LEUNG'S
(CHINESE) HERB NEWS
Number 40
July/August/September 2003

Herbs in this issue:
Chamomile (Matricaria recutita)

Anthemis cotula

Star anise (Illicium verum)

Illicium spp.

I. anisatum

I. lanceolatum

The unsung heroes of herbs

 

        Time flies!  It has been 7 full years since I started this Newsletter in September of 1996.  The original reason for publishing this was to provide a source of factual information, especially relating to Chinese materia medica, for those who seek the truth and to expose certain unethical practices in the herbal field, including twisting facts and/or perpetuating misinformation/disinformation for personal gain.  This hasn’t changed. 

      In recent years, the dietary supplement industry, which includes the herbal industry, has become much more sophisticated, particularly in political, public relations and marketing matters.   And, despite its self-serving side, the herbal industry has emerged as the leading community of experts known for its balanced knowledge in herbs.  This has been the result of hard and dedicated work by a handful of scientists and herbalists, who are true herbal devotees.  Unlike some of their better-known self-promoting and self-aggrandizing colleagues, these dedicated few have selflessly and often quietly been guiding the collection and dissemination of correct information on herbs.

 

Dr. Leung is author of the Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics (Wiley-Interscience), which was published in 1980 and revised in 1996. He is also creator of PHYTOMED, a prototype computer database on Chinese herbal medicine developed under contract with the National Cancer Institute.


 

Their work has often been used without acknowledgement or remuneration by those who have used it to promote their own largely undeserved status in the field.  Here, I want to acknowledge a colleague and friend who has contributed tremendously to the science of herbal medicine/supplements but who has so far not been duly acknowledged for his contribution.  I am sure many of my colleagues will agree with me when they know who this person is.  I am talking about Dennis V.C. Awang, Ph.D., who is certainly no stranger to experts in the field.  Dennis and I have known each other for over 15 years now, though we actually crossed path over 35 years ago when he went to my alma mater, University of Michigan, as a new postdoctoral fellow at the Chemistry Department while I was about to leave Michigan to take up a postdoc position at the University of California Pharmacy School in San Francisco.  Over the years, Dennis and I have collaborated in a number of projects and have certainly exchanged technical information relating to herbs.  More recently, Dennis and I have been co-Principal Investigators of a 3-year NCCAM SBIR grant awarded to Phyto-Technologies, Inc. to investigate the development of a reproducible feverfew preparation for clinical trial, which is now in its second year.  Dennis is also one of the co-authors (the other being Ken Jones) of the 3rd Edition of my Encyclopedia, which is now in preparation.1 

I admire Dennis not just for his personal and scientific integrity, but also for his unbelievable productivity in his writings, especially when you consider he still, yes, handwrites his drafts!  I jokingly call him the ‘dinosaur,’ though perhaps ‘bionic dinosaur’ may be more appropriate.  In any case, as an example of his incessant production from his ‘bionic dinosaur hand,’ here is a short review that I think will help clarify some of the misinformation and misinterpretation published so far regarding alleged anaphylaxis attributed to chamomile.

(1) Leung, A.Y., D.V.C. Awang, and K. Jones, Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics, 3rd Ed., Wiley-Interscience, New York (in preparation).

 

Chamomile Allergy and Alleged Anaphylaxis  by D.V.C. Awang, Ph.D., F.C.I.C.

         While there were about 50 reports which referred to allergic reactions associated with ‘chamomile’ contact, in only five cases did a formal botanical identification allow association of the most common commercial chamomile, Matricaria recutita, formerly Matricaria chamomilla and Chamomilla recutita (German or Hungarian chamomile) with the observed lesions; experimental studies in guinea pigs demonstrated a low sensitizing capacity for this plant.1  The overwhelming majority of cases involved Anthemis cotula (stinking mayweed, dog’s chamomile, dog-fennel), which contains high levels of the sesquiterpene lactone, anthecotulid, shown responsible for numerous instances of primary irritant contact dermatitis.1 A vouchered sample of M. recutita, claimed to be of Argentinian origin and to contain 7.3% anthecotulid, was retrieved from the herbarium of the University of Texas, Austin, and revealed by German researchers to be, in fact, A. cotula.1 These researchers note that the bisabolol oxide B-chemotype of M. recutita contains variable but low levels of anthecotulid, and recommend that chamomile for pharmaceutical and cosmetic purposes be free of the sensitizing linear sesquiterpene lactone. 

         The apparently widespread belief that chamomile may cause anaphylaxis and other severe hypersensitivity reactions is an underserved indictment of M. recutita, whose flowerheads have long been used in Europe for making a beverage of great medicinal reputation.2  English, or Roman, chamomile (Chamaemelum nobile, formerly Anthemis nobilis) is far less used, and its chemical profile is significantly different from that of M. recutita.2,3

         The chamomile anaphylactic scare was generated by an article in The Medical Letter entitled “Toxic reactions to plant products sold in health food stores,”4 which warned patients allergic to any member of the Compositae (Asteraceae) family to avoid teas made not only from chamomile flowerheads, but also from those of goldenrod, marigold and yarrow.  However, the paper cited therein, inflammatorily entitled “Anaphylactic reaction to chamomile tea,”5 does not clearly identify the purported chamomile material implicated in the single case referenced: a 35-year-old female who suffered from ragweed hay fever and developed anaphylaxis following ingestion of a single cup of the purported chamomile tea.  The authors of this publication cited two cases of contact dermatitis due to ‘chamomile’ in support of their case.  Surprisingly, the first6 deals with A. cotula as a skin irritant, while the second7 examines contact dermatitis caused by oil of cloves and oil of “camomile tea (A. cotula)”!  Further, the former study,6 explicitly reveals the results of a comparison between A. cotula and M. chamomilla (M. recutita): twelve normal people tested with these two plants, “as purchased from the druggist.”  All gave marked twenty-four-hour and delayed reactions to the first species and none reacted to the second (emphasis added).  Two other reports of anaphylactic reaction to tea prepared from purported chamomile9,10 failed to confirm the botanical identity of the implicated materials.

         These revelations underline the importance of examining primary sources, particularly when medical judgments and health advice are to be given.  Finally, Farnsworth and Morgan8 have noted that chamazulene, an artifactitious terpenoid constituent of M. chamomilla has been shown to have anti-allergenic as well as anti-inflammatory properties – and that another constituent of the plant, cis-en-yn-dicycloether has been shown to elicit anti-inflammatory, anti-anaphylactic (emphasis added), spasmolytic and bacteriostatic activity. 

References: (1) Hausen BM, Busker E, Carle R.  The sensitizing capacity of Compositae plants VII.  Experimental investigations, with extracts and compounds of Chamomilla recutita (L.) Rauschert and Anthemis cotula L. Planta medica 1984; 34:229-235. (German, with English abstract); (2) Tyler VE. The Honest Herbal, 3rd ed., George F. Stickley, Philadelphia 1993; pp. 83-85;  (3) Duke JA. CRC Handbook of Medicinal Herbs. CRC Press: Boca Raton, Florida 1985. pp. 111, 297-298;  (4) Anonymous, Toxic reactions to plant products sold in health food stores.  The Medical Letter. M. Abramowicz, Ed. 1979; 21(7): 29-32;  (5) Benner MH, Lee HJ. Anaphylactic reaction to chamomile tea.  J. Allergy Clin. Immunol. 1973; 52(5): 307-308;  (6) Rowe AH. Chamomile (Anthemis cotula) as a skin irritant. J. Allergy 1934; 5: 383-388;  (7) Sternberg L. Contact dermatitis. Cases caused by oil of cloves and by oil of camomile tea (Anthemis cotula). J. Allergy 1937; 8: 185-186;  (8) Farnsworth NR, Morgan BM. Herb drinks: Camomile tea (Letter). JAMA    1972; 221(4): 410;  (9) Casterline CL. Allergy to chamomile tea. JAMA 1980; 244: 330;  (10) Subiza J, Subiza JL, Alonso M, Hinojosa M, Garcia R, Jerez M, Valdivieso R, Subiza E. Anaphylactic reaction after the ingestion of chamomile tea: A study of cross-reactivity with other composite pollens. J. Allergy Clin. Immunol. 1989; 84: 353.

 

So, there you have it, folks.  Drink your chamomile (German or Hungarian) tea with peace of mind. 

 

This article further illustrates the acute need for well-defined herbal materials in research and reporting.  Herbal medicines/supplements are NOT single-chemical drugs!  We must know precisely what we have (in this case, M. recutita or C. cotula) before proceeding with research, clinical trials, or reporting.  If not, we will continue to accumulate and disseminate misinformation, wrong and useless data, which will continue to misguide health research, wasting our limited financial and human resources (see Issues 18, 19, 35, 37).  

 

 

Star anise adulterant – which one(s)?

        Recently, the US Food and Drug Administration has issued an advisory regarding the adulteration of the commonly used non-toxic spice, star anise (also known as Chinese star anise, Illicium verum Hook. f.), with what is purported to be Japanese star anise (Illicium anisatum L.) which is a very toxic fruit.  The FDA has contracted the American Herbal Pharmacopoeia to provide a full characterization of these “2 plants.”  I have always known the toxic adulterant to be Illicium lanceolatum A.C. Smith, which in Chinese is known as mangcao.  Hence out of curiosity, I quickly checked a few relevant Chinese materia medica manuals in my library, including my own Encyclopedia.  What I found was rather enlightening, which I believed would allow my readers to appreciate what is in the Chinese literature. 2-6 

         Fruits from at least half-a-dozen Illicium species are known in China as potential adulterants of star anise, some of which are extremely toxic.  They include:         

1.        Illicium lanceolatum A.C. Smith

2.        I. anisatum L. (I. religiosum Sieb. et Zucc.)

3.        I. henryi Diels

4.        I. henryi Diels var. multistamineum A.C. Smith

5.        I. majus Hook. f. et Thoms

6.        I. brevistylum A.C. Smith

7.        I. difengpi K.I.B. et K.I.M.

8.        I. simonsii Maxim. (I. yunnanense Franch. ex Finet et Gagnep.)

         In all, including I. verum (the true star anise), there are 15 species and 17 species of Illicium being listed, respectively, in Refs 2 and 3.  Most of these species are distributed south of Chang Jiang (the Yangtse River), from Sichuan and Yunnan in the West to Zhejiang and Fujiang in the East, and to Guangdong in the South. 

There has been confusion with I. lanceolatum and I. anisatum.  In the Zhongyao Da Cidian (Encyclopedia of Chinese Materia Medica), a major Chinese work published in 1977, the 2 were deemed equivalent.  This information was included in my Encyclopedia (both 1st and 2nd editions).  But now, at least 2 major, newer Chinese works have given them distinctly different identities, and both fruits are deemed highly toxic (Refs 2 and 3).  However, the most up-to-date and comprehensive work on Chinese materia medica, The Chinese Herbal (Ref  4) does not mention I. anisatum.   Rather curious, and to clarify this, I contacted my colleague and friend, Prof. Hu Shilin, who is the resident expert pharmacognosist at the Institute of Chinese Materia Medica in Beijing.  He confirmed that I. lanceolatum and I. anisatum are indeed distinctly different species, with the latter’s fruit not easily available in China. 

The leaf, root and root bark of I. lanceolatum and their medicinal uses have been documented for over 3,000 years (first in the Shan Hai Jing and later in the Shennong Bencao Jing), long before star anise was first described in the Bencao Pinhui Jingyao (A.D. 1505).  As with other Illicium species (except I. verum) its fruit is not used. 

Although in the English literature (e.g., Bisset’s Herbal Drugs and Phytopharmaceuticals7) where the major adulterant of star anise is generally listed as the fruit of I. anisatum, there does not appear to be concrete evidence that this information is indeed correct.  On the contrary, unless the adulterated star anise originates in other Asian countries than China, the toxic adulterant is more likely the fruit of I. lanceolatum or any one of over half-a-dozen Illicium spp., including the extremely toxic I. simonsii.  To settle this issue once and for all would require much more effort and funding than what has been allocated for only 1 potential adulterant or “plant.” 

(2) Zeng, M.Y., and J.F. Zeng, Eds., Zhongguo Zhongyao Ziyuan Zhiyao (Essential Records of Resources in Chinese Materia Medica), Scientific Press, Beijing, 1994, pp. 279-281;  (3) Inst. Ch. Materia Medica, Ch. Acad. TCM, Eds., Quanguo Zhongcaoyao Mingjian (Manual of Chinese Materia Medica of All China), 3 vols., People’s Health Publications, Beijing, 1996. Vol. 1, pp. 94-96;  (4) Zhonghua Bencao Editiorial Committee, Chinese State Administration of TCM, Eds.  Zhonghua Bencao (The Chinese Herbal), 10 vols., Shanghai Scientific and Technical Press, Shanghai, 1999.  Vol. 2, pp. 919-928;   (5) Zhang, G.J., and G.J. Xu, Eds., Changyong Zhongyao Jianding Daquan (Comprehensive Manual for the Identification of Commonly Used Chinese Materia Medica), Heilongjiang Scientific & Technical Press, Harbin, 1993, pp. 8-10;   (6) Ch. Inst. Drug & Biologicals Asaay and  Guangdong Provincial Inst. Drug Assay, Eds., Zhongguo Zhongcaocai Zhenwei Jianbie Taodian (Pictorial Encyclopedia for the Differentiation of Genuine and Adulterated Chinese Crude Drugs), 4 vols., Guangdong Scientific Technical Press, Guangzhou, 1997, Vol. 3, pp. 1-4;  (7) Bisset, N.G., Ed. Herbal Drugs and Phytopharmaceuticals, Medpharm Scientific Publishers, Stuttgart, 1994, 76-78.

 

 

Marketing and scientific credibility

 

        Marketing has become as American as apple pie.  It sells everything from sugar water to politicians (congressmen, senators, and presidents), often telling untruths.  Personally, when I see a product being heavily promoted, my first impression is that they have something to hide by covering it up with a marketing spiel, which often sounds too good to be true.  I know it’s illogical of me to think that way, but I can’t help it.  Nevertheless, in order to have a product reach more people in a relatively short time, one needs to do something to draw their attention to it.  But what one does after he has the consumers’ attention will then reveal whether he is a fast-buck artist or a legitimate businessman.  A legitimate marketer (at least in my book) stays within the realm of decency and tells the truth while a fast-buck artist makes up any story (usually untrue) to sell his product. 

         Celebrity endorsement is one of the major tools in marketing products.  For example, we often see a beautiful model with naturally smooth skin to be the spokesperson for a skin-care product, even though she may not use the product at all; or a celebrity peddling his own line of products in which he has absolutely no expertise.  In the herbal business, there are numerous well-known ‘hired guns’ who lend their names to promote certain products or brands.  Since they are scientists (even though commercially compromised), their endorsement of a product gives you the impression that it must be good and ‘scientifically’ controlled and manufactured, or in the current marketing lingo, “supported by science.”  Typically, many cash-strapped academic scientists find it irresistible when a company offers them even a paltry sum to support a commercial product either personally, through their research, or as members of its scientific or medical advisory board.  Few of these boards are legitimate, despite their impressive sounding names, because their main function is to provide ‘scientific’ or ‘medical’ support implied for company products through the association of these products with the boards.  Often associated with this ‘scientific/medical’ support are what we call ‘dirty’ clinical trials to support the products.  These trials are quite common, designed to yield the desired results that have nothing to do with the true nature of the products.  These results are then touted as being based on ‘independent research.’  You certainly won’t hear these companies say that the research has been supported and positive results dictated by them.  All this has happened and is still on-going.8  I have also seen it first hand over the years.  Sometimes the results of this kind of company-sponsored research do get published, but the funding source of the research is seldom revealed in the publications, giving you the impression the research was scientifically conducted without bias, yet in fact it is just the opposite.  So consumers, beware!

         Imagine my surprise to see a report that tells it like it is!9  The double-blind, randomized controlled trial was conducted by researchers at the Australian National University in Canberra on a Chinese herbal formula marketed as “Clear the Way” by a company called Green Medicine Company that funded the study and supplied the product.  The formula as stated in the report “contains measured amounts of 13 powdered herbs (morus leaf, chrysanthemum flower, platycodon root, lonicera flower, forsythia fruit, schizonepeta stem, field mint, great burdock fruit, bamboo leaf, reed rhizome, kudzu root, magnolia flower and liquorice root).”  On the company’s website, this formula is described as “A powerful herbal concentrate of thirteen fast-acting herbs that relieve flu symptoms such as headache, fever, cough, sore throat, and congestion...”  It’s obvious the company and the researchers didn’t seem to know what their product contained.  In any case, the results of the study were negative, as there was no difference between the product and placebo in any of the parameters evaluated.  The fact is, with such loose quality control of the formula in this trial, it doesn’t matter whether the results were negative or positive, no one would be able to reproduce the results anyway.  However, the unique thing about this study is that it was supported by the company that markets the product and is so stated in the report! 

(8) Fessenden, F., “Studies of Dietary Supplements Come Under Growing Scrutiny,” The New York Times, June 23, 2003, pp. 1 & 18;  (9) Audera, C., et al., “Effect of a specific preparation of Chinese herbs (“Clear the Way”) on duration and severity of the common cold,” Med. J. Austral., 175: 389 (2001).

  

New herb manual – the Herbal Vade Mecum by Gazmend Skenderi - recommended!

         There is a story behind the publication of this manual, which, unfortunately, is not unusual.  Mr. Skenderi is a recent immigrant from Albania who came to this country a few years ago with great expectations like most immigrants.  He is a pharmacist and pharmacognosist, and a recognized expert in Albania.  He had great hopes of publishing an herb manual based on his expertise and extensive experience in this field.  However, after he landed on US soil, he was promptly exploited by the same self-promoting colleagues mentioned earlier.  I have no reason to doubt his story, but I certainly hope the whole thing was a big misunderstanding. 

         Nevertheless, Mr. Skenderi finally self-published his herb manual earlier this year, 2 years later than he had planned.  After a quick review, I have found it to be a worthwhile manual to have.  It covers 800 botanical products in 657 succinct monographs.  It’s well suited for busy health professionals and laymen alike who can obtain a quick overview of any of the 800 herbs, including decent but brief information on common names, sources, chemistry, pharmacological activities, traditional properties, uses, caution, etc.  I think this work is better than any others like it published by major publishers, despite the fact that, like all others on the market, the Herbal Vade Mecum (Herbal Go-With-Me) has not delved into its reference sources to ascertain whether or not the original research is valid.  Price:  $49.95. Ordering information:  www.amazon.com or www.herbal-vademecum.com