Introduction
Herbalists use the leaves, flowers, stems, berries, and roots of plants to prevent, relive, and treat illness. From a scientific perspective, many herbal treatments are considered experimental (Kraft & Hobbs, 2004 p.356). Many familiar medications of the twentieth century were developed fro-ancient healing traditions that treated health problems with specific plants (Schulze & Hansel, 2001 p.266). Many plant components are now synthesized in large laboratories for use in pharmaceutical preparations (Gladstar, & Hirsch, 2001 p.432; Kraft & Hobbs, 2004 p.356). Throughout the middle Ages, homegrown botanicals were the only medicines readily available, and for centuries, no self-respecting household would be without a carefully tended and extensively used herb garden (Hoffmann, & Manning, 2002 p.176; O’Mathuna ; Larimore, 2001 p.76). In this study, the three primary focused herbs are dandelions, parsley and rosemary.
Discussion
Parsley
Parsley, which occasionally escapes cultivation in America, has—like anise, dill, fennel, and other umbelliferous plants—a long, conspicuous history extending back to classical times as both a culinary herb and a medicine. It was considered an important medicinal plant for Elizabethan gardens when John Gerard (1597) described it and other parsleys (particularly the seeds) as hot and dry and possessing deobstruent actions (Earnst, 2000 p.561; Appendino, 1998). These actions included diuresis (and dissolving stones and treating dropsy), breaking wind, drawing drowsiness, and an anti-poison action was noted (Tiera, 2003 p.68; Capasso, 2000; Kreydiyyeh ; Usta, 2001). Parsley seems to have been popular in the eighteenth century arid, like celery, was often noted as one of the five greater opening roots. John Hill (1751) described it as attenuate, aperients, detergent, and diuretic: “It is given in diet drinks in chronic cases arising from obstructions of the viscera, and is in any form a powerful diuretic (Gladstar, ; Hirsch, 2001 p.431; Wilson, 2001 p.79; Kreydiyye, 2001). It was the diuretic action (sometimes said to be mild)—discussed widely in eighteenth-, nineteenth-, and early- twentieth century materia medica and domestic medicine texts from both Europe and America—that came to the fore rather than the carminative action, a well-known characteristic of many umbelliferous fruits (Earnst, 2000 p.561; Weiss, 2001 p.355).
Occasionally an author gives a sense that parsley root also relieves “nephritic pains, and obstructions of urine” without a marked diuretic effect (Kraft ; Hobbs, 2004 p.356; Rivera etal, 2002; Capasso, 2000). Another aspect of parsley’s reputation— mentioned particularly in the literature of the eighteenth century and earlier is galactogogue action (increasing the flow of breast milk) (Green, 2001 p.213; Pinn, G., ; Pallett, 2002). Reported actions on the uterus (for example. parsley juice was said to cause delivery of a dead child and hasten labor) suggest that a specific physiological effect might be at play rather than a reputation owing much to a theory of deobstruent action (Kraft ; Hobbs, 2004 p.356; Weiss, 2001 p.355). Toward the end of the century, however, renewed enthusiasm in parsley emerged through interest in apiol (dimethoxysafrole) isolated from the volatile oil. Apiol was originally introduced to treat malaria because of a “fancied resemblance in its toxic action to quinine,” but was soon considered to act on uterine muscle and to be useful for amenorrhea, and was also recommended for neuralgia (Schulze ; Hansel, 2001 p.266; Yarnell, 2002). Published information on the action of apiol on menstrual disorders is confusing, perhaps reflecting variable concentrations of a related constituent, myristicin, in the more than thirty varieties of parsley (Weiss ; Fintelmann, 2001 p.432). The evidence certainly suggests specific uterine action, though most rationalizations reflect the comments in the authoritative British Pharmaceutical Codes: apiol is “chiefly used in dysmenorrhea and no doubt, acts by local reflex irritation during excretion by the urinary tract (Weiss ; Fintelmann, 2001 p.433). Apiol and myristicin have been said to be responsible for the diuretic reputation of the seeds and oil (Kraft ; Hobbs, 2004 p.356; Kreydiyyeh ; Usta, 2001).
Dandelions
The historical medicinal use of dandelion dates back to the tenth and eleventh centuries. Dandelion exhibits properties such as enhancement of bile flow (cholekinetic), improvement in liver congestion, choleretic activity, and use in treating hepatitis (Hoffmann, ; Manning, 2002 p.176). Clinical use of dandelion is officially recognized in Britain, France, and Germany. Dandelion is a rich source of nutrients, including chlorophyll and carotenoids (Cho etal, 2002). In addition to being a great food, it is also a great medicine, Dandelion is one of the best liver remedies because it enhances the flow of bile, and it is therefore used to treat a variety of liver ailments (Seeff et al, 2001). In China, dandelion has been used to treat breast cancer. The leaf of the dandelion is an excellent diuretic, comparable to Lasix; yet, dandelion replenishes potassium and other minerals that are normally depleted by diuretics (Tiera, 2003 p.65). Dandelion’s use as a gastric and hepaticibiliary stimulant is straightforward (O’Mathuna & Larimore, 2001 p.76; Lee, 1999). The tea or tincture taken before meals is a reliable bitter tonic. It increases digestive prowess by stimulating an array of gastric secretions. Use the plant if prone to indigestion and combine with Dogweed or Mountain marigold if there is a tendency for bloating (Lee, 1999). Dandelion is stimulating to bile production by the liver and release by the gallbladder, and likewise small intestinal fat digestion is augmented (Green, 2001 p.213; Pittler and Earnst, 2003). The plant tends to be more cooling to the liver than other hepatic stimulants such as Desert barberry, so its use in liver inflammations, like hepatitis C, is better suited (Hoffmann, & Manning, 2002 p.176). In fact alone or combined with Milk thistle, Dandelion reduces user sensitivity, upper body tightness, and itchy eyes and skin associated with subacute liver inflammation (Pittler and Earnst, 2003). Moreover, a cup of roasted or plain Dandelion root tea in the morning before breakfast is an effective way of thinning bile so gallstones tend not to develop. Small amounts of the tea over a longer period will diminish established gallstones from overly concentrated bile (Earnst, 2000 p.561; Poppenga, 2002).
Dandelion, particularly the leaf, is diuretic. It is indicated in resolving uric acid kidney stones and acts systemically in eliminating uric acid deposits responsible for gout (William et al, 1996). Dandelion roots have substantial inulin content, a complex carbohydrate that enters the colon intact due to the body’s inability to digest it. In the colon, inulin promotes beneficial flora growth, particularly of bifidobacteria. This in turn stabilizes the large intestinal environment, limiting pathogenic bacteria and their destructive by-products. Use Dandelion in the nefarious “leaky gut syndrome” — a title meant to describe a symptom picture of skin allergies, joint inflammation, fatigue, and colon instability dependent upon proliferation of harmful colon bacteria, their by-products, and heightened leukocyte activity Pittler and Earnst, 2003). For this purpose, combine Dandelion with Yucca. The combination tends to stabilize beneficial flora levels, while binding harmful endotoxins (William et al, 1996).
Rosemary
Rosemary is an aromatic evergreen shrub that grows to a height of three feet (one meter). It bears thick, narrow, parallel green leaves and pale blue to blue-violet flowers. The leaves and the essential oil distilled from the leaves are used in herbal medicine (Duke, & Castleman, 2001 p.34). Rosemary is also used in food preparation as an antioxidant and preservative, particularly for meats, and in the preparation of liqueurs such as Benedictine and Danziger Goldwasser. Rosemary a potent antioxidant, antiseptic, and antispasmodic (Ebadi, 2006 p.431). In European folk medicine, it was used both internally and externally, or ills including nervous disorders, upset stomach, headaches, baldness, arthritis, pain, strains, and bruises. More recently, it has been investigated as a cancer therapy. For Alzheimer’s disease, Rosemary contains compounds that prevent the breakdown of acetylcholine, a brain chemical that allow, the nerve cells responsible for memory and reasoning to communicate with one another (Gladstar, & Hirsch, 2001 p.432). Rosemary also improves circulation to the brain. For cancer therapy, research shows that rosemary has strung antioxidant effect (Ebadi, 2006 p.431). Several animal studies indicate that rosemary can prevent cancer-causing chemicals from binding to and causing mutations in cellular DNA (Cassileth, 2008). This was later reconfirmed in human cells (Dougherty, 2005 p.312). Rosemary has been shown to inhibit the carcinogen aflatoxin from binding to liver cell, and to prevent benzopyrene from binding to bronchial ceils (O’Mathuna ; Larimore, 2001 p.79; Moss et al, 2003). These results show that its potential protective abilities go beyond one carcinogen and one type of tissue. Other research has found that whole rosemary extract can stimulate liver enzymes that defuse carcinogens and reduces those enzymes that can enhance carcinogens (Dragland et al, 2003). For circulatory problems, eczema, rheumatic disorders and sore muscles, rosemary baths were used to prevent bacterial infection complicating eczema. Rosemary baths also stimulate blood circulation to the skin (Moss et al, 2003). This action helps the body to circulate the immune cells that cause eczema away from the skin and to circulate antibodies and other immune cells that fight infection to the skin (Chitturi, ; Farrell, 2000 p.72). Rosemary contains camphor, which increases the blood supply to the skin. Due to this property, using rosemary in the bath helps to reduce pain in rheumatic muscles and joints. Rosemary baths also help to improve disorders characterized by chronic circulatory weakness, such as low blood pressure, varicose veins, bruises, and sprains (Dragland et al, 2003).
Conclusion
In the conclusion of the study, rosemary, dandelion and parsley possess various and specific medicinal purposes that have been utilized even from the past by mostly European medicinal folklore. Rosemary has been determined as a potent antioxidant, which gives the possible medicinal contribution to cancer therapy. Moreover, it initiates antispasmodic effect and antiseptic effects. On the other hand, dandelions are effective for improvement in liver congestion, choleretic activity, cholekinetic and use in treating hepatitis. Parsley has been noted to provide a mild to strong diuretic effect, which revolutionizes urine excretion, and galactogogue action or enhancement of breast milking.
References
Balch, P. A. (2002). Prescription for Herbal Healing. Avery.
Cassileth, B. R. (2008, March 8). Complementary and Alternative Cancer Medicine. Journal of American Society of Clinical Oncology, 17, 44-52.
Chitturi, S., ; Farrell, G. C. (2000, October). Herbal hepatotoxicity: An expanding but poorly defined problem. Journal of Gastroenterology and Hepatology, 15, 1093-1099.
Dougherty, K. (2005). Herbal Voices: American Herbalism Through the Words of American Herbolarium. Haworth Press.
Duke, J. A., ; Castleman, M. (2001). The Green Pharmacy Anti-Aging Prescriptions: Herbs, Foods, and Natural Medicine. Rodale.
Earnst, E. (2000). Herbal Medicine: A Concise Overview for Professionals. Elsevier Health Sciences.
Ebadi, M. S. (2006). Pharmacodynamic Basis of Herbal Medicine. CRC Press.
Gladstar, R., ; Hirsch, P. (2000). Planting the Future: Saving Our Medicinal Herbs. Inner Traditions / Bear and Company.
Green, J. (2000). The Herbal Medicine-Makers Handbook: A Home Manual. The Crossing Press.
Hoffmann, F. W., ; Manning, M. (2002). Herbal Medicine and Botanical Medical Fads. Haworth Press.
Kraft, K., ; Hobbs, C. (2004). Pocket Guide to Herbal Medicine. Thieme.
O’Mathuna, D., & Larimore, L. W. (2001). Alternative Medicine: The Christian Handbook. Zondervan.
Pinn, G., & Pallett, L. (2002, May). Herbal medicine in pregnancy. Complementary Therapies in Nursing and Midwifery , 8, 77-80.
Rivera etal, J. O. (2002, January). Evaluation of the Use of Complementary and Alternative Medicine in the Largest United States–Mexico Border City. American College of Clinical Pharmacy, 22, 256-264.
Schulze, V., & Hansel, R. (2001). Rational Phytotherapy: A Physician’s Guide to Herbal Medicine. Haworth Press.
Seeff etal, L. B. (2001, June 28). Complementary and alternative medicine in chronic liver disease. American Association for the Study of Liver Diseases, 34, 595 – 603.
Tiera, L. (2003). Healing with the Herbs of Life. The Crossing Press.
Weiss, R. F. (2001). Weiss’s Herbal Medicine. Thieme.
Weiss, R., & Fintelmann, V. (2000). Herbal Medicine. Thieme.
Wilson, L. (2000). Becoming a Complementary Therapist. How To Books Ltd.
Appendino etal, G. I. (1998, November). Structural revision of the parsley sesquiterpenes crispanone and crispane. Phytomedicine , 49, 1719-1722.
Capasso etal, R. (2000, August). Phytotherapy and quality of herbal medicines. Journal of Oncology and Stat, 71, S58-S65.
Cho etal, S. (2002, March). Alternation of hepatic antioxidant enzyme activities and lipid profile in streptozotocin-induced diabetic rats by supplementation of dandelion water extract. Journal of Oncology and Stat, 317, 109-117.
Dragland etal, S. (2003, May). Several Culinary and Medicinal Herbs Are Important Sources of Dietary Antioxidants. ournal of Human Nutrition and Metabolism, 113, 1286-1290.
Kreydiyye etal, S. I. (2001, November). The mechanism underlying the laxative properties of Parsley extract. Phytomedicine , 8, 382-388.
Kreydiyyeh, S., & Usta, J. (2002, March). Diuretic effect and mechanism of action of parsley. Journal of Ethnopharmacology , 79, 353-357.
Lee, L. (1999, May). Introducing herbal medicine into conventional health care settings. Journal of Nurse-Midwifery , 44, 253-266.
Moss etal, M. (19982003, January). AROMAS OF ROSEMARY AND LAVENDER ESSENTIAL OILS DIFFERENTIALLY AFFECT COGNITION AND MOOD IN HEALTHY ADULTS. International Journal of Neuroscience, 113, 15 – 38.
Pittler, M. H., & Earnst, E. (2003, September). Hepatotoxic events associated with herbal medicinal products. . Alimentary Pharmacology & Therapeutics, 18, 451-471.
Poppenga, R. H. (2002, February). Herbal medicine: Potential for intoxication and interactions with conventional drugs. Journal of Oncology and Stat, 17, 6-18 .
Stapleton, H. (1995, December). The use of herbal medicine in pregnancy and labour. Part II: events after birth, including those affecting the health of babies. Complementary Therapies in Nursing and Midwifery , 1, 165-167.
Williams etal, C. A. (1996, May). Flavonoids, cinnamic acids and coumarins from the different tissues and medicinal preparations of Taraxacum officinale. Journal of Oncology and Stat, 42, 121-127.
Yarnell, E. (2002, November). Botanical medicines for the urinary tract. World Journal of Urology, 20, 285-293.
Parsely
Pinn, G., & Pallett, L. (2002, May). Herbal medicine in pregnancy. Complementary Therapies in Nursing and Midwifery , 8, 77-80.
Abstract
The objective of the study was to assess the frequency of alternative medical usage in an antenatal population. A survey of alternative medicine usage was carried out among 305 consecutive patients over 2 months at their registration in mid-pregnancy at an Australian Antenatal Clinic. The study showed that something like 40% of patients used alternative medical therapy, including 12% herbal therapy. No specific study of pregnancy outcome was carried out, but it is of concern that some herbs taken had the potential to adversely affect pregnancy outcome. The herbal therapies commonly used in pregnancy are reviewed with their potential complications; examples of toxicity are also discussed. It is important to obtain a herbal medicine history at any time but particularly in pregnancy. Herbs may have unrecognised effects on pregnancy or labour, have interactions with prescribed medications and have potentially serious complications for the foetus.
Capasso etal, R. (2000, August). Phytotherapy and quality of herbal medicines. Journal of Oncology and Stat, 71, S58-S65.
Abstract
The extensive use of plants as medicines has pointed out that herbal medicines are not as safe as frequently claimed. Therefore, it can be harmful to take herbal medicines without being aware of their potential adverse effects. A comprehensive surveillance system for monitoring the adverse effects of herbal medicines is now essential. Also knowledge of the correlation existing between the marker compounds and other ingredients that occur in plants is a necessary requirement for ensuring the efficacy and quality of the herbal medicines.
Kreydiyyeh, S., & Usta, J. (2002, March). Diuretic effect and mechanism of action of parsley. Journal of Ethnopharmacology , 79, 353-357.
Abstract
This work provides substantial evidence for the advocated diuretic effect of parsley in folk medicine and determines the mechanism of action of the herb. Rats offered an aqueous parsley seed extract to drink, eliminated a significantly larger volume of urine per 24 h as compared to when they were drinking water. These findings were supported by the results of other experiments using an in situ kidney perfusion technique which demonstrated also a significant increase in urine flow rate with parsley seed extract. This effect was still apparent in presence of amiloride, furosemide and in the absence of sodium, but not in the absence of potassium, suggesting that the diuretic effect of the herb is mediated through an increase in K+ retention in the lumen. Parsley extract, was shown on the other hand, to reduce the activity of the Na+–K+ ATPase in both cortex and medulla homogenates. Such an inhibition would decrease apical cellular Na+ reabsorption, lower K+ secretion, increase K+ concentration in the intercellular space and consequently would inhibit passive K+ influx across the tight junctions. The mechanism of action of parsley seems to be mediated through an inhibition of the Na+–K+ pump that would lead to a reduction in Na+ and K+ reabsorption leading thus to an osmotic water flow into the lumen, and diuresis.
Yarnell, E. (2002, November). Botanical medicines for the urinary tract. World Journal of Urology, 20, 285-293.
Abstract
Four important categories of urologic herbs, their history, and modern scientific investigations regarding them are reviewed. Botanical diuretics are discussed with a focus on Solidago spp (goldenrod) herb, Levisticum officinale (lovage) root, Petroselinum crispus (parsley) fruit, and Urtica dioica (stinging nettle) herb. Urinary antiseptic and anti-adhesion herbs, particularly Arctostaphylos uva-ursi (uva-uri) leaf, Juniperus spp (juniper) leaf, and Vaccinium macrocarpon (cranberry) fruit are reviewed. The antinephrotoxic botanicals Rheum palmatum (Chinese rhubarb) root and Lespedeza capitata (round-head lespedeza) herb are surveyed, followed by herbs for symptoms of benign prostatic hyperplasia, most notably Serenoa repens (saw palmetto) fruit, Urtica dioica root, and Prunus africana (pygeum) bark.
Kreydiyye etal, S. I. (2001, November). The mechanism underlying the laxative properties of Parsley extract. Phytomedicine , 8, 382-388.
Abstract
Parsley has been claimed in folk medicine to possess laxative properties attributed to the presence therein of some volatile oils that are more concentrated in seeds than in stems or leaves. The advocated physiological effect of parsley, does not have, however, any proven scientific background and relies mainly on simple observations and empirical information. This work aims at providing the scientific evidence that would confirm or reject the claimed laxative role of parsley, and at determining its mechanism of action if present. A perfusion technique was used to measure the net fluid absorption from the rat colon. The addition of an aqueous extract of parsley seeds to the perfusion buffer, and the omission of sodium, both reduced significantly net water absorption from the colon, as compared to the control. Parsley, added to a sodium-free buffer did not lead to any further significant change in water absorption as compared to parsley alone inferring that with parsley sodium absorption was already inhibited. Since K+ and Cl– secretion depends on the activity of the NaKCl2 transporter, the latter was inhibited with furosemide which increased significantly net water absorption. When parsley and furosemide were added together, net water absorption was significantly higher than with parsley alone and significantly lower than with furosemide alone. In addition, parsley extract was shown to inhibit the in vitro activity of the Na+?K+ATPase in a colon homogenate and the activity of a partially purified dog kidney ATPase. The results suggest that parsley acts by, inhibiting sodium and consequently water absorption through an inhibition of the Na+?K+ pump, and by stimulating the NaKCl2 transporter and increasing electrolyte and water secretion.
Appendino etal, G. I. (1998, November). Structural revision of the parsley sesquiterpenes crispanone and crispane. Phytomedicine , 49, 1719-1722.
Abstract
The structure of the sesquiterpenes crispanone and crispane was revised to that of siol angelate and lasidiol angelate, respectively. A novel phenylpropanoid (apional) was also isolated. The following substitutes has been proven to have potent effects in both urinary and electrolyte regulation of the body; hence, correspondingly effective in promoting diuresis.
Dandelions
Chitturi, S., & Farrell, G. C. (2000, October). Herbal hepatotoxicity: An expanding but poorly defined problem. Journal of Gastroenterology and Hepatology, 15, 1093-1099.
Abstract
Alternative therapies, including herbal remedies, are popular in the general population and even more so among patients with liver disease. The use of such products is now well established in western society and is no longer confined to traditional medicine practitioners in Asia, Africa and the Middle-East. Their perceived benefits remain generally unproven and concern about adverse effects is leading to closer scrutiny of these products. Herbal hepatotoxicity has been recognized for many years, but new agents are constantly being identified. The varied manifestations of liver injury include steatosis, acute and chronic hepatitis, hepatic fibrosis, zonal or diffuse hepatic necrosis, bile duct injury, veno-occlusive disease, acute liver failure requiring liver transplantation and carcinogenesis. Potential interactions between herbal medicines and conventional drugs may interfere with patient management. Concurrent use of such products is not often disclosed unless specifically sought after and can lead to perpetuation of the liver injury. The present review focuses on emerging herbal hepatotoxins, newer patterns of liver injury among the older agents and provides an updated tabulation of the adverse effects of major herbal hepatotoxins. Key issues of diagnosis and prevention of this growing problem are addressed. Continued public education, physician awareness and more stringent licensing are required to tackle this growing problem.
Cho etal, S. (2002, March). Alternation of hepatic antioxidant enzyme activities and lipid profile in streptozotocin-induced diabetic rats by supplementation of dandelion water extract. Journal of Oncology and Stat, 317, 109-117.
Abstract
Background: Dandelion water extract (DWE), an herbal medication, may have an effect on the activity and mRNA expression of hepatic antioxidant enzymes and lipid profile in streptozotocin (STZ)-induced diabetic rats. Methods: Male Sprague–Dawley rats were divided into nondiabetic (control), diabetic, and diabetic-DWE-supplemented groups. Diabetes was induced by injecting streptozotocin (55 mg/kg BW, i.p.) in a citrate buffer. The extract was supplemented in 2.4 g of a DWE/kg diet. Results: The DWE supplement significantly decreased the serum glucose concentration in the diabetic rats. The hepatic superoxide dismutase and catalase activities significantly increased and the GSH-Px activity decreased in the diabetic rats, compared with the control group. When the DWE supplement was given to the diabetic rats, the antioxidant enzyme activity reverted to near-control values. However, there was no difference in the mRNA expression concentrations of these enzymes between the groups. With regard to the hepatic lipid peroxidation product, the malondialdehyde (MDA) content was significantly higher in the diabetic group than in the nondiabetic group. However, the DWE supplement lowered the hepatic MDA concentration in the diabetic-induced rats. The DWE supplement also lowered the total cholesterol and triglyceride concentrations in the serum and hepatic tissue, while increasing the serum HDL-cholesterol in the diabetic rats. Conclusions: A DWE supplement can improve the lipid metabolism and is beneficial in preventing diabetic complications from lipid peroxidation and free radicals in diabetic rats.
Williams etal, C. A. (1996, May). Flavonoids, cinnamic acids and coumarins from the different tissues and medicinal preparations of Taraxacum officinale. Journal of Oncology and Stat, 42, 121-127.
Abstract
Three flavonoid glycosides: luteolin 7-glucoside and two luteolin 7-diglucosides were isolated from dandelion flowers and leaves together with free luteolin and chrysoeriol in the flower tissue. The hydroxycinnamic acids, chicoric acid, monocaffeyltartaric acid and chlorogenic acid were found throughout the plant and the coumarins, cichoriin and aesculin were identified in the leaf extracts. This represents the first report of free chrysoeriol (luteolin 3?-methyl ether) in Taraxacum officinale agg. An earlier provisional identification of chicoric acid, chlorogenic acid, cichoriin and aesculin in a phenolic survey of the tribe Cichorieae is confirmed. Chicoric acid and the related monocaffeyltartaric acid were found to be the major phenolic constitutents in flowers, roots, leaves and involucral bracts and also in the medicinal preparations tested.
Poppenga, R. H. (2002, February). Herbal medicine: Potential for intoxication and interactions with conventional drugs. Journal of Oncology and Stat, 17, 6-18
Abstract
The use of herbal remedies for the prevention and treatment of a variety of illnesses in small animals has increased tremendously in recent years. Whereas most herbal remedies, when used as directed and under the supervision of knowledgeable individuals, are safe, the potential for adverse effects or intoxications certainly exists. Due to inherent toxicity, some herbal remedies should not be used under any circumstance. In addition, because nearly all herbal remedies contain multiple, biologically active constituents, interaction with conventional drugs is a concern. It is incumbent upon clinicians to be aware of those herbs that can cause intoxication, and to be cognizant of potential herb-drug interactions. There are a number of evidence-based resources available to assist clinicians in the safe use of herbal remedies.
Pittler, M. H., & Earnst, E. (2003, September). Hepatotoxic events associated with herbal medicinal products. . Alimentary Pharmacology & Therapeutics, 18, 451-471.
Abstract:
Background: Large proportions of patients use herbal medicinal products, and encouraging data in terms of effectiveness exist for some of these. One aspect, however, which is still largely under-investigated is the question of potential harm.
Aim: To review the recent evidence on hepatotoxic events associated with the use of herbal medicinal products.
Methods: Systematic literature searches were performed on Medline, Embase, The Cochrane Library, Amed and Ciscom. To identify additional data, searches were conducted by hand in relevant medical journals and in our own files. The screening and selection of articles and the extraction of data were performed independently by the two authors. There were no restrictions regarding the language of publication. In order to be included articles were required to report data on hepatotoxic events associated with the therapeutic use of herbal medicinal products.
Results: Single medicinal herbs and combination preparations are associated with hepatotoxic events. Clinically, the spectrum ranges from transient elevations of liver enzyme levels to fulminant liver failure and death. In most instances hepatotoxic herbal constituents are believed to be the cause, while others may be due to herb-drug interactions, contamination and/or adulteration.
Conclusions: A number of herbal medicinal products are associated with serious hepatotoxic events. Incidence figures are largely unknown, and in most cases a causal attribution is not established. The challenge for the future is to systematically research this area, educate all parties involved, and minimize patient risk.
Lee, L. (1999, May). Introducing herbal medicine into conventional health care settings. Journal of Nurse-Midwifery , 44, 253-266.
Abstract
Herbal therapy is one of several holistic therapies gaining recognition within the health care community in the United States. As a discipline, herbal medicine is in its infancy regarding educational standards for credentialling, standardization, and regulation of products and clinical applications within this health care system. This article discusses professional considerations for midwives who are interested in integrating herbal healing into their clinical practices, and offers examples of how to incorporate herbal medicine into midwifery care. Resources for practitioners including books, newsletters, journals, courses, computer sites, and databases are presented. The author offers guidance for creating an herbal practice manual for the midwifery office as well as the hospital setting and for documenting herbal healing in the medical record. Collegial support, barriers to practice, liability, and insurance issues are discussed. A clinical applications section includes specific herbal formulas for preconception health, pregnancy-induced hypertension, gestational diabetes, and postdates pregnancy.
Rosemary
Chitturi, S., & Farrell, G. C. (2000, October). Herbal hepatotoxicity: An expanding but poorly defined problem. Journal of Gastroenterology and Hepatology, 15, 1093-1099.
Abstract
Alternative therapies, including herbal remedies, are popular in the general population and even more so among patients with liver disease. The use of such products is now well established in western society and is no longer confined to traditional medicine practitioners in Asia, Africa and the Middle-East. Their perceived benefits remain generally unproven and concern about adverse effects is leading to closer scrutiny of these products. Herbal hepatotoxicity has been recognized for many years, but new agents are constantly being identified. The varied manifestations of liver injury include steatosis, acute and chronic hepatitis, hepatic fibrosis, zonal or diffuse hepatic necrosis, bile duct injury, veno-occlusive disease, acute liver failure requiring liver transplantation and carcinogenesis. Potential interactions between herbal medicines and conventional drugs may interfere with patient management. Concurrent use of such products is not often disclosed unless specifically sought after and can lead to perpetuation of the liver injury. The present review focuses on emerging herbal hepatotoxins, newer patterns of liver injury among the older agents and provides an updated tabulation of the adverse effects of major herbal hepatotoxins. Key issues of diagnosis and prevention of this growing problem are addressed. Continued public education, physician awareness and more stringent licensing are required to tackle this growing problem.
Moss etal, M. (2003, January). AROMAS OF ROSEMARY AND LAVENDER ESSENTIAL OILS DIFFERENTIALLY AFFECT COGNITION AND MOOD IN HEALTHY ADULTS. International Journal of Neuroscience, 113, 15 – 38.
Abstract
This study was designed to assess the olfactory impact of the essential oils of lavender (Lavandula angustifolia) and rosemary (Rosmarlnus officinalis) on cognitive performance and mood in healthy volunteers. One hundred and forty-four participants were randomly assigned to one of three independent groups, and subsequently performed the Cognitive Drug Research (CDR) computerized cognitive assessment battery in a cubicle containing either one of the two odors or no odor (control). Visual analogue mood questionnaires were completed prior to exposure to the odor, and subsequently after completion of the test battery. The participants were deceived as to the genuine aim of the study until the completion of testing to prevent expectancy effects from possibly influencing the data. The outcome variables from the nine tasks that constitute the CDR core battery feed into six factors that represent different aspects of cognitive functioning. Analysis of performance revealed that lavender produced a significant decrement in performance of working memory, and impaired reaction times for both memory and attention based tasks compared to controls. In contrast, rosemary produced a significant enhancement of performance for overall quality of memory and secondary memory factors, but also produced an impairment of speed of memory compared to controls. With regard to mood, comparisons of the change in ratings from baseline to post-test revealed that following the completion of the cognitive assessment battery, both the control and lavender groups were significantly less alert than the rosemary condition; however, the control group was significantly less content than both rosemary and lavender conditions. These findings indicate that the olfactory properties of these essential oils can produce objective effects on cognitive performance, as well as subjective effects on mood.
Dragland etal, S. (2003, May). Several Culinary and Medicinal Herbs Are Important Sources of Dietary Antioxidants. ournal of Human Nutrition and Metabolism, 113, 1286-1290.
Abstract
We assessed the contribution of culinary and medicinal herbs to the total intake of dietary antioxidants. Our results demonstrate that there is more than a 1000-fold difference among antioxidant concentrations of various herbs. Of the dried culinary herbs tested, oregano, sage, peppermint, garden thyme, lemon balm, clove, allspice and cinnamon as well as the Chinese medicinal herbs Cinnamomi cortex and Scutellariae radix all contained very high concentrations of antioxidants (i.e., >75 mmol/100 g). In a normal diet, intake of herbs may therefore contribute significantly to the total intake of plant antioxidants, and be an even better source of dietary antioxidants than many other food groups such as fruits, berries, cereals and vegetables. In addition, the herbal drug, Stronger Neo-Minophagen C, a glycyrrhizin preparation used as an intravenous injection for the treatment of chronic hepatitis, boosts total antioxidant intake. It is tempting to speculate that several of the effects due to these herbs are mediated by their antioxidant activities.
