Citrus in Traditional Medicine

Citrus in traditional Asiatic medicine In a comparative study of the use of herbal drugs in the traditional medicines of India and Europe, Pun () found a marked similarity between the drugs used in the two continents. He attributed this not only to the similarity of the vegetation in the two areas, but also to the influence that traditional Indian medicine, in particular the Atherveda, one of the most ancient repositories of human knowledge, had on Egypt, Greece and Rome. He listed the principal uses of a small number of these drugs, including bitter orange peel, which in India is used as an aromatic, stomachic, tonic, astringent and carminative agent, and lemon, which is used as a flavouring and for its carminative and stomachic effects. In the Valmiki-Ramayana, written after the Vedas and one of the most sacred of all religious books which enumerates the virtues of the medicinal plants that Lord Rama (Vishnu) met during his fourteen-year journey around different parts of India, Karnick and Hocking () identified and listed fifty of these drugs with their use as described in the Ayurvedica (or native Indian) system of medicine. The immature fruit of Citrus aurantifolia (Christm) Swingle was used as an fortifier, Read more […]

Specific Medicinal Uses of Cannabis: Use as an Antiemetic

Many agents used in cancer chemotherapy produce severe nausea and vomiting in most patients. Symptoms can last for hours or days and have a major impact on patient nutrition and electrolyte status, body weight and physical and mental resilience to both the disease and its treatment. The current choice of available anti-emetics is limited and most are only partially effective, which may lead patients to refuse therapy all together, or for clinicians to use chemotherapeutic regimens which are less than optimum. For these reasons, the search for more effective antiemetics continues. Cannabis In the late 1960s and early 1970s, patients receiving various cancer chemotherapy regimes (including mustine, vincristine, prednisone and procarbazine) noted that smoking cannabis from illicit sources, before and during chemotherapy, reduced the incidence of nausea and vomiting to a variable degree. Only since the isolation of THC have formal clinical trials on the safety and efficacy of cannabis derivatives been conducted. As far as crude cannabis is concerned, we have only anecdotal evidence that inhaling its smoke is effective in a variable percentage of patients who vomit, despite supposedly adequate doses of standard antiemetics. There Read more […]

A Gynecological Remedy

So what do our classical writers say about the uses of artemisia in gynaecology and do those attributed to mugwort differ? Dioscorides recommends a decoction of the herb in a bath to draw down the menstrual blood and to bring out the foetus and the afterbirth. This is achieved by a warming and thinning effect, which could also procure an abortion. A pessary made from the juice of artemisia mixed with myrrh Commiphora molmol, or three drachms (12 g, increasing to 15 g in Ibn Sina’s entry) of the leaves given in drink will similarly draw out the menstrual blood or contents of the womb. The herb liberally plastered onto the lower abdomen will bring on a period and the decoction added to the bath water will treat uterine closure and inflammation. Pliny mentions only the pessary as cleansing for the uterus, with oil of iris or figs as a substitute for myrrh. Galen records that both artemisias have a heating effect in the second degree or above and are moderately drying in the first or second degree. They are of thin parts and can be used for fomentations of the uterus. Apuleius mentions no gynaecological uses and may be writing of Mattioli’s Artemisia tenuifolia instead. Having cited the classical texts, Bauhin moves Read more […]

α-ADRENOCEPTOR ANTAGONISTS

α-ADRENOCEPTOR ANTAGONISTS (also known as α-adrenergic receptor antagonists, α-adrenoceptor blocking drugs or α-blockers) are drugs that inhibit certain actions of the sympathetic nervous system by preventing the action of adrenaline and noradrenaline (catecholamine mediators acting predominantly as hormone or neurotransmitter, respectively) by acting as antagonists at the α-adrenoceptors on which the catecholamines act. (Correspondingly, β-ADRENOCEPTOR ANTAGONISTS are drugs used to inhibit the remaining actions, by occupying the other class of adrenoceptor, β-adrenoceptors). In disease states some sympathetic actions may be inappropriate, exaggerated and detrimental, so α-blockers may be used to restore a balance. One use of antagonists is in lowering blood pressure when it is raised in cardiovascular disease (see ANTIHYPERTENSIVE AGENTS), since they prevent the vasoconstrictor actions of noradrenaline and adrenaline (including in phaeochromocytoma), though a high incidence of side-effects means they are nowadays much less used. The apblockers are also used to treat urinary retention in benign prostatic hyperplasia (through an action on the blood circulation within the prostate). Examples of α1-blockers Read more […]

ANTICHOLINESTERASES

ANTICHOLINESTERASES are agents that inhibit cholinesterases, enzymes that fall into two main families — acetylcholinesterases (AChE) and butyrylcholinesterases (BChE). These enzymes are of related molecular structures but have different distributions, genes and substrate preferences. The enzymes have globular catalytic subunits that are the soluble form of the esterases (as in plasma or CSF), or they can be attached via long collagen tails to the cell membrane. Acetylcholinesterase (AChE) (also termed ‘true cholinesterase’) is found in the synaptic cleft of cholinergic synapses, and is of undoubted importance in regulation of neurotransmission by rapid hydrolysis of released endogenous acetylcholine (ACh). AChE is also found in erythrocytes and in the CSF, and can be present in soluble form in cholinergic nerve terminals, but its function at these sites is not clear. AChE is specific for substrates that include acetylcholine and the agents methacholine and acetylthiocholine. but it has little activity with other esters. It has a maximum turnover rate at very low concentrations of AChE (and is inhibited by high concentrations). Butyrykholinesterase (BChE) (also termed pseudocholinesterase) has a wide distribution, Read more […]

St John’s wort: Clinical Use

Up until recently, most trials conducted with St John’s wort used a 0.3% hypericin water and alcohol extract known as LI 150. Subsequently, studies using different preparations, such as WS 5573 (standardised to hyperforin) or ZE 117 (a low concentration hyperforin preparation), have been tested. DEPRESSION AND ANXIETY Clinical note — The Hamilton Depression Scale The Hamilton Depression Scale is an observer-rated scale that focuses mainly on somatic symptoms of depression. Although the original version included 21 items, a similar version using 17 items is more commonly used in clinical trials. Most studies using the Hamilton Depression Scale report the number of ‘treatment responders’ (patients achieving a score less than 10 and/or less than 50% of the baseline score). Mild to moderate depression St John’s wort has shown efficacy as a successful treatment for mild to moderate depression in numerous double-blind placebo-controlled trials, confirmed by several meta-analyses. The most recent Cochrane review released in 2005 analysed data from 37 double-blind, randomised studies (n = 4925) that used monopreparations of St John’s wort over a treatment period of at least 4 weeks. It concluded that hypericum Read more […]

Saw palmetto: Practice Points – Patient Counselling. FAQ

• Substantial scientific evidence has shown that saw palmetto is an effective treatment for stages 1 and 2 of BPH in cases where the diagnosis of cancer is negative. It is as effective as finasteride and alpha-adrenoreceptor antagonist drugs such as tamsulosin and alfuzosin, although prazosin may be slightly more effective. • Typically, symptom reduction is experienced within 1-2 months’ treatment, which is well tolerated, and associated with fewer side effects than finasteride and tamsulosin. • The herb does not affect PSA levels therefore PSA test results will be unaffected. • If symptoms worsen, blood is detected in the urine or acute urinary retention occurs, seek professional advice. Answers to Patients’ Frequently Asked Questions What will this herb do for me? Saw palmetto has been investigated in numerous scientific studies and shown to reduce symptoms of enlarged prostate with few side-effects. There is also some early research suggesting it may be useful in some forms of hair loss and prostatitis. When will it start to work? Symptom relief for enlarged prostate is generally experienced within 4-8 weeks. Are there any safety issues? Saw palmetto is well tolerated; however, Read more […]

Saw palmetto: Adverse Reactions. Significant Interactions. Pregnancy Use

The herb is generally well tolerated, with only non-specific symptoms reported, such as gastrointestinal upset, constipation, nausea, abdominal pain and diarrhea. These minor complaints are generally resolved by taking the herb in association with meals. One large clinical study identified headache and rhinitis as the most common side-effects associated with use. Significant Interactions No controlled studies are available and theoretical interactions are difficult to predict, due to the poorly understood nature of the herb’s mechanism of action. FINASTERIDE (AND OTHER 5-ALPHA REDUCTASE INHIBITOR AGENTS) Additive effect theoretically possible — potential beneficial effect, although the clinical significance is unknown. ANDROGENIC DRUGS Theoretically, saw palmetto may reduce effectiveness of therapeutic androgens such as testosterone— observe patient for lack of drug effect. Contraindications and Precautions If symptoms of BPH worsen, blood is detected in the urine, or acute urinary retention occurs, professional reassessment is required. Pregnancy Use Use of saw palmetto during pregnancy is contraindicated due to the herb’s hormonal effects. In clinical practice, it is not used in pregnancy. Read more […]