Amenorrhoea: From 6 Different Sources
Suppression of normal menstrual flow during the time of life when it should occur. The most common cause is pregnancy but it can arise from hormonal imbalance, trauma, anaemia, fibroids, polyps, constitutional disorder or emotional problems. Though not prejudicial to health it marks a departure from normal.
Symptoms. Scanty irregular or absent periods.
Alternatives. Agnus Castus, Black Cohosh, Blue Cohosh, Chaparral, Feverfew, Helonias, Life root, Lovage, Marigold, Motherwort, Mugwort, Parsley root, Pennyroyal, Rosemary, Rue, Tansy, Thuja, Southernwood, Wormwood, Yarrow, Hedge Hyssop (Gratiola officinalis).
Tea: Combine: Agnus Castus, Motherwort, Yarrow. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup thrice daily.
Formula. Combine: Helonias 2; Agnus Castus 2; Blue Cohosh 1. Doses. Powders: 500mg (two 00 capsules, or one-third teaspoon). Liquid Extracts: 30-60 drops. Tinctures: 1-2 teaspoons.
In water or honey, thrice daily.
Agnus Castus. Success reported.
Due to thyroid imbalance: Kelp, Bladderwrack, Irish Moss.
Vitamins: A. B-complex. E.
Minerals: Calcium. Zinc.
Note: Patients with amenorrhoea are at risk of osteoporosis. (Middlesex Hospital, London)
The absence of menstrual periods. Primary amenorrhoea is defined as failure to start menstruating by the age of 16. Secondary amenorrhoea is the temporary or permanent cessation of periods in a woman who has menstruated regularly in the past.
The main cause of primary amenorrhoea is delayed puberty. The delay may not indicate a disorder, but, rarely, it may result from a disorder of the endocrine system, such as a pituitary tumour, hypothyroidism, an adrenal tumour, or adrenal hyperplasia. Another rare cause of delayed puberty is Turner’s syndrome. In some cases, menstruation fails to take place because the vagina or the uterus has been absent from birth, or because there is no perforation in the hymen to allow blood to escape.
The most common cause of temporary secondary amenorrhoea is pregnancy. Periods may also cease temporarily after a woman has stopped taking oral contraceptives. Secondary amenorrhoea may also result from hormonal changes due to stress, depression, anorexia nervosa, or certain drugs. Another possible cause is a disorder of the ovary such as polycystic ovary (see ovary, polycystic) or an ovarian tumour. Amenorrhoea occurs permanently following the menopause or after a hysterectomy.
Absence of MENSTRUATION at the time of life at which it should normally occur. If menstruation has never occurred, the amenorrhoea is termed primary; secondary amenorrhoea is de?ned as menstruation ceasing after a normal cycle has been experienced for a number of years.
A few patients with primary amenorrhoea have an abnormality of their CHROMOSOMES or malformation of the genital tract such as absecence of the UTERUS (see TURNER’S SYNDROME). A gynaecological examination will rarely disclose an IMPERFORATE HYMEN in a young girl who may also complain of regular cycles of pain like period pains.
There are many causes of secondary amenorrhoea and management requires dealing with the primary cause. The commonest cause is pregnancy. Disorders of the HYPOTHALAMUS and related psychological factors such as anorexia nervosa (see EATING DISORDERS) also cause amenorrhoea, as can poor nutrition and loss of weight by extreme dieting. It is common in ballet dancers and athletes who exercise a great deal, but can also be triggered by serious illnesses such as tuberculosis or malaria. Excess secretion of prolactin, either due to a micro-adenoma (see ADENOMA) of the PITUITARY GLAND or to various prescription drugs will produce amenorrhoea, and sometimes GALACTORRHOEA as well. Malfunction of other parts of the pituitary gland will cause failure to produce GONADOTROPHINS, thus causing ovarian failure with consequent amenorrhea. In CUSHING’S SYNDROME, amenorrhoea is caused by excessive production of cortisol. Similarly, androgen-production abnormalities are found in the common POLYCYSTIC OVARY SYNDROME. These conditions also have abnormalities of the insulin/glucose control mechanisms. Taking the contraceptive pill is not now considered to provoke secondary amenorrhoea but OBESITY and HYPOTHYROIDISM are potential causes.
When the cause is weight loss, restoring body weight may alone restore menstruation. Otherwise, measuring gonadotrophic hormone levels will help show whether amenorrhoea is due to primary ovarian failure or secondary to pituitary disease. Women with raised concentrations of serum gonadotrophic hormones have primary ovarian failure. When amenorrhoea is due to limited pituitary failure, treatment with CLOMIPHENE may solve the problem.
Failure of menstruation
n. the absence or stopping of the menstrual periods. It is normal for the periods to be absent before puberty, during pregnancy and milk secretion, and after the end of the reproductive period (see menopause). In primary amenorrhoea the menstrual periods fail to appear at puberty, due to absence of the uterus or ovaries, a genetic disorder (e.g. *Turner’s syndrome), or hormonal imbalance. It is diagnosed when *menarche has not occurred by the age of 16½ years but there is normal development of secondary sexual characteristics or by the age of 14 years if secondary sexual characteristics are absent. In secondary amenorrhoea the menstrual periods stop after establishment at puberty for a minimum of six months. Causes include disorders of the hypothalamus (a part of the brain), deficiency of ovarian, pituitary, or thyroid hormones, mental disturbance, depression, anorexia nervosa, or a major change of surroundings or circumstances.
absence of menstruation.
A periodic change occurring in (female) human beings and the higher apes, consisting chie?y in a ?ow of blood from the cavity of the womb (UTERUS) and associated with various slight constitutional disturbances. It begins between the ages of 12 and 15, as a rule – although its onset may be delayed until as late as 20, or it may begin as early as ten or 11. Along with its ?rst appearance, the body develops the secondary sex characteristics: for example, enlargement of the BREASTS, and characteristic hair distribution. The duration of each menstrual period varies in di?erent persons from 2– 8 days. It recurs in the great majority of cases with regularity, most commonly at intervals of 28 or 30 days, less often with intervals of 21 or 27 days, and ceasing only during pregnancy and lactation, until the age of 45 or 50 arrives, when it stops altogether – as a rule ceasing early if it has begun early, and vice versa. The ?nal stoppage is known as the MENOPAUSE or the CLIMACTERIC.
Menstruation depends upon a functioning ovary (see OVARIES) and this upon a healthy PITUITARY GLAND. The regular rhythm may depend upon a centre in the HYPOTHALAMUS, which is in close connection with the pituitary. After menstruation, the denuded uterine ENDOMETRIUM is regenerated under the in?uence of the follicular hormone, oestradiol. The epithelium of the endometrium proliferates, and about a fortnight after the beginning of menstruation great development of the endometrial glands takes place under the in?uence of progesterone, the hormone secreted by the CORPUS LUTEUM. These changes are made for the reception of the fertilised OVUM. In the absence of fertilisation the uterine endometrium breaks down in the subsequent menstrual discharge.
Disorders of menstruation In most healthy women, menstruation proceeds regularly for 30 years or more, with the exceptions connected with childbirth. In many women, however, menstruation may be absent, excessive or painful. The term amenorrhoea is applied to the condition of absent menstruation; the terms menorrhagia and metrorrhagia describe excessive menstrual loss – the former if the excess occurs at the regular periods, and the latter if it is irregular. Dysmenorrhoea is the name given to painful menstruation. AMENORRHOEA If menstruation has never occurred, the amenorrhoea is termed primary; if it ceases after having once become established it is known as secondary amenorrhoea. The only value of these terms is that some patients with either chromosomal abnormalities (see CHROMOSOMES) or malformations of the genital tract fall into the primary category. Otherwise, the age of onset of symptoms is more important.
The causes of amenorrhoea are numerous and treatment requires dealing with the primary cause. The commonest cause is pregnancy; psychological stress or eating disorders can cause amenorrhoea, as can poor nutrition or loss of weight by dieting, and any serious underlying disease such as TUBERCULOSIS or MALARIA. The excess secretion of PROLACTIN, whether this is the result of a micro-adenoma of the pituitary gland or whether it is drug induced, will cause amenorrhoea and possibly GALACTORRHOEA as well. Malfunction of the pituitary gland will result in a failure to produce the gonadotrophic hormones (see GONADOTROPHINS) with consequent amenorrhoea. Excessive production of cortisol, as in CUSHING’S SYNDROME, or of androgens (see ANDROGEN) – as in the adreno-genital syndrome or the polycystic ovary syndrome – will result in amenorrhoea. Amenorrhoea occasionally follows use of the oral contraceptive pill and may be associated with both hypothyroidism (see under THYROID GLAND, DISEASES OF) and OBESITY.
Patients should be reassured that amenorrhoea can often be successfully treated and does not necessarily affect their ability to have normal sexual relations and to conceive. When weight loss is the cause of amenorrhoea, restoration of body weight alone can result in spontaneous menstruation (see also EATING DISORDERS – Anorexia nervosa). Patients with raised concentration of serum gonadotrophin hormones have primary ovarian failure, and this is not amenable to treatment. Cyclical oestrogen/progestogen therapy will usually establish withdrawal bleeding. If the amenorrhoea is due to mild pituitary failure, menstruation may return after treatment with clomiphene, a nonsteroidal agent which competes for oestrogen receptors in the hypothalamus. The patients who are most likely to respond to clomiphene are those who have some evidence of endogenous oestrogen and gonadotrophin production. IRREGULAR MENSTRUATION This is a change from the normal monthly cycle of menstruation, the duration of bleeding or the amount of blood lost (see menorrhagia, below). Such changes may be the result of an upset in the balance of oestrogen and progesterone hormones which between them control the cycle. Cycles may be irregular after the MENARCHE and before the menopause. Unsuspected pregnancy may manifest itself as an ‘irregularity’, as can an early miscarriage (see ABORTION). Disorders of the uterus, ovaries or organs in the pelvic cavity can also cause irregular menstruation. Women with the condition should seek medical advice. MENORRHAGIA Abnormal bleeding from the uterus during menstruation. A woman loses on average about 60 ml of blood during her period; in menorrhagia this can rise to 100 ml. Some women have this problem occasionally, some quite frequently and others never. One cause is an imbalance of progesterone and oestrogen hormones which between them control menstruation: the result is an abnormal increase in the lining (endometrium) of the uterus, which increases the amount of ‘bleeding’ tissue. Other causes include ?broids, polyps, pelvic infection or an intrauterine contraceptive device (IUD – see under CONTRACEPTION). Sometimes no physical reason for menorrhagia can be identi?ed.
Treatment of the disorder will depend on how severe the loss of blood is (some women will become anaemic – see ANAEMIA – and require iron-replacement therapy); the woman’s age; the cause of heavy bleeding; and whether or not she wants children. An increase in menstrual bleeding may occur in the months before the menopause, in which case time may produce a cure. Medical or surgical treatments are available. Non-steroidal anti-in?ammatory drugs may help, as may tranexamic acid, which prevents the breakdown of blood clots in the circulation (FIBRINOLYSIS): this drug can be helpful if an IUD is causing bleeding. Hormones such as dydrogesterone (by mouth) may cure the condition, as may an IUD that releases small quantities of a PROGESTOGEN into the lining of the womb.
Traditionally, surgical intervention was either dilatation and curettage of the womb lining (D & C) or removal of the whole uterus (HYSTERECTOMY). Most surgery is now done using minimally invasive techniques. These do not require the abdomen to be cut open, as an ENDOSCOPE is passed via the vagina into the uterus. Using DIATHERMY or a laser, the surgeon then removes the whole lining of the womb. DYSMENORRHOEA This varies from discomfort to serious pain, and sometimes includes vomiting and general malaise. Anaemia is sometimes a cause of painful menstruation as well as of stoppage of this function.
In?ammation of the uterus, ovaries or FALLOPIAN TUBES is a common cause of dysmenorrhoea which comes on for the ?rst time late in life, especially when the trouble follows the birth of a child. In this case the pain exists more or less at all times, but is aggravated at the periods. Treatment with analgesics and remedying the underlying cause is called for.
Many cases of dysmenorrhoea appear with the beginning of menstrual life, and accompany every period. It has been estimated that 5–10 per cent of girls in their late teens or early 20s are severely incapacitated by dysmenorrhoea for several hours each month. Various causes have been suggested for the pain, one being an excessive production of PROSTAGLANDINS. There may be a psychological factor in some sufferers and, whether this is the result of inadequate sex instruction, fear, family, school or work problems, it is important to o?er advice and support, which in itself may resolve the dysmenorrhoea. Symptomatic relief is of value.... menstruation
One of a naturally occurring or synthetically produced group of steroid HORMONES, including PROGESTERONE, that help to maintain normal pregnancy. Progestogens are used in contraceptives (see CONTRACEPTION) and are useful in treating AMENORRHOEA, premenstrual tension, and abnormal uterine bleeding.... progestogen
A noncancerous tumour of the pituitary gland that causes overproduction of prolactin. In women, this may result in galactorrhoea, amenorrhoea, or infertility. In men, it may cause impotence and gynaecomastia. In either sex, it may cause headaches, diabetes insipidus, and, if the tumour presses on the optic nerves, loss of the outer visual field. Diagnosis is made from blood tests and CT scanning or MRI of the brain. Treatment may involve removal of the tumour, radiotherapy, or giving the drug bromocriptine.... prolactinoma
Ruta chalepensisRutaceaeSan: Gucchapatra;Hin: Pismaram, Sadab, Satari;Ben: Ermul;Mal: Aruta, Nagatali;Tam: Aruvadam, Arvada;Kan: Sadabu, Nagadali; soppu, Simesdanu;Tel: Sadapa, ArudaImportance: Common rue or Garden rue also known as Herb of Grace due to its service in the Roman Catholic Church for sprinkling the holy water among the congregation, is an aromatic perennial herb. The plant is useful in vitiated conditions of kapha and vata, strangury, fever, flatulence, colic, amenorrhoea, epilepsy and hysteria. The oil acts as a stimulant for uterine and nervous systems. The fresh leaves are used for rheumatalgia. The juice obtained from the leaves is given to children for helminthic infections and is good for odontalgia and otalgia (Warrier et al, 1996). The dried leaves, powdered and combined with aromatics, are given as a remedy for dyspepsia and with the fresh leaves a tincture is made which is used as an external remedy in the first stages of paralysis (Nadkarni, 1998).Distribution: The plant is a native of South Europe and it is found in subtropical countries. It is commonly cultivated in Indian gardens.Botany: Ruta chalepensis Linn.syn. R. graveolens Linn. var. angustifolia Sensu Hook. f. belongs to the family Rutaceae. It is an aromatic perennial herb growing upto 75cm height. Leaves are compound, shortly petiolate with ultimate segments oblong or obovate-oblong. Flowers are yellow. Fruits are capsules and shortly pedicelled (Warrier et al, 1996).Agrotechnology: The plant is suited to areas which are about 1000m above mean sea level and with moderate rainfall and sunlight. The plant can be propagated either by seeds or stem cuttings. Seeds are to be sown in seedbeds. Stem cuttings of length 20-25cm are to be planted in polybags for rooting. About 3-4 months old seedlings can be transplanted to pots and harvested when plants attain 6-8 months age. In highlands land is to be ploughed to a fine tilth, mixed with organic manure and seedlings are to be transplanted at a spacing of 45cm between plants. Irrigation is essential during summer months. Regular weeding is to be done. The plant is not attacked by any serious pests and diseases. Harvesting commences from sixth month onwards. The economic part is the whole plant and the oil extracted from it (Prasad et al, 1997).Properties and activity: Roots contain coumarins-xanthyletin and (-)-byakangelicin. The alkaloids are rutacridone-epoxide, gravacridonol and its monomethyl ether, gravacridonchlorine, furacridone, 1-hydroxy-3-methoxy-N-methylacridone, iso-gravacridonechlorine, dictamine, r-fragarine and skimmianine. Skimmianine is also present in leaves and stem. Leaves and stem also contain graveolinine (1-methyl-2(3’,4’-methylenedioxyphenol)-4-methoxy- quinoline). Aerial parts give coumarins bergapten, xanthotoxin and psoralen. Coumarin- imperatin has also been reported from the plant. Herb contains alkaloids such as kokusagenine, rutamine(methylgraveoline) and graveoline(1-methyl-2(3’,4’- methylenedioxyphenyl)-4-quinoline). Tissue culture of the plant gives furacridone alkaloids-1-hydroxyrutacridone-epoxide, rutagravin and gravacridonol. Gravacridondiol and its glucoside have been obtained from the root tissue culture. The essential oil from leaves, stem and root yielded aliphatic ketones including 2-nonanone (10-35%), undecyl-2-acetate (0.5-15%), 2-nonyl acetate (trace-10%), nonylacetate, nonanol, 2-nonylpropionate, 2- nonylpropionate, 2-undecanol and its esters. The oil from roots gave pregeijerene also.The plant is spasmolytic which is due to the presence of bergapten, xanthotoxin, the essential oil and a coumarin. It is also antispasmodic, emmenagogue, irritant, abortifacient and anti-bacterial. Leaf is analgesic, antirheumatic, antihysteric and anthelmintic (Husain et al, 1992).... garden rue
Aristolochia bracteolataAristolochiaceaeSan: KitamariHin: Kiramar, Kitamar Mal: Attuthottappala, AtuthinnappalaTam: AtutinnappalaiImportance: The bracteated birthwort or worm killer is a perennial prostrate herb. As the name suggests it is a killer of intestinal worms especially roundworms. It is also used in vitiated conditions of kapha and vata, constipation, inflammations, amenorrhoea, dysmenorrhoea, foul ulcers, boils, syphilis, gonorrhoea, dyspepsia, colic, skin diseases, eczema, artheralgia and intermittent fevers. The plant is an insect repellent due to the presence of aristolochic acid, which is poisonous to man and livestock. Plant is also used against scorpion sting. Seeds ground in water to form a lotion and used for softening hair. Powdered root is used in fertility control.Distribution: The plant is found in Sri Lanka, Arabian countries and tropical Africa. In India, the plant is grown in Deccan and Carnatic Plateau.Botany: Aristolochia bracteolata Lam. syn. A. bracteata Retz. belongs to the family Aristolochiaceae. It is a perennial prostrate herb with weak, glabrous stems. Leaves are simple, alternate, reniform or broadly ovate, cordate at the base with a wide sinus upto 7.5cm in diameter, reticulately veined. Flowers are solitary with a large sessile orbicular bract at the base. Perianth tube is cylindric with dark purple tip having revolute margins. Fruits are oblong-ellipsoid 12-ribbed glabrous capsules. Seeds are deltoid with slightly cordate base (Warrier et al, 1993) Another important species belonging to the genus Aristolochia is A. indica Linn. The plant grows wild throughout the low hills and plains of India from Nepal to West Bengal and South India. It is a valuable anti-dote to snake bite and to bites of poisonous insects as scorpion, etc. It is given in cases of cholera and diarrhoea after macerating with black pepper corns. The juice of the leaves has stimulant, tonic and antiperiodic properties.Agrotechnology: Shady areas and well-drained soils are most suited to Aristolochia. The plant can be seed propagated. 3-month-old seedlings raised in polybags are required for transplanting. Pits of size 50cm cube are to be taken at a distance of 3m and filled with sand, topsoil and dried cowdung. To these pits, the seedlings are to be transplanted. Regular irrigation and organic manure application is beneficial. The plant is to be trailed on iron wires tied to poles. The plant is not attacked by any serious pests or diseases. Plant attains good spread within one year. Leaves can be collected for the next 10 years. Roots and leaves constitute the economi c parts (Prasad et al, 1997).Properties and activity: Leaves and fruits yield ceryl alcohol, -sitosterol and aristolochic acid. Root contains aristolochic acid. Seeds give an alkaloid magnoflorine, aristolochic acid, fatty oil comprising palmitic, stearic, lignoseric and oleic acids and -sitosterol.The plant is anthelmintic, cathartic, antiperiodic and emmenagogue. Leaf is antigonorrhoeic, larvicidal and used in eczema on children’s leg and ulcers. The plant is oxytocic (Husain et al,1992).... worm killer
Organs whose function it is to secrete into the blood or lymph, substances known as HORMONES. These play an important part in general changes to or the activities of other organs at a distance. Various diseases arise as the result of defects or excess in the internal secretions of the di?erent glands. The chief endocrine glands are:
Adrenal glands These two glands, also known as suprarenal glands, lie immediately above the kidneys. The central or medullary portion of the glands forms the secretions known as ADRENALINE (or epinephrine) and NORADRENALINE. Adrenaline acts upon structures innervated by sympathetic nerves. Brie?y, the blood vessels of the skin and of the abdominal viscera (except the intestines) are constricted, and at the same time the arteries of the muscles and the coronary arteries are dilated; systolic blood pressure rises; blood sugar increases; the metabolic rate rises; muscle fatigue is diminished. The super?cial or cortical part of the glands produces steroid-based substances such as aldosterone, cortisone, hydrocortisone, and deoxycortone acetate, for the maintenance of life. It is the absence of these substances, due to atrophy or destruction of the suprarenal cortex, that is responsible for the condition known as ADDISON’S DISEASE. (See CORTICOSTEROIDS.)
Ovaries and testicles The ovary (see OVARIES) secretes at least two hormones – known, respectively, as oestradiol (follicular hormone) and progesterone (corpus luteum hormone). Oestradiol develops (under the stimulus of the anterior pituitary lobe – see PITUITARY GLAND below, and under separate entry) each time an ovum in the ovary becomes mature, and causes extensive proliferation of the ENDOMETRIUM lining the UTERUS, a stage ending with shedding of the ovum about 14 days before the onset of MENSTRUATION. The corpus luteum, which then forms, secretes both progesterone and oestradiol. Progesterone brings about great activity of the glands in the endometrium. The uterus is now ready to receive the ovum if it is fertilised. If fertilisation does not occur, the corpus luteum degenerates, the hormones cease acting, and menstruation takes place.
The hormone secreted by the testicles (see TESTICLE) is known as TESTOSTERONE. It is responsible for the growth of the male secondary sex characteristics.
Pancreas This gland is situated in the upper part of the abdomen and, in addition to the digestive enzymes, it produces INSULIN within specialised cells (islets of Langerhans). This controls carbohydrate metabolism; faulty or absent insulin production causes DIABETES MELLITUS.
Parathyroid glands These are four minute glands lying at the side of, or behind, the thyroid (see below). They have a certain e?ect in controlling the absorption of calcium salts by the bones and other tissues. When their secretion is defective, TETANY occurs.
Pituitary gland This gland is attached to the base of the brain and rests in a hollow on the base of the skull. It is the most important of all endocrine glands and consists of two embryologically and functionally distinct lobes.
The function of the anterior lobe depends on the secretion by the HYPOTHALAMUS of certain ‘neuro-hormones’ which control the secretion of the pituitary trophic hormones. The hypothalamic centres involved in the control of speci?c pituitary hormones appear to be anatomically separate. Through the pituitary trophic hormones the activity of the thyroid, adrenal cortex and the sex glands is controlled. The anterior pituitary and the target glands are linked through a feedback control cycle. The liberation of trophic hormones is inhibited by a rising concentration of the circulating hormone of the target gland, and stimulated by a fall in its concentration. Six trophic (polypeptide) hormones are formed by the anterior pituitary. Growth hormone (GH) and prolactin are simple proteins formed in the acidophil cells. Follicle-stimulating hormone (FSH), luteinising hormone (LH) and thyroid-stimulating hormone (TSH) are glycoproteins formed in the basophil cells. Adrenocorticotrophic hormone (ACTH), although a polypeptide, is derived from basophil cells.
The posterior pituitary lobe, or neurohypophysis, is closely connected with the hypothalamus by the hypothalamic-hypophyseal tracts. It is concerned with the production or storage of OXYTOCIN and vasopressin (the antidiuretic hormone).
PITUITARY HORMONES Growth hormone, gonadotrophic hormone, adrenocorticotrophic hormone and thyrotrophic hormones can be assayed in blood or urine by radio-immunoassay techniques. Growth hormone extracted from human pituitary glands obtained at autopsy was available for clinical use until 1985, when it was withdrawn as it is believed to carry the virus responsible for CREUTZFELDT-JAKOB DISEASE (COD). However, growth hormone produced by DNA recombinant techniques is now available as somatropin. Synthetic growth hormone is used to treat de?ciency of the natural hormone in children and adults, TURNER’S SYNDROME and chronic renal insu?ciency in children.
Human pituitary gonadotrophins are readily obtained from post-menopausal urine. Commercial extracts from this source are available and are e?ective for treatment of infertility due to gonadotrophin insu?ciency.
The adrenocorticotrophic hormone is extracted from animal pituitary glands and has been available therapeutically for many years. It is used as a test of adrenal function, and, under certain circumstances, in conditions for which corticosteroid therapy is indicated (see CORTICOSTEROIDS). The pharmacologically active polypeptide of ACTH has been synthesised and is called tetracosactrin. Thyrotrophic hormone is also available but it has no therapeutic application.
HYPOTHALAMIC RELEASING HORMONES which affect the release of each of the six anterior pituitary hormones have been identi?ed. Their blood levels are only one-thousandth of those of the pituitary trophic hormones. The release of thyrotrophin, adrenocorticotrophin, growth hormone, follicle-stimulating hormone and luteinising hormone is stimulated, while release of prolactin is inhibited. The structure of the releasing hormones for TSH, FSH-LH, GH and, most recently, ACTH is known and they have all been synthesised. Thyrotrophin-releasing hormone (TRH) is used as a diagnostic test of thyroid function but it has no therapeutic application. FSH-LH-releasing hormone provides a useful diagnostic test of gonadotrophin reserve in patients with pituitary disease, and is now used in the treatment of infertility and AMENORRHOEA in patients with functional hypothalamic disturbance. As this is the most common variety of secondary amenorrhoea, the potential use is great. Most cases of congenital de?ciency of GH, FSH, LH and ACTH are due to defects in the hypothalamic production of releasing hormone and are not a primary pituitary defect, so that the therapeutic implication of this synthesised group of releasing hormones is considerable.
GALACTORRHOEA is frequently due to a microadenoma (see ADENOMA) of the pituitary. DOPAMINE is the prolactin-release inhibiting hormone. Its duration of action is short so its therapeutic value is limited. However, BROMOCRIPTINE is a dopamine agonist with a more prolonged action and is e?ective treatment for galactorrhoea.
Thyroid gland The functions of the thyroid gland are controlled by the pituitary gland (see above) and the hypothalamus, situated in the brain. The thyroid, situated in the front of the neck below the LARYNX, helps to regulate the body’s METABOLISM. It comprises two lobes each side of the TRACHEA joined by an isthmus. Two types of secretory cells in the gland – follicular cells (the majority) and parafollicular cells – secrete, respectively, the iodine-containing hormones THYROXINE (T4) and TRI-IODOTHYRONINE (T3), and the hormone CALCITONIN. T3 and T4 help control metabolism and calcitonin, in conjunction with parathyroid hormone (see above), regulates the body’s calcium balance. De?ciencies in thyroid function produce HYPOTHYROIDISM and, in children, retarded development. Excess thyroid activity causes thyrotoxicosis. (See THYROID GLAND, DISEASES OF.)... endocrine glands
Underactivity of the PITUITARY GLAND. It can cause dwar?sm, delayed puberty, impotence, infertility, AMENORRHOEA, hypothyroidism (see THYROID GLAND, DISEASES OF), and hypoadrenalism. Causes include tumours, irradiation of the gland, SARCOIDOSIS, and necrosis associated with post-partum haemorrhage (Sheehan’s syndrome).... hypopituitarism
Solanum spp.SolanaceaeSolanums comprise a very important group of medicinal plants having multifarious uses.These plants belong to the family Solanaceae and genus Solanum. A number of species are reported to be medicinal which are briefly described below.1. S. anguivi Lam. syn. S. indicum auct. non Linn.Eng: Poison berry; San: Brhati, Simhi;Hin: Barhauta, Birhatta;Mal: Puthirichunda, Cheruchunda;Tam: Karimulli, Puthirichundai;Kan: Ramagulla;Tel: Cittimulaga, Tellamulaka It is found throughout the tropics, in plains and at low elevations. It is much branched, very prickly undershrub, 0.3-1.5m in height. Leaves are simple, large, ovate, subentire, sinuate or lobed. Flowers are blue in extra-axillary cymes having stellately hairy and prickly peduncles. Fruits are globose berries, reddish or dark yellow with smooth or minutely pitted seeds. Its roots are useful in vitiated conditions of vata and kapha, odontalgia, dyspepsia, flatulence, colic, verminosis, diarrhoea, pruritus, leprosy, skin diseases, strangury, cough, asthma, bronchitis, amenorrhoea, dysmenorrhoea, fever, cardiac disorders and vomiting. Roots bitter, acrid, astringent, thermogenic, anodyne, digestive, carminative, anthelmintic, stomachic, constipating, resolvent, demulcent, depurative, diuretic, expectorant, aphrodisiac, emmenagogue, febrifuge and cardiotonic.2. S. dulcamara Linn.Eng: Bittersweet, Bitter night shade; San: Kakmachi; Pun: Rubabarik It is found in tropical situations in India and Sikkim. The plant is rich in alkaloidal glycosides like solamarine, tomatidenol, solasodine and soladulcine. The berry and twig are alterative, antisyphilitic, diaphoretic, resolvent, narcotic, diuretic, antirheumatic and used in liver disorders and psoriasis.3. S. erianthum D. Don, syn. S. verbascifolium auct. non Linn.San: Vidari;Hin: Asheta;Mal: Malachunda;Tam: Malaichundai, AnaisundaikkaiPun: Kalamena;Tel: RasagadiThe plant is distributed over the tropical and subtropical zones of India. The plant contains alkaloids and steroidal sapogenins. Leaves and fruits contain solasodine, solasodiene, solafloridine, diosgenin, vespertilin and pregnenolone. The plant is CNS depressant, antiinflammatory and useful in burns.4. S. melongena Linn.Eng: Brinjal, Egg plant; San: Varttaki;Hin: Bengan, Badanjan;Mal: VazhuthinaTam: Kattirikkai;Kan: Badanekaya, Doddabadane;Tel: Vankaya, NiruvangaIt is mainly cultivated as a vegetable throughout the tropics and subtropics. It is an erect or suffrutescent, herbaceous, armed or unarmed perennial shrub. Leaves are simple, large, entire and lobed. Flowers are blue, in clusters of 2-5. Fruits are large, white, yellow or dark purple berries of different shapes capped with thick persistent calyx. Seeds are many, yellow or cream and discoid. The roots, leaves and unripe fruits are useful in cholera, bronchitis, asthma, odontalgia and fever. The roots are laxative, analgesic and cardiotonic. Leaves are sialagogue, narcotic and antiherpetic. The unripe fruits are bitter, acrid, sweet, aphrodisiac, cardiotonic and haematinic.5. S. melongena var. incanum (Linn.) Prain syn. S. incanum Linn., S. coagulens Forsk.San: Brihati;Hin: Baigan;Mal: CheruvazhuthinaIt is a herbaceous prickly plant found in warm humid tropics. It is grown almost throughout the year in the plains and during summer on the hills. It grows 0.6-2m in height. Leaves are simple, alternate lobed. Flowers are blue or white, 5 lobed, calyx with spines. Fruits are ellipsoid berries. The plant is a constituent of the dasamoola which helps to overcome vitiated tridoshas and cures dyspepsia, fever, respiratory and cardiac disorders, skin ailments, vomiting, ulcers and poisonous affections. In Ayurveda the formulations like Brihatyadi Kashaya, dashamoolarishta, Indukantaghritam, Dasamoolaharithaki, etc are the important preparations with the roots. It is also used in the treatment of toothache and sore throat. The fruit is reported to stimulate the intrahepatic metabolism of cholesterol. Roots are antiasthmatic and stimulant. Leaves are used in cholera, bronchitis and asthma. Fruits are useful in liver complaints.6. S. nigrum Linn. syn. S. rubrum Mill.Eng: Black night shade; San: Kakamachi;Hin: Makoy, Gurkkamai;Mal: Karimthakkali;Tam: Manathakkali, Milagutakkali;Kan: Kakarndi;Tel: Kamachi, KachiIt is seen wild throughout India. It is an erect, divaricately branched, unarmed, suffrutescent annual herb. Leaves are ovate or oblong, sinuate-toothed or lobed and glabrous. Flowers are 3-8 in extra-axillary drooping subumbellate cymes. Fruits are purplish black or reddish berries. Seeds are many, discoid, yellow, minutely pitted. The whole plant is useful in vitiated conditions of tridosha, rheumatalgia, swellings, cough, asthma, bronchitis, wounds, ulcers, flatulence, dyspepsia, strangury, hepatomegaly, otalgia, hiccough, opthalmopathy, vomiting, cardiopathy, leprosy, skin diseases, fever, splenomegaly, haemarrhoids, nephropathy, dropsy and general debility. The plant is bitter, acrid, emollient, antiseptic, antiinflammatory, expectorant, anodyne, vulnerary, digestive, laxative, diuretic, cardiotonic, depurative, diaphoretic, febrifuge, rejuvenating, sedative, alterant and tonic.7. S. spirale Roxb.
Hin: Munguskajur
It is seen wild in Assam and Khasi hills in India. Its root is diuretic and narcotic.8. S. stramoniifolium Jacq., syn. S. ferox auct. non Linn.San: Garbhada;Hin: Rambaigan;Mal: Anachunda;Tam: Anaichundai;Tel: MulakaIt is observed in India in the states of Assam, Maharashtra, Karnataka and Tamil Nadu. Its berries contain glycoalkaloids such as solasonine and solasodine. Its roots and berries are bechic, antiasthmatic, antirheumatic, antiviral, anticancerous and spermicidal.9. S. surattense Burm. F. syn. S. xanthocarpum schrad. & Wendl., S. jacquinii Willd.Eng: Yellow-berried nightshade; San: Kantakari, Nidigdhika;Hin: Remgani,Kateli;Mal: Kantakarichunda;Tam: Kantankattiri;Kan: Nelagulli;Tel: CallamulagaIt is found throughout India and Pakistan in dry situations as weed on roadsides and wastelands. It is prickly, diffuse, bright green, suffrutescent, perennial undershrub, with zigzag branches. Leaves are ovate-oblong, hairy on both sides and armed on the midrib and the nerves. Flowers are bluish purple, in extra-axillary cymes. Fruits are glabrous, globular drooping berry, yellow or white with green veins, surrounded by the calyx. Seeds are many, small, reniform, smooth and yellowish brown.The whole plant is useful in vitiated conditions of vata and kapha, helminthiasis, dental caries, inflammations, flatulence, constipation, dyspepsia, anorexia, leprosy, skin diseases, hypertension, fever, cough, asthma, bronchitis, hiccough, lumbago, haemorrhoids and epilepsy. The plant is bitter, acrid, thermogenic, anthelmintic, antiinflammatory, anodyne, digestive, carminative, appetiser, stomachic, depurative, sudorific, febrifuge, expectorant, laxative, stimulant, diuretic, rejuvenating, emmenagogue and aphrodisac. Fruits contain solasonine, solamargine and solasodine.10. S. torvum Sw.Eng: West Indian Turkey Berry;Hin,Ben: Titbaigan;Mal: Kattuchunda;Kan: Kadu Sunde;Tam: Sundaikai, Amarakai;Tel: Kundavustic, Kotuvestu; Ass: HathibhekuriIt is seen throughout tropical India, particularly in Orissa, Bihar and Manipur. The plant is CVS active and used in splenomegaly. Fruits and leaves contain solasonine, solasodine, jurubine, jurubidine, torvonin, torvogenin, chlorogenin, paniculogenin, sisalogenone, neosolaspigenin and solaspigenin.11. S. trilobatum Linn.Eng: Climbing Brinjal; San: Alarka;Mal: Tutavalam;Tam: Tuduvalai;Kan: Mullumusta;Tel: TelavusteIt is mostly seen in South and Western India. The plant contains alkamine and solamarine. The berry and flowers are bechic and used in bronchitis. The alkaloid solamarine is antibiotic and possesses antitumour activity.12. S. viarum Dunal, syn. S. Khasianum C. B. Clarke
Hin: Kantakari
It is widely distributed in Khasi, Jaintia and Naga hills of Assam and Manipur upto 2000m and in Sikkim, West Bengal, Orissa and in the Niligiris. The plant and berries contain solasonine (which on hydrolysis yields solasodine), solamargine, khasianine, nantigenin, solasodine, diosgenin and saponin-solakhasianin. The plant is spasmolytic and CNS active. The berry is a source of solasodine used in the synthesis of corticosteroidal hormones.Agrotechnology: The agrotechnology for the solanaceous group of plants are almost similar. They come up very well in tropical and subtropical climate upto 2000m altitude. They can be raised on a variety of soils good in organic matter. Propagation is by seeds. The seedlings are first raised in the nursery and transplanted to the main field 30-45 days after sowing when the plants attain 8-10cm height. During rainy season, planting is done on ridges while during summer in furrows, at a spacing ranging from 30-90cm depending upon the stature and spreading habit of the plant. The transplanted seedlings should be given temporary shade for 2-4 days during summer. FYM or compost at 20-25t/ha is applied at the time of land preparation. A moderate fertiliser dose of 75:40:40 N, P2O5, K2O/ha may be given. P is given as basal dose, N and K are applied in 2-3 split doses. One or two intercultural operations are needed to control weeds. The plants need earthing up after weeding and topdressing. Irrigation is needed at 3-4 days interval during summer and on alternate days during fruiting period. Plants need staking to avoid lodging due to heavy bearing. Shoot borers, mealy bugs, leaf webbers and miners are noted on the crop, which can be controlled by spraying mild insecticides. Root knot nematode, wilting and mosaic diseases are also noted on the crop. Field sanitation, crop rotation and burning of crop residues are recommended.... solanums
Bulimia means insatiable appetite of psychological origin. This eating-disorder symptom may be of psychological origin or the result of neurological disease – for example, a lesion of the HYPOTHALAMUS. Bulimia nervosa is linked to anorexia nervosa and is sometimes called the binge and purge syndrome. Bulimia nervosa is characterised by overpowering urges to eat large amounts of food, followed by induced vomiting or abuse of laxatives to avoid any gain in weight. Most of the victims are prone to being overweight and all have a morbid fear of obesity. They indulge in bouts of gross overeating, or ‘binge rounds’ as they describe them, to ‘?ll the empty space inside’. By their bizarre behaviour, most of them manage to maintain a normal weight. The condition is most common in women in their 20s; it is accompanied by irregular menstruation, often amounting to amenorrhoea (see MENSTRUATION). Although there are many similarities to anorexia nervosa, bulimia nervosa di?ers in that there is no attempt at deceit; sufferers freely admit to an eating disorder and feel distress about the symptoms that it produces. In spite of this, the response to treatment is, as in anorexia nervosa, far from satisfactory. (See EATING DISORDERS.)... bulimia
Synonym: C. verum Persl.
Family: Lauraceae.
Habitat: Western Ghats at low levels. Plantations of cinnamon are confined to Kerala State.
English: Cinnamon, Ceylon Cinnamon.
Ayurvedic: Tvak, Daaruchini, Chochaa, Choncha, Varaanga, Utkata, Daarusitaa (bark).
Unani: Daarchini (bark).
Siddha/Tamil: Elavangappattai.
Folk: Daalchini.
Action: Bark—carminative, astringent, antispasmodic, expectorant, haemostatic, antiseptic. Leaf— antidiabetic. Ground cinnamon is used in diarrhoea and dysentery; for cramps of the stomach, gastric irritation; for checking nausea and vomiting; used externally in toothache, neuralgia and rheumatism. The bark is included in medicinal preparations for indigestion, flatulence, flu, mothwashes, gargles, herbal teas.
Key application: As antibacterial and fungistatic. Internally, for loss of appetite, dyspeptic complaints such as mild spastic conditions of the gastrointestinal tract, bloating and flatulence. (German Commission E, ESCOP.) Contraindicated in stomach and duodenal ulcers. (WHO.)The Ayurvedic Pharmacopoeia ofIn- dia indicated the use of dried mature leaves of Cinnamomum tamala and dried inner bark of C. zeylanicum in sinusitis.Cinnamaldehyde is the major constituent (74%) of the essential oil from bark.Major constituent of the leaf oil is eugenol (28-98%) and that of root- bark oil camphor (60%).Cinnamaldehyde is hypotensive, spasmolytic and increases peripheral blood flow; and it inhibits cyclooxy- genase and lipoxygenase enzymes of arachidonic acid metabolism.Cinnamaldehyde exhibits CNS stimulant effects at high doses. (Natural Medicines Comprehensive Database, 2007.)The bark oil and extracts exhibit antibacterial, antifungal and antiviral activities, and enhance trypsin activity.Eugenol content of the leaf oil is antiseptic and anaesthetic. It is not inter- changable with the bark oil.Root bark oil acts as a stimulant in amenorrhoea. The bark contains tannins (6.5%) consisting of tetrahydrox- yflavandiols; diterpenes, cinnzeylanin and cinnzeylanol.C. malabatrum (Burm. f.) Blume is equated with Jangali Daarchini.
Dosage: Dried inner bark—1-3 g powder. (API Vol. I.)... cinnamomum zeylanicum
Absence or defects of the uterus
Rarely, the UTERUS may be completely absent as a result of abnormal development. In such patients secondary sexual development is normal but MENSTRUATION is absent (primary amennorhoea). The chromosomal make-up of the patient must be checked (see CHROMOSOMES; GENES): in a few cases the genotype is male (testicular feminisation syndrome). No treatment is available, although the woman should be counselled.
The uterus develops as two halves which fuse together. If the fusion is incomplete, a uterine SEPTUM results. Such patients with a double uterus (uterus didelphys) may have fertility problems which can be corrected by surgical removal of the uterine septum. Very rarely there may be two uteri with a double vagina.
The uterus of most women points forwards (anteversion) and bends forwards (ante?exion). However, about 25 per cent of women have a uterus which is pointed backwards (retroversion) and bent backwards (retro?exion). This is a normal variant and very rarely gives rise to any problems. If it does, the attitude of the uterus can be corrected by an operation called a ventrosuspension.
Endometritis The lining of the uterine cavity is called the ENDOMETRIUM. It is this layer that is partially shed cyclically in women of reproductive age giving rise to menstruation. Infection of the endometrium is called endometritis and usually occurs after a pregnancy or in association with the use of an intrauterine contraceptive device (IUCD – see CONTRACEPTION). The symptoms are usually of pain, bleeding and a fever. Treatment is with antibiotics. Unless the FALLOPIAN TUBES are involved and damaged, subsequent fertility is unaffected. Very rarely, the infection is caused by TUBERCULOSIS. Tuberculous endometritis may destroy the endometrium causing permanent amenorrhoea and sterility.
Menstrual disorders are common. Heavy periods (menorrhagia) are often caused by ?broids (see below) or adenomyosis (see below) or by anovulatory cycles. Anovulatory cycles result in the endometrium being subjected to unopposed oestrogen stimulation and occasionally undergoing hyperplasia. Treatment is with cyclical progestogens (see PROGESTOGEN) initially. If this form of treatment fails, endoscopic surgery to remove the endometrium may be successful. The endometrium may be removed using LASER (endometrial laser ablation) or electrocautery (transcervical resection of endometrium). Hysterectomy (see below) will cure the problem if endoscopic surgery fails. Adenomyosis is a condition in which endometrial tissue is found in the muscle layer (myometrium) of the uterus. It usually presents as heavy and painful periods, and occasionally pain during intercourse. Hysterectomy is usually required.
Oligomenorhoea (scanty or infrequent periods) may be caused by a variety of conditions including thyroid disease (see THYROID GLAND, DISEASES OF). It is most commonly associated with usage of the combined oral contraceptive pill. Once serious causes have been eliminated, the patient should be reassured. No treatment is necessary unless conception is desired, in which case the patient may require induction of ovulation.
Primary amenorrhoea means that the patient has never had a period. She should be investigated, although usually it is only due to an inexplicable delay in the onset of periods (delayed menarche) and not to any serious condition. Secondary amenorrhoea is the cessation of periods after menstruation has started. The most common cause is pregnancy. It may be also caused by endocrinological or hormonal problems, tuberculous endometritis, emotional problems and severe weight loss. The treatment of amenorrhoea depends on the cause.
Dysmenorrhoea, or painful periods, is the most common disorder; in most cases the cause is unknown, although the disorder may be due to excessive production of PROSTAGLANDINS.
Irregular menstruation (variations from the woman’s normal menstrual pattern or changes in the duration of bleeding or the amount) can be the result of a disturbance in the balance of OESTROGENS and PROGESTERONE hormone which between them regulate the cycle. For some time after the MENARCHE or before the MENOPAUSE, menstruation may be irregular. If irregularity occurs in a woman whose periods are normally regular, it may be due to unsuspected pregnancy, early miscarriage or to disorders in the uterus, OVARIES or pelvic cavity. The woman should seek medical advice.
Fibroids (leiomyomata) are benign tumours arising from the smooth muscle layer (myometrium) of the uterus. They are found in 80 per cent of women but only a small percentage give rise to any problems and may then require treatment. They may cause heavy periods and occasionally pain. Sometimes they present as a mass arising from the pelvis with pressure symptoms from the bladder or rectum. Although they can be shrunk medically using gonadorelin analogues, which raise the plasma concentrations of LUTEINISING HORMONE and FOLLICLE-STIMULATING HORMONE, this is not a long-term solution. In any case, ?broids only require treatment if they are large or enlarging, or if they cause symptoms. Treatment is either myomectomy (surgical removal) if fertility is to be retained, or a hysterectomy.
Uterine cancers tend to present after the age of 40 with abnormal bleeding (intermenstrual or postmenopausal bleeding). They are usually endometrial carcinomas. Eighty per cent present with early (Stage I) disease. Patients with operable cancers should be treated with total abdominal hysterectomy and bilateral excision of the ovaries and Fallopian tubes. Post-operative RADIOTHERAPY is usually given to those patients with adverse prognostic factors. Pre-operative radiotherapy is still given by some centres, although this practice is now regarded as outdated. PROGESTOGEN treatment may be extremely e?ective in cases of recurrence, but its value remains unproven when used as adjuvant treatment. In 2003 in England and Wales, more than 2,353 women died of uterine cancer.
Disorders of the cervix The cervix (neck of the womb) may produce an excessive discharge due to the presence of a cervical ectopy or ectropion. In both instances columnar epithelium – the layer of secreting cells – which usually lines the cervical canal is exposed on its surface. Asymptomatic patients do not require treatment. If treatment is required, cryocautery – local freezing of tissue – is usually e?ective.
Cervical smears are taken and examined in the laboratory to detect abnormal cells shed from the cervix. Its main purpose is to detect cervical intraepithelial neoplasia (CIN) – the presence of malignant cells in the surface tissue lining the cervix – since up to 40 per cent of women with this condition will develop cervical cancer if the CIN is left untreated. Women with abnormal smears should undergo colposcopy, a painless investigation using a low-powered microscope to inspect the cervix. If CIN is found, treatment consists of simply removing the area of abnormal skin, either using a diathermy loop or laser instrument.
Unfortunately, cervical cancer remains the most common of gynaecological cancers. The most common type is squamous cell carcinoma and around 4,000 new cases (all types) are diagnosed in England and Wales every year. As many as 50 per cent of the women affected may die from the disease within ?ve years. Cervical cancer is staged clinically in four bands according to how far it has extended, and treatment is determined by this staging. Stage I involves only the mucosal lining of the cervix and cone BIOPSY may be the best treatment in young women wanting children. In Stage IV the disease has spread beyond the cervix, uterus and pelvis to the URINARY BLADDER or RECTUM. For most women, radiotherapy or radical Wertheim’s hysterectomy – the latter being preferable for younger women – is the treatment of choice if the cancer is diagnosed early, both resulting in survival rates of ?ve years in 80 per cent of patients. Wertheim’s hysterectomy is a major operation in which the uterus, cervix, upper third of vagina and the tissue surrounding the cervix are removed together with the LYMPH NODES draining the area. The ovaries may be retained if desired. Patients with cervical cancer are treated by radiotherapy, either because they present too late for surgery or because the surgical skill to perform a radical hysterectomy is not available. These operations are best performed by gynaecological oncologists who are gynaecological surgeons specialising in the treatment of gynaecological tumours. The role of CHEMOTHERAPY in cervical and uterine cancer is still being evaluated.
Prolapse of the uterus is a disorder in which the organ drops from its normal situation down into the vagina. First-degree prolapse is a slight displacement of the uterus, second-degree a partial displacement and third-degree when the uterus can be seen outside the VULVA. It may be accompanied by a CYSTOCOELE (the bladder bulges into the front wall of the vagina), urethrocoele (the urethra bulges into the vagina) and rectocoele (the rectal wall bulges into the rear wall of the vagina). Prolapse most commonly occurs in middle-aged women who have had children, but the condition is much less common now than in the past when prenatal and obstetric care was poor, women had more pregnancies and their general health was poor. Treatment is with pelvic exercises, surgical repair of the vagina or hysterectomy. If the woman does not want or is not ?t for surgery, an internal support called a pessary can be ?tted – and changed periodically.
Vertical section of female reproductive tract (viewed from front) showing sites of common gynaecological disorders.
Hysterectomy Many serious conditions of the uterus have traditionally been treated by hysterectomy, or removal of the uterus. It remains a common surgical operation in the UK, but is being superseded in the treatment of some conditions, such as persistent MENORRHAGIA, with endometrial ablation – removal of the lining of the uterus using minimally invasive techniques, usually using an ENDOSCOPE and laser. Hysterectomy is done to treat ?broids, cancer of the uterus and cervix, menorrhagia, ENDOMETRIOSIS and sometimes for severely prolapsed uterus. Total hysterectomy is the usual type of operation: it involves the removal of the uterus and cervix and sometimes the ovaries. After hysterectomy a woman no longer menstruates and cannot become pregnant. If the ovaries have been removed as well and the woman had not reached the menopause, hormone replacement therapy (HRT – see MENOPAUSE) should be considered. Counselling helps the woman to recover from the operation which can be an emotionally challenging event for many.... uterus, diseases of
Suppression of. See: AMENORRHOEA. ... menses
A progestogen drug used to treat endometriosis and certain types of breast cancer and uterine cancer (see uterus, cancer of). It is sometimes used to treat menstrual disorders such as amenorrhoea (absence of menstruation). Medroxyprogesterone can also be used as a contraceptive, administered by injection at 3-monthly intervals (see contraception, hormonal methods of). Possible adverse effects include weight gain, swollen ankles, and breast tenderness.... medroxyprogesterone
The generic term for the group of hormones produced by the ADRENAL GLANDS, with a profound e?ect on mineral and glucose metabolism.
Many modi?cations have been devised of the basic steroid molecule in an attempt to keep useful therapeutic effects and minimise unwanted side-effects. The main corticosteroid hormones currently available are CORTISONE, HYDROCORTISONE, PREDNISONE, PREDNISOLONE, methyl prednisolone, triamcinolone, dexamethasone, betamethasone, paramethasone and de?azacort.
They are used clinically in three quite distinct circumstances. First they constitute replacement therapy where a patient is unable to produce their own steroids – for example, in adrenocortical insu?ciency or hypopituitarism. In this situation the dose is physiological – namely, the equivalent of the normal adrenal output under similar circumstances – and is not associated with any side-effects. Secondly, steroids are used to depress activity of the adrenal cortex in conditions where this is abnormally high or where the adrenal cortex is producing abnormal hormones, as occurs in some hirsute women.
The third application for corticosteroids is in suppressing the manifestations of disease in a wide variety of in?ammatory and allergic conditions, and in reducing antibody production in a number of AUTOIMMUNE DISORDERS. The in?ammatory reaction is normally part of the body’s defence mechanism and is to be encouraged rather than inhibited. However, in the case of those diseases in which the body’s reaction is disproportionate to the o?ending agent, such that it causes unpleasant symptoms or frank illness, the steroid hormones can inhibit this undesirable response. Although the underlying condition is not cured as a result, it may resolve spontaneously. When corticosteroids are used for their anti-in?ammatory properties, the dose is pharmacological; that is, higher – often much higher – than the normal physiological requirement. Indeed, the necessary dose may exceed the normal maximum output of the healthy adrenal gland, which is about 250–300 mg cortisol per day. When doses of this order are used there are inevitable risks and side-effects: a drug-induced CUSHING’S SYNDROME will result.
Corticosteroid treatment of short duration, as in angioneurotic OEDEMA of the larynx or other allergic crises, may at the same time be life-saving and without signi?cant risk (see URTICARIA). Prolonged therapy of such connective-tissue disorders, such as POLYARTERITIS NODOSA with its attendant hazards, is generally accepted because there are no other agents of therapeutic value. Similarly the absence of alternative medical treatment for such conditions as autoimmune haemolytic ANAEMIA establishes steroid therapy as the treatment of choice which few would dispute. The use of steroids in such chronic conditions as RHEUMATOID ARTHRITIS, ASTHMA and DERMATITIS needs careful assessment and monitoring.
Although there is a risk of ill-effects, these should be set against the misery and danger of unrelieved chronic asthma or the incapacity, frustration and psychological trauma of rheumatoid arthritis. Patients should carry cards giving details of their dosage and possible complications.
The incidence and severity of side-effects are related to the dose and duration of treatment. Prolonged daily treatment with 15 mg of prednisolone, or more, will cause hypercortisonism; less than 10 mg prednisolone a day may be tolerated by most patients inde?nitely. Inhaled steroids rarely produce any ill-e?ect apart from a propensity to oral thrush (CANDIDA infection) unless given in excessive doses.
General side-effects may include weight gain, fat distribution of the cushingoid type, ACNE and HIRSUTISM, AMENORRHOEA, striae and increased bruising tendency. The more serious complications which can occur during long-term treatment include HYPERTENSION, oedema, DIABETES MELLITUS, psychosis, infection, DYSPEPSIA and peptic ulceration, gastrointestinal haemorrhage, adrenal suppression, osteoporosis (see BONE, DISORDERS OF), myopathy (see MUSCLES, DISORDERS OF), sodium retention and potassium depletion.... corticosteroids
a condition in which *amenorrhoea and infertility follow a major haemorrhage in pregnancy. It may result from overvigorous curettage of the uterus in an attempt to control the bleeding. This removes the lining, the walls adhere, and the cavity is obliterated to a greater or lesser degree. Some 50% of such patients are subsequently infertile, and of those who become pregnant, only a minority achieve an uncomplicated delivery. Compare Sheehan’s syndrome. [J. G. Asherman (20th century), Czechoslovakian gynaecologist]... asherman syndrome
Linn.
Family: Euphorbiaceae.
Habitat: Smaller var., equated with E. thymifolia, is found in tropical plains and low hills of India, ascending to 1,750 m. Bigger var., E. pilulifera/E. hirta Linn. is found in warmer parts of India from Punjab eastwards, and southwards to Kanyakumari.
Ayurvedic: Dudhi (smaller var.), Dugdhikaa, Naagaarjuni, Swaaduparni.
Siddha/Tamil: Sittrapaladi.
Action: Plant—antispasmodic, bronchodilator, antiasthmat- ic (used in bronchial asthma), galactagogue (also used for spermatorrhoea). Root—used in amenorrhoea. Latex—used in ringworm, dandruff. Leaf, seed and latex—purgative. A decoction of the plant, with honey, is given to treat haematuria.
Aerial parts gave epitaraxerol, n- hexacosanol, euphorbol, two derivatives of deoxyphorbol-OAC, 24-meth- ylene cycloartenol and quercetin galactoside. Co-carcinogenic activity is due to phorbol derivatives. The plant exhibits antimicrobial activity due to alkaloids.
Dosage: Whole plant—10-20 g paste. (CCRAS.)
Family: Euphorbiaceae.
Habitat: Native to Africa; naturalized in the warmer parts of India.
English: Milk-Bush, Milk Hedge, Indian tree Spurge, Aveloz, Petroleum Plant
Ayurvedic: Saptalaa, Saatalaa.
Siddha/Tamil: Tirukalli.
Folk: Angulia-thuuhar.
Action: Purgative, emetic, antiasthmatic, bechic. Used for whooping cough, asthma, dyspepsia, biliousness, jaundice, enlargement of spleen, leucorrhoea. Latex—applied externally on warts.
Used as a purgative and for rheumatism and neuralgia. Stem bark—used for gastralgia, colic, asthma.The latex contains an ingol ester besides triterpenoids, euphorbinol and cycloeuphordenol.Presence of a number of ingenol and phorbol esters (diterpenoids), and tri- terpenoids are reported from the plant. The stem gave hentriacontane, hentri- acontanol, beta-sitosterol, Me-ellagic and ellagic acids and kaempferol glu- coside.The latex is a weak tumour promoter.... euphorbia thymifolia
n. severe cyclical abdominal pain in association with *amenorrhoea, usually about a year after the expected onset of menstruation and usually due to an *imperforate hymen. On parting the labia, a bulging blue membrane is seen above the hymen and a pelvic mass is felt on examination. Treatment is by incision of the membrane.... cryptomenorrhoea
(FSH) a hormone (see gonadotrophin) synthesized and released by the anterior pituitary gland. FSH stimulates ripening of the follicles in the ovary and formation of sperm in the testes. It is administered by injection to treat sterility due to lack of ovulation, amenorrhoea, and decreased sperm production. Stimulation of ovulation by FSH may, in some cases, lead to multiple pregnancy.... follicle-stimulating hormone
n. the period of time around the *menopause in which marked changes in the menstrual cycle occur, usually accompanied by hot flushes, and in which no 12 consecutive months of *amenorrhoea have yet occurred.... perimenopause
a condition in which *amenorrhoea and infertility follow a major haemorrhage in pregnancy. It is caused by necrosis (death) of the anterior lobe of the pituitary gland as a direct result of the haemorrhage reducing the blood supply to the gland. Compare Asherman syndrome. [H. L. Sheehan (20th century), British pathologist]... sheehan’s syndrome
The term ‘eating disorders’ covers OBESITY, feeding problems in childhood, anorexia nervosa, and bulimia nervosa. The latter two are described here.
Anorexia nervosa Often called the slimmer’s disease, this is a syndrome characterised by the loss of at least a quarter of a person’s normal body weight; by fear of normal weight; and, in women, by AMENORRHOEA. An individual’s body image may be distorted so that the sufferer cannot judge real weight and wants to diet even when already very thin.
Anorexia nervosa usually begins in adolescence, affecting about 1–2 per cent of teenagers and college students at any time. It is 20 times more common among women than men. Up to 10 per cent of sufferers’ sisters also have the syndrome. Anorexia may be linked with episodes of bulimia (see below).
The symptoms result from secretive self-starvation, usually with excessive exercise, self-induced vomiting, and misuse of laxatives. An anorexic (or anorectic) person may wear layers of baggy clothes to keep warm and to hide the ?gure. Starvation can cause serious problems such as ANAEMIA, low blood pressure, slow heart rate, swollen ankles, and osteoporosis. Sudden death from heart ARRHYTHMIA may occur, particularly if the sufferer misuses DIURETICS to lose weight and also depletes the body’s level of potassium.
There is probably no single cause of anorexia nervosa. Social pressure to be thin seems to be an important factor and has increased over the past 20–30 years, along with the incidence of the syndrome. Psychological theories include fear of adulthood and fear of losing parents’ attention.
Treatment should start with the general practitioner who should ?rst rule out other illnesses causing similar signs and symptoms. These include DEPRESSION and disorders of the bowel, PITUITARY GLAND, THYROID GLAND, and OVARIES.
If the diagnosis is clearly anorexia nervosa, the general practitioner may refer the sufferer to a psychiatrist or psychologist. Moderately ill sufferers can be treated by COGNITIVE BEHAVIOUR THERAPY. A simple form of this is to agree targets for daily calorie intake and for acceptable body weight. The sufferer and the therapist (the general practitioner or a member of the psychiatric team) then monitor progress towards both targets by keeping a diary of food intake and measuring weight regularly. Counselling or more intensely personal PSYCHOTHERAPY may help too. Severe life-threatening complications will need urgent medical treatment in hospital, including rehydration and feeding using a nasogastric tube or an intravenous drip.
About half of anorectic sufferers recover fully within four years, a quarter improve, and a quarter remain severely underweight with (in the case of women) menstrual abnormalities. Recovery after ten years is rare and about 3 per cent die within that period, half of them by suicide.
Bulimia nervosa is a syndrome characterised by binge eating, self-induced vomiting and laxative misuse, and fear of fatness. There is some overlap between anorexia nervosa and bulimia but, unlike the former, bulimia may start at any age from adolescence to 40 and is probably more directly linked with ordinary dieting. Bulimic sufferers say that, although they feel depressed and guilty after binges, the ‘buzz’ and relief after vomiting and purging are addictive. They often respond well to cognitive behaviour therapy.
Bulimia nervosa does not necessarily cause weight loss because the binges – for example of a loaf of bread, a packet of cereal, and several cans of cold baked beans at one sitting – are cancelled out by purging, by self-induced vomiting and by brief episodes of starvation. The full syndrome has been found in about 1 per cent of women but mild forms may be much more common. In one survey of female college students, 13 per cent admitted to having had bulimic symptoms.
Bulimia nervosa rarely leads to serious physical illness or death. However, repeated vomiting can cause oesophageal burns, salivary gland infections, small tears in the stomach, and occasionally dehydration and chemical imbalances in the blood. Inducing vomiting using ?ngers may produce two tell-tale signs – bite marks on the knuckles and rotten, pitted teeth.
Those suffering from this condition may obtain advice from the Eating Disorders Association.... eating disorders
(gonadal dysgenesis) a genetic defect in women in which there is only one X chromosome instead of the usual two. Affected women are infertile: they have female external genitalia but their ovaries fail to develop normally, resulting in absence of menstrual periods (see amenorrhoea). Characteristically they are short and have variable developmental defects, which may include webbing of the neck. [H. H. Turner (1892–1970), US endocrinologist]... turner’s syndrome
Mill.
Family: Umbelliferae; Apiaceae.
Habitat: Native to the Mediterranean region; now cultivated mainly in Punjab, Assam, Maharashtra and Vadodara (Gujarat).
English: Fennel. (Poison hemlock has been misidentified as fennel.)
Ayurvedic: Mishreyaa, Mishi, Mad- hurikaa, Madhuraa, Shatapushpaa, Shataahvaa. (Shatpushpaa is equated with Saunf and Shataahvaa with Soyaa. Some authors treat these as vice-versa.)
Unani: Baadiyaan, Saunf.
Siddha/Tamil: Sombu.
Action: Carminative, stomachic, antispasmodic, emmenagogue, galactagogue, anti-inflammatory, diuretic. Relieves bloating, nausea, settles stomach and stimulates appetite. Also used in amenorrhoea and enuresis.
Key application: In dyspepsias such as mild, spastic, gastrointestinal afflictions, fullness, flatulence. Fennel syrup or honey can be used for the catarrh of the upper respiratory tract in children. Fennel oil preparations not recommended during pregnancy. (German Commission E, ESCOP, WHO.)German Commission E reported that fennel seed promotes gastrointestinal motility and in higher concentrations acts as antispasmodic. In experiments anethole and fenchone have been shown to have a secre- tolytic action in respiratory tract. The British Herbal Pharmacopoeia and Indian Herbal Pharmacopoeia report its carminative and spasmolytic property.Fennel seed contain about 8% volatile oil (about 50-60% anethole, among others 10-15% fenchone and methyl- chavicol), flavonoids, coumarins (including bergapten) and sterols.The extract of seeds inhibits the growth of micro-organism, especially Streptococcus mutans, that are responsible for dental caries and periodontal diseases.The essential oil from the seed is reported to be antibacterial, antifungal, antioxidant, emmenagogue, oxytocic and abortifacient.The fatty acid, petroselenic acid, obtained from the oil, exhibited antimicrobial activity.Anethole, a major constituent of fennel seed/oil has been found to be an active estrogenic agent with minimal hepatotoxicity and no teratogenic effect.The oil also exhibits anticarcino- genic activity and can be used as a che- moprotective agent.It possesses antioxidant activity close to BHT.Anethole and limonene are used in pharmaceutical compositions for decreasing the side effects of chemotherapy and increasing the immune function.Limonene showed the capacity to inhibit mammary tumours in rats.The boiling water extract of leaves shows hypotensive effect in rats.The methanolic extract of seed showed antispasmodic activity, while aqueous extract accelerated the spontaneous movement of rabbit stomach.
Dosage: Dried fruit—3-6 g powder. (API Vol. I.)... foeniculum vulgare
Gymnema sylvestreAsclepiadaceaeSan: Mesasrngi, Madhunasini;Hin: Gudmar, Merasimgi;Ben: Merasingi;Mal: Chakkarakolli, Madhunasini;Tam: Sirukurumkay, Sakkaraikkolli;Kan: Kadhasige;Tel: Podapatra; Mar: KavaliImportance: Gymnema, Australian Cowplant, Small Indian Ipecacuanha or Periploca of the woods is a woody climber. It is reported to cure cough, dyspnoea, ulcers, pitta, kapha and pain in the eyes. The plant is useful in inflammations, hepatosplenomegaly, dyspepsia, constipation, jaundice, haemorrhoids, strangury, renal and vesical calculi, helminthiasis, cardiopathy, cough, asthma, bronchitis, intermittent fever, amenorrhoea, conjuctivitis and leucoderma. The fresh leaves when chewed have the remarkable property of paralysing the sense of taste for sweet and bitter substance for some time (Warrier et al, 1995). The drug is described as a destroyer of madhumeha (glycosuria) and other urinary disorders. Root has long been reputed as a remedy for snakebite. Leaves triturated and mixed with castor oil are applied to swollen glands and enlargement of internal viscera as the liver and spleen (Nadkarni, 1954). The drug is used to strengthen the function of heart, cure jaundice, piles, urinary calculi, difficult micturition and intermittent fevers (Sharma,1983). The drug enters into the composition of preparations like Ayaskrti, Varunadi kasaya, Varunadighrtam, Mahakalyanakaghrtam, etc. They suppress the activity of taste of tongue for sweet taste and for this reason it was considered that it destroys sugar, hence the name Madhunashini or Gurmar and has been prescribed as an anti-diabetic. The crude drug as well as its dried aqueous extract is mainly used in bronchial troubles.Distribution: It is a tropical climber. It mainly grows in Western Ghats, Konkan, Tamil Nadu and some parts of Bihar. The plant is cultivated in plains of India but the drug is mainly important from Afghanistan and Iran.Botany: Gymnema sylvestre (Retz.)R. Br. syn. Asclepias germinata Roxb. belonging to the family Asclepiadaceae is a large, woody much branched climber with pubescent young parts. Leaves are simple, opposite, elliptic or ovate, more or less pubescent on both sides, base rounded or cordate. Flowers are small, yellow and arranged in umbellate cymes. Fruits are slender and follicles are upto 7.5cm long (Warrier et al, 1995).Two allied species, G. hirsutum found in Bundelkh and Bihar and Western Ghats and G. montanum growing wild in Eastern Ghats and Konkan are also used for the same purpose and are also called “Gurmar” (Thakur et al, 1989).Agrotechnology: The plant can be propagated both by seeds and stem cuttings. Seedlings are to be raised in polybags. Pits of size 50cm cube are to be taken, filled with 10kg dried cowdung or FYM and covered with topsoil. On these pits about 3-4 months old seedlings are to be transplanted from polybags. Trailing can be facilitated by erecting poles and tying the plants to the poles. The plant will attain good spread within one year. Regular weeding, irrigation and organic manure application are beneficial. The plant is not attacked by any serious pests or diseases. Leaves can be collected from the first year onwards at an internal of one week. This can be continued for 10-12 years. Fresh or dried leaves can be marketed (Prasad et al, 1997).Properties and activity: Nonacosane and hentriacontane were isolated from the hexane extract of leaves. An attempt to isolate nitrogenous compounds led to the isolation of amino acids such as leucine, iso-leucine, valine, allanine and - amynobutyric acid. Isolation of trimethyl amine oxide was of particular interest. An alkaloid gynamine which is a trace constituent was isolated and identified (Sinsheimer et al, 1967). Antisweet constituent of the leaves has been found to be a mixture of triterpene saponins. These have been designated as gymnemic acids A,B,C and D which have the gymnemagenin and gymnestrogenins as the aglycones of gymnemic acid A and B and gymnemic acid C and D respectively. These are hexahydroxy triterpenes the latter being partially acylated. The sugar residues are glucuronic acid and galacturonic acid while ferulic and angelic acids have been attached as the carboxylic acid.Chewing of leaves reduces sensitivity to sweet substances. Effects of gymnema extracts had been variable. While verifying the effect of G. sylvestre leaves on detoxification of snake venom, it has been reported that a toxic component of venom ATP and gymnemate bind at the same site inhibiting venom ATP-ase. The active principles which have been identified as glycosides (7 gymnemic acids) suggest that the topical and selective anaesthetic effect of the plant might result from the competition of the receptor sites between glycosides and the sweet substances (Warren et al, 1969). The leaves are antidiabetic and insulinotropic. Gymnemic acid is antiviral. The plant is bitter, astringent, acrid, thermogenic, antiinflammatory, anodyne, digestive, liver tonic, emetic, diuretic, stomachic, stimulant, anthelmintic, alexipharmic, laxative, cardiotonic, expectorant, antipyretic and uterine tonic.... gymnema
In?ammation of the LIVER which damages liver cells and may ultimately kill them. Acute injury of the liver is usually followed by complete recovery, but prolonged in?ammation after injury may result in FIBROSIS and CIRRHOSIS. Excluding trauma, hepatitis has several causes:
Viral infections by any of hepatitis A, B, C, D, or E viruses and also CYTOMEGALOVIRUS (CMV), EPSTEIN BARR VIRUS, and HERPES SIMPLEX.
Autoimmune disorders such as autoimmune chronic hepatitis, toxins, alcohol and certain drugs – ISONIAZID, RIFAMPICIN, HALOTHANE and CHLORPROMAZINE.
WILSON’S DISEASE.
Acute viral hepatitis causes damage throughout the liver and in severe infections may destroy whole lobules (see below).
Chronic hepatitis is typi?ed by an invasion of the portal tract by white blood cells (mild hepatitis). If these mononuclear in?ammatory cells invade the body (parenchyma) of the liver tissue, ?brosis and then chronic disease or cirrhosis can develop. Cirrhosis may develop at any age and commonly results in prolonged ill health. It is an important cause of premature death, with excessive alcohol consumption commonly the triggering factor. Sometimes, cirrhosis may be asymptomatic, but common symptoms are weakness, tiredness, poor appetite, weight loss, nausea, vomiting, abdominal discomfort and production of abnormal amounts of wind. Initially, the liver may enlarge, but later it becomes hard and shrunken, though rarely causing pain. Skin pigmentation may occur along with jaundice, the result of failure to excrete the liver product BILIRUBIN. Routine liver-function tests on blood are used to help diagnose the disease and to monitor its progress. Spider telangiectasia (caused by damage to blood vessels – see TELANGIECTASIS) usually develop, and these are a signi?cant pointer to liver disease. ENDOCRINE changes occur, especially in men, who lose their typical hair distribution and suffer from atrophy of their testicles. Bruising and nosebleeds occur increasingly as the cirrhosis worsens, and portal hypertension (high pressure of venous blood circulation through the liver) develops due to abnormal vascular resistance. ASCITES and HEPATIC ENCEPHALOPATHY are indications of advanced cirrhosis.
Treatment of cirrhosis is to tackle the underlying cause, to maintain the patient’s nutrition (advising him or her to avoid alcohol), and to treat any complications. The disorder can also be treated by liver transplantation; indeed, 75 per cent of liver transplants are done for cirrhosis. The overall prognosis of cirrhosis, however, is not good, especially as many patients attend for medical care late in the course of the disease. Overall, only 25 per cent of patients live for ?ve years after diagnosis, though patients who have a liver transplant and survive for a year (80 per cent do) have a good prognosis.
Autoimmune hepatitis is a type that most commonly occurs in women between 20 and 40 years of age. The cause is unknown and it has been suggested that the disease has several immunological subtypes. Symptoms are similar to other viral hepatitis infections, with painful joints and AMENORRHOEA as additional symptoms. Jaundice and signs of chronic liver disease usually occur. Treatment with CORTICOSTEROIDS is life-saving in autoimmune hepatitis, and maintenance treatment may be needed for two years or more. Remissions and exacerbations are typical, and most patients eventually develop cirrhosis, with 50 per cent of victims dying of liver failure if not treated. This ?gure falls to 10 per cent in treated patients.
Viral hepatitis The ?ve hepatic viruses (A to E) all cause acute primary liver disease, though each belongs to a separate group of viruses.
•Hepatitis A virus (HAV) is an ENTEROVIRUS
which is very infectious, spreading by faecal contamination from patients suffering from (or incubating) the infection; victims excrete viruses into the faeces for around ?ve weeks during incubation and development of the disease. Overcrowding and poor sanitation help to spread hepatitis A, which fortunately usually causes only mild disease.
Hepatitis B (HBV) is caused by a hepadna virus, and humans are the only reservoir of infection, with blood the main agent for transferring it. Transfusions of infected blood or blood products, and injections using contaminated needles (common among habitual drug abusers), are common modes of transfer. Tattooing and ACUPUNCTURE may spread hepatitis B unless high standards of sterilisation are maintained. Sexual intercourse, particularly between male homosexuals, is a signi?cant infection route.
Hepatitis C (HCV) is a ?avivirus whose source of infection is usually via blood contacts. E?ective screening of blood donors and heat treatment of blood factors should prevent the spread of this infection, which becomes chronic in about 75 per cent of those infected, lasting for life. Although most carriers do not suffer an acute illness, they must practise life-long preventive measures.
Hepatitis D (HDV) cannot survive independently, needing HBV to replicate, so its sources and methods of spread are similar to the B virus. HDV can infect people at the same time as HBV, but it is capable of superinfecting those who are already chronic carriers of the B virus. Acute and chronic infection of HDV can occur, depending on individual circumstances, and parenteral drug abuse spreads the infection. The disease occurs worldwide, being endemic in Africa, South America and the Mediterranean littoral.
Hepatitis E virus (HEV) is excreted in the stools, spreading via the faeco-oral route. It causes large epidemics of water-borne hepatitis and ?ourishes wherever there is poor sanitation. It resembles acute HAV infection and the patient usually recovers. HEV does not cause chronic infection. The clinical characteristics of the ?ve hepatic
viruses are broadly similar. The initial symptoms last for up to two weeks (comprising temperature, headache and malaise), and JAUNDICE then develops, with anorexia, nausea, vomiting and diarrhoea common manifestations. Upper abdominal pain and a tender enlarged liver margin, accompanied by enlarged cervical lymph glands, are usual.
As well as blood tests to assess liver function, there are speci?c virological tests to identify the ?ve infective agents, and these are important contributions to diagnosis. However, there is no speci?c treatment of any of these infections. The more seriously ill patients may require hospital care, mainly to enable doctors to spot at an early stage those developing acute liver failure. If vomiting is a problem, intravenous ?uid and glucose can be given. Therapeutic drugs – especially sedatives and hypnotics – should be avoided, and alcohol must not be taken during the acute phase. Interferon is the only licensed drug for the treatment of chronic hepatitis B, but this is used with care.
Otherwise-?t patients under 40 with acute viral hepatitis have a mortality rate of around
0.5 per cent; for those over 60, this ?gure is around 3 per cent. Up to 95 per cent of adults with acute HBV infection recover fully but the rest may develop life-long chronic hepatitis, particularly those who are immunode?cient (see IMMUNODEFICIENCY).
Infection is best prevented by good living conditions. HVA and HVB can be prevented by active immunisation with vaccines. There is no vaccine available for viruses C, D and E, although HDV is e?ectively prevented by immunisation against HBV. At-risk groups who should be vaccinated against HBV include:
Parenteral drug abusers.
Close contacts of infected individuals such as regular sexual partners and infants of infected mothers.
Men who have sex with men.
Patients undergoing regular haemodialysis.
Selected health professionals, including laboratory sta? dealing with blood samples and products.... hepatitis
Linn. var. saxatillis Palias.
Synonym: J. communis auct. non L.
Family: Pinaceae; Cupressaceae.
Habitat: Native to Europe and North America. Distributed in Western Himalayas from Kumaon westwards at 1,700-4,200 m.
English: Common Juniper.
Ayurvedic: Hapushaa, Havushaa, Haauber, Matsyagandha.
Unani: Abahal, Haauber, Hubb-ul- arar, Aarar.
Action: Berries—diuretic, urinary antiseptic, carminative, digestive, sudorific, anti-inflammatory, emmenagogue. Used for acute and chronic cystitis, renal suppression (scanty micturition), catarrh of the bladder, albuminuria, amenorrhoea, leucorrhoea. Aerial parts—abortifacient.
Key application: In dyspepsia. (German Commission E.) Juniper berry may increase glucose levels in diabetics. (ESCOP.) As a diuretic.(The British Herbal Pharmacopoeia.)The Ayurvedic Pharmacopoeia of India recommends the dried fruit in malabsorption syndrome.Animal studies have shown an increase in urine excretion as well as a direct effect on sooth muscle contraction. (German Commission E, ESCOP.)Con- traindicated in kidney disease. (Sharon M. Herr.)(In Kerala, Hapushaa and Mundi are considered to be synonyms; Syphaer- anthus indicus,Asteraceae, is used as Hapushaa.)The major constituents of the volatile oil are alpha-pinene, sabinene and alpha-terpinene. Methanolic extract of the plant gave several labdane diter- penoids and diterpenes. The leaves contain the biflavones, cupressufla- vone, amentoflavone, hinokiflavone, isocryptomerin and sciadopitysin. The berries also contain condensed tannins. Seeds gave haemagglutinin.Juniperus recurva Buch-Ham ex D. Don, syn. J. excelsa auct. non-Bieb. (temperate Himalaya from Kashmir to Bhutan) is known as Weeping Blue Juniper. J. macropoda Boiss. (the Himalaya from Nepal onwards) is known as Himalayan Indian Juniper. Both the species are used like J. communis var. saxatillis.The berries gave a diterpene ketone, sugrol, beta-sitosterol glucoside and 10-nonacosanol.Plant extract can be used in toothpastes and mouth-rinses to reduce dental plaque and bleeding.
Dosage: Dried fruit—2-6 g powder. (API, Vol. III.)... juniperus communis
Plumbago spp.PlumbaginaceaeThe genus Plumbago belonging to the family Plumbaginaceae is a popular and medicinally very important group of medicinal plants. Three species, namely P. rosea, P. zeylanica and P. auriculata have been identified. Among these P. rosea and P. zeylanica are important ones.Plumbago, in general is an esteemed remedy for leucoderma and other skin diseases. The synonyms of fire like agnih, vahnih, etc. are attributed to this drug to indicate the very burning action of the root, causing blisters on the skin (daranah). The drug is used only after adequate curing and purification. Root is the officinal part and it enters into the composition of preparations like Citrakasavam, Dasamularista, Gulgulutiktaka kasaya, Yogarajachurna, etc.1. P. rosea Linn. syn. P. indica Linn.Eng: Rosy-flowered Leadwort; San: Citrakah, Dhahanah;Hin: Lalcitra, Raktacitra;Ben: Lalchita;Mal: Kotuveli, Chettikkoduveli, Chuvannakotuveli;Tam: Chenkotuveli, Cittiramulam;Kan: Kempacitramula;Tel: YerracitramulamRosy-flowered leadwort or Fire plant is a native of Coromandel Coast. It is found throughout India, in moist situations as well as cultivated. The roots are useful in dyspepsia, colic, inflammations, cough, bronchitis, helmenthiasis, haemorrhoids, elephantiasis, chronic and intermittent fever, leprosy, leucoderma, ringworm, scabies, hepatosplenomegaly, amenorrhoea, odontalgia, vitiated conditions of vata, kapha and anaemia. It is a pretty subscandent perennial shrub with semi -woody striate stems and flexible branches. Leaves are simple, alternate oblong, short cuneate at the base passing into a very short amplexicaul, exauriculate, and reddish petiole. Flowers are bright red, arranged in long terminal spikes. The calyx ribs are covered with stipitate, bifarious and subsessile gland. Corolla tube is slender and four times as long as the calyx. The stout roots are cylindrical, irregularly bent, light yellowish brown with smooth surface having short transverse shallow fissures at the regions of the bents. A light yellowish juice excudes from the cut surface. A healthy plant may produce 18-20 stout roots (Warrier et al, 1995).The chemical constituents include plumbagin and sitosterol glucoside. Clinical trials have demonstrated that plumbagin oil from P. indica is useful in common wart (Satyavati et al, 1987). The roots are acrid, astringent, thermogenic, anthelmintic, constipating, expectorant, antiinflammmatory, abortifacient, alterant, anti-periodic, carminative, digestive, sudorific, narcotic, gastric, nervous stimulant and rejuvenating. Root is a powerful sialogogue and vesicant.2. P. zeylanica Linn.Eng:White flowered Leadwort; San:Chitraka;Hin, Ben:Chitarak, Chitra; Mal:VellakotuveliTam: Sittragam, Chittiramoolam;Kan: Vahini; Mar: Chitraka;Tel: ChitramulamWhite flowered Leadwort or Chitarak is found wild in peninsular India and mostly in West Bengal. Root is used externally in leprosy and other skin diseases or obstinate character, aphthae, abscesses, influenza, piles and anasarca. Juice is used externally in scabies and ulcers. One of the important preparations of Chitrak is “Yograjguggal”, prescribed for arthritis, rheumatism, etc. The other well known preparations are “Chitrak Adivati” and “ Chitraka Haritaki”. In Unani system it is an ingredient of “Aqaruva-i- Kabir”, “Hab Ashkhar”, “Ma’jun Baladur”, “Ma’jun Raig Mahi”, etc. It is a branched undershrub. Roots are long and tuberous. Stem is striate. Leaves are simple, alternate, short petioled, ovate or ovate-oblong, acute with entire or wavy margin, 7x3.8cm and glabrous. Flowers are white, arranged in terminal spikes. Calyx is tubular, glandular-hairy. Corolla tube is slender; limb rotate and 5 lobbed. Stamens are 5 on a disc. Style is slender with 5 stigmatic branches. Fruit is membranous capsule enclosed within the persistent calyx.The roots of P. zeylanica have been exhaustively studied and naphthaquinones have been isolated, namely, plumbagin, 3-chlroplumbagin, droserone (Sidhu et al, 1971; Padhye et al, 1973), 3,3’-biplumbagin(Chitranone), zeylanone and iso-zeylanone and a coumarin, elliptinone (Sankaram et al, 1976, 1979). It also contains 1,2(3)-tetrahydro-3,3’-biplumbagin and plumbazeylanone. The leaf is antirheumatic. Root is appetiser, sudorific, relieves pain, vasicant, diuretic, caustic, antidiarrhoeal and expellent of phlegmatic tumours. Root is uterine stimulant. Root and fruits have antiimplantation activity. Plumbagin induces antiimplantation, has abortifacient and antiovulatory activity and causes selective testicular lesions in dogs. It is also a mitotic inhibitor. In lower concentration it behaves like a spindle, poison but in higher concentration it exhibits radiomimetic, nucleotoxic and cyclotoxic effects. It also has antibacterial, antifungal and anticoagulant activities and shows antagonism to amphetamine hyperactivity in mice.3. P. auriculata Lam. syn. P. capensisEng: Blue flowered Leadwort;Mal: NeelakotuveliThe blue flowered Leadwort is often grown in gardens throughout India (Moos, 1976; Chunekar, 1982; Sharma, 1983). It is a native of Cape Province in South Africa. It is a constituent of many Ayurvedic drugs (KAU, 1991). The plant is a subshrub growing to a height of 1-1.5m. Leaves are elliptic to obovate, 3-4 x 1.5-2cm. Inflorescence is a raceme of length 3-4cm. Corolla is blue to violet. Stamens are 5 in number. Flowers and fruits may be upto 12 in number (Matthew, 1995).Agrotechnology: The plant is grown in tropical to subtropical ecosystems. Warm humid tropical climate is most suited. They come up well in almost all types of deep and well drained soils. It is propagated vegetatively by stem cuttings. Three stem cuttings of size 15cm long are planted in polybags of size 14x10cm. IAA and IBA treatments will improve rooting of cuttings. The land is to be ploughed well. About 4 tonnes of FYM are to be applied, mixed thoroughly and seed bed of size 50cm breadth, 1.5cm height and convenient length are to be prepared. On these beds pits are taken at a distance of 25cm and the rooted plants are transplanted from the polybags. Regular irrigation and weeding are to be carried out. In the second year with the onset of monsoon, seedbeds are again refreshed after adding about 4 tonnes of FYM. At the end of second year tubers are collected. Care should be taken to wear gloves, else the chemical plumbagin present in the roots will cause burning sensation. The collected tubers are washed, tied into bundles and marketed. Plumbago yields about 7-10t tubers/ha with good management (Prasad et al, 1997).... leadwort
Natural or synthetic androgen hormones used as drugs; one of the most important is testosterone. These drugs are used in the treatment of male hypogonadism (underactivity of the testes) to stimulate the development of sexual characteristics.
Androgen drugs are occasionally used to treat certain types of breast cancer. They have been widely used by sportsmen wishing to increase muscle bulk and strength, a practice that is dangerous to health (see steroids, anabolic).
Adverse effects include fluid retention, weight gain, increased blood cholesterol, and, rarely, liver damage. When taken by women, the drugs can cause male characteristics, such as facial hair, to develop.
androgen hormones A group of hormones that stimulate the development of male sexual characteristics.
Androgens are produced by specialized cells in the testes in males and in the adrenal glands in both sexes. The ovaries secrete very small quantities of androgens until the menopause. The most active androgen is testosterone, which is produced in the testes. The production of androgens by the testes is controlled by certain pituitary hormones, called gonadotrophins. Adrenal androgens are controlled by ACTH, another pituitary hormone.
Androgens stimulate male secondary sexual characteristics at puberty, such as the growth of facial hair and deepening of the voice. They have an anabolic effect (they raise the rate of protein synthesis and lower the rate at which it is broken down). This increases muscle bulk and accelerates growth. At the end of puberty, androgens cause the long bones to stop growing. They stimulate sebum secretion, which, if excessive, causes acne. In early adult life, androgens promote male-pattern baldness.
Androgen deficiency may occur if the testes are diseased or if the pituitary gland fails to secrete gonadotrophins. Typical effects include decreased body and facial hair, a high-pitched voice, underdevelopment of the genitalia, and poor muscle development.
Overproduction of androgens may be the result of adrenal disorders (see adrenal tumours; adrenal hyperplasia, congenital), of testicular tumours (see testis, cancer of), or, rarely, of androgensecreting ovarian tumours (see ovary, cancer of).
In men, excess androgens accentuate male characteristics; in boys, they cause premature sexual development.
In women, excess androgens cause virilization, the development of masculine features such as an increase in body hair, deepening of the voice, clitoral enlargement, and amenorrhoea.... androgen drugs
Lam.
Synonym: P. tectorius auct. non Soland ex Parkinson. P. odoratissimus Linn. f.
Family: Pandanaceae.
Habitat: Sea coast of the Indian Peninsula on both sides, and the Andaman Islands.
English: Screw Pine.
Ayurvedic: Ketaka, Ketaki, Suuchikaa pushpaa, Jambuka, Trinshunya, Ketakark, Krakchhada.
Unani: Keoraa.
Siddha/Tamil: Thazhai, Thalay.
Action: Flower—carminative, stomachic, cooling, antiseptic. Used for headache, ulcers, dysuria, scabies and other skin diseases. Root— used for osteoarthritis, leucorrhoea and amenorrhoea; contraindicat- ed during pregnancy. Leaves— used for skin diseases, small pox, scabies, leprosy. The Ayurvedic Pharmacopoeia of India recommends the decoction of the root in abdominal inflammation. Oil and otto—stimulant, antispasmodic, antirheumatic.
The chief constituent of the oil is methyl ether of beta-phenylethyl alcohol. The oil also contains diterpene, d-linalool, phenylethyl acetate, citral, phenylethyl alcohol, ester of phthalic acid, fatty acids and stearoptene.The leaves contain the piperidine alkaloids.
Dosage: Root—29-30 g for decoction (API, Vol. I); flower linctus—25-30 ml. (CCRAS.).... pandanus facicularis
(Mill.) Airy-Shaw.
Synonym: Apium crispum Mill.
Family: Umbelliferae; Apiaceae.
Habitat: Native to Europe, now cultivated throughout India.
English: Parsley.
Unani: Fitraasaaliyum, Karafs-e- Kohi.
Action: Diuretic (used for bladder disorders, painful urination, retention of excess fluid in the tissues), antispasmodic, uterine tonic, emmenagogue, sedative (used for PMS and menopausal hot flushes, also in prostatitis), carminative, expectorant, aperient, antiseptic, anti-inflammatory.
Key application: For flushing out the efferent urinary tract in disorders of the same and in prevention and treatment of kidney gravel. (German Commission E.) Contraindicated in kidney inflammations.The British Herbal Compendium approves the internal use of the herb for flatulent dyspepsia, dysuria and rheumatic conditions.The leaves and roots contain furo- coumarins—psoralen, 5-and 8-meth- oxy psoralen, imperatorin, oxypeuce- danin, iso-pimpinelin. Myristicin has been isolated from the leaf oil. The plant gave flavonoids—apiin, luteolin, apigenin-7-glucoside, luteolin-7-glu- coside among others.Myristicin showed high activity as an inducer of the detoxifying enzyme system, Glutathione S-transferase (GST) in the liver and small intestines of female mice (may be considered as a cancer chemoprotective agent).The flavonoids, particularly api- genin, have been shown to be anti- inflammatory, to inhibit histamine release and to act as a free radical scavenger. Apiole, a constituent of the volatile oil, is reportedly antipyretic and phthalides of the root, seed and leaf are sedative in mice.Both apiole and myristicin exhibit aquaretic and uterine stimulant activity, while sodium retention has been observed. (Natural Medicines Comprehensive Database, 2007.)In homoeopathy, the herb is used for the treatment urinary disorders—sudden urge to urinate with severe pain, dribbling of urine after urination, gleet discharge and for amenorrhoea and neuralgic dysmenorrhoea.... petroselinum crispum
Linn.
Family: Polygonaceae.
Habitat: Throughout India in wet places.
English: Water Pepper, Pepperwort, Smartweed.
Folk: Paakur-muula, Paani-maricha (Bengal).
Action: Haemostatic, astringent, anti-inflammatory, diuretic, lithotriptic, emmenagogue (used as infusion for delayed menses and amenorrhoea), antifungal (root and leaf used externally). Contraindicated during pregnancy.
The herb contains sesquiterpenes, including warburganal and polygodial, in the leaves; polygonal, isodrimeni- nol, isopolygodial and confertifolin in the seeds; and flavonoids including quercetin, kaempferol, isorhamnetin and rhamnesin; polygonolide (an iso- coumarin).Isoquercitrin exhibited significant anti-oxidative activity. Polygodial and warburganal possess significant an- tifungal property. Warburganal also possesses potent cytotoxic and antibiotic activity. (The herb is used against cancer.)
Folk: Muniyaaraa (Bihar), Raani- phool, Macheti, Dubiaa Saaga.
Action: Galactogenic, antidiar- rhoeal. Powdered herb is given in pneumonia.
The whole plant yields 11% tannin. The rootstock contains oxymethylan- thraquinone.Flowers gave oleanolic acid, betulin- ic acid, epi-friedelanol, beta-sitosterol, and flavonoids—quercetin, quercetin- 3-arabinoside and quercetin-3-rutino- side.... polygonum hydropiper
Linn.
Family: Cruciferae; Brassicaceae.
Habitat: Cultivated in Uttar Pradesh, Punjab, Maharashtra and Gujarat.
English: Radish.
Ayurvedic: Muulaka, Laghu- muulaka, Muulakapotikaa, Visra, Shaaleya, Marusambhava. Pods— Sungraa, Singri, Mungraa.
Unani: Muuli, Turb Fajal.
Siddha/Tamil: Mullangi.
Action: Radish—preparations are used in liver, gallbladder and urinary complaints. Green leaves— diuretic and carminative. Seeds— diuretic, purgative, expectorant.
A decoction of dry radish is given orally in piles. Extract of the dry root is given for hiccough, influenza, dysentery, colic and urinary troubles.
Key application: In peptic disorders, especially those related to dyskinesia of the bile ducts; and in catarrhs of the upper respiratory tract. (German Commission E.)The Ayurvedic Pharmacopoeia of India recommends the juice of the whole plant in sinusitis; juice of the root in diseases of the throat and sinusitis; and the seed in amenorrhoea, cough and dyspnoea.The fleshy root and seeds contain trans-4-methyl-thiobutenyl isothio- cyanate glucoside (the pungent principle), cyanidin-5-glucoside-3-sophoro- side, pelargonidin diglycoside, cyani- din diglycoside, 5-methyl-L-cysteine- sulphoxide (methiin), steroidal sa- pogenins and sulphorophene.The enzymes present in the radish are phosphatase, catalase, sucrase, amylase, alcohol dehydrogenase and pyruvic carboxylase.Radish contains caffeic acid and fer- ulic acid which exhibit hepatoprotec- tive and choleretic properties. It contains choline which prevents deposition of fat in liver. Amino acids, or- nithine, citrulline, arginine, glutamic acid and asparatic acid remove toxins from the body and urea acumulation.Radish is a good source of ascorbic acid (15-40 mg/100 g), trace elements include aluminium, barium, lithium, manganese, silicon, titanium, also iodine (upto 18 mcg/100 g) and ascor- bigen.Roots, leaves, flowers and pods are active against Gram-positive bacteria.The seeds are reported to contain a broad spectrum antibiotic, machro- lysin, specific against Mycobacterium tuberculosis. Raphanin, extracted from the seeds, is active against Grampositive and Gram-negative bacteria.A purified basic protein, homologous to nonspecific lipid transfer proteins, from seeds showed antifungal activity.Raphanus caudatus Linn., synonym R. sativus var. caudatus, is known as Rat-Tail Radish.A native to Java, it is cultivated in northern and western India. The root is not used; pods, purple or violet in colour, are consumed for properties attributed to Raphanus sp. These are known as Mungraa or Sungraa.
Dosage: Whole plant-20-40 ml juice; root—15-30 ml juice. (API, Vol. II.) Seed—1-3 g powder. (API, Vol. III.)... raphanus sativus
Linn.
Synonym: R. munjesta Roxb.
Family: Rubiaceae.
Habitat: Throughout India, ascending to an altitude of 3,700 m.
English: Indian Madder, Bengal Madder.
Ayurvedic: Manjishthaa, Vikasaa, Samangaa, Yojanavalli, Kaalameshi- ka, Raktaangi, Raktayashtikaa, Arunaa, Gandira, Jingi.
Unani: Manjeeth.
Siddha/Tamil: Manjitti.
Action: Roots and dried stem— blood purifier, astringent, diuretic, emmenagogue, deobstruent, antidysenteric, antiseptic, alterative.
The Ayurvedic Pharmacopoeia ofIn- dia recommends the use of the dried stem in blood, skin and urinogenital disorders; dysentery; piles, ulcers, inflammations; erysipelas, skin diseases and rheumatism. (Roots, leaves and seeds of R. cordifolia, R. tinctorum and allied species are used in amenorrhoea, liver diseases, gall and spleen complaints.) (Mutagenic and carcinogenic aspects of the drug are under investigation.)It is reported that after oral administration of the root decoction, the urine and bones of the patient show a red tinge.The roots are rich in anthraquinones and their glycosides (around 20), the important ones include purpurin (tri- hydroxy anthraquinone), munjistin (xanthopurpurin-2-carboxylic acid); besides xanthopurpurin, peudopur- purin (purpurin-3-carboxylic acid), free alizarin as well as its glucoside.Whole plant yielded pentacylic tri- terpenic acids—rubicoumaric and ru- bifolic acids.Antitumour cyclic hexapeptides have been isolated from the root (while lucidin is thought to be carcinogenic).The root extracts of R. sikkimensis Kurz, known as Naaga-Madder (Nepal eastwards to Assam, Nagaland and Ma- nipur); are very similar to those of R. cordifolia.
Dosage: Stem—2-4 g. (API, Vol. III.)... rubia cordifolia
Linn.
Synonym: S. orientale Linn.
Family: Pedaliaceae.
Habitat: Uttar Pradesh, Madhya Pradesh, Rajasthan, Orissa, Gujarat, Andhra Pradesh, Tamil Nadu, and Maharashtra.
English: Sesame, Gingelly.
Ayurvedic: Tila, Snehphala.
Unani: Kunjad, Til.
Siddha: Ellu (seed), Nallennai (oil).
Action: Seeds—an important source of protein; also rich in thiamine and niacine. Nourishing, lactagogue, diuretic, laxative, emollient. Powdered seeds—given internally in amenorrhoea and dysmenorrhoea. (Black seeds are preferred in Indian medicine.) Paste is applied to burns, scalds, piles. Leaves—used in affections of kidney and bladder. Bland mucilage is used in infantile diarrhoea, dysentery, catarrh and bladder troubles, acute cystitis and strangury.
Non-saponifiable fraction of the seed oil gave sterols, a lignans, sesamin and a nitrolactone, sesamolin. Sesamin and sesamolin are not found in any other vegetable oil. Sesamin is present in a concentration of 0.5 to 1.0%. The oil from the white seeds from West Bengal and Assam is reported to contain about 2.5% sesamin. Sesamol, a phenolic antioxidant, is present in traces.The leaves gave a flavonoid, pedalin. Pinoresinol has also been reported from the plant.The seed contains thiamine, niacin, riboflavin, nicotinic acid, pantothenic acid, folic acid, biotin, pyridoxine, in- ositol, choline, p-aminobenzoic acid, ascorbic acid, vitamin A, alpha-and beta-tocopherol. Sugars present are glucose, surcose, galactose, planteose, raffinose. Fatty acid in the seed are myristic, palmitic, stearic, arachidic, hexadecenoic, oleic, linoleic and lig- noceric.Basic aroma compounds of the roasted seeds consisted of mainly dimethyl thiazole and substituted pyrozines.
Dosage: Seed—5-10 g powder. (API, Vol. IV.)... sesamum indicum
Linn.
Family: Aizoaceae.
Habitat: South India, Gujarat, Rajasthan, Uttar Pradesh and Haryana.
Ayurvedic: Varshaabhu (related species).
Siddha/Tamil: Vellai Sharunnai.
Folk: Bisakhaparaa.
Action: Root—deobstruent; used for asthma, hepatitis and amenorrhoea. The root, leaf and stem gave positive test for alkaloid. The plant is a good source of zinc (1.077 ± 0.188) and copper (0.416 ± 0.057) mg/100 g.
Synonym: T. monogyna Linn.
Family: Aizoaceae.
Habitat: Cultivated fields and wastelands.
English: Horse Purslane.
Ayurvedic: Varshaabhu, Vrshchira, Vishakharparikaa, Shilaatikaa, Shothaghni, Kshdra. Wrongly equated with Shveta-punarnavaa or Rakta-punarnavaa. Varshaabhu and Punarnavaa are two different herbs. T. portulacastrum is a rainy season annual. Rakta-punarnavaa is equated with Boerhavia diffusa, Shveta-punarnavaa with white- flowered species, B. erecta L. (B. punarnava).
Unani: Biskhaparaa.
Siddha: Sharunai.
Folk: Pathari, Bisakhaparaa.
Action: Root—antipyretic, analgesic, spasmolytic, deobstruent, cathartic, anti-inflammatory.
Leaves—diuretic; used in oedema and dropsy. A decoction of the herb is used as an antidote to alcoholic poison.The Ayurvedic Pharmacopoeia ofIn- dia recommends the dried root in diseases of the liver and spleen, anaemia and oedema.Ethanolic extract of the aerial parts exhibited hepatoprotective activity in CCl4-induced intoxication in rats. The acetone-insoluble fraction of the extract is responsible for the activity.The red and white flowers contain an alkaloid trianthemine, also punaranavine. The plant also gave ecdysterone (0.01 g/kg), a potential chemosterilant; nicotinic acid and ascorbic acid. The plant is rich in phosphorus and iron but poor in calcium.The high content of oxalate affects the assimilation of calcium. Carotene (2.3 mg/100 g) has also been reported.Trianthema sp. are used as adulterant of the roots of Boerhavia diffusa.
Dosage: Root—2-5 g powder. (API, Vol. IV.)... trianthema portulacastrum
Acorus calamusAraceaeSan: Vaca, Ugragandha, Bhadra;Hin: Bacc, Gorbacc;Ben: Bach; Mal:Vayampu;Tam: Vasampu;Kan: Bajai;Tel: Vasa VadajaImportance: The sweet flag is an important medhya drug, capable of improving memory power and intellect. It is used in vitiated conditions of vata and kapha, stomatopathy, hoarseness, colic, flatulence, dyspepsia, helminthiasis, amenorrhoea, dismenorrhoea, nephropathy, calculi, strangury, cough, bronchitis, odontalgia, pectoralgia, hepatodynia, otalgia, inflammations, gout, epilepsy, delirium, amentia, convulsions, depression and other mental disorders, tumours, dysentery, hyperdipsia, haemorrhoids, intermittent fevers, skin diseases, numbness and general debility. It is reportedly useful in improving digestion, clearing speech and curing diarrhoea, dysentery, abdominal obstruction and colic. It is also useful in infantile fever, cough bronchitis and asthma. The drug is reported to cure hysteria, insanity and chronic rheumatic complaints. The rhizome is an ingredient of preparations like Vacaditaila, Ayaskrti, Kompancadi gulika, Valiya rasnadi kashaya, etc.Distribution: The plant is a native of Europe. It is distributed throughout the tropics and subtropics, especially in India and Sri Lanka. It is found in marshes, wild or cultivated, ascending the Himalayas upto 1800m in Sikkim. It is plentiful in marshy tracts of Kashmir and Sirmoor, in Manipur and Naga Hills.Botany: Acorus calamus Linn. belonging to the family Araceae is a semi -aquatic rhizomatous perennial herb. Rhizome is creeping, much branched, cylindrical or slightly compressed, light brown or pinkish brown externally, white and spongy within. Leaves are bright green, distichous, ensiform, base equitant, thickened in the middle and with wavy margins. Flowers are light brown and densely packed in sessile cylindric spadix. Fruits are oblong, turbinate berries with a pyramidal top. Seeds are few and pendant from the apex of the cells (Warrier et al, 1993).Another species belonging to the genus Acorus is A. gramineus Soland, the roots of which are used in tonic, antiseptics and insecticidal preparations (Chopra et al, 1956).Agrotechnology: Acorus is a hardy plant found growing from tropical to subtropical climates. It needs a good and well distributed rainfall throughout the year. It needs ample sunlight during the growth period as well as after harvest for drying the rhizomes. It may be cultivated in any good but fairly moist soil. It is usually grown in areas where paddy can be grown. It comes up well in clayey soils and light alluvial soils of river bank. The field is laid out and prepared exactly as for rice, irrigated sufficiently and after ploughing twice, watered heavily and again ploughed in the puddle. Sprouted rhizome pieces are used for planting and pressed into the mud at a depth of about 5cm at a spacing of 30x30cm. The rhizomes are planted in such a way that the plants in the second row comes in between the plants of the first row and not opposite to them. FYM is to be applied at 25t/ha. Fertilisers are applied at 25:50:60 kg N:P2O5:K2O/ha/yr. Whole of FYM and 1/3 of N, P2O5 and K2O are to be added in the field during March - April as a basal dose. The remaining 2/3 of nutrients is to be given in two equal split doses at 4 months and 8 months after planting. The field is to be regularly irrigated. About 5 cm of standing water is to be maintained in the field in the beginning. Later, it is to be increased to 10 cm as the plant grows. The field is to be regularly weeded. About 8 weedings are to be carried out in all. At each weeding the plants are pressed into the soil. The plant is attacked by mealy bugs. Both shoot and root mealy bugs can be controlled by spraying the shoot and drenching the roots of grown up plants with 10 ml Methyl parathion or 15ml Oxydemeton methyl or 20ml Quinalphos in 10 litres of water. The crop is ready for harvest at the end of first year. The field is to be dried partially so that sufficient moisture is left in the soil to facilitate deep digging. The leaves start turning yellow and dry, indicating maturity. The rhizome will be at a depth of 60cm and having about 30-60cm spread. Therefore, harvesting is to be done carefully. The rhizomes are to be cut into 5-7.5cm long pieces and all the fibrous roots are to be removed. Yield of rhizome is about 10t/ha (Farooqi et al, 1991).Properties and Activity:Rhizomes, roots and leaves yield essential oil. The important constituents of the Indian oil are asarone and its -isomer. Other constituents are and -pinene, myrcene, camphene, p-cymene, camphor and linalool, sesquiterpenic ketones like asarone, calamone, calacone, acolamone, iso-acolamone, acoragermacrone, epishyobunone, shyobunone and iso- shyobunone. Alcohol present is preisocalamendiol. Sesquiterpene hydrocarbons like elemene, elemane and calarene are also present. Tricyclic sesquiterpenes present are caryophyllene, humulene, guaiene, S-guaizulene, arcurcumene, -cadinene, cadinane, calamenene, calacorene, dihydrocalacorene(calamenene), cadalene and selinene. Roots yield acoric acid as a main constituent in addition to choline. Plant also yields a flavone diglycoside- luteolin 6,8-C-diglucoside.-asarone is the ma jor constituent of essential oil from rhizome (Dandiya et al, 1958,1959; Raquibuddoula, 1967).Rhizome is insecticidal, pisicidal, spasmolytic, hypothermic, CNS active and analgesic. Essential oil is anticonvulsant. Rhizome is acrid, bitter, thermogenic, aromatic, intellect promoting, emetic, laxative, carminative, stomachic, anthelmintic, emmenagogue, diuretic, alexeteric, expectorant, anodyne, antispasmodic, aphrodisiac, antiinflammatory, sudorific, antipyretic, sialagogue, insecticidal, tranquillizer, sedative, analgesic, antithermic, antiasthmatic, hypotensive, respiratory depressant, aperitive and tonic.... sweet flag
Linn.
Synonym: V. malabarica Bl.
Family: Dipterocarpaceae.
Habitat: Peninsular India, from Kanara to Trivandrum and in Coorg.
English: White Damar, Indian Copal-Tree, Malabar Tallow tree, Piney Varnish-Tree.
Ayurvedic: Sarja, Sarjaka, Karsya, Sasyasumbara, Devdhuupa, Marich-patraka. Chhaagakar- na. Ajakarna and Shaala (related species) are also equated with V indica.
Unani: Raal.
Siddha/Tamil: Kungiliyam, Vellai Kundarakam.
Action: Resin—astringent, antibacterial, antidiarrhoeal, emmena- gogue. Used for chronic bronchitis, piles, skin eruptions, ringworm, scrofula, tubercular glands, ulcers, wounds, boils; urinary discharges; amenorrhoea; gonorrhoea and syphilis. Bark—antidysenteric. Oil and resin—antirheumatic. Resin enters into a number of antiseptic and anti-inflammatory ointments. Leaves—juice is applied to cure burns. Orally administered to prevent vomiting.
The Ayurvedic Pharmacopoeia ofIn- dia recommends the resinous exudate internally (1-2 g) in lipid disorders, anaemia, genitourinary diseases, diarrhoea and diseases due to vitiated blood; externally in gout, abscesses, skin diseases, burns, eruptions.The bark contains polyphenols—dl- epi-catechin, levorotatory isomers of fisetinidol, fzelechin; and bergenin.Resin is a complex mixture of several triterpene hydrocarbons, ketones, alcohols and acids, along with small amounts of sesquiterpenes. On distillation, the oleoresin gave an essential oil (76%), consisting of phenolic constituents and azulenes. The essential oil shows marked antibacterial activity against Gram-positive and Gramnegative micro-organism.The leaves and roots contain berge- nin and hope phenol. The seed also contain bergenin. Hope phenol showed fungicidal activity. The plant exhibited anti-ulcerogenic activity in rats.The fruit shell contains 25% tannins.
Dosage: Resinous exudate—1-2 g (API, Vol. IV.)... vateria indica
Chaste tree. Vitex agnus castus L. Part used: dried ripe fruits.
Contains aucubin and agnuside (iridoid glycosides), flavonoids, castin (bitter), fatty and ethereal oils. Action: acts on the anterior pituitary gland, reducing FSH (follicle-stimulating-hormone) and increasing LSH (luteum-stimulating-hormone). Stimulates production of progesterone but reducing that of oestrogen. “Has a corpus luteum hormone effect” (Dr Weiss 1974 322. New herbal Practitioner, March 1977). Alternative to hormone replacement therapy (HRT).
Uses: Symptoms caused by excess FSH and low progesterone output. used as substitution therapy for primary and secondary corpus luteum deficiency. Pre-menstrual symptoms, especially nervous tension, irritability, mood-swings, depression, anxiety, crying, forgetfulness, insomnia. Amenorrhoea (by regulating sex hormones). Pain in breasts. To promote breast milk in nursing mothers; assist bust development. Acne vulgaris (to restore sex hormone balance). Water-retention (pre-menstrual) caused by oestrogen excess or progesterone deficiency. “Regular bleeding between periods decreased following temporary increase” (Dr W. Amann, Bundesanzeiger, No 90, 15/5/1985). Premature old age from sexual excess and masturbation. Agnus lowers sexual vitality; reduces nervous excitability. By opposing excess oestrogen it lessens the risk, however small, of endometrial carcinoma. For symptoms of the menopause and of withdrawal on giving-up The Pill.
Preparations: Extracts made from crushed roots.
Tablets: 300mg; 2 tablets after meals thrice daily.
Liquid Extract: 1:1 in 25% alcohol. Dose: 2-4ml.
Caution: Not taken in the presence of progesterone drugs.
Contra-indications and interaction with other drugs: None known.
Tincture: 10-20 drops daily morning dose during second half of menstrual cycle. ... agnus castus
LOSS OF. Anorexia. Due to one of many causes including: kidney, liver or heart disorder, coeliac disease, adrenal insufficiency, glandular disorder, indigestion, hepatitis, vitamin deficiencies, pernicious anaemia, infection (influenza, colds), emotional conflict, thread-worms, anxiety, stress. Refer to entry of relevant disorder. Where due to absence of menses: see AMENORRHOEA.
Alternatives: before meals, thrice daily.
Teas. Alfalfa, Agrimony, Balm, Balmony, Bogbean, Calamus, Calumba, Caraway, Centuary, Chamomile, Coriander seeds, Dandelion, Fenugreek seeds, Garlic, Galangal, Gentian, Ginger, Goldenseal, Milk Thistle, Horseradish, Mugwort (where linked with menstrual disorders), Peruvian bark, Quassia, Sage, Southernwood, Wormwood.
Tea mixture. Formula. Equal parts: Agrimony, Balm, Chamomile. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup.
Decoction. 1 teaspoon Gentian root to each cup cold water. 1 cup.
Powders. Formula. Equal parts: Gentian, German Chamomile. Dose: 750mg (three 00 capsules or half a teaspoon).
Liquid Extract. Goldenseal BPC 1949: 5-15 drops.
Tincture Gentian BHP (1983). 15-60 drops.
Diet. Wholefood.
Supplements. Vitamin B-group. Zinc. ... appetite
Juniperus communis L. German: Wacholder. French: Genie?vre. Spanish: Junipero. Italian: Ginepro. Chinese: Kuli. Iranian: Abhala. Arabian: Habul hurer. Indian: Hanbera. Dried ripe berries. Keynotes: kidney and bladder.
Constituents: volatile oil, resin, grape sugar, diterpene acids, tannins, Vitamin C.
Action: urinary antiseptic, stimulating diuretic, digestive tonic, emmenagogue, parasiticide (externally), carminative, sudorific. The action of gin as a diuretic is due to oil expressed from the berries. Anti- diabetic (unconfirmed).
Uses: Cystitis, renal suppression (scanty micturition), catarrh of the bladder, proteinuria (albuminuria). Digestive weakness caused by poor secretion of gastric juices, flatulence. Aching muscles due to excess lactic acid. Amenorrhoea.
External. Aromatherapy for gout: lotion for joints. As an ingredient of massage oils for rheumatism and arthritis. Cirrhosis of the liver: upper abdominal massage.
Combination: Parsley Piert enhances action in bladder disorders. Combines well with Wild Carrot and Hydrangea for stone.
Preparations: Thrice daily, or as prescribed.
Tea: half-1 teaspoon crushed berries to each cup boiling water; infuse 30 minutes. Half-1 cup.
Tablets/capsules. 250mg. 1-2.
Tincture BHP (1983): 1 part to 5 parts 45 per cent alcohol. 1-2ml.
Basis of Martini and gin (gin and tonic).
Oil: 5-6 drops in honey after meals.
Aromatherapy. 3-6 drops in two teaspoons Almond oil or other base oil, for massage. Precaution. Not used internally without a break for every two weeks. Contra-indicated: pregnancy, Bright’s disease. ... juniper berries
Apium graveolens
FAMILY: Apiaceae (Umbelliferae)
SYNONYM: Celery fruit.
GENERAL DESCRIPTION: A familiar biennial plant, 30–60 cms high, with a grooved, fleshy, erect stalk, shiny pinnate leaves and umbels of white flowers.
DISTRIBUTION: Native to southern Europe; extensively cultivated as a domestic vegetable. The oil is principally produced in India, and also Holland, China, Hungary and the USA.
OTHER SPECIES: There are many cultivated varieties, such as celeriac root (A. graveolens var. rapaceum) and the salad vegetable (A. graveolens var. dulce).
HERBAL/FOLK TRADITION: Celery seed is widely used as a domestic spice. The seed is used in bladder and kidney complaints, digestive upsets and menstrual problems; the leaves are used in skin ailments. It is known to increase the elimination of uric acid and is useful for gout, neuralgia and rheumatoid arthritis. A remedy for hepatobiliary disorders, it has been found to have a regenerating effect on the liver.
Current in the British Herbal Pharmacopoeia as a specific for rheumatoid arthritis with mental depression.
ACTIONS: Anti-oxidative, antirheumatic, antiseptic (urinary), antispasmodic, aperitif, depurative, digestive, diuretic, carminative, cholagogue, emmenagogue, galactagogue, hepatic, nervine, sedative (nervous), stimulant (uterine), stomachic, tonic (digestive).
EXTRACTION: Essential oil by steam distillation from the whole or crushed seeds. (An oil from the whole herb, an oleoresin and extract are also produced in small quantities.)
CHARACTERISTICS: A pale yellow or orange oil with a spicy-warm, sweet, long-lasting odour. It blends well with lavender, pine, opopanax, lavage, tea tree, oakmoss, coriander and other spices.
PRINCIPAL CONSTITUENTS: Limonene (60 per cent), apiol, selinene, santalol, sedanolide and sedanolic acid anhydride, among others.
SAFETY DATA: Non-toxic, non-irritant, possible sensitization. Avoid during pregnancy.
AROMATHERAPY/HOME: USE
Circulation Muscles And Joints: Arthritis, build-up of toxins in the blood, gout, rheumatism.
Digestive System: Dyspepsia, flatulence, indigestion, liver congestion, jaundice.
Genito-Urinary And Endocrine Systems: Amenorrhoea, glandular problems, increases milk flow, cystitis.
Nervous System: Neuralgia, sciatica.
OTHER USES: Used in tonic, sedative and carminative preparations, and as a fragrance component in soaps, detergents, cosmetics and perfumes. Extensively used as a flavouring agent in foods, especially by the spice industry, and in alcoholic and soft drinks.... celery seed
Ormenis multicaulis
FAMILY: Asteraceae (Compositae)
SYNONYMS: O. mixta, Anthemis mixta, Moroccan chamomile.
GENERAL DESCRIPTION: A handsome plant, 90 to 125 cms high with very hairy leaves and tubular yellow flowers, surrounded by white ligulets.
DISTRIBUTION: Native to north west Africa and southern Spain, having probably evolved from the very common Ormenis species which grows all around the Mediterranean. Also found growing on the plains in Israel. The oil is distilled in Morocco.
OTHER SPECIES: It is distantly related to the German and Roman chamomile botanically, although it does not resemble them physically.
HERBAL/FOLK TRADITION: This is one of the more recent oils to appear on the market, and as such it does not have a long history of usage. The oil is often mistaken for a ‘true’ chamomile, though it should more correctly be called ‘Ormenis oil’ since: ‘Chemically and olfactorily, the oil is distinctly different from the German or the Roman chamomile oils, and cannot be considered as a replacement for them.’.
ACTIONS: Antispasmodic, cholagogue, emmenagogue, hepatic, sedative.
EXTRACTION: Essential oil by steam distillation from the flowering tops.
CHARACTERISTICS: Pale yellow to brownish yellow mobile liquid with a fresh-herbaceous top note and a sweet rich-balsamic undertone. It blends well with cypress, lavender, lavandin, vetiver, cedarwood, oakmoss, labdanum, olibanum and artemisia oils.
PRINCIPAL CONSTITUENTS: Unknown.
SAFETY DATA: Generally non-toxic and non-irritant – more specific safety data is unavailable at present.
AROMATHERAPY/HOME: USE ‘Sensitive skin, colic, colitis, headache, insomnia, irritability, migraine, amenorrhoea, dysmenorrhoea, menopause, liver and spleen congestion.’. Little is known about its therapeutic history and usage.
OTHER USES: Employed extensively in perfumery work, especially in colognes, chypres and fougère fragrance.... chamomile, maroc
(Rokitansky–Küster–Hauser syndrome, Müllerian agenesis) congenital absence of the uterus and upper part of the vagina due to failure of development of the *Müllerian duct. It may be associated with skeletal, renal, and auditory abnormalities, but usually presents with amenorrhoea in a patient with otherwise normal secondary sexual characteristics. There is a multidisciplinary approach to treatment, with psychological support, counselling, discussion of creation of a ‘neovagina’ with gradual use of vaginal dilators, and/or surgical vaginal reconstruction. Surrogacy is the only option for childbearing, although oocyte donation from the mother to a surrogate can be discussed. [K. W. Mayer (1795–1868), German gynaecologist; K. von Rokitansky (1804–78), Austrian pathologist; H. Küster and G. A. Hauser (20th century), German gynaecologists]... mayer–rokitansky–küster–hauser syndrome
(climacteric) n. the time in a woman’s life when the ovaries cease to produce an egg cell every four weeks: menstruation ceases and the woman is no longer able to bear children. The menopause can occur at any age between the middle thirties and the middle fifties, most commonly between 45 and 55 (the median age is 51). Natural menopause can only be established in retrospect after 12 consecutive months of *amenorrhoea. Around the time of the menopause (the perimenopause) there are marked changes in the menstrual cycle. Menstruation may decrease gradually in successive periods or the intervals between the periods may lengthen; alternatively there may be a sudden and complete stoppage of the periods. There is a change in the balance of sex hormones in the body, which sometimes leads to hot flushes and other *vasomotor symptoms, palpitations, and dryness of the mucous membrane lining the vagina. Some women may also experience emotional disturbances. Some of these symptoms may be alleviated by *hormone replacement therapy. The term ‘menopause’ is also used for the postmenopausal period. See also postmenopausal bleeding. —menopausal adj.... menopause
(PCOS, Stein–Leventhal syndrome) a heterogeneous disorder characterized by *hyperandrogenism (clinical hirsutism, biochemical hyperandrogenism, or both) and ovarian dysfunction (with *polycystic ovaries), which results in amenorrhoea or oligomenorrhoea (absent or infrequent menstrual periods) and is associated with subfertility (from lack of ovulatory menstrual cycles). The condition is associated with obesity and *insulin resistance, which increase the risk of type 2 *diabetes mellitus, endometrial cancer, and cardiovascular disease. Treatment is based on dietary and exercise advice, *metformin, hormones to regulate the menstrual cycle, and in cases of subfertility, *clomifene to induce ovulation; the hyperandrogenism usually responds to *anti-androgens.... polycystic ovary syndrome
Daucus carota
FAMILY: Apiaceae (Umbelliferae)
SYNONYMS: Wild carrot, Queen Anne’s lace, bird’s nest.
GENERAL DESCRIPTION: Annual or biennial herb, with a small, inedible, tough whitish root. It has a much-branched stem up to 1.5 metres high with hairy leaves and umbels of white lacy flowers.
DISTRIBUTION: Native to Europe, Asia and North Africa; naturalized in North America. The essential oil is mainly produced in France.
OTHER SPECIES: An oil is also produced by solvent extraction from the red fleshy root of the common edible carrot (D. carota subspecies sativus) mainly for use as a food colouring.
HERBAL/FOLK TRADITION: A highly nutritious plant, containing substantial amounts of Vitamins A, C, B1 and B2. The roots have a strong tonic action on the liver and gall bladder, good for the treatment of jaundice and other complaints. The seeds are used for the retention of urine, colic, kidney and digestive disorders, and to promote menstruation. In the Chinese tradition it is used to treat dysentery and to expel worms.
The dried leaves are current in the British Herbal Pharmacopoeia for calculus, gout, cystitis and lithuria.
ACTIONS: Anthelmintic, antiseptic, carminative, depurative, diuretic, emmenagogue, hepatic, stimulant, tonic, vasodilatory and smooth muscle relaxant.
EXTRACTION: Essential oil by steam distillation from the dried fruit (seeds).
CHARACTERISTICS: A yellow or amber-coloured liquid with a warm, dry, woody-earthy odour. It blends well with costus, cassie, mimosa, cedarwood, geranium, citrus and spice oils.
PRINCIPAL CONSTITUENTS: Pinene, carotol, daucol, limonene, bisabolene, elemene, geraniol, geranyl acetate, caryophyllene, among others.
SAFETY DATA: Non-toxic, non-irritant, non-sensitizing.
AROMATHERAPY/HOME: USE
Skin Care: Dermatitis, eczema, psoriasis, rashes, revitalizing and toning, mature complexions, wrinkles.
Circulation Muscles And Joints: Accumulation of toxins, arthritis, gout, oedema, rheumatism.
Digestive System: Anaemia, anorexia, colic, indigestion, liver congestion.
Genito-Urinary And Endocrine Systems: Amenorrhoea, dysmenorrhoea, glandular problems, PMT.
OTHER USES: Fragrance component in soaps, detergents, cosmetics and perfumes. Flavour ingredient in most major food categories, especially seasonings.... carrot seed
Foeniculum vulgare
FAMILY: Apiaceae (Umbelliferae)
SYNONYMS: F. officinale, F. capillaceum, Anethum foeniculum, fenkel.
GENERAL DESCRIPTION: Biennial or perennial herb up to 2 metres high, with feathery leaves and golden yellow flowers. There are two main varieties of fennel: bitter or common Fennel, slightly taller with less divided leaves occurring in a cultivated or wild form and sweet fennel (also known as Roman, garden or French fennel) which is always cultivated.
DISTRIBUTION: Bitter fennel is native to the Mediterranean region, found growing wild in France, Spain, Portugal and North Africa (they produce the ‘weed’oil). It is cultivated extensively worldwide, the main oil producers being Hungary, Bulgaria, Germany, France, Italy and India.
Sweet fennel is thought to have originated on the island of Malta, having been introduced by monks or crusaders thousands of years ago. It is now grown principally in France, Italy and Greece.
OTHER SPECIES: Bitter fennel (F. vulgare var. amara) and sweet fennel (F. vulgare var. dulce) are both closely related to the Florence fennel (F. azoricum), a smaller plant with a large cylindrical fleshy root which can be eaten as a vegetable. There are also many other cultivated varieties such as the German or Saxon fennel, the Russian, Indian and Japanese fennel, all of which produce slightly different oils.
HERBAL/FOLK TRADITION: A herb of ancient medical repute, believed to convey longevity, courage and strength. It was also used to ward off evil spirits, strengthen the eyesight and to neutralize poisons. In eastern and western herbalism it is considered good for obstructions of the liver, spleen and gall bladder and for digestive complaints such as colic, indigestion, nausea and flatulence (an ingredient of children’s ‘gripe water’).
It has traditionally been used for obesity, which may be due to a type of oestrogenic action, which also increases the milk of nursing mothers. Still current in the British Herbal Pharmacopoeia, used locally for conjunctivitis, blepharitis and pharyngitis.
ACTIONS: Aperitif, anti-inflammatory, antimicrobial, antiseptic, antispasmodic, carminative, depurative, diuretic, emmenagogue, expectorant, galactagogue, laxative, orexigenic, stimulant (circulatory), splenic, stomachic, tonic, vermifuge.
EXTRACTION: Essential oil by steam distillation. 1. Sweet fennel oil is obtained from crushed seeds, and 2. bitter fennel oil from crushed seeds or the whole herb (the wild ‘weed’).
CHARACTERISTICS: 1. A colourless to pale yellow liquid with a very sweet, anise-like, slightly earthy-peppery scent. It blends well with geranium, lavender, rose and sandalwood. 2. The seed oil is a pale yellow liquid with a sharp, warm camphoraceous odour; the ‘weed’ oil is pale orange-brown with a sharp, peppery-camphoraceous odour.
PRINCIPAL CONSTITUENTS: Anethole (50–60 per cent), limonene, phellandrene, pinene, anisic acid, anisic aldehyde, camphene, limonene, among others. In addition, bitter fennel oil contains 18–22 per cent fenchone, whereas the sweet fennel oil contains little or none.
SAFETY DATA: Non-irritant, relatively non-toxic, narcotic in large doses; bitter fennel may cause sensitization in some individuals. Sweet fennel oil is preferred in aromatherapy and perfumery work, since it does not contain the harsh ‘fenchone’ note, and because it is non-sensitizing. Bitter fennel oil should not be used on the skin at all, although it is considered superior medicinally. Neither oil should be used by epileptics or during pregnancy. Use in moderation.
AROMATHERAPY/HOME: USE Bitter fennel – none.
Sweet fennel:
Skin Care: Bruises, dull, oily, mature complexions, pyorrhoea.
Circulation Muscles And Joints: Cellulitis, obesity, oedema, rheumatism.
Respiratory System: Asthma, bronchitis.
Digestive System: Anorexia, colic, constipation, dyspepsia, flatulence, hiccough, nausea.
Genito-Urinary System: Amenorrhoea, insufficient milk (in nursing mothers), menopausal problems.
OTHER USES: In pharmaceutical products it is known as ‘codex’ fennel oil, used in cough drops, lozenges, etc; also used in carminative and laxative preparations. Extensively used as a flavour ingredient in all major food categories, in soft drinks and especially in alcoholic drinks such as brandy and liqueurs. Fennel oil (mainly sweet) is used in soaps, toiletries and perfumes. It also provides a good masking agent for industrial products, room sprays, insecticides, etc.... fennel
Humulus lupulus
FAMILY: Moraceae
SYNONYMS: Common hop, European hop, lupulus.
GENERAL DESCRIPTION: Perennial creeping, twining herb up to 8 metres high, which bears male and female flowers on separate plants. It has dark green, heart-shaped leaves and greeny yellow flowers. A volatile oil, called lupulin, is formed in the glandular hairs of the cones or ‘strobiles’.
DISTRIBUTION: Native to Europe and North America; cultivated worldwide, especially in the USA (California and Washington), Yugoslavia and Germany. The oil is mainly produced in France, UK and Germany.
OTHER SPECIES: Related to the common stinging nettle (Urtica dioica) and to the fig (Ficus carica).
HERBAL/FOLK TRADITION: Best known as a nerve remedy, for insomnia, nervous tension, neuralgia, and also for sexual neurosis in both sexes. It supports the female oestrogens, and is useful for amenorrhoea (heavy periods). ‘A mild sedative, well known in the form of the hop pillow where the heavy aromatic odour has been shown to relax by direct action at the olfactory centres … it is the volatile aromatic component that appears to be the most active.’. It has also been used for heart disease, stomach and liver complaints, including bacterial dysentery.
In China it is used for pulmonary tuberculosis and cystitis. It is used to make beer. Current in the British Herbal Pharmacopoeia as a specific for restlessness with nervous headaches and/or indigestion.
ACTIONS: Anodyne, an aphrodisiac, antimicrobial, antiseptic, antispasmodic, astringent, bactericidal, carminative, diuretic, emollient, oestrogenic properties, hypnotic, nervine, sedative, soporific.
EXTRACTION: Essential oil by steam distillation from the dried cones or catkins, known as ‘strobiles’. (An absolute is also produced by solvent extraction for perfumery use.)
CHARACTERISTICS: A pale yellow to reddish-amber liquid with a rich, spicy-sweet odour. It blends well with pine, hyacinth, nutmeg, copaiba balsam, citrus and spice oils.
PRINCIPAL CONSTITUENTS: Mainly humulene, myrcene, caryophyllene and farnesene, with over 100 other trace components.
SAFETY DATA: Generally non-toxic (narcotic in excessive amounts) and non-irritant; may cause sensitization in some individuals. Should be avoided by those suffering from depression.
AROMATHERAPY/HOME: USE
SKIN CARE: Dermatitis, rashes, rough skin, ulcers.
RESPIRATORY SYSTEM: Asthma, spasmodic cough.
DIGESTIVE SYSTEM: Indigestion, nervous dyspepsia.
GENITO-URINARY AND ENDOCRINE SYSTEMS: Amenorrhoea, menstrual cramp, supports female oestrogens, promotes feminine characteristics, reduces sexual overactivity.
NERVOUS SYSTEM: Headaches, insomnia, nervous tension, neuralgia, stress-related conditions.
OTHER USES: Employed as a fragrance ingredient in perfumes, especially spicy or oriental types. Used in flavour work in tobacco, sauces and spice products, but mainly in alcoholic drinks, especially beer.... hops
Hyssopus officinalis
FAMILY: Lamiaceae (Labiatae)
SYNONYM: Azob.
GENERAL DESCRIPTION: An attractive perennial, almost evergreen subshrub up to 60 cms high with a woody stem, small, lance-shaped leaves and purplish-blue flowers.
DISTRIBUTION: Native to the Mediterranean region and temperate Asia; now grows wild throughout America, Russia and Europe. It is mainly cultivated in Hungary and France, and to a lesser degree in Albania and Yugoslavia.
OTHER SPECIES: There are four main subspecies of hyssop, but H. officinalis is the main oil producing variety. The species H. officinalis var. decumbens is less toxic than many other types, and well suited to aromatherapy use. To be distinguished from hedge hyssop (Gratiola officinalis) which is still used in herbal medicine but belongs to an entirely different family.
HERBAL/FOLK TRADITION: Although hyssop is mentioned in the Bible, it probably does not refer to this herb but to a form of wild marjoram or oregano, possibly Oreganum syriacum. Nevertheless H. officinalis has an ancient medical reputation and was used for purifying sacred places, and employed as a stewing herb. ‘The healing virtues of the plant are due to a particular volatile oil.’.
It is used principally for respiratory and digestive complaints, and externally for rheumatism, bruises, sores, earache and toothache. It is also used to regulate the blood pressure, as a general nerve tonic, and for states of anxiety or hysteria. It is current in the British Herbal Pharmacopoeia as a specific for bronchitis and the common cold.
ACTIONS: Astringent, antiseptic, antispasmodic, antiviral, bactericidal, carminative, cephalic, cicatrisant, digestive, diuretic, emmenagogue, expectorant, febrifuge, hypertensive, nervine, sedative, sudorific, tonic (heart and circulation), vermifuge, vulnerary.
EXTRACTION: Essential oil by steam distillation from the leaves and flowering tops.
CHARACTERISTICS: A colourless to pale yellowy-green liquid with a sweet, camphoraceous top note and warm spicy herbaceous undertone. It blends well with lavender, rosemary, myrtle, bay leaf, sage, clary sage, geranium and citrus oils.
PRINCIPAL CONSTITUENTS: Pinocamphone, isopinocamphone, estragole, borneol, geraniol, limonene, thujone, myrcene, caryophyllene, among others.
SAFETY DATA: Non-irritant, non-sensitizing; the oil is moderately toxic due to the pinocamphone content. It should be used only in moderation and avoided in pregnancy and by epileptics.
AROMATHERAPY/HOME: USE
Skin Care: Bruises, cuts, dermatitis, eczema, inflammation, wounds.
Circulation Muscles And Joints: Low or high blood pressure, rheumatism.
Respiratory System: Asthma, bronchitis, catarrh, cough, sore throat, tonsillitis, whooping cough.
Digestive System: Colic, indigestion.
Genito-Urinary System: Amenorrhoea, leucorrhoea.
Immune System: Colds, ’flu.
Nervous System: Anxiety, fatigue, nervous tension and stress-related conditions.
OTHER USES: Employed as a fragrance component in soaps, cosmetics and perfumes, especially eau-de-cologne and oriental bases. Used as a flavour ingredient in many food products, mainly sauces and seasonings; also in alcoholic drinks, especially liqueurs such as chartreuse.... hyssop
Levisticum officinale
FAMILY: Apiaceae (Umbelliferae)
SYNONYMS: Angelica levisticum, Ligusticum levisticum, smellage, maggi herb, garden lavage, common lavage, old English lavage, Italian lavage, Cornish lovage.
GENERAL DESCRIPTION: A large perennial herb up to 2 metres high with a stout hollow stem and dense ornamental foliage. It has a thick fleshy root and greenish-yellow flowers. The whole plant has a strong aromatic scent.
DISTRIBUTION: Native to southern Europe and western Asia; naturalized in North America. It is cultivated in central and southern Europe, especially in France, Belgium, Czechoslovakia, Hungary, Yugoslavia and Germany.
OTHER SPECIES: Several related plants are also used to produce essential oils, such as sea lavage (Ligusticum scoticum) and alpine lavage (L. mutellina).
HERBAL/FOLK TRADITION: A herb of ancient medical repute, used mainly for digestive complaints, oedema, skin problems, menstrual irregularities and fever. It was also believed to be good for the sight. The leaf stalks used to be blanched and used as a vegetable or in salads. The root is current in the British Herbal Pharmacopoeia as a specific for flatulent dyspepsia and anorexia.
ACTIONS: Antimicrobial, antiseptic, antispasmodic, diaphoretic, digestive, diuretic, carminative, depurative, emmenagogue, expectorant, febrifuge, stimulant (digestive), stomachic.
EXTRACTION: Essential oil by steam distillation from 1. the fresh roots, and 2. the herb – fresh leaves and stalks.
CHARACTERISTICS: 1. An amber or olive brown liquid with a rich, spicy-warm, root-like odour. 2. A very pale yellow mobile liquid with a spicy, warm odour and sweet-floral undertone. It blends well with rose, galbanum, costus, opopanax, oakmoss, bay, lavandin and spice oils.
PRINCIPAL CONSTITUENTS: Mainly phthalides (up to 70 per cent) such as butylidene, dihydrobutylidene, butylphthalides and ligostilides, with lesser amounts of terpenoids, volatile acids, coumarins and furocoumarins.
SAFETY DATA: Non-toxic, non-irritant, possible sensitization/phototoxic effects. Use with care. Avoid during pregnancy.
AROMATHERAPY/HOME: USE
Circulation muscles and joints: Accumulation of toxins, congestion, gout, oedema, poor circulation, rheumatism, water retention.
Digestive system: Anaemia, flatulence, indigestion, spasm.
Genito-urinary system: Amenorrhoea, dysmenorrhoea, cystitis.
OTHER USES: The root oil is used as a fragrance component in soaps, cosmetics and perfumes. The oils and extracts are used as savoury flavouring agents and in liqueurs and tobacco.
ACTIONS: Antiseptic, antispasmodic, carminative, digestive, diuretic (mild), laxative (mild), sedative, stimulant (digestive and lymphatic), tonic.... lovage
Juniperus communis
FAMILY: Cupressaceae
SYNONYM: Common juniper.
GENERAL DESCRIPTION: An evergreen shrub or tree up to 6 metres high, with bluish green narrow stiff needles. It has small flowers and little round berries, which are green in the first year, turning black in the second and third.
DISTRIBUTION: Native to the northern hemisphere: Scandinavia, Siberia, Canada, northern Europe and northern Asia. The oil is mainly produced in Italy, France, Yugoslavia, Austria, Czechoslovakia, Spain, Germany and Canada.
OTHER SPECIES: In Yugoslavia an oil is produced from the fruit and twigs of J. smerka, less rich and sweet than that of common juniper. There are various other species of juniper such as J. oxycedrus which produces cade oil, J. virginiana which produces the so-called Virginian cedarwood oil, and J. sabina which produces savin oil. See also Botanical Classification section.
HERBAL/FOLK TRADITION: The needles and berries have a long traditional history of use. It is used medicinally for urinary infections such as cystitis and urethritis; for respiratory problems such as bronchitis, colic and coughs; as well as gastro-intestinal infections and worms. It helps expel the build-up of uric acid in the joints, and is employed in gout, rheumatism and arthritis. Current in the British Herbal Pharmacopoeia for rheumatic pain and cystitis.
ACTIONS: Antirheumatic, antiseptic, antispasmodic, antitoxic, aphrodisiac, astringent, carminative, cicatrisant, depurative, diuretic, emmenagogue, nervine, parasiticide, rubefacient, sedative, stomachic, sudorific, tonic, vulnerary.
EXTRACTION: Essential oil by steam distillation from 1. the berries (sometimes fermented first as a by-product of juniper – brandy manufacture – the oil is considered an inferior product), and 2. the needles and wood. A resinoid, concrete and absolute are also produced on a small scale.
CHARACTERISTICS: 1. A water-white or pale yellow mobile liquid with a sweet, fresh, woody-balsamic odour. It blends well with vetiver, sandalwood, cedarwood, mastic, oakmoss, galbanum, elemi, cypress, clary sage, pine, lavender, lavandin, labdanum, fir needle, rosemary, benzoin, balsam tolu, geranium and citrus oils. 2. A water-white or pale yellow mobile liquid with a sweet-balsamic, fresh, turpentine-like odour.
PRINCIPAL CONSTITUENTS: Mainly monoterpenes: pinene, myrcene, sabinene with limonene, cymene, terpinene, thujene and camphene, among others.
SAFETY DATA: Non-sensitizing, may be slightly irritating, generally non-toxic. However, it stimulates the uterine muscle (an abortifacient) and must not be used during pregnancy. Neither should it be used by those with kidney disease due to its nephrotoxic effect. The wood oil is usually adulterated with turpentine oil. It is best to use only juniper berry oil, in moderation.
AROMATHERAPY/HOME: USE
Skin care: Acne, dermatitis, eczema, hair loss, haemorrhoids, oily complexions, as a skin toner, wounds.
Circulation muscles and joints: Accumulation of toxins, arteriosclerosis, cellulitis, gout, obesity, rheumatism.
Immune system: Colds, ’flu, infections.
Genito-urinary system: Amenorrhoea, cystitis, dysmenorrhoea, leucorrhoea.
Nervous system: Anxiety, nervous tension and stress-related conditions.
OTHER USES: Berries and extracts are used in diuretic and laxative preparations; also veterinary preventatives of ticks and fleas. Employed as a fragrance component in soaps, detergents, cosmetics and perfumes, especially spicy fragrances and aftershaves. Extensively used in many food products but especially alcoholic and soft drinks: the berries are used to flavour gin.... juniper
Artemisia vulgaris
FAMILY: Asteraceae (Compositae)
SYNONYMS: Armoise, wild wormwood, felon herb, St John’s plant.
GENERAL DESCRIPTION: An erect, much-branched, perennial herb up to 1.5 metres high, with purplish stems, dark green divided leaves which are downy white beneath, and numerous small reddish-brown or yellow flowers.
DISTRIBUTION: Believed to have originated in eastern Europe and western Asia; now found in temperate zones all over the world. The oil is produced in southern France, Morocco, Germany, Hungary, India, China and Japan.
OTHER SPECIES: There are many different species in the Artemisia group (see Botanical Classification), which includes wormwood and tarragon. There are also several different types of mugwort such as the great mugwort (A. arborescens) and the Chinese mugwort (A. moxa and A. sinensis) which are both used to make ‘moxa’ in Japan, containing mainly borneol.
HERBAL/FOLK TRADITION: In Europe, the herb has been associated with superstition and witchcraft, and was seen as a protective charm against evil and danger. It is said that St John the Baptist wore a girdle of the leaves in the wilderness. It was also seen as a woman’s plant, used as a womb tonic, for painful or delayed menstruation and as a treatment for hysteria and epilepsy. It was also used to expel worms, control fever and as a digestive remedy.
In the East the white fluffy underside of the leaves is used for moxibustion, a process often combined with acupuncture, in which the compressed dried herb is burned over a certain point in the body to stimulate it with heat. Moxa was also used in Europe to relieve gout and rheumatism. It is current in the British Herbal Pharmacopoeia as a specific for amenorrhoea and dysmenorrhoea.
ACTIONS: Anthelmintic, antispasmodic, carminative, choleretic, diaphoretic, diuretic, emmenagogue, nervine, orexigenic, stimulant, stomachic, tonic (uterine, womb), vermifuge.
EXTRACTION: Essential oil by steam distillation from the leaves and flowering tops.
CHARACTERISTICS: A colourless or pale yellow liquid with a powerful camphoraceous, bitter-sweet, herbaceous odour. It blends well with oakmoss, patchouli, rosemary, lavandin, pine, sage, clary sage and cedarwood.
PRINCIPAL CONSTITUENTS: Thujone, cineol, pinenes and dihydromatricaria ester, among others.
SAFETY DATA: Oral toxin, due to high thujone content. Abortifacient.
AROMATHERAPY/HOME: USE None. ‘It should not be used in therapy either internally or externally.’.
OTHER USES: Used as a fragrance component in soaps, colognes and perfumes. Limited use in flavouring due to toxic levels of thujone.... mugwort
Origanum majorana
FAMILY: Lamiaceae (Labiatae)
SYNONYMS: Marjorana hortensis, knotted marjoram.
GENERAL DESCRIPTION: A tender bushy perennial plant (cultivated as an annual in colder climates), up to 60 cms high with a hairy stem, dark green oval leaves and small greyish white flowers in clusters or ‘knots’. The whole plant is strongly aromatic.
DISTRIBUTION: Native to the Mediterranean region, Egypt and North Africa. Major oil-producing countries include France, Tunisia, Morocco, Egypt, Bulgaria, Hungary and Germany.
ACTIONS: Analgesic, anaphrodisiac, antioxidant, antiseptic, antispasmodic, antiviral, bactericidal, carminative, cephalic, cordial, diaphoretic, digestive, diuretic, emmenagogue, expectorant, fungicidal, hypotensive, laxative, nervine, sedative, stomachic, tonic, vasodilator, vulnerary.
EXTRACTION: Essential oil by steam distillation of the dried flowering herb. An oleoresin is also produced in smaller quantities.
CHARACTERISTICS: A pale yellow or amber coloured mobile liquid with a warm, woody, spicy camphoraceous odour. It blends well with lavender, rosemary, bergamot, chamomile, cypress, cedarwood, tea tree and eucalyptus.
OTHER SPECIES: There is a great deal of confusion regarding the various species of marjoram or oregano. The most common types are the pot or French marjoram (Origanum onites or Marjorana onites), which is a hardier plant than the sweet marjoram and of a spreading nature; the Spanish marjoram or oregano (Thymus mastichina) and the wild or common marjoram or oregano (Origanum vulgare) which is used to produce the so-called ‘oregano oil’. See entries on common oregano, Spanish oregano and also the Botanical Classification section.
HERBAL/FOLK TRADITION: A traditional culinary herb and folk remedy. It was used by the ancient Greeks in their fragrances, cosmetics and medicines; the name oregano derives from a Greek word meaning ‘joy of the mountains’. lt is a versatile herb which has a soothing, fortifying and warming effect; it aids digestive and menstrual problems, as well as nervous and respiratory complaints.
It is ‘comforting in cold diseases of the head, stomach, sinews and other parts, taken inwardly or outwardly applied ... helps diseases of the chest, obstructions of the liver and spleen.’. It is also very helpful for muscular and rheumatic pain, sprains, strains, stiff joints, bruises, etc.
PRINCIPAL CONSTITUENTS: Terpinenes, terpineol, sabinenes, linalol, carvacrol, linalyl acetate, ocimene, cadinene, geranyl acetate, citral, eugenol, among others.
SAFETY DATA: Non-toxic, non-irritant, non-sensitizing. Not to be used during pregnancy.
AROMATHERAPY/HOME: USE
Skin care: Chilblains, bruises, ticks.
Circulation muscles and joints: Arthritis, lumbago, muscular aches and stiffness, rheumatism, sprains, strains.
Respiratory system: Asthma, bronchitis, coughs.
Digestive system: Colic, constipation, dyspepsia, flatulence.
Genito-urinary system: Amenorrhoea, dysmenorrhoea, leucorrhoea, PMT.
Immune system: Colds.
Nervous system: Headache, hypertension, insomnia, migraine, nervous tension and stress-related conditions.
OTHER USES: The oil and oleoresin are used as fragrance components in soaps, detergents, cosmetics and perfumes. Employed in most major food categories, especially meats, seasonings and sauces, as well as soft drinks and alcoholic beverages such as vermouths and bitters.... marjoram, sweet
Salvia lavendulaefolia
FAMILY: Lamiaceae (Labiatae)
SYNONYMS: Lavender-leaved sage.
GENERAL DESCRIPTION: An evergreen shrub, similar to the garden sage but with narrower leaves and small purple flowers. The whole plant is aromatic with a scent reminiscent of spike lavender.
DISTRIBUTION: Native to the mountains in Spain, it also grows in south west France and Yugoslavia. The oil is mainly produced in Spain.
OTHER SPECIES: A very similar oil is distilled in Turkey from a Greek variety, S. triloba, which is used for pharmaceutical purposes. See also entries on clary sage and common sage for other types of sage.
HERBAL/FOLK TRADITION: In Spain it is regarded as something of a ‘cure-all’. Believed to promote longevity and protect against all types of infection (such as plague). Used to treat rheumatism, digestive complaints, menstrual problems, infertility and nervous weakness.
ACTIONS: Antidepressant, anti-inflammatory, antimicrobial, antiseptic, antispasmodic, astringent, carminative, deodorant, depurative, digestive, emmenagogue, expectorant, febrifuge, hypotensive, nervine, regulator (of seborrhoea), stimulant (hepatobiliary, adrenocortical glands, circulation), stomachic, tonic (nerve and general).
EXTRACTION: Essential oil by steam distillation from the leaves.
CHARACTERISTICS: A pale yellow mobile liquid with a fresh-herbaceous, camphoraceous, slightly pinelike odour. It blends well with rosemary, lavandin, lavender, pine, citronella, eucalyptus, juniper, clary sage and cedarwood.
PRINCIPAL CONSTITUENTS: Camphor (up to 34 per cent), cineol (up to 35 per cent), limonene (up to 41 per cent), camphene (up to 20 per cent), pinene (up to 20 per cent) and other minor constituents.
SAFETY DATA: Relatively non-toxic, non-irritant, non-sensitizing. Avoid during pregnancy; use in moderation.
AROMATHERAPY/HOME: USE
Skin care: Acne, cuts, dandruff, dermatitis, eczema, excessive sweating, hair loss, gingivitis, gum infections, sores.
Circulation muscles and joints: Arthritis, debility, fluid retention, muscular aches and pains, poor circulation, rheumatism. Respiratory system: Asthma, coughs, laryngitis.
Digestive system: Jaundice, liver congestion.
Genito-urinary system: Amenorrhoea, dysmenorrhoea, sterility.
Immune system: Colds, fevers, ’flu.
Nervous system: Headaches, nervous exhaustion and stress-related conditions.
OTHER USES: Extensively used as a fragrance component in soaps, cosmetics, toiletries and perfumes, especially ‘industrial’ type fragrances. Extensively employed in foods (especially meat products), as well as alcoholic and soft drinks.... sage, spanish
Commiphora myrrha
FAMILY: Burseraceae
SYNONYMS: Balsamodendron myrrha, gum myrrh, common myrrh, hirabol myrrh, myrrha.
GENERAL DESCRIPTION: The Commiphora species which yield myrrh are shrubs or small trees up to 10 metres high. They have sturdy knotted branches, trifoliate aromatic leaves and small white flowers. The trunk exudes a natural oleoresin, a pale yellow liquid which hardens into reddish-brown tears, known as myrrh. The native collectors make incisions in the bark of the tree to increase the yield.
DISTRIBUTION: The Commiphora species are native to north east Africa and south west Asia, especially the Red Sea region (Somalia, Yemen and Ethiopia).
OTHER SPECIES: There are several C. species which yield myrrh oleoresin: African or Somali myrrh (C. molmol) and Arabian or Yemen myrrh (C. abyssinica). Bisabol myrrh or opopanax (C. erthraea) also belongs to the same family.
HERBAL/FOLK TRADITION: Myrrh has been employed since the earliest times in Eastern and Western medicine; its use is mentioned some 3700 years ago. The ancient Egyptians used it for embalming purposes and in their perfumes and cosmetics. In China it is used for arthritis, menstrual problems, sores and haemorrhoids. In the West it is considered to have an ‘opening, heating, drying nature’ (Joseph Miller), good for asthma, coughs, common cold, catarrh, sore throat, weak gums and teeth, ulcers and sores. It has also been used to treat leprosy.
Current in the British Herbal Pharmacopoeia as a specific for mouth ulcers, gingivitis and pharyngitis.
ACTIONS: Anticatarrhal, anti-inflammatory, antimicrobial, antiphlogistic, antiseptic, astringent, balsamic, carminative, cicatrisant, emmenagogue, expectorant, fungicidal, revitalizing, sedative, stimulant (digestive, pulmonary), stomachic, tonic, uterine, vulnerary.
EXTRACTION: 1. Resinoid (and resin absolute) by solvent extraction of the crude myrrh. 2. Essential oil by steam distillation of the crude myrrh.
CHARACTERISTICS: 1. The resinoid is a dark reddish-brown viscous mass, with a warm, rich, spicy-balsamic odour. It is not pourable at room temperature so a solvent, such as diethyl phthalate, is sometimes added. 2. The essential oil is a pale yellow to amber oily liquid with a warm, sweet-balsamic, slightly spicy-medicinal odour. It blends well with frankincense, sandalwood, benzoin, oakmoss, cypress, juniper, mandarin, geranium, patchouli, thyme, mints, lavender, pine and spices.
PRINCIPAL CONSTITUENTS: The crude contains resins, gum and about 8 per cent essential oil composed mainly of heerabolene, limonene, dipentene, pinene, eugenol, cinnamaldehyde, cuminaldehyde, cadinene, among others.
SAFETY DATA: Non-irritant, non-sensitizing, possibly toxic in high concentration. Not to be used during pregnancy.
AROMATHERAPY/HOME: USE
Skin care: Athlete’s foot, chapped and cracked skin, eczema, mature complexions, ringworm, wounds, wrinkles.
Circulation muscles and joints: Arthritis.
Respiratory system: Asthma, bronchitis, catarrh, coughs, gum infections, gingivitis, mouth ulcers, sore throat, voice loss.
Digestive system: Diarrhoea, dyspepsia, flatulence, haemorrhoids, loss of appetite.
Genito-urinary system: Amenorrhoea, leucorrhoea, pruritis, thrush.
Immune system: Colds.
OTHER USES: The oil, resinoid and tincture are used in pharmaceutical products, including mouthwashes, gargles and toothpaste; also used in dentistry. The oil and resinoid are used as fixatives and fragrance components in soaps, detergents, cosmetics and perfumes, especially oriental types and heavy florals. Used as flavour ingredients in most major food categories, alcoholic and soft drinks.... myrrh
Asarum canadense
FAMILY: Aristolochiaceae
SYNONYMS: Wild ginger, Indian ginger.
GENERAL DESCRIPTION: An inconspicuous but fragrant little plant not more than 35 cms high with a hairy stem, two glossy, kidney-shaped leaves and a creeping rootstock. The solitary bell-shaped flower is brownish purple, and creamy white inside.
DISTRIBUTION: Native to North America, especially North Carolina, Kansas and Canada. The oil is produced in the USA mainly from wild-growing plants.
OTHER SPECIES: It should not be confused with ‘serpentaria oil’ from the Virginian snakeroot (Aristolochia serpentaria) which belongs to the same botanical family but contains asarone and is considered toxic.
HERBAL/FOLK TRADITION: This plant has been employed for centuries in folk medicine but is now little prescribed. It used to be used for chronic chest complaints, dropsy, rheumatism and painful bowel and stomach spasms. It was also considered a ‘valuable stimulant in cases of amenorrhoea and colds’ and for ‘promoting a copious perspiration’. .
The name (of the Virginian variety at least) derives from its use in aiding the body to combat nettle rash, poison ivy and some snake bites.
ACTIONS: Anti-inflammatory, antispasmodic, carminative, diuretic, diaphoretic, emmenagogue, expectorant, febrifuge, stimulant, stomachic.
EXTRACTION: Essential oil by steam distillation from the dried rhizomes and crushed roots.
CHARACTERISTICS: A brownish-yellow or amber liquid with a warm, woody-spicy, rich, gingerlike odour. It blends well with bergamot, costus, oakmoss, patchouli, pine needle, clary sage, mimosa, cassie and other florals.
PRINCIPAL CONSTITUENTS: Pinene, linalol, borneol, terpineol, geraniol, eugenol and methyl eugenol, among others.
SAFETY DATA: Non-toxic, non-irritant, nonsensitizing. Avoid during pregnancy.
AROMATHERAPY/HOME: USE May possibly be used for its antispasmodic qualities, for example for period pains or indigestion.
OTHER USES: Occasionally used in perfumery work. Mainly used as a flavouring agent with other spicy materials, especially in confectionery.... snakeroot
Petroselinum sativum
FAMILY: Apiaceae (Umbelliferae)
SYNONYMS: P. hortense, Apium petroselinum, Carum petroselinum, common parsley, garden parsley.
GENERAL DESCRIPTION: A biennial or shortlived perennial herb up to 70 cms high with crinkly bright green foliage, small greenish-yellow flowers and producing small brown seeds.
DISTRIBUTION: Native to the Mediterranean region, especially Greece. It is cultivated extensively, mainly in California, Germany, France, Belgium, Hungary and parts of Asia. The principal oil-producing countries are France, Germany, Holland and Hungary.
OTHER SPECIES: There are over thirty-seven different varieties of parsley, such as the curly leaved type (P. crispum), which is used in herbal medicine.
HERBAL/FOLK TRADITION: It is used extensively as a culinary herb, both fresh and dried. It is a very nutritious plant, high in vitamins A and C; also used to freshen the breath. The herb and seed are used medicinally, principally for kidney and bladder problems, but it has also been employed for menstrual difficulties, digestive complaints and for arthritis, rheumatism, rickets and sciatica. It is said to stimulate hair growth, and help eliminate head lice.
The root is current in the British Herbal Pharmacopoeia as a specific for flatulent dyspepsia with intestinal colic.
ACTIONS: Antimicrobial, antirheumatic, antiseptic, astringent, carminative, diuretic, depurative, emmenagogue, febrifuge, hypotensive, laxative, stimulant (mild), stomachic, tonic (uterine).
EXTRACTION: Essential oil by steam distillation from 1. the seed, and 2. the herb. (An essential oil is occasionally extracted from the roots; an oleoresin is also produced by solvent extraction from the seeds.)
CHARACTERISTICS: 1. A yellow, amber or brownish liquid with a warm woody-spicy herbaceous odour. 2. A pale yellow or greenish liquid with a heavy, warm, spicy-sweet odour, reminiscent of the herb. It blends well with rose, neroli, cananga, tea tree, oakmoss, clary sage and spice oils.
PRINCIPAL CONSTITUENTS: 1. Mainly apiol, with myristicin, tetramethoxyally benzene, pinene and volatile fatty acids. 2. Mainly myristicin (up to 85 per cent), with phellandrene, myrcene, apiol, terpinolene, menthatriene, pinene and carotel, among others.
SAFETY DATA: Both oils are moderately toxic and irritant – myristicin has been shown to have toxic properties, and apiol has been shown to have irritant properties; otherwise non sensitizing. Use in moderation. Avoid during pregnancy.
AROMATHERAPY/HOME: USE
Circulation muscles and joints: Accumulation of toxins, arthritis, broken blood vessels, cellulitis, rheumatism, sciatica.
Digestive system: Colic, flatulence, indigestion, haemorrhoids.
Genito-urinary system: Amenorrhoea, dysmenorrhoea, to aid labour, cystitis, urinary infection.
OTHER USES: Used in some carminative and digestive remedies, such as ‘gripe waters’. The seed oil is used in soaps, detergents, colognes, cosmetics and perfumes, especially men’s fragrances. The herb and seed oil as well as the oleoresin are used extensively in many types of food flavourings, especially meats, pickles and sauces, as well as alcoholic and soft drinks.... parsley
Artemisia dracunculus
FAMILY: Asteraceae (Compositae)
SYNONYMS: Estragon (oil), little dragon, Russian tarragon.
GENERAL DESCRIPTION: A perennial herb with smooth narrow leaves; an erect stem up to 1.2 metres tall, and small yellowy-green, inconspicuous flowers.
DISTRIBUTION: Native to Europe, southern Russia and western Asia. Now cultivated worldwide, especially in Europe and the USA. The oil is mainly produced in France, Holland, Hungary and the USA.
OTHER SPECIES: The so-called French tarragon or ‘sativa’, which is cultivated as a garden herb, is a smaller plant with a sharper flavour than the Russian type and is a sterile derivative of the wild species.
HERBAL/FOLK TRADITION: The leaf is commonly used as domestic herb, especially with chicken or fish, and to make tarragon vinegar. The name is thought to derive from an ancient use as an antidote to the bites of venomous creatures and ‘madde dogges’. It was favoured by the maharajahs of India who took it as a tisane, and in Persia it was used to induce appetite.
‘The leaves, which are chiefly used, are heating and drying, and good for those that have the flux, or any prenatural discharge.’. The leaf was also formerly used for digestive and menstrual irregularities, while the root was employed as a remedy for toothache.
ACTIONS: Anthelmintic, antiseptic, antispasmodic, aperitif, carminative, digestive, diuretic, emmenagogue, hypnotic, stimulant, stomachic, vermifuge.
EXTRACTION: Essential oil by steam distillation from the leaves.
CHARACTERISTICS: A colourless or pale yellow mobile liquid (turning yellow with age), with a sweet-anisic, spicy-green scent. It blends well with labdanum, galbanum, lavender, oakmoss, vanilla, pine and basil.
PRINCIPAL CONSTITUENTS: Estragole (up to 70 per cent), capillene, ocimene, nerol, phellandrene, thujone and cineol, among others.
SAFETY DATA: Moderately toxic due to ‘estragole’ (methyl chavicol); use in moderation only. Possibly carcinogenic. Otherwise non-irritant, non-sensitizing. Avoid during pregnancy.
AROMATHERAPY/HOME: USE
Digestive system: Anorexia, dyspepsia, flatulence, hiccoughs, intestinal spasm, nervous indigestion, sluggish digestion.
Genito-urinary system: Amenorrhoea, dysmenorrhoea, PMT.
OTHER USES: Used as a fragrance component in soaps, detergents, cosmetics and perfumes. Employed as a flavour ingredient in most major food categories, especially condiments and relishes, as well as alcoholic and soft drinks.... tarragon
Salvia sclarea
FAMILY: Lamiaceae (Labiatae)
SYNONYMS: Clary, clary wort, muscatel sage, clear eye, see bright, common clary, clarry, eye bright.
GENERAL DESCRIPTION: Stout biennial or perennial herb up to 1 metre high with large, hairy leaves, green with a hint of purple, and small blue flowers.
DISTRIBUTION: Native to southern Europe; cultivated worldwide especially in the Mediterranean region, Russia, the USA, England, Morocco and central Europe. The French, Moroccan and English clary are considered of superior quality for perfumery work.
OTHER SPECIES: Closely related to the garden sage (S. officinalis) and the Spanish sage (S. lavendulaefolia), which are both used to produce essential oils. Other types of sage include meadow clary (S. pratensis) and vervain sage (S. verbenaca). Clary sage should not be confused with the common wayside herb eyebright (Euphrasia).
HERBAL/FOLK TRADITION: This herb, highly esteemed in the Middle Ages, has now largely fallen out of use. It was used for digestive disorders, kidney disease, uterine and menstrual complaints, for cleansing ulcers and as a general nerve tonic. The mucilage from the seeds was used for treating tumours and for removing dust particles from the eyes.
Like garden sage, it cools inflammation and is especially useful for throat and respiratory infections.
ACTIONS: Anticonvulsive, antidepressant, antiphlogistic, antiseptic, antispasmodic, aphrodisiac, astringent, bactericidal, carminative, cicatrisant, deodorant, digestive, emmenagogue, hypotensive, nervine, regulator (of seborrhoea), sedative, stomachic, tonic, uterine.
EXTRACTION: Essential oil by steam distillation from the flowering tops and leaves. (A concrete and absolute are also produced by solvent extraction in small quantities.)
CHARACTERISTICS: A colourless or pale yellowy-green liquid with a sweet, nutty herbaceous scent. It blends well with juniper, lavender, coriander, cardamon, geranium, sandalwood, cedarwood, pine, labdanum, jasmine, frankincense, bergamot and other citrus oils.
PRINCIPAL CONSTITUENTS: Linalyl acetate (up to 75 per cent), linalol, pinene, myrcene and phellandrene, among others. Constituents vary according to geographical origin – there are several different chemotypes.
SAFETY DATA: Non-toxic, non-irritant, nonsensitizing. Avoid during pregnancy. Do not use clary sage oil while drinking alcohol since it can induce a narcotic effect and exaggerate drunkenness. Clary sage is generally used in preference to the garden sage in aromatherapy due to its lower toxicity level.
AROMATHERAPY/HOME: USE
Skin care: Acne, boils, dandruff, hair loss, inflamed conditions, oily skin and hair, ophthalmia, ulcers, wrinkles.
Circulation muscles and joints: High blood pressure, muscular aches and pains.
Respiratory system: Asthma, throat infections, whooping cough.
Digestive system: Colic, cramp, dyspepsia, flatulence.
Genito-urinary system: Amenorrhoea, labour pain, dysmenorrhoea, leucorrhoea.
Nervous system: Depression, frigidity, impotence, migraine, nervous tension and stress-related disorders.
OTHER USES: The oil and absolute are used as fragrance components and fixatives in soaps, detergents, cosmetics and perfumes. The oil is used extensively by the food and drink industry, especially in the production of wines with a muscatel flavour.... sage, clary
Achillea millefolium
FAMILY: Asteraceae (Compositae)
SYNONYMS: Milfoil, common yarrow, nosebleed, thousand leaf – and many other country names.
GENERAL DESCRIPTION: A perennial herb with a simple stem up to 1 metre high, with finely dissected leaves giving a lacy appearance, bearing numerous pinky-white, dense flowerheads.
DISTRIBUTION: Native to Eurasia; naturalized in North America. Now found in most temperate zones of the world. The oil is mainly distilled in Germany, Hungary, France and Yugoslavia, also the USA and Africa.
OTHER SPECIES: A very extensive species. Other varieties include the Ligurian yarrow (A. ligustica) and the musk yarrow or iva (A. moschata), which also produces an essential oil containing mainly cineol – used in the preparation of ‘iva liquor’, a medicinal aperitif.
HERBAL/FOLK TRADITION: An age-old herbal medicine used for a wide variety of complaints including fever, respiratory infections, digestive problems, nervous tension and externally for sores, rashes and wounds. Its use in the treatment of wounds is said to go back to Achilles who used it for injuries inflicted by iron weapons.
It is used in China mainly for menstrual problems and haemorrhoids. In Norway it is also used for rheumatism. The stalks are traditionally used for divination in the I Ching, the Chinese classic. It is current in the British Herbal Pharmacopoeia as a specific for thrombotic conditions with hypertension.
ACTIONS: Anti-inflammatory, antipyretic, antirheumatic, antiseptic, antispasmodic, astringent, carminative, cicatrisant, diaphoretic, digestive, expectorant, haemostatic, hypotensive, stomachic, tonic.
EXTRACTION: Essential oil by steam distillation from the dried herb.
CHARACTERISTICS: A dark blue or greenish olive liquid with a fresh, green, sweet herbaceous, slightly camphoraceous odour. It blends well with cedarwood, pine, chamomile, valerian, vetiver and oakmoss.
PRINCIPAL CONSTITUENTS: Azulene (up to 51 per cent), pinenes, caryophyllene, borneol, terpineol, cineol, bornyl acetate, camphor, sabinene and thujone, among others. Constituents, especially azulene levels, vary according to source.
SAFETY DATA: Non-toxic, non-irritant, possible sensitization in some individuals.
AROMATHERAPY/HOME: USE
Skin care: Acne, burns, cuts, eczema, hair rinse (promotes hair growth), inflammations, rashes, scars, tones the skin, varicose veins, wounds.
Circulation muscles and joints: Arteriosclerosis, high blood pressure, rheumatoid arthritis, thrombosis.
Digestive system: Constipation, cramp, flatulence, haemorrhoids, indigestion.
Genito-urinary system: Amenorrhoea, dysmenorrhoea, cystitis and other infections.
Immune system: Colds, fever, ’flu, etc.
Nervous system: Hypertension, insomnia, stress-related conditions.
OTHER USES: Occasionally used in pharmaceutical bath preparations for skin conditions. Limited use in perfumes and aftershaves. Employed as a flavour ingredient in vermouths and bitters.... yarrow
Amenorrhoea/lack of menstruation (M,B):
French basil, carrot seed, celery seed, cinnamon leaf, dill, sweet fennel, hops, hyssop, juniper, laurel, lovage, sweet marjoram, myrrh, parsley, rose (cabbage & damask), sage (clary & Spanish), tarragon, yarrow.
Dysmenorrhoea/cramp, painful or difficult menstruation (M,C,B):
Melissa, French basil, carrot seed, chamomile (German & Roman), cypress, frankincense, hops, jasmine, juniper, lavandin, lavender (spike & true), lovage, sweet marjoram, rose (cabbage & damask), rosemary, sage (clary & Spanish), tarragon, yarrow.
Cystitis (C,B,D):
Canadian balsam, copaiba balsam, bergamot, cedarwood (Atlas, Texas & Virginian), celery seed, chamomile (German & Roman), cubebs, eucalyptus blue gum, frankincense, juniper, lavandin, lavender (spike & true), lovage, mastic, niaouli, parsley, Scotch pine, sandalwood, tea tree, thyme, turpentine, yarrow.
Frigidity (M,S,B,V):
Cassie, cinnamon leaf, jasmine, neroli, nutmeg, parsley, patchouli, black pepper, cabbage rose, rosewood, clary sage, sandalwood, ylang ylang.
Lack of nursing milk (M):
Celery seed, dill, sweet fennel, hops.
Labour pain & childbirth aid (M,C,B):
Cinnamon leaf, jasmine, true lavender, nutmeg, parsley, rose (cabbage & damask), clary sage.
Leucorrhoea/white discharge from the vagina (B,D):
Bergamot, cedarwood (Atlas, Texas & Virginian), cinnamon leaf, cubebs, eucalyptus blue gum, frankincense, hyssop, lavandin, lavender (spike & true), sweet marjoram, mastic, myrrh, rosemary, clary sage, sandalwood, tea tree, turpentine.
Menopausal problems (M,B,V):
Cypress, sweet fennel, geranium, jasmine, rose (cabbage & damask).
Menorrhagia/excessive menstruation (M,B):
Chamomile (German & Roman), cypress, rose (cabbage & damask).
Premenstrual tension/PMT (M,B,V):
Carrot seed, chamomile (German & Roman), geranium, true lavender, sweet marjoram, neroli, tarragon.
Pruritis/itching (D):
Bergamot, Atlas cedarwood, juniper, lavender, myrrh, tea tree.
Sexual overactivity (M,B):
Hops, sweet marjoram.
Thrush/candida (B,D):
Bergamot, geranium, myrrh, tea tree.
Urethritis (B,D):
Bergamot, cubebs, mastic, tea tree, turpentine.
Immune System
Chickenpox (C,S,B):
Bergamot, chamomile (German & Roman), eucalyptus (blue gum & lemon), true lavender, tea tree.
Colds/’flu (M,B,V,I):
Angelica, star anise, aniseed, copaiba balsam, Peru balsam, French basil, West Indian bay, bergamot, borneol, cabreuva, cajeput, camphor (white), caraway, cinnamon leaf, citronella, clove bud, coriander, eucalyptus (blue gum, lemon & peppermint), silver fir, frankincense, ginger, grapefruit, immortelle, juniper, laurel, lemon, lime, sweet marjoram, mastic, mint (peppermint & spearmint), myrtle, niaouli, orange (bitter & sweet), pine (longleaf & Scotch), rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, turpentine, yarrow.
Fever (C,B):
French basil, bergamot, borneol, camphor (white), eucalyptus (blue gum, lemon & peppermint), silver fir, ginger, immortelle, juniper, lemon, lemongrass, lime, mint (peppermint & spearmint), myrtle, niaouli, rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, yarrow.
Measles (S,B,I,V):
Bergamot, eucalyptus blue gum, lavender (spike & true), tea tree.... genito-urinary and endocrine systems
Health Encyclopedia