The Commission E Monographs |
THE COMPLETE GERMAN COMMISSION E MONOGRAPHS
THERAPEUTIC GUIDE TO HERBAL MEDICINES
Copyright © 1999 American Botanical Council
Part One Introduction
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Indexes and Cross-References
In order to make this publication as useful as possible, particularly to
health professionals and researchers, we have attempted to provide as much
information as possible in the form of indexes and cross-references. This allows
for a "user-friendly" method of accessing information by looking up a
particular use, side effect, contraindication, or drug interaction and then
referring to a specific monograph. When these indexes are being used as a quick
reference, the reader is encouraged to refer to the monograph for more complete
information. The indexes and cross-references are not intended to be used as the
sole mechanism in making therapeutic decisions but instead as a skeletal
reference to the monographs — a database for research. Similarly, to help the
reader with the taxonomy and nomenclature, cross-references of English, German,
Latin, and pharmacopeial names are provided, as well as a column showing the
herbs by botanical family.
Uses and Indications
of Approved Herbs Index
This section, condensed from the monographs, provides information on the
appropriate use of herbs. It links medical indications and uses cited in the
text and the Approved Herbs found effective in their treatment. However, some of
the herbs listed here may have been found effective for treatment of minor
symptoms or for prevention of a condition or disease, or in some cases as
adjuvant (secondary) therapy. For example, Blonde Psyllium seed husk is used as
an adjuvant therapy for anal fissures — a mild laxative to soften the stool
but not directly beneficial to the anal fissures themselves. Herbs in approved
fixed combinations are abbreviated "F.C."
The information is prepared as a guide for health professionals, researchers,
and consumers but should not be considered a suggestion for self-medication. It
is essential that the reader refer to the complete monograph in order to view
the role the herb may provide for each indication as well as any
contraindications and side effects. A guide of indications by medical category
is included to help identify the types of indications listed in this section.
Immediately following this guide, the herbs are listed alphabetically under each
Approved Herbs Index
This chapter, condensed from the monographs, provides contraindications cited
in the text with the herbs that should be avoided with particular conditions or
diseases. It is essential that the reader refer to the complete monograph before
making any therapeutic judgements. For example, the contraindication listed in
the Anise seed monograph is "allergy to anise and anethole" but this
section lists Anise seed under "Allergy/ Hyper-sensitivity" without
specifying an allergy to a particular constituent of the herb. A guide of
contraindications by medical category is included to help identify the types of
contraindications listed in this section. Immediately following this guide, the
herbs are listed alphabetically under each contraindication.
Side Effects of
Approved and Unapproved Herbs Indexes
There are two indexes, both condensed from the monographs, that list
potential adverse side effects of Approved Herbs and Unapproved Herbs. These are
listed in an index format. The listing of a particular herb to a corresponding
side effect does not necessarily constitute a clear correlation of the herb with
the effect; it means that it may be produced under certain conditions in some
individuals. It is essential that the reader refer to the complete monograph for
the available data included by the Commission before making any therapeutic
judgments. Side effects are sometimes only observed "in rare cases"
and/or "in sensitive individuals." For example, nausea and vomiting
are listed here as possible side effects of Uva Ursi. However, the monograph
clarifies that "nausea and vomiting may occur in persons with sensitive
stomachs." Thus, inclusion of a particular herb under a corresponding side
effect should not be interpreted as an inevitable result of using the herb.
A guide of side effects by medical category is included to help identify the
types of side effects listed in this section. Immediately following this guide,
the herbs are listed alphabetically under each side effect.
Conventional Drugs Index
This section, condensed from the monographs, summarizes all the possible
antagonistic or synergistic interactions an herb may have with conventional
pharmaceutical medicines, as determined by the literature available to the
Commission. The interactions are divided into two sub-indexes: by the herb with
the corresponding drugs and by drug and other substance with the corresponding
herbs. It is essential that the reader refer to the complete herb monograph
before making any therapeutic judgments.
Actions of Approved and Unapproved Herbs Indexes
There are two indexes, both condensed from the monographs, that provide a
list of pharmacological actions of Approved and Unapproved Herbs. In some cases,
the pharmacological actions listed were demonstrated in in vitro experiments or
in in vivo studies (on animals) but may not have been confirmed in human
clinical trials. Thus, they are not necessarily correlated to the activity
observed in human clinical trials and/or clinical experience. Their inclusion is
intended to help health professionals understand the potential activity, risks,
or benefits of the herb. It is essential that the reader refer to the complete
herb monograph before making any therapeutic judgments.
A guide of pharmacological actions by medical category is included to help
identify the types of actions listed in this chapter. Immediately following this
guide, the herbs are listed alphabetically under each pharmacological action.
Administration for Approved Herbs Index
This section consists of a table listing 42 Approved Herbs for which the
monographs note some time limitation of administration. In general, most of the
Approved Herbs are relatively safe to take without limiting the duration of use.
However, responsible therapeutic use of some herbs may require that they be used
for only a set period of time. This is due to several factors, including concern
regarding laxative dependence and potential intestinal sluggishness for
stimulant laxatives. Nine herbs listed in this section are approved to treat
diarrhea; in cases where the diarrhea persists for more than 3 to 4 days, the
monograph instructs the patient to seek medical advice. The rationale for the
limitation of administration of other herbs is not explained in some of the
The taxonomic cross-reference provides a means of accessing the monographs
using different types of nomenclature. Five separate indexes are provided:
English common name, Latin binomial, family name, pharmacopeial name, and German
Chemical Glossary and Index
We have provided a comprehensive chemical index so the reader may locate
those herbs that contain a compound or class of compounds, included in each
herb's monograph. This index presents definitions of the chemical
classifications listed in the monographs and an index of herbs by compound.
Despite the wealth of information available on the chemical constituents of
most of the herbs reviewed by Commission E and because the monographs are
intended as therapeutic guides, the Commission chose to mention only compounds
or the general classes of naturally occurring phytochemicals (tannins,
flavonoids, saponins, etc.) believed to contribute to the plant drug's efficacy.
The chemical index lists only those compounds and classes of chemicals mentioned
in the monographs.
In some cases only one main compound is mentioned, due to safety concerns. An
example is the monograph for Nutmeg (Unapproved), which lists the safrole
content but does not mention myristicin, a chemical whose name is derived from
Nutmeg's genus (generic) name, Myristica , and that has known
hallucinogenic effects when taken in excessive dosage (Hocking, 1997).
Consequently, in the chemical tables, myristicin is mentioned only with Parsley
seed, not Nutmeg.
Within each monograph chemical constituents are found generally in the
Composition of Drug section. However, they are sometimes mentioned in other
sections. For example, in the Cinchona bark monograph quinidine and quinine are
mentioned in the Contraindications and Side Effects sections.
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