Herbal Medicine Materia Medica 1

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1 Herbal Medicine Materia Medica 1 WHMF112 Session 7 Immune System (Immuno-modulators) Part II

2 Session 7 Assessment: Mid Semester Exam Immune System (Immuno-modulators) Part II: Materia Medica (from Traditional literature & research): Astragalus membranaceus Hemidesmus indicus Eleutherococcus senticosus Tylophora indica Uncaria tomentosa

3 Astragalus membranaceus Plant family: Leguminosae Parts used: Root Description: Polysaccharides increase hepatic lysome activity, tissue dehydrogenase and liver glycogen levels. Enhanced natural killer cell activity, increased thymus weight, balanced Th2:Th1, enhanced T cell function. Enhanced levels of IgM, IgE, IgA and camp. (van Wyk & Wink, 2004; Bone & Mills, 2013)

Astragalus membranaceus Description: Saponins can modulate NA +, K + - ATPase in heart muscle (positive inotropic & reduced resting potential), balance suppressed immune function caused by tumor

4 Astragalus membranaceus Description: Saponins can modulate NA +, K + - ATPase in heart muscle (positive inotropic & reduced resting potential), balance suppressed immune function caused by tumor mediated cell signals or drugs. Flavonoids can protect against paracetamol induced liver damage & inhibite tissue inflammation. (van Wyk & Wink, 2004; Bone & Mills, 2013) (Sinclair, J, (2013) IMG_0539 Viewed 12/07/2014)

5 Astragalus membranaceus Description: Enhanced DNA replication, repair and reduced damage, cell health & longevity, protection against cell hypoxia and enhanced tolerance to stress including liver, kidney, heart, nerve cells. Nutritive high in polysaccharides, flavonoids, over 20 amino acids and trace minerals. (Leung, 2010; Bone & Mills, 2013)

6 Astragalus membranaceus Historical & Traditional Prescribing Tonifies the Qi, blood and spleen. Postpartum fever and recovery from severe blood loss, fatigue linked to decreased appetite, diarrhoea and anaemia. (Bone 2003) (Doroneko. (2007). Astragalus membranaceus Retrieved 20 th April, 2014 fromhttp://upload.wikimedia.org/wikipedia/common s/0/0f/astragalus_membranaceus.jpg)

7 Astragalus membranaceus Cautions and Contraindications / Warnings; Not advisable to use in the acute stage of infections Herb/Drug Interactions: Enhanced effect: anticoagulant, antidiabetic, antihypertensive, antilipemic, CNS stimulant, diuretic Altered effects: antineoplastic, steroidal agents Reduced effects: beta blockers, immunosuppressant Pregnancy and Lactation Data: None known (Davis, 2011; Bone & Mills, 2013)

8 Astragalus membranaceus Preparation Adult ml/g Dosage directions & considerations Oral Effects are seen within two weeks Tincture1:2 (25%) 30-60mL/ week Reduced level of polysaccharides. Take up to three times per day Dried root decoction 10-30gm/day Higher levels of polysaccharides & saponins. Take up to three times per day (Braun & Cohen 2010; Bone & Mills, 2013) Taste: Sweet and warm (Thomsen & Gennet 2009)

9 Eleutherococcus senticosus Plant family: Arialaceae Parts used: Root Description: Increase the resistance to stressors. Stimulates immune function, reduces oxygen deprived cell damage, protects liver, heart cells. Normalizes adrenal and thyroid function, stabilized blood sugar levels (Hoffmann, 2003; Bone & Mills, 2013) (Dorenko S. (2007). Eleutherococcus senticosus, leaves Retrieved 20 th April, 2014 fromhttp://commons.wikimedia.org/wiki/file:eleutheroco ccus_senticosus_leaves.jpg)

Eleutherococcus senticosus Historical & Traditional Prescribing As a tonic to increase Qi in yang deficiency of spleen and kidney; to increase sexual function; for bronchitis; heart ailments;

10 Eleutherococcus senticosus Historical & Traditional Prescribing As a tonic to increase Qi in yang deficiency of spleen and kidney; to increase sexual function; for bronchitis; heart ailments; rheumatism; to improve general health; restore memory; promote appetite; for longevity; as a general tonic; considered to be sedative. (Fisher 2009) (Dorenko S. (2007). Eleutherococcus senticosus, Retrieved 20 th April, 2014 from< ons/c/c9/eleutherococcus_senticosus.jpg>)

Eleutherococcus senticosus Cautions / Contraindications: Traditional prescribing contraindicates use in acute infections & hypertension Drug / Herb Interactions: Altered effect on digoxin Pregnancy &

11 Eleutherococcus senticosus Cautions / Contraindications: Traditional prescribing contraindicates use in acute infections & hypertension Drug / Herb Interactions: Altered effect on digoxin Pregnancy & Lactation: Category B1 in pregnancy & may be compatible in lactation (Leung, 2010; Bone & Mills, 2012) (Lohrie, (2007). Ginseng harvest in Walsrode, Germany Retrieved 20 th April, 2014 from< s/thumb/8/88/ginsengernte_in_walsrode.jpg/800p x-ginsengernte_in_walsrode.jpg>)

12 Eleutherococcus senticosus Preparation Adult ml/g Dosage directions & considerations Oral Healthy individuals & elderly 6 week course with 2 week break High doses may cause transient insomnia, palpitations, tachycardia and hypertension Tincture 1:2 (25%) 15-55mL/week Take up to three times per day Powdered or cut teas 2-3gm/day (Blumenthal et al 2000; Hoffmann, 2003) Taste: Slightly sweet, warm, fibrous, woody. (Wood, 2008; Thomsen & Gennet 2009)

Uncaria tomentosa Plant family: Rubiaceae Parts used: Stem bark Description: Immune modulating / reduce allergy effect, anti-inflammatory (inhibits the production of

13 Uncaria tomentosa Plant family: Rubiaceae Parts used: Stem bark Description: Immune modulating / reduce allergy effect, anti-inflammatory (inhibits the production of proinflammatory cytokines & TNF-α) antioxidant actions. (van wyk & Wink, 2004; Mosby, 2010) (Stelfox D. (2002). Uncaria tomentosa_thorn and leaves, viewed 30/06/2014)

Uncaria tomentosa Historical & Traditional Prescribing Used by Ashaninka priests exclusively to eliminate disturbance in communication between body and spirit.

14 Uncaria tomentosa Historical & Traditional Prescribing Used by Ashaninka priests exclusively to eliminate disturbance in communication between body and spirit. Traditional Peruvian medicinal uses include degenerative & inflammatory conditions, gastric ulcers, diabetes, asthma, convalescence and debility. Traditional Peruvian medicine also used cat s claw as a tonic or restorative. (Bone 2003) (Vangeliq P. (2012). Uncaria tomentosa, Retrieved 20 th April, 2014 fromhttp://upload.wikimedia.org/wikipedia/commons/9/94/uncaria_tomentosa.jpg)

15 Uncaria tomentosa Drug / Herb Interactions: Additive effects: Analgesic, anticoagulant, antidiabetic, antihypertensive, antilipemic, photosensitizers, inhibits CYP450 3A4 activity Reduced effects: oestrogens, progesterone, immunosuppressants, nephrotoxic agents Altered effects: Antineoplastic, diagnostic radiopharmaceuticals Pregnancy and Lactation: Insufficient evidence. Traditional use as an abortifacient (Bone 2003, p.131: Davis, 2011)

16 Uncaria tomentosa Preparation Adult ml/g Dosage directions & considerations Oral Diarrhoea, nausea, vomiting, headache after indigestion have occurred especially in high doses Tincture1:2 (60%) 30-75mL/week Take up to three times per day Dry herb 3-6gm/day Taste: warm (Thomsen & Gennat 2009) (Bone 2003; Thomsen & Gennat 2009; Davis, 2011)

Hemidesmus indicus Plant family: Asclepiadaceae Parts used: Root Description: Found to depress both cellmediated and humoral components of the immune system Diaphoretic, immune depressant, depurative

17 Hemidesmus indicus Plant family: Asclepiadaceae Parts used: Root Description: Found to depress both cellmediated and humoral components of the immune system Diaphoretic, immune depressant, depurative (Bone, 2003) (Ganguly B. (2013). Hemidesmus indicus Retrieved 20 th April, 2014 from < Horticultural_Society_of_India_-_Alipore_-_Kolkata_ _2301.JPG/320px- Hemidesmus_indicus_-_Agri-Horticultural_Society_of_India_-_Alipore_-_Kolkata_ _2301.JPG>)

Hemidesmus indicus Historical & Traditional Prescribing Diseases of the genitourinary system Topically as an antiinflammatory remedy Loss of appetite, fever, skin diseases, chronic cough In Ayurveda,

18 Hemidesmus indicus Historical & Traditional Prescribing Diseases of the genitourinary system Topically as an antiinflammatory remedy Loss of appetite, fever, skin diseases, chronic cough In Ayurveda, it is regarded as a depurative and tonic (Bone 2003) Lalithamba (2010). Hemidesmus indicus var. indicus Retrieved 20 th April, 2014 from< b/c/c3/hemidesmus_indicus_var._indicus.jpg/320px- Hemidesmus_indicus_var._indicus.jpg>)

Hemidesmus indicus Cautions and Contraindications: None known Pregnancy and Lactation: No adverse effects are expected Side effects / Adverse Events: None expected if taken within the recommended

19 Hemidesmus indicus Cautions and Contraindications: None known Pregnancy and Lactation: No adverse effects are expected Side effects / Adverse Events: None expected if taken within the recommended dosage range (Bone 2003) (Ganguly B. (2013).Hemidesmus indicus Retrieved 20 th April, 2014 from< Horticultural_Society_of_India_-_Alipore_-_Kolkata_ _2303.JPG/320px-Hemidesmus_indicus_- _Agri-Horticultural_Society_of_India_-_Alipore_-_Kolkata_ _2303.JPG>)

20 Hemidesmus indicus Preparation Adult ml/g Dosage directions & considerations Oral Tincture 1:2 (45%) 25-60mL/week Take up to three times per day Dried herb 3-9gm/day Taste: cool (Thomsen & Gennat 2009) (Thomsen & Gennat 2009)

Tylophora indica Plant family: Asclepiadaceae Parts used: Leaf Description: Antiasthmatic, antiinflammatory, immune depressant, antiallergic, emetic (Bone 2003) (Pradesh A,. (2010).

21 Tylophora indica Plant family: Asclepiadaceae Parts used: Leaf Description: Antiasthmatic, antiinflammatory, immune depressant, antiallergic, emetic (Bone 2003) (Pradesh A,. (2010). Tylophora indica Retrieved 20 th April, 2014 from< mool_%28tylophora_indica%29_in_talakona_forest%2c_ap_w_img_8310.jpg>)

22 Tylophora indica Historical & Traditional Prescribing Bronchial asthma, chronic bronchitis, catarrh, dysentery. Snakebite (in large doses). As an emetic, diaphoretic and expectorant, a substitute for Ipecacuanha. (Bone 2003) (Lalithamba, (2010). Tylophora indica, Retrieved 20 th April, 2014 fromhttp://upload.wikimedia.org/wikipedia/commons/thu mb/a/a1/tylophora_indica_%28burm.f%29_merr._- _Flickr_-_lalithamba.jpg/320px- Tylophora_indica_%28Burm.f%29_Merr._-_Flickr_- _lalithamba.jpg)

23 Tylophora indica Cautions / Contraindications: Allergy/ hypersensitivity, immunocompromised patients. Warnings and Precautions: Laxative and purgative properties Herb/Drug Interactions: Additive effect: CNS depressants, immunosupressants Pregnancy and Lactation: Traditional use as an abortifacient, don t use in pregnancy. Not recommended in lactation (Davis 2011)

24 Tylophora indica Preparation Adult ml/g Dosage directions & considerations Oral Tincture 1:5 (45%) 7-14mL/ week Dry herb mg / day 1-3 times per day Taste: cool (Thomsen & Gennat 2009) Short term use (max four weeks only) Side effects abdominal pain, diarrhoea, dysgeusia, mouth soreness, nausea/vomiting, salivation even at low dose Take up to three times per day First 10 to 14 days of each calendar month (Bone 2003, Thomsen & Gennat 2009; Davis, 2011)

25 Discussion Class Discussion: When would you use immuno-suppressant herbs? What dosage (within a weekly range) would you employ & why? How long would you use them for? When would you stop? Why? What would the specific dosage instructions to the clients be?

26 Tutorial Session 7

27 Assessment Open Book In-class Mid Semester Exam Students have 1 hour (+ 5 minutes reading time) to complete this exam. Students may use printed notes & text books: Printed: powerpoint notes, herbal actions & materia medica worksheet Texts: Fisher, C. (2009). Materia Medica of Western Herbs Braun & Cohen, (2014). Herbs and Natural Supplements (4 th ed). No electronic devices are allowed

28 References (2010). Astragalus. In Leung's encyclopedia of common natural ingredients: Used in food, drugs and cosmetics, Wiley, Hoboken, USA. Retrieved 11 July 2014, from Credo Reference (2010) Eleuthero. In Leung's encyclopedia of common natural ingredients: Used in food, drugs and cosmetics, Wiley, Hoboken, USA. Retrieved 11 July 2014, from Credo Reference (2010). Cat's claw. In Mosby's handbook of herbs & natural supplements, Elsevier Health Sciences, Philadelphia, USA. Retrieved 11 July 2014, from Credo Reference (2011). Astragalus (Astragalus membranaceus). In Davis's pocket guide to herbs and supplements, F.A.Davis Company, Philadelphia, USA. Accessed: 11 July 2014, from Credo Reference (2011). Cat's claw (Uncaria tomentosa, Uncaria guianensis. In Davis's pocket guide to herbs and supplements, F.A.Davis Company, Philadelphia, USA. Accessed: 11 July 2014, from Credo Reference

29 References Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. St. Louis, Missouri. Churchill Livingston. Bone, K., & Mills, S. (2013). Principles and practice of phytotherapy (2 nd ed.). New York, USA. Churchill Livingston Elsevier. Braun, L., & Cohen, M. (2010). Herbs and natural supplements: An evidence based approach, vol. 2 (4 th ed.). Chatswood, NSW. Churchill Livingstone Elsevier. Ellingwood, F. (1898). American materia medica, therapeutics and pharmacognosy. Reprint, Eclectic medical publications Fisher, C. (2009). Materia medica of western herbs. Nelson, New Zealand. Vitex Medic. Hoffmann, D. (2003). Medical herbalism: The science and practice of herbal medicine, Rochester, Vermont. Healing Arts Press.

30 References Thomsen, M., & Gennat, H. (2009). Phytotherapy desk reference. Global Natural Medicine Pty Ltd l. Retrieved 20 th February, 2015 from Van Wyk, B., & Wink, B. (2010). Medicinal plants of the world. London, UK. Timber Press Inc. Wood, M. (2008). The Earthwise herbal: A complete guide to old world medicinal plants. Berkley, California. North Atlantic Books.

31 Recommended Readings Braun, L., & Cohen, M. (2014). Herbs and natural supplements: An evidence based approach, vol. 2 (4 th ed.). Chatswood, NSW. Churchill Livingstone Elsevier. Astragalus membranaceus p Eleutherococcus senticosus p Fisher, C. (2009). Materia medica of western herbs. Nelson, New Zealand. Vitex Medic. Baptisia tinctoria p Eleutherococcus senticosus p Monograph on Astragalus by Alternative Medicine Review 2003 Thorne Research Vol 8 No 1

32 Recommended Readings You, Y. et al. (2012). Antiatherosclerotic function of Astragali Radix extract: Downregulation of adhesion molecules in vitro and in vivo. BMC Complementary & Alternative Medicine 12:54 World Health Organisation. (2007). WHO monographs on selected medicinal plants Volume , Geneva Switzerland: World Health Organisation. Monograph on Uncaria

33 Recommended Readings World Health Organisation (1999). WHO monographs on selected medicinal plants Volume 1. Geneva Switzerland: World Health Organisation. Monograph on Astragalus World Health Organisation. (2004). WHO monographs on selected medicinal plants Vol. 2. Geneva Switzerland: World Health Organisation. Monograph on Eleutherococcus

34 Endeavour College of Natural Health endeavour.edu.au 34

Herbal Medicine Materia Medica 1

Herbal Medicine Materia Medica 1 WHMF112 Session 12 Digestive System Part I Endeavour College of Natural Health endeavour.edu.au Student Feedback Surveys Your feedback is important to us! In the first