Artemisia Species in Traditional Chinese Medicine and the Discovery of Artemisinin

Qing hao-an antimalarial herb A herb, named Qing Hao (usually pronounced ching how) in Chinese, sweet Annie or sweet wormwood in English, and properly known as Artemisia annua L. has become well known in western countries during the last 20 years. Herbal companies, which deal with traditional Chinese medicine (TCM), receive several inquiries concerning this herb every day. A. question commonly asked by those about to travel to Africa or S.E. Asia is “Can I take the herb called Qing Hao to prevent malaria during my trip?” Unfortunately, the answer has disappointed many people because although this herb is used for the treatment of malaria in TCM, usually combined with other herbs, it is not recommended for the prevention of the disease or as a deterrent to mosquitoes. However, the leaves of Qing Hao were burned as a fumigant insecticide to kill mosquitoes in ancient China but this practice no longer continues today since the development and marketing of more efficient mosquito-repellant devices. The discovery of artemisinin Qing Hao is a herb commonly used in China with a long history of use as an antipyretic to treat the alternate chill and fever symptoms of malaria and other “heat syndromes” in the traditional Chinese Read more […]

Cinchona

Importance, Distribution and Botanical Features The commercial value of Cinchona comes almost entirely from the alkaloids, quinine and quinidine, extracted from the bark: a subsidiary use for the remainder of the tree is as a fuel wood for fires. Quinine has been used for centuries for the suppression and treatment of malaria, being administered as the sulphate, bisulphate, hydrochloride and dihydrochloride (British Pharmacopaeia 1973). The use of quinine for these purposes has decreased with the development since the 1940’s of synthetic anti-malarial drugs (e.g. Chloroquine, Proguanil). Resistance of the malarial parasite to the synthetic antimalarials is widely recorded but much less so to quinine, thus quinine can often still be used either alone or in mixture, in areas where the “synthetics” are ineffective. Further factors in favour of using quinine are its relatively low price (£ 40 per kg in 1985) and wide availability. Additional important uses for quinine are as a treatment for “night cramps”, as a bittering and brightening agent in the soft drinks and food industry and as the starting material for the industrial production of quinidine. Quinidine can also be used to treat malaria, but its main and Read more […]

Northern Asia

In the history of medicinal plant use in eastern Asia and Siberia, a very important school of medical practice, traditional Chinese medicine, links practices from a number of traditions that have been handed down by word of mouth (as in Siberia or northern China) and for which written historical sources are very rare and poorly investigated (e.g., Mongolian traditional medicine and the Tibetan school). The Chinese Materia Medico, has been growing throughout the last 2,000 years. This increase results from the integration of drugs into the official tradition from China’s popular medicine as well as from other parts of the world. The first major Materia Medica after Tao Hong Jing was the Xin xiu ben cao 659 ad, also known as Tang Materia Medica, which was the official pharmacopoeia of the Tang dynasty. It contained 844 entries and was China’s first illustrated Materia Medica. Zheng lei ben cao, 1108 ad, was the major medical treatise during the Song dynasty and contained 1,558 substances. However, China’s most celebrated medical book is represented by Li Shi-Zhen’s Ben cao gang mu, posthumously printed in 1596 ad, with 1,173 plant remedies, 444 animal-derived drugs and 275 minerals. This tradition has continued into Read more […]

Chronic Pelvic Pain

Chronic pelvic pain (CPP) is defined as pelvic pain lasting more than 6 months. Some authors add the additional criteria that the pain be noncyclic. It is one of the most common presenting complaints in gynecologic practice, affecting as many as one in seven American women. Chronic pelvic pain comprises up to 10% of outpatient gynecologic visits, accounts for 20% of laparoscopies, and results in 12% (75,000 / year) of all hysterectomies performed annually in the United States. Estimated annual direct medical costs for outpatient visits for chronic pelvic pain in the United States among women 18 to 50 years old is estimated to be $881.5 million. It is often an extremely frustrating condition for both patient and care provider because in many cases an etiology cannot be identified and there is no apparent pathology. Treatment of presumed underlying conditions is frequently ineffective, and the “pain itself becomes the illness.” Because the cause often cannot be identified, chronic pelvic pain is frequently attributed to psychogenic causes. Although these may play a role in chronic pelvic pain for some women with lack of an identifiable cause, this does not necessarily equate with a psychosomatic origin for this complaint. Common Read more […]

Herb-Drug Interactions: Cat’s claw

Uncaria tomentosa DC, Uncaria guianensis J.F.Gmel. (Rubiaceae) Synonym(s) and related species Life-giving vine of Peru, Samento, Saventaro, Una de gato. Pharmacopoeias Cat’s Claw (US Ph 32); Powdered Cat’s Claw (US Ph 32); Powdered Cat’s Claw Extract (US Ph 32); Cat’s Claw Tablets (US Ph 32); Cat’s Claw Capsules (The United States Ph 32). Constituents The main constituents of both the closely related species of cat’s claw include the tetracyclic oxindole alkaloids, isorhynchophylline and rhynchophylline, and the indole alkaloids, dihydrocoryynantheine, hirsutine, and hirsuteine. Quinovic acid glycosides have also been isolated. Note that there are two chemotypes of Uncaria tomentosa, one primarily containing the tetracyclic oxindole alkaloids, isorhynochophylline and rhynchopylline, and one primarily containing the pentacychc oxindole alkaloids, (iso)pteropodine and (iso)mitraphylline. Use and indications Cat’s claw roots, bark and leaves have been used for gastric ulcers, arthritis, gonorrhoea, dysentry, herpes zoster, herpes simplex and HIV, and as a contraceptive. In various preclinical studies, antiviral, anti-inflammatory, antirheumatic, immunostimulating, antimutagenic, antitumour and hypotensive Read more […]

Herb-Drug Interactions: St John’s wort

Hypericum perforatum L. (Clusiaceae) Synonym(s) and related species Hypericum, Millepertuis. Hypericum noeanum Boiss., Hypericum veronense Schrank. Pharmacopoeias St John’s Wort (British Ph 2009, European Ph 2008, US Ph 32); St John’s Wort Dry Extract, Quantified (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Constituents The main groups of active constituents of St John’s wort are thought to be the anthraquinones, including hypericin, isohypericin, pseudohypericin, protohypericin, protopseudohypericin and cyclopseudohypericin, and the prenylated phloroglucinols, including hyperforin and adhyperforin. Flavonoids, which include kaempferol, quercetin, luteolin, hyperoside, isoquercitrin, quercitrin and rutin; biflavonoids, which include biapigenin and amentoflavone, and catechins are also present. Other polyphenolic constituents include caffeic and chlorogenic acids, and a volatile oil containing methyl-2-octane. Most St John’s wort products are standardised at least for their hypericin content (British Pharmacopoeia 2009), even though hyperforin is known to be a more relevant therapeutic constituent, and some preparations are now standardised for both (The United Read more […]

Ginkgo biloba: Clinical Use

Ginkgo biloba is a complex herb that contains many different active constituents and works by means of multiple mechanisms. In practice, its therapeutic effect is a result of interactions between constituents and mechanisms, giving it applications in many varied conditions. To date, most of the research conducted in Europe has used a standardised preparation known as EGb 761, available commercially as Rokan, Tanakan or Tebonin. DEMENTIA, MEMORY IMPAIRMENT Ginkgo biloba has been used and studied as a cognitive activator in a variety of populations, such as cognitively intact people, those with cerebral insufficiency, age-related memory impairment, Alzheimer’s dementia or multi-infarct dementia. A 2002 Cochrane review of the scientific literature concluded that Ginkgo biloba produces benefits superior to placebo within 12 weeks’ treatment in people with acquired cognitive impairment, including dementia, of any degree of severity. Cognition, activities of daily living and measures of mood and emotional function show significant benefit for ginkgo compared with placebo. Some clinical studies have also found that EGb 761 improves the capacity of geriatric patients to cope with the stressful demands of daily life. Clinical Read more […]

Turmeric: Background. Actions

Common Name Turmeric Other Names Chiang huang, curcuma, curcumae longae rhizoma, curcuma rhizome, e zhu, haridra, Indian saffron, jiang huang, jiang huang curcumae rhizoma, turmeric rhizome, turmeric root, yellow root, yu jin, zedoary Botanical Name / Family Curcuma longa (family Zingiberaceae [ginger]) Plant Part Used Dried secondary rhizome (containing not less than 3% curcuminoids calculated as curcumin and not less than 3% volatile oil, calculated on dry-weight basis). Chemical Components Turmeric rhizome contains 5% phenolic curcuminoids (diarylheptanoids), which give turmeric the yellow colour. The most significant curcuminoid is curcumin (diferuloymethane). It also contains up to 5% essential oil including sesquiterpene (e.g. Zingerberene), sesquiterpene alcohols and ketones, and monoterpenes. Turmeric also contains immune stimulating polysaccharides, including acid glucans known as ukonan A, B and C. Historical Note Turmeric is a perennial herb, yielding a rhizome that produces a yellow powder that gives curry its characteristic yellow colour and is used to colour French mustard and the robes of Hindu priests. Turmeric was probably first cultivated as a dye, and then as a condiment and cosmetic. Read more […]