Arthrella

Arthrella is a fixed combination disease-modifying arthritis rheumatoid drug (DMARD). The clinical
efficacy of Arthrella tablets is comparable to that of diclofenac sodium. Arthrella tablets can
be used for reducing the pain and inflammation of RA.

Nux Vomica

ACTIONS AND PHARMACOLOGY

COMPOUNDS
Indole alkaloids (2.0-5.0%): chief alkaloids strychnine and brucine (approximately in a 1:1 ratio), including
among others, 12-hydroxystrychnine, 15-hydroxystrychnine, alphacolubrine, beta-colubrine, icajine
Fatty oil
Polysaccharides as insoluble reserve substances
Iridoide monoterpenes: including among others, loganin

Extract Of Nux Vomica, I.P. (In House Specification)

An acetic acid extract of nux vomica purified by precipitating with alcohol and containing, when assayed
by the process by I. P., 0.3-1.2 per cent, of strychnine.

Actions

Antidiarrhoeal activity

Study of antidiarrhoeal activity of four medicinal plants in castor-oil induced diarrhoea

A study was undertaken to evaluate the effect of aqueous and methanolic plant extracts of Acorus
calamus rhizome, Pongamia glabra leaves, Aegle marmelos unripe fruit and Strychnos nux-vomica
root bark for their antidiarrhoeal potential against castor-oil induced diarrhoea in mice. The methanolic
plant extracts were more effective than aqueous plant extracts against castor-oil induced diarrhoea. The
methanolic plant extracts significantly reduced induction time of diarrhoea and total weight of the faeces.
The result obtained established the efficacy of these plant extracts as antidiarrhoeal agents.

Nervine tonic and a potent CNS stimulant.

Nux Vomica increases reflex excitability. Endogenic and exogenic stimuli reach the targeted organ
without hindrance and, as a result, possess a strengthened effect that can be attributed to the alkaloid
strychnine. The toxic principle strychnine deadens the inhibitory synapse of the CNS and results in
overextended musculature reactions. The strychnine and brucine components act as competitive
antagonists of the neurotransmitter glycine. The drug is psychoaaateptic due to an increase in reflex
action, i.e., endogenic and-~e)tGgenic stimuli reach-the targeted organ without hindrance and as a result
have a strengthened effect. In addition, strychnine is cholinolytic in animal experiments.

The Ayurvedic Pharmacopoeia of India recommends detoxified seeds in paralysis, facial paralysis,
sciatica and impotency. Homeopathic remedies use a very dilute solution of nux vomica to treat atonic
muscles, constipation, paralysis and pain. Nux vomica seeds contain an alkaloid called brucine, which is
similar to strychnine, the other poisonous alkaloid in the seeds, but not as poisonous. A study published
in the October 2003 issue of the "Journal of Ethnopharmacology" found that brucine reduces pain and
inflammation in test animals with induced arthritis by affecting both the peripheral and central nerve
pathways. Nux vomica seed is often incorporated with other herbs to treat conditions such as pain and
swelling, inflammation of the throat, arthralgia and rheumatism. In controlled doses, it can help stimulate
muscular activity.

Gold Salts (Suvarna Paan)

Immunomodulatory/DMARD activity

Gold compounds primarily depress the immune response. A study conducted by the University of
Pittsburg revealed that gold salts restrain the release of HMGB1 from cells. This is carried out by blocking
the two molecular helper’s namely nitric oxide and interferon beta which facilitate the release of HMGB1
from the cells.

Experts explained that when the HMGB1 is released, it provokes the immune system to increase
inflammations. This results in an uneven distribution of the HMGB1 throughout the body. Now the most
important observation that they made was that the synovial fluids and tissues contain high proportions of
HMGB1 that can cause much agony and discomfort at joints.

Gold inhibits the release of HMGB1 which provokes inflammation, the key process underlying the
development of rheumatoid arthritis by interfering with the activity of two helper molecules that ease
HMGB1's release from the cell, interferon beta and nitric oxide. When HMGB1 is released from the cell --
either through normal processes or cell death -- it becomes a stimulus to the immune system and
enhances inflammation.

Gold also suppresses the function of another important component of the immune system, MHC class II
proteins, which are associated with autoimmune diseases such as rheumatoid arthritis. Brian DeDecker,
Stephen De Wall, and colleagues from the Harvard Medical School found that gold therapy works by
freeing autoimmune-provoking peptides from MHC class II proteins.

DeDecker and co-author Stephen De Wall undertook a large-scale search for new drugs that would
suppress the function of an important component of the immune system, MHC class II proteins, which are
associated with autoimmune diseases. MHC class II proteins normally hold pieces of invading bacteria
and viruses on the surface of specialized antigen presentation cells. Presentation of these pieces alerts
other specialized recognition cells of the immune system, called lymphocytes, which starts the normal
immune response. Usually this response is limited to harmful bacteria and viruses, but sometimes this
process goes awry and the immune system turns toward the body itself, causing autoimmune diseases
such as juvenile diabetes, lupus, and rheumatoid arthritis.They found that platinum was just one member
of a class of metals, including a special form of gold, that all render MHC class II proteins inactive.

In subsequent experiments in cell culture, gold compounds were shown to render the immune system
antigen presenting cells inactive, further strengthening this connection. These findings now give
researchers a mechanism of gold drug action that can be tested and explored directly in diseased tissues.
Gold Salts in the Treatment of Rheumatoid Arthritis
A Double-Blind Study
1. JOHN W. SIGLER, M.D., F.A.C.P.;
2. GILBERT B. BLUHM, M.D.;
3. HOWARD DUNCAN, M.D., F.A.C.P.;
4. JOHN T. SHARP, M.D., F.A.C.P.;
5. DWIGHT C. ENSIGN, M.D., F.A.C.P.; and
6. W. ROSS MCCRUM, Ph.D.

+ Author Affiliations

1. Detroit, Michigan, and Houston, Texas

A 2-year double-blind study was made of gold salt treatment in 27 patients who had active rheumatoid
arthritis for less than 5 years. The gold salt (gold sodium thiomalate) was well tolerated in 13 of 15
patients. Improvement, measured by physical examination, ring sizes, and grip strength, was significant in
the treated group. Radiologic examination showed that the bone and cartilage destruction was arrested in
several patients, and the mean progression rate of destruction was significantly slowed for the treated
group.

From the Rheumatology and Neurology Divisions, Henry Ford Hospital, Detroit, Michigan, and the
Department of Internal Medicine, Baylor College of Medicine, Texas Medical Center, Houston, Texas.

Boswellia Serrata (Frankincense)

DMARD activity

Boswellia or Frankincense: Contains Acetyl-beta-boswellic-acid (anti-inflammatory), Alpha-boswellic-

acid (antiarthritic, anti-inflammatory, antioxidant and COX-2-Inhibitor), Beta-boswellic-acid (anti-
inflammatory), Borneol ((analgesic, anti-inflammatory, antipyretic, antispasmodic), Myrcene (analgesic),
P-cymene (analgesic) [Dr. James Duke, Phytochemical and Ethnobotanical Databases].

Studies on experimental models in India have shown that ingestion of a defatted alcoholic
extract of Boswellia acts as a DMARD through a decrease in polymorphonuclear leukocyte
infiltration and migration, decrease in primary antibody synthesis 6-8, and an almost total
inhibition of the classical complement pathway. In vitro testing has revealed that Boswellia
specifically, and in a dose-dependent manner, blocks the synthesis of pro-inflammatory 5-
lipoxygenase products, including 5-hydroxyeicosatetraenoic acid and leukotriene B4.

Clinical Studies

In a double-blind, placebo-controlled trial, Boswellia demonstrated beneficial effect on knee osteoarthritis.

Thirty patients were given either 1,000 mg Boswellia daily or placebo in three divided doses for eight
weeks. Patients in the Boswellia group experienced a significant decrease in pain and swelling and
increase in range of motion compared to placebo (p < 0.001).25

In a double-blind, placebo-controlled, crossover study, Boswellia in combination with ashwagandha,

turmeric, and zinc was studied in osteoarthritis patients.26 Forty-two patients received either the herbal-
mineral formulation or placebo for three months, then switched to the other protocol after a 15-day
washout period for another three months. The treatment group experienced significant decreases in pain
severity (p<0.001) and disability scores (p<0.05) compared to placebo. Radiological evaluation found no
significant changes in either group. A placebo (n=19) versus Boswellia (n=18) study in rheumatoid
arthritis patients found no significant differences between the two groups in any measured parameters.
NSAID dosage, however, decreased 5.8 percent in the treatment group and 3.1 percent in the placebo
group.27 The researchers concluded that controlled studies including a greater number of subjects are
warranted.

The resin of Boswellia serrata is used traditionally for a variety of inflammatory diseases, such as
rheumatoid arthritis, osteoarthritis, and cervical spondylitis (inflammation of the vertebrae). The main
constituents of the resin are boswellic acids, which have been found to inhibit the synthesis of
leukotrienes (inflammatory compounds produced when oxygen interacts with polyunsaturated fatty acids).
A number of chronic inflammatory conditions are associated with leukotriene formation. Unlike
pharmaceutical corticosteroids which inhibit leukotriene synthesis, boswellic acids exhibit no significant
side effects or toxicity. (23,24) Boswellic acids have been found specifically to inhibit 5-lipoxygenase, the
key enzyme of leukotriene biosynthesis. (25) 22

In a clinical investigation, boswellic acids were given to more than 260 patients with rheumatoid arthritis.
Definite effects were found in the reduction of swelling and pain as compared to placebo; morning
stiffness was reduced; patients reported cutting back on their intake of NSAIDs during the treatment
period; and patients’ general health and well-being showed improvement. The boswellic acids were
found to be effective in reducing the symptoms of rheumatoid arthritis in 50-60 percent of the patients
involved in the investigation. (26)

23. Singh, G.B., S. Bani, and S. Singh. Toxicity and safety evaluation of boswellic acids.
Phytomedicine 1996; 3(1): 87-90.
24. Webb G. Boswellia (Guggul) Research Presented at Special Symposium. Herb Clips. American
Botanical Council 1997, Accessed October 15, 2004 from
http://www.herbalgram.org/youngliving/herbclip/review.asp?i=41757.
25. Safayhi H, Sailer ER, RF Howenlein, HPT Ammon, H Fafayhi. 5-Lipoxygenase Inhibition by
Acetyl-11-ß-Boswellic Acid (AKBA) By a Novel Mechanism. Phytomedicine 1996; 3(1):71-72.
26. Etzel, R. Special extract of BOSWELLIA serrata (H 15) in the treatment of rheumatoid arthritis.
Phytomedicine 1996; 3(1):91-94

Vitex negundo Linn (Five-leaved Chaste Tree)

Action: Leaf—anti-inflammatory, analgesic; A water extract of the leaves, when administered to rats,
exhibited antiinflammatory, analgesic, antihistaminic and membrane stabilizing and antioxidant activities.
(J. Ethnopharmocol, 2003, (203), 199–206.) Methanolic extract of leaves showed remarkable
antihistaminic activity. The leaves contain iridoid glycosides, isomeric flavanones and flavonoids, besides
casticin and the glucosides, luteolin-7-glucoside and alpha-D-glucoside of a tetrahydroxy monomethoxy
flavone. Leaves of VN have been investigated for its anti-inflammatory activity in past2-6, including its
mechanism of action2, 6. Telang et al2 first noticed non steroidal anti-inflammatory drugs (NSAID) like
activity of VN. Similarly, fresh leaves of VN have been suggested to possess anti-inflammatory and pain
suppressing activities possibly mediated via prostaglandin (PG) synthesis inhibition, antihistaminic,
membrane stabilizing and antioxidant activities6.

Oroxylum indicum
Constituents: The limited amount of chemical research conducted on O. indicum indicates the presence
of flavones including scutellarein, baicalein, oroxinden, oroxylin A and B and chrysin. Other constituents
include the ursolic acid, benzoic acid, several naphthalene related compounds, ?-sitosterol, an isoflavone,
terpenes, alkaloids, saponins and tannin (Jiwajinda et al 2002; Chen et al 2003; Kizu et al 1994; Kapoor
1990, 252)

Medical research:

The leaves of Acanthus ebracteatus, stembark of Oroxylum indicum and the stems of Cryptolepis
buchanani and Derris scandens are used as traditional remedies in Thailand for arthritis. One teaspoon of
stem bark juice is given with a cup of milk twice daily to treat rheumatic pain. Aqueous and alcoholic
extracts were tested using three different in vitro systems for effects relevant to anti-inflammatory activity.
The aqueous extracts of O. indicum and D. scandens significantly reduced myeloperoxide release.

Antioxidant: An ethanol extract of the fruit pods of Oroxylum indicum was screened for its suppressive
effects on superoxide generation using a xanthine oxidase assay system. Two flavones, oroxylin A and
chrysin, and a triterpene carboxylic acid, ursolic acid, were identified as inhibitors of superoxide
generation in the xanthine oxidase assay system. Researchers report that these compounds also showed
marked inhibitory effects on the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced
superoxide generation in dimethylsulfoxide differentiated HL-60 cells (Jiwajinda et al 2002). The aqueous
extract of O. indicum was found to significantly reduce myeloperoxide release in vitro, an enzyme found in
neutrophils and in the lysosomes of monocytes that catalyzes the conversion of hydrogen peroxide and
chloride ions (Cl) into hypochlorous acid, a potent inflammatory and antimicrobial agent
(Laupattarakasem et al 2003).

Ginger

Ginger is used in folk medicine, and is a popular food spice. It has many therapeutic uses. It is mentioned
in British Pharmacopoea as a carminative. It occupies an important place in Ayurvedic and Graeco-Arabic
(Tibb) systems of medicine where, among other things, it is recommended against rheumatism (32).
Chemically ginger, as one may expect, contains several classes of compounds.

The chemical composition of dried ginger is as follows: starch 40-60%, proteins 10%, fats 10%,
firbes 5%, inorganic material 6%, residual moisture 10%, and essential oil (oleoresin) 1-4%. In all more
than 200 different volatile substances have been characterized in the essential oil fraction wherein the
pharmacologically active compounds are to be found.

Ginger, its extracts and fractions thereof have been shown to inhibit platelet aggregation both in vitro (33)
and ex vivo (34). The last one is related to an incidental observation by Dr. Dorso (the donor of blood) that
only one-time consumption the previous evening of a large quantity of an excellent marmalade (Ginger
with Grapefruit, Crabtree and Evelyn, London) whose major ingredient (15%) was ginger produced
inhibition of AA-induced platelet aggregation which returned to normal after about a week time.
We and others have shown that ginger strongly inhibits prostaglandin synthesis (11,33,35). Even some of
the components identified in ginger were more potent than indomethacin in inhibiting prostaglandin
synthesis (35). Ginger contains also several 5-lipoxygenase (5-LO) inhibitors (36). Ginger consumption
resulted in reduced formation of thromboxane in human blood (37). Ginger has been shown to ameliorate
symptoms of pain and swelling in musculo-skeletal diseases, which is brought about, at least, by its
inhibition of cyclooxygenase and 5- LO pathways (that is, a dual inhibitor of AA metabolism) (38-40). In
addition, ginger was found to exert abortive and prophylactic effects in migraine headache (41).
Ginger is known to possess antihistamic and antioxidant properties (32). The role of free radicals as
endogenous histamine liberators has attracted attention. Significant peroxidation of membrane lipids
could have damaging effects on membrane fluidity and cell compartmentalization with a consequent
leakage of endocellular compounds, including histamine. In this context, AA may be considered to be a
source of free radicals. Release of histamine from mast cells dependent on the generation of
PGendoperoxides from AA has been demonstrated (42). The release of histamine from mast cells by
metabolitically activated AA is not associated with a significant leakage of LDH; this may suggest it to be
an exocytotic secretory process. As this process was blocked by reduced glutathione, D-mannitol, and by
lipoxygenase and cyclooxygenase pathway inhibitors, and was not reproduced by AAand by the end-
products of the AA cascade, it may be suggested that free radical intermediates generated in the
metabolic activation of AA are involved in mast cell histamine release (42,43).

33. Srivastava KC (1986) Isolation and effects of some ginger components on platelet aggregation and
eicosanoid biosynthesis. Prostagl Leukotr Med 25:187-198

34. Dorso CR, Levin RI, Elder A, Jaffle EA, Weksler BB(1980) Chinese food and platelets. N Engl J Med
303: 756-757

35. Kiuchi F, Shibuya M, Sankawa U (1982) Inhibitors of prostaglandin biosynthesis from ginger. Chem
Pharm Bull 30: 754-757

36. Flynn DL, Rafferty MF, Bactor AM (1986) Inhibition of human neutrophil 5-lipoxygenase activity by
gingerdione, shogaol, capsaicin and related pungent compounds. Prostagl Leukotr Med 24: 195-198

37. Srivastava KG (1989) Effect of onion and ginger consumption on platelet thromboxane production in;
humans. Prostagl Leukotr Essentl Fatty Acids 35:183-185

38. Srivastava KG, Mustafa T (1989) Ginger (Zingiber officinale) and rheumatic disorders. Med
Hypotheses 29: 25-28.

39. a. Editorial News (1991) Ginger relieves RA symptoms in open Danish trial; spice a dual inhibitor of
eicosanoid biosynthesis? Current Rheumatology 12(6):5 b. Srivastava KG, Mustafa (1991) Efficacy of
ginger (Zingiber officinale) in rheumatoid arthritis and muscular discomfort. 4th Interscience World
Conference on Inflammation, Geneva (Switzerland) April 15-18, 1991.

40. Srivastava KG, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders.
Med Hypotheses, 1992 (in press)

41. Mustafa T, Srivastava KG (1990) Ginger (Zingiber officinale) in migraine headache. J Ethnopharmacol
29: 267-273

42. Masini E, Palmerani B, Bani-Sacchi T, Giannella E, Fantozzi R, Mannaioni PF (1987) Mast cell
histamine release induced by intermediate products of arachidonic acid metabolism. Int Archs Allergy
Appl Immunol 82: 279-282
Research suggests ginger root inhibits production of prostaglandins and leukotrienes, which are involved
in pain and inflammation. In an uncontrolled 1992 Danish study, 56 patients who had either RA, OA or
muscular discomfort took powdered ginger. All of those with musculoskeletal pain and three-fourths of
those with OA or RA reported varying degrees of pain relief and no side effects, even among those who
took the ginger for more than two years.

In a 2001 clinical trial a pill containing extracts of the root spice has proved to be as effective as
conventional painkillers. Scientists at the University of Miami Medical School tested a highly-concentrated
ginger supplement on 250 people with osteoarthritis, the most common form of the condition. Each was
suffering from moderate to severe pain. Over a six week period, some were given a 255 milligram dose of
the dietary supplement twice a day. The rest were given a placebo. The results revealed that two-thirds of
those given the ginger pills reported relief from pain - significantly more than those taking the placebo.
Professor Altman, the study's leader, said: "The effect is similar to that seen with trials using conventional
drugs." Rheumatologist Professor Ray Altman, who led the study, believes the highly-concentrated
supplement could help to reduce the pain suffered by two out of three people with arthritis.
Full findings are published in the official journal of the American College of Rheumatology, Vol 44, 2001,
November 2001, No.11.

Arthritis-related problems with your aging knees? Regularly spicing up your meals with fresh ginger may
help, suggests a study published in 2003 issue of Osteoarthritis Cartilage. In this twelve month study, 29
patients with painful arthritis in the knee (6 men and 23 women ranging in age from 42-85 years)
participated in a placebo-controlled, double-blind, crossover study. Patients switched from placebo to
ginger or vice versa after 3 months. After six months, the double-blind code was broken and twenty of the
patients who wished to continue were followed for an additional six months.

By the end of the first six month period, those given ginger were experiencing significantly less pain on
movement and handicap than those given placebo. Pain on movement decreased from a score of 76.14
at baseline to 41.00, while handicap decreased from 73.47 to 46.08. In contrast, those who were switched
from ginger to placebo experienced an increase in pain of movement (up to 82.10) and handicap (up to
80.80) from baseline. In the final phase of the study when all patients were getting ginger, pain remained
low in those already taking ginger in phase 2, and decreased again in the group that had been on
placebo.

Not only did participants' subjective experiences of pain lessen, but swelling in their knees, an objective
measurement of lessened inflammation, dropped significantly in those treated with ginger. The mean
target knee circumference in those taking ginger dropped from 43.25cm when the study began to
39.36cm by the 12th week. When this group was switched to placebo in the second phase of the study,
their knee circumferences increased, while those who had been on placebo but were now switched to
ginger experienced a decrease in knee circumference. In the final phase, when both groups were given
ginger, mean knee circumference continued to drop, reaching lows of 38.78 and 36.38 in the two groups.

How does ginger work its anti-inflammatory magic? Two other recent studies provide possible reasons.

A study published in the November 2003 issue of Life Sciences suggests that at least one reason for
ginger's beneficial effects is the free radical protection afforded by one of its active phenolic constituents,
6-gingerol. In this in vitro (test tube) study, 6-gingerol was shown to significantly inhibit the production of
nitric oxide, a highly reactive nitrogen molecule that quickly forms a very damaging free radical called
peroxynitrite. Another study appearing in the November 2003 issue of Radiation Research found that in
mice, five days treatment with ginger (10 mg per kilogram of body weight) prior to exposure to radiation
not only prevented an increase in free radical damage to lipids (fats found in numerous bodily
components from cell membranes to cholesterol), but also greatly lessened depletion of the animals'
stores of glutathione, one of the body's most important internally produced antioxidants.

A study published in the February 2005 issue of the Journal of Alternative and Complementary Medicine
sheds further light on the mechanisms of action that underlie ginger's anti-inflammatory effectiveness. In
this research, ginger was shown to suppress the pro-inflammatory compounds (cytokines and
chemokines) produced by synoviocytes (cells comprising the synovial lining of the joints), chrondrocytes
(cells comprising joint cartilage) and leukocytes (immune cells).

• Srivastava KC, Mustafa T. Ginger (Zingiber officinale) and rheumatic disorders. Med Hypothesis
29 (1989):25-28 1989.
 • Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal
disorders. Med Hypothesis 39(1992):342-8 1992.
• Wigler I, Grotto I, Caspi D, Yaron M. The effects of Zintona EC (a ginger extract) on symptomatic
gonarthritis. Osteoarthritis Cartilage. 2003 Nov;11(11):783-9. 2003.

Ginger has about 477 constituents and actions and 500 compounds, It is also a Cox 2 inhibitor, it is the
opposite of Celebrex (celebrex having only one molecule, designed to do one thing) Ginger also has anti-
ulcer effects. Ginger has powerful cox 2 inhibitors and demonstrates 56% inhibition of inflammatory
prostaglandins (creation of prostaglandins appears to be mainly a function of cox 2 activity). Ginger
contains melatonin, a hormone secreted by the pineal gland and metabolically related to serotonin.
Melatonin is structurally related to an internationally recognized NSAID known as indomethacin, and
Japanese research confirmed that ginger has at least 4 prostaglandin inhibitors more powerful than
indomethacin. With a long history as a folk medicine, ginger inhibits Cox-2 and another
pro-inflammatory compound, 5-lipoxygenase. Ginger also inhibits COX-1 enzymes and
prevents blood clotting more effectively than aspirin.

Effective anti-platelet and COX-1 enzyme inhibitors from pungent constituents of ginger.2

Nurtjahja-Tjendraputra E, Ammit AJ, Roufogalis BD, Tran VH, Duke CC.

Herbal Medicines Research and Education Center, Faculty of Pharmacy, University of Sydney, NSW
2006, Australia

BACKGROUND: Based on recent studies, pungent constituents of ginger (Zingiber officinale) and related
substances represent a potential new class of anti-platelet agents. The ability of 20 pungent constituents
of ginger and related substances to inhibit arachidonic acid (AA) induced platelet activation in human
whole blood was studied. METHODS: Anti-platelet activity of the compounds was measured in vitro by
the Chrono Log whole blood platelet aggregometer. Molecular hydrophobicity (log P) was measured by
reversed-phase high-performance liquid chromatography. COX-1 (ovine) inhibitory effect of [8]-paradol
and analogues 1 and 5 was carried out using a COX-1 inhibitor assay kit. RESULTS: [8]-Gingerol, [8]-
shogaol, [8]-paradol and gingerol analogues (1 and 5) exhibited anti-platelet activities with IC(50) values
ranging from 3 to 7 microM, whilst under similar conditions the IC(50) value for aspirin was 20+/-11
microM. The COX-1 inhibitory activity of [8]-paradol (IC(50)=4+/-1 microM) was more potent than the
gingerol analogues (1 and 5) (IC(50) approximately 20 microM). CONCLUSION: The above findings show
that gingerol compounds and their derivatives are more potent anti-platelet agents than aspirin under the
conditions described in this study. [8]-Paradol, a natural constituent of ginger, was found to be the most
potent COX-1 inhibitor and anti platelet aggregation agent. The mechanism underlying AA-induced
platelet aggregation inhibition may be related to attenuation of COX-1/Tx synthase enzymatic activity.
Lastly, important features of phenolic compounds for inhibition of AA-induced platelet aggregation and
COX-1 activity were revealed in this study.
PMID: 14693173 [PubMed - in process]

References:
1. Nurtjahja-Tjendraputra E, Ammit AJ, Roufogalis BD, Tran VH, Duke CC. Effective anti-platelet and
COX-1 enzyme inhibitors from pungent constituents of ginger. Thromb Res. 2003;111(4-5):259-65.

Med Hypotheses. 1992 Dec;39(4):342-8.

Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders.

Srivastava KC, Mustafa T.

Department of Environmental Medicine, Odense University, Denmark.

One of the features of inflammation is increased oxygenation of arachidonic acid which is metabolized by
two enzymic pathways--the cyclooxygenase (CO) and the 5-lipoxygenase (5-LO)--leading to the
production of prostaglandins and leukotrienes respectively. Amongst the CO products, PGE2 and
amongst the 5-LO products, LTB4 are considered important mediators of inflammation. More than 200
potential drugs ranging from non-steroidal anti-inflammatory drugs, corticosteroids, gold salts, disease
modifying anti-rheumatic drugs, methotrexate, cyclosporine are being tested. None of the drugs has been
found safe; all are known to produce from mild to serious side-effects. Ginger is described in Ayurvedic
and Tibb systems of medicine to be useful in inflammation and rheumatism. In all 56 patients (28 with
rheumatoid arthritis, 18 with osteoarthritis and 10 with muscular discomfort) used powdered ginger
against their afflictions. Amongst the arthritis patients more than three-quarters experienced, to varying
degrees, relief in pain and swelling. All the patients with muscular discomfort experienced relief in pain.
None of the patients reported adverse effects during the period of ginger consumption which ranged from
3 months to 2.5 years. It is suggested that at least one of the mechanisms by which ginger shows its
ameliorative effects could be related to inhibition of prostaglandin and leukotriene biosynthesis, i.e. it
works as a dual inhibitor of eicosanoid biosynthesis.
PMID: 1494322 [PubMed - indexed for MEDLINE]

J Med Food. 2005 Summer;8(2):125-32.

Ginger--an herbal medicinal product with broad anti-inflammatory actions.

Grzanna R, Lindmark L, Frondoza CG.

RMG Biosciences, Inc.

The anti-inflammatory properties of ginger have been known and valued for centuries. During the past 25 years,
many laboratories have provided scientific support for the long-held belief that ginger contains constituents with
antiinflammatory properties. The original discovery of ginger's inhibitory effects on prostaglandin biosynthesis in the
early 1970s has been repeatedly confirmed. This discovery identified ginger as an herbal medicinal product that
shares pharmacological properties with non-steroidal anti-inflammatory drugs. Ginger suppresses prostaglandin
synthesis through inhibition of cyclooxygenase-1 and cyclooxygenase-2. An important extension of this early work
was the observation that ginger also suppresses leukotriene biosynthesis by inhibiting 5-lipoxygenase. This
pharmacological property distinguishes ginger from nonsteroidal anti-inflammatory drugs. This discovery preceded
the observation that dual inhibitors of cyclooxygenase and 5-lipoxygenase may have a better therapeutic profile and
have fewer side effects than non-steroidal anti-inflammatory drugs. The characterization of the pharmacological
properties of ginger entered a new phase with the discovery that a ginger extract (EV.EXT.77) derived from Zingiber
officinale (family Zingiberaceae) and Alpina galanga (family Zingiberaceae) inhibits the induction of several genes
involved in the inflammatory response. These include genes encoding cytokines, chemokines, and the inducible
enzyme cyclooxygenase-2. This discovery provided the first evidence that ginger modulates biochemical pathways
activated in chronic inflammation. Identification of the molecular targets of individual ginger constituents provides an
opportunity to optimize and standardize ginger products with respect to their effects on specific biomarkers of
inflammation. Such preparations will be useful for studies in experimental animals and humans.PMID: 16117603
[PubMed - indexed for MEDLINE]

Chem Pharm Bull (Tokyo). 1994 Jun;42(6):1226-30.

Stomachic principles in ginger. III. An anti-ulcer principle, 6-gingesulfonic acid, and three
monoacyldigalactosylglycerols, gingerglycolipids A, B, and C, from Zingiberis Rhizoma
originating in Taiwan.

Yoshikawa M, Yamaguchi S, Kunimi K, Matsuda H, Okuno Y, Yamahara J, Murakami N.

Kyoto Pharmaceutical University, Japan.

An anti-ulcer constituent, 6-gingesulfonic acid, and three monoacyldigalactosylglycerols, gingerglycolipids A, B, and

C, were isolated from Zingiberis Rhizoma, the dried rhizome of Zingiber officinale Roscoe which was cultivated in
Taiwan, together with (+)-angelicoidenol-2-O-beta-D-glucopyranoside. Based on chemical reactions and
physicochemical evidence, the structures of 6-gingesulfonic acid, gingerglycolipids A, B, and C have been
determined. In addition, the absolute stereostructure of (+)-angelicoidenol-2-O-beta-D-glucopyranoside was clarified
on the basis of its synthesis from d-borneol. 6-Ginesulfonic acid showed weaker pungency and more potent anti-ulcer
activity than 6-gingerol and 6-shogaol.

Hyoscamus niger - Synonym—Henbane

CONSTITUENTS—
Hyoscyamine, Hyoscine, Scopolamine, Hyoscipicrin.

While power to temporarily increase nerve force—mild stimulant properties—is ascribed to hyoscyamus,
that influence is much less marked than belladonna and stramonium, although its general effects are in
many ways similar to these agents in medicinal doses. It is almost entirely devoid of irritant properties, but
is soothing, calmative and sedative to a marked degree.

Specific Symptomatology—It is specific in excitable mental conditions, and in the violent and noisy
delirium of fevers and acute inflammations, to subdue the excitement and to induce sleep.

The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley
Ellingwood, M.D

Henbane has a long history of use as a medicinal herb, and has been widely cultivated to meet the
demand for its use. All parts of the plant, but especially the leaves and the seeds, can be used – they are
mildly pain-relieving, antispasmodic, mildly diuretic, hallucinogenic, hypnotic, pupil-dilating, narcotic and
sedative. The leaves and the seeds are the parts medicinally used. The leaves are collected in the
second year, when the plant is in flower; the seeds are gathered when perfectly ripe. Henbane is a
powerful narcotic but, unless improperly and injudiciously used, it is only considered moderately
poisonous. For sedative uses it is considered better than opium, as it does not produce constipation. It is
used principally to cause sleep, and remove irregular nervous action. Combined with other preparations it
is most excellent for gout and rheumatism.

Recognized Commercial Medicinal Preparations

Hyoscyamine is used to control symptoms associated with disorders of the gastrointestinal (GI) tract. It
works by decreasing the motion of the stomach and intestines and the secretion of stomach fluids,
including acid. Hyoscyamine is also used in the treatment of bladder spasms, peptic ulcer disease,
diverticulitis, colic, irritable bowel syndrome, cystitis, and pancreatitis. Hyoscyamine may also be used to
treat certain heart conditions, to control the symptoms of Parkinson's disease and rhinitis (runny nose),
and to reduce excess saliva production. – Plant-Life.org

Brand names
• Anaspaz® • Hyospaz® • Levsin®/SL
• Cystospaz® • Levbid® • Levsinex® Timecaps®
• Cystospaz-M® • Levsin®
• NuLev®
• Hyosol® SL • Levsin® Drops

Side Effects

Hyoscyamine may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:

• drowsiness
• dizziness or lightheadedness
• headache
• blurred vision
• flushing (feeling of warmth)
• dry mouth
• constipation
• difficulty urinating
• increased sensitivity to light

If you experience any of the following symptoms, call your doctor immediately:

• diarrhea
• skin rash
• eye pain
• fast or irregular heartbeat
- Medline Plus

Cyperus Rotundus (Nut Grass)

Action _ Carminative, astringent, anti-inflammatory, antirheumatic, hepatoprotective, diuretic,

antipyretic, analgesic, hypotensive, emmenagogue and nervine tonic.

Used for intestinal problems, indigestion, sprue, diarrhoea, dysentery, vomiting and fever; also
as a hypocholesterolaemic drug and in obesity. Along with other therapeutic applications,
The Ayurvedic Pharmacopoeia of India indicated the use of the rhizome in rheumatism,
inflammations, dysuria, puerperal diseases and obesity.
The tuber is rich in Cu, Fe, Mg and Ni. Beta-sitosterol, isolated from the tubers, exhibits
significant anti-inflammatory activity against carrageenan- and cotton pellet-indu induced
oedema in rats; the activity is comparable to hydrocortisone and phenylbutazone when
administered intraperitoneally.

The alcoholic and aqueous extracts of the tubers possess lipolytic action and reduce obesity by
releasing enhanced concentrations of biogenic amines from nerve terminals of the brain which
suppress the appetite centre. Presence of eudalne group of sesquiterpenic compounds of
sesquiterpene alcohol, isocyperol is said to play an important role in lipid metabolism.

Aqueous-alcoholic extract of the tuber exhibited hypotensive, diuretic, antipyretic and analgesic
activities. These are attributed to a triterpenoid. The essential oil (0.5–0.9%) from the tubers
contains mainly sesquiterpenes.

Cyperus Rotundus is a common weed with aromatic tubers that grow all around India. The root
tuber is commonly used for diarrhea dysentery, dyspepsia, indigestion, and piles.11 The tubers
contain 0.5-0.9 percent of an essential oil containing sesquiterpenes, beta-sitosterol, and a
flavonoid glycoside.12 The acetone and alcoholic extracts have shown broad spectrum
antibacterial activity.

Twenty patients with chronic diarrhea of more than3 weeks duration or those in which there was
early recurrence, after an acute attrack, were given 2g of fine powder of Cyperus Rotundus
root tuber thrice daily along with 50ml decoction made from 50g tuber powder given daily for 15
days. The frequency of defecation was controlled by the fifth day of treatment. In addition it
helped decrease fat malabsorption and improved lactose intolerance. Forty percent off patients
were considered cured, whereas there was improvement in 30 percent.14 Further work is
required to confirm and expand the scope of use.

Cyperus Rotundus is generally considered safe and often used to treat stomach
complaints in children. In commonly used doses of 1-3g twice daily no adverse
reactions have been reported.15