alsarexALSAREX TABLET reduces hyperacidity, prevents reflux and improves mucosal resistance. It also exerts an astringent action on the gastric mucosa and relieves epigastric pain and dyspepsia. It is known to help in gastric ulcer, duodenal ulcer and non-ulcer dyspepsia. As a co-prescription with NSAIDS to prevent muscular erosion in stomach and duodenum.

Clinical Pharmacology

Antacid: Glycyrrhiza glabra, Asparagus racemosus, Tinospora cordifolia, Emblica

officinalis,

Digestive: Devil’s Horsewhip, Cumin, Clove, Root of Long Pepper, Terminalia chebula,

Emblica officinalis, Trichosanthes dioica, Eclipta alba, Zingiber officinale, Elettaria

cardamomum

Demulcent: Glycyrrhiza glabra, Emblica officinalis, Achyranthes aspera, Eclipta

alba, Cumin, Asparagus racemosa, Tinospora cordifolia

Laxative: Cassia angustifolia, Terminalia chebula

Anti-emetic: Zingiber officinale, Achyranthes aspera

Anagelsic & Antiinflammatory: Zingiber officinale, Tinospora cordifolia, Glycyrrhiza glabra

Accelerated healing of gastric, duodenal, peptic ulcers, antispasmodic: Glycyrrhiza glabra

INDICATIONS:• GASTRIC ULCER, DUODENAL ULCER, NON-ULCER DYSPEPSIA• AS A CO PRESCRIPTION WITH NSAIDS TO PREVENT MUCOSAL EROSION IN STOMACH AND   DUODENUM

BENEFITS:• FAST RELIEF OF ULCER PAIN• REDUCES HYPERSECRETIONOF ACID AND NEUTRALIZES EXCESSIVE ACID• RELIEVES NAUSEA, VOMITING AND ACID REGURGITATION• ACCELERATES ULCER HEALING PROCESS• SAFE FOR LONG-TERM USE• NO KNOWN DRUG INTERACTIONS

DOSAGE:GENERAL: TWO TABLETS TWO TO THREE TIMES A DAY WITH A “BLAND DIET” FOR THREE TO SIX WEEKS.

DO'S AND DON'TS:DO'S• CONSUMPTION OF ORANGE JUICE, RIPE BANANA AND DRIED GRAPES ARE RECOMMENDED.• LEAFY VEGETABLES, BITTER GOURD, TOMATO AND VARIETY OF PUMPKIN ARE ADVISED.

• CONSUMPTION OF MUNG, HONEY, GHEE, AND BUTTER IN A BALANCED AMOUNT IS ADVISED.

• PRACTICE LIGHT EXERCISE AND MORNING WALK.

DON'TS• AVOID FRIED OILY AND SPICY FOODS.• AVOID TOO MUCH MENTAL AND PHYSICAL EXERTION.• AVOID FOOD RECIPES CAUSING CONSTIPATION.

Achyranthes aspera Linn. Or devil’s horsewhip in jamaica.Habitat _ Throughout the tropical and subtropical regions, up to an altitude of 2,100 m, in the southern Andaman Islands.

English _ Prickly Chaff Flower.

Action _ Astringent, pectoral (ashes of the plant used in asthma and cough), diuretic, hepatoprotective, emmenagogue. Benzene extract of the plant exhibited abortifacient activity. The flowers, ground and mixed with sugar, are given for menorrhagia. Roots—astringent, haemostatic. Seeds—emetic; used for biliousness. Essential oil— antifungal.

Key application _ As astringent, emetic. (Indian Herbal Pharmacopoeia.)

Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicates the use of the whole plant in lipid disorders and obesity, the root for its blood-purifying property.

The plant juice and ash are used for treating bleeding piles. An alkaline powder of the plant is used in preparing Kshaarasutra of Ayurvedic medicine, which is recommended for treating fistula-in-ano.

The whole plant contains the alkaloids achyranthine and betaine. Achyranthine,a water-soluble alkaloid, is reported to dilate blood vessels, lower blood pressure, decrease heart rate and increase the rate and amplitude of respiration. It also shows spasmodic effects on the rectus muscle of frog, diuretic and purgative action in albino rats.

The presence of ecdysterone and oleanolic acid is also reported in the root.

The ashes of the plant yield large quantities of potash. The seeds yield saponins and oleanolic acid and its ester. The presence of tannins and glycosides is also reported in the plant.

Cumin (cuminum cyminum)

DESCRIPTIONMedicinal Parts: The medicinal parts are the Cumin oil extracted from the ripe fruit and the ripe, dried fruit.

Habitat: The plant is indigenous to Turkestan (Hager) or northern Egypt (Grieve), but is cultivated today in the whole of the Mediterranean region as well as in Iran, Pakistan, India, China, the U.S. and South America.

Production: Cumin is the dried ripe fruit of Cuminum cyminum.

Actions & Pharmacology Compounds

Volatile oil (2 to 5%): chief components cuminaldehyde, gamma-terpenes, beta-pinenes, p-cymene, 1,3-p-menthandial

Fatty oil (10 to 15%): chief fatty acids petroselic acid, palmitic acid

Proteic substances (15 to 20%)

Action _ Carminative, antispasmodic (used in dyspepsia and diarrhoea), stimulant, diuretic, antibacterial, emmenagogue, galactagogue.

Antimicrobial: The drug contains fatty oil (mainly petroselic acid and oil acid) and has an antimicrobial effect. A powder suspension of the drug has diverse inhibitory effects; it stunts mycelium growth, toxin production or afla-toxin production in Aspergillus ochraceus, C. versicolor, and C. flavus.

Influence on blood-clotting: A dried Cumin ether extract inhibits (in vitro) arachidon acid-induced plate aggregation in platelet-rich human plasma.

Other effects (for which there are no experimental results) include the following: obstructive influence on fertility, galactogen, antispasmodic, diuretic and aphrodisiac. Cumin also has carminative, stimulant and analgesic effects.

Cumin seeds contain up to 14.5% lipids. They are reported to contain 14 flavonoid glycosides; 7 belong to apigenin, 5 to luteolin and 2 to chrysoeriol group. Major constituents of the essential oil include cuminaldehyde (20-40% of the oil) and p-cymene.

EtOH (50%) extract of the fruit exhibits spasmolytic and hypotensive activity. Cumin is considered superior is comforting carminative qualities to Fennel or Caraway.

Indications and UsageUnproven Uses: In folk medicine, Cumin is used as a carminative for stomach disorders, diarrhea and colic, particularly in veterinary medicine.

In America, Africa and India the drug is used as an abortive and as an emmenagogue.

In Indonesia, Cumin is used in cases of bloody diarrhea and headache (paste is applied to the forehead). It is also taken orally for rheumatic ailments.

Indian Medicine: In India, Cumin is used as an abortifacient, for kidney and bladder stones, chronic diarrhea, leprosy and eye disease.

PRECAUTIONS AND ADVERSE REACTIONSNo health hazards or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

Clove or Syzygium aromaticum syn. Caryophyllus aromaticus Linn.

DESCRIPTIONMedicinal Parts: The medicinal parts are the oil extracted from the whole or macerated flower buds, the pedicles and leaves, the dried flower buds and the not quite ripe fruit.

Habitat: The plant is indigenous to the Molucca Islands and is cultivated there and in Tanzania, Madagascar, Brazil and other tropical regions.

Production: Cloves consist of the hand-picked and dried flower buds of Syzygium aromaticum (syn. Jambosa caryophyllus, Eugenia caryophyllata).

ACTIONS AND PHARMACOLOGYCOMPOUNDSVolatile oil (15-21%): chief components eugenol (70-90%), eugenyl acetate (aceteugenol, up to 17%), beta-caryophyllene (5-12%)

Flavonoids: including astragalin, isoquercitrin, hyperoside, quercetin-3,4'-di-0-glycoside

Tannins (10%): ellagitannins, including eugenin

Triterpenes: oleanolic acid (1%), crataegolic acid (maslic acid, 0.15%)

Steroids: sterols, including beta-sitosterol

EFFECTSClove is antiseptic, antibacterial, antifungal, antiviral, spasmolytic and a local anaesthetic.

INDICATIONS AND USAGEApproved by Commission E:• Dental analgesic• Inflammation of the mouth and pharynx

Indian Medicine: The drug is used for halitosis, toothache, eye disease, flatulence, colic, gastropathy, and anorexia.

Action _ Carminative, antiinflammatory, antibacterial. Flower buds—antiemetic, stimulant, carminative. Used in dyspepsia, gastric irritation. Oil—employed as a local analgesic for hypersensitive dent lines and carious cavities; internally as a carminative and antispasmodic.

Key application _ In inflammatory changes of oral and pharyngeal mucosa; in dentistry; for topical anesthesia. (German Commission E.)

Eugenin, triterpene acids, crategolic acid and steroid glucosides afford anti-inflammatory and antiseptic properties to the buds. Eugenol, a major component of the oil, is antibacterial.Acetone extract of clove, eugenol and acetyleugenol possess cholagogue activity.The eugenol and acetyleugenol components of the clove oil inhibit arachidonate-, adrenalin- and collagen induced platelet aggregation.

Whole cloves might have chemoprotective activity against liver and bone marrow toxicity. (The Review of Natural Products by Facts andComparisons,1999.)

PRECAUTIONS AND ADVERSE REACTIONSNo health hazards or side effects are known in conjunction with the proper administration of designated therapeutic dosages. Allergic reactions to eugenol occur rarely. In concentrated form, oil of clove may be irritating to mucosa.

DOSAGEMode of Administration: As a powdered, ground, or whole herb for the recovery of the essential oil, and other galenic preparations for topical use.

Daily Dosage: Aqueous solutions corresponding to 1 to 5% essential oil are used externally for mouthwashes. In dentistry, the undiluted essential oil is used.

Storage: Do not store the drug in plastic containers, and protect it from light.

Piper longum root

Habitat _ Warmer parts of India, from Central Himalayas to Assam, lower hills of West Bengal; Uttar Pradesh, Andhra Pradesh, Western Ghats from Konkan southwards to Trivandrum. Often cultivated.

Applied locally on muscular pains and inflammations. Its roots also have several medicinal uses. The root is useful in bronchitis, stomach ache, diseases of spleen and tumours . The root and fruit decoction are used in acute and chronic bronchitis and cough.

Several aristolactams and dioxoaporphines have been isolated from Indian long pepper. It also contains the long chain isobutyl amide, longamide, besides guineensine and the lignans,pluviatilol, methyl pluviatilol (fargesin), sesamin and asarinine.

Piperine is the major alkaloid of peppers.

Piperine is antipyretic, hypotensive, analeptic, CNS stimulant. It has been reported to exert significant protection against CCl4-induced hepatotoxicity in mice. It improves drug availability in experimental animals, and is used for enhancing the efficacy of coadministered medicaments.

Piperine enhanced bioavailability of hexobarbital, phenytoin, propranolol and theophylline. (Sharon M. Herr.) (Piperine is also a component of Piper nigrum.)

N-isobutyl-deca-trans-2-trans-4-dienamide, isolated from the fruit, exhibited antitubercular property.

Milk extract of the fruit effectively reduced passive cutaneous anaphylaxis in rats. It protected guinea-pigs against antigen-induced bronchospasm.

37. A New fast acting Antitussive from piper longum L. M.A.Yaqoob, Ghazala H. Rizwani and M. Ahmad proc 2 nd nat. conf. on herb medicines & therapeutics (27 th Nov.1999).

Piperine

Long Pepper and Black Pepper contains the alkaloid piperine which is known to increase the bioavailability of a number of drugs such as vasicine (a.k.a. peganine) an antiasthmatic alkaloid from Adhatoda vasica (Johri et al 1992). In 1928, Bose, while studying the anti-asthmatic properties of Adhatoda vasica, noted that Long pepper, when added to Adhatoda leaves, would increase their efficacy (in Atal et al. 1981).

Effects on bioavailability

Several studies have demonstrated that Trikatu (as well as some of its ingredients, see below) can significantly affect the bioavailability of other compounds, including herbal and pharmaceutical drugs. Most of these studies appear to suggest that Trikatu and its components can increase the bioavailability of other substances.

The constituent responsible for this bioavailability enhancing effect is piperine..2;34

As mentioned above, an early study found that adding Long pepper to Adhatoda vasica leaves increased their efficacy in asthma (in Atal et al. 1981).

Enhanced bioavailability as a result of co-administration with either piperine, Black pepper or Long pepper, or Trikatu has been observed for several drugs including vasicine (from Adhatoda vasica), sparteine (from Spartium junceum but also found in broom, Cytisus scoparius), phenytoin, propranolol, theophylline, pentobarbitone, sulphadiazine and tetracycline.1;2;34;35

For example, piperine administered at a dose of 30 mg/kg together with sparteine to rats more than doubled the bioavailability of sparteine.2

The primary mechanism by which piperine (and Trikatu) affects the bioavailability of other compounds seems to be via the nonspecific and noncompetitive inhibition of microsomal liver metabolism involving the cytochrome P-450 enzyme system.1;13;16;34;36;3

Clinical References

Long Pepper has been used in the treatment of asthma and chronic bronchitis in Ayurvedic and Unani medicine.10 In a study involving 240 children of different age groups suffering from frequent asthma attacks, long term administration of Long Pepper fruits significantly reduced the severity of asthma attacks.15 25 patients in the study group showed no occurrence of asthma attacks, 161 showed clinical improvement, 47 did not benefit from the treatment, and 7 patients deteriorated.

In another study 20 pediatric patients with asthma received Long Pepper in dosages of 9.35 to 15.75 grams daily for several weeks. As a result of this treatment all patients showed clinical improvement.

Terminalia belerica

(Terminalia belerica), is a gentle bowel tonic excellent for chronic constipation and IBS and for clearing toxins from the bowel. It can be taken in powder or capsule form at bedtime.Among the Ayurvedic medicines available for treatment of constipation.

Habitat _ Throughout deciduous forests of India.

English _ Belleric Myrobalan, Bastard Myrobalan.

Action _ Fruit—purgative when half ripe, astringent when ripe; antipyretic; used in prescriptions for diarrhoea, dyspepsia, biliousness; cough, bronchitis and upper respiratory tract infections, tropical pulmonary eosinophilia and allergic eruptions.

The Ayurvedic Pharmacopoeia of India recommends the drug in powder form in emesis and worm infestation, in addition to other therapeutic applications.

The fruits contain beta-sitosterol, gallic and ellagic acids, ethyl gallate, galloyl glucose, chebulagic acid and a cardiac glycoside, bellaricanin. The fruits produce hepato-protective effect in CCl4-induced liver injury in mice. Alcoholic extract of the fruit exerted a negative chrono-and inotropic and hypotensive effect of varying magnitude in a dose dependent fashion on isolated rat and frog atria and rabbit heart. The fruit contains all components of Chebulicmyrobalan (T. chebula) except corilagin and chebulic acid. The fleshy fruit pulp contains 21.4% tannin, both condensed and hydrolysable types.

Terminalia chebula or tropical almond

DESCRIPTIONMedicinal Parts: The medicinal part of the tree is the fruit.

Habitat: IndiaProduction: Tropical Almond fruit is the dried ripe fruit of Terminalia chebula.

Other Names: Black Myrobalan, Chebulic Myrobalan, Myrobalan

ACTIONS AND PHARMACOLOGY

COMPOUNDSTannins (20 to 45%): gallotannins, including terchebulin, terflavin A, punicalagin, corilagin, chebulic acid, and chebulinic acid

Monosaccharides/oligosaccharides (9%): including D-glucose, D-fructose, saccharose

Fruit acids: including quinic acid (1.5%), shikimic acid (2%)

Fatty oil (in the seeds, to 40%)

EFFECTSIts high tannin content explains the use of the drug as an astringent. A variety of experiments have demonstrated antibacterial, cardiotonic and antiarteriosclerotic (lowering of cholesterol levels) effects for the drug.

Action _ Gentle purgative, astringent (unripe fruits are more purgative, ripe ones are more astringent; sennoside A and anthraquinone glycoside is laxative, tannins are astringent), stomachic, antibilious, alterative. Used in prescriptions for treating flatulence, constipation, diarrhoea, dysentery, cyst, digestive disorders, vomiting, enlarged liver and spleen, cough and bronchial asthma, and for metabolic harmony. Bark—diuretic.

The Ayurvedic Pharmacopoeia of India, along with other therapeutic applications, indicated the use of powder of mature fruits in intermittent fevers, chronic fevers, anaemia and polyuria.

The fruits of T. chebula are used in combination with Emblica officinalis and T. bellirica (under the name Triphalaa) in the treatment of liver and kidney dysfunctions. The main purgative ingredient of Triphalaa is T. chebula (the purgative principle is in the pericarp of the fruit).

Shikimic, gallic, triacontanoic and palmitic acids, beta-sitosterol, daucosterol, triethyl ester of chebulic acid and ethyl ester of gallic acid; a new ellagitannin, terchebulin, along with punicalagin and teaflavin A have been isolated from the fruits. A new triterpene, chebupentol, and arjungenin, terminoic acid and arjunolic acid were also isolated from the fruit.

Antioxidant constituents of the plant, phloroglucinol and pyrogallol have been isolated along with ferulic, vanillic, p-coumaric and caffeic acids. Ether extract showed higher antioxidant activity than BHA and BHT, Acid esters present in phenolic fraction of extract, were found most effective.

INDICATIONS AND USAGE

Chinese Medicine: Tropical Almond is used for chronic diarrhea, chronic dysentery, rectal prolapse, loss of voice because of chronic coughs, blood in the stool, leucorrhea, night sweats and undesired discharges.

Indian Medicine: The drug is used in the treatment of wounds, ulcers, gingivitis, excitation, gastric complaints, anorexia, worm infestation, flatulence, hemorrhoids, jaundice, for liver and spleen disease, pharyngodynia, hiccups, coughs, epilepsy, eye disease, skin changes, leprosy, intermittent fever, cardiac dysfunction, gastritis and neuropathy.

PRECAUTIONS AND ADVERSE REACTIONS

No health hazards are known in conjunction with the proper administration of designated therapeutic dosages, although even therapeutic dosages could lead to constipation, due to the high tannin content (administration as an antidiarrheal).

Cassia angustifolia Vahl. Sym. C. senna

DESCRIPTIONMedicinal Parts: The medicinal parts are the leaves, fruit and flowers.

Habitat: Cassia species is found in the tropical and subtropical regions of all continents except Europe. Most varieties are indigenous to North, Central, and South America.

Other Names: Tinnevelly Senna, India Senna, Alexandrian Senna, Khartoum Senna

ACTIONS AND PHARMACOLOGYCOMPOUNDSAnthracene derivatives (2.5-3.5%): chief components sennosides A, Al and B, as well as sennosides C and D

Naphthacene derivatives: including 6-hydroxymusizin glucoside (0.85% in Cassia senna), tinnevellin-6-glucosides (0.3% in Cassia angustifolia)

Action _ Purgative (free from astringent action of rhubark type herbs, but causes gripe), used in compounds for treating biliousness, distention of stomach, vomiting and hiccups. Also used as a febrifuge, in splenic enlargements, jaundice, amoebic dysentery. Contraindicated in inflammatory colon diseases.

Key application _ Leaf and dried fruit—in occasional constipation.(German Commission E.) As a stimulant laxative. (The British Herbal Pharmacopoeia.) 1,8- dihydoxy-anthracene derivatives have a laxative effect. This effect is due to the sennosides, specifically, due to their active metabolite in the colon, rheinanthrone. The effect is primarily caused by the influence on the motility of the colon by inhibiting stationary and stimulating propulsive contractions. (German Commission E, ESCOP, WHO.) Senna has been included in I.P. as a purgative.

EFFECTSLaxative Effects

Senna is an anthranoid-type stimulating laxative. The laxative effect is due to the action of sennosides and their active metabolite, rhein anthrone, in the colon. The laxative effect is realized by inhibition of water and electrolyte absorption from the large intestine, which increases the volume and pressure of the intestinal contents. This will stimulate colon motility resulting in propulsive contractions.

In addition, stimulation of active chloride secretion increases water and electrolyte content of the intestine. These changes in active electrolyte transport are dependent on calcium in the serosal

surface (Donowitz, 1984; Yamauchi, 1993). The laxative action of Senna is partially via stimulation of colonic fluid and electrolyte secretion, and this secretion is mediated by stimulation of endogenous prostaglandin E2 formation (Beubler. 1988: Yamauchi, 1993).

CLINICAL TRIALSLaxative EffectsA randomized, single-blind study evaluated the efficacy of Senna compared to polyethylene glycol (PEG) for mechanical preparation for elective colorectal resection. Five hundred twenty-three patients included in the study were undergoing resection, followed by anastomosis. All patients received 5% providone iodine antiseptic enema before surgery, and ceftriaxone sodium and metronidazole were given at anesthesia induction. Senna was significantly better than PEG with regard to colonic cleanliness and less fecal matter in the colonic lumen. The risk for moderate or large intraoperative fecal soiling was lower with senna and overall clinical tolerance did not differ significantly between the treatment groups. Senna was better tolerated in patients with stenosis. There was no statistical difference between the treatment groups with postoperative infective complications or anastomotic leakage (Valverde. 1999).

A prospective randomized trial evaluated the efficacy of the addition of senna to a polethylene glycol electrolyte lavage solution (PEG-ELS). One hundred and twenty patientsreceived either a Senna extract with PEG-ELS or placebo with PEG-ELS before a total colonoscopy. Superiority by physician assessment was seen in the group with Senna. The colon was free of solid debris in 66.7% of patients after PEG-ELS and in 90% after Senna/PEG-ELS administration, which was a significant difference. Patient tolerance was similar in both groups, and significantly less lavage fluid was needed in the Senna/PEG-ELS treatment group (Ziegenhagen, 1991).

A randomized, open, parallel group study was conducted to determine the efficacy of senna compared to lactulose in terminal cancer patients treated with opioids. Ninety-one terminal cancer patients were treated with either senna (starting with 0.4 mL daily) or lactulose (starting with 15 mL daily) for a 27-day period. The main outcome measures were defecation-free intervals of 72 hr, days with defecation, general health status, and treatment cost. Both treatment groups had similar scores for defecation-free intervals and in days with defecation. The final scores for general health status were similar in both groups (Agra, 1998).

INDICATIONS AND USAGE• ConstipationSenna is used for constipation and for evacuation of the bowel prior to diagnostic tests of the gastrointestinal and colorectal area.

Indian Medicine: The herb is used for constipation, liver disease, jaundice, splenomegaly, anemia, and typhoid fever.Note: Stimulating laxatives must not be used over a period of more than 1 to 2 weeks without medical advice.

CONTRAINDICATIONSThe herb is not to be administered in the presence of intestinal obstruction, acute inflammatory intestinal diseases or appendicitis.

PRECAUTIONS AND ADVERSE REACTIONS

General: Spasmodic gastrointestinal complaints can occur as a side effect to the drug's purgative effect or from overdosage. In rare cases, prolonged use may lead to cardiac arrhythmias, nephropathies, edema and accelerated bone deterioration. Senna abuse has also resulted in tetany, aspartylglucosamine excretion, and . hypogammaglobulinemia (Levine, 1981; Malmquist, 1980; Prior, 1978). Electrolyte Abnormalies: Long-term use leads to loss of electrolytes, in particular potassium ions. As a result of hypokalemia, hyperaldosteronism, albuminuria, hematuria, inhibition of intestinal motility, and muscle weakness may occur. Enhancement of cardioactive glycosides and antiarrythics may also occur with hypokalemia.

Cardamom

Elettaria cardamomum

DESCRIPTIONMedicinal Parts: The medicinal parts are the oil extracted from the seeds and fruit plus seeds harvested shortly after ripening.

Characteristics: Cardamom has an aromatic and pleasant odor. The taste is aromatic and pungent.

Habitat: The plant is indigenous in southern India and Sri Lanka and is cultivated in tropical regions in Southeast Asia and Guatamala.

Production: Cardamom consists of the dried, almost ripe, greenish to yellow-gray fruit of Elettaria cardamomum. Medicinal use is limited to the seed, which is removed from its fruit capsule. The main harvest is in October and November of the third year after planting. The fruit is then dried either in the sun or in so-called 'curing houses' and then sorted according to size, form, color etc.

ACTIONS AND PHARMACOLOGYCOMPOUNDSVolatile oil: composition varies according to the specific strain, chief components cineol, alpha-terpinyl acetate, linalyl acetate

Fatty oil

Starch

EFFECTSThe drug is a cholagogue and has virustatic properties. The essential oil (monoterpene) of the drug is antibacterial and antimycotic. In animal experiments the essential oil caused an increase in the secretion of bile and a reduction of gastric juice production.

INDICATIONS AND USAGEApproved by Commission E:• Common cold• Cough/bronchitis• Fevers and colds• Inflammation of the mouth and pharynx• Liver and gallbladder complaints

• Loss of appetite• Tendency to infection

Chinese Medicine: Cardamom is used for stomachache, nausea, vomiting and flatulence.

Indian Medicine: In Indian medicine, Cardamom is used for disorders of the efferent urinary tract.

Action _ Carminative antiemetic, stomachic, orexigenic, anti-gripe, antiasthmatic, bechic, Oil— antispasmodic, antiseptic. Used for flatulence, loss of appetite, colic, bronchitis, asthma. Paste used as balm for headache, husk for rheumatism.

Key application _ In dyspepsia; also as cholagogue. (German Commission E.)

The seeds yield an essential oil (6–11% dry basis). The major constituents are, 1,8-cineole and alpha-terpinylacetate, with limonene, alpha-terpineol, sabinene and linalool. The seeds contain palmitic and oleic as dominant fatty acids, besides linoleic and linolenic acids, along with alpha-tocopherol, desmosterol and campesterol.

Cineole also known as Eucalyptol which stimulates the central nervous system, is antiseptic, is expectorant, and eliminates gas. Studies show that cineole has both expectorant and decongestant activity when ingested.

Dr. Duke'sPhytochemical and Ethnobotanical DatabasesChemicals and their Biological Activities in: Cardamom

1,8-CINEOLE (also known as Eucalyptol) Fruit 525 – 56,000 ppm Allelopathic; Allergenic; Anesthetic; Anthelminthic; Antiacetylcholinesterase IC50=41 ug/ml; Antiallergic; Antibacterial 50 ppm; Antibronchitic; Anticatarrh; Anticholinesterase; Antifatigue; Antihalitosic; Antilaryngitic; Antipharyngitic; Antirhinitic; Antiseptic; Antispasmodic; Antistaphylococcic; Antitussive; Candidicide; Choleretic; CNS-Stimulant; Convulsant; Counterirritant; Cytochrome-P450-Inducer; Degranulant 0.3 ul/ml; Dentifrice;Edemagenic inj; Expectorant; FLavor FEMA 1-200; Fungicide; Gram(+)icide; Gram(-)icide; Hepatotonic; Herbicide IC50=78 uM; Hypotensive; Inflammatory inj; Insectifuge; Irritant; Myorelaxant; Nematicide; Neurotoxic; P450-Inducer; Perfume; Pesticide; Rubefacient; Secretogogue; Sedative; Spasmogenic; Surfactant; Testosterone-Hydroxylase-Inducer; Trichomonicide LD100=1,000 ug/ml

LIMONENE Fruit 595 - 9,481 ppm DUKE1992A Acaricide LC100=8 uM; AChE-Inhibitor; Allelochemic; Allergenic 1/20th carene; Antiacetylcholinesterase IC22-26=1.2 mM ; Antiadenomic; Antiasthmatic; Antibacterial; Antiesophagitic; Antifeedant; Antiflu ; Antiinflammatory; Antilithic; Antilymphomic; Antimetastatic (Stomach); Antimutagenic; Antiobesity; Antiseptic; Antispasmodic ED50=0.197 mg/ml; Antitumor; Antitumor (Breast) ; Antitumor (Colon) ; Antitumor (Pancreas) ; Antitumor (Prostate) ; Antitumor (Stomach) ACT13:64 ; Antiviral; Apoptotic; Bronchoprotectant; Cancer-Preventive ; Candidistat; Chemopreventive ; Cholesterolytic; Detoxicant; Enterocontractant; Expectorant; FLavor PJB1(3):242 ; Fungiphilic JAF43:2283 ; Fungistat JAF40:2330 ; GST-Inducer; Herbicide IC50=45 uM TOX ; Histaminic; Immunomodulator; Insecticide 0.37 uM/fly;

Insectifuge 382 ; Interleukin-6-Inhibitor; Irritant; Lipolytic; Myorelaxant 50 mg/kg; Nematicide IC=100 ug/ml NIG ; NO-Genic X15778119 ; Ornithine-Decarboxylase-Inhibitor ~750 mg/kg (diet); Ozone-Scavenger; P450-Inducer; Peristaltic; Pesticide DUKE1992B ; Photosensitizer RIN ; Sedative ED=1-32 mg/kg W&W ; Transdermal

ALPHA-TOCOPHEROL Seed: DUKE1992A Antialzheimeran; Antianginal; Antiarthritic; Antiasthmatic; Antiatherosclerotic; Anticancer ; Anticataract ; Anticonvulsant Synergen ; Antidementia ; Antidiabetic ; Antiinfarctal ; Antiinfertility ; Antiischemic ; Antimaculitic ; Antimutagenic ; Antineuropathic; Antioxidant 5 x quercetin IC34=10 uM ; Antiparkinsonian; Antiradicular 5 x quercetin ; Antiretinotic ; Antirheumatic ; Antistroke ; Antitumor ; Antitumor (Bladder) PIL ; Antitumor (Prostate) PIL ; Antitumor (Stomach); Antitumor-Promoter; Cancer-Preventive ; Cardioprotective; Circulotonic; Immunomodulator

Eucalyptol is an ingredient in many brands of mouthwash and cough suppressant. It controls airway mucus hypersecretion and asthma via anti-inflammatory cytokine inhibition. Eucalyptol is an effective treatment for nonpurulent rhinosinusitis. Research showed that treated subjects experienced fewer headaches on bending, frontal headache, and sensitivity of pressure points of trigeminal nerve, impairment of general condition, nasal obstruction, and rhinological secretion. Side effects from treatment were minimal.

The extracts of cardamom cause a significant decrease in gastric secretion after 3 h of treatment.The effect of methanol extract is primarily observed as decreased pepsin output.

Terpineol and acetylterpineol, the active principles of cardamom seeds, showed greater penetration enhancing capacities than Azone which was used as a comparative penetration enhancer for the diffusion of Prednisolone through mouse skin in vitro.

Volatile components exhibit antimicrobial activity. The oil inhibits aflatoxin synthesis.The cardamom seed can trigger gallstone colic (spasmodic pain) and is not recommended for self-medication in patients with gallstone. (German Commission E, PDR, NaturalMedicinesComprehensive Database, 2007.)

PRECAUTIONS AND ADVERSE REACTIONSNo health hazards or side effects are known in conjunction with the proper administration of designated therapeutic dosages. The drug can trigger gallstone colic, due to its motility-enhancing effect.

DOSAGEMode of Administration: Ground seeds, as well as galenic preparations for internal use.

Daily Dosage: The average daily dosage is 1.5 gm of drug.When using a tincture, the dosage range is l to 2 gm.

Storage: Cardamom should be stored in a cool, dry place protected from light in tightly sealed containers. The powder can be stored for a maximum of 24 hours. Loose seeds without the testa cannot be stored.

Tinospora cordifolia stem

Habitat _ Tropical India and the Andamans.

Action _ Herb—antipyretic, antiperiodic, anti-inflammatory, antirheumatic, spasmolytic, hypoglycaemic, hepatoprotective. Water extract increases urine output. Stemjuice—prescribed in high fever; decoction in rheumatic and bilious fevers. Aqueous extract of the plant—fabrifuge. Starch—antacid, antidiarrhoeal and antidysenteric.

The Ayurvedic Pharmacopoeia of India, along with other therapeutic applications, recommends the dried stems in jaundice, anaemia, polyuria and skin diseases.

The stem contains alkaloidal constituents, including berberine; bitter principles, including columbin, chasmanthin, palmarin and tinosporon, tinosporic acid and tinosporol.

The drug is reported to possess one fifth of the analgesic effect of sodiumsalicylate. Its aqueous extract has a high phagocytic index.Alcoholic extract of the stem shows activity against E. coli. Active principles were found to inhibit in vitro the growth of Mycobacterium tuberculosis.

Oral administration of alcoholic extract of the root resulted in a significant reduction in blood and urine glucose and in lipids in serum and tissues of alloxan diabetic rats. (Phytother Res. 2003 17 (4), 410–3.)

A new hypoglycaemic agent was isolated from the plant; it was found to be 1,2-substituted pyrrolidine.

The starch from roots and stem, used in chronic diarrhoea and dysentery, contains a polysaccharide having 1–4 glucan with occasional branching points.

A significant reduction in levels of SGOT, SGPT, ALP and bilirubin were observed following T. cordifolia treatment during CCl4 intoxication in mature rats. (J. Toxicol Sci. 2002, 27 (3), 139–46.) The plant extract showed in vitro inactivating activity in Hepatitis-B surface antigen. (Indian Drugs, 1993,30, 549.)

In Sanskrit T.cordifolia is also called ‘Pittaghni’ i.e bile destroying.2 It is used as an immuno modulator in immunosuppression of obstructive jaundice, peritonitis and Sepsis.

The plant has been found effective in preventing fibrous changes and promotesregeneration of the liver against CCl4 induced hepatotoxicity.

Padhya MA, “Biosynthesis of Isoquinoline alkaloid berberine in tissue culturesof T.cordifolia” INDIAN DRUGS 1986; 24:47-8.

The clinical study of Tinospora Cordifolia was conducted in 10 patients of jaundice who attended as outpatients and inpatients to the department of Kayachikitsa, S.S. Hospital, I.M.S., B.H.U., Varanasi. After administration of a Tinospora Cordifolia decoction 50 ml twice daily, a quick response within few days was observed, such as an improvement in appetite, the decreased appearance of icterus, reappearance of icterus, reappearance of the normal colour of the urine and stools. By the end of 3-4 weeks considerable improvement was observed both on clinical and biochemical pramaeters. At the end of the 4th week or after the 4th follow up, final assessment of the results was done on the basis of clinical improvement as well as normalization of the altered L.F.T.

Dr. Sunil Gupta and Dr. Rai, N.P. Institute of Medical Science, B.H.U., “Tinospora cordifolia (Amrita) in the treatment of viral hepatitis.” AYURVEDA NEWS OCT. 1998; (16-31)

Trichosanthes dioica Roxb.

Habitat _ Warmer regions of India, particularly in Uttar Pradesh. Bihar, West Bengal and Assam.

English _ Pointed Gourd.

Action _ Aerial parts—hypoglycaemic. Fruits—juice of unripe fruits used in spermatorrhoea.Leaves—febrifuge; prescribed as a diet in enlargement of liver and spleen; piles and fistula. Root—cathartic, febrifuge. The fruits contain free amino acids, nicotinic acid, riboflavin, vitamin C, thiamine, 5-hydroxytryptamine. Mature plant and root gave cucurbita-5, 24-dienol. Colocynthin, trichosanthin, hentriacontane have been isolated from the root.

Fatty acids from the seeds comprise elaeostearic, linoleic, oleic and saturated acids.

The whole fruit and pulp produced significant hypocholesterolaemic, hypotriglyceridaemic and hyper-phospholipidaemic effects in normal and midly diabetic human subjects. The fruits are used as a vegetable is particularly useful for convalescents, as they are laxative and easily digestible. Fruits also show some prospect in control of cancer-like conditions.

Extracts of seeds exhibit haemagglunating activity.

Dosage _ Leaf—10–2 ml juice. (CCRAS.)

Eclipta alba

Trailing Eclipta Leaf and Root (Eclipta alba)Traditionally used as a cholagogue (aids bile secretion) and deobstruent (removes functional obstructions in the body) in hepatic enlargement, for jaundice, and other

ailments of the liver and gall bladder. Two coumestans, wedelolactone and demethyl-wedelolactone, were isolated as the main active principles present in trailing eclipta. Both constituents showed anti-hepatotoxic activity in assays using liver enzyme-induced cytotoxicity in cultured rat hepatocytes. These constituents also showed a significant stimulatory effect on liver cell regeneration.9 Evidence suggests that trailing eclipta exerts its protective actionthrough a reduction in GSH depletion.9,10

Action _ Deobstruent, antihepatotoxic, anticatarrhal, febrifuge. Used in hepatitis, spleen enlargements, chronic skin diseases.

Key application _ As hepatoprotective. (Indian Herbal Pharmacopoeia; The Ayurvedic Pharmacopoeia of India.)

The herb should be dried at room temperature under shade. Its active principles are lost due to aerial oxidation during sun drying or drying under reduced pressure below 40°C.The herbcontains wedelolactone and demethylwedelolactone, which showed a dose dependenteffect against CCl4, d-galactosamine- or phalloidin-induced cytotoxicity in primary cultured rat hepatocytes, and exhibited potent antihepatotoxic property. The whole plant shows effect on liver cell regeneration. Immunoactive property has been observed against surface antigen of hepatitisB-virus. The plant is also reported to be effective in the treatment of peptic ulcer, inflammatory diseases, including rheumatoid arthritis, diseases of the gallbladder and skin infections.

Aqueous extract of leaves exhibits myocardial depressant and hypotensive activity (unrelated to cholinergic and histaminergic effects).

In Ayurvedic medicine, the leaf extract is considered to be powerful liver tonic, rejuvenative and especially good for the hair. A black dye obtained from Eclipta alba is also for dyeing hair and tattooing. It also has traditional external uses, like eczema and dermatitis, on the scalp to treat hair loss and the leaves have been used in the treatment of scorpion stings. It is reported to improve hair growth and colour. Coumestan derivatives such as wedelolactone and demethylwedelolactone and nor-wadelolactone.Thiophene derivatives ecliptal and various dithiemylacetylene esters (I, II, III) reported from roots, saponin compounds like eclalbosaponins I-IV and other common sterols and triterpenoids. The flavonoids glycoside eg: luteolin-7 O glucoside and long chain alcohols such as hentriacontanol, 14- heptacosanol have also been reported along with certain alkaloids and polypeptides. The whole plant contains ecliptine, nicotine and stigmasterol. The entire plant contains triterpenes: ecalbatin, echinocystic acid, oleanic acid, ursolic acid, flavone. It is a potential hepatoprotective agent, in jaundice and in conditions of liver and spleen enlargement, Hypotensive and myocardial depressant activity, anti-inflammatory, abortion and miscarriage, piles, insect bites, swellings and other skin diseases.

Dried aerial parts are used as a purgative, emetic, cholagogue, antiasthmatic. Leaves are used to treat epilepsy in India. Roots are used for insanity. The entire plant is used for tuberculosis and as haemostatic. Oil soluble extracts helps in promotion of growth and colour of hairs. Its hair oil preparations are used as a scalp tonic in India9. Coumestans are known to possess estrogenic activity. Wedelolactone possesses a wide range of biological activities and is used for the treatment of hepatitis and cirrhosis, as an antibacterial, anti-haemorrhagic, as an antidote for snake venom. The hydroalcoholic extract of the dried leaf reported analgesic activity, when administered intragastrically in mouse 100 mg/kg. The chloroform and methanol extract of the dried leaf 1 gm/ml showed antibacterial activity against Bacillus subtilis,

Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. Various Other biological activities which have been reported in the literature for the extracts of E. alba: hepatoprotective, antiviral, antirheumatic, molluscicidal, antimalarial and antifertility.

Ginger rhizome

DESCRIPTIONMedicinal Parts: The medicinal part is the root.

Ginger Rhizome (Zingiber officinale)Traditionally used to promote digestion. Ginger has been found to have a stimulatory effect on gastric secretions and has metabolic and circulatory enhancing effects, which reinforces the therapeutic activity of other herbs.8

Ginger has been used as a medicine since ancient times, recorded in early Sanskrit and Chinese texts and ancient Greek, Roman, and Arabic medical literature (Bone, 1997). In Asian medical practices, dried ginger has been used as a drug to treat stomachache, diarrhea, and nausea for thousands of years. It is traditionally prepared in aqueous decoctions and infusions (Bruneton, 1995; But et al., 1997; Kapoor, 1990; Leung and Foster, 1996). In Africa, dried ginger is used much as it is in Asia (GHP, 1992; Iwu, 1990). Today, ginger is official in the national pharmacopeias of Austria, China, Egypt, Germany, Great Britain, Japan, and Switzerland (BP, 1988; Bradley, 1992; DAB, 1997; JP XII, 1993; Newall et al., 1996; AB, 1981; Ph.Helv.VII, 1987; Tu, 1992). The Chinese pharmacopeia lists ginger forepigastric pain with cold feeling, vomiting and diarrhea accompanied by cold extremities and faint pulse, dyspnea, and cough with copious frothy expectoration (Tu,1992). The Ayurvedic Pharmacopoeia specifically recommends ginger for flatulent intestinal colic (Karnick, 1994).

ACTIONS AND PHARMACOLOGYCOMPOUNDSVolatile oil (2.5-3.0%): chief components vary greatly, depending upon country of origin: (-)-zingiberene and arcurcumene, beta-bisabolene and ar-curcumene, neral and geranial, D-camphor, beta-phellandrene, geranial, neral and linalool, (E)-alpha-farnesene, important as aroma carrier zingiberol (mixture of cis- and trans-beta-eudesmol)

Aryl alkanesGingerols: chief components [6]-gingerol (pungent substances), [8]-gingerol, [10]-gingerol

Shogaols: chief components [6]-shogaol (pungent substane), [8]- shogaol, [10]- shogaol (artifacts formed during storage. arising from the gingerols)

Gingerdiols

Diarylheptanoids: including among others, gingerenone A and B

Starch (50%)

EFFECTS

Compounds isolated from the Ginger rhizome have been studied in numerous in vitro and animal experiments. Other studies show that Ginger root is positively inotropic. antithrombotic; has anti-oxidant, anti-migraine and anti-lipidemic effects, and promotes secretion of saliva, gastric juices and bile.

Anti-Inflammatory EffectsThe anti-inflammatory effect of Ginger is thought to be due to inhibition of cyclooxygenase and 5-lipoxygenase, results in reduced leukotriene and prostaglandin synthesis (Kiuchi. 1992; Srivastava & Mustafa, 1992).

Miscellaneous EffectsIn humans, Ginger increases the tone and peristalsis of the intestine (Bisset, 1994; Iwu, 1993). The root of Zingiber officinale has also shown immune system stimulation (Chang, 1995) and platelet aggregation inhibitory activity (Verma, 1993).

INDICATIONS AND USAGEApproved by Commission E:• Loss of appetite• Travel sickness• Dyspeptic complaints

Unproven Uses: In folk medicine. Ginger is used as a carminative, expectorant, and astringent.Chinese Medicine: In China. Ginger is used to treat colds, nausea, vomiting and shortness of breath.

Indian Medicine: Indian medicine uses include anorexia, dyspeptic symptoms and pharyngitis.

CONTRAINDICATIONSThe German Commission E contraindicates the use of Ginger in morning sickness associated with pregnancy. Most research provides evidence that Ginger can be used and is effective in the treatment of morning sickness. It is recommended that excessive doses are avoided for this purpose (see PRECAUTIONS and ADVERSE REACTIONS).

Because of its cholagogic effect, the drug should not be taken in the presence of gallstone conditions except after consultation with a physician. Ginger has been found to inhibit thromboxane synthesis, therefore it should not be used by patients who are at risk for hemorrhage (Bracken, 1991)

PRECAUTIONS AND ADVERSE REACTIONSGeneral: No health hazards or side effects are known in conjunction with the proper administration of designated therapeutic dosages.

It has been reported that administration of 6 grams of dried powdered Ginger has been shown to increase the exfoliation of gastric surface epithelial cells in human subjects. It is postulated that this action may possibly lead to ulcer formation. Therefore, it- is recommended that dosages on an empty stomach be limited to 6 grams (Desai, 1990).

There have been reports that Ginger can cause hypersensitivity reactions resulting in dermatitis. Large overdoses can cause central nervous system depression and cardiac arrhythmias.

Pregnancy: A study in 27 pregnant patients with hyperemesis gravidarum (persistent vomiting occurring prior to the 20th week of pregnancy and requiring hospitalization) found that 1 gram per day (250 milligrams 4 times a day) for 4 days caused no adverse effects. One spontaneous abortion occurred; a causal relationship between the abortion and the use of Ginger was not determined. All infants were normal (Fischer-Rasmussen, 1990).

Drug Interactions: More than one in-vitro study confirms an antithrombotic effect. It is recommended that patients taking anticoagulants or those with bleeding disorders avoid the use of large doses of Ginger.

OVERDOSAGEAccording to research, the LD50 of 6-gingerol and 6-shogaol is set between 250 and 680 mg/kg. (Fulder & Tenne, 1991; Suekawa et al, 1984.) Toxicity tests in mice using a Ginger extract via lavage resulted in no mortality or adverse effects in doses up to 2.5 g/kg over a 7 day period. When the dose was increased to between 3 and 3.5 g/kg, a 10% to 30% mortality rate was reported (Macola, 1989.) Overdosage may cause cardiac arrhythmia and CNS depression(Iwu, 1993).

DOSAGEMode of Administration: Comminuted rhizome and dry extracts for teas and other galenic preparations for internal use. The powdered drug is used in some stomach preparations.

Emblica Officinalis (Indian Gooseberry)

Emblica provides a broad-based approach to preventing cardiovascular damage through its powerful cholesterol regulating and multi-faceted antioxidant properties. Two of its most exciting effects are its ability to reduce cholesterol and LDL (bad cholesterol) levels, and improve glucose tolerance and blood sugar regulation. This is especially important because both high blood cholesterol and high blood sugar are risk factors for the development of cardiovascular disease. A study just published in March 2003 suggests that the tannins in Emblica inhibit the production of aldose reductase, an enzyme implicated in the development of diabetic cataracts.12

Emblica has the ability to lower cholesterol by the unique concerted action of both inhibiting cholesterol production and enhancing cholesterol degradation. It has also shown the amazing property of actually reducing plaque in clogged arteries caused by high cholesterol levels in some animal studies.

A study at the University of Delhi in India tested the effects of Emblica on cholesterol levels in men aged 35 to 55. One group had normal cholesterol and the other group had high cholesterol. After 28 days, both the normal and high cholesterol groups showed a decrease in cholesterol levels. And after two weeks of not taking Emblica, the serum cholesterol levels of the men in the high cholesterol group rose significantly, almost to the initial levels.13

Several animal studies have also shown that the flavonoids in Emblica reduce lipid serum levels and aortic plaques.14,15 Rabbits that had been fed a high cholesterol diet were given fresh Emblica juice for 60 days. Their serum cholesterol and LDL levels were lowered by 83% and 90%, respectively. Similarly, the tissue lipid levels showed a significant reduction and aortic plaques decreased in size. Consequently, the researchers suggested that Emblica be used as a pharmaceutical tool for patients wanting to reduce their cholesterol levels.16

12. Suryanarayana P, Kumar PA, Saraswat M, Petrash JM, Reddy GB. Inhibition of aldose reductase by tannoid principles of Emblica officinalis: implications for the prevention of sugar cataract. Mol Vis. 2004 Mar 12;10:148-54.

13. Jacob A, Pandey M, Kapoor S, Saroja R. Effect of the Indian gooseberry (amla) on serum cholesterol levels in men aged 35-55 years. Eur J Clin Nutr. 1988 Nov;42(11):939-44.

14. Anila L, Vijayalakshmi NR. Flavonoids from Emblica officinalis and Mangifera indica-effectiveness for dyslipidemia. J Ethnopharmacol. 2002 Jan;79(1):81-7.

15. Thakur CP. Emblica officinalis reduces serum, aortic and hepatic cholesterol in rabbits. Experientia. 1985 Mar 15;41(3):423-4.

Mathur R, Sharma A, Dixit VP, Varma M. Hypolipidaemic effect of fruit juice of Emblica officinalis in cholesterol-fed rabbits. J Ethnopharmacol. 1996 Feb;50(2):61-8.

Glycyrrhiza glabra or licorice

Licorice root has been used therapeutically for several thousand years in both Western and Eastern systems of medicine (Bradley, 1992; Leung and Foster, 1996). A chronological, documented summary of its medical uses since 2100 B.C.E. to the present, with correlations to modern pharmacological research, has been published (Gibson, 1978). Its use is first documented in Assyrian clay tablets (ca. 2500 B.C.E.) and Egyptian papyri. It was used in ancient Arabia to treat coughs and to relieve the unwanted effects of laxatives (Bruneton, 1995). Its use in ancient Scythia spread to Greece. Greek natural scientist Theophrastus (ca. 372–287 B.C.E.) reported its use for dry cough, asthma, and all pectoral diseases (Grieve, 1979). Pliny the Elder (ca. 23–79 C.E.) reported licorice cleared the voice and had expectorant and carminative actions (Der Marderosian, 1999). In China, licorice is first mentioned in the Shen Nong Ben Cao Jing (ca. 25 C.E.), reconstructed "materia medica" from lost text attributed to Shen Nong Shi (ca. 3000 B.C.E.) (Foster and Yue, 1992). According to the Chinese pharmacopeia, licorice, either aqueous dry extract or hydroalcoholic fluid extract, is an irritant, often used in combination with expectorants and antitussives to diminish irritation of the mucous membrane of the pharynx. It also relieves spasms of the gastrointestinal smooth muscle and shows desoxycorticosterone-like action (Tu, 1992). In India, licorice is used in traditional Ayurvedic, Siddha, and Unani medicines (Nadkarni, 1976). The present-day Ayurvedic Pharmacopoeia reports it is expectorant, demulcent, spasmolytic,

antinflammatory, an adrenal agent, and a mild laxative (Karnick, 1994). It is also official in the Indian Pharmacopoeia as a demulcent (IP, 1996).

In Germany, licorice root is licensed as a standard medicinal tea for bronchitis and for chronic gastritis. It is also used in bronchial teas, stomach teas, and laxative teas available only in the pharmacy. Aqueous and alcoholic extracts of licorice root are used in many bronchial, gastrointestinal, liver and bile, and urological preparations. In the United States, licorice root is often a component of demulcent, expectorant, or laxative preparations (dietary supplement and OTC drug) in aqueous infusion, hydroalcoholic fluidextract and tincture, and solid dosage forms. Licorice root and extracts, fluid and solid, are official in the U.S. National Formulary (NF, 1985).

Chemistry and Pharmacology

Licorice root contains triterpenoid saponins (4–24%), mostly glycyrrhizin, a mixture of the potassium and calcium salts of glycyrrhizic acid; flavonoids (1%), mainly the flavanones liquiritin and liquiritigenin, chalcones isoliquiritin, isoliquiritigenin and isoflavonoids (formononetin); amines (1–2%) asparagine, betaine, and choline; amino acids; 3–15% glucose and sucrose; starch (2–30%); polysaccharides (arabinogalactans); sterols (b-sitosterol); coumarins (glycerin); resin; and volatile oils (0.047%) (Bruneton, 1995; Bradley, 1992; Budavari, 1996; Leung and Foster, 1996; List and Hrhammer, 1973–1979; Newall et al., 1996; Wichtl and Bisset, 1994). An extensive review of licorice chemistry has been published recently (Tang and Eisenbrand, 1992).

The Commission E reported that, according to controlled clinical studies, glycyrrhizic acid and the aglycone of glycyrrhizic acid accelerate the healing of gastric ulcers. Secretolytic and expectorant effects have been confirmed in tests on rabbits. In the isolated rabbit ileum, an antispasmodic action has been observed at concentrations of 1:2500–1:5000.

The British Herbal Compendium reported its actions as anti-inflammatory, expectorant, demulcent, and adrenocorticotropic (Bradley, 1992).

The pseudo-aldesterone-like effects are generally attributed to the glycyrrhizic acid. New research suggests that the glycyrrhetenic acid, the hydrolytic metabolite of glycyrrhizic acid, is the primary active component that causes inhibition of peripheral metabolism of corticol, which binds to mineralocorticoid receptors in the same way as aldosterone (Heikens et al., 1995).

The main constituent found in the root is glycyrrhizin. The plant also contains various sugars (to 14%), starches (30%), flavonoids, saponoids, sterols, amino acids, gums, and essential oil. Glycyrrhizin, stimulates the secretion of the adrenal cortex hormone aldosterone.

It can be as effective as codeine, and safer, when used as a cough suppressant. Rhizomes in the plant have a high mucilage content which, when mixed with water or used in cough drops, sooths irritated mucous membranes. The drug also has an expectorant effect which increases the secretion of the bronchial glands. It is an effective remedy for throat irritations, lung congestion, and bronchitis.

Glycyrrhizin also encourages the production of hormones such as hydrocortisone which give it anti-inflammatory properties. Like cortisone it can relieve arthritic and allergy symptoms, without the side effects.

Uses

The Commission E approved the internal use of licorice root for catarrhs of the upper respiratory tract and gastric or duodenal ulcers.

The British Herbal Compendium indicates its use for bronchitis, peptic ulcer, chronic gastritis, rheumatism and arthritis, and adrenocorticoid insufficiency (Bradley, 1992). The German Standard License approves licorice root infusions for loosening mucus, alleviating discharge in bronchitis, and as an adjuvant in treating spasmodic pains of chronic gastritis (Bradley, 1992; Braun et al., 1997; Wichtl and Bisset, 1994). In France, licorice preparations may be used to treat epigastric bloating, impaired digestion, and flatulence (Bruneton, 1995).

The World Health Organization recognizes no uses for licorice as being supported by clinical data; WHO recognizes the following uses as being described in pharmacopeias and in traditional systems of medicine: demulcent for sore throats; expectorant in treatment of coughs and bronchial catarrh; prophylaxis and treatment of gastric and duodenal ulcers; used in dyspepsia; anti-inflammatory in treating allergic reactions, rheumatism, and arthritis; to prevent liver toxicity; and to treat tuberculosis and adrenocorticoid insufficiency (WHO, 1999).

The Glycyrrhiza glabra root component Glycyrrhizin induces potassium excretion in conjunction with sodium and water re-absorption in the kidneys, resulting in hypokalemia and hypertension, if used in large amounts for prolonged periods (Brinker, 2001). However, licorice extracts are safer than consuming an equivalent amount of pure glycyrrhizin, due to modified intestinal absorption and bioavailability of the glycyrrhizin when it is combined with other licorice components (Cantelli-Fort et al 1994).

Licorice is added to so many mixtures in Chinese medicine as a synergistic agent, both as a potentiator and detoxifier. These effects are now becoming better understood, and it is known that licorice potentiates compounds such as paeoniflorin as a neuromuscular blocking agent, while affecting intestinal absorption of toxic substances such as the aconite alkaloids (Miaorong and Jing, 1996).

Asparagus racemosus (Shatavari)

Habitat _ Found wild in tropical and subtropical parts of India, including the Andamans and ascending in the Himalayas to 1,500 m.

English _ Indian asparagus.

Ayurvedic _ Shatavari

Action _ Used as a galactagogue and for disorders of female genitourinary tract; as a styptic and ulcer-healing agent; as an intestinal disinfectant and astringent in diarrhoea; as a nervine tonic, and in sexual debility for spermatogenesis.

Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicates the use of the tuberous root in gout, puerperal diseases, lactic disorders, haematuria, bleeding disorders and also recommends it for hyperacidity.

The plant contains saponins—shatavarinsI–IV. Shatavarin IV is a glycoside of sarsasapogenin. The saponin in doses of 20-500 mcg/ml produces a special blockade of syntocinon (oxytocin)- induced contraction of rat, guinea-pig and rabbit uteri in vitro and in situ. It also blocks the uterine spontaneous motility.

The dried root yields sitosterol; 5,6-dihydroxy-2–O-(2’ hydroxyisobutyl) benzaldehyde and undecanyl cetanoate, and contains a large amount of saccharine matter, mucilage and minerals— Ca (0.172), Cu (0.033), Na (14.60), K (8.32), Mg (0.169), Mn (0.0074),Ni (0.105) and Zn (0.072) mg/g(dry weight).

The root was found to reduce gastric emptying time comparable to that of metoclopramide. Asparagus was found in clinical trials to be comparable to the drug Maxolon for relieving nausea. (J Postgrad Med, 1990, 36(2), 91–94).

The powdered dried root of Asparagus racemosus (Shatavari) is used in Ayurveda for dyspepsia (amlapitta or acid regurgitation) and to increase milk secretion in a lactating

woman. A mixture 'Lactare', containing Asparagus racemosus as its major component, has

been reported to cause significant rise in scrum prolactin levels[1]. The alcoholic extract of

Asparagus racemosus has been shown to increase the prolactin levels in female rats[5].

Metoclopramide, a dopamine receptor antagonist with a poor penetration of the blood-brain

barrier, is used in radiology and in patients with dyspepsia to increase the rate of emptying of

the stomach, and also causes increase in milk secretion by increasing prolactin levels[2],[4].

With a working hypothesis that the therapeutic effects of Asparagus racemosus may be due to a

principle containing dopamine receptor antagonist activity, we decided to compare Shatavari

and metoclopramide for their effects on gastric emptying time.

  ::   Material and method  

This study was carried out in 8 normal healthy male volunteers aged 40 + 18.6 years (mean +

S.D.). Each subject underwent physical examination and laboratory investigations to rule out

anaemia, diabetes and any abnormality in renal and liver functions.

The study was accepted by the institution's ethics committee. Informed written consent was

obtained from the volunteers.

After an overnight fast, subjects reported to the nuclear medicine laboratory at 8.30 a.m. on 3

occasions at 4 day intervals.

On the first day of the study, 25 ml of water was given and half an hour later, 2 radio-labelled

jam sandwiches were given (60 gm of jam was mixed with 250-300 ?Ci of technetium 99m-

labelled sulphur colloid, and applied over 4 slices of bread).

The test meal was given along with 100 ml of water. On the next 2 visits, subjects received 2 gm

of powdered root of Shatavari, or a 10 mg tablet of metoclopramide according to a

randomisation scheme. Drug administration and recording of gastric emptying rate was done by

different investigators.

After the test meal, subjects were made to lie supine under a Picker Dyna-4 gamma camera

having a computer on-line (MDS-A2, Meditronic). The stomach was identified by its

configuration on the image screen, and the whole stomach (fundus to pylorus) was selected for

scanning. Counting was done manually as well as by a computer. Counts were recorded for 30

sec every 5 minutes, till the counts reached half of their initial value, or upto 3 hours after

administration of the test meal, whichever was earlier.

Gastric emptying time was by a linear regression of counts/30 seconds Vs time in on an IBM PC

using a created by program Lotus 1-2-3.

Statistical analysis was carried out by a 2-way analysis of variance, followed by a Neuman-

Keuls modification of the Studentised range.

To evaluate the central dopaminergic effect of Asparagus racemosus, a preliminary study was

carried out in male rats weighing 100-120 gm. Three groups of animals (10 in each group) were

taken; the first group served as a control, receiving 1 ml distilled water orally, the second and

the third groups were treated with 1 gm/kg and 2 gm/kg of Asparagus racemosus orally

respectively. The animals were observed at 1/2 hourly intervals for 4 hours, and after 24 hours.

  ::   Results  

As shown in [Table - 1], we found that both Shatavari and metoclopramide significantly reduced gastric emptying halftime. The difference between Shatavari and metoclopramide was not statistically significant.Analysis of the results was performed using a 2-way analysis of variance and finding the F ratio for variance due to treatment differences. This turned out to be highly significant (17=29.9 for 2, 14 d.f., p < 0.001) [Table - 2] and hence a comparison between individual treatments was performed using a Neuman-Keuls modification of the Studentised range. This showed significant differences (p <0.01) between control and metoclopramide, and between control and Shatavari.In the experiment in rats, Shatavari in doses of 1 gm/kg and 2 gm/kg did not produce catalepsy or sedation.