Schisandra chinensis, a climbing perennial vine with deciduous leaves, has been an official drug in the Russian Pharmacopeia since 1961 and has myriad uses in Traditional Chinese Medicine.
Schisandra (pronounced shiz’-an-dra) will pucker your mouth in more ways than one: Rolling the word across your tongue and chewing on the plant’s dried fruit can both be a taste treat. In China the name is known as wu-wei-zi, which means “five-flavor fruit,” because it tantalizes the taste buds with four basic flavors—sweet, sour, salty, and bitter—plus pungency. Schisandra is also a rising star in herbal scientific literature and has been safely used for thousands of years as a tonic and an anti-aging substance. New studies show it has potent antioxidant activity, although human clinical studies are needed to catapult it into the twenty-first century.
What is schisandra?
Schisandra (the name also serves as the plant group’s genus name) is a vine in the magnolia family (Schisandraceae), the fruits of which have myriad uses in Traditional Chinese Medicine (TCM). The name is derived from the Greek schizein, meaning “to cleave,” and andros, “man,” referring to the cleft anther cells on the stamens of the American southern magnolia vine, the first species known to Western botanists.
East Asia is home to about twenty-five species of schisandra, and only one—Schisandra glabra, also known as Schisandra coccinea or, more commonly, as the southern magnolia vine, smooth magnolia vine, bay star vine, or star vine—grows in North America. Southern magnolia vine is a hard-to-find plant that grows in undisturbed stream and creek bottoms, rich woods, and ravines in North Carolina, Tennessee, Georgia, Florida, Louisiana, and Arkansas. Although it is considered threatened, a U.S. Fish and Wildlife Service survey conducted in the 1990s found it sufficiently abundant to keep it off the federal endangered species list.
The fruits of two Chinese species of schisandra—S. chinensis and S. sphenanthera (known in China as “North” and “South” wei-zi for the areas of the country in which they’re found)—are sold in the herb trade. Most schisandra that enters the U.S. market is S. chinensis, a climbing perennial vine with deciduous leaves. A rare plant in U.S. horticulture but relatively common in English and western European gardens, this woody vine was introduced to the United States via Russia in the late 1850s. The hardy vine with shiny leaves produces male and female flowers on separate plants. Its grapelike bunches of small, peppercorn-size, bright red fruits make it an attractive ornamental for autumn color.
I first saw schisandra cultivated in the Czech Republic; it is also an important medicinal herb of the former Soviet bloc and has been an official drug in the Russian pharmacopeia since 1961. A couple of years ago a friend gave me two plants. Last fall they produced fruits for the first time. What a delight to chew on flavorful, freshly dried fruits that met the Chinese standards for the best quality: bright red, large (3/8 to 1/4 inch wide), plump, oily, and shiny.
Schisandra, which has been commonly used in TCM for more than 2,000 years, is one of the top fifty herbs used in modern China. It is first mentioned in the ancient ben-cao (Chinese herbal) of the divine plowman emperor Shen-Nong, thought to have lived more than 4,000 years ago. His first-century a.d. herbal, Shen-Nong-Ben-Cao-Jing, with more than 365 herb descriptions, is the historical starting point for TCM (see “Chinese Herbs: A Westerner’s Perspective” on page 70). In the work, herbs were listed in three classes, according to importance. Shen-Nong placed schisandra in the first class, which included the important tonic herbs. It is also cited extensively in the 1596 classic Ben Cao Gang Mu, by Li Shi-Zhen, a sixteen-volume encyclopedia that preceded the first edition of Gerard’s Herbal, published in 1597. Li Shi-Zhen was the first author to distinguish between species of schisandra used in the north and south of China.
In addition to being a general tonic, schisandra fruit is used in TCM to treat nervous conditions, coughs, and liver conditions. These uses have been confirmed by modern research, which attributes the herb’s medicinal effects to more than forty compounds known as lignans (about 19 percent of the weight of the fruits) called schisandrins. (Unfortunately, most of the controlled clinical studies of schisandra’s effect on humans have taken place in China and are poorly designed.)
Schisandra is considered to be a somewhat weaker but less toxic adaptogen than Panax ginseng and Siberian ginseng. In the Far East (including Russia and China), the fruits have been used as a stimulating, fortifying agent to combat physical exhaustion and fatigue. Laboratory experiments coupled with clinical trials in China confirm that schisandra helps improve brain efficiency, increase work capacity, mildly stimulate the central nervous system, improve reflexes, build strength, and increase endurance of healthy individuals. Already widely recognized in China, Russia, and Japan for its adaptogenic effect, schisandra may become a more widely used adaptogen in the twenty-first century.
Studies have looked at other potential actions as well. Animal experiments suggest schisandra extracts calm the central nervous system and can counteract caffeine’s stimulatory effect. Studies on cardiovascular effects have shown that it helps normalize blood pressure. It has been shown to have a cough-suppressing and expectorant effect in laboratory animals. It increases nonresistant immune response, reduces tiredness and sleeplessness, and may help enhance vision.
Schisandra is also considered an antioxidant, and its ability to protect the liver against toxic compounds, much like milk thistle (Silybum marianum), has been studied extensively. In a number of Chinese, Japanese, and Russian studies, it has been found to be effective in treating viral and chemical-induced hepatitis. Chinese studies show that it is more effective than vitamin E as an antioxidant for liver conditions.
Researchers in Chile, Argentina, and Sweden recently studied schisandra’s use as an adaptogen for sluggish racehorses at the San Isidro Sporting Club in Buenos Aires, Argentina. The researchers chose two groups of twelve racehorses of similar age, weight, temperament, and training, all exhibiting low performances, high levels of liver enzymes, and high levels of creatinine phosphokinase (an enzyme found in striated and heart muscles that is excreted during intense anaerobic exercise). After seven and fourteen days, the two liver enzymes were measured, and the creatinine phosphokinase levels were significantly reduced in the horses given a standardized schisandra extract, compared with those given a placebo. Fifty percent of the treated horses showed improved physical performance and hair appearance. Whether such results are relevant to humans will have to be determined by clinical studies.
How is schisandra used?
Schisandra is traditionally used to treat nervous conditions, coughs, liver conditions, stress, and as a tonic and anti-aging agent. Typically, schisandra is used at an average daily dose of 1.5 to 6 g, made into tea or taken as a powder. A typical dose in powdered form is in the range of 1.5 g per day. A rounded teaspoonful of the whole fruit equals about 4 g. One traditional prescription for nervousness, for example, calls for 9 to 15 g of schisandra in decoction. The fruits are simmered in about a quart of water, down to about half of the original volume, cooled, then drunk in a wine glass-size dose three times a day. Mild gastrointestinal upset is the only reported side effect.
Schisandra is one of the few Chinese herbs commonly used in the form of an alcoholic extract or tincture. A tincture is made by soaking 30 g (about an ounce) of dried schisandra fruits in about 11/3 cups of a mix of 40 percent water and 60 percent alcohol (ethanol or ethyl alcohol, never isopropyl or rubbing alcohol) for seven days. Shake once a day, then strain and press the remaining liquid out of the fruit. The tincture is also used as a mild sedative or adaptogen for nervousness in doses equivalent to 1 shot-glassful of tincture per day (divided into three portions).
A traditional treatment for cough involves a prescription made from 2 parts powdered poppy seeds to 1 part schisandra. The powder is mixed together, then rolled in honey to make a pill, which is taken before going to bed.
Hancke, J., et al. “Reduction of serum hepatic transaminases and CPK in sport horses with poor performance treated with a standardized Schisandra chinensis fruit extract.” Phytomedicine 1996, 3 (3):237–240.
Ip, S. P., et al. “Effect of a lignan-enriched extract of Schisandra chinensis on aflatoxin B1 and cadmium chloride-induced hepatotoxicity in rats.” Pharmacology and Toxicology 1996, 78 (6):413–416.
Ko, K. M., et al. “Effect of a lignan-enriched fructus Schisandra extract on hepatic glutathione status in rats: Protection against carbon tetrachloride toxicity.” Planta Medica 1995, 61 (2): 134–137.
Lu, H., and G. T. Liu. “Anti-oxidant activity of dibenzocyclooctene lignans isolated from Schisandraceae.”Planta Medica 1992, 58 (4):311–313.
Nishiyama, N., Y. L. Wang, and H. Saito. “Beneficial effects of S-113m, a novel herbal prescription, on learning impairment model in mice.” Biological Pharmaceutical Bulletin 1995, 18 (11):1498–1503. Song, W. Z., and P. G. Xiao. “Medicinal plants of Chinese Schisandraceae and their lignan components.” Chinese Traditional and Herbal Drugs 1982, 13 (1):40–48.
Ten years after our first meeting, Dr. Hu introduced me to Professor Yue Chongxi, a scientist at the Academy of Traditional Chinese Medicine in Beijing, China’s primary medicinal plant research institution. Professor Yue is from a famous family of pharmacists that stretches back more than 400 years. Before the Communist takeover in 1949, the Yue family owned China’s oldest drugstore, Tong-Ren-Tang, which has been operating in the same location since 1667. The family served as pharmacists for China’s emperors from the end of the Ming through the Qing dynasties, the final eras of imperial rule.
In 1987, Professor Yue lived with me for nine months, providing me an opportunity to learn about Chinese herbs firsthand. One important lesson was that Chinese herbs do not have to be mysterious, strange, and exotic. In fact, many plants and even common weeds found in U.S. gardens are Chinese medicinal plants. These include peonies, mums, forsythia, Japanese honeysuckle, and even kudzu.
The second major revelation was that Chinese and American minds create different conceptions of the same world. For example, when Professor Yue and I were walking together along a highway, I kept a careful eye on him to make sure he didn’t get hit by a car. Attention to the danger of cars was simply not part of his consciousness. We simply perceived the world indifferent ways. To understand how herbs are used in Traditional Chinese Medicine (TCM), Westerners must be willing to change their assumptions about how the world works. We must approach herbs with a new thought paradigm.
Understanding Chinese herbs
In a Western context, we think of a “tonic” as an ambiguous term for an herb that may help to improve overall health. In TCM, the term “tonic” is much more specific, an herbal prescription that will restore “deficiency.” Indications and symptoms of deficiency in TCM include fatigue and weakness (or lack of strength), behavior patterns that might be characterized as passive or withdrawn, a weak pulse, thinner-than-normal tongue coating, and pains or discomfort that may be relieved by touch or pressure. A deficiency requiring a tonic may have further qualifiers, such as “deficiency of lung qi” (pronounced “chee”—defined as the life force animating the human ability to move, think, feel, and work). Deficiency of lung qi could be signaled by several symptoms, resulting not from a specific infectious organism but from an imbalance of internal patterns that affect the lungs. It may be characterized by exhaustion, low spirits, low voice, lack of desire to talk, and weak breathing patterns. In Western thought, such a condition might include a variety of named “diseases,” including allergies, emphysema, chronic bronchitis, or pulmonary tuberculosis.
How are Chinese herbs used?
Some of the fundamental principles of herb use in TCM are far more complex than simply swallowing a capsule of a single herb or a few drops of a tincture. Each herb is targeted to a specific organ system and is processed in ways that make it safer or more effective. Herbs are generally used in combinations and in conjunction with changes in diet, exercise, nutrition, and of course, acupuncture.
TCM is based on the five- element theory. Everything consists of metal, wood, water, fire, and earth. Five major organ groups are recognized: the heart, liver, spleen, lung, and kidney. Each herbal medicine possesses a unique character (cold, hot, warm, and cool), taste (sour, hot, bitter, salty, and a little sweet), function, and use. Plant medicines are processed to affect or “correct” their original character or render the herb nonpoisonous. This might include boiling, baking, stir- frying with honey, rice, or wheat hulls, or soaking in alcohol. Some of the processing methods are extremely elaborate. Plants are used in combinations of three to 100 herbs. Each herb in a formula has a specific synergistic action in relationship to other herbs. A “minister” herb increases the effect of the “monarch,” or main herb, in a prescription. The “assistant” herb helps a particular organ or can help treat a disease complex. For example, in a patient being treated for a liver condition that has spread to the spleen, the assistant herb helps the diseased spleen. An herb can also “supervise” the function of other herbs, increasing or decreasing their effects, or act as an “antagonist” to alter the effects of other herbs in the prescription. Finally, the “guide” herb enhances the efficacy of other medicines or improves the taste of the prescription, as in the use of licorice root.
Herbs used in TCM
Say the name “fo-ti” to a Chinese herbalist, and he or she may not know what you are talking about. It is actually a name created for the U.S. market about thirty years ago. In China, this important tonic herb is known by its centuries’-old name, he-shou-wu. In TCM, the processed root is used to strengthen the blood, invigorate the liver and kidneys, and tonify vital energy (also called qi). Its use as a tonic was said to promote longevity, increase vigor, and enhance fertility. Studies have shown that the root can help lower cholesterol and reduce plaque deposits on the walls of arteries.
Most herb-savvy consumers are familiar with American skullcap (Scutellaria lateriflora), used as a sleep aid or mild sedative. Rock garden enthusiasts may also be familiar with Baikal skullcap. The root, known as huang-qin, is used in TCM prescriptions for fevers, colds, high blood pressure, hypertension, insomnia, and other conditions. Chinese scientists found that it has antibacterial, antiviral, and diuretic properties and that it reduces fevers and lowers blood pressure.
You can find balloon flower at virtually every garden center that offers perennials. The root, known in TCM as jie-geng, is used primarily as an expectorant in prescriptions for coughs, congestion, sore throats, lung abscesses, and related conditions. In Korea, it is used as a base for soup stocks. Pharmacological research has confirmed its expectorant, antitussive, and anti-bacterial effects. Japanese patent medicines employ root extracts to treat bronchitis.
Rehmannia is rare in U.S. horticulture. In China, the root is known as di-huang and is one of the most widely used herbs in TCM. It is added to many formulas as a blood tonic, especially for gynecological disorders. According to Chinese clinical studies, the prepared or steamed root has proven useful in treating hypertension. It helps reduce blood pressure and serum cholesterol levels while improving blood flow to the brain. It dilates blood vessels to the kidneys, producing a diuretic effect and a heart-tonic action. The fresh or the dried root may protect the liver. Laboratory experiments show that the fresh root has an antifungal effect. Chinese clinical studies have included the effect of various root preparations in rheumatoid arthritis, infectious hepatitis, hypertension, and dermatitis with positive results.
The root of this plant, rare in U.S. horticulture, is called dan-shen in TCM. It is traditionally used to promote blood circulation, reduce swelling, alleviate pains, and tranquilize the mind by nourishing the heart. It is thought to promote the growth of new tissue and is widely used in Chinese herbal prescriptions to regulate menstruation. Because it is believed to improve circulation, it is also used to treat angina pectoris in China. In recent years, the plant has been the subject of numerous studies, showing that it can dilate coronary blood vessels and peripheral blood vessels, increase blood flow, and lower blood pressure.
Lemon balm for cold sores
Researchers in Berlin, Germany, and Sofia, Bulgaria, recently published results of a double-blind, placebo-controlled, randomized clinical trial on the effects of standardized lemon balm cream on patients with herpes labialis, a form of herpes simplex that causes cold sores, or fever blisters, on the lips. Sixty-six Caucasian patients with a history of recurrent cold sores (at least four outbreaks a year), all of whom could recognize the pre-symptoms of a herpes sore outbreak (itching, tingling, burning, or tightness), were chosen.
Thirty-four patients were treated with Lomaherpan cream, a German product made from a dry extract of 70 parts crude lemon balm leaf to 1 part water extract, and thirty-two patients were treated with a placebo cream four times a day for five days. After the second day of treatment, the lemon balm cream was found to significantly shorten the healing period faster than the placebo. It helped prevent the infection from spreading and reduced symptoms such as itching, tingling, burning, swelling, and stabbing pains associated with cold sores.
Lemon balm (Melissa officinalis) has gained scientific attention in the past decade for it antiviral activity. The herb has a documented history of at least 2,000 years of medicinal use. Avicenna, a famous Arab philosopher and physician who lived from 980 to 1037, mentioned topical use of the herb for the treatment of wounds, ulcers, and scabies. In the twentieth century, interest shifted to focus primarily on the herb’s mild sedative activity.
The German government allows lemon balm teas and extracts for sleep difficulties due to nervous conditions and for functional gastrointestinal symptoms. Various studies over the past twenty years have provided experimental evidence that lemon balm hot-water extracts have strong antiviral properties against mumps, herpes simplex, vaccinia, and other viruses.
A 1979 study that screened extracts of seventy-three plant species for potential antiviral activity found that lemon balm showed potent antiviral effects. For more than a decade, the German lemon balm cream (also available in the United States) has been marketed in Europe for treating herpes sores. (1)
Unsafe ginkgo compounds
A recent study by a researcher at the Medical University of Lübeck in Germany found that a crude extract of ginkgo leaves (a tincture), ginkgolic acid concentrate, and other ginkgolic acid-containing extracts are extremely toxic. This study confirmed the need to remove a group of compounds known as alkylphenols, which include anacardic or ginkgolic acids, caranols, and cardols—none of which contributes to the medicinal benefits of ginkgo leaf extract—when making standardized extracts.
Of all herbal medicines currently on the market, ginkgo leaf extracts, standardized to 24 percent flavone glycosides and 6 percent ginkgolides, are among the most complex. Most clinical studies and hundreds of other scientific studies have used a purified extract identified as EGb-761, which is manufactured using an elaborate, twenty-two-step process. During the extraction process, alkylphenols are largely removed from the fruits and leaves. In fact, the German regulatory monograph on ginkgo leaf requires that finished ginkgo products contain less than 5 parts alkylphenols per million.
Because of the toxicity of these compounds, handling fresh ginkgo leaves or fruits can cause dermatitis, similar to that produced by contact with poison ivy. The bottom line for the consumer: Avoid making or using homemade ginkgo leaf tinctures, teas, or other concoctions. (2)
Recently researchers in Hawaii identified a polysaccharide-rich fraction from the fruit juice of noni that seemed to stimulate several cancer-preventing or tumor-suppressing mechanisms, primarily by stimulating the immune system. This is one of the first pharmacological studies on noni, the fruit juice of a South Pacific tree known as Morinda citrifolia, which has had dozens of unscientific claims attached to it. The findings led researchers to conclude that noni may reduce chemotherapy’s toxic effects while improving its therapeutic benefits.
Although noni has become a phenomenon among multi-level sales companies and their customers, you probably won’t see noni juice at your supermarket any time soon. The fruits, which resemble a hand grenade in appearance, have a smell similar to dirty feet or Limburger cheese. Nevertheless, they have become popular as a tonic and have been written about in national newspapers and magazines.
U.S. servicemen used noni as a survival food during World War II. Polynesian societies have historically used the fruit as a tonic, a treatment for diabetes, tonsillitis, and sore throats, and externally for wounds, toothaches, and other conditions. (3)
(1) Koyrchev, R., R. G. Alken, and S. Dundarov. “Balm mint extract (Lo-701) for topical treatment of recurring Herpes labialis.” Phytomedicine 1999, 6(4):225–230.
(2) Siegers, C. P. “Cytotoxicity of Alkylphenols from Ginkgo biloba.” Phytomedicine 1999, 6(4):281–283.
(3) Hirazumi, A., and E. Furusawa. “An Immunomodulatory Polysaccharide-Rich Substance from the Fruit Juice of Morinda citrifolia (Noni) with Antitumour Activity.” Phytotherapy Research 1999, 13:380–387.