A Supplement to The Herb Companion From the
American Botanical Council and The Herb Research Foundation
Last summer, as I was stooping to photograph a plant, the muscles in my left shoulder and neck suddenly became locked. My head was frozen at a 45° angle, and a sharp pain radiated through my upper body. During the next two days, I took the muscle relaxants and painkillers prescribed by my physician, tried drinking a kava-root extract to relax the muscles, and even ventured to the chiropractor’s for realignment–to no avail. My neck stayed as crooked and painful as ever. Finally, an acupuncturist relaxed my muscles and reduced their inflammation by inserting needles and rubbing my neck with a cooling menthol balm.
Muscle pain is one of the most common complaints for which people seek advice from health-care practitioners. It may arise through overuse, injury, or disorders such as osteoarthritis, spinal tuberculosis, or kidney or liver disease. Sudden changes of temperature and humidity also can cause temporary stiffness and soreness. One time-honored approach to treating muscle pain is to massage the affected area with an analgesic salve, like the menthol preparation my acupuncturist rubbed on my neck. External analgesics provide an easy and effective way to cope with muscle pain; in fact, they have been the fastest-growing nonprescription drugs since 1990, with sales increasing at about 11 percent per year.
External Analgesics Provide an Easy and Effective Way to Cope with Muscle Pain.
Many popular over-the-counter topical pain relievers contain ingredients derived from plants, such as mustard seed, sweet birch oil, peppermint, and red peppers. These are all counterirritants–substances that relieve pain by producing a lesser pain and sometimes also mild skin inflammation above the site of the aching muscle. Some suspect that counterirritants also increase blood flow to the muscles, allowing the heat they produce to penetrate the skin to deeper tissues.
Allyl isothiocyanate
A traditonal remedy for chest colds and sore muscles is the mustard poultice, a paste of powdered mustard seed, flour, and water spread on a piece of cloth which is laid briefly on the skin (contact with the skin for more than a few minutes can cause blisters). Today, German health authorities allow the use of mustard-seed poultices to treat upper respiratory congestion and injuries to joints and soft tissue.
The volatile oil of the seeds of black mustard (Brassica nigra) and brown mustard (B. juncea) contain allyl isothiocyanate, a powerful counterirritant. Pharmaceutical mustard oil, which contains at least 93 percent allyl isothiocyanate, is used in minute, safe quantities in over-the-counter lotions, but the pure oil should never be applied to the skin, inhaled, or tasted: to do so can blister the skin, irritate the eyes and respiratory passages, damage the kidneys and liver, and/or cause unconsciousness.
Methyl salicylate
Drinking a tea made from the leaves of wintergreen (Gaultheria procumbens) has been a traditional American treatment for colds, headache, stomachache, and fevers; the same tea was also used as a wash for sore muscles. The essential oil of wintergreen is chemically nearly identical to that of black, or sweet, birch (Betula lenta), which has been traditionally used to treat rheumatism, gout, scrofula, skin eruptions, scurvy, bladder disorders, gonorrhea, neuralgia, and fevers.
The active and major ingredient in these oils is methyl salicylate, which is chemically related to aspirin (acetylsalicylic acid) but far more irritating to the stomach. Today, synthetically produced methyl salicylate is mainly used as a topical counterirritant. It is found in ointments, liniments, and analgesic balms at concentrations of 1 to 30 percent; minute amounts (0.04 percent) scent cosmetics and flavor foods and toothpastes. Products containing more than 5 percent methyl salicylate should not be used on children as it is rapidly absorbed through the skin and even small quantities can be fatal. Individuals who are allergic to aspirin should also avoid using products containing methyl salicylate.
Menthol
Menthol is an alcohol comprising 29 to 48 percent of the essential oil of peppermint. One of the most widely used natural products, it is found in everything from candy and chewing gum to cigarettes, toothpastes, and liqueurs. At low concentrations (0.1 to 1 percent) in topical preparations, menthol helps to interrupt pain signals. At concentrations of 1.25 to 16 percent, it acts as a counterirritant by first stimulating nerves that perceive cold and later nerves that perceive warmth while at the same time depressing nerves that perceive pain.
Apply menthol preparations no more than four times a day. Contact dermatitis is a rare side effect. Pure menthol is toxic and should never be ingested or applied to the skin.
Camphor
Natural camphor is derived from the essential oil of Cinnamomum camphora, a large evergreen tree of the laurel family that is native to eastern Asia. Grown as a shade tree in both Florida and California, it has become naturalized in Africa and the Mediterranean region. Most natural camphor is produced in Taiwan, China, and Japan; however, most of the camphor used in topical analgesics is synthesized from pinene, a major constituent of pine oil.
When applied to the skin in the low concentrations found in these products, camphor stimulates nerve endings, producing a mild pain at the skin surface that serves to mask deeper muscular pain. Higher concentrations can be toxic.
Capsaicin
The pungent compound capsaicin, the “bite” of hot peppers, is used in over-the-counter and prescription topical creams to treat muscle pain as well as severe pain associated with shingles and postherpetic neuralgia (acute pain along a nerve following an attack of shingles), diabetic neuropathy, and arthritis.
A single application of the cream to the skin results in the normal release of substance P, a protein responsible for relaying pain messages from nerve endings to the brain–along with the familiar burning sensation of cayenne. However, repeated applications over several weeks deplete supplies of substance P, bringing pain relief even when the underlying cause of the pain still exists.
Pain relief with nonprescription capsaicin products usually occurs within two weeks but may take as long as six weeks. Do not try substituting cayenne or other red peppers in any form for capsaicin.
Finding and Using Herbal Topical Analgesics
You’ll find topical analgesics containing herbs wherever over-the-counter drugs are sold: as gels, creams, ointments, liniments, rubs, powders, sticks, lotions, liquids, aerosol sprays, and massage oils. Many are greaseless and nonstaining; most are intended for use by adults and children over two years of age. Follow label instructions and don’t exceed the recommended dosage. Because heat can greatly increase the absorption of these products, don’t use them in conjunction with a heating pad or hot water bottle. After strenuous exercise or in a hot climate, cool off before applying a topical analgesic. Keep out of the reach of children.
Further Reading
Bradly, P. R., ed. British Herbal Compendium. Vol. 1. Dorset, England: British Herbal Medicine Association, 1992.
Foster, S. Herbs for Your Health. Loveland, Colorado: Interweave Press, 1996.
Jacknowitz, A. I. “External Analgesic Products.” In Handbook of Nonprescription Drugs. 11th ed. Washington, D.C.: American Pharmaceutical Association, 1996.
Tyler, V. E. Herbs of Choice: The Therapeutic Use of Phytomedicinals. Binghamton, New York: Pharmaceutical Products Press, 1994.
Tyler, V. E., L. R. Brady, and J. E. Robbers. Pharmacognosy. 9th ed. Philadelphia, Pennsylvania: Lea and Febiger, 1988.
Dandelion: More than a weed
Wherever humans find a home, so does the lowly dandelion (Taraxacum officinale). It is so familiar and so pervasive that most of us consider it a weed, but dandelion is also an herb with a long history of use as a food ingredient, fragrance, and medicinal. You can struggle to banish dandelions from your yard, or you can welcome the harvest of food and medicine.
A World of Dandelions
The genus Taraxacum, a member of the aster family, includes about 60 species of perennial or biennial herbs whose taxonomy and nomenclature have been described as “in utter confusion.” The genus is native to northern temperate and Arctic regions as well as to temperate South America. North America has several native species in addition to the common dandelion, an introduction from Eurasia.
Dandelion is a robust perennial herb with a stout taproot (just try pulling it out!) and milky latex that exudes from any part of the plant when broken. The coarsely toothed leaves, arranged in a basal rosette, may grow a foot or more in height in fertile soil but in frequently mowed lawns may reach only a couple of inches off the ground. The sunny yellow flower heads consist of dozens of tiny, straplike individual florets. They usually appear in early spring or summer, but plants may bloom again in autumn. The wind disperses the fluffy seedheads.
Dandelion in History
The word “dandelion” is derived from the French dent-de-lion, “lion’s tooth,” a reference to the plant’s serrated leaves. The name that the French use for dandelion, pissenlit, “wet-the-bed”, refers to its reputed diuretic properties. The generic name Taraxacum seems to come, via the Arabic t¸arakhshaq˜un, from the Persian talkh chakok, “bitter herb.”
The Persian physicians Rhazes (flourished 925) and Avicenna (980-1037) were among the first to record their use of dandelion as a medicine (for inflammation of the eyes). By the fifteenth century, it was common in British apothecary shops, and, in 1649 when Nicholas Culpeper published The Complete Herbal, use of both leaf and root as a diuretic and for “removing obstructions of the liver, gall bladder and spleen” was well established. Dandelion root was an official drug of the U. S. Pharmacopoeia from 1830 until 1910, but while Wooster Beach, founder of the Eclectic movement, considered the plant one of the most valuable in the materia medica for treating liver obstructions, many other physicians viewed dandelion as merely a home remedy for mild liver and kidney afflictions. The root was also a key ingredient in nineteenth-century patent medicines including digestive bitters, liver pills, and blood purifiers. Pharmacists’ formula books abound with recipes combining dandelion extract with peppermint as a digestive tonic, with bearberry (uva-ursi) as a diuretic, and with the highly toxic hemlock and mandrake for “hepatic and bilious affections.”
In China, the leaves of T. mongholicus traditionally have been taken internally to treat cough, excessive thirst, jaundice, and inflammation of the throat, mouth, and gums. Poultices of the dried, powdered leaves have also been applied to insect bites, hemorrhoids, and swellings.
Modern Appeal
The long tradition of folk use prompted a 1938 Italian study of the effect of an injection of dandelion extract on twelve subjects with symptoms of liver dysfunction such as loss of appetite, low energy, and jaundice. Indicators of liver function including cholesterol levels and urinary bilirubin were measured before and after treatment. Although the study was not designed and executed according to modern standards, all subjects reported feeling better, and cholesterol levels dropped significantly in all but one.
A 1974 Romanian study found that 50 ml per kg body weight of a leaf-water extract strongly promoted urine flow in rats and mice. The researchers rated the extract superior to other herbal diuretics and as effective as the prescription diuretic furosemide. They also discovered that potassium in the dandelion extract (potassium constitutes 4 to 7 percent of the dried leaves) replaced potassium serum electrolytes lost in the urine. Loss of potassium is a common adverse side effect of the use of many diuretics. This study is the basis for the use of dandelion preparations for diuresis in modern European herbal medicine.
In Germany, dandelion leaves are prescribed primarily as a diuretic in cases of water retention and for bloating accompanied by flatulence and loss of appetite. The dried leaf is used as a tea, tincture, or extracts. The fresh leaf juice is also considered medicinal.
The root is used in Germany primarily to improve digestion by promoting bile secretion in the liver. Alcoholic root extracts have been shown to increase bile secretion in laboratory animals by more than 40 percent. The root also has been shown to reduce inflammation, supporting its use in treating rheumatism, and to lower blood sugar. It is also considered mildly laxative and antibiotic. The dried root is believed to be less potent than the fresh root or its preparations.
Dandelion’s Power
Dandelion leaves and roots contain a group of compounds called sesquiterpene lactones that may contribute to its biological activity. The amounts of dandelion’s various constituents fluctuate throughout the year. Autumn-harvested roots, for example, contain about 40 percent inulin, compared with 2 percent in the spring-harvested root. Inulin, not to be confused with insulin, is a nondigestible complex carbohydrate that is used in a standard test of kidney function.
Dried leaves and roots are widely available, as are teas, capsules, tablets, tinctures, and extracts made from them. Alcoholic extracts are believed to stimulate bile flow better than water extracts due to the greater solubility of the active compounds in alcohol than in water. Of course, fresh dandelions are as close as your backyard. Choose only unsprayed plants.
To make a tea, pour a cup of boiling water over a big handful of the leaves or 1 to 2 teaspoons of the cut-and-sifted dried root and steep, covered, for fifteen minutes. Drink as many as three cups a day of leaf tea or two cups of the root tea. The root is also roasted for use as a coffee substitute, but coffee lovers may be disappointed in the flavor.
Consult a physician before taking dandelion if you are being treated for gallstones or an obstructed bile duct. Contact with the latex in the fresh herb may cause dermatitis; ingestion of bitter herbs such as dandelion may cause gastric hyperacidity.
Further Reading
European Scientific Cooperative for Phytotherapy (ESCOP). Proposal for European Monographs. vol 3. Bevrijdingslaan, Netherlands: ESCOP, 1992.
Foster, S. Herbs for Your Health. Loveland, Colorado: Interweave Press, 1996.
Gail, P. The Dandelion Celebration: A Guide to Unexpected Cuisine. Cleveland Heights, Ohio: Goosefoot Acres Press, 1994.
Hobbs, C. “Taraxacum officinale: A Monograph and Literature Review”. Eclectic Dispensatory of Botanical Therapeutics, edited by E. Alstat. Portland, Oregon: Eclectic Medical Publications, 1989.
Leung, A., and S. Foster. Encyclopedia of Common Natural Ingredients Used in Foods, Drugs and Cosmetics. 2nd ed. New York: Wiley, 1996.
Capsules
Astragalus review
The Chinese herb huang-qi, better known in the West as astragalus or milk vetch (Astragalus membranaceus), is becoming increasingly popular in Europe and America. A 1997 European review of the scientific literature on A. membranaceus and its close cousin A. mongholicus was undertaken to consolidate information and inform westerners of their powers to protect the liver, stimulate the immune system, and combat viruses.
In the past decade, Asian studies have identified saponins and polysaccharides as components of A. membranaceus root that help protect the liver against damaging compounds.
Since the late 1970s, physicians in China have given astragalus to patients undergoing chemotherapy to counteract immunosuppression by the chemotherapeutic agents. Chinese researchers investigating the herb’s anticancer properties found that a water extract of A. membranaceus kept mouse cells from mutating when they were exposed to a carcinogen aflatoxin. In animal tests, the extract also inhibited the growth of viruses but was ineffective against human immunodeficiency virus (HIV).
Comprising more than 2,000 species, Astragalus is one of the largest genera of flowering plants. North America has nearly 400 species, concentrated primarily in the western states. These include the locoweeds as well as other species that concentrate selenium; both groups can poison livestock. Not all species are toxic, however: ground plum or buffalo pea (A. crassicarpus), which grows from Minnesota to Texas, produces thick, fleshy pods that can be pickled or eaten like edible-podded peas, and the Asian species A. gummifer yields gum tragacanth, which is widely used to emulsify and thicken pharmaceuticals, cosmetics, salad dressings, and even ice creams. A number of species are also grown as ornamentals.(1)
A Closer Look at Tiger Balm
Tiger Balm, a popular topical headache treatment in Asia and North America, has shown its claws in the first controlled clinical study of its effectiveness. The fragrant salve, which contains camphor, menthol, cajeput oil, and clove oil in a base of paraffin and petroleum, relieved acute tension headache faster than an oral analgesic in a 1996 Australian randomized, double-blind trial.
Three times, at thirty-minute intervals, 22 subjects diagnosed with acute tension headache applied Tiger Balm to their temples; 20 applied a placebo cream. Fifteen other subjects received a single dose of 1000 mg of an oral analgesic.
Subjects evaluated headache severity within three hours of treatment using a seven-point scoring system. All but two patients (91 per cent) in the Tiger Balm group reported significant relief from their headaches; 16 (73 percent) said they would use the product again for headache relief. Relief also came sooner for this group than for those receiving the oral analgesic.(2)
Chaste Tree and PMS
The fruit of the chaste tree (Vitex agnus-castus) has been used to treat menstrual difficulties for at least 2,500 years. Today, German health authorities permit the use of chaste-tree preparations in cases of pressure and swelling in the breasts; premenstrual syndrome (PMS); heavy, too frequent, irregular, or suppressed menses; and other conditions. No single constituent of the fruit has been pinpointed as causing its biological activity; nevertheless, clinical trials have confirmed the effectiveness of liquid preparations (tinctures) in treating symptoms associated with PMS.
To test the efficacy of a solid chaste-tree preparation (capsules), a research group in Germany conducted a controlled, double-blind study comparing chaste tree with pyridoxine (vitamin B6), a nutritional supplement widely used to treat PMS (although there is no evidence of its effectiveness). Over the course of three menstrual cycles, 85 women received 3.5 to 4.2 mg daily of the solid chaste-tree preparation standardized to flavonoid content; 90 women received a placebo daily for fifteen days and 200 mg of pyridoxine a day for the remainder of each cycle, when PMS symptoms are most likely to occur. Forty-six women in the chaste-tree group and 59 in the pyridoxine group completed the study.
Thirty-seven women in the chaste-tree group (80 percent) experienced a reduction of PMS symptoms, including breast tenderness, edema, tension, headache, constipation, and depression; physicians rated efficacy as excellent in 11 cases (24 percent). Twelve women in the chaste-tree group (26 percent) reported transient gastrointestinal complaints, headaches, or mild skin reactions. No serious side effects were observed.(3)
References
(1) R’os, J. L., and P. G. Waterman. “A Review of the Pharmacology and Toxicology of Astragalus”. Phytotherapy Research 1997, 11:411-418.
(2) Schattner, P., and D. Randerson. “Tiger Balm as a Treatment of Tension Headache”. Australian Family Physicians 1996, 25(2):216-222.
(3) Lauritzen, C. H., et al. “Treatment of Premenstrual Tension Syndrome with Vitex agnus-castus: Controlled, Double-Blind Study Versus Pyridoxine”. Phytomedicine 1997, 4(3):183-189.
