24: Materia Medica

CHAPTER 24 Materia Medica




INTRODUCTION


Thousands of medicinal plants are in use around the world. We have chosen the herbs in this section with a variety of purposes in mind. Those that are supported by a great deal of evidence and deserve additional veterinary research are discussed in the greatest detail, but we have also included herbs that are popular among pet owners, even if professional herbalists do not use or recommend them. We have included herbs that have almost no supporting evidence but that are commonly found in urban and suburban environments, so that herbalists may begin to explore their native (or introduced and invasive) plants. Animals may also accidentally ingest these plants, which is another good reason for one to become familiar with their purported effects.


The monographs in this chapter are organized in the following way:


Common Name:


This is the most common name, as indicated in Herbs of Commerce (McGuffin, 2000), the official authority recognized by the U.S. Food and Drug Administration and by the Therapeutic Goods Administration, the group that regulates medicine in Australia.


Botanical Name:


This is the taxonomic classification, with authority, that is generally agreed to indicate the correct species used in commerce, according to information from Herbs of Commerce.


Distribution:


This information is provided so that herbalists may know which plants are native to their areas and what plants may be grown locally. Please note that if a plant is invasive (which we try to note in the “Notes of Interest” section), it should not be planted, even if it can be grown locally. On the other hand, if the “Notes” section indicates that the plant is threatened or endangered, the authors encourage herbalists to plant it in their gardens and encourage local growers to produce it, so that populations will be increased and pressure on wild populations reduced.


Similar Species:


Occasionally (but less often than one might guess), a number of species in a single genus may be used for similar medical conditions. Whenever we could identify this similarity, the other species are listed in this section.


Other Common Names:


These are names that have been used historically or in languages other than English. They may or may not be in common use at this time.


Family:


This is the taxonomic classification that indicates related plants on the basis of morphologic structure. Knowledge of the plant family may assist the herbalist in identifying plants in the wild or as fresh or dried specimens.


Parts Used:


All parts of the plants used for medicine (and in most cases, those used for food) are listed.


Collection:


In general, herbalists recommend that when the roots of a plant are used, it is best to collect in spring before growth has started (so as to take advantage of a winter-long process of storing energy and manufacturing unique constituents that reside there). Late autumn is also considered acceptable. When the aerial parts are used, harvest should be accomplished during the growing season and when the plant is in bloom, where applicable. Barks and resins are sometimes harvested with special instructions in accordance with the experience of the grower. In cases where exceptions to these rules and special instructions are available, they have been included in this section. This information is included to educate herbalists on the complexities of harvest and preparation, and to guide them should they choose to prepare their own herbs for personal use. However, in this text, high-quality liquid extracts and tinctures are recommended for ease of formulating and for their concentration, which allows small doses to be used in animals.


Selected Constituents:


We have elected to include the more individually unique constituents here, as opposed to listing every possible constituent that may occur in a plant. Be aware that in plant medicine, no one constituent can be singled out as “the active constituent,” and, even if all of the vitamins, minerals, proteins, fixed fats, and sugars in a plant are not listed, these are important active constituents as well.


Clinical Actions:


These are the actions for which the herb is best known through long traditional use and recent research findings.


History and Traditional Usage:


Here, we have tried to trace the use of the herb from its earliest recorded history but have concentrated on the more descriptive written records from the 1600s onward. We rely heavily on the literature of the Eclectic and Physiomedical doctors from the 1850s (approximately) through the 1930s. We have also scanned the veterinary literature from the late 1700s through the 1950s to determine how the herb was used in animals. These sources are listed in the reference section after each herb (although each claim in the text of the monographs has not been referenced).


Energetics:


Chapter 5 contains more detailed information to which this subheading refers. Briefly, energetics describes the taste of the herb and the end clinical effects that it has on patients, according to traditional understanding of the herb. Energetic characteristics may include reference to Heat, Damp, Cold, and Phlegm, and to Traditional Chinese Medicine (TCM) organs such as Spleen, Liver, Kidney, Heart, and Stomach; reference is not made to Western medicine organs of the same name.


Published Research:


In the interest of brevity, we have elected to review the information available on herbs in the following way.


With few exceptions, we have not described in detail studies on isolated constituents. Herbalists believe that the whole plant has broadly based benefits, and that studies of the whole plant are more likely to shed light on the traditional uses that humankind has come to know over the past few millennia. However, if experimental studies tended to confirm a traditional use, we may include a brief note on the subject.


In vitro studies are not emphasized, unless the herb is used topically and is not significantly metabolized. Examples include herbs used for cutaneous or gastrointestinal applications. Whole plants are metabolized in vivo to produce effects that are complex and unpredictable compared with those noted in in vitro trials.


We have placed little emphasis on laboratory animal studies, except when they might prove useful for the treatment of pocket pets. The studies frequently involve artificial models, whereas genetically identical groups of animals in controlled environments are subjected to chemical or surgical changes to create a model of a naturally occurring human or animal disease. Because the results of these studies translate inconsistently to real-life patients, we have not discussed them in detail and have not always referenced them.


Many herbs (especially traditional Chinese herbs) are commonly administered in formulas. Because the effect of a formula is different from the effect of a single constituent herb, we have not emphasized studies in which an herb was investigated as part of a formula, unless a particularly relevant clinical trial in a companion food or animal species was available.


When controlled clinical trials in humans or domestic animals, or even case series involving clinical patients, are available, we have highlighted these reports.


Indications:


These indications are based on solid traditional uses and evidence-based findings.


Suggested Veterinary Indications:


These indications are based on solid traditional uses and on evidence-based findings, as well as on the authors’ experience. We did not always agree on the potential use of individual herbs for some indications, but this controversy reflects the current state of herbal practice until additional scientific studies have been completed.


We have used evidence from clinical trials in humans as fair support for use of herbs in companion and farm animals. Although the principles of evidence-based medicine relegate research in other species to a low priority, we consider this to be better evidence than that acquired through laboratory animal research.


Notes of Interest:


This section contains various points of interest, such as historical minutiae and conservation status. Maude Grieve’s book, A Modern Herbal, contains many interesting historical and botanical notes and is available online at www.botanical.com. For more information on invasive species, see www.invasive.org. For information on threatened or endangered species, see the following Web sites:


• Convention on International Trade on Endangered Species of Wild Fauna and Flora http://www.cites.org

• United Plant Savers http://www.unitedplantsavers.org

• TRAFFIC http://www.traffic.org

• National Center for the Preservation of Medicinal Plants http://home.frognet.net/~rural8/frames2.html

• Australian Environment Protection and Biodiversity Conservation Act of 1999 List of endangered species provided at: http://www.deh.gov.au/cgi-bin/sprat/public/publicthreatenedlist.pl?wanted=flora

• The Australian Network for Plant Conservation http://www.anbg.gov.au/anpc/

• National Park Service Medicinal Plant Working Group http://www.nps.gov/plants/medicinal/plants.htm

Contraindications; Toxicology and Adverse Effects; Drug Interactions:


Aside from information on commonly recognized effects found in the general literature on any specific herb, two primary references were used for this section. The Botanical Safety Handbook, published by the American Herbal Products Association, is an important collection of safety grades that was published in 1997. The grading system used was based on a critical review of world literature and is defined as follows:


• Class 1: Herbs that can be safely consumed when used appropriately

• Class 2: Herbs for which the following use restrictions apply, unless otherwise directed by an expert who is qualified in the use of the described substance:
2a: For external use only

2b: Not for use during pregnancy

2c: Not to be used while nursing

2d: Other specific use restrictions as noted

• Class 3: Herbs for which significant data exist for recommendation of the following labeling: “To be used only under the supervision of an expert qualified in the appropriate use of this substance.” Labeling must include proper information about dosage, contraindications, potential adverse effects, drug interactions, and any other relevant information related to safe use of the substance.

• Class 4: Herbs for which insufficient data are available to allow classification.

The other reference used was Herr’s Herb–Drug Interaction Handbook. This book is a comprehensive collection of the adverse events, contraindications, and drug interactions thought to be associated with individual herbs. It is one of the more up-to-date references available at this writing. Unfortunately, much of the information contained is purely theoretical and is based on an understanding of isolated constituents of herbs. In this section, we have attempted to present practical cautions but also to modulate the potential misinformation that may result from this last reference. It is critical for the reader to understand, however, that domestic ani-mals may have unique problems with individual herbs, and that as these come into clinical use, we may discover new and unusual adverse effects, contraindications, and drug interactions.


Preparation Notes:


When herb pharmacists have determined that a particular preparation is endowed with the most potent activity, and others less, we note it here.


Dosage:


In addition to small animal doses, we have provided human doses. This is because they are better understood than animal doses, but also because they help the practitioner to derive animal doses for various available forms. Wherever possible, we have included doses from old veterinary texts, but most small animal doses are based on the authors’ experience or on extrapolations from a number of the texts listed below, under Selected References, as well as manufacturers’ recommendations for products that we use in our practices.


The reader will find that dose ranges are very wide, and that human and animal doses vary widely when the calculated total dry herb equivalents (explained below) for all forms are compared. This is because no optimal dose has been established in many cases; thus, we chose to present recommended doses from various authorities and manufacturers, and information on the forms that they recommend or use. Even the authors do not agree on optimal doses at this time! It will be up to future practitioners and researchers to determine optimal doses within these ranges.


Various forms of herbs can usually be converted to a dry herb equivalent. A 1 : 1 fluid extract, for instance, contains the soluble constituents of 1 g (1000 mg) of dried herb in 1 mL of solvent. A 1 : 5 extract, therefore, would contain 1/5 of that amount, or 0.2 g (200 mg) per mL. For the most part, with generally safe herbs, the most concentrated tinctures are recommended here (1 : 2-1 : 3). If the reader can obtain only more dilute tinctures (1 : 5), then the doses listed should be increased by approximately 25% to 50%. For extracts made from fresh herbs, although the water content may tend to produce a more dilute final product, the lack of processing and resultant retention of undamaged constituents may compensate, making them as potent as, if not more potent, than tinctures made from dried herbs. Therefore, in practice, there is little reason to modify doses when tinctures made from fresh versus dried herb are used.


The reader will also note that dried herb doses may be substantially higher than expected when dried herb equivalents in the extract forms are compared, particularly when the dose is tripled or quadrupled, as is suggested for dried unprocessed herbs. This is to be expected because dried herbs deteriorate more quickly than most extracts, so higher doses may be necessary to compensate for this effect.


We would like to especially thank Dr. Eric Yarnell for his assistance in making sense of the widely varying dose recommendations in the human literature. He tends to use the highest doses described here. As a general rule of thumb, safe herbs tinctured at 1 : 2 or 1 : 3 concentration are given to humans at a dose of 3 to 5 mL 3 times daily—up to 6 times daily for acute conditions. Dried herbs are given at a dose of 3 to 10 g 3 times daily—up to 6 times daily for acute conditions. For chronic conditions, smaller doses are usually used. Infusions and decoctions are made by using 5 to 30 g of herb per cup of water, with 1 cup of the tea given 3 times a day—up to 6 times daily acutely. Our dose recommendations span the lowest doses recommended by more conservative authors up to these higher doses.


Similarly, a general rule for small animals is 0.5 to 1.5 mL per 10 kg (20 lb) total daily dose, divided into two or three doses (assuming a 1 : 2 to 1 : 3 tincture). A total daily dose of a multiple herbs in a formula can be calculated by selecting a dose in the the given range for each herb and adding all doses together. Select the higher dose for herbs with the primary desired action or effect. Then, simply multiply the individual herb volume by the number of doses needed to arrive at the formula; round up or down to make dispensing easy. For example, if the daily dose for an herb is 0.5 to 1.5 mL daily for a 10-kg dog, the prescriber will, for instance, select 1 mL. For 14 doses (or 2 weeks of treatment), 14 mL is required, which can be rounded up to 15 mL. If the patient is 20 kg, you will need 30 mL in the formula. Infusions are made as for humans (5-30 g per cup of water) and administered at a rate of ½ cup to 1 cup per 10 kg (20 lb) per day, divided and added to meals or given by mouth. Dried herb extracts (assuming they have been extracted, then dried) are generally between 25 and 75 mg per kg per day, but this depends on the individual product. For simple dried herb, up to 4 times this dose may be indicated.


Note that the very highest doses and more frequent administrations are used over the short term in acute conditions; lower doses are used for weaker patients for longer periods. Also, note that human dosing frequencies are optimally every 4 to 8 hours. The pet caretaker should be advised as to how to divide the daily dosage into as many daily doses as is practical; twice daily is usually readily achievable by adding herbs to food at meal times.


For herbs with a high safety profile, the higher dose of the range can be used. When herbs are given in combination, the lower dose of the range can be used for each herb, and the key herb might be used at the higher end. Clearly, the exact dose depends not only on the weight of the patient and the concentration of the extract, but also on the patient’s sensitivity to medication and relative strength (in terms of digestive and metabolic capacities).


If the practitioner lacks experience with a particular herb, it is wise to start with the lowest recommended dose and increase slowly (to the higher dose in the range). Experienced herbalists may use much higher doses for specific herbs than given here for various reasons. In general, a formula with mutiple herbs is dosed at the lower end of the range for individual herbs (so that the total volume is easy to administer and to take into account synergy). When in doubt, the prescriber should counsel owners that the initial dose is a low starting dose, and that if no results are seen within a few days to a week, the dose may be increased. Chapter 14 provides additional information on dose calculation and administration of herbs.


Combinations:


Occasionally, we include this section, wherein combinations with other herbs are uniquely effective or commonly used.


Selected References:


References most relevant to practical use of these medicinal herbs are included in this section. These may consist of scientific citations, as well as books, book chapters, Internet manuals, and Web sites. Much more information than is referenced in this section was gathered to generate each monograph. The sources used most heavily for the Materia Medica are as follows:





Bone K. A Clinical Guide to Blending Liquid Herbs. Sydney: Churchill Livingstone, 2003.


Brinker F. Complex Herbs, Complete Medicines. Sandy, Ore: Eclectic Medical Publications, 2004.


Evans WC. Trease and Evans Pharmacognosy, 15th edition. Philadelphia: WB Saunders, 2002.


Felter HW, Lloyd JU. King’s American Dispensatory (1898). Available at: http://www.henriettesherbal.com (provided free on the Web on Henriette Kress’s Herbal Homepage).


Grieg JR, Boddie GF. Hoare’s Veterinary Materia Medica and Therapeutics, 6th edition. London: Bailliere, Tindall and Cox, 1942.


Grieve M. A Modern Herbal (1931). New York: Barnes and Noble Books; 1996. Also available online at www.botanical.com.


Herr SM. Enst E, Young VSL, editors. Herb-Drug Interaction Handbook, 2nd ed., Nassau, NY: Church Street Books, 2002.


Hoffmann D. Medical Herbalism. Rochester, Vt: Healing Arts Press, 2003.


Karreman H. Treating Dairy Cows Naturally: Thoughts and Strategies. Paradise, Pa: Paradise Publications, 2004.


Kirk H. Index of Treatment in Small-Animal Practice. Baltimore, Md: Williams and Wilkins, 1948.


Kuhn M, Winston D. Herbal Therapy and Supplements: A Scientific and Traditional Approach. Philadelphia, Pa: Lippincott, Williams and Wilkins, 2001.


Marsden S. Foundations in Formula Design: Achieving Balance and Synergy with Western Herbs. Thesis presented to the Faculty of the Department of Classical Chinese Medicine, National College of Naturopathic Medicine, Portland, Ore, 2000.


McGuffin M, Hobbs C, Upton R, et al. Botanical Safety Handbook. Boca Raton, Fla: CRC Press, 1997.


McGuffin M, Kartesz JT, Leung AY, et al. Herbs of Commerce, 2nd edition. Silver Spring, Md: American Herbal Products Association, 2000.


Milks HJ. Practical Veterinary Pharmacology, Materia Medica and Therapeutics, 6th edition. Chicago, Ill: Alex Eger, Inc, 1949.


Mills S, Bone K. Principles and Practice of Phytotherapy: Modern Herbal Medicine. New York: Churchill Livingstone, 2000.


Moerman DE. Native American Ethnobotany. Portland, Ore: Timber Press, 1998.


Skenderi G. Herbal Vade Mecum: 800 Herbs, Spices, Essential Oils, Lipids, Etc. Constituents, Properties, Uses and Caution. Rutherford, NJ: Herbacy Press, 2004.


Tierra M. Planetary Herbology. Twin Lakes, Wis: Lotus Press, 1988.


Van Wyk B-E, Wink M. Medicinal Plants of the World: An Illustrated Scientific Guide to Important Medicinal Plants and Their Uses. Pretoria, South Africa: Briza Publications, 2004.


Weiss RF. Herbal Medicine, Translated from the German 6th edition. Beaconsfield, England: Beaconsfield Publishers, Ltd, 1994.


Wichtl M. Bisset NG, editor. Herbal Drugs and Phytopharmaceuti-cals: A Handbook for Practice on a Scientific Basis. Boca Raton, Fla: CRC Press, 1989. (English language edition, 1994.)


Williamson EM. Major Herbs of Ayurveda. United Kingdom: Churchill Livingstone, 2002.


Winslow K. Veterinary Materia Medica and Therapeutics, 6th edition. New York: William R. Jenkins Co, 1909.


Yarnell E. Clinical Botanical Medicine. Larchmont, NY: Mary Ann Liebert, Inc, 2003.




In addition, the following websites were indispensable and should be bookmarked on the reader’s computer:


• Veterinary Botanical Medicine Association www.vbma.org

• Henriette’s Herbal Homepage http://www.henriettesherbal.com

• Southwest School of Botanical Medicine www.swsbm.com

• Medline, of the National Library of Medicine www.pubmed.org

• David Winston’s Herbal Therapeutics Research Library http://www.herbaltherapeutics.net/herbal_therapeutics_library.htm

• Veterinary Medicines Summary Reports from the European Medicines Agency http://www.emea.eu.int/index/indexv1.htm



Agrimonyimage



image

Agrimonia eupatoria • Agim-MOH-nee-uh yew-pat-TOH-ree-uh


Other Names: Church steeples, sticklewort, cockeburr, Agrimoniae herba. Should be distinguished from unrelated species known as hemp agrimony (Eupatorium cannabinum) and water agrimony (Bidens tripartita). Agrimonia pilosa is a related plant used in Traditional Chinese Medicine.


Family: Rosaceae


Parts Used: Aerial parts


Selected Constituents: Tannins (up to 21%), flavonoids, triterpenes, coumarins, glycosidal bitters, polysaccharides


Clinical Actions: Astringent, antidiarrheal, antimicrobial, anti-inflammatory, hemostatic, mild choleretic, mild diuretic


Energetics: Slightly bitter, astringent, warm; affects primarily lung, liver, spleen (Tierra)


History and Traditional Usage: Grieve (1931) claims that sheep and goats eat the plant, but cattle, horses, and swine do not. Used since medieval times for wounds of all sorts and snakebites, this plant is an astringent antidiarrheal. Native American tribes used a native species (Agrimonia gryposepala) for similar purposes when astringents were called for—for diarrhea, for skin eruptions, as a styptic, and so forth. It has been used for a “relaxed throat” (in physiomedical philosophy) and has been used since the time of Dioscorides for liver problems. This astringent is also used for cystitis and urinary incontinence. Agrimony is considered when copious mucous secretions emerge from any mucous membrane.


Published Research: Older clinical trials using formulas containing agrimony in humans point to possible benefit in chronic gastroduodenitis and in cutaneous porphyria.


Potential Veterinary Indications: Acute diarrhea and gastritis. Hemorrhagic cystitis. May be useful for dogs with seasonal allergies that manifest as reverse sneezing and snoring. Stomatitis/gingivitis—as a mouthwash. Orally and topically (as a compress or dressing) for indolent ulcers, skin eruptions, and slowly healing wounds.


Contraindications: Pregnancy and lactation are usually listed as contraindications.


Toxicology and Adverse Effects: American Herbal Products Association (AHPA) class 1. Potential but not reported—photodermatitis and photosensitivity; acts as a hypoglycemic agent according to a single laboratory animal study and may complicate glycemic control in diabetics. Contains coumarins, so coagulation problems may surface during concurrent use with anticoagulant drugs.


Potential Drug Interactions: Theoretical interactions with hypoglycemic drugs and anticoagulants have been suggested.


Dosage:


Human:


Dried herb: 1-10 g TID, up to 6 times daily for acute conditions


Infusions and decoctions: 5-15 g per cup of water, with ¼-1 cup of the tea given TID, up to 6 times daily acutely


Tincture (commonly 35%-45% alcohol; some pharmacies use some glycerin to prevent precipitation by tannins): 1 : 2 or 1 : 3: 1-5 mL TID, up to 6 times daily for acute conditions


Small Animal:


Dried herb: 25-300 mg/kg divided daily (optimally TID)


Infusion: 5 g per cup of water, administered at a rate of ¼-½ cup per 10 kg (20 lb), divided daily (optimally TID)


Tincture (commonly 35%-45% alcohol; some pharmacies use some glycerin to prevent tannin precipitation): 1 : 2-1 : 3: 0.5-1.5 mL per 10 kg (20 lb), divided daily (optimally TID) and diluted or combined with other herbs for up to 1 week. Higher doses may be appropriate if the herb is used singly and is not combined in a formula.


Combinations: David Hoffmann suggests use with carminatives for gastrointestinal (GI) problems. It has also been used with yarrow for bladder inflammation and hematuria.



Selected Reference



Grieve M. A Modern Herbal. London: C.F. Leyel, 1931.



Albiziaimage


Albizia lebbeck [L.] Benth. • Al-BIZ-ee-uh LEB-ek


Other Names: Siris, siris tree, albizzia, pit shirish


Family: Fabaceae


Parts Used: Stem bark, leaves, and seeds (flowers also used)


Distribution: Albizia is a large deciduous tree common throughout India and used as an ornamental tree elsewhere.


Selected Constituents: Saponins, cardiac glycosides, tannins, flavonoids


Clinical Actions: Antiallergic, antimicrobial, anticholesterolemic


Energetics: Cooling, dry


History and Traditional Usage: It has been used for bronchitis, leprosy, paralysis, and helminth infections and by Ayurvedic physicians for bronchial asthma and eczema. Albizia seeds have been used in the treatment of patients with diarrhea and dysentery. The leaves are nutritious and palatable and can be used as fodder.


Published Research: Albizia has antidiarrheal activity, which supports the historical use of the seeds in the treatment of patients with diarrhea and dysentery. An extract potentiated the activity of loperamide (1 mg/kg intraperitoneally [ip]). Naloxone (0.5 mg/kg ip) significantly inhibited the antidiarrheal activity as well as the loperamide did, suggesting a role in the opioid system (Besra, 2002). Albizia has some nootropic activity involving monoamine neurotransmitters (Chintawar, 2002). The antiallergic activity of albizia was investigated, showing a significant action on mast cells and inhibiting early sensitization and synthesis of reaginic-type antibodies. The active ingredients of the bark appear to be heat stable and water soluble (Tripathi, 1979).


Indications: Albizia is reported to have antiseptic, antidysenteric, and antitubercular properties. It is indicated for use in asthma, allergic rhinitis, eczema, urticaria, and high cholesterol.


Potential Veterinary Indications: Allergic bronchitis, allergic skin disease, mast cell tumors


Toxicology and Adverse Effects: May depress T and B lymphocyte activity. Some data suggest an antifertility effect in animals.


Potential Drug Interactions: Caution with inotropic heart medications—may be synergistic


Dosage:


Human:


Dried herb: 3-10 g TID


Tincture: 1 : 2 or 1 : 3: 1-5 mL TID


Small Animal:


Dried herb: 25-200 mg/kg, divided daily (optimally TID)


Tincture: 1 : 2-1 : 3: 0.5-1.0 mL per 10 kg (20 lb), divided daily (optimally TID) and diluted or combined with other herbs



References



Besra SE, Gomes A, Chaudhury L, Vedasiromoni JR, Ganguly DK. Antidiarrhoeal activity of seed extract of Albizzia lebbeck Benth. Phytother Res. 2002;16:529-533.


Chintawar SD, Somani RS, Kasture VS, Kasture SB. Nootropic activity of Albizzia lebbeck in mice. J Ethnopharmacol. 2002;81:299-305.


Tripathi RM, Sen PC, Das PK. Studies on the mechanism of action of Albizzia lebbeck, an Indian indigenous drug used in the treatment of atopic allergy. J Ethnopharmacol. 1979;1:385-396.



Alfalfaimage


Medicago sativa L. • Med-DIK-ah-go sa-TEE-vuh


Other Names: Lucerne, luzerne, Spanish clover


Family: Fabaceae


Parts Used: Leaf used medicinally. Sprouted seeds used as food.


Selected Constituents: Proteins, cellulose, triterpenoid saponins, phytosterols, flavonoids, coumarins, amino acids, chlorophyll, carotenoids, vitamins, minerals, organic acids, porphyrins


Clinical Actions: Nutritive


Energetics: Sweet, pungent, cool; nourishes Yin, moistens dryness (Marsden)


History and Traditional Usage: Used mostly as food.


Published Research: No relevant clinical trials found.


Indications: Generally used as a nutritional supplement. Has been used as a source of phytoestrogens in the treatment of women with hot flashes in menopause. Is a recognized estrogenic agent in ruminants.


Potential Veterinary Indications: As a source of vitamins, minerals, flavonoids, and amino acids for chronically ill or geriatric animals.


Contraindications: In humans, pharmacognosists warn against using the herb in the presence of estrogen receptor–positive tumors because of the potential estrogen-like effects of coumarins and isoflavones (daidzein and formononetin). The amino acid canavanine (in sprouts) has been implicated in causing flare-ups of lupus.


Toxicology and Adverse Effects: None reported. AHPA class 1. Generally recognized as safe (GRAS) classification by U.S. Food and Drug Administration (FDA).


Potential Drug Interactions: Theoretical interactions have been suggested with estrogenic drugs, anticoagulants, lipid-lowering drugs, hypoglycemic drugs, and drugs or herbs that induce photosensitivity.


Preparation Notes: Dried herb usually has a very acceptable taste to dogs and cats.


Dosage:


Human:


Dried herb: 1-10 g TID


Infusions and decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely


Tincture (usually prepared in 35% ethanol): 1 : 2 or 1 : 3: 1.5-5 mL TID, up to 6 times daily for acute conditions


Small Animal:


Dried herb: 50-500 mg/kg, divided daily (optimally TID)


Infusion: 5-30 g per cup of water, administered at a rate of ¼-½ cup per 10 kg (20 lb), divided daily (optimally TID)


Tincture: 1 : 2-1 : 3: 1.0-2.5 mL per 10 kg (20 lb), divided daily (optimally TID) and diluted or combined with other herbs. This is a very safe herb that can be used at higher doses as a single prescription.




Aloeimage



Aloe vera (L.) Burm. f., or its synonym, Aloe barbadensis Mill • AL-oh VER-uh or AL-oh bar-buh-DEN-sis


Also:


Aloe ferox Mill


Aloe perryi Baker (socotrine aloes)


Distribution: Native to Africa and introduced and naturalized in the Mediterranean region, the tropics, and warmer areas of the world, including America, Central America, Asia, China, and India.


Similar Species: Aloe chinensis, Aloe elongata, Aloe indica, Aloe officinalis, Aloe perfoliata, Aloe rubescens


Common Names: Aloe capensis, aloe curacao, Barbados aloe, cape aloe, Curaçao aloe, star cactus, aloès vrai, laloi, ecte aloe, sábila


Family: Aloaceae


Parts Used: Aloe vera gel is the viscous, colorless, trans-parent liquid from the inside of the leaf. Aloe vera juice arises from juice in the cells of the pericycle and adjacent leaf parenchyma and flows spontaneously from the cut leaf; it is usually dried. To obtain aloe gel, the leaf is processed and aloin is removed. The cape aloes preparation consists of dried latex from bundle sheath cells within the leaf, which is high in hydroxyanthrone derivatives of aloe emodin (such as aloin) and is the source of laxative preparations.


Constituents: Aloe vera gel consists primarily of water and polysaccharides (glucomannan, acemannan, mannose derivatives, pectin, hemicelluloses), as well as amino acids, lipids, sterols (campesterol, B-sitosterol, lupeol), and enzymes (Bruneton, 1995). Mannose-6-phosphate is a major sugar component (Davis, 1994). Cinnamoyl, p-coumaroyl, feruloyl, caffeoyl aloesin, and related compounds have been isolated from Aloe species. Aloe latex contains as its major and active principles hydroxyanthrone derivatives (Bruneton, 1995).



image

Emodin


Clinical Actions: Demulcent, vulnerary, stimulant laxative


Energetics: Gel slightly bitter; juice sour and very bitter


History and Traditional Usage: Aloe vera was used in the Middle East and Egypt as early as 1500 bc; it has been used for centuries as a topical treatment for various conditions and as a cathartic. Aloe vera gel is widely used for the external treatment of wounds, burns, and skin inflammation. Aloe vera has been described in folk medicine for a wide range of indications, including the treatment of patients with seborrheic dermatitis, peptic ulcer, tuberculosis, fungal infection, psoriasis, anemia, glaucoma, and blindness (WHO, 1999). American Eclectic doctors used aloe as a tonic, purgative, emmenagogue, and anthelmintic. The specific indication for its use was as follows: “Atony of large intestine and rectum, mucoid discharges, prolapsus ani, pruritis ani, ascaris vermicularis … difficulty in evacuating the lower bowel.”


Modern clinical use of the gel began in the 1930s, with reports of successful treatment of x-ray and radium burns, which led to additional experimental studies that used laboratory animals in subsequent decades (Grindlay, 1986).


Modern veterinary usage was first reported in 1975 (Northway, 1975); however, in Europe, it was a popular ingredient of physic balls and was used in combination with ginger as a purgative for horses; it was used for horses that were coming off grass to undergo training. It was also a common ingredient in “condition” balls used to condition a horse for training, to aid assimilation of food, to improve skin, and to help condition the coat. Also used for the treatment of colic in horses (RCVS, 1920). In dogs, aloe was incorporated into “alterative balls” and condition pills (RCVS, 1920). Milks (1949) recommended aloe for whenever a “good brisk cathartic” is required, for instance, in “colic, hidebound, overloaded stomach or bowels, to expel worms after a vermicide, to promote excretion of waste products from the bowels and blood,” or as a tonic. He also recommended it to stimulate wound healing and suggested that ruminants were less sensitive to it than horses, and that dogs and cats required as much as 5 to 10 times the dose a human should take!


It has been advocated for the treatment of farm animals with constipation, indigestion, worms, and urinary ailments and externally for the cure of corneal ulcers and keratitis (de Bairacli Levy, 1963). Aloe was used as a purgative for horses; it was also used in veterinary practice as a bitter tonic (in small doses) and “externally as a stimulant and desiccant” (Grieves, 1931). Aloe nuttii has been used to treat Newcastle’s disease in poultry, worms, and dystocia; Aloe perfoliata has been used to treat pneumonia in livestock (Kambewa, 1997). Aloe vera is one of four major medical plants used to treat health problems in poultry in Trinidad and Tobago (Lans, 1998).


Published Research:





Laxative effect


Aloe’s laxative mechanism of action is twofold. The juice (not the gel) stimulates colonic motility, augmenting propulsion and accelerating colonic transit, which reduces fluid absorption from the fecal mass and increases the water content in the large intestine (de Witte, 1993). The laxative effects are due to the glycosides aloin A and B (formerly known as barbaloin). These are hydrolyzed in the colon by intestinal bacteria and then reduced to active metabolites, which act as stimulants and irritants to the GI tract. The laxative effect of aloe is generally not observed before 6 hours after oral administration, and sometimes not until 24 hours or longer after administration (WHO, 1999).



Wound healing activity


Clinical studies indicate that aloe vera gel accelerates wound healing, and in vivo studies demonstrate that it promotes wound healing by directly stimulating macrophage and fibroblast activity (Davis, 1994). It is suggested that the polysaccharide mannose is responsible for the wound healing properties of the gel (Davis, 1994).


Other mechanisms of action include the hydrating, insulating, and protective properties of the gel (Bruneton, 1995). The gel inhibits thromboxane A2, a mediator of progressive tissue damage (Davis, 1994) produced in burned dermal tissue and pressure sores (Swaim, 1987, 1992). Angiogenesis is essential in wound healing, and the gel has been shown to be angiogenic (Moon, 1999). The constituent allantoin enhances epithelialization in suppurating wounds and resistant ulcers (Swaim, 1992). Another constituent, acemannan, stimulates macrophages to produce the cytokines interleukin-1 and tumor necrosis factor, which, in turn, stimulate angiogenesis, epithelialization, and wound healing (Cera, 1980). It also has anti-inflammatory and analgesic activities because of the presence of a salicylate-like substance (Swaim, 1987).


The effects of topical aloe gel have been compared with the therapeutic effects of systemic pentoxifylline in the treatment of frostbite on the ears of 10 New Zealand white rabbits. Pentoxifylline improved tissue survival (20%), as did aloe vera cream (24%), and the combination of both was best (30%) (Miller, 1995). Another study showed a 62.5% reduction in wound diameter in mice (with induced biopsy punch wounds) that received 100 mg/kg/day oral aloe, and a 50.8% reduction was recorded in animals that were given topical 25% aloe. These data suggest that aloe is effective through both oral and topical routes of administration (Davis, 1989).


Swaim (1992) compared the effects of aloe vera gel with those of triple antibiotic ointment on footpad wounds in dogs. Beagles were anesthetized, and a full-thickness 0.7-cm square defect was incised on one pad of each rear limb. In 12 dogs, one defect was treated with a dressing of aloe vera gel, and the other was treated with a dressing of triple antibiotic ointment. Three control dogs received no treatment. Monitoring of wound size occurred on days 7, 14, and 21. Although no differences were observed in wound size on days 14 and 21, the aloe-treated wounds were smaller on day 7. Compared with outcomes in controls, both treatments resulted in faster healing at day 14; however, control wounds were equivalent in size to treated wounds by day 21. Investigators concluded that aloe vera gel appears to stimulate early wound healing.

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Jul 18, 2016 | Posted by in PHARMACOLOGY, TOXICOLOGY & THERAPEUTICS | Comments Off on 24: Materia Medica

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