Chinese cinnamon is a medium-sized evergreen tree native to China and Vietnam, now cultivated in southwestern China, Cambodia, India, Japan, Java, Sri Lanka, Sumatra, and Vietnam (Bruneton, 1995; Grieve, 1979; Tyler et al., 1988; Yen, 1992). The cultivated trees are kept as coppices, and prevented from growing higher than 10 feet (Grieve, 1979; Leung and Foster, 1996). The material of commerce used in Chinese medicine is produced in Guangdong, Guangxi, and Yunnan provinces, Cambodia, and Vietnam (Yen, 1992). The genus name Cinnamomum may be from Arabic, Hebrew, or Malay language origins and its species name, cassia, is from the Greek kassia, meaning to strip off the bark. Its medical use is recorded in Chinese formularies around 2700 B.C.E. and somewhat later in ancient Greek and Latin texts (Leung and Foster, 1996; Tyler et al., 1988). According to the energetics theory in traditional Chinese medicine (TCM), it acts to supplement body 'fire,' to 'warm' and tone the 'spleen' and 'kidney,' thus making it effective for precordial and abdominal pain with 'cold' sensation, diarrhea due to asthenia and pathogenic 'cold,' and hypofunction of the kidney (Chang and But, 1986; Tu, 1992). Galenical preparations of Chinese cinnamon bark are used as a carminative, digestive, or stomachic component of compounds in TCM, traditional Greco-European medicines, and traditional Indian Ayurvedic and Unani medicine (Bruneton, 1995; Grieve, 1979; Nadkarni, 1976; Tu, 1992).
Modern clinical studies have investigated its use to treat abdominal pain, diarrhea, gastrointestinal disturbances, bronchial asthma, and asthenia of blood and vital energy. (Chang and But, 1986). Its clinical use is usually as a component in polypharmacy and only rarely as a monopreparation.
One clinical study reported the stimulation of blood circulation and improved digestive function with two different herbal formulas containing Chinese cinnamon, prescribed in TCM in an aqueous decoction, to supplement 'vital energy and blood' (Chang and But, 1986; ZMC, 1975). Another study reported improvement in 21 cases treated for bronchial asthma using an alcoholic fluidextract (0.15-0.3 ml) combined with procaine hydrochloride to make a 2 ml dose. The drug was injected into the bilateral 'Feishu' acupoints. Asthmatic attacks were controlled in 20 cases and improvement reported in all 21 cases (Chang and But, 1986). Because the cinnamon was combined with other therapeutic agents, either an herbal or a conventional drug, it is not clear what conclusions can be attributed to the action of cinnamon alone.
The modern therapeutic applications for Chinese cinnamon are supportable based on thousands of years of use in well established systems of traditional medicine, in vitro studies, in vivo studies in animals, phytochemical investigations, and some modern clinical studies. Its composition is similar to that of Ceylon cinnamon and the two herbs are often used interchangeably.
In both the United States and Germany, Chinese cinnamon is used as a digestive or stomachic componentof herbal compounds, in aqueous infusion or decoction, alcoholic fluidextract and/or tincture, dry powder in capsules and tablets, and essential oil. It also appears in both countries as one herb among many in cough, cold, and fever formulas.
Pharmacopeial grade Chinese cinnamon bark contains 1-2% volatile oils composed mainly of cinnamaldehyde and cinnamic acid (Chang and But, 1986).
Description
Chinese cinnamon consists of the dried branch bark and occasionally stem bark, separated from the cork, of Cinnamomum aromaticum Nees (syn. C. cassia Blume) [Fam.Lauraceae] and preparations thereof in effective dosage. The bark contains essential oil.
Chemistry and Pharmacology
Chinese cinnamon contains volatile oils (1-2%) mainly composed of cinnamaldehyde (75-90%); phenolic compounds (condensed tannins), flavonoid derivatives (proanthocyanidins and oligomers or cinnamtannins); mucilage; calcium oxalate, resins, sugars, and coumarins (Bruneton, 1995; Leung and Foster, 1996; Hänsel et al., 1992; List and Hörhammer, 1973; Newall et al., 1996).
The Commission E reported antibacterial, fungistatic, and motility-promotion effects. Antifungal, antiviral, bactericidal, and larvicidal actions have been reported for the volatile oil (Leung and Foster, 1996). Due to auto-oxidation and evaporation during decoction, it is doubtful that cinnamaldehyde contributes much to the overall therapeutic efficacy of Chinese cinnamon (Hikino, 1985). An aqueous extract demonstrated anti-ulcerogenic activities in rats as effectively as cimetidine (Akira et al., 1986). Chinese cinnamon has shown in vivo inhibitory activity against complement formation due to its diterpenoid and condensed tannin content (Hikino, 1985). The aqueous decoction of Chinese cinnamon bark had an inhibitory action against fungi in vitro (Chang and But, 1986). A hydroalcoholic extractive of cinnamon bark was found to inhibit bacterial endotoxins (Azumi et al., 1997).
Uses
The Commission E approved the internal use of cinnamon for loss of appetite, and dyspeptic complaints such as mild spasms of the gastrointestinal tract, bloating, and flatulence. The British Herbal Pharmacopoeia indicates its use for flatulent dyspepsia, flatulent colic, and diarrhea, specifically colic or dyspepsia with flatulent distension and nausea (BHP, 1983; Newall et al., 1996). The German Standard License for cinnamon bark tea infusion recommends it for a feeling of distension, flatulence, and mild cramp-like gastrointestinal disorders due to reduced production of gastric juice (Braun et al., 1997). The French Herbal Remedies, Notice to Applicants for Marketing Authorization of 1990 allows the same indications for use for Chinese cinnamon as for Ceylon cinnamon (Bruneton, 1995).
Contraindications
Allergy to cinnamon or Peruvian balsam.
Side Effects
Frequently, allergic reaction of the skin and mucosa.
Use During Pregnancy and Lactation
Not recommended (McGuffin et al., 1997).
Interactions with Other Drugs
None known.
Dosage and Administration
Unless otherwise prescribed: 2-4 g per day of ground bark.
Infusion or decoction: 0.7-1.3 g in 150 ml water, three times daily.
Fluidextract 1:1 (g/ml): 0.7-1.3 ml, three times daily.
Tincture 1:5 (g/ml): 3.3-6.7 ml, three times daily.
Essential oil: 0.05-0.2 ml.
References
Akira, T., S. Tanaka, M. Tabata. 1986. Pharmacological studies on the antiulcerogenic activity of Chinese cinnamon. Planta Med 52(6):440-443.
Azumi, S., A. Tanimura, K. Tanamoto. 1997. A novel inhibitor of bacterial endotoxin derived from cinnamon bark. Biochem Biophys Res Commun 234(2):506-510.
Braun, R. et al. 1997. Standardzulassungen für Fertigarzneimittel—Text and Kommentar. Stuttgart: Deutscher Apotheker Verlag.
British Herbal Pharmacopoeia (BHP).1983. Keighley, U.K.: British Herbal Medicine Association.
Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing.
Chang, H.M. and P.P.H. But (eds.) 1986. Pharmacology and Applications of Chinese Materia Medica. Philadelphia: World Scientific. 510-514.
Grieve, M. 1979. A Modern Herbal. New York: Dover Publications, Inc.
Hänsel, R., K. Keller, H. Rimpler, G. Schneider (eds.). 1992. Hagers Handbuch der Pharmazeutischen Praxis, 5th ed. Vol. 4. Berlin-Heidelberg: Springer Verlag.
Hikino, H. 1985. Oriental Medicinal Plants. In: Wagner, H., H. Hikino, N.R. Farnsworth. 1985. Economic and Medicinal Plant Research, Vol. 1. London: Academic Press. 69-70.
Leung, A.Y. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc.
List, P.H. and L. Hörhammer (eds.). 1973. Hagers Handbuch der Pharmazeutischen Praxis, Vol. 4. New York: Springer Verlag. 54, 884.
McGuffin, M., C. Hobbs, R. Upton, A. Goldberg. 1997. American Herbal Product Association's Botanical Safety Handbook. Boca Raton: CRC Press.
Nadkarni, K.M. 1976. Indian Materia Medica. Bombay: Popular Prakashan. 328330.
Newall, C.A., L.A. Anderson, J.D. Phillipson. 1996. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press.
Tu, G. (ed.). 1992. Pharmacopoeia of the People's Republic of China (English Edition 1992). Beijing: Guangdong Science and Technology Press. 31.
Yen, K.Y. 1992. The Illustrated Chinese Materia Medica—Crude and Prepared. Taipei: SMC Publishing, Inc.
Zhongshan Medical College Editorial Group (ZMC). 1975. Clinical Application of Chinese Traditional Drugs, 1st ed. Guangdong: Guangdong People's Publishing House. 8, 201.
Additional Resources
British Herbal Pharmacopoeia (BHP). 1996. Exeter, U.K.: British Herbal Medicine Association.
Der Marderosian, A. (ed.). 1999. The Review of Natural Products. St. Louis: Facts and Comparisons.
Hili, P., C.S. Evans, R.G. Veness. 1997. Antimicrobial action of essential oils: the effect of dimethylsulphoxide on the activity of cinnamon oil. Lett Appl Microbiol 24(4):269-275.
Koh, W.S. et al. 1998. Cinnamaldehyde inhibits lymphocyte proliferation and modulates T-cell differentiation. Int J Immunopharmacol 20(11):643-660.
Nagai, H. et al. 1982. Immunopharmacological studies of the aqueous extract of Cinnamomum cassia (CCAq). II. Effect of CCAq on experimental glomerulonephritis. Jpn J Pharmacol 32(5):823-831.
Nagai, H., T. Shimazawa, N. Matsuura, A. Koda. 1982. Immunopharmacological studies of the aqueous extract of Cinnamomum cassia (CCAq). I. Anti-allergic action. Jpn J Pharmacol 32(5):813-822.
Tanaka, S. et al. 1989. Antiulcerogenic compounds isolated from Chinese Cinnamon. Planta Med 55(3):245-248.
Trease, G.E. and W.C. Evans. 1989. Trease and Evans' Pharmacognosy, 13th ed. London; Philadelphia: Baillire Tindall. 453.
Wichtl, M. and N.G. Bisset (eds.). 1994. Herbal Drugs and Phytopharmaceuticals. Stuttgart: Medpharm Scientific Publishers.
Zhu, Z.P., M.F. Zhang, Y.Q. Shen, G.J. Chen. 1993. [Pharmacological study on spleen-stomach warming and analgesic action of Cinnamomum cassia Presl] [In Chinese]. Chung Kuo Chung Yao Tsa Chih 18(9):513-515, 553-557.
This material was adapted from The Complete German Commission E Monographs—Therapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.
1) The Overview section is new information.
2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.
3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:
Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
Infusion: 2 g in 150 ml of water
Fluidextract 1:1 (g/ml): 2 ml
Tincture 1:5 (g/ml): 10 ml
4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.
This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.
Excerpt from Herbal Medicine: Expanded Commission E Monographs Copyright 2000 American Botanical Council Published by Integrative Medicine Communications Available from the American Botanical Council.