Herbal Medicine: Expanded Commission E
Marshmallow root
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Latin Name: Althaea officinalis
Pharmacopeial Name: Althaeae radix
Other Names: Althaea root, Althea root
Overview
Marshmallow is a perennial herb native throughout damp areas of Europe and western Asia,naturalized in North America in salt marshes from Massachusetts to Virginia, now cultivated from western Europe to Russia (Karnick, 1994;Leung and Foster, 1996;Wichtl and Bisset, 1994).The material of commerce is harvested from cultivated plantsmainly fromBelgium, Bulgaria, Hungary, the former Yugoslavia, and the former U.S.S.R. (BHP, 1996;Wichtl and Bisset, 1994).The plant must be at least two years old before harvesting the roots(Bradley, 1992).In Germany, marshmallow is listed in Annex1 of the German Federal Ordinance on the Conservation of Species (BArtSchV) and a permit is necessary for import or export of any wild-collected material (Lange and Schippmann, 1997). Marshmallow has been used in traditional European medicines for more than two thousand years (Leung and Foster, 1996). Its therapeutic use was first recorded in the ninth century B.C.E.; it was widely used in Greek medicine(Bown, 1995).Its genus name Althaea comes from the Greek altho, to cure, and its order name, Malvaceae, is derived from the Greek malake, soft (Grieve, 1979).Its use in traditional Greek medicine spread to Arabian medicine and to traditional Indian Ayurvedic and Unani medicines. Early Arab physicians prepared a poultice with the leaves to suppress inflammation. The present day Ayurvedic Pharmacopoeia reports its actions as demulcent, diuretic, emollient, and vulnerary (Karnick, 1994). In Germany,marshmallow root and leaf are both licensed as standard medicinal teas. The root is also used as a componentof a few prepared cough tea and cough syrup medicines. In the United States,marshmallow isused as a component of dietary supplementantitussive and demulcent preparations. Marshmallow root and extract were formerly official in the United States Pharmacopeia and the National Formulary. The approved modern therapeutic applications for marshmallow are supportable based on its history of use in well established systems of traditional medicine,on phytochemical investigations, and in vitro studies and in vivo experiments in animals. Pharmacopeial grade marshmallow leaf must have a swelling index of not less than 12 and pass botanical identification by macroscopic and microscopic authentication (DAC, 1986; AB, 1981). The British Herbal Pharmacopoeia requires marshmallow leaf to be harvested before the flowering period, pass identification by thin-layer chromatography (TLC), and conform with additional quantitative standards, including water-soluble extractive not less than 15% (BHP, 1996). Pharmacopeial grade marshmallow root, peeled or unpeeled,must have a swelling index of not less than 10, with the pulverized root, and pass macroscopic and microscopic authentication tests (DAB, 1997; AB, 1981; Ph.Eur.3, 1998; Wichtl and Bisset, 1994). The British Herbal Pharmacopoeia requires peeled marshmallow root to pass botanical identification by a TLC method, plus additional quantitative standards, including not less than 22% water-soluble extractive, calculated with reference to the oven-dried material (BHP, 1996).The Swiss Pharmacopoeia requiresa swelling index of not less than 15 (Ph.Helv.VII, 1987; Wichtl and Bisset, 1994).
Description
Marshmallow root consists of the dried root, unpeeled or peeled, of Althaea officinalis L. [Fam.Malvaceae], and its preparations in effective dosage.
Chemistry and Pharmacology
Marshmallow root contains mucilage polysaccharides (6.211.6%) composed of galacturonorhamnans, arabinans, glucans, and arabinogalactans; carbohydrates (2535% starch, 11% pectin); the flavonoid glycosides kaempferol and quercetin; caffeic, chlorogenic, ferulic, and syringic phenolic acids; tannins; sugars (10% sucrose); amines (up to 2% asparagine); fat (1.7%); calcium oxalate; coumarins; and sterols (Bradley, 1992; ESCOP, 1997; Leung and Foster, 1996; List and Hrhammer, 19731979; Newall et al., 1996; Wichtl and Bisset, 1994). The Commission E reported that it alleviates local irritation, inhibits mucociliary activity, and stimulates phagocytosis. The British Herbal Compendium reported its actions internally as demulcent and topically as emollient and vulnerary (Bradley, 1992). The mucilage from marshmallow root coats the mucosa, protecting them from local irritations (ESCOP, 1997).
Uses
The Commission E approved the internal use of marshmallow root for irritation of the oral and pharyngeal mucosa and associated dry cough, and for mild inflammation of the gastric mucosa. The British Herbal Compendium indicates its use internally for gastroenteritis, peptic and duodenal ulceration, common and ulcerative colitis, and enteritis. Topically: as a mouthwash or gargle for inflammation of the mouth and pharynx; as a poultice or ointment/cream in furunculosis, eczema and dermatitis (Bradley, 1992). ESCOP lists its use for dry cough and irritations of the oral, pharyngeal, or gastric mucosa (ESCOP, 1997). The German Standard License for marshmallow root tea approves its use for soothing of irritation from mucosal inflammations in the mouth and pharynx, upper respiratory tract, and gastrointestinal tract (Bradley, 1992; Wichtl and Bisset, 1994).
Contraindications
None known.
Side Effects
None known.
Use During Pregnancy and Lactation
No restrictions known.
Interactions with Other Drugs
The absorption of other drugs taken simultaneously may be delayed.
Dosage and Administration
Unless otherwise prescribed: 6 g per day of cut or ground root. Cold maceration: 2-5 g in 150 ml cold water for 30 minutes stirring frequently; strain and warm before drinking, up to three times daily. Dried root: 2-5 g, up to three times daily. Fluidextract 1:1 (g/ml): 2-5 ml, up to three times daily. Tincture 1:5 (g/ml): 10-25 ml, up to three times daily. Native dry extract 3.5-5.0:1 (w/w): 0.4-0.6 g, up to three times daily. Native soft extract 2.3-3.2:1 (w/w): 0.6-0.9 g, up to three times daily. Syrupus Althaeae: Single dose: 10 ml, to be used only in treating throat irritation. Note: Marshmallow syrup: diabetics need to allow for sugar concentration.
References
Bown, D. 1995. Encyclopedia of Herbs and Their Uses. New York: DK Publishing, Inc. 236. Bradley, P.R. (ed.). 1992. British Herbal Compendium, Vol. 1. Bournemouth: British Herbal Medicine Association. British Herbal Pharmacopoeia (BHP). 1996. Exeter, U.K.: British Herbal Medicine Association. 6364. Deutsches Arzneibuch (DAB 1997). 1997. Stuttgart: Deutscher Apotheker Verlag. Deutscher Arzneimittel-Codex (DAC). 1986. Stuttgart: Deutscher Apotheker Verlag. ESCOP. 1997. 'Althaeae folium' and 'Althaeae radix.' Monographs on the Medicinal Uses of Plant Drugs. Exeter, U.K.: European Scientific Cooperative on Phytotherapy. Europäisches Arzneibuch, 3rd ed., 1st suppl. (Ph.Eur.3). 1998. Stuttgart: Deutscher Apotheker Verlag. Grieve, M. 1979. A Modern Herbal. New York: Dover Publications, Inc. Karnick, C.R. 1994. Pharmacopoeial Standards of Herbal Plants, Vols. 12. Delhi: Sri Satguru Publications. Vol. 1:3031; Vol. 2:90. Lange, D. and U. Schippmann. 1997. Trade Survey of Medicinal Plants in GermanyA Contribution to International Plant Species Conservation. Bonn: Bundesamt f r Naturschutz. 3233, 114121. 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. Hrhammer (eds.). 19731979. Hagers Handbuch der Pharmazeutischen Praxis, Vols. 17. New York: Springer Verlag. Newall, C.A., L.A. Anderson, J.D. Phillipson. 1996. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press. sterreichisches Arzneibuch, Vols. 12, 1st suppl. ( AB). 19811983. Wien: Verlag der sterreichischen Staatsdruckerei. Ph.Eur.3. See Europäisches Arzneibuch. Pharmacopoeia Helvetica, 7th ed. Vol. 14.(Ph.Helv.VII). 1987. Bern: Office Central Fdral des Imprims et du Matriel. Wichtl, M. and N.G. Bisset (eds.). 1994. Herbal Drugs and Phytopharmaceuticals. Stuttgart: Medpharm Scientific Publishers.
Additional Resources
Braun H. and D. Frohne. 1987. Heilpflanzenlexikon f r rzte und Apotheker, 5th ed. Stuttgart-New York: Gustav Fischer Verlag. 1415. Braun, R. et al. 1997. Standardzulassungen f r FertigarzneimittelText and Kommentar. Stuttgart: Deutscher Apotheker Verlag. British Herbal Pharmacopoeia (BHP). 1990. Bournemouth, U.K.: British Herbal Medicine Association. . 1983. Keighley, U.K.: British Herbal Medicine Association. Council of Europe. 1981. Flavouring Substances and Natural Sources of Flavourings, 3rd ed. Strasbourg: Maisonneuve. Franz, G. 1966. Die Schleimpolysaccharide vom Althaea officinalis und Malva sylvestris. Planta Med 14:90110. . 1989. Polysaccharides in pharmacy: current applications and future concepts. Planta Med 55(6):493497. Franz, G. and M. Chladek. 1973. Vergleichende Untersuchungen ber die Zusammensetzung von Rohschleimen aus Kreuzungsnachkommen von Althaea officinalis L. x Althaea armeniaca Ten [Comparative studies on the composition of crude mucus from crossbred descendants of Althaea officinalis L. and Althaea armeniaca Ten]. Pharmazie 28(2):128129. Franz, G. and A. Madaus. 1990. Stabilitt von Polysacchariden. Untersuchungen am Beispiel des Eibischschleims. Dtsch Apoth Ztg 130:21942199. Hnsel, R., K. Keller, H. Rimpler, G. Schneider (eds.). 1992. Hagers Handbuch der Pharmazeutischen Praxis, 5th ed. Vol. 4. Berlin-Heidelberg: Springer Verlag. 233239. Kantee, H. 1973. Althaea, ipecacuanha, senega ja thymus yskanlaakkeissa [Althaea, ipecac, senega and thyme as cough medicines] [In Finnish]. Sairaanhoitaja 49(5):32. Kapoor, L.D. 1990. Handbook of Ayurvedic Medicinal Plants. Boca Raton: CRC Press. 32. 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. 8485. Pharmacope Franaise Xe dition (Ph.Fr.X.). 19831990. Moulins-les-Metz: Maisonneuve S.A. Reynolds, J.E.F. (ed.). 1993. Martindale: The Extra Pharmacopoeia, 30th ed. London: The Pharmaceutical Press. Trease, G.E. and W.C. Evans. 1989. Trease and Evans' Pharmacognosy, 13th ed. London; Philadelphia: Baillire Tindall. 375. Wagner, H., S. Bladt, E.M. Zgainski. 1984. Plant Drug Analysis. Berlin-Heidelberg: Springer Verlag. 163 et seq. Weiss, R.F. 1991. Lehrbuch der Phytotherapie, 7th ed. Stuttgart: Hippokrates Verlag. 258259. Wichtl, M. (ed.). 1997. Teedrogen, 4th ed. Stuttgart: Wissenschaftliche Verlagsgesellschaft. This material was adapted from The Complete German Commission E MonographsTherapeutic 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.
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