which treatment strategies are derived. are addressed, the functions and indi- for those involved with Chinese herbs, but These treatment strategies are categorically cations are discussed. Where appropri- it is definitely not a book of wisdom, as the related to the materia medica sections that ate, cautions are also discussed. Dosages subtitle implies. The stories usually start form the building blocks of an herbal and preparations are addressed along with with “Once upon a time…” or with a place formula. major combinations. In the commentary, designation, such as “In the south part Garran identifies primary sources for his Garran relates his clinical experience and, of the Yangtze River…” and then launch work in the traditions of great herbalists of where pertinent, he discusses the transla- into a somewhat complex story. Typically, the early 20th century, including the Eclec- tion of source material for those plants with the stories relate very petty—and often tics and Physiomedicalists such as Lloyd, analogues in China. mean—aspects of human nature, which

68 | HerbalGram 83 2009 www.herbalgram.org Book Reviews is why you won’t find much true or mean- medical tradition, so there is a story about a similar illness and recovered, he asked the ingful “wisdom” here; these are not like cinnabar (a mercury compound), one about servant what herb he had taken to cure the fables or parables—couched in terms of the poisonous animals (3 examples given), and disease. The servant said he didn’t take any “moral of the story”—but sketches leading another about animal droppings (3 exam- herbs, but upon being pressed further, he up to a brief description of the herb and ples given: rabbit, bat, and silkworm, in reported eating some roots where he had its name, how the herb came to be known case you are wondering!). Before each story, fallen down and told Hu it was the herb for having a certain therapeutic property, Steven Foster has added a paragraph of that was used for “making fires.” A tea from or both. background information, such as botani- these roots cured the son. The word for These folk stories were collected by Miao cal aspects of the herb as well as medici- fire wood is chai, and Hu Jin Shi named it Wen-wei from the years 1934 to 1980 from nal uses known today, usually stated in also after himself, so the herb is to this day traditional doctors and others in the central more general terminology than is found in called “firewood Hu” or Chai Hu. coastal region of China’s Jiangsu, Anhui, Chinese medicine books. The reader gets a sense of several differ- and Zhejiang provinces. The China Society To give an example of a story in Herbal ent aspects of Chinese culture from these for Folk Literature and Art published this Pearls, here is a summary of the book’s stories—not usually the finer parts of that collection in 1981, and in the 1990s, it was entry on how the Chinese herb Bupleu- culture, but for those who haven’t spent translated into English by Yue Chong-xi. rum (Bupleurum spp., Apiaceae) received time in rural areas of China, the tales can Many years ago, after several visits to its name: be quite revealing. One receives a little bit China, I became interested in such stories The authors state that the genus Bupleu- of herbal lore in the stories (not very much, and tried to track them down. They were rum has 180 species, of which 42 are in but, as in the case above, some common usually to be found in oral tradition rather China, though 22 of those are rare. The use of the herb [to aid chills and fever] and than writing, though some efforts to record story focuses on Bupleurum chinense, wide- the part of the herb used [the root] is indi- them took place after the revolution, and spread throughout central and northern cated). the stories were mainly limited to those China. We learn it is used to “enhance Probably the best way to utilize this regions that were known to be the best or the effects of other herbs, reduce fever and collection is to read one story at a time and original sources of an herb. No one seemed enhance vital energy, dispersing conges- spread it over a couple of months—a story to know when the stories arose or who had tion in the liver” etc. After letting the a day—rather than plowing through one authored them, and often there were 2 or reader know that this famous herb is avail- story after another. In general, each story 3 competing stories explaining the herb’s able wherever Chinese herbs are sold, the (with the added introduction) is about 3 name or property. I suspect that most of story—collected in 1952 from an oral tale pages, so it only takes a few minutes to read the stories that come to us today, such as of northern China—is presented. one. As such, it is a fine waiting room book in this collection, probably arose during It opens with “In ancient times…” and for clinicians who prescribe Chinese herbs. the latter half of the Qing Dynasty period gives a brief explanation of the Confucian But don’t leave it on a book shelf collecting (1644–1912). civil service examination system in China. dust when you’re done. This book offers a collection of 53 stories One of the persons who passed the exams I can recommend this book to persons about herbs. For those not familiar with with honors was a Mr. Hu. This part of who are studying Chinese herbs at any Chinese medicine, “herbs” refer also to the story is given because it explains his level, whether specializing in Traditional mineral and animal substances used in the full name: since he passed the examination Chinese Medicine (TCM) or just expand- for state or provincial officials, he earned ing knowledge of herbalism into the realm the title Jin Shi, and so he was called Hu of Eastern traditions. It offers a different Jin Shi. He had a long-term servant at angle on medicinal herbs than the stilted his estate who became ill with alternating view sometimes created by TCM text- chills and fever. Mr. Hu, annoyed that the books, where the herb information is far sick man was no longer a reliable worker removed from its original context. Special and worried that the disease might be thanks to Yue Chong-xi and Steven Foster contagious, treated him cruelly and sent for bringing these stories to the English- him away. Mr. Hu told his servant he could speaking world. only come back when he was well again and able to work, which Hu presumed would —Subhuti Dharmananda, PhD never occur. The poor servant became so Founder and Director weakened he could not even make it to a Institute for Traditional Medicine nearby pond to get some water to drink. He Portland, OR lay down and eventually dug up some roots within reach, which he ate as his only source Herb, Nutrient and Drug Interactions: of food. A few days later he was better and Clinical Implications and Therapeutic returned to work for mean Mr. Hu. A while Strategies by Mitchell Bebel Stargrove, after that, Mr. Hu’s only son came down Jonathan Treasure, and Dwight L. McKee. with a serious illness, one with symptoms St. Louis, MO: Mosby Elsevier; 2008. 932 just like his servant had experienced. So pages; ISBN 978-0-323-02964-3. $92.95. when Hu remembered how his servant had Available in ABC’s online store. www.herbalgram.org 2009 HerbalGram 83 | 69 Book Reviews

This is a remarkably helpful book that is which makes for a quick and easy way to (single nucleotide polymorphisms). immensely well organized. This book starts answer common questions for each herb. The book is well-priced considering its with a foreword by Tieraona Low Dog, The book explores interactions of size (932 pages) and accompanying refer- MD, and a detailed preface by the authors. herbs, vitamins, minerals, amino acids, ence-containing CD. As such, I recom- Credits are given to an impressive support nutraceuticals, and physiologics. Each mend this as an essential day-to-day inter- team and reviewers, and an accompanying herb profile within the book contains a actions counseling reference for any and all CD lists the scientific references. The open- summary, description of the various herb persons in healthcare, whether integrative ing chapter explains the “Interactions Eval- forms, its use in clinical practice, an inter- or conventional. Plus, all involved in herb uation Guide,” which is also abbreviated as actions review, and then specific herb- and nutrient marketing and manufacture a handy “Quick Guide to Interactions Eval- drug interactions. An example of a specific will find this an essential and helpful back- uation System” in the flyleaf. The interac- interaction is valerian (Valeriana officinalis, grounder reference. The authors are to be tions evaluation system establishes catego- Valerianaceae) and benzodiazepines (Prob- congratulated on their valuable work and ries of numbers and symbols that show ability rating 3, for “Possible”). This section encouraged to provide periodic updates of the probability, type and clinical signifi- includes theoretical, speculative, and this book with Internet access. cance, and strength preliminary interactions and quality of interac- from research including —Thomas L. Kurt, MD tions. These are listed unsubstantiated claims. Clinical Professor in each herb and nutri- There are also cross- University of Texas Southwestern ent section with the indexes at the back of Dallas, TX prescription drug being the book for interactions reviewed. by drug class, interactions Stevia: The Genus Stevia. A. Doug- The first category by generic drug name, las Kinghorn (ed). New York, NY: Taylor explained in the inter- and interactions by drug & Francis; 2002. Hardcover; 211 pages. actions evaluation trade name. These cross- ISBN 0-415-26830-3. $129.95. Available guide addresses the indexes are followed by a in ABC’s online store. probability of clinically well executed index. Editor’s note: Given all of the attention significant interactions. To explore the depth that stevia (Stevia rebaudiana, Asteraceae) These are arranged of this book, I looked has received recently in the news, we thought in a numbered list: 1. for details, such as the it might be constructive to remind readers certain, 2. probable, eosinophilia-myalgia of the availability of this book (which was 3. possible, 4. plau- syndrome associated with not reviewed previously), even though it was sible, 5. improbable, contamination of the published in 2002. and 6. unknown. The dimer of L-tryptophan in This book, which constitutes volume 19 next category contains 21 symbols used to the accelerated manufacturing process of of the “Medicinal and Aromatic Plants— convey the type and clinical significance Showa Denko in Japan 1989; I found this Industrial Profiles” series from Taylor of an interaction. In this section, symbols topic well-covered historically, although & Francis, is highly relevant to today’s have meanings ranging from “potential or not referenced in the index. As well, I was burgeoning stevia industry. The book theoretical adverse interaction of uncer- pleased to encounter a detailed discussion offers an in-depth examination of this tain severity” to “potentially harmful or of Bendictin (doxylamine and pyridoxine) increasingly popular herb, originally from serious adverse interaction—avoid” with issues beginning in 1969, which gave rise South America and now cultivated in large a large amount of detail for each symbol. to the famous Supreme Court decision quantities in China for use as a non-caloric The last category contains symbols for Daubert v. Merrill Dow Pharmaceuticals sweetening agent. the strength and quality of the source Inc. evidence. Here symbols are used to convey The pharmacogenomic basics of why 5 categories of quality: (a) Consensus: an interactions occur, such as the cytochrome interaction has been demonstrated across (CYP) P450 subenzyme system, are an array of clinical experience and research described under summaries and interac- literature; (b) Emerging: the interaction tions reviews for each herb. This includes has been supported in several pieces of CYP 3A4 for St. John’s wort (Hypericum clinical experience and research literature; perforatum, Clusiaceae). It would have been (c) Preliminary: an interaction has been helpful for these metabolic pathways to suggested by some preliminary data or be more globally covered in the introduc- partial evidence; (d) Mixed: the interaction tory chapters and listed in the index. This has been proposed but with partial, contra- would present an opportunity to elucidate dictory, or otherwise inconclusive evidence; other basic aspects of herb and drug metab- and (e) Inadequate: the interaction has been olism and excretion (such as glucuronida- proposed using obsolete, discredited, or tion, sulfation, and esterase metabolism in inadequate/inappropriate evidence. These the liver) as well as metabolic influences criteria are listed with each herb examined, from the epigenetic demethylation of SNPs

70 | HerbalGram 83 2009 www.herbalgram.org Book Reviews

The US Food and Drug Administration informative and authoritative book is a African American slave medicine. Chap- (FDA) banned the importation of stevia must-have for anyone in the stevia indus- ter 2 discusses the medical care delivery for use in herbal teas and other herbal try—producers, marketers, manufacturers, system as provided by whites, while chapter products in 1990, purportedly based on et al.—as well as consultants, toxicologists, 3 provides a lens into the work of the slave concerns that the safety of stevia had not and others involved with this new mainstay practitioners. Chapter 4, “Conjuring and been adequately documented for use in in the world’s food supply. Hoodoo,” discusses West African spiritual- foods. FDA then lifted the ban in 1995 ity and the supernatural (steeped in voodoo for stevia sold as a dietary supplement. In —Mark Blumenthal traditions) as applied to medical practices the spring of 2008, several companies self- of the time. Chapter 5 delves into the use affirmed GRAS (generally recognized as African-American Slave Medicine: of plants and herbs in the medicine of the safe) status of their stevia extracts of 95% Herbal and Non-Herbal Treatments by slaves, while chapter 6 looks at non-herbal steviol glycosides and started selling stevia- Herbert C. Covey. Lanham, MD: Lexing- treatments as they impacted the African sweetened foods and dry stevia extracts as ton Books; 2008. Paperback; 216 pages. American materia medica. The last chap- stand-alone food sweeteners. In December ISBN-13: 978-0739116456. $24.95. ter, “Closing Observations,” gives Covey’s 2008, the FDA accepted the self-affirma- African-American Slave Medicine provides precise analysis and thoughts on why many tions of GRAS status of stevia extracts that historical insights into how medicine was of these practices persist in today’s society. had been submitted through the partner- delivered to a sub-set of the US population Covey notes “that the practice of medical ships of Cargill-Coca Cola and Pepsi-Meri- during a formative period in the country’s care provided some patients with a sense of sant. Stevia sweeteners and stevia-sweet- history, based on available information. self-determination. Under the yoke of slav- ened products are now increasingly appear- From a historical perspective this is an ery, the oppressed could control or at least ing in mainstream food stores, and numer- excellent treatment of a subject of increas- attempt to control an important aspect of ous other ingredient suppliers are offering ing interest for the lay public and schol- their lives—their health and the health of various types of extracts. ars alike. Current fasci- others. Sometimes they The book’s first chapter provides an nation with the subject did this as effectively, or excellent and panoramic overview of stevia, of slave medicine arises even more so, than their written by Professor A. Douglas King- in part because much of White counterparts.” horn, PhD, DSc, the book’s editor, and a the oral history, which There are 3 appen- world-renowned expert on plant-derived in itself would have been dices at the end of the sweeteners (now Jack L. Beal Professor and instructive, was unfor- volume that are criti- Chair in the Division of Medicinal Chem- tunately lost before it cal to all the informa- istry and Pharmacognosy at the College of was recorded. At best tion that precedes them. Pharmacy at Ohio State University). Two there are some tantaliz- Appendix A, “Plant and chapters by Prof. D. Doel Soejarto, of the ing snippets of history Herb Treatments,” lists University of Illinois at Chicago, provide that lack the richness of the plants, medical uses, an authoritative review of the botany and a more robust histori- and the WPA source for ethnobotany of this plant, used by South cal record. Much of the data reported. This American Indians for its sweet properties. this oral tradition could appendix will be frus- The ethnobotany chapter is based on field have been salvaged by a trating to some because work conducted by Soejarto in Paraguay in culture that should have plants are first listed the early 1980s. given more value to the by common name and Other chapters contain information on non-traditional medical then scientific name. the phytochemistry of stevia, both the sweet practices of the African For scholars knowl- and non-sweet constituents, and methods Slave culture of North edgeable in science and to synthesize steviol compounds, as well as America. scientific naming, this methods to improve the taste of the sweet Chapter 1 provides an historical over- might prove annoying. That being said, the principles of stevia. Ryan Huxtable’s chap- view of the field and briefly covers several appendix presents a wealth of information ter on the pharmacology and toxicology of important topics, including: whether the previously undocumented as to source, now compounds such as steviol, stevioside, and slaves were active in their own healthcare, confirmed and associated with real people rebaudioside A are still relevant, although whether or not they were medically as sources. Appendix B, “Unknown Plant/ additional data have been published since neglected, their life expectancy and mortal- Herbal Treatments,” contains many plants its writing that further support the general ity rates, common diseases of the time, and that cannot be assigned to any specific safety of the herb and its extracts. The possible remaining questions. Although known plant or scientific name. This book also has a chapter on the cultivation many previous studies have established appendix is a compilation of names taken and use of stevia in other countries such as that “slaves suffered from poor health and from interviews from the WPA archives. Japan and Korea, where stevia extracts and received inadequate, unequal, or no medi- Although it does not say, it is obvious that derivatives have been widely accepted as a cal care,” Covey has turned to a previously the author could not equate any of these food ingredient for several decades. untapped resource in the Works Project names with any scientific names for plants. Despite the relatively hefty price for Administration (WPA) narratives to give So the exact correlation of an herb/plant such a relatively short volume, this highly the reader new perspectives on the topic of name will remain obscure scientifically www.herbalgram.org 2009 HerbalGram 83 | 71 Book Reviews until much more comprehensive work can of the plantation system and slavery. This cine, Dr. Weil has a commanding perspec- be done by some other curious individual. volume cannot help but enrich the reader. tive on beneficial and injurious plants. The list provides an opportunity for further Plant-related toxicities account for about scholarly research. Appendix C provides 10% of all reports to poison control centers. a comprehensive list of non-plant herbal —W. Hardy Eshbaugh More than 57,000 calls related to expo- treatments. The importance of and scholar- Professor Emeritus sures to plants were made to poison control ship imbedded in these appendices cannot Department of Botany centers in 2003, 85% of which involved be overstated. We owe a real debt to Covey Miami University children under the age of 6 years—compris- for bringing the WPA data set to the atten- Oxford, OH ing the 7th most common form of reported tion of the scientific community. toxic exposures in children. The authors One major criticism of previous such hasten to clarify that most of these expo- works is that too often they failed to give Handbook of Poisonous and Injurious sures did not result in toxicity; they were a voice (credit) to the people who provided Plants, 2nd ed., by Lewis S. Nelson, Rich- merely exposures, not incidents of adverse the researchers with the very information ard D. Shih, and Michael J. Balick. New events. Nevertheless, there are numerous (data) upon which their papers and books York, NY: Springer/The New York Botani- toxic and injurious plants in home gardens, depended. Covey has refreshingly taken cal Garden; 2007. Paperback; 340 pages. public parks, roadsides, vacant lots, wilder- another approach by using many quotes to ISBN-13: 978-0387312682. $39.95. ness areas, etc. Health professionals and enrich the text. Current knowledge and the This book is a significant revision of the consumers need information on the proper literature of folk medicine have always been 1985 publication from the American Medi- identification of these plants, their toxic dependent on traditional knowledge. cal Association titled The AMA Hand- parts, and their appropriate management if book of Poisonous and Injurious Plants, by a toxic event occurs. When us was chillum, us went root en Kenneth Lampe, Mary Ann McCann, and The first section of the book wisely herb gatherin’ ter git things fer de winters the American Medical Association. With provides a brief primer on botanical medicine. Us uster gather wild cherry bark, 434 four-color photos and illustrations nomenclature, some of which has changed horseradish root, dand’line root, hickory throughout, it is almost since the publication of bark, mullen, penny-royal, poke-root, en a field guide to poison- the first volume, e.g., poke berries, en de Lord knows what— ous plants. family names for plants things I clear fergit. Chicken gizzard skin The authors are 2 (Apiaceae is preferred was saved fer medicine, en I reckon goose physicians with active for Umbelliferae; grease is still used fer lots of things, even en practices in medical Asteraceae is preferred this day en time…. toxicology and emer- for Compositae; etc.). —Dulcinda Baker Martin, Kentucky gency medicine plus a The second section leading ethnobotanist: deals with poisonings, An speakin’ of oures, white folks, us Lewis S. Nelson, MD, poisoning syndromes, niggers had ‘em. My grandmammy was of the New York Univer- and their clinical manage- a midwife an’ she useta gib women cloves sity School of Medicine; ment. This section an’ whiskey to ease der pain. She also gib Richard D. Shih, MD, of includes chapters deal- ‘em dried watermelon seeds to git rid of the Morristown Memo- ing with various types der grabel in de kidneys. For night sweats rial Hospital in Morris- of plant poisons: plants Grandmammy would put an axe under der town, New Jersey; and with anticholinergic bed of der sick pusson wid de blade asittin’ Michael J. Balick, PhD, (antimuscarinic) poisons straight up. An’ iffen yu’ is sick an’ wants director of the Institute (i.e., plants with tropane to keep de visitors away, jus putt a fresh of Economic Botany at alkaloids, e.g., Atropa, laid aig in front of de do’ an’ dey won’t The New York Botani- Datura, Hyoscyamus, come in. cal Garden. Dr. Balick et al.); calcium oxalate —Dellie Lewis, Alabama is also a member of the crystals (Philodendron, et Board of Trustees of the American Botani- al.); cardioactive steroids/cardiac glycosides Such statements may seem to have little cal Council. (Convallaria, Digitalis, Strophanthus, et relevance to the science behind bush medi- The combination of experienced medical al.); convulsant poisons (Lobelia, Nicoti- cine, but they capture the thinking of the practice and 3 decades of ethnobotany have ana, Conium, Strychnos, et al.); cyanogenic time and provide a clearer understanding of produced a book that is highly authorita- compounds (Prunus, Sambucus, et al.); the thinking of the people who were a part tive in scope and depth. gastrointestinal toxins; mitotic inhibitors of this culture. The brief introduction by Andrew T. (Catharanthus, Colchicum, Podophyllum, et This book has much to recommend it to Weil, MD, noted author and pioneering al.); nicotine-like alkaloids (Baptisia, Lobe- a wide interdisciplinary audience. First and proponent of integrative medicine and the lia, Nicotiana, Sophora, et al.); pyrrolizidine foremost, it presents a history that has rele- rational use of medicinal plants, applauds alkaloids (Crotolaria, Heliotropum, Senecio, vance for all who study the history of medi- the integration of medical experts and an et al.); sodium channel blockers (Aconitum, cine, especially the era of African Ameri- experienced botanist to create this volume. Kalmia, Veratrum, et al.); and toxalbumins cans in the New World during the time A trained botanist before studying medi- (Jatropha, Momordica, et al.). (Note that

72 | HerbalGram 83 2009 www.herbalgram.org Book Reviews some of these genera contain plant species hydroxycitric acid (usually derived from regulations relating to nutritional supple- sometimes used in herbal medicine, usually Garcinia cambogia, Clusiaceae), multivita- ments in Europe and the United States. In in clinical practice, not in generally-avail- mins, and pumpkin seed (Cucurbita pepo, contrast to the United States, where dietary able herbal teas or dietary supplements.) Cucurbitaceae). supplements are regulated as foods, not One of the most common forms of plant- Generally, botanicals are included only if drugs, in most European countries supple- related injuries is plant-induced dermati- they are marketed as products intended to ments must be demonstrated to be safe, and tis—irritation to skin. The third section supplement the diet. Clearly, there is a hazy only those proven to be safe can be sold contains 6 tables listing plants that are toxic dividing line between herbs intended to without prescription. to skin, including those that have mech- supplement the diet and those herbal prod- Vitamin A is a case in point as the vita- ano-chemical toxicity (e.g., the acetylcho- ucts that are used to maintain or improve min is essential in small quantities but line-formic acid-serotonin-filled stinging health. Primarily, the supplements covered dangerous in large amounts. The vitamin hairs in nettles [Urtica spp., Urticaceae]), by this volume are vitamins, minerals, A entry simply states the range of daily allergens, and phototoxins (e.g., wild carrot amino acids, fatty acids, and enzymes, as reference values (DRV), providing interest- [Daucus carota, Apiaceae]). well as a range of other substances, like ing comparative data. It is clear that DRVs The fourth part provides methods for shark cartilage or green-lipped mussel, or have been established at a significantly gastrointestinal decontamination, includ- chemical constituents of plants, such as higher level for the US consumer than for ing the use of syrup of ipecac (Cephaelis isoflavones. most European countries. (This is based on ipecacuanha, Rubiaceae—the Latin bino- There are monographs on the follow- different regulatory systems.) There is also mial is curiously omitted from the para- ing herbs and plant-based ingredients: aloe an appendix providing guidance on safe graph on this standby herbal remedy), vera (Aloe barbadensis, upper levels of vitamins orogastric lavage, activated charcoal, and Liliaceae); chlorella (Chlo- and minerals for Europe whole bowel irrigation. rella vulgaris, Chlorophy- and the United States. The main part consists of the profiles ceae); evening primrose oil Mason’s approach to on over 150 individual plants. Each profile (Oenothera biennis, Onagra- the task is balanced, contains the following: plant family, Latin ceae); flaxseed oil (Linum credible, solid, and prac- binomial(s), common names, botani- usitatissimum, Linaceae); tical. The 88 mono- cal description, distribution, toxic part(s), garlic (Allium sativum, graphs are listed alpha- toxin, clinical findings, clinical manage- Liliaceae); ginkgo (Ginkgo betically and presented ment, and references. Included are usually biloba, Ginkgoaceae); clearly, concisely, and 1–2 color photos and/or a color painting on Asian ginseng (Panax impartially, providing each plant. ginseng, Araliaceae); grape independent evidence- Physicians and other healthcare profes- seed extract (Vitis vinif- based summaries in a sionals (including veterinarians), herbalists, era, Vitaceae); green structured format from hikers, naturalists, gardeners, horticultur- tea extract (Camel- the scientific informa- ists, parents of small children, pet owners, lia sinensis, Theaceae); tion. There is a catego- and all those who interact with plants and guarana (Paullinia cupana, rized assessment of level the landscapes (both indoors and outdoors), Sapindaceae); kelp (Lami- of evidence for efficacy would find this book of great value. It is naria spp., Laminariaceae); from C=convincing to well worth the investment. psyllium (Plantago ovata, I=insufficient. Data clas- Plantaginaceae); and spirul- sified as convincing is —Mark Blumenthal ina (Arthrospira platensis, Oscillatoriaceae). not narrowly confined to evidence from The author, Pamela Mason, is a pharma- randomized clinical trials or meta-anal- Dietary Supplements Pocket Compan- ceutical and nutrition writer and consultant yses but includes epidemiological stud- ion by Pamela Mason. London, UK: Phar- based in Monmouthshire, South Wales. ies, prospective observational studies, and maceutical Press; 2009. Paperback; 278 Her interest in food supplements began biological plausibility; insufficient evidence pages. ISBN 978-0-85369761-9. $39.95. during her own studies in nutrition and her is that based on findings from a few studies Based on the larger, fully referenced experience in community pharmacy, where where the data are suggestive but unsup- comprehensive text Dietary Supplements, she was frequently asked questions about ported by well-designed research studies. now in its 3rd edition, this Pocket Compan- dietary supplements. She teaches nutri- The standard categories used for each ion is designed as a practice-relevant, quick tion to pharmacists and gives conference monograph are as follows (brief descrip- reference, easily accessible text primarily presentations about supplements in both tions): for health professionals looking for up-to- the United Kingdom and abroad. • Human Requirements—lists for differ- date information on efficacy and safety Mason’s primary point of reference ent ages and sex (where established) of dietary supplements. This pocket-sized and experience is the United Kingdom. • Dietary Intake—states amounts of edition provides concise versions of the However, the author makes every effort nutrients provided by the average adult 82 monographs in the larger reference to ensure international relevance for the diet work, with an additional 6 monographs information in the monographs. Data • Action—gives information on the role on arginine, dong quai (Angelica sinensis, is presented where applicable in tabular of the substance in maintaining physi- Apiaceae), 5-HTP (5-hydroxytryptamine), format and includes recommendations and ological function and identifies phar- www.herbalgram.org 2009 HerbalGram 83 | 73 Book Reviews

macological actions where appropriate they have done an admirable job in discuss- seed in comparison to other sources of • Dietary sources—lists significant food ing the role of industrialization in limiting omega-3 fatty acids like flax seed (Linum sources the food sources of much of today’s popu- usitatissimum, Linaceae), algae, and marine • Possible uses—lists potential indica- lation. oils. The authors have devoted significant tion for use of substance with informa- In the first chapter of this book, the discussion on superiority of chia seed over tion on strength of evidence authors discuss the paradox of hunger all other sources, though they have made • Bioavailability—where information is despite over-abundance of agricultural some errors. They write that flax has never available, data on bioavailability of the crops, and they introduce the idea of going been used as a food. In the 8th century dietary ingredient is provided back to the past to review new sources of CE, the great Western European leader • Precautions/contraindications— food for today. Charlemagne considered flax so impor- provides lists of diseases and condi- In the second chapter, the authors explore tant for the health of his subjects that he tions where the substance should be changes in composition of food eaten by passed laws and regulations requiring its avoided or used with caution hunter-gatherers as compared to today’s consumption.1 On page 120, the authors • Pregnancy and breastfeeding— Western diets. Hunter-gatherers ate high have raised an issue of toxicity of flax due comments on potential toxicity during amounts of animal meat, yet this still to the presence of cyanogenic glycosides pregnancy and lactation provided lower fat content than today’s and other anti-nutritional factors. In • Adverse effects—describes risks asso- typical Western diet. This is due to differ- discussing these, they have selectively used ciated with excessive intake, as well as ences in the composition of meat, since the literature, omitting the references to signs and symptoms of toxicity animals then were free-roaming and grazed work done on safety of flax seed, which • Interactions—lists drugs and other on wild plants, as opposed to the ration- has concluded that up to 50 g per day of nutrients that may interact with the fed cattle living in confined spaces that flax seed consumption is not associated supplement constitute the majority of meat in today’s with any safety concerns.2,3 The spellings • Dose—gives recommended dosage Western diet. The diet of hunter-gatherers, of cyanogenic glycosides of flax are wrong where established depending on geographical location, also (it is not “cianogicosides limarin”). On • References—provides no more than came from a large variety of plants (esti- page 121, the authors have raised concerns 10 per supplement since all original mated in some cases to be over 200 species) on reproductive toxicity of SDG (secoiso- source material is in the comprehen- compared to very limited number of agri- lariciresinol diglucoside) in animal stud- sive textbook, Dietary Supplements. cultural crops in today’s diet. ies. First, the authors have misspelled the This volume has a clear and specific Modern diets typically include consump- compound’s name, and secondly, they have purpose, which is well executed. Mason’s tion of far more omega-6 fatty acids than interpreted the studies incorrectly. The slim, vinyl-covered guide to the safety and omega-3 fatty acids. The authors discuss authors of those studies concluded that the efficacy of the most commonly used vita- the importance of dietary omega-3 fatty minor effects observed in the animals have mins, minerals, and dietary supplements is acids in maintaining health and the role of no clinical or physiological significance. authoritative, convenient, and internation- other lipids and fats on health. They state The books’ authors have also claimed that ally relevant to the consumer and health that an excess of omega-6 fatty acids, with chia has the highest source of omega-3 practitioner. deficiency of omega-3 fatty acids, leads to fatty acids. Chia oil has a higher amount higher incidences of chronic heart disease of omega-3 fatty acids than flax oil (62% —Jacqueline C. Wootton and other inflammatory conditions. But in versus 58%), but the flax seed contains President, Alternative Medicine an attempt to simplify a complex message, higher amounts of oil (38–42%) compared Foundation, Inc. the authors have made some errors. On to 28–32% for chia seed. Hence, on weight Director, HerbMed® HerbMedProTM, page 35, they state that omega-6 fatty acids Potomac, MD increase production of eicosanoids while omega-3 fatty acids decrease the production. This is not true. The omega-3 fatty Chia: Rediscovering a Forgotten Crop acids decrease the production of series 2 of the Aztecs by Ricardo Ayerza and Wayne prostaglandins and increase the production Coates. Tucson, AZ: University of Arizona of series 3 prostaglandins. They just change Press; 2005. Paperback; 215 pages. ISBN- the distribution of different eicosanoids, 13: 978-0816524884. $15.95. which lead to anti-inflammatory actions. The authors have compiled an excellent Chapter 3 includes a detailed discus- piece of work covering the anthropologi- sion of crops used by Aztec Indians and cal, historical, and nutritional aspects of the role of chia in the nahuatl culture’s chia seed (Salvia hispanica, Lamiaceae). At food and medicine. The authors have done the time the book was published, Ricardo a commendable job in describing the old Ayerza, Jr. was an associate at the Univer- literature on the role of chia seeds. Chap- sity of Arizona’s Office of Arid Lands ter 4 describes the botany and agronomics Studies, and Wayne Coates was a research of chia, with a great deal of discussion on professor at the same facility. They appear production aspects. to have an extensive knowledge of chia, and Chapter 5 deals with chemistry of chia

74 | HerbalGram 83 2009 www.herbalgram.org Book Reviews BECOME A SPONSOR MEMBER basis, flaxs eed has higher amount of omega-3 fatty acids than chia seed. OF THE On page 128, the use of chia is mentioned as a dietary strategy to increase omega-3 content of commercially-produced chicken eggs. Commer- cially, very little, if any, chia seed is used for this purpose. Commercial omega-3-enriched eggs are produced mainly by feeding flax meal or fish meal to poultry. The reference for table 6.3, “Choles- terol, Total Fat, Saturated Fatty Acid, and Omega- 3 Fatty Acid Content of Eggs Produced by 2 Lines of Hens Fed 5 Different Omega-3 Diets,” is not easily accessible (the reference was not shown). For this study, the same amount of chia and flax were As a Sponsor Member of ABC, your company fed but the content of fish meal is not presented in will have multiple points of access to science- the table. As flax seed contains a high amount of total and soluble fiber, total fat, and omega-3 fatty based, peer reviewed information on hundreds acid on weight basis, the diets were not equiva- of herbs and medicinal plants from a reliable, lent. The effect of differential levels of fiber is not independent source. discussed. The data for table 6.1, “Cholesterol, Total Fat, Saturated Fatty Acid, and Omega-3 Fatty Acid Content of Eggs Produced by Shaver You’ll get access to our expert staff and White Laying Hens Fed 4 Diets,” include 100% you’ll get our many publications, in print and chia or a blend of chia and flax, while 100% flax was not studied. Data for tables 6.1 and 6.3 show online, including HerbalGram, HerbClip, and different effects on DHA content of eggs, which is our wealth of searchable resources at not explained. Also, data in table 6.1 demonstrate www.herbalgram.org. a dose-dependent inhibitory effect of chia on the DHA content of chicken eggs. Excluding the shortcomings mentioned above, ABC will provide the resources to help you: the book is a valuable resource about the emerging role and importance of chia as a healthy food and Educate your employees on the latest herbal dietary supplement. scientific developments Learn about and be prepared to respond to References impending media coverage 1. Murray M, Pizzorno J, Pizzorno L. The Encyclopedia Access documentation supporting structure/ of Healing Foods. Memphis, TN: Atria Publishing; 2005. function claims 2. Cunnane SC, Thompson LU (eds). Flaxseed in Reach a targeted group through ABC advertising Human Nutrition. AOCS Press, Champaign, IL: Network to find legal and regulatory counsel, AOCS Press; 1995. 3. Cunnane SC, Ganguli S, Menard C, et al. High a- suppliers, customers and others linolenic acid flaxseed (Linum usitatissimum): some nutritional properties in humans. British Journal of As a Sponsor Member, you’ll also help ensure that Nutrition. 1993;69(2):443-453. ABC can continue its unique nonprofit educational —Rakesh Kapoor, PhD mission which includes: Director, Science and Technology Numerous publications, such as HerbalGram Bioriginal Food and Science Corp. Internship programs for dietetic and pharmacy Saskatoon, Canada students Public education through online resources and on-site tours of ABC Acting as a source of reliable information to the media

detailed list of healing properties. There Vinton McCabe. Laguna Beach, CA: New Book Profiles is also a specific emphasis on efficiency in Basic Health Publications, Inc; 2009. 322 The Naturopathic Way: How to treating health problems and conditions pages, paperback, appendix, index. ISBN- Detox, Find Quality Nutrition, and common in women. 13: 978-1-59120-073-4. $19.95. Restore Your Acid-Alkaline Balance. Rosemary Gladstar’s Herbal Recipes This book enables readers to learn Christopher Vasey and Jon Graham for Vibrant Health: 175 Teas, Tonics, the fundamentals of a simplistic form (trans). Rochester, VT: Healing Arts Oils, Salves, Tinctures, and Other of homeopathic treatments and focuses Press; 2007. 133 pages, paperback, glos- Natural Remedies for the Entire Family. on biochemical medicine—the concept sary, references, resources, index. ISBN- Rosemary Gladstar. North Adams, MA: of treating nutritional deficiencies with 13: 978-1-59477-260-3. $14.95. Storey Publishing; 2009. 400 pages, chemical compounds that occur in the This book presents the idea that paperback, appendices, resources, index. human body. Also featured is a compre- naturopathic treatment is far from the ISBN-13: 978-1-60342-078-5. $16.95 hensive look at cell salts, their uses in conventional allopathic medical pathway. This book suggests herbal remedies for treating specific conditions, and how they It provides information on naturopathic common ailments such as insomnia, the can become a part of daily nutrition ideals, particularly the treatment of common cold, dry skin, etc. The author programs at home. common illnesses through one’s own is a well known and respected herbal- The Healing Power of Meditation. health choices. Also included are diagrams, ist who provides this information in an Gabriel Weiss. Laguna Beach, CA: Basic charts, and tables, some with suggested accessible format that also includes an Health Publications, Inc; 2008. 260 replacement foods, to help guide readers overview of common herbal knowledge. pages, paperback, references, index, medi- toward a more naturopathic lifestyle. Also contained are tables, pictures, and tation CD. ISBN-13: 978-1-59120-246-2. The Vegan Cook’s Bible. Pat Crocker. recipes. $24.95. Toronto, Ontario, Canada: Robert Rose Chicle: The Chewing Gum of the Physician and author Gabriel Weiss Inc; 2009. 383 pages, paperback, glos- Americas, From the Ancient Mayas to explains how meditation can aid healing. sary, resources, references, index. ISBN- William Wrigley. Jennifer Matthews and Meditation is suggested as a treatment for 13: 978-0-7788-0217-4. $24.95. Gillian Schultz. Tucson, AZ: The Univer- common illnesses and conditions such as This cookbook features 250 recipes and sity of Arizona Press; 2009. 142 pages, stress, high blood pressure, chronic pain, 150 profiles on different food categories, paperback, references, index. ISBN-13: heart disease, and cancer. Also provided providing information on food uses and 978-0-8165-2821-9. $17.95. are meditation exercises for specific health tips on buying, storing, and cooking. From a Maya archaeologist comes a problems. Also featured is a section on specific body book on the history of chewing gum. This The ACP Evidence-Based Guide to systems and how to best support each title examines chicle and its historical Complementary & Alternative Medi- through different healthy ingredients, roots among the Aztec and Maya, the tree cine. Bradly Jacobs and Katherine functional foods, and lifestyle changes. where chicle comes from, the personality Gundling. Philadelphia, PA: ACP Press; From colorful pictures to original recipes, of chicle extractors and manufacturers, 2009. 452 pages, paperback, appendix, this book aims to satisfy vegans, as well and an underlying story of greed, growth, index. ISBN-13: 978-1-934465-04-2. as anyone interested in unique, healthy and collapse. $69.95. E-book available for $19.95. recipes. Plants of Semillas Sagradas: An ACP provides an evidence-based guide Complementary and Integrative Ethnomedicinal Garden in Costa Rica. to complementary and alternative thera- Medicine in Cancer Care and Preven- Rafael Ocampo and Michael J. Balick. pies for practicing physicians. This book tion: Foundations & Evidence Based Costa Rica, SA: La Nueva Extractos; includes recommendations for advising Interventions. Marc S. Micozzi. New 2009. 109 pages, paperback, index. ISBN- the use of each therapy, as well as informa- York, NY: Springer Publishing Company, 13: 978-0-615-27415-7. Free PDF copy tion on drug-supplement interactions and LLC; 2007. 478 pages, hardcover, index. available at www.fincalunanuevalodge. legal, insurance, and regulatory issues. ISBN-13: 0-8261-0305-7. $80.00. com. Essential Herbal Wisdom: A The book provides up-to-date informa- This book provides profiles of 250 Complete Exploration of 50 Remark- tion for health professionals on certain plant species common in the Semillas able Herbs. Nancy Arrowsmith. Wood- uses of diet, nutrition, and herbs, as Sagradas (or sacred seeds) ethnomedicinal bury, MN: Llewellyn Publications; 2009. well as mind-body therapies, for provid- sanctuary in Costa Rica. Entries include 561 pages, paperback, references, herbal ing integrative care to cancer patients. common and Latin name, description, use chart. ISBN-13: 978-0-7387-1488-2. Also included are tables, illustrations, and history and traditional use, pharmacol- $29.95. an entire section on herbs and dietary ogy and biological activity, toxicity, and Each of the 50 herb profiles include tips supplements. conservation status and trade. Printed on on growing, gathering, drying, and stor- Healing Herbs A to Z. Diane Stein. 100% recycled paper with vegetable-based ing, as well as culinary merits, cosmetic Berkeley, CA: Crossing Press; 2009. 239 inks, this book is intended to provide properties, medicinal uses, veterinary pages, paperback. ISBN-13: 978-1-58091- better understanding of the importance of applications, and household functions. 192-4. $16.95 conservation of these medicinal plants, as Also provided are folk histories and step- This quick reference provides herb well as a history of the sanctuary. by-step directions on how to cook with profiles in alphabetical order, including The Healing Echo: Discovering herbs and prepare herbal remedies. common names, Latin names, and a Homeopathic Cell Salt Remedies.

76 | HerbalGram 83 2009 www.herbalgram.org In Memoriam

“As I read these books, something ignited in me,” said Gladstar. “I Juliette de felt like I had found a kindred soul. I wrote her a long ‘love’ letter, tell- Bairacli Levy ing her of my love and fascination with medicinal plants and sent the letter off to her publishers in England, never, of course, expecting to 1912–2009 hear from her. But several months later a letter did arrive, and Juliette and I began a correspondence and then a friendship that lasted for Juliette de Bairacli Levy, a nearly 4 decades.” world renowned herbalist, Gladstar also reminisced about visiting de Bairacli Levy with a author, and pioneer of holis- group of herbalists when de Bairacli Levy lived in a “little stone cottage tic veterinary medicine, passed by the sea” with no electricity or running water on an island off the away on May 28, 2009, at the coast of Greece named Kythira: “We camped by the sea, cooked out age of 96 in Burgdorf, Switzer- 1 with her over a small cookstove and shared stories late into the night,” land. said Gladstar. “Juliette was a superb storyteller and had lived such a “Juliette is the grandmother fascinating life and she could entertain us, and did, for hours.” of the renaissance of herbal Gladstar further added, “From the moment I read her first book to medicine in America,” said Susun Weed, de Bairacli Levy’s friend our first and final meeting, I always held Juliette as a kindred spirit, a of 20 years (oral communication, June 22, 2009). free-spirited gypsy woman, beautiful beyond words, amazingly origi- De Bairacli Levy was born on November 11, 1912, in Manches- nal, a great story teller, and a complex and deep human being. The ter, England. She studied veterinary medicine at the Universities of 1 force of her spirit was so strong and charismatic, that even as an older Manchester and Liverpool, but she ultimately did not approve of woman, I would watch people stop and stand to watch her walk by,” the treatment of animals at these universities. said Gladstar. “She just had a power about her….” “She was disturbed by the drugs that were given to animals and De Bairacli Levy was also a dedicated naturalist, according to friend the use of hypodermics,” said Weed. “That’s when she set her sights Caroline MacDougall, founder and CEO of Teeccino Herbal Coffee toward learning herbal medicine from the people of the earth— (e-mail, June 16, 2009). “She was happy eating the simplest of foods gypsies.” made from locally grown fruits, vegetables and herbs, and eating cheese After 2 years in veterinary school, de Bairacli Levy went on the 1 she made herself from goat’s milk,” said MacDougall. “Juliette was so road to study herbal medicine from gypsies and peasants. In the committed to a natural lifestyle that when she contracted typhoid fever late 1930s, she had a distemper clinic in London, where she treated while nursing her baby daughter, she trained her goat to come every 4 and cured hundreds of dogs with herbs and diet when many were hours so her daughter could nurse directly from the goat’s teat!” dying of distemper worldwide. De Bairacli Levy also preferred fresh ocean water when enjoying one During the 1930s, de Bairacli Levy developed a line of herbal of her favorite hobbies: “She was a great swimmer and great lover of the supplements for animals, called Natural Rearing Products. These sea, and always, until just a few years before she died, would go into were the only products of their kind on the market for 50 years, 1 whatever body of water was near and swim daily, but she loved the sea and they are still nationally available today. She wrote many influ- best,” said Gladstar. ential books on veterinary herbs, including The Complete Herbal th De Bairacli Levy was also well known for traveling with her 2 chil- Handbook for Farm and Stable (Faber & Faber, 1952, 4 edition dren, award-winning afghan hounds, owls and other animals all over 1991), The Complete Herbal Book for the Dog and Cat (Faber & the world while gardening and gathering herbal remedies.1 “She loved Faber, 1955, 6th edition 1992), Common Herbs for Natural Health rd the wild places and nature with all her soul and being and, until the (Schocken Books, 1976, Ash Tree Publishing, 3 edition 1997) very end, was an advocate for animals and nature,” said Gladstar. and Nature’s Children (Faber & Faber, 1968, Ash Tree Publishing, In 1998 Frontier Herbs presented de Bairacli Levy with a Lifetime 1997). Achievement Award for her contribution to the herbal world.1 Also in “When I first read one of Juliette’s books, it was as though she 1998, Juliette of the Herbs, a documentary film about de Bairacli Levy breathed life into my heart. She gave me the courage to learn herbal directed and produced by Tish Streeten, film-maker and herbalist, medicine from the plants themselves,” said Weed. “She will live on became available by Mabinogion Films. More information about the through her writing. A new generation of herbalists will be influ- film is available at: www.julietteoftheherbs.com. enced, nurtured, and touched by her books and herbal knowl- “Juliette was truly one of a kind who lived her life intuitively and edge.” close to the earth,” said MacDougall. “My life owes so much to her Weed, editor-in-chief of Ash Tree Publishing, will bring 3 books inspiration. I give thanks for all the wisdom she imparted that brought by de Bairacli Levy back into print by 2010 so that her influence so many of us to the herbal world.” will continue into the next century. Those books are: Spanish De Bairacli Levy is survived by her daughter Luz, her son Rafik, and Mountain Life (Faber & Faber, 1961), Gypsy in New York (Faber & 3 grandchildren. More information about de Bairacli Levy is available Faber, 1965), and Summer in Galilee (Faber & Faber, 1963). at www.wise-woman-way.com/Juliette-de-Levy-Bairacli.html. Rosemary Gladstar, a widely known and respected herbalist and author, said she first discovered de Bairacli Levy’s books in —Kelly Saxton Lindner the 1970s during a trip to Sonoma County library, where she was researching what at that time was highly limited information about Reference medicinal herbalism (e-mail, June 23, 2009). She came across 2 1. Streeten T. Biography: Juliette de Bairacli Levy. Available at: http://www. titles by de Bairacli Levy, Gypsy in New York and Traveler’s Joy juliette-de-bairacli-levy.de/bio.html. Accessed June 29, 2009. (Keats Publishing, 1979, 1994) www.herbalgram.org 2009 HerbalGram 83 | 77 In Memoriam

Over the 40 years of his professional career, he published more than 200 articles and participated in the development of more than 35 medicinal plant cultivars and 20 patents. To promote medicinal plant science, he established a special journal, Herba Hungarica, in 1962. Until 1991, this professional journal provided the opportunity for both Hungarian and international scientists to publish articles on a variety of topics in the medicinal plant sciences, including agriculture, botany, biotechnology, genetics, chemistry, and others. He retired in 1991, but continued his chemotaxonomic work on a theoretical level until the last days of his life. Prof. Tétényi was not only an outstanding scientist but also a good politician. During the socialist era in Hungary, especially in the 1960s and early 1970s, he had the difficult and dangerous task of maintaining an open door to the West. He recognized the importance and advantages of international relations and carefully initiated cooperation with Western scientists. As a result of his efforts, using his personal scientific merits as a first step, a new era in cooperative science became possible. In 1972, he was elected vice-president of the Medicinal Plant Section of the International Pharmaceutical Federation (FIP), and 4 years later he became the president of the Section. His scientific merits were appreciated by the International Society of Horticultural Sciences (ISHS), and in 1982, he became the chairman of the Medicinal and Aromatic Plant Section within the Society. In the mid-1980s, he was one of the scientists who initiated the establishment of the International Péter Tétényi Council of Medicinal and Aromatic Plants (ICMAP) to harmo- nize the activity of different international societies interested in 1924–2009 medicinal plant research. As a member of the Council, he played an important role in the organization of 3 WOCMAP Congresses Péter Tétényi, a remarkable scientist who worked with medicinal held in Maastricht, the Netherlands; Mendoza, Argentina; and and aromatic plants, passed away on February 26, 2009. Chang Mai, Thailand. He was born in 1924, in Budapest. His qualification in horticul- Through his efforts, Prof. Tétényi was able to build a fruitful ture was taken at Budapest University in 1947. In 1957, he became cooperation with the Food and Agriculture Organization of the the director of the Hungarian Research Institute for Medici- United Nations (FAO) and the United Nations Industrial Devel- nal Plants. Under his leadership, this small Institute located in opment Organization (UNIDO) for recognition of medicinal Budapest developed quickly, becoming a modern research facility plants, and he contributed to many development projects spon- equipped with new buildings, phytotrons (chambers designed to sored by these organizations in both Asia and Africa. In 1984, provide controlled environments for the study of plants), green- he became the chief editor of Newsletter of Medicinal Aromatic houses, research fields, and analytical laboratories, relocated to Plants, published through financial support of FAO and ISHS. Budakalász in 1973. The new Institute, and the results achieved by This publication, edited by him until his retirement, became a the scientists of the Institute, became recognized throughout the main information source for those interested in happenings in the world for medicinal plant research. medicinal plants sector. In addition to developing and supervising the Institute, Prof. Prof. Tétényi received recognition for his wide-ranging and Tétényi contributed to the development of many fields of research successful work in the form of several Hungarian and inter- in the science of medicinal plants, including chemotaxonomy. national tributes and awards. Among others, he was elected to This area of research was the main subject of his thesis, for which the corresponding member of the Royal Spanish Pharmaceuti- he was granted the degree Doctor of Biology of Hungarian Acad- cal Academy in 1978 and the French National Pharmaceutical emy of Sciences in 1964. His book, written in English and titled Academy in 1980. He was a great personality and an outstanding Intraspecific Chemical Taxa of Medicinal Plants (published in 1970 scientist who contributed greatly to the development of medicinal by Academic Publishers, Budapest), was one of the first scientific plant sciences. We, his former colleagues and friends, will keep works on this subject and brought him widespread international his memory alive. interest and acclaim. Prof. Tétényi is survived by his wife Magdolna Erdosi, PhD, and In Budakalász, he created a new type of botanical garden based sons Péter Tétényi, PhD, and Tamás Tétényi, PhD, all of whom on the Dahlgren plant classification system, using modern tools live in Budapest. for chemotaxonomic systematization. This unique garden arrange- —Prof. Jenö Bernáth, DSc, former vice-director of the ment has maintained high botanical value over the years and Hungarian Research Institute for Medicinal Plants became preserved in Hungary as a national nature protectorate in 2003.

78 | HerbalGram 83 2009 www.herbalgram.org In Memoriam

South America is now one of the leading pharmaceutical compa- Victor Siaulys nies in Brazil. Siaulys worked directly with this company for 30 1936–2009 years and contributed to the development of products, according to information provided by staff from Aché (written communi- Victor Siaulys, a leading devel- cation, May 14, 2009). He later served as president of the share- oper of natural products and phar- holders council for Aché as well as on the scientific board of the maceuticals in Brazil, passed away laboratory. on March 19, 2009, at age 73, Siaulys also founded the Brazilian Association of Assistance for in São Paulo from complications the Visually Impaired, or Laramara, to help support visually and related to leukemia.1 physically impaired individuals.2 His inspiration came from his Siaulys was well-known for daughter, Lara, a premature baby who lost her sight due to a retina his contributions in developing problem, according to Aché staff. Brazil’s pharmaceutical industry as well as his pioneering work Siaulys survived 3 other cancers during his lifetime: thyroid, developing natural pharmaceuticals, such as phytomedicines made skin, and prostate.3 He described his overall battles with various from the Brazilian plant Cordia verbenacea (Boraginaceae). cancers as “a sword hanging with a thread of silk [over] his head,” “Victor had many important accomplishments, which include but he remained optimistic.3 co-founding the first entirely Brazilian pharmaceutical company,” “Throughout my life I have fought and won 3 different types said Paul Altaffer, vice president of business and product devel- of cancer,” said Siaulys, according to an article in Epoca Negócios.3 opment at RFI Ingredients (e-mail, June 5, 2009). “He is also “As you notice, I will not yield easily to this new challenge….” responsible for supporting, leading, and funding the development In the same source, he described his long stay in Albert Einstein of drugs that come from plants, especially from Brazilian biodi- Hospital as the perfect opportunity to “finish the dream of writ- versity. Cordia verbenacea is a prime example of the kind of project ing a book.”3 He called his autobiography Mercenário ou Mission- he envisioned, promoted, and funded. Cordia cream (Achéflan® ário (Mercenary or Missionary, Laramara Publishing, 2008), in Brazil, Cordia Extreme™ in the US) is one of the best selling because he often described himself as a man with those 2 person- topical anti-inflammatory products in South America.” He was alities, according to Aché staff. also considered a “visionary, dynamic, and tireless entrepreneur,” “Victor Siaulys was a very generous man who was always according to Altaffer. surrounded by his friends and family,” said Dr. Pianowski, “He According to Luiz Pianowski, PhD, owner of the pharmaceuti- was a very cheerful person and he loved life.” cal consulting company Pianowski & Pianowski and past direc- Siaulys is survived by his wife Mara and their 3 children Jonas, tor of research and development at Aché, Siaulys often applied a Tatiana, and Lara. home-made hydroalcoholic extract of C. verbenacea to his knees to relieve pain after playing tennis (e-mail, June 30, 2009). “As —Kelly Saxton Lindner he noticed that the preparation was extremely effective, he started to study the plant at Aché,” said Dr. Pianowski. This led to the References development of the cream. Dr. Pianowski added that originally the 1. Morre em São Paulo o empresário Victor Siaulys. Época Negócios. company believed that the active ingriendent was in the flavonoid [Businessman Victor Siaulys dies in São Paulo. Business Times.] March (compound); however, it was actually in the essential oil: “Thus, 20, 2009. Available at: http://epocanegocios.globo.com/Revista/ Common/0,,EMI64804-16377,00-MORRE+EM+SAO+PAULO+O+ Achéflan® became a clear cream instead of a dark ointment, and EMPRESARIO+VICTOR+SIAULYS.html. Accessed June 1, 2009. more effective,” said Dr. Pianowski. 2. Sentidos. Livro conta a trajetória de sucesso do Victor Siaulys. Siaulys was born May 19, 1936, in the Pompéia neighborhood [Book of the trajectory of success of Victor Siaulys. Sense.] July in São Paulo.2 He worked as a fishmonger and an errand runner, 21, 2008. Available at http://sentidos.uol.com.br/canais/materia. then graduated from the Largo São Francisco Law School of the asp?codpag=13104&cod_canal=8. Accessed June 1, 2009. University of São Paulo. 3. O céu pode esperar. Época Negócios. [Heaven Can Wait. Busi- In 1965 Siaulys co-founded the pharmaceutical company Prodoc- ness Times.] January 20, 2009. Available at: http://epocanego- tor in São Paulo with co-founders Adalmiro Dellape Baptista and cios.globo.com/Revista/Common/0,,EMI23229-16642,00- O+CEU+PODE+ESPERAR.html. Accessed June 1, 2009. Antônio Gilberto Depieri. In 1966, the 3 friends acquired an old pharmaceutical company, Aché. Aché Pharmaceutical Laboratories

Letter to the Editor I’m writing to tell you how much I appreciate Courtney Cava- IUCN [International Union for Conservation of Nature] discus- liere’s excellent article “The Effects of Climate Change on Medici- sions on climate change initiatives and, more broadly, to help build nal and Aromatic Plants,” from HerbalGram 81, and to thank you a case for expanding the Global Strategy for Plant Conservation more generally for the attention HerbalGram is giving to this and under the Biodiversity Convention to include a target on climate other conservation issues for medicinal and aromatic plants. change. The timing of publication of the climate change article is —Danna J. Leaman, PhD enabling the Medicinal Plant Specialist Group to make a stronger Research Associate, Canadian Museum of Nature case for attention to economically important plants within current Chair, IUCN-SSC Medicinal Plant Specialist Group www.herbalgram.org 2009 HerbalGram 83 | 79 August 13–17: 2009 International August 19–22: American Associa- August 24–25: 4th Practical Short Conference and Exhibition of the tion of Naturopathic Physician’s 24th Course on Functional Oils: Omega-3 Modernization of Chinese Medicine Annual Convention and Exposition: Fatty Acids: Market Trends, Nutri- and Health Products. Wanchai, Hong Physicians, Heal Thy Planet. Tacoma, tion and Health, Utilization in Food Kong, China. This trade show features WA. This year’s convention theme Systems. Chicago, IL. This year’s

Calendar exhibitors showcasing products from the focuses on providing long-term health updated program includes sessions on areas of Chinese medicine, health supple- solutions for a sustainable world amid functionality mechanisms and health ments, healthcare and therapy, raw mate- the economic recession. The 4-day event effects, functionality technology, and rial and equipment, research and devel- features numerous track and concur- applications in food products. Designed opment, as well as services from trade rent sessions and research presentations, as a “crash course,” the event provides associations. For more information, visit which will discuss topics such as yoga opportunities for participants to network the Web site at: www.cmdds.or.kr. and cancer, child immunizations, birth and discuss innovation and new products August 13–16: Zak Salaam India— control options in primary care, and elec- and attendees include technicians, prod- ZAK India Herbal Expo. Singapore. tronic medical records in naturopathic uct formulators, plant engineers, proces- This event will showcase a variety of the practices. Keynote addresses will be sors, chemists, and sales and marketing Indian herbal industry’s companies, new given each morning by speakers includ- specialists. For more information or to offerings, and products, including herbal ing James Duke, PhD, Dana Ullman, register, visit the Web site at: http:// soaps, medicines, skin and hair products, MPH, and James Gordon, MD. Social home.scarlet.be/~tpm12374/smartshort- and health food. In order to popular- events include a casino night, dances, courses/flipids-US/index.html. ize Indian herbs, herbal products, and and an awards banquet. For more infor- August 27–29: The 7th Natural Prod- medical technologies, attendees will have mation or to register, visit the Web ucts Expo Asia. Hong Kong, China. This the opportunity to make business-to- site at: www.naturopathic.org/content. tradeshow event showcases the numerous business connections. Also, producers, asp?contentid=61. products from the Asia–Pacific region’s manufacturers, importers, and exporters August 23–28: 2nd World Congress natural, organic, and health products can network and explore joint ventures of Agroforestry. Nairobi, Kenya. Follow- industry. Event attendees will find infor- and partnerships with bulk buyers of ing the first Congress held in 2004 in mation on products ranging from supple- herbal products and raw materials in the Florida, this event’s theme is The Future ments to herbs and pet products to foods South East Asia regions. For more infor- of Global Land Use. To assess instances and beverages. This year’s expo features mation, please visit the Web site: www. in which scientific agroforestry can be a newly-added ingredient/supply pavil- biztradeshows.com/zak-ihe/. used to promote the sustainable use of ion and, for the first time, will also take August 14-16: A Weekend with land worldwide, the Congress provides a place concurrently with Nutracon Asia. Matthew Wood. Edmonton, Alberta, forum for researchers, educators, policy- Trade show attendees will have oppor- Canada. Northern Star College will host makers, and practitioners to share their tunities to create or extend business a 3-day herbal medicine workshop with research and experience. It will consist throughout the Asia–Pacific region. For Matthew Wood, an active practitioner of plenary, symposia, concurrent and more information, visit the Web site at: of traditional Western herbalism for 27 poster sessions, all of which will discuss www.naturalproductsasia.com. years. Topics discussed will include ener- a variety of topics focused on the major August 27–29: Nutracon Asia. Hong getics, animal medicines, plant signa- themes of: food security and livelihoods, Kong, China. Held concurrently with tures, and constitutional aspects of plant conservation and rehabilitation of natu- the 7th Natural Products Expo Asia, medicine. For more information, contact ral resources, and policies and institu- Nutracon Asia brings together natural Robert Rogers at [email protected]. tions. For more information or to regis- products industry executives, product August 16–20: 57th International ter, visit the Web site at: www.worldagro- developers, scientists, formulators, brand Congress and Annual Meeting of the forestry.org/wca2009/. managers, and regulatory affairs manag- Society for Medicinal Plant and Natu- August 23–29: Applied Nature ers. Participants will discuss dietary ral Product Research. Geneva, Switzer- Studies: Wild Plants as Medicines, supplement trends and regulation, Asian land. Taking place at the International Teas, and Foods. Steuben, ME. During sourcing and marketing, and food and Conference Center in Geneva, this event this event, clinical herbalist and perma- beverage innovation. Also available is the explores the themes of isolation, structure culture designer Frank Cook will teach chance to attend natural beauty work- determination, analysis, and bioactivity participants how to holistically under- shops, which will take a look at oppor- of natural products. Additional sessions stand nature. After instructing them tunities and market regulation issues in will discuss plants helpful in treating the on the natural world, Cook will guide China’s natural and organic cosmetics problems associated with aging, natu- participants through local ecosystems industry. For more information, visit the ral products for neglected diseases, and and teach them how to collect foods and Web site at: www.naturalproductsasia. anti-cancer agents. A global array of medicinal plants from the wild, which com/index.php?option=com_content&t speakers have been invited and presenta- they will then process and ferment. Spon- ask=view&id=122&Itemid=112. tions on scientific contributions to other sored by the Humboldt Field Research August 30–September 5: Medici- medicinal plant topics are welcomed. Institute, this event explores topics nal Plants, Aromatic Phytochemicals, Aside from the scientific features of including botany, mycology, fermenta- and Aromatherapy with Dr. James A. this event, social activities will also be tion, permaculture, ethnobotany, and Duke. Steuben, ME. To provide attend- offered, including a trip to the Medicinal ecology. For more information or to ees with a broad overview of botany, Plant Garden of the Swiss Alps. For more register, visit the Web site at: www. chemistry, and the economic potential of information or to register, visit the Web eaglehill.us/programs/nhs/nhs-calendar. medicinal and aromatic plants, Dr. Duke site at: www.ga2009.org/index.htm. shtml. will discuss aromatic phytochemicals in

80 | HerbalGram 83 2009 www.herbalgram.org several contexts. The seminar, sponsored ers and scientists from around the world sation. Thimphu, Bhutan. With such a by the Humboldt Field Research Institute, to share updates on the findings and broad theme, this congress covers numer- will also include field work. Taking place progress of seabuckthorn research, show- ous topics, such as cultivation of the in Eastern North America and focus- case new technologies of high quality body, plants and traditional knowledge ing on practical uses of medicinal and seabuckthorn product development, and and practices, challenges of the global-

aromatic plants, the seminar will include to develop strategies for scientific and ization of traditional Asian medicines, Calendar discussions on edibility, culinary and commercial seabuckthorn partnerships. tensions between local and global produc- cultural usages, and toxicity. Dr. Duke The major themes explored at the confer- tion, interpretation, professionalization will focus on the evidence for culinary ence will include gene resources utiliza- and evaluation, as well as issues of trade, medicinal plants and spices, and during tion and breeding, plantation and horti- economy and ecology. For more informa- the field trips, students are encouraged to culture technologies, nutritional and tion or to register, visit the Web site at: collect herbarium specimens, which they medical applications, processing and www.iastam.org/conferences_VII.htm. will later identify, label, and share. For marketing, and soil conservation. For more information or to register, visit the more information, visit the Web site at: www.eaglehill.us/programs/ Web site at: www.isahome. nhs/nhs-calendar.shtml. net/organization_Asort_show. September 1–6: 4th International asp?ID=733&SortID=25. Seabuckthorn Association Confer- September 7–11: 7th Inter- More calendar listings at ence. Belokuriha, Russia. This confer- national Congress on Tradi- ence, titled “Seabuckthorn: on the Way tional Asian Medicine: www.HerbalGram.org between Science and Industry Interac- Cultivating Traditions and tion,” will gather seabuckthorn research- the Challenges of Globali-

In this department of HerbalGram, we list resources such as publications, organizations, seminars, and networking opportunities for our readers. A listing in this section does not constitute any endorsement or approval by HerbalGram, ABC, or its Advisory Board.

GreenPharmacy.com, the all-new Web related to the development of the medici- ethnobiology undergraduate informa- Access site from Jim Duke, PhD, is now online. nal plants sector and is available with tion. Participants can include professors, Also called “Dr. Jim Duke’s Botanical a subscription. More information and students, universities, and research insti- Reference Desk,” the site keeps visitors abstracts from the current issue are avail- tutions who share educational techniques, informed on Dr. Duke’s latest appear- able at: www.indianjournals.com/ijor. materials, and experiences. This will form ances, media interviews and books, as aspx?target=ijor:mpijpri&type=home. a web-based portal of “expert voices,” well as recent news relating to herbs, Skin Deep: Cosmetic Safety Data- curriculum models, and lessons for use food safety, and ethnobotany. Visitors base is a Web site created in 2004 by in classrooms and non-traditional educa- can read Dr. Duke’s latest writings in the the Environmental Working Group tional settings. The goal is to engage “Field Journal,” which features his poems, (EWG), a national nonprofit whose goal educators and students in ethnobiology observations, reactions to news, and opin- is to protect public health and the envi- through scientific inquiry by providing ions on industry issues. Other sections ronment. As an online safety guide for “open-source” materials and web tools, include pages on the swine flu outbreak, cosmetics and personal care products, such as Wikipedia. The Network also ethnobotany and prominent ethnobota- Skin Deep was built by EWG scien- plans to host quarterly meetings and nists, policy issues, and a gallery of recent tists in order to provide consumers with 2 summit meetings each year, one of and historical photos. Visitors will also safety ratings for almost 42,000 products which will take place in conjunction with enjoy reading his detailed autobiography and more than 8,000 ingredients, many the annual meeting for the Society for and listening to bluegrass music written of which are botanical. Consumers can Economic Botany. More information at: and/or performed by Dr. Duke himself. type in the name of a company, brand, http://sites.google.com/site/ethnobiolo- www.greenpharmacy.com. product, or ingredient to find informa- gycenter/Home or www.wiserearth.org/ Medicinal Plants - International tion on each one’s safety score, diseases/ group/opensci_ethnobiology. Journal of Phytomedicines and Related disorders/concerns to which the ingredi- CapsugelSolutions.com, a new Web Industries has recently been launched by ents are linked, what research backs up site from Capsugel, the world’s largest the Indian-based Society for Conservation these findings, and the existing gap in capsule manufacturer, focuses on the and Resource Development of Medicinal data. Products on the database include dietary supplements industry in North Plants. This journal aims to meet the goals makeup, skincare, hair care, eye care, nail and South America and provides informa- of the Society, which include promoting care, baby care, oral care, and fragrances. tion on products and services that can be and undertaking research on and devel- The site also has a section devoted to helpful when launching new products in opment of medicinal crop plants, devel- sunscreen safety and ranks the top 10 supplement markets. Web site visitors can oping organic processes for the cultiva- safest sunscreens with a list of recom- also find advice on building brands and tion of medicinal plants, interacting with mended common brands. www.cosmetic- expanding product lines, as well as infor- government agencies and scientific orga- sdatabase.com. mation on Capsugel University, vege- nizations in order to protect and promote Open Science Network is a National tarian capsule options, liquid capsules, the interests of medicinal crop producers, Science Foundation-funded project that and natural colorants. www.capsugelsolu- and more. Published twice a year, Medici- creates an interdisciplinary and inter- tions.com. nal Plants explores the multiple issues national network for the exchange of www.herbalgram.org 2009 HerbalGram 83 | 81 Get Certified with ABC’s Publications Herbal Information Course. 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Request your city state/province profits and growth for 12 years. free catalog today 810-487-8839, www.achs.edu. ACHS 5940 SW $1,100,000. (512) 468-9478 Hood Ave, Portland OR 97223. zip country Accredited member DETC. Do not share my contact info Do not send me the e-mail newsletter 82 | HerbalGram 83 2009 www.herbalgram.org Individuals, organizations, and companies support ABC through membership

The

Invites You To Join Us The American Botanical Council is the leading nonprofit education and research organization using science-based and traditional information to promote the responsible use of herbal medicine. Founded in 1988, the member-supported American Botanical Council: SERVES members in more than 70 countries worldwide EDUCATES consumers, healthcare professionals, researchers, educators, industry and the media on the safe and effective use of medicinal plants ADVOCATES responsible herbal production and use ADVISES the media on emerging herbal science PROMOTES a healthier world through responsible herbal use.

Join Us! In return, you’ll receive access to a wealth of herbal data via: ABC’s acclaimed quarterly journal, HerbalGram 7 online databases of herbal information (depending on membership level) Regular electronic updates on herbal news that matters to you • 12 monthly HerbalEGrams and 24 HerbEClips per year, plus other Member Advisories And much more.

Learn more at www.herbalgram.org or contact Denise Meikel at [email protected] or (512) 926-4900 ext. 120.