FWD 2 Expanded Commission E: Myrrh

Herbal Medicine: Expanded Commission E

Myrrh

Latin Name: Commiphora molmol
Pharmacopeial Name: Myrrha
Other Names: common myrrh, gum myrrh, hirabol myrrh, heerabol myrrh, gummi myrrh

Overview

Gum-resin myrrh is a product of several species of Commiphora, a perennial tree or shrub native to Nubia (Egypt and Sudan), Somaliland (northeast Somalia, Djibouti, and east Ethiopia) and the Arabian Peninsula of southwest Asia (Yemen) (Budavari, 1996; Leung and Foster, 1996; Tyler, 1993; Wichtl and Bisset, 1994). The material of commerce is collected mainly from wild trees in the Horn of Africa (Erythrea, Ethiopia, Somalia), Sudan, and Yemen (BHP, 1996; Iwu, 1990; Wichtl and Bisset, 1994; Yen, 1992). It is also under cultivation in Kenya, Tanzania, Ethiopia and other north African countries (Iwu, 1990). The material used in traditional Chinese medicine, Commiphora molmol Engl. = C. myrrha Engl., is imported from Africa and Arabia and is wrapped in dogskin (Yen, 1992). The species used in Ayurvedic medicine (C. mukul Engl.) grows in the rocky tracts of the northwestern Indian state of Rajasthan and in the west Indian state of Gujarat (API, 1989). It is also found in the northeast Indian state of Assam, in Bangladesh, and in the province of Sind, Pakistan (Kapoor, 1990). When the bark is cut, myrrh seeps out in yellow to reddish brown agglutinated (stuck together), tear-shaped, irregular masses that are sometimes as big as walnuts (BHP, 1996; Grieve, 1979; Karnick, 1994; Tyler, 1993).

Myrrh has been used in Middle Eastern medicine for treatment of infected wounds and bronchial complaints for thousands of years (Bown, 1995). It was also used as an embalming agent by the ancient Egyptians. It is familiar to many cultures as incense used in religious rituals. Myrrh is a Jewish holy oil, and is mentioned in the first books of the Jewish, Muslim, and Christian holy texts (Grieve, 1979). In the time of Christ, the gum-resin of both frankincense (Boswellia spp.) and myrrh were some of the most highly valued commodities in trade (Wilford, 1997). Today, crude myrrh is dispensed throughout eastern Africa and Saudi Arabia as an anti-inflammatory and anti-rheumatism drug (Iwu, 1990).

Myrrh has a long history of therapeutic use in the Indian Ayurvedic system of medicine (Bown, 1995), where it is used to treat mouth ulcers, gingivitis and pharyngitis, as well as respiratory catarrh (Karnick, 1994). As a treatment for stomatitis (inflammation of the mouth), it is combined with honey and rectified spirit, then dissolved in rose petal infusion, and taken as a mouthwash. Externally, it is used as an astringent topical application to ulcers and as a gargle for spongy gums (Nadkarni, 1976). Myrrh tincture is also used to treat many disorders associated with the female reproductive cycle, particularly dysmenorrhea and amenorrhea, and to help relieve some of the uncomfortable symptoms of menopause (Frawley and Lad, 1986; Nadkarni, 1976). These uses have not been corroborated by clinical studies. Its use was later introduced into both the Chinese and Tibetan systems of medicine sometime during the seventh century C.E. (Bown, 1995; Clifford, 1984; Leung and Foster, 1996). The Gyu-zhi, or Four Tantras, by Chandranandana is the earliest Indian medical text to be translated into Tibetan (eighth century C.E.). In it, Indian myrrh (C. mukul) is included as a component of various psychiatric incenses, still used in Tibetan Buddhist medicine (Clifford, 1984). It is available today, for example, as a component of the Tibetan drug 'Agar 31' in an incense-stick dosage form for inhaling, produced in India and Nepal (Tsarong, 1986). In Chinese medicine, Somalian myrrh (C. myrrha) is used to treat impact injury, incised wounds, sinew and bone pain, menstrual block, and hemorrhoids, among other conditions. It is used as a component in many patent medicines, including bu-gu-zhi-wan (Psoralea Pills) and zhi-wan (Hemorrhoid Pills), as well as various topical plaster-adhesives and lotions, including die-da-yao-jing (Traumatic Injury Medicine Essence) (Fratkin, 1986; Yen, 1992).

In Germany, myrrh gum-resin and myrrh tincture are both official in the German Pharmacopeia, approved in the Commission E monographs, and the tincture dosage form is official in the German Standard License monographs (Braun et al., 1997; DAB, 1997; Wichtl and Bisset, 1994). The tincture is used as a mono-preparation and also as a component of various dental remedies and mouthwashes, ointments, paints, and coated tablets. Application by paint, gargle, and/or rinse are used in dentistry (Wichtl and Bisset, 1994). For example, the product Merfluan is an effervescent dentifrice salt with myrrh (Mielck, 1970). In German pediatric medicine, tincture of myrrh is used to treat oral candidiasis (thrush), which is common in infants. It is applied undiluted with a cotton-wool tip to small areas of affection, or diluted 1:1 with chamomile flower tea for larger areas (Schilcher, 1997). In the United States, myrrh was formerly official in the United States Pharmacopeia and National Formulary (Leung and Foster, 1996; Taber, 1962). It was used as an aromatic, astringent mouthwash (Taber, 1962). Myrrh's constituents include aldehydes and phenols, which stimulate drying and cleansing actions through topical administration. As a salve, myrrh is used to treat hemorrhoids, wounds, and bed sores. In tincture form, gargles and mouthwashes are considered useful in treating sore throats or other oral mucosal or gingival irritations (Tyler, 1993). The approved modern therapeutic applications for myrrh are based on its long history of use in well established systems of traditional and conventional medicine, case studies, in vitro studies, pharmacological studies in animals, and on phytochemical studies of its volatile oil, gum, and resin fractions.

German pharmacopeial grade myrrh consists of the air-dried oleo-gum resin exuded from the bark of C. molmol Engler and/or other chemically similar species. It may contain no more than 65% ethanol-insoluble extractive. Botanical identity is confirmed by thin-layer chromatography (TLC), macroscopic and microscopic examinations, and organoleptic evaluations. Myrrh tincture is also official in the German Pharmacopeia. It must be manufactured according to the DAB tincture monograph, macerating 1 part pulverized myrrh with 5 parts ethanol 90% (v/v) (DAB, 1997; Wichtl and Bisset, 1994). The Pharmacopeia of Austria requires myrrh to have an acid value of 19.522.0 and also includes color reaction tests for the presence of characteristic sesquiterpenes ( AB, 19811983; Wichtl and Bisset, 1994). The British Herbal Pharmacopoeia defines myrrh as the oleo-gum resin obtained from the stems of C. molmol Engler and/or other related species. It must contain not less than 6% volatile oil and not more than 70% ethanol (90%)-insoluble residue. Botanical identity is confirmed by TLC and macroscopic and organoleptic evaluations (BHP, 1996). Indian pharmacopeial grade myrrh, referred to as guggulu, consists of the exudate of C. wightii (Arn.) Bhand [syn. Balsamodendron mukul Hook. ex Stocks (C. mukul Engl.)] collected by making incisions in the bark during winter. It must contain not less than 1% (v/w) volatile oil, not less than 53% water-soluble extractive and not less than 27% alcohol-soluble extractive. Botanical identity is confirmed by macroscopic and organoleptic evaluations as well as by chemical tests (API, 1989).

[Note: Some European references refer to the official species used in India as false myrrh and consider it to be an adulterant to genuine myrrh (Wichtl and Bisset, 1994).]

Description

Myrrh consists of oleo-gum resin extruded from the stems of C. molmol Engler [Fam. Burseraceae], then air-dried, and its preparations in effective dosage. Myrrh can also originate from other Commiphora species, if the chemical composition is comparable to the official preparation.

Chemistry and Pharmacology

Myrrh contains approximately 3060% water-soluble gum; 2040% alcohol-soluble resins consisting of commiphoric acids, commiphorinic acid and heerabomyrrhols; approximately 8% volatile oil (Bradley, 1992; Leung and Foster, 1996; Newall et al., 1996). The volatile oil fraction contains myrcene and a-camphorene; steroids including Z-guggulsterol, and I, II, III guggulsterol (Huang, 1999; Kapoor, 1990). The water-soluble gum or mucilage fraction is composed mainly of acidic polysaccharide with galactose, 4-O-methyl-glucuronic acid and arabinose in a ratio of 8:7:2 with approximately 1820% proteins (Bradley, 1992; Jones and Nunn, 1955; Wichtl and Bisset, 1994). Characteristic constituents are mainly terpenoids, including furanosesquiterpenoids with eudesmane, germacrane, elemane, or guaiane structures (Bradley, 1992; Wichtl and Bisset, 1994). Its characteristic odor is due to the furanosesquiterpenes (Bruneton, 1995), which may also be the characteristic components of pharmaceutical myrrh (Wichtl and Bisset, 1994).

The Commission E reported astringent activity.

The British Herbal Pharmacopoeia reported antiseptic action (BHP, 1996). The Merck Index reported its therapeutic action as carminative and astringent (Budavari, 1996). It has also been shown to have disinfecting, deodorizing, and granulation-promoting properties (Wichtl and Bisset, 1994).

Uses

The Commission E approved myrrh for topical treatment of mild inflammations of the oral and pharyngeal mucosa.

The British Herbal Compendium indicates the use of myrrh tincture as a gargle to treat pharyngitis and tonsillitis, as a mouthwash for gingivitis and ulcers, and external application to treat sinusitis and minor skin inflammations (Bradley, 1992). In France, its topical use is approved for the treatment of small wounds, for nasal congestion from the common cold, and for local application as an anodyne to treat affections of the buccal cavity and/or the oropharynx (Bradley, 1992; Bruneton, 1995). The German Standard License for myrrh tincture indicates its use for inflammations of the gums and mouth mucosa such as gingivitis and stomatitis, and also for prosthesis pressure marks (Braun et al., 1997).

Contraindications

None known.

Side Effects

None known.

Use During Pregnancy and Lactation

Not recommended during pregnancy. No restrictions known for lactation.

Interactions with Other Drugs

None known.

Dosage and Administration

Unless otherwise prescribed: Powdered resin, myrrh tincture, and other galenical preparations for topical use.

Tincture of myrrh 1:5 (g/ml), 90% ethanol (DAB 10): For use in gargles, mouthwashes, rinses, and paints.

Gargle or rinse: Add 5-10 drops of tincture to a glass of warm water (Commission E).

Mouthwash or gargle solution: Add 30-60 drops of tincture to a glass of warm water (Braun et al., 1997).

Paint: Apply the undiluted tincture to the affected areas on the gums or the mucous membranes of the mouth and paint with a brush or swab, two to three times daily (Commission E; Braun et al., 1997).

Undiluted tincture 1:5 (g/ml): Apply locally to affected areas of the gums or mucous membranes of the mouth, two to three times daily (Braun et al., 1997).

Dental powders: Containing 10% powdered resin (Commission E).

References

The Ayurvedic Pharmacopoeia of India, Part 1, Vol. 1, 1st ed. (API). 1989. Delhi: Government of IndiaMinistry of Health and Family Welfare, Department of Health. 43.

Bown, D. 1995. Encyclopedia of Herbs and Their Uses. New York: DK Publishing, Inc. 265.

Bradley, P.R. (ed.). 1992. British Herbal Compendium, Vol. 1. Bournemouth: British Herbal Medicine Association.

Braun, R. et al. 1997. Standardzulassungen f r FertigarzneimittelText and Kommentar. Stuttgart: Deutscher Apotheker Verlag.

British Herbal Pharmacopoeia (BHP). 1996. Exeter, U.K.: British Herbal Medicine Association. 141.

Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing.

Budavari, S. (ed.). 1996. The Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals, 12th ed. Whitehouse Station, N.J.: Merck & Co, Inc. 1086.

Clifford, T. 1984. Tibetan Buddhist Medicine and Psychiatry. York Beach, ME: Samuel Weiser, Inc.

Deutsches Arzneibuch, 10th ed. Vol. 16. (DAB 10). 1991. Kommentar. Stuttgart: Wissenschaftliche Verlagsgesellschaft.

Deutsches Arzneibuch (DAB 1997). 1997. Stuttgart: Deutscher Apotheker Verlag.

Fratkin, J. 1986. Chinese Herbal Patent FormulasA Practical Guide. Boulder, CO: Shya Publications. 125134, 142148.

Frawley, D. and V. Lad. 1986. The Yoga of Herbs: An Ayurvedic Guide to Herbal Medicine. Twin Lakes: Lotus Press.

Grieve, M. 1979. A Modern Herbal. New York: Dover Publications, Inc.

Huang, K.C. 1999. The Pharmacology of Chinese Herbs, 2nd ed. Boca Raton: CRC Press. 183.

Iwu, M.M. 1990. Handbook of African Medicinal Plants. Boca Raton: CRC Press. 160161.

Jones, J.K. and J.R. Nunn. 1955. The constitution of gum myrrh. J Chem Soc 30013004.

Kapoor, L.D. 1990. Handbook of Ayurvedic Medicinal Plants. Boca Raton: CRC Press. 131132.

Karnick, C.R. 1994. Pharmacopoeial Standards of Herbal Plants, Vol. 1. Delhi: Sri Satguru Publications. 103104.

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.

Mielck, W. 1970. Merfluanein brausendes zahnsalz mit myrrhe [Merfluanan effervescent dentifrice salt with myrrh]. Dent Dienst 22(11):21.

Nadkarni, K.M. 1976. Indian Materia Medica. Bombay: Popular Prakashan. 170171.

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.

Schilcher, H. 1997. Phytotherapy in PaediatricsHandbook for Physicians and Pharmacists. Stuttgart: Medpharm Scientific Publishers. 29.

Taber, C.W. 1962. Taber's Cyclopedic Medical Dictionary. Philadelphia, PA: F.A. Davis Company. M65.

Tsarong, T.J. 1986. Handbook of Traditional Tibet DrugsTheir Nomenclature, Composition, Use, and Dosage. Kalimpong, India: Tibetan Medical Publications. 45.

Tyler, V.E. 1993. The Honest Herbal, 3rd ed. New York: Pharmaceutical Products Press.

Wichtl, M. and N.G. Bisset (eds.). 1994. Herbal Drugs and Phytopharmaceuticals. Stuttgart: Medpharm Scientific Publishers.

Wilford, J.N. 1997. Ruins in Yemeni Desert Mark Route of Frankincense Trade. New York Times. Jan. 28:B1, B10.

Yen, K.Y. 1992. The Illustrated Chinese Materia MedicaCrude and Prepared. Taipei: SMC Publishing, Inc. 202.

Additional Resources

Felter, H.W. and J.U. Lloyd. 1985. King's American Dispensatory, Vols. 12. Portland, OR: Eclectic Medical Publications [reprint of 1898 original].

McGuffin, M., C. Hobbs, R. Upton, A. Goldberg. 1997. American Herbal Product Association's Botanical Safety Handbook. Boca Raton: CRC Press.

Pharmacopoeia Helvetica, 7th ed. Vol. 14.(Ph.Helv.VII). 1987. Bern: Office Central Fdral des Imprims et du Matriel.

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.