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Authors requiring further information regarding Elsevier’s archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright Author's personal copy Journal of Ethnopharmacology 125 (2009) 108–144 Contents lists available at ScienceDirect Journal of Ethnopharmacology journal homepage: www.elsevier.com/locate/jethpharm Local uses of Aristolochia species and content of nephrotoxic aristolochic acid 1 and 2—A global assessment based on bibliographic sources Michael Heinrich a,∗ , Jennifer Chan a , Stefan Wanke b , Christoph Neinhuis b , Monique S.J. Simmonds a,c a Centre for Pharmacognosy and Phytotherapy, The School of Pharmacy, University London, 29-39 Brunswick Square, London WC1N 1AX, UK Institut für Botanik, Zellescher Weg 20b, Technische Universität Dresden, 01062 Dresden, Germany c Royal Botanic Gardens, Kew, Richmond, Surrey TW9 3AB, UK b a r t i c l e i n f o Article history: Received 9 April 2009 Received in revised form 20 May 2009 Accepted 28 May 2009 Available online 6 June 2009 Keywords: Traditional medicine Aristolochia Aristolochic acids Risk assessment Toxicology Nephropathy Medicinal plants Chinese herb nephropathy Traditional Chinese medicine (TCM) a b s t r a c t Aims of the study: More than 100 cases of nephropathy over the last 10 years caused by the systemic and longer term application of Chinese snakeroot (Aristolochia fangchi) highlighted the risk of using preparations which contain aristolochic acids. On the other hand anecdotal evidence highlights the widespread use of Aristolochia species (Aristolochiaceae) in many regions of the world. Therefore, it was our objective to systematically assess the scientific literature available on the local and traditional use of Aristolochia spp. on a worldwide scale. Our review identifies core species which need to be investigated and which may need monitoring (esp. in national and international trade). Methods: An extensive review of the literature available in libraries in London on the uses of species of Aristolochia was undertaken. Relevant information was extracted and entered into a database for analysis. Results: Based on the assessment of 566 reference sources 685 individual sets of data were recorded. Seven species – Aristolochia indica L. (Asia), Aristolochia serpentaria L. (North America), Aristolochia debilis Sieb & Zucch. (China), Aristolochia acuminata Lam (India), Aristolochia trilobata L. (Central/South America, Caribbean), Aristolochia clematitis L. (Europe) and Aristolochia bracteolata Lam. (Africa) – are reported widely as being used medicinally. The medical uses vary, but of particular interest are uses in case of gastrointestinal problems, which is likely to result in repeated exposure to the botanical drugs by an individual. About half of all records relate to uses of Aristolochia species in Asia, one-third to the Americas, a continent which has so far received practically no attention in terms of assessing the risk of using species of Aristolochia. Of the 99 species (plus several identified at genus level only) for which we were able to summarise ethnobotanical information, preliminary phytochemical information is only available for 24 species and some of the most common ones including Aristolochia acuminata have so far not been studied phytochemically. Conclusions: Species of Aristolochia are used medicinally in many regions of the world and both from an ethnopharmacological and a public health perspective this poses a risk. A systematic assessment of the content of aristolochic acids in the most widely used species is needed to evaluate whether their uses pose a potential health risk. In China and Europe species of Aristolochia have been associated with nephropathy and it is important to evaluate whether nephropathy occurs in other parts of the world, especially India and Central America where the use of species of Aristolochia are reported to be commonly used in traditional medicine. © 2009 Elsevier Ireland Ltd. All rights reserved. 1. Introduction The use of the genus Aristolochia (Aristolochiaceae) in traditional and local medicines (WHO, 2007) and herbal products Abbreviations: AA, aristolochic acid (1 or 2); C. Am. & Mex., Central America and Mexico (incl. the Caribbean); cult, cultivated; E, East/Eastern; N, North/Northern; n.a., not available; S, South/Southern; STDs, sexually transmitted diseases; W, West/Western. ∗ Corresponding author. Tel.: +44 20 77535844; fax: +44 20 77535909. E-mail address: michael.heinrich@pharmacy.ac.uk (M. Heinrich). 0378-8741/$ – see front matter © 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.jep.2009.05.028 has been of concern since the 1990s after an herb-based slimming formula used in a Belgium clinic contained Aristolochia fangchi instead of Stephaniae tetrandrae. Aristolochia fangchi contains aristolochic acids (AAs), whereas Stephaniae tetrandrae does not. After taking these AAs containing formula more than 100 patients were admitted to Belgian hospitals with renal failure and severe atrophy of the proximal renal tubules. This inadvertent exchange of plant species ultimately resulted in many patients suffering from end-stage renal failure and urethral damage (Tang and Eisenbrand, 1992; Bieler et al., 1997; Cosyns et al., 1998; Lampert and Xu, 2002). Removal of the kidneys and urethras in end-stage patients highlighted a high preva- Author's personal copy M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 lence (46%) of urothelial carcinoma (Muniz Martinez et al., 2002). The renal toxicity associated with the use of herbal products made with aristolochic acid containing plants from China has been labelled, somewhat inappropriately, as “Chinese Herb Nephropathy” (CHN). Similarly, endemic (Balkan) nephropathy, a devastating renal disease affecting people in rural areas of Bosnia, Bulgaria, Croatia, Romania, and Serbia has been linked to the consumption of AAs containing food. This form of nephropathy is characterized by its insidious onset, invariable progression to chronic renal failure and a strong association with transitional cell (urothelial) carcinoma of the upper urinary tract (Grollman et al., 2007). Species of Aristolochia have often been reported as important medicinal plants in ethnobotanical studies. In Europe, species of Aristolochia were already mentioned by the Greek scholar Dioscorides (1st century, Gunther, 1933; Berendes, 1970; Beck, 2005) and aristolochic acid and extracts obtained from European snakeroot (Aristolochia clematitis L.) were formerly licensed for use against abscesses, eczemas and other long-lasting skin diseases and as an non-specific stimulant of the immune system but in 1982 they were withdrawn due to suspected carcinogenic effects (BGA, 1981). Overall, members of the genus seem to have a long history of medicinal use in Europe, Asia (incl. China), Africa, and Central America (Chen, 1993; Muniz Martinez et al., 2002), which is also exemplified in studies on indigenous Mexican medicine (Heinrich et al., 1998 and references therein, Leonti et al., 2001; Giovannini and Heinrich, 2009). Aristolochia fangchii and 31 related species from the genus are known to contain AAs, nitrophenanthrene carboxylic acids responsible for the nephrotoxic and genotoxic effects associated with CHN (Kumar et al., 2003). Two AAs considered to be of particular significance are aristolochic acid I (1) and aristolochic acid II (Pokhrel and Ergil, 2000; Arlt et al., 2002). From the perspective of molecular pharmacology a hallmark of the nephropathy caused by AAs are covalent dA-aristolactam (AL) and dG-AL adducts formed after metabolic activation. These adducts persist for an extended period, which facilitates its detection in target tissues. AL-DNA adducts are well known mutagens, leading Grollman et al. (2007) to determine the p53 mutational spectrum of transitional cell cancers in patients with endemic nephropathy. They also demonstrated that DNA adducts derived from AAs are present in renal tissues of patients with documented endemic nephropathy. These adducts can be detected in transitional cell cancers, and A:T and T:A transversions (Grollman et al., 2007 and references cited). These effects can be linked to the medicinal uses of Aristolochia clematitis, a plant widely distributed in Europe and also found in the Balkan regions. Wheat germ has been reported to be contaminated by the seeds of Aristolochia clematitis and this could be a source of how AAs might be getting into the diet in these regions (Hranjec et al., 2005). However, this has not yet been proven unequivocally. There is a growing body of evidence from research in China and Europe that exposure to AAs is associated with the rare form of nephropathy that can result in the subsequent development of tran- 109 sitional cell cancer. Species of Aristolochia are widely distributed in practically all continents, expect for Australia, a continent for which only few species are known. Since ethnobotanical studies indicate that members of the genus are frequently used medicinally a systematic assessment of any adverse reports associated with the use of these species should be undertaken to evaluate their toxicity and potential risk to users. The literature on the use of the genus is scattered throughout the literature and currently there is no review that brings together information about the diversity of species used, where they are used and whether they are known to contain AAs. This review aims to fill this gap and provide a systematic assessment of which species of Aristolochia are used medicinally and whether their use in traditional medicines has implications for public health (Jaeger, 2005). Specifically, this allows us to prioritise species for future phytochemical–analytical research. Such a systematic review of existing bibliographic evidence has been used successfully, for example, in order to find new lead plants in drug discovery (e.g. Adams et al., 2007). 2. Materials and methods In order to assess the use and diversity of the species of Aristolochia used on a world-wide level, literature sources available both online and in print were reviewed critically. Relevant bibliographic items were identified systematically in the relevant libraries by searching for key terms including Aristolochia, ethnobotany, medicinal plants, Chinese herbs and botanical. Initially other terms were considered such as natural products, pharmacognosy, folk medicine and botany, but then excluded since their use did not result in relevant references being found. Six libraries with holdings both on useful/medicinal plants/pharmacognosy and the history of medicine/pharmacy were selected: • • • • • • The Natural History Museum, London. The Linnean Society, London. Royal Horticultural Society, London. Royal Botanic Gardens, Kew, Richmond, Surrey. Wellcome Library of Medicine, London. The School of Pharmacy, University of London, London. These libraries contain relevant literature, which span a wide time period and most importantly cover the period prior to the introduction of electronic databases. The books chosen were searched for relevant information. Most but not all sources are written in English. Initially, the index of each book was scanned for the key word Aristolochia. When this was not present, a second search was undertaken using the trivial or common English names, such as birthwort or snakeroot. For those books that had no index or content pages then the text was quickly looked at to establish whether the book might contain relevant information. If these searches did not identify any key words, then the book was recorded as having no data. However, when there was relevant information, this was noted on the recording sheet. A database search in BIOSIS Preview [keywords Aristolochia AND codes 54000 (Pharmacognosy and Pharmaceutical Botany) and 51522 (Plant Physiology – Chemical Constituents)]: was conducted in order to identify key references. Each of the articles was checked for its relevance by assessing the title and abstract before deciding whether the article should be assessed in full. In addition and in view of the fact, that specific genera are often not listed in databases, the following specialist plant journals available to the authors were searched for relevant information using the journals’ search facilities or manually (years included in brackets): Author's personal copy 110 • • • • • M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Economic Botany (2002–2007) Fitoterapia (1999–2007) Journal of Ethnobiology and Ethnomedicine (start–2007) Journal of Ethnopharmacology (1995–2007) Phytotherapy Research (1997–2007) The terms ‘Aristolochia, medicinal herb, Chinese, folk medicine, traditional, ethnobotanical and ethnomedicine’ were used. These terms had identified relevant publications in a pilot survey of the Journal of Ethnopharmacology. Individually, the search results were refined searching for the key word ‘Aristolochia’ anywhere in the article. In the case of ‘Economic Botany’ and ‘The Journal of Ethnobiology and Ethnomedicine’, this procedure was not required and a single search was completed to find the key word ‘Aristolochia’ appearing anywhere in the article. Taxonomic validity of all species was checked and here we report both the names as they appear in the original article and the reassignment based on current nomenclature information available to the authors. 3. Results and discussion A total of 566 reference sources were consulted, 99 of these were from the selected journals and 467 from books. Overall, 237 contained relevant information while the rest (329, 58.1%) contained no relevant data. From these a total of 685 individual sets of data about uses of members of the genus were recorded (Appendix A). We concentrated on documents that focused directly on the use of species of Aristolochia, and excluded, for example, use reports on alcoholic extracts of caterpillars that had fed on Aristolochia trilobata (Nossin and Weniger, 2009). The names of the majority of species of Aristolochia cited in the literature were the accepted Latin scientific binomial names but in some cases names such as Aristolochia galen and Aristolochia dioscorides had been used, which could not be assigned to a known taxonomically valid species (see Appendix A). While these names are not taxonomically accepted and might not be species of Aristolochia it was decided to keep them in the database in order to achieve a more complete overview of the medicinal uses of plants considered to be Aristolochia as recorded in the literature. 3.1. Data analysis Of the 99 species of Aristolochia (excluding several identified at genus level only) reported to be used medicinally 7 species were recorded particularly frequently (Table 1, Fig. 1). Other species cited more than five times are Aristolochia contorta (China, 20 records), Aristolochia manshuriensis (Asia, 18), Aristolochia grandiflora (S. America, Central America/Mexico, 14), Aristolochia elegans (S. America, Central America/Mexico, 12), ArisTable 1 The seven most frequently cited species of the genus Aristolochia based on a global assessment of the genus’ medical use. Species Continent where species is reported to be used No. of records Aristolochia indica Aristolochia bracteolata (incl. Aristolochia bracteolate) Aristolochia serpentaria Aristolochia debilis Aristolochia acuminata (incl. Aristolochia tagala) Aristolochia trilobata Aristolochia clematitis Indian subcontinent Africa 105 64 North America China India 54 38 34 Central America, Caribbean Europe 34 34 Fig. 1. Aristolochia indica, the most frequently cited species (drawing by B. Schulz, Universität Dresden). tolochia heterophylla (Asia, 11), Aristolochia rotunda (Europe, 11), Aristolochia maxima (S. America, Central America/Mexico, 10), Aristolochia albida (Africa, 8), Aristolochia reticulata (USA, 8), Aristolochia fangchi (China, 8), Aristolochia mollisima (China, 7), Aristolochia rugosa (S. America, Central America/Mexico, 7), Aristolochia seriaca (Philippines, 7), Aristolochia triangularis (S. America, 6), Aristolochia paucinervis (Western Mediterranean, 5), Aristolochia philippinensis (Philippines, 5). These data suggest that of the 25 species of Aristolochia cited in the literature more than five times a greater diversity of these species are being used in Asia and the Americas than in other parts of the world. A geographical analysis of the data (Table 2) for the genus shows that about half of all records relate to uses of Aristolochia species in Asia, but that about one-third are from the Americas, a continent which has so far received practically no attention in terms of assessing the risk of using species of Aristolochia. There were fewer records for African (9%) and Europe (6.6%) Aristolochia species being used, which is, of course, due to multiple factors like differences in species richness or poorer coverage in terms of ethnopharmacological field studies in parts of Africa. Species were assigned to broad categories based on the organs in the body they were used to treat or the symptoms associated with an ailment. It was found that they are most commonly used in the treatment of gastrointestinal complaints especially for the treatment of diarrhoea, which accounts for 14.9% of all reported uses (Table 3). Also, as implied by the common name of many species, the use in the treatment of snakebites and poisoning is common (10.2%) as is their use for the treatment of gynaecological (113 reports/7.8%) conditions including the treatment of sexually transmitted diseases (STDs) such as syphilis and gonorrhoea. This also includes common female problems such as urine or bladder problems, and complaints relating to the reproductive system such Author's personal copy 111 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Table 2 Number of use reports for each of the major continents and number of species. Continent Number of citations (n = 685) Percentage of total (%) (n = 685) Number of species with recorded uses Africa America (including, Central, North and South) 54 221 7.9 32.3 Asia Oceania Europe Not stated 339 3 45 23 49.5 0.4 6.6 3.3 17 Approx 45—N. America (14), S. America (33), C. America (17) 50 3 5 Not included as contraception as well as induction of labour and abortive purposes, treatments linked to a commonly used name for taxa from the genus—birthwort. Species are used to treat conditions of the central nervous system (6.8%). Local and traditional uses relating to parasitology are another important group of use reports (5.9% of all citations). This includes the treatment of malaria, intestinal worms and as an insecticide (Appendix A). There were a total of 80 citations (5.5%) listing species of Aristolochia being used for dermatological conditions. Many of the sources did not specify the exact disease being treated, although some mentioned their use in the treatment of eczema and also for fungal skin conditions (Appendix A). Other uses for species of Aristolochia are in cardiovascular and respiratory conditions representing 4.6% and 2.0% of the citations, respectively. Common uses for the genus in cardiovascular conditions are to treat hypertension or as a cardiotonic. A large proportion of the citations fell under the category of ‘miscellaneous’ which included the use of the genus in the treatment of cancer. Many were placed in the “miscellaneous” category because the author reported the species as being used ‘medicinally’ but provided no specific information about the use (Appendix A). 3.2. Evidence for beneficial effects of Aristolochia species There is some in vitro and in vivo pharmacological evidence to support some of the uses of Aristolochia. For example, the antibacterial effects of extracts of Aristolochia paucinervis Pomel (e.g. Gadhi et al., 1991; Mims et al., 2004) and Aristolochia bracteolata Lam. (as Aristolochia bracteata Retz, Manikandar et al., 2006) could be relevant for the use of these species in the treatment of gastrointestinal problems. Some evidence is available to support uses of Aristolochia elegans in Mexcio for the treatment of stings and of the toxic effects of venoms (Jiménez-Ferrer et al., 2005) as it reduced the toxicity of the Mexican scorpion Centruroides limpidus Karsch. Tsai et al. (1980) report effects of AAs in inactivating snake venoms in mice in vivo. In the later study AAs were effective against Elapid venoms Table 3 Medicinal uses of species of the genus Aristolochia. Use Number of citations, total (n) = 1445 % of citations of the total number of citations Cardiovascular Central nervous system Bites and poison Dermatology Endocrinology Gastrointestinal Gynaecology including STDs Infectious diseases Musculoskeletal Respiratory Nephrology Parasitology Veterinary uses Miscellaneous including general ‘medicinal use’ 29 99 147 80 17 215 113 78 67 67 73 85 8 227 2.0 6.8 10.2 5.5 1.2 14.9 7.8 5.4 4.6 4.6 5.1 5.9 0.6 15.7 (Naja naja atra and Bungarus multicinctus), but not effective against Crotalid venoms (Trimeresurus mucrosquamatus, Agkistrodon acutus and Trimeresurus gramineus). Considerable research efforts have gone into the investigation of the abortive activity of the genus (Haruna and Choudhury, 1997; Jadhav and Bhutani, 2005), as exemplified by research on Aristolochia indica Linn. (Pakrashi and Shaha, 1978). A sesquiterpene was identified as the active constituent, which they then administered to mice (Pakrashi and Shaha, 1977). This compound caused an abortive effect that occurred between the 8th and 10th day of pregnancy. A dose-dependent abortive activity was observed with 97.1% abortive activity when a dose of 100 mg/(kg body weight) was given (Pakrashi and Shaha, 1977). The methyl ester of aristolochic acid, extracted from Aristolochia indica, was also shown to have abortive actions. When given to mice on the sixth and seventh day of pregnancy at a dose of 60 mg/(kg body weight), the abortive rate was 100% with a dramatic decrease in this value when given to mice on the 10th (25%) and the 12th day (20%) (Pakrashi et al., 1975; Pakrashi and Shaha, 1978). There is a lack of pharmacological data to support the use of the genus for the treatment of STDs or for the treatment of CNS conditions. However, there are some data to support the use of species against parasites. Agarwal and Ghosh (1985) stated that Aristolochia bracteolata Lam (named Aristolochia bracteata Retz. by the authors) is useful in the treatment of roundworms by causing their expulsion. El Tahir et al. (1999) evaluated the anti-malarial activity of Aristolochia bracteolata Lam (as Aristolochia bracteata) by testing extracts from different parts of the plant against various strains of Plasmodium falciparum. The methanol extract of the seeds had the highest activity with an IC50 of 4 ␮g/ml (El Tahir et al., 1999). Additionally, Jbilou et al. (2008) investigated the activity of Aristolochia baetica L. extract using methanol against Tribolium castaneum, a pest that is commonly found in grains. The growth of the larvae was inhibited, the ␣-amylase activity was also decreased and the amount of offspring produced was stopped completely. The rationale behind the usage of the species in eczema is probably to treat bacterial infections associated with the condition especially ones caused by Staphylococcus aureus and sometimes by Streptococcus pyogenes. Experimental work has shown that inhibition of these bacteria does occur. Kumar et al. (2006) used the root of Aristolochia indica L. and found that it was able to inhibit Staphylococcus aureus. The essential oils found in the aerial parts of Aristolochia indica was also found to inhibit the same bacteria indicating that the effects are not limited to one part of the plant (Shafi et al., 2002). This is also supported by Gadhi et al. (1991) using chloroform extracts of Aristolochia paucinervis Pomel. The ethyl acetate and butanol extracts, however, did not show any inhibitory effects. The use of the genus in fungal skin infections is supported by research by Gadhi et al. (2001b) who investigated the effects of the leaves of Aristolochia paucinervis on various fungi that can cause skin infections and ringworm. The extracts used were hexane, chloroform and ethyl acetate. The hexane extract was found to be the most effective and upon investigation this extract was found to contain ‘chlorophyll, fatty acids and other constituents’, clearly not a sufficient explanation for the species’ use. There was some form of inhibition Author's personal copy 112 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 observed for each of the fungi tested. The fungi most inhibited were Trichophyon tonsurans, Trichophyton schoenleinii, Trichophyton violaceum and Epidermophyton floccosum with a minimum inhibitory concentration of 64 ␮g/mL in the hexane fraction (Gadhi et al., 2001b). In general the anti-microbial properties of the genus relate to topical application of the plant extracts and thus may be of less toxicological concern than when the extracts are taken orally. Seventy eight references (5.4%) report Aristolochia species as being used in the treatment of infectious diseases. Some of these claims are supported by pharmacological data and as has already been discussed, extracts from some species have been shown to inhibit various Gram-positive and Gram-negative bacteria. Additionally, Machado et al. (2005) showed that Aristolochia cymbifera inhibits methicillin-resistant bacteria. Species of Aristolochia are also used in wound healing (Appendix A). This use has been researched by Shirwaikar et al. (2003). They observed that the ethanol extracts of the leaves of Aristolochia bracteata (syn. of Aristolochia bracteolata) caused wounds in rats to contract and they measured an increased presence of antioxidant enzymes, resulting in an increase in the rate of wound healing. The author suggests that this provides substantial evidence for its use in wound healing (Shirwaikar et al., 2003). A total of 4.6% of citations listed the use of the species in muscoskeletal conditions (Appendix A). This includes rheumatism, arthritis and gout. The use of the leaves and bark of Aristolochia trilobata for this purpose is supported by Sosa et al. (2002) based on studies with hexane, methanol and chloroform extracts on the ear oedema of mice. The chloroform extract had the greatest activity, which was comparable to that of Indomethacin: an anti-inflammatory drug indicated in the treatment of gout and rheumatism (Sosa et al., 2002). AAs are believed to be partly responsible for the anti-inflammatory actions since they are able to inhibit phospholipase A2, an enzyme which forms pro-inflammatory mediators (Sosa et al., 2002). Binding to the phospholipase A2 enzyme resulting in a non-competitive inhibitor via the formation of hydrogen bonds has been proposed as the underlying biochemical mechanism (Mors et al., 2000b). The anti-inflammatory actions of the genus was also confirmed by Muschietti et al. (1996) who in their study used water, dichloromethane and methanol extracts of the root of Aristolochia triangularis Cham. There was also a positive improvement in individuals who had taken Aristolochia manshuriensis Kom. as part of a combination with another herbal product for rheumatic lumbago (Chang and But, 2001). The antihypertensive uses of Aristolochia manshuriensis are supported by Chang and But (2001) using intravenous administration to dogs. They found that this caused an initial increase in blood pressure which was then followed by a decrease in the blood pressure which was maintained. The effects were described as being similar to that of Digitalis on the hearts of toads and guinea pigs (Chang and But, 2001). There are data to support uses of Aristolochia against coughs, for various infections of the respiratory tract and for bronchitis. The Table 4 Evidence for the presence of aristolochic acids 1 and 2 in recognised species of the genus based on published information. Species (with name in the original reference given in brackets) Ethnobotanical information available (see Appendix A) Aristolochic acid 1 Aristolochic acid 2 Reference Aristolochia argentina Gris Aristolochia auricularia Boiss. Aristolochia bracteolata Lam. (Aristolochia baetica Linn.) Aristolochia bracteolata Lam (Aristolochia bracteata) Aristolochia chilensis Bridges in Lindl. Aristolochia cinnabarina C.Y. Cheng & J.L. Wu; possibly Aristolochia tuberosa Liang et S.W. Hwang Aristolochia clematitis L. Aristolochia contorta Bunge Aristolochia cucurbitifolia Hayata Aristolochia debilis Sieb & Zucc (syns: Aristolochia longa Thump, Aristolochia recurvilabra Hance, Aristolochia sinarum Lindl.) Aristolochia elegans Mast (Aristolochia hassleriana Chodat) Aristolochia fangchi Wu Aristolochia heterophylla Hemsl Aristolochia indica L Aristolochia kaempferi Willd (syns.: Aristolochia chrysops Stapf., Aristolochia feddei H. Lev, Aristolochia heterophylla Hernsl, Aristolochia mollis, Aristolochia setchuenensis Franch, Aristolochia shimadai Hayata) Aristolochia kaempferi Willd (Aristolochia kankauensis Sasaki) Aristolochia liukiuensis Hatus Aristolochia kunmingensis C.Y.Cheng & J.S.Ma Aristolochia kwangsiensis Chun & F.C. How (Aristolochia austroszechuanica C.B. Chien & C.Y. Cheng) Aristolochia sp. (Aristolochia longa L.) Yes No Yes Yes Yes No Pres Pres Pres Pres Pres Pres Pres Pres Pres Priestap (1987) Kumar et al. (2003) Achenbach and Fischer (1997) Kumar et al. (2003) Kumar et al. (2003) Kumar et al. (2003) Yes Yes Yes Yes Pres Yes Yes Yes Yes Yes Pres Pres Pres Pres Pres No Pres Pres No No Pres Pres Pres Pres Wu et al. (2004) Kumar et al. (2003) Kumar et al. (2003) Kumar et al. (2003) Yes Pres Pres Aristolochia iquitensis O.C. Schmidt (Aristolochia macrophylla Lam) Aristolochia manshuriensis Kom Aristolochia maurorum Linn. Aristolochia mollis Stand & Stey (Syn) Aristolochia mollisima Hance. Yes Pres Pres De Pascual Tesesa et al. (1983) and Kumar et al. (2003) Schaneberg et al. (2002) Yes Yes Yes Yes Pres Pres Pres Pres Pres Aristolochia moupinensis Franch Aristolochia odoratissima L. Aristolochia pontica Lam (Aristolochia ponticum) Aristolochia serpentaria L. Aristolochia trilobata L. Aristolochia tubiflora Dunn Aristolochia versicolor S.M. Hwang Yes Yes No Yes Yes No No Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Pres Kumar et al. (2003) Kumar et al. (2003) Wu et al. (2000) Kumar et al. (2003) Wu et al. (2001a,b) Kumar et al. (2003) Kumar et al. (2003) Che et al. (1984) Kumar et al. (2003) Kumar et al. (2003) Kumar et al. (2003) Jou et al. (2004) Wu et al. (2001a,b), Kumar et al. (2003) Kumar et al. (2003) Jou et al. (2004) Kumar et al. (2003) Schaneberg et al. (2002) Jou et al. (2004) Kumar et al. (2003) Kumar et al. (2003) Author's personal copy M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 essential oils of Aristolochia indica L. inhibited Pseudomonas aeruginosa, a bacteria associated with lower respiratory tract infections and commonly found in teenagers with cystic fibrosis (Mims et al., 2004; Shafi et al., 2002). However, Gadhi et al. (1991) and Kumar et al. (2006) were unable to demonstrate inhibition of Pseudomonas aeruginosa. Although, Kumar et al. (2006) demonstrated inhibition of Bordetella bronchiseptica when the root of Aristolochia indica L. was used. Since this bacterium is involved in causing whooping coughs, these results provide in vitro evidence for its use for this purpose. Aristolochia contorta Bunge has been found to have expectorant activity. Although not very potent in rabbits, it was able to stop bronchospasms in guinea pigs (Chang and But, 2001). Additionally, effective treatment of bronchitis has also been seen with various species of Aristolochia. Dosing with AAs resulted in a change in the viscosity of the sputum indicating that AAs may play an active role in the treatment of bronchitis (Chang and But, 2001). The cytotoxic effects of Aristolochia species, listed in Table 1 under miscellaneous have been assessed in various studies. Ruffa et al. (2002) used a methanol extract of the leaves of Aristolochia trilobata L. (named Aristolochia macroura Gomez by the authors) and showed its inhibitory effect on the growth of Hep G2 cells, a heptocellular carcinoma cell. This effect was shown to be dose-dependant (Ruffa et al., 2002). Overall these data highlight that for some species there is a substantial body of evidence from in vitro and in vivo studies for pharmacological effects, which in part explains the therapeutic importance of these species. However, this can, of course, not be seen as a justification for the overall therapeutic benefits of the species. 3.3. The presence of aristolochic acids in Aristolochia species In this part we link the information available on local and other uses of Aristolochia species with the limited information on the species’ chemistry as it relates to the presence of AAs, most notably AA1 and AA2. Unfortunately, it is not possible to get reliable data to quantify the presence of AAs in these species. The majority of research on the distribution of AA’s in Aristolochia has been undertaken on species of Aristolochia entering the trade in Europe, North America and China (FDA, 2000) or those being used in traditional medicine in China (Wu et al., 2007). Despite the recent concerns about the toxicity associated with the AA’s in species of Aristolochia used in traditional medicine the occurrence of these compounds in many of the species being used in Central and South America or Africa remains unclear (Cosyns, 2003). Although, AAs are thought to occur in all species of Aristolochia (Wu et al., 2004) of the 99 species of Aristolochia covered in this review, only 23 (as well as eight species for which no ethnobotanical information was found) are reported to contain AAs (Table 3). Additionally nine species are reported to contain AAs for which we have not found information on local or traditional uses (Table 4). Aristolochia indica, the most commonly recorded species, was reported to only contain aristolochic acid 1 (Kumar et al., 2003). Of the other most frequently used species there are no phytochemical data available for the AAs content of Aristolochia acuminata (incl. Aristolochia tagala) and Aristolochia bracteolata was only investigated as Aristolochia bracteata and Aristolochia baetica. No data about the AAs content of the other frequently used species are available including Aristolochia albida, Aristolochia grandiflora, 113 Aristolochia manshuriensis, Aristolochia rotunda, Aristolochia maxima, Aristolochia paucinervis, Aristolochia philippinensis, Aristolochia reticulata, Aristolochia rugosa, Aristolochia seriaca and Aristolochia triangularis. Overall the data are scarce and also very little information is available in terms of the phytochemical variability of the species both in terms of which parts of the plant are used and regional variability. 4. Conclusions Our data demonstrates the worldwide importance of members of the genus in practically all regions where Aristolochia species are found. The data also demonstrates that many species seem to be used relatively widely in these regions (e.g. Mexico/Central America, India, parts of Africa, Southern Europe). However, aside from Chinese Herb Nephropathy associated with the use of Aristolochia fangchi and the emerging data on Balkan Endemic Nephropathy very limited epidemiological or clinical information is available about any toxicity associated with the medicinal use of species of Aristolochia. While some in vitro and in vivo pharmacological data provide evidence for the rational for using members of the genus, the long-term toxic effects seem to have remained unrecognised in all cultures, which traditionally used Aristolochia species. This bibliographic study has some limitations. An inclusive review of all sources which include information on Aristolochia species is not feasible. It has not been possible to cover information included on herbarium specimes. The majority of data are from monographs, an often lesser used source of ethnopharmacological information. Here we focus on data that are based on ethnobotanical reports and secondary sources, and this may have resulted in some repetitions of data. Sources not available in English were in most cases excluded. Clearly, national journals may contain important additional information about the uses and chemistry of species of Aristolochia. The amount of ethnobotanical data being published in international journals varies from country-to-country and from continent-to-continent, a factor that limits our ability to collate information about the diversity of Aristolochia species being used. However, the main goal of this work is to select species which need to be prioritised for future research and which are likely to require special attention in terms of monitoring there use in international and national trade. This study contributes to this selection and highlights a core group of particularly widely used species. Our data also highlight that there still is a huge gap in our knowledge about the individual species’ phytochemistry and the quantities of AAs found in them. Clearly concerted efforts are needed to address both the research needs on the use of this genus and on a systematic and worldwide assessment of the risks associated with the species being used. More immediately, it is important to initiate training and outreach programmes to highlight the potential risks of using species of Aristolochia. Acknowledgements This project was developed without external funding. We are grateful to Christine Leon and Dr. Geoffrey Kite at the Royal Botanic Gardens Kew, UK for input to various aspects of this work, to Mr. Bernd Schulz, Dresden for an excellent botanical line drawing of Aristolochia indica and to the many librarians for their invaluable help including specifically the staff at the School of Pharmacy’s Library (Peter Field and colleagues). Author's personal copy 114 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A. Aristolochia species and their usage—a worldwide assessment based on bibliographic data Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia acuminata Lam. (as Aristolochia acumianta) (possibly Aristolochia albida) [(1)] Indian Ocean Island (Madagascar: Comoros, Seychelles and Mascarenes) (AF) Indian Ocean Island (Magascar: Comoros, Seychelles and Mascarenes) (AF) Root Used in young children: made into a poultice by crushing and applied to the stomach. Used in palpitations. When drunk can be used as a tonic and to reduce a fever, treating heterosyphilitic children. Venereal diseases—when combined with various other plants. Use not specified. Gurib-Fakim and Brendler (2004) Aristolochia acuminata Lam. [possibly Aristolochia albida (1)] Leaf Aristolochia acuminata Lam. (Aristolochia tagala Cham (2)) Kouthalai of Tirunelveli hills, India (AS) Leaf Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) E. India (AS) in Himalaya n.a. Andhra Pradesh, India (AS) Root Aristolochia acuminata Lam. (Aristolochia tagala Cham) India (AS) Root Aristolochia acuminata Lam. (Aristolochia tagala Cham) Malay-Peninsula (AS) Leaf Aristolochia acuminata Lam. (Aristolochia tagala Cham) Philippines (AS) Root Aristolochia acuminata Lam. (Aristolochia tagala Cham) India (AS) Fruit and root Aristolochia acuminata Lam. (Aristolochia tagala Cham) India (AS) Leaf Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) India (AS) Whole plant Nepal eastwards-Himalaya and in Assam Bihar. Also Konkan southward-Western Ghats (AS) Plant Aristolochia acuminata Lam. (Aristolochia tagala Cham) Kouthalai of Tirunelveli hills, India (AS) Root Aristolochia acuminata Lam. (Aristolochia tagala Cham) Kouthalai of Tirunelveli hills, India (AS) Leaf Aristolochia acuminata Lam. (Aristolochia tagala Cham) Variety of places including: Coimbatorie, Madurai, Kanniyakumaru, Nilgiri, Salem, Tirunelveli, Sri Lanka, Burma and Java (AS) Root Aristolochia acuminata Lam. (Aristolochia tagala Cham) Philippines (AS) Root Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) Philippines (AS) n.a. Philippines (AS) n.a. Moluccas (AS) Leaf Aristolochia acuminata Lam. (Aristolochia tagala Cham) To increase the production of breast milk and also as a carminative agent. As a tonic, carminative and also as a emmenagogue i.e. to promote menstrual bleeding. Used for fevers, applied to the head. For swollen limbs, abdomen and bilious disorders formincation. Used as an emmenagogue, for infantile lympanites, as a carminative and a tonic. Used as a treatment for malaria, toothaches, rheumatism, treating snakebites and dyspepsia. For the treatment of stomachaches, for snakebites, fevers and fits. To treat bowel complaints. Is a substitute of Aristolochia indica and functions as a carminative and promotion of menstrual bleeding i.e. acts as an emmenagogue and is also used as a carminative. Snakebites and scorpian bites, mixed with leaves and seeds of Aglaia roxburghiana. Snakebites, scorpian bites and insect bites—combined with Cipadessa baccifera and Tragia involucrate. Used as a replacement for Aristolochia indica L. and is considered to have many properties including as a carminative, a tonic and emmagogue. as a carminativem an emmenagogic and for infantile lympaniles. For the treatment of bowel complaints. Given as a tonic and as a carminative. Women also take this plant to induce menstruation. External use. Gurib-Fakim and Brendler (2004) Ayyanar and Ignacimuthu (2005) Samant et al. (1998) Pullaiah (2002) Padua et al. (1999) Perry and Metzger (1980) Perry and Metzger (1980) Jain and DeFilipps (1991) Jain and DeFilipps (1991) Jain and DeFilipps (1991) Akhtur et al. (1992) Ayyanar and Ignacimuthu (2005) Ayyanar and Ignacimuthu (2005) Yoganarasimhan (2000) Quisumbing (1951) Quisumbing (1951) Quisumbing (1978) Padua et al. (1999) Author's personal copy 115 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) Malaysia (AS) Leaf For fevers applied to the head. Papua New Guiana (AS) Philippines (AS) Leaf India (AS) (Mizoram) N.E. India (AS) Root Has unspecified medicinal properties and is rubbed to the head and drunk. Tonic and also to promote menstural bleeding as an emmenagogue. Also has uses in treating infantile lympanites. Treatment of bowel complaints. Padua et al. (1999) Padua et al. (1999) Padua et al. (1999) Manhanti (1994) Kumar (2002) Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) Aristolochia acuminata Lam. (Aristolochia tagala Cham) Dodu Island, Papua New Guinea (AS) India (AS) Root/bark Root Root and leaf Has analgesic properties and can be used for rheumatic pains and toothaches as well as in snakebites. Other uses are as an emmenagogue, as a tonic and a carminative. Abortive. India (AS) Whole plant Root India (AS) Leaf Aristolochia acuminata Lam. (Aristolochia tagala Cham) Philippines (AS) Leaf Aristolochia acuminata Lam. (Aristolochia tagala Cham) Areas around India (AS), including Bengal, the Upper gangetic plain, Bundelkhan, Sind, Konkondan, Deecan and Carnatic Vietnam (AS) Whole plant Bowel complaints. Root India (AS) Root Aristolochia acuminata Lam (Aristolochia roxburghiana Klotsch) Aristolochia acutifolia (Aristolochia Medicinalis R.E. Schult) Aristolochia albida Duch India (AS) n.a. Used for its properties as a stomachic in the treatment of colic, gastritis, diarrhoea, food poisoning, enteritis, furunculosis, rheumatism, oedema, dysmenorrhoea and malaria. Gastrointestinal complaints such as diarrhoea, colic, gastritis, food poisoning, gastritis, dystentery. Other uses are in rheumatism, oedema, tuberculosis, malaria, by women in dysmenorrhoea, carminative, tonic and emmenagogue. Use not specified. Upper Amanzon (Kubeomen) (SA) Root Epileptic like nature where individual has periodic attacks. Schultes and Raffauf (1990) Various (AF) Root Neuwinger (2000) Aristolochia albida Duch Various (AF) Leaf Aristolochia albida Duch Root Aristolochia albida Duch Nigeria, Bauchi State (AF) Ghana (AF) Treatment of all types of pains and cold related symptoms such as a sore throat and coughs. Other uses are in worms, treatment of inguinal, scrotal hernia, malaria, the sexually transmitted disease, syphilis and as a snakebite antidote. To treat guinea worms, acts as an aphrodisiac and can also be used to treat coughs. Antimicrobial activity, used in emesis and nausea. Root Aristolochia albida Duch South Africa (AF) n.a. Remedy for guinea worms, a tonic as well as in fevers. Other uses are in malaria, for its stomachic actions and as a local analgesic. Believed to have a ‘magical sense’. Aristolochia albida Duch Nigeria (AF) (AF) Rhizomes In the treatment of inflammation and various cancers. Aristolochia albida Duch Mali (AF) n.a. Aristolochia albida Duch (Aristolochia densivenia Engl.) E. Africa (AF) n.a. Antimicrobial activity, stomach tonic, malarial fevers and parasites. Antidote for snakebites and for arrow poison. Aristolochia albida Duch (Aristolochia densivenia Engl.) ‘Tanganyika’ (AF) Root and leaf Aristolochia acuminata Lam. (Aristolochia roxburghiana Klotsch) Aristolochia acuminata Lam. (Aristolochia roxburghiana Klotsch) Bone fractures. Cambie and Brown (1997) Bakshi et al. (1999) Bakshi et al. (1999) Bakshi et al. (1999) Gastrointestinal compliants such as for dyspepsia and colic. Other uses are for snakebites and for toothaches. Acts as an antidote for snakebites and used for rheumatism, malaria, fevers and fits. Also given for gastrointestinal complaints such as flactulence, stomachaches and flactulence. Treatment of cancer. Sexual stimulant and as a cough remedy. Graham et al. (2000) and Masilungan et al. (1971) Kirikar and Basu (1975) Prajapati et al. (2006) Niir (2005) Neuwinger (2000) Adamu et al. (2005) Iwu (1993) Arnold et al. (2002) Abubakar et al. (2007) Lehman et al. (2007) Watt and BreyerBrandwijk (1962) Watt and BreyerBrandwijk (1962) Author's personal copy 116 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia albida Duch (Aristolochia petersiana Klottzsch) Aristolochia albida Duch (Aristolochia petersiana Klottzsch) Aristolochia albida Duch. (as Aristolochia acumianta Lam.) [(1)] Aristolochia albida Duch. (as Aristolochia acumianta Lam.) [(1)] Aristolochia albida Duch. (as Aristolochia acumianta Lam.) [(1)] Aristolochia albida Duch (Aristolochia petersiana Klottzsch) Aristolochia anguicida Jacq E. Africa (AF) Root Coughs and sore throats. Antidote for arrow poison and snakebites. Kokwaro (1976) Ghana/West Africa (AF) Root Fevers and for symptoms of colds such as a cough and in sore throats. Other uses are in dysentery and also in snakebites. Iwu (1993) Madagascar (AF) Root Treatment of malaria, for worms and in fever. Neuwinger (2000) Madagascar (AF) Leaf (sap) To treat dyspepsia Neuwinger (2000) Madagascar (AF) Stem In the treatment of malaria. Neuwinger (2000) Tropics (n.a.) Root In the treatment of malaria. Leeuwenberg (1987) Root Snakebites and stomachaches. Morton (1981) Aristolochia anguicida Jacq Guatemala, El Savador & Bolivia (CA/SA) Brazil (SA) n.a. To prevent poisonin by snakes venoms and to kill the snake. Aristolochia arcuata Mast. Brazil (SA) Vine Malaria and for fevers. Aristolochia argentina Gris Argentina (SA) n.a. Digestive problems. Aristolochia argentina Gris Argentina (SA) n.a. Insecticide. Aristolochia argentina Gris Argentina (SA) n.a. Insecticide. Aristolochia asclepiadifolia Brandegee Mexico (CA) Plant Known to have hypoglycaemic effects. Aristolochia asclepiadifolia Brandegee Aristolochia asclepiadifolia Brandegee Aristolochia baetica L. (Aristolochia boetica Linn) (3) Aristolochia balansae Franch Mexico (CA) Root Stomachaches and vomitting. Mexico (CA) Vine and root n.a. To counteract the bites of black widow. Indo-China (AS) (AS) Bark Dystentary and anuria. Aristolochia bilobata L. Brazil (SA) n.a. Aristolochia bilobata L. Root Aristolochia birostris Duch Haiti and the Dominican Republic (CA) Brazil (SA) As an alexiteric [against contagious and infectious diseases, and the effects of poison in general]. Stimulant and tonic, as an emmenagogue and on ulcers. Millspaugh (1887) Milliken (1997) Palacios et al. (2007) Broussalis et al. (1999) Broussalis et al. (1999) AndradeCetto and Heinrich (2005) Leonti et al. (2001) Leonti et al. (2001) Millspaugh (1887) Perry and Metzger (1980) Millspaugh (1887) Morton (1981) Root Given on prescription for rattlesnake poisoning. Aristolochia birostris Duch Brazil (SA) Leaf Aristolochia boliviensis Kuntze Bolivian Chaco (SA) Aerial parts Aristolochia bracteolata Lam Root Aristolochia bracteolata Lam India – Andhra Pradesh (AS) Africa (AF) Used to promote sweating (diaphoretic) (Oxford Concise medical dictionary) and as an anticatarrhal agent Use not specified but known to be used in this part of world. Also shown to have activity against Plasmodium falciparum and FBIT experimentally. Promote healing of ulcers and for roundworms. Seed To treat convulsions. Aristolochia bracteolata Lam Africa (AF) Root Aristolochia bracteolata Lam Africa (AF) Leaf Aristolochia bracteolata Lam Africa (AF) Fruit In the treatment of malaria, abdominal pain and scorpian stings. Has purgativa actions and is used in the treatment of flu, vomitting and pneumonia. It can also be used for polymeorrhea and treatment of oedema. Has a purgative action. Aristolochia bracteolata Lam Tamil Nadu (N. India to Peninsular India (AS)) Tamil Nadu (N. India to Peninsular India (AS)) India, Chittoor District (AS) Leaf Eczema. Root Has purgative and anthelmintic actions and used in the treatment of round worms. Yoganarasimhan (2000) Leaf Cuts and wounds as well as an anthelmintic and in the skin disorder psoriosis. Vedavathy et al. (1997) Aristolochia bracteolata Lam Aristolochia bracteolata Lam Germany (EU) To prevent arthiritis, as a stimulant and an emmenagogue. Mors et al. (2000a) Mors et al. (2000a) Bourdy et al. (2004) Parrotta (2001) Neuwinger (2000) Neuwinger (2000) Neuwinger (2000) Neuwinger (2000) Yoganarasimhan (2000) Author's personal copy 117 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia bracteolata Lam India (AS) Root and leaf Prajapati et al. (2006) Aristolochia bracteolata Lam Pakistan (Soutwest) (AS) India (AS) Herb Used for many purposes such as by women for the treatment of amenorrhoea and dysmenorrhoea but can also be used in the treatment of sexually transmitted diseases: syphilis and gonorrhoea. It is also used in the treatment of pain in the joints and has anti-inflammatory actions. Other uses are in intestinal worms, dyspepsia, intermittent fever, for skin diseases, eczema, boils, ulcers, constipation and acts as an appetiser. Additionaly, has thermogenic, sudorific, an anthemintic, cathartic properties and is a bitter. Has emmenaguem anthelmintic and purgative properties. Aristolochia bracteolata Lam Aristolochia bracteolata Lam Whole plant Root Emmenagogue and anthemlminic. Fruit and root n.a. Malaria and in HIV-1 patients. Whole plant Whole plant Used as a bitter, a purgative and as an antielmintic. Baquar and Tasnif (1983) Parrotta (2001) Baquar and Tasnif (1983) Aristolochia bracteolata Lam Pakistan (Southwest W.) (AS) Sudan (AF) Aristolochia bracteolata Lam n.a. (AF) Aristolochia bracteolata Lam Nepal (AS) Aristolochia bracteolata Lam India (AS) Aristolochia bracteolata Lam India-(hot arid zones) (AS) Seed Soften the hair. Aristolochia bracteolata Lam India (AS) Leaf Eczema. Aristolochia bracteolata Lam India (AS) Leaf Antidote in snakebites. Aristolochia bracteolata Lam India (in the Gangetic plain, Gujarat, W. Bengal and Peninsular) (AS) India (AS) (in the low hills region and the plains) Nepal (AS) Whole plant Used in worms because of its anthelmintic actions, in carthartic and has antperiodic actions. Can also be used as an emmenagogue to help in menstrual bleeding. Root In children, it is used in the treatment of eczema. Other uses includes legs ulcers, as a larvicidal and antiggonorrhoeic. Akhtur et al. (1992) Leaf Eczema. Stem Has anti-microbial activity and can be used as an anthelmintic. Aristolochia bracteolata Lam Nigeria (Bauchi State) (AF) India (AS) Leaf Wound and cuts healing. To speed up the process. Aristolochia bracteolata Lam India (AS) Wound treatment. Aristolochia bracteolata Lam India (AS) Leaf and whole plant n.a. Baral and Kurmi (2006) Adamu et al. (2005) Shirwaikar et al. (2003) Kumar et al. (2007) Aristolochia bracteolata Lam India (AS) Root To expel roundworms. Aristolochia bracteolata Lam Nepal (AS) Root Aristolochia bracteolata Lam Aristolochia bracteolata Lam India (AS) India, Bengal, W. Peninsula, Gujarati, Deccan,Kerala and Karnataka (AS) Seed Root and leaf Aristolochia bracteolata Lam n.a. Aristolochia bracteolata Lam India-plain regions (AS) India (AS) Used to treat roundworms by causing their expulsion and is falsely reputated in the treatment of snakebites. Not stated. Plant contains many medicinal properties such as anti-inflammatory actions, acts as an emmenagogue, appetiser, thermogenic as well as being bittter in taste. Medically, it is used for the treatment of intestinal worms especially round worms as well as in constipation and inflammation. It can also be used for women with disturbances to their menstrual cycle such as ammenorrhoea and dysmenorrhoea. Other uses includes in skin disorders, eczema as well as boils and foul ulcers. It can also be used in sexually transmitted diseases such as syphilis and gonorrhoea. Intermittent fevers and anthralgia can also be treated with this plant. Used for foul ulcers and in the treatment of worms. Root Used to promote uterine contraction and to expel worms. Aristolochia bracteolata Lam India (AS) Leaf Used for eczema and for old foul ulcers. Also used for sexually transmitted diseases such as sypilis and gonorrhoea. Aristolochia bracteolata Lam Aristolochia bracteolata Lam Aristolochia bracteolata Lam Roundworms. Mainly used in vetinary and is used as an antielmintic. Used medicinally. Used as a purgative and as an anthelmagodue. Ali et al. (2002) Padua et al. (1999) Baral and Kurmi (2006) Schultes and von Reis (1995) Schultes and von Reis (1995) Upadhyay et al. (2007) Jain et al. (2005) Akhtur et al. (1992) Padua et al. (1999) Padua et al. (1999) Baral and Kurmi (2006) Naik (2004) Sala et al. (1993) Jain (1968) Jain and DeFilipps (1991) Jain and DeFilipps (1991) Author's personal copy 118 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia bracteolata Lam India (AS) Whole plant Used for its purgative, antielmintic and emmonagogue properties. Aristolochia bracteolata Lam India (AS) n.a. Used for stimulating phagocytosis. Aristolochia bracteolata Lam Sudan (Eastern Nuba mountains) (AF) n.a. (n.a.) Root Used for scorpian stings and for treatment of abdominal pains. n.a. Used for treatment of worms and in ulcers. S.W. Saudi Arabia-near Mabayel (AS) Sudan (AF) n.a. Used for snakebites and in scorpian stings. Jain and DeFilipps (1991) Jain and DeFilipps (1991) Ghazali et al. (1987) Bhattacharjee and Micheal (1998) Abulfaith (1987) n.a. Used in scorpian bites. Africa (AF) n.a. India (AS) n.a. Used as an antidote for snakebites and scorpian stings and as a cure for boils and guinea worm. Also used for animals in vetinary practice. Posesses antifungal action and used in treatment of scabies. Not specified (AF) Leaf India (C. and E. Himalaya (AS)) Tropical Africa (AF) n.a. Used for the treatment of eczema on children’s legs and on foul and neglected ulcers. Use not specified. n.a. For chronic ulcers and also in eczema. India (AS) n.a. Scabies. India (AS) n.a. Use not specified. ‘Arabia’ (AS) n.a. For various skin problems and in snake and scorpian bites. Sudan (White Nile Provinces) (AS) India, Rajasthan (AS) Anti-tumour agent. India, Rajasthan (AS) Whole plant Whole plant Leaf India, Rajasthan (AS) Seed Used for ‘stiff hair’. India (AS) n.a. Scabies and as an anthemintic. Aristolochia bracteolata Lam (Aristolochia bracteata Retz) India, N.W. Udaipur District (AS) Leaf Aristolochia bracteolata Lam (Aristolochia bracteata Retz) India, Ganges and South India (AS) Herb, seed, leaf and almost all parts Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) India (AS) n.a. Used in ethnovetinary medicine: it can be used in the treatment of wounds and also in wounds where maggots are present. Can also be used in lympanitis. Anthelmintic and an emmagogue, to increase the concentration of utenus during labour. When combined with caster oil, it can be used in colic and tormina, ammenorrhoea, dysmenorrhoea, where there is a complication in labour, in the treatment of worms, intermittent fevers, for several sexually transmitted diseases including syphilis and gonorrhoea and also in skin diseases. It is also used as an antidote in where there is snake poisoning. For itching and as an athelmintic. India, S. and banks of Ganges (AS) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) N. India, Andra Pradesh, Konkan, Maharashtra, Karataka & Bengal (AS) India, N., Andra Pradesh, Konkan, Maharashtra, Karataka & Bengal (AS) India, N., Andra Pradesh, Konkan, Maharashtra, Karataka & Bengal (AS) Whole plant, leaf and seed Root, leaf and entire plant The root is used by women in the treatment of various complaints such as amenorrhea, dysmenorrhea and during labour by increasing the number of contractions of the uterus. Bitter in nature and has purgative, emmenagogue and anthelmintic actions. Root Is an emmenagogue and used to increase the uterine contracions as well in the treatment of roundworms by causing their expulsion. Joshi (2000) Leaf Used to aid the healng of foul and neglected ulcers. Also used on the legs of children with ulcers. Joshi (2000) Aristolochia bracteolata Lam Aristolochia bracteolata Lam Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Boils. Snakebites. Chevaillier (2001) Sofowora (1982) Sofowora (1982) Sofowora (1982) Samant et al. (1998) Prendergast et al. (1996) Prendergast et al. (1996) Niir (2005) Ghazanfar (1994) El-Ghazali et al. (1994) Katewa et al. (2004) Katewa et al. (2004) Katewa et al. (2004) Watt and BreyerBrandwijk (1962) Trivedi and Sharma (2004) Rastogi et al. (1995) Millspaugh (1887) Kapoor (1990) Joshi (2000) Author's personal copy 119 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Pakistan, Gujarat, the Decca, and Bengal (AS) Leaf Dastur (1977) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Pakistan, Guajarat (AS) India, incl Bengal, Bundel Khand Sind (AS) India, incl. Bengal (AS) Areas around India, including Bengal, the Upper gangetic plain, Bundelkhan, Sind, Konkondan, Deecan and Carnatic (AS) Mexico, Pima Bajo (CA) Mexcio, Yaqui (CA) Mexico, Wariji (Guajirio) (CA) Mexico, Beja California Sur (CA) USA, MontereyCalifornia) (NA) Root Sexually transmitted diseases, syphilis and gonorrhoea and is also used by women as an emmenagogue and causes the contraction of the uterus during labour. Other uses are in the treatment of worms and for wounds infested with maggots. It has purgative and antiperiodic actions. It can also be used in griping, colic, scabies and is used by children with eczema on their legs and problems with bowels. Roundworms by causing their expulsion. Also used to cause contraction of the uterine during labour. Roundworms by causing their expulsion and also as a cathartic. Root Used externally to treat ulcers that are foul and neglected and in children for the treatment of eczema. Roundworms by causing their expulsion. Kirikar and Basu (1975) Kirikar and Basu (1975) Root Stomach or kidney disorders. Kay (1996) Root Root Stomachaches. Stomach or kidney disorders. Kay (1996) Kay (1996) n.a. Diabetes, diarrhoea and malaria. Kay (1996) Root Moore (1993) Aristolochia chamissonis (Klotzsch) Duch Aristolochia chilensis Bridges in Lidl. Aristolochia chiquitensis Duch Brazil (SA) Entire plant Used as a simple bitter tonic which helps improve appetite as well as restoring nitrogen metabolism. Other uses are to increase the metabolism of liver protein, white blood cell scavenging and causing an increase in metabolism by stimulating macrophages. In debility. Chile (SA) Root Bolivia, Chaco (SA) Aerial parts Aristolochia clematitis L. Various (EU) n.a. Aristolochia clematitis L. C. & S. Europe (EU) Root Aristolochia clematitis L. UK, E. Anglia (EU) n.a. Aristolochia clematitis L. Mediterranean region (EU) Stimulation of the immune system and gastrointestinal and gall bladder colic where this is caused by an allergic reaction. Aristolochia clematitis L. (4) China (AS) Aerial parts in blossom or root otherwise n.a. Aristolochia clematitis L. n.a. (n.a.) n.a. Aristolochia clematitis L. Fruit Aristolochia clematitis L. Serbia, Kopaonik mountain (EU) Serbia, Kopaonik Mountain (EU Bulgaria (EU) Gynecolocical related complaints as well as in the treatment of climacteric symptoms, wounds and ulcers. Used for ENT treatments where the patient has undergome surgery. Aromatic tonic containing antibacterial properties. Also used to treat skin infections and wounds when applied externally. Repel insects and human fleas. Aristolochia clematitis L. Italy (EU) Rhizomes Wounds. Others used include: A.rotunda L. and Aristolochia pistolochia L. Aristolochia clematitis L. Greece, near Portaria region (EU) C. & E. Europe (EU) Leaf and bark To assist with parturition. Whole plant Egypt (AF) Fresh plant and dried root Used by women for menstrual problems and as an abotrive. Can also be used to treat snakebites, for arthiritis and rheumatism where it is said to have a soothing effect and for wounds and ulcers. Diaphoretic, an emmenagogue and as a stimulant. Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia bracteolata Lam (Aristolochia bracteata Retz) Aristolochia brevipes Benth Aristolochia brevipes Benth Aristolochia brevipes Benth Aristolochia brevipes Benth Aristolochia californica Torr Aristolochia clematitis L. Aristolochia clematitis L. Aristolochia clematitis L. [not native, possibly cult.] n.a. Leaf Fresh plant (part n.a.) Root Was drunk well in to the second half of the last century to reduce abundant lochia (puerperal secretions). Use not specified but known to be used Used by women during childbirth and in to increase healing times of wounds. Not commonly used today but was in the past used in the treatment of wounds, sores and snakebites. Also used by women to induce menstruation and to prevention infection after childbirth. To assist with parturition and has other medicinal properties. Absessess, joint pains, stomachaches and malaria. Used for wounds where inflammation is present. Others species include: A.rotunda L. and Aristolochia pistolochia L. Dastur (1977) Agarwal and Ghosh (1985) Wu et al. (2004) Wu et al. (2004) Bourdy et al. (2004) Sayre (2001) Prajapati et al. (2006) Hartfield and Joice (1994) Gruenwald (2004) Gruenwald (2004) Gruenwald (2004) Jarić et al. (2007) Jarić et al. (2007) Leporatti and Ivancheva (2003) Leporatti and Ivancheva (2003) Brusser (2004) Schauenberg (1977) Manniche (1989) Author's personal copy 120 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia clematitis L. [not native, possibly cult.] Aristolochia clematitis L. [not native, possibly cult.] Egypt (AF) Stem Stimulate childbirth. Egypt (AF) n.a. Aristolochia clematitis L. (cult.) USA, S.W. and Mexican West (NA) Root bark Aristolochia clematitis L. Aristolochia clematitis L. n.a. n.a. Aristolochia clematitis L. USA, C. & S.m. (NA) S.E Europe and E. England (EU) Europe (EU) Prolapsuo uteri, to stimulate chilbirth and for disorders of the womb. Other uses are in the treatment of bites of reptiles, for sores on the head and for those who are unable to sleep. Respiratory conditions: for the treatment of asthma cough as well as in the treatment of kidney stones, the Spanish plague, syphilis, to open obstructions in order to remove a cold and for the treatment of a headache. It can also be used by women in order to provoke menstruation and to accelerate birth. Emmenagogue properties. For childbirth. Manniche (1989) Manniche (1989) n.a. Aristolochia clematitis L. Europe (EU) n.a. Aristolochia clematitis L. Germany (EU) n.a. Skin—both diseases lasting for a long time and eczema, abscess, stimulating the immune system in a non-specific way. Aristolochia clematitis L. Europe (EU) Root Aristolochia clematitis L. Aristolochia clematitis L. Central and South Europe (EU) Great Britain (EU) Root and whole herb Root For treating wounds, can be used as an aromatic and also as a stimulant. Anti-inflammatory and immunostimulant action but also mentions ‘other effects’. Inducing abortion, childbirth and in treating wounds. Aristolochia clematitis L. N. Europe (EU) n.a. Aristolochia clematitis L. S.W. Asia (AS) Root Aristolochia clematitis L. European countries Meditarrian, Turkey and Caucasus (EU) n.a. (n.a.) n.a. Aristolochia clematitis L. Aristolochia clematitis L. Aristolochia clematitis L. Britian & N. Europe (EU) Europe (EU) Aristolochia clematitis L. n.a. (n.a.) Aristolochia clematitis L. (cult.) N. America (NA) Aristolochia clematitis L. (cult.) Japan (AS) Aristolochia constricta Griseb S. America (SA) Whole plant if in flower, otherwise, use root Flower When in flower, then whole plant. Otherwise, dried root used n.a. When in flower, then whole plant. Otherwise, dried root used When in flower, then whole plant. Otherwise, dried root used Aerial parts Used by women for its emmenagogue properties and oxytocic properties, complications during labour and for amenorrhoea and dysmenorrhoea. General uses are for muscular pains, to increase the immune system and asthma. For inducing abortion and decreasing menstrual flow. Also used as a diuretic and in treatment of arthritis. Amenorrhoea, to induce menstruation, purgative action and also to induce abortion. For reduction of a fever and as an emmenagogue. Not commonly used today but was in the past used in the treatment of wounds, sores, to ulcers and for the treatment of snakebites. Also used by women to induce menstruation, as an abortificant and to prevention infection after childbirth. Skin disorders such as eczema, used in frost bile acne, circulatory problems and intestinal disorders. Also used by women in menstrual disorders. Kay (1996) Grieve (1974) Barker (2002) Kenner and Requena (2001) Yaniv and Bachrach (2005) Yaniv and Bachrach (2005) Williamson (2003) Van Wyk and Wink (2004) Bianchini et al. (1979) Millspaugh (1887) Prajapati et al. (2006) Podlech (1996) Diaphoretic, an emmenagogue, febrifuge and an oxytocic stimulant. It was uased by Egyptian in the treatment of snakebites. Other uses are by women to promote urinary contractions as well as for prevention of menstrual and abdominal complaints, wounds and ulcers. Applied externally to infected toe nails, in order to heal wounds and for the treatment of eczema. In the past, this plant was used in the treatment of rheumatism and gout. It is now used as a diaphoretic, oxytoxic and as an emmenagogue. The stem is used by women to induce childbirth. Lust (1986) Colds, chills, fevers and in the treatment of asthma. Lewis and Elvin-Lewis (2003) Chevaillier (2001) In the past, this plant was used in the treatment of rheumatism and gout. It is now used as a diaphoretic, oxytoxic and as an emmenagogue. The stem is used by women to induce childbirth. Launert (1981) Chevaillier (2001) In the past, this plant was used in the treatment of rheumatism and gout. It is now used as a diaphoretic, oxytoxic and as an emmenagogue. The stem is used by women to induce childbirth. Chevaillier (2001) Prevention of snakebites, as an emmenagogue and as an anthelmintics. Capasso et al. (2000), Montes and Wilkcomirsky (1985) Author's personal copy 121 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia constricta Griseb Panama, Guaymi (CA) Panama, the Teribe and San San rivers in the province of Bocas del Toro (CA) Panama, Teribe and San San Rivers, Province of Bocas del Toro (CA) Japan & N. China (AS) Imported from China to Indo-China (AS) Japan & N. China (AS) n.a. Snakebites. Gupta (1995) Stem Snakebites. Gupta et al. (2005) Leaf Leishmaniasis disease. Gupta et al. (2005) Stem Three main uses: increases circulation of blood, induces flow of urine and used to reduce pain. Used for its action as a purgative against rabies. Also used as a sedative to aid sleeping and in the treatment of dystery. Wee (1990) Aristolochia constricta Griseb Aristolochia constricta Griseb Aristolochia contorta Bunge Aristolochia contorta Bunge Aristolochia contorta Bunge Root Leaf and root Aristolochia contorta Bunge Japan, Korea & China (AS) Fruit and root Aristolochia contorta Bunge Japan & N. China (AS) China (AS) ‘Indo-China’ (AS) Fruit Aristolochia contorta Bunge Aristolochia contorta Bunge Indigestion associated with pains in the stomach, hypertension, diarrhoea and dysentary. It can also be used as an antidote for snake poisoning and also for insect bite poisoning. Used for the treatment of coughs and sputum and has various properties such as a hallocingen, is immunostimulating, antitumour effects and anti-hypotensive actvity so can be used in the treatment of hypertension.and causes hallucinations. In snake poisoning as an antidote. Seed Root Medicinal use—specific use not mentioned Purgative and in treatment of dystentary. Also been suggested to prevent rabies. Root Snake and insect bites as well as different hernial disorders and carbunicles. Also useful in the treatment of pain and distension around the stomach region, to help to relieve general pain. Aristolochia contorta Bunge China, various areas incl. Hebei, Shan Xi, Henan (AS) China (AS) Ripe fruit Respiratory diseases, antitussive and antiasthmatic. Aristolochia contorta Bunge China (AS) Ripe fruit Aristolochia contorta Bunge China (AS) Ripe fruit Aristolochia contorta Bunge China, Northern regions (AS) n.a. Hemmorhoidal bleeding, epistaxis, spitting blood, hematochezia. Acts as an antitussive and antiasmatic in the treatment of respiratory diseases. Similar uses as in native ranges. Aristolochia contorta Bunge China (AS) n.a. Similar uses. Aristolochia contorta Bunge Korea (AS) Fruit Same way as Aristolochia debilis. Aristolochia contorta Bunge China (AS) Fruit Sputum presenting with blood, coughs and asthma. Aristolochia contorta Bunge (18) El Salvador (CA) Leaf Aristolochia contorta Bunge Fruit Aristolochia contorta Bunge China, various area incl. Hebei, Shan Xi, Henan (AS) China (AS) Fruit Sexually transmitted diseases in women and given to children for dystentery. High blood pressure which would cause light headiness and flushing, hemorrhoids and respiratory disorders such as wheezing, coughing and removal of phlegm. Cancer, as an antitussive and an expectorant. Aristolochia contorta Bunge China (AS) Aerial parts Diuretic effect so is used against oedema, antirheumatic. Aristolochia contorta Bunge China (AS) Aerial parts Antirheumatic and diuretic—used against oedema. Aristolochia cordigera Willd ex Klozsch Aristolochia cordigera Willd ex Klozsch Brazil (SA) Root Brazil (SA) Leaves Aristolochia cordigera Willd ex Klozsch Aristolochia cucurbitifolia Hayata Brazil, Ceará (SA) Root Will promote menstrual bleeding and is an excitant. It is indicated in the treatment of typhoid fever and in malaria. In fevers since it promotes sweating and helps to reduce the body temperature i.e. acts as a sudorific. (Oxford consise medical dictionary) Other uses are in colds and bronchial asthma. Intermittent fevers. Taiwan, Tainan (AS) Leaf Abdominal pain. Aristolochia contorta Bunge Duke and Ayensu (1985) Wee (1990) Prajapati et al. (2006) Wee (1990) Read (1936) Perry and Metzger (1980) Bensky et al. (1993) Tang and Eisenbrand (1992) Craker and Simon (1989) Padua et al. (1999) Duke and Ayensu (1985) Institute of Chinese Materia Medica (1989) Perry and Metzger (1980) Craker and Simon (1989) Morton (1981) Bensky et al. (1993) Duke and Ayensu (1985) Tang and Eisenbrand (1992) Padua et al. (1999) Mors et al. (2000a) Mors et al. (2000a) Milliken (1997) Chang (2003) Author's personal copy 122 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia cucurbitifolia Hayata Aristolochia cucurbitifolia Hayata Aristolochia cucurbitifolia Hayata Taiwan, Tainan (AS) Leaf Eye disorders. Chang (2003) Taiwan, Tainan (AS) Leaf Wounds. Chang (2003) Taiwan (AS) n.a. Snakebites, stomachaches, bechic, as an expectorant and for febrifuge. Aristolochia cymbifera Mart Brazil (SA) n.a. Against poison, paralsis and disease symptoms. Aristolochia cymbifera Mart & Zucc Aristolochia cymbifera Mart & Zucc S. America (SA) n.a. Snakebites, fever, ulcer and colic. Brazil, Bahia to Rio Grande do Sul (SA) n.a. Aristolochia cymbifera Mart & Zucc Aristolochia cymbifera Mart & Zucc Brazil (SA) Wood and bark Root Used internally and externally. When used externally, it is used in the treatment of ulcers associated with dead skin, pain in the joints (arthralgia), dandruff and in orchitis. Infectous diseases. Perry and Metzger (1980) Millspaugh (1887) Van Wyk and Wink (2004) Mors et al. (2000a) Aristolochia daemoninoxia Mast Guyana, Coastal Region (SA) Vine Aristolochia daemoninoxia Mast Guyana, Coastal Region (SA) Bark Aristolochia debilis Sieb & Zucc China (AS) Root Aristolochia debilis Sieb & Zucc China (AS) Root Aristolochia debilis Sieb & Zucc China (AS) Fruit Aristolochia debilis Sieb & Zucc China (AS) Aerial parts Aristolochia debilis Sieb & Zucc (18) C. Europe, Meditarrian, seen in Britin but is rare and scattereed, Turkey and Caucasus (EU) China, E. & Central (AS) n.a. Has been shown to reduce the size of tumours and can be used in the treatment of snakebites, for stomach pains and sore throats. It also has analgesic properties. Root, fruit and vine Aristolochia debilis Sieb & Zucc China (E. & Central) (AS) Root Antidote for snakebites by expelling the poison. Other uses: hypertension, swellings, indigestion associated with pain in stomach region, summer diarrhoea and dystery. Wounds. Aristolochia debilis Sieb & Zucc China, E. & Central (AS) Vine Aristolochia debilis Sieb & Zucc China, N. (AS) Fruit Stimulating circulation, to increase flow of urine, for relieving pain and to give strength. Prescribed for pregnant women presenting with dropsy and abdominal pain. Various pulmonary diseases. Aristolochia debilis Sieb & Zucc China (AS) n.a. Antihypertensive. Aristolochia debilis Sieb & Zucc China (AS) Root Aristolochia debilis Sieb & Zucc China (AS) Herb Aristolochia debilis Sieb & Zucc China, E. & Central (AS) n.a. Antihypertensive agent, improve body defence mechanism by increasing immunological activity. In traditional medicines, it was used in the management of pain, in the treatment of rheumatism and hypertension. In modern medicine, it is used in hypertension, gastric spasms as well as gastric pain. With the supervision of a Physician, it has been used in the treatmet of infectious diseases, chronic bone marrow infection, chronic bronchitis and also in chronic skin infections. Similar uses as in native ranges Aristolochia debilis Sieb & Zucc Aristolochia debilis Sieb & Zucc China (AS) China (AS) Root Ripe fruit Aristolochia debilis Sieb & Zucc China (AS) Stem and root Aristolochia debilis Sieb & Zucc Brazil (SA) Various diseases and conditions. This includes in the treatment of fever, intermittent fevers and various fevers as well as diarrhoea and asthma. Can also be used in orchitis and amennhoea as well as conditions relating to the GI treact such as gout and.dyspepsia. Also reported for usage in malaria. Contraceptive, abortifiacient, as emetic, in dropsy and also as an antispasmodic. When given as an enema, it is used in the treatment of thrush. Other uses are in coughs, asthma, for the relief of indigestion and as an antispasmodic. Snakebites, insect bites, abdominal extension, dizinness, hypertension, headache. Arthritis, where there is an increased blood pressure and treating snakebites. Where there is an increase in blood pressure, for the treatment of haemorrhoids and for respiratory disorders such as asthma, bronchitis and coughs. Antirheumatic and diuretic, against oedema. Medicinal use—specific use not mentioned. Acts as an antitussive and antiasmatic in the treatment of respiratory diseases. For hypertension, treatment of snakebites and skin diseases as well as an antifebrile agent. Machado et al. (2005) Botsaris (2007) LachmanWhite et al. (1987) LachmanWhite et al. (1987) Craker and Simon (1989) Sayre (2001) Sayre (2001) Padua et al. (1999) Podlech (1996) Perry and Metzger (1980) Perry and Metzger (1980) Perry and Metzger (1980) Perry and Metzger (1980) Perry and Metzger (1980) Huang (1993) Huang (1993) Duke and Ayensu (1985) Read (1936) Padua et al. (1999) Ling (1995) Author's personal copy 123 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia debilis Sieb & Zucc Aristolochia debilis Sieb & Zucc China (AS) China (AS) Fruit Fruit Ling (1995) Duke and Ayensu (1985) Aristolochia debilis Sieb & Zucc China (AS) n.a. Aristolochia debilis Sieb & Zucc China (AS) Stem and root Aristolochia debilis Sieb & Zucc China & Japan (AS) Fruit Supress asthma, to relieve a cough and to eliminate asthma. Respiratory disorders such as pulmonary disorders, as an antitussive and in the treatment of asthma and bronchitis where it is used as an expectorant. Additionally, it is used by those with an opium addition as well as for the treatment of ascitis, itch and hemorrhoids. Fistulae associated with pain and swelling, for haemorrhoids, loss of voice, lung dyspepsia, coughs and expertoration of blood vessels. Inflammation and treatment of pain. It is also useful where there is distension or pain around the chest, hypochondriac or abdomen region where this is related to stagnation of the liver or the stomach. It also acts to decrease the blood pressure, for he treatment of boils and can give relief for snake and insect bites. Coughs and dyspepsia where there is retention of sputum. Aristolochia debilis Sieb & Zucc China & Japan (AS) Fruit Coughs and dyspnea. Aristolochia debilis Sieb & Zucc China & Japan (AS) Root Externally can be used for the treatment of poisonous snakebites. Other uses are for rheumatic arthiritis and bone injury as well as in stomachaches, bruising, sore throats, toothaches and eczema. Aristolochia debilis Sieb & Zucc China & Japan (AS) Root Aristolochia debilis Sieb & Zucc China & Japan (AS) Herb Stomachaches, snakebites, sore throats, toothaches, bone injury, bruises, bruises, rheumatic arthritis and dizziness associated with hypertension. Coughs and dyspepsia. Aristolochia debilis Sieb & Zucc China (AS) Fruit Aristolochia debilis Sieb & Zucc Aristolochia debilis Sieb & Zucc n.a. Fruit Aristolochia debilis Sieb & Zucc China (AS) Chin, incl. Jiangsu, Anhui, Zhejiana, Jiangxi, Hubei, Hunan (AS) China, incl. Jiangsu, Anhui, Zhejiana, Jiangxi, Hubei, Hunan (AS) China (AS) Aristolochia debilis Sieb & Zucc China (AS) Root, stem and fruit Aristolochia debilis Sieb & Zucc China (AS) Root Aristolochia debilis Sieb & Zucc China (AS) Plant A stimulant and a tonic. Moreover, it is used as an antitussive and as a carminative. Aristolochia debilis Sieb & Zucc Japan & China, N. (AS) Leaf and root Aristolochia debilis Sieb & Zucc Japan & N. China (AS) Japan & N. China (AS) China (AS) Stem Indigestion associated with pains in the stomach, hypertension, diarrhoea and dysentary. It can also be used as an antidote for snake poisoning and also for insect bite poisoning. Three main uses: increases circulation of blood, induces flow of urine and used to reduce pain. Snake poisoning as an antidote. Root China (AS) China (AS) Aristolochia debilis Sieb & Zucc Aristolochia debilis Sieb & Zucc Aristolochia debilis Sieb & Zucc (Aristolochia recurvilabra Hance) Aristolochia debilis Sieb & Zucc (Aristolochia recurvilabra Hance) Aristolochia debilis Sieb & Zucc. (Aristolochia contorta) (5) Root Root Fruit Pulmonary disorders and in the treatment of asthma due to its properties as an antitussive and expectorant. Gastritis-like disorders. High blood pressure which would cause lightheadiness and flushing, hemorrhoids and respiratory disorders such as wheezing, coughing and removal of phlegm. Snake and insect bites as well as in different hernial disorders and carbunicles. Also useful in the treatment of pain and distension around the stomach region and will help to relieve general pain also. Pain as well as rheumatism and hypertension in the past. It is now used in the treatment of hypertension, skin infections, infections of the bone marrow, bronchitis, gastric acid spasms and gastric pain. Sore throats, coughs and wheezing. Can additionally be used for snakebites, Additional uses are in the treatment of nausea, pain and abdominal pain. Shown to be clinically effective in the treatment of hypertension and is used for snakebites and dyspepsia. Yen (1992) Wu (2005) Prajapati et al. (2006) Institute of Chinese Materia Medica (1989) Institute of Chinese Materia Medica (1989) Prajapati et al. (2006) Prajapati et al. (2006) Keys (1997) Li et al. (2005) Bensky et al. (1993) Bensky et al. (1993) Huang (1993) Duke and Ayensu (1985) Duke and Ayensu (1985) Duke and Ayensu (1985) Wee (1990) Wee (1990) Wee (1990) Shin-Chen (2003) Root Various disorders of the digestive system, for example in women and children, this plant can be used for chronic refluxes. Further uses include in chronic diarrhoea, summer diarrhoes and in dystentery. In expelling poison when bitten by a snake. Medicinal use—specific use not mentioned. Vegatative tissue Pricking pain in epigastrium and also used in weak blood circulation. Can also be used in Arthralgia. Craker and Simon (1989) Read (1936) Author's personal copy 124 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source “Aristolochia dioscorides” (Round species) (nom. illeg.) (possibly Arum dioscorides) Aristolochia disticha Mast n.a. (n.a.) n.a. For convulsions, spleen hardness, lung stuffiness and for ruptures. Culpeper (1995) Venezuela, Yutajé (SA) n.a. Diarrhoea and as a contraceptive. Uganda, Bulamogi (AF) Mexico, Morelos (CA) Leaf For treating cows: used in treatment of ‘East coast fever’. n.a. Scorpion stings. Root Snakebites. Aristolochia elegans Mast (cult.) Uganda, Bulamogi (AF) Uganda (AF) Root Aristolochia elegans Mast (cult.) Uganda (AF) Seed Abdominal complaints including pain and swelling associated with this region. Abdominal pain and malaria. Aristolochia elegans Mast (cult.) Uganda (AF) Leaf Against snakebites. Aristolochia elegans Mast Brazil, Minas, Gerais, Rio de Janeiro, sao Paulo (SA) Brazil, Ceará (SA) n.a. Against snakebites. Roth and Lindorf (2002) Tabuti et al. (2003b) JiménezFerrer et al. (2005) Tabuti et al. (2003a) Neuwinger (2000) Neuwinger (2000) Neuwinger (2000) Mors et al. (2000a) Root Intermittent fever. Mexico, Teenek Tsabaal (CA) Mexico (CA) Root Respiratory purposes: for the treatment of coughs. Root In Type 2 diabetes. Mexico, Chikindzonot, Yucatán (CA) Libya (AF) Root Type 2 diabetes. Root and leaf Aristolochia elegans Mast (cult.) Aristolochia elegans Mast Aristolochia elegans Mast (cult.) Aristolochia elegans Mast Aristolochia elegans Mast Aristolochia elegans Mast (Aristolochia littoralis D. Parodi) Aristolochia elegans Mast (Aristolochia littoralis D. Parodi) Aristolochia elegans Mast (cult.) Aristolochia fangchi Wu China (AS) Root Contains allantonin which is extracted for cosmetic purposes and used as part of the ingredients in facial creams. Other uses are in rheumatism, gout and as an emmenagogue. Used as an antirheumatic and a diuretic. Aristolochia fangchi Wu China (AS) n.a. Not stated. Aristolochia fangchi Wu China (AS) Root Antirheumatic and diuretic. Aristolochia fangchi Wu China (AS) Root Diuretic effect so is used against oedema, antirheumatic. Aristolochia fangchi Wu China (AS) Root Aristolochia fangchi Wu China (AS) Aristolochia fangchi Wu China (AS) Root and rhizome n.a. Rheumatic anthralgia (pain in the joints), oedema and oliguria where there is minimal production of urine (Oxford consise medical dictionary). Used medicinally and for ‘wind-damp-dispelling’. Aristolochia fangchi Y C Wu ex LK Chow & SM Hwang China (AS) Root and sStem Aristolochia fimbriata Cham & Schltdl n.a. (n.a.) [possibly South Africa] n.a. Will remove wind dampness and will treat any obstruction. Other uses are in the treatment of pain, will help with urination, oedema, thirst and a yellow and greasy coating found on the tougue. Reduce pain and fever. Other uses are for rheumatism and arthritis as well as acting as a diuretic in the treatment of hephritis and urosis. Colds, chills, fevers and in the treatment of asthma. Aristolochia foetida Kunth n.a. (n.a.) n.a. Colds, chills, fevers and in the treatment of asthma. Aristolochia fordiana Hemsl Hong Kong (AS) Root Various pains, such as rheumatic bone pain, epigastric pain. Also used for traumatic injury and snakebites. Aristolochia fragrantissima Ruiz Peru (SA) n.a. As an alexiteric. Aristolochia grandiflora Sw. (Aristolochia arborescens L.) Aristolochia grandiflora Sw. (Aristolochia arborescens L.) Panama (CA) Root Snakebites. Panama (CA) Leaf and root Colds, gastrointestinal disorders such as dystentery and sexually transmitted diseases. Other uses are to reduce fever, to promote sweating and used by women as an emmenagogue. Milliken (1997) Alcorn (1984) AndradeCetto et al. (2006) AndradeCetto et al. (2006) Kotb (1985) Tang and Eisenbrand (1992) Van Wyk and Wink (2004) Padua et al. (1999) Padua et al. (1999) Craker and Simon (1989) Wiseman and Ye (1998) Bensky et al. (1993) Ling (1995) Lewis and Elvin-Lewis (2003) Lewis and Elvin-Lewis (2003) Chinese Medicinal Herbs of Hong Kong (1978–1986) Millspaugh (1887) Morton (1981) Morton (1981) Author's personal copy 125 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia aff. grandiflora Sw Panama (Teribe and San San rivers in the province of Bocas del Toro) (CA) Nigeria, Hausa and Fulani (AF) Nigeria, Hausa and Fulani (AF) Nigeria, Hausa and Fulani (AF) Leaf Snakebites. Gupta et al. (2005) Root Snakebites and scorpian stings. Ainslie (1937) Flower Worn as a charm against snakebites. Ainslie (1937) Used for its anthelmintic properties and can be used externally for the treatment of pimples. Ainslie (1937) For convulsions, spleen hardness, lung stuffiness and for ruptures. Used medicinally. Culpeper (1995) Velázquez et al. (2003) Mors et al. (2000a) Aristolochia gadakura [nom. illeg.] = Aristolochia sp. Aristolochia gadakura [nom. illeg.] = Aristolochia sp. Aristolochia gadakura [nom. illeg.] = Aristolochia sp “Aristolochia galen” [nom. illeg.] = Aristolochia sp. Aristolochia gibertii Hook n.a. (n.a.) Leaf (sometimes root) n.a. Paraguay (SA) n.a. Aristolochia gibertii Hook (Aristolochia esperanzae var cobra) Aristolochia grandiflora Sw. (Aristolochia glaucescens Kunth) Aristolochia grandiflora Sw. (Aristolochia cordiflora Mutis ex Kunth) Aristolochia grandiflora Sw Brazil, Mato Grosso (SA) n.a. Abortive, in amenorrhoea, malaria, facial neuralgia and also in treatment of scabies. Peru (SA) n.a. Malaria and for fevers. Milliken (1997) Panama, Guaymi Indians (CA) n.a. For treatment of snakebites. Gupta (1995) Brazil (SA) Stem Traditionally as a febrifuge. Modern uses unknown. Aristolochia grandiflora Sw Honduras, rural regions (CA) Colombia, N.W. (SA) Jamaica (CA) Root Used by women during childbirth. It is used by midwives in order to help in the process of removing the placenta. Snakebites. C. America to Mexico (CA) El Salvador (CA) Root Snakebites and scorpian stings. Leaves Skin diseases. n.a. Syphilitic sores and also rheumatism. Stem and root n.a. Cholera. Aristolochia grandiflora Sw Mexico, Yucatán (CA) Mexico, Yucatán (CA) Cuba (CA) Aristolochia grandiflora Sw Guatemala (CA) Leaf Used by women for its emmenagogue properties and can also be used as an antispetic, to stop diarrhoea, to promote sweating and for preventing rheumatism. Poultice. Giorgetti et al. (2007) Ticktin and Dalle (2005) Otero et al. (2000) Millspaugh (1887) Morton (1981) Morton (1981) Morton (1981) Morton (1981) Morton (1981) Aristolochia grandiflora Sw Mexico, Yucatán (CA) Mexico, Yucatán (CA) Brazil, Minas Gerais, Sao Paula, Parana (SA) Brazil (SA) Leaf Snakebites. Root and stem n.a. Rheumatism, acts on the nervous system for neualgia, can be given as a tonic and has febrifuge actions. Used for the same purpose as other [Brazilian] Aristolochia species in general. Morton (1981) Morton (1981) Morton (1981) Mors et al. (2000a) n.a. As an emmenagogue, abortive and antiseptic; treatment of wounds and skin diseases. Wu et al. (2004) Zimbabwe (AF) Root Diarrhoea. Aristolochia heppii Merxm n.a. (AF) Root Aristolochia heppii Marxm Tropics (possibly Zaire) (n.a.) South Africa (AF) Root Swollen legs, as an abortifacient, for abdominal pain and for abortion purposes. Diarrhoea. Root Abortifacient. n.a. (n.a.) n.a. As an alexiteric. India & Sri Lanka (AS) India (AS) Seed Biliosness and to reduce inflammation. Root Neuwinger (2000) Neuwinger (2000) Leeuwenberg (1987) Steenkamp (2003) Millspaugh (1887) Yoganarasimhan (2000) Williamson (2003) Vedavathy et al. (1997) Van Wyk and Wink (2004) Thakur et al. (1989) Aristolochia grandiflora Sw Aristolochia grandiflora Sw Aristolochia grandiflora Sw Aristolochia grandiflora Sw Aristolochia grandiflora Sw Aristolochia grandiflora Sw Aristolochia grandiflora Sw Aristolochia grandiflora Sw. (Aristolochia gigantea Mark et Zucc) Aristolochia grandiflora Sw. (Aristolochia gigantea Mark et Zucc) Aristolochia heppii Merxm Aristolochia heppii Merxm. Aristolochia hirsute [nom. illeg.] = Aristolochia sp. Aristolochia indica L Aristolochia indica L Whole plant n.a. As an alexiteric. Leaf Aristolochia indica L India Chittoor District (AS) n.a. (n.a.) Inducing abortion by preventing implantation and oestrogen release. Leucoderma. n.a. Contraceptive. Aristolochia indica L India (AS) Root Leprosy and diarrhoea. Also acts as a carminative. Aristolochia indica L Author's personal copy 126 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia indica L India (AS) Root Antidote for snakebites. Aristolochia indica L n.a. Use not specified. Root and rhizome Leaf Bitter tonic, as a gastric stimulant. Aristolochia indica L India (AS) (W., C., E. Himalaya) India, Andhra Pradesh (AS) India (AS) Aristolochia indica L India (AS) n.a. Snakebites and scorpian stings. Aristolochia indica L India (AS) Leaf Ulcers and eczema (mixed with caster oil). Aristolochia indica L India (AS) Rhizome Aristolochia indica L Thailand (AS) Leaf Used in a variety of conditions and which includes as a bitter tonic acting as a gastric stimulant and also in the treatment of intermittant fevers. Snakebites. Thakur et al. (1989) Samant et al. (1998) Pullaiah (2002) Padua et al. (1999) Padua et al. (1999) Padua et al. (1999) Padua et al. (1999) Aristolochia indica L Thailand (AS) Root Aristolochia indica L ‘Indo-China’, Vietnam (AS) n.a. To reduce fever, as an emmenagogue i.e. to promote menstrual bleeding, as an expectorant, as a tonic and also in anti-fertility. Loss of appetite, dropsy and intermittent fever. Aristolochia indica L ‘Indo-China’, Vietnam (AS) Root Skin diseases. Aristolochia indica L Aristolochia indica L India (AS) India (AS) Use not specified. Not stated. Aristolochia indica L India (AS) n.a. Whole plant Leaf Aristolochia indica L India (AS) Rhizome Useful in the treatment of inflammation but is also used in cholera, bowel complaints and intermittent fevers in children. Aphrodisiacs and is also useful in impotence. Aristolochia indica L Root Emmenagogue and for snakebites, acts as an antidote. Aristolochia indica L Pakistan, E. Chittagong (AS) India (AS) Leaf Abortifacient properties as well as for snakebites, pain in the breast region and for supparation. Aristolochia indica L India (AS) Seed Joint pains and to reduce inflammation. Aristolochia indica L India (AS) n.a. Cholera and stimulating phagocytosis. Aristolochia indica L India, in the low hills region and the plains (AS) India, in the low hills region and the plains (AS) India (AS) Root Emmangogue in order to promote menstrual bleeding and as an abortifacient. Can be used in the prevention of arthiritis, alexeteric stimulant and in antiperiodic and leucoderma. Poisoning by cobra. Aristolochia indica L Aristolochia indica L Aristolochia indica L Leaf India, mainly found in S. & E. regions (AS) India (AS) Stem and root Has anti-inflammatory properties and used in the prevention of rheumatism as well as in as an antibilious. Can be given to children in the treament of dyspnoea. Used in treatment of irregular menstruation, indigestion and in fevers. Acts as a stimulant and can be given as a tonic. n.a. As a bitter. India, Kancheepuram, Tamil Nadu (AS) n.a. (n.a.) n.a. For many different diseases. Specific not stated. Root Contraceptive activity. Aristolochia indica L India at low elevations (AS) Root Aristolochia indica L India, Kerala (AS) n.a. Ulcers, ‘vitiated conditions of Kapha and Vata’ as well arthralgia inflammations, leprosy, vitiligo, skin diseases, disorders of the digestive system such as dyspepsia and flactulence. It can also be used in the treatment of intestinal worms as well as in conditions such as strangury, cardiac debility, intermittent fever, cough catarrah and various poisonous bites and stings. In children, Aristolochia indica is used in abdominal disorders. An ayurvedic drug. Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Seed Coughs. Padua et al. (1999) Padua et al. (1999) Perry and Metzger (1980) Perry and Metzger (1980) Niir (2005) Naik (2004) Sala et al. (1993) Lewis and Elvin-Lewis (2003) Khan et al. (1965) Jain and DeFilipps (1991) Jain and DeFilipps (1991) Jain and DeFilipps (1991) Akhtur et al. (1992) Akhtur et al. (1992) Akhtur et al. (1992) Bhattacharjee and Micheal (1998) Bellamy and Pfister (1992) Muthu et al. (2006) Unny et al. (2003) Sala et al. (1993) Kaushik and Dhiman (1999) Author's personal copy 127 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia indica L Root Given as a stimulant, for intermittent fever: to reduce fever, in impotence, for treating snakebites and leucoderma. Also given to children for trating bowel complaints. Joshi (2000) Stem and root Given as a small dose as a tonic and in controlled doses in order to regulate menstruation and in promotion of digestion. Jain (1968) Aristolochia indica L Aristolochia indica L Nepal and India, Chittagog, Konkan, Declan, Peninsula (AS) India, mainly in S. and E. but throughout in plains and hilly regions (AS) Inida, Konkan (AS) India (AS) n.a. Rhizome Wiart (2000) Wiart (2000) Aristolochia indica L Aristolochia indica L Aristolochia indica L Vietnam (AS) Burma (AS) Philippines (AS) Rhizome Leaf Rhizome Aristolochia indica L India, Chittoor District (AS) India, Chittoor District (AS) India, Chittoor District (AS) India, Santhal Pargana (AS) India, N.W. Udaipur District (AS) Stem Combined with other herbal plants for colic during cholera. Impotence, inflammation, emetic, tonice and in fever associated with malaria. Malaria, fever, oedema and appetite loss. Skin disease—used internally and externally. Used in poisionous bites of insects as an antidote. Other uses include fever associated with malaria, irregular menses, tiredness and intestinal disorders. In the treatment of leucorrhea. Aristolochia indica L India, N.W. Udaipur District (AS) Root Aristolochia indica L India (AS) n.a. Aristolochia indica L India, Assam (AS) Root Aristolochia indica L India, Assam (AS) Leaf Ethnoventinary medicine: used for bone fractures, where the uterus has dislocated and after the animal has given birth and are weak. Used by women with irregularites in their menstruation cycle and for nervous and spasmoidic affections. For complaints relating to the urinary and the spleen. Other uses are in rheumatic pain and for snakebites. For the treatment of snakebites and for cholera. Aristolochia indica L India (AS) n.a. Used for bowel complaints. Aristolochia indica L India (AS) Root Aristolochia indica L India (AS) Leaf Used as an antidote to snakebites and poisonous insect bites. It is a powerful emmenagogue, antithritic, white leprosy, cholera and diarrhoea. Has antiperiodic properties and acts as a stimulant and tonic. Aristolochia indica L India (AS) Bark Aristolochia indica L Root Aristolochia indica L India, tropical regions incl. Bengal, Kerala, Konkan and the Coromadal coast (AS) India, tropical regrions incl. Bengal, kerala, Konkan and the Coromadal coast (AS) Nepal & India, Chittagog, Konkan, Declan, Peninsula (AS) India, Assam (AS) Aristolochia indica L Aristolochia indica L Aristolochia indica L India, Assam (AS) India, Assam (AS) Australia (AU) Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Whole plant Root Treatment of eczema. Root Used as an antidote for snakebites and scorpian stings as well as in treating chronic fevers. Used in ethnoventinary medicine: used to treat indigestion. Whole plant For fevers and treating snakebites. Used by children in the treatment of bowel complaints and in the treatment of intermittent fevers. Used internally and externally and is used in the treatment as an antidote for the treatment of snakebites or poisonous insects. Wiart (2000) Wiart (2000) Wiart (2000) Vedavathy et al. (1997) Vedavathy et al. (1997) Vedavathy et al. (1997) Varma et al. (1999) Trivedi and Sharma (2004) Trivedi and Sharma (2004) Srivastava (1989) Sharma (2004) Sharma (2004) Quisumbing (1978) Nadkarni (1908) Nadkarni (1908) Nadkarni (1908) Kapoor (1990) Leaf and bark Can be given in the treatment of intermittent fever and by children in the treatment of various bowel complaints as well as diarrhoea and cholera. Kapoor (1990) Root, rhizome, leaf, stem and seeds Root and rhizome Stem Seed n.a. Used to relieve burning sensation and has anthelmintic actions. Other uses are in snake poisoning, skin diseases and to heal wounds. Joshi (2000) Given as a tonic. In the treatment of dropsy and a gastric stimulant. Also has emetic and emmenagogue actions. Used to reduce fever, as tonic and a stimulant. To reduce inflammation, biliosness and relieves dry coughs. Used as an abortive. Joshi (2000) Root Used for reduction of fever and in dyspepsia. Leaf Used for treating poisoning by cobra. Aristolochia indica L India and S.W. Asia (AS) India and S.W. Asia (AS) Fiji (AU) n.a. Chemicals present found to have antitumour activity. Aristolochia indica L India (AS) Leaf Given as a tonic and used in syphilitic chachexia and for syphiltic ulcers. Aristolochia indica L Aristolochia indica L Joshi (2000) Joshi (2000) Cribb and Cribb (1981) Cribb and Cribb (1981) Cribb and Cribb (1981) Cambie and Ash (1993) Behl et al. (1993) Author's personal copy 128 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia indica L Nepal (AS) Root, leaf, seed and fruit Baral and Kurmi (2006) Aristolochia indica L India (AS) Root Aristolochia indica L India (AS) Leaf Used as a bitter, as an astrigent and a thermogent. Other uses are as a purgative, as an anodyne, in problems relating to the digestive system as a stomachic, an anthemintic and in the treatment of dyspepsia. As a diretic, sudorific, emmenagogue and a tonic. Has beneficial effects in ulcers, leprosy and skin diseases such as leucoderma, intestinal worms, colic and flu like symptoms such as a fever, cough and catarrah. It is given to children in the treament of abdominal disorders. Has a variety of uses and actions. Can be given as a tonic and is often used as a stimulant. Additionally, it is an emmenagogue and given to children with bowel complaints. Other uses are in the skin condition, leucoderma and impotence. Give after a snakebite and for coughs. Aristolochia indica L India (AS) Seed Usedin biliousness, for inflammation and also dry coughs. Aristolochia indica L India (AS) Stem and root Aristolochia indica L India (AS) Aristolochia indica L Myanmar (AS) Whole plant Root Aristolochia indica L Myanmar (AS) Leaf Gastrointestinal complaints such as as a digestion aid, as a gastric stimulant and in dyspepsia. It is given to women in order to control menstruation. Other uses are as a tonic and for fevers. Used by women as an abortificient. Also acts as a diuretic and has anti-inflammatory actions. Increase sweating, in the treatment of chronic arthiritis, laryngeal disease, leucoderma, pyrexia and headches. An antidote after bites by a snake or a scorpian. It is also used in gastrointestinal disorders such as dysentery and given to children in the treatment of diarrhoea. Women also take this plant for amennhoea. To treat ascities. Aristolochia indica L Myanmar (AS) Leaf Given as an antidote for snakebites. Aristolochia indica L Indo-Tiebtan (AS) n.a. Aristolochia indica L India, Sri Lanka, Nepal and Bangladesh (AS) India, Sri Lanka, Nepal and Bangladesh (AS) India, Sri Lanka, Nepal and Bangladesh (AS) India, Sri Lanka, Nepal and Bangladesh (AS) India, E. Ghats (AS) n.a. Has a biter taste and is used in the treatment of parasitic infestations as well as scorpian stings and ulcers. As an appetiser, for various skin dieases, as an aphrodisiac and an anthelminic. Aristolochia indica L Aristolochia indica L Bakshi et al. (1999) Bakshi et al. (1999) Bakshi et al. (1999) Bakshi et al. (1999) Bakshi et al. (1999) Soe and Ngwe (2004) Soe and Ngwe (2004) Soe and Ngwe (2004) Dash (1994) Williamson (2002) Leaf Snakebites. Williamson (2002) Leaf and bark Given to children for the treatment of bowel complaints. Also used for the treatment of diarrhoea and intermittent fevers. Williamson (2002) Root and rhizome Diarrhoea and leprosy. Williamson (2002) Root Rashes. India, Bidar district (AS) Whole plant To unduce abortion purposes. Aristolochia indica L India (AS) Aerial parts Aristolochia indica L India (AS) Root Used for several reasons, can be used as a sedative, for the prevention of intestinal worms and in cholera. Other uses are in types of inflammation and for poisonous bites and stings. Diarrhoea and cholera. Ram et al. (2004) Vidyasagar and Prashantkumar (2007) Shafi et al. (2002) Aristolochia indica L India, S.Tamilnadu (AS) India, Uttara Kannada district of Karnataka (AS) India, Karnataka (AS) Root As an antidote for those with snakebites. Root Skin diseases such as scabies and skin allergies. Root Externally as an antiseptic. Nepal to India, Chittagog, Konkan, Declan, Peninsula (AS) India (AS) Leaf and bark Given to children for the treatment of bowel complaints. Also used in other gastrointestinal complaints such as cholera and diarrhoea as well as for the treatment of intermittent fevers. Root, rhizome and leaf Root and stem Leucoderma and in the treatment of other skin disorders such as infections. Can also be used in the treatment of the sexally transmitted dieases, syphilis and gonorrhoea. Used in ethnovetinary medicine agains snakebites, for rheumatism, to alleviate aches and pains and to assist with madness. Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L India, Sri Lanka, Nepal and Bangladesh (AS) Kumar et al. (2006) Samy et al. (2008) Harsha et al. (2003) Kshirsagar and Singh (2001) Joshi (2000) Behl et al. (1993) Williamson (2002) Author's personal copy 129 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia indica L India (AS) Seed In inflammation, biliousness and in treatment of coughs. Aristolochia indica L India (AS) Seed Aristolochia indica L India (AS) Root Aristolochia indica L India (AS) Whole plant Joint pains, inflammation, biliousness, dry cough and in children, it is used in dyspnea. Acts as a stimulant and an emetic. Other uses are in the treatment of fevers, to promote digestion as well as for treating diarrhoea, regulating the mensturation cycle and applied to wounds. Snakebites. Padua et al. (1999) Sala et al. (1993) Jain and DeFilipps (1991) Aristolochia indica L India (AS) Root Aristolochia indica L India (AS) n.a. Aristolochia indica L India and Pakistan (AS) India and Pakistan (AS) Leaf and bark Root and stem Root Aristolochia indica L India and Pakistan (AS) Nepa, low hills and plain region. And India, Lower Bengal to Chittagong in Decan, Peninsula and Kongkan and in the south region (AS) India and Sri Lanka (AS) Tibete Aristolochia indica L Bangladesh Seed Aristolochia indica L Bangla Desh (AS) Root Aristolochia indica L Bangla Desh (AS) Leaf Aristolochia indica L India and adjacent regions (AS) Root, seed and leaf Aristolochia indica L (cult) Aristolochia iquitensis O.C. Schmidt (Aristolochia macrophylla Lam) Aristolochia kaempferi Willd US, C. & S. (NA) USA Cherokee (NA) Root Stem China (AS) Fruit Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) China (AS) (C. & S.W.) Root China (AS) (Hopeti and Hunan) n.a. Similar uses as in native ranges. Vietnam (AS) n.a. Oedema because of its diuretic properties and also for dysuria China (AS) Root Oedema as well as for the treatment of urinary disorders and gonorrhea. Taiwan, Tiusinron and Barisan community in Chistian district, Kaohslung State (AS) Taiwan, Lilongshan community in Kuanshan district, Kaohsiung state (AS) Leaf Snakebites. Duke and Ayensu (1985) Chang (2003) Root Snakebites. Chang (2003) Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia indica L Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) n.a. Cholera and diarrhoea (anti-microbial actions: in this study, there was inhibition of 11 micoorganisms tested). As an emmenagogue, for prevention of arthritis and as a stomachic. Croup, for cholera and in various bowel complaints, also for intermittent fever and for leucoderma patches. Constipation, as a stimulant, tonic, a carminative and for its emmenagogue properties. Prevention of arthritis and as a febrifuge. Leucoderma and for the treatment of poisoning by metals and nacrotic plants since it has emetic properties. A tonic, used as a stimulant and in the treament of leucoderma, it also has emmenagogue properties and can be used in snakebites since it also has emetic properties. Can also be given to children in the treatment of flatulence and dyspepsia. Leaf Coughs. n.a. Snake and scorpian bites as well as treatment of ulcers. Has a bitter taste. Dry cough, treatment of inflammation and biliousness. Aristolochic acid contained is used as an Ant tubercular agent. Shown to have antifertility action in rats. Used in Bangla Desh for impotence, itching, bowel complaints and intermittent fevers. Stomachic, tonic, antiperiodic and in children the leaf preparation is used in the treatment of croup. Used by women since it has antifertility actions, antiestrogenic and anti-implantation effects. Other properties as antitubericular, antifeedant, phagocytic, antispermatogenic and anti-inflammatory actions Used as a bitter principle. Used by those with yellow urine. All forms of pulomonary infections, ascites, heartburn and in heartburn. Sexually transmitted disease like gonorrhea, treatment of urinary disorders and dropsy. Jain and DeFilipps (1991) Kumar et al. (2006) Millspaugh (1887) Dastur (1977) Dastur (1977) Dastur (1977) Agarwal and Ghosh (1985) Yoganarasimhan (2000) Dash (1994) Ghani (2003) Ghani (2003) Ghani (2003) Sharma (2004) Nelson (1951) Duke (1986) Shin-Chen (2003) Perry and Metzger (1980) Duke and Ayensu (1985) Padua et al. (1999) Author's personal copy 130 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) Taiwan, Tyiuubusu community in Datiu District, Hsinchu and Lilongshan community in Kuanshan district, Taitung town (AS) Vietnam (AS) Root Abdominal pain. Chang (2003) Root As a diuretic and is prescribed to patients in the treatment of oedema and dysuria. Duong (1993) China (AS) Root and rhizome Used as a medicinal and for ‘wind-damp-dispelling’. Wiseman and Ye (1998) China (AS) Fruit Ascites, hemorrhoids, opium addition and for itching. China (AS) Fruit Used in a variey of conditions such as in opium addiction, heartburn, ascites, hemorrhoids and for lung aliments. Amazon (SA) n.a. Snakebites. Peru, Rio Loretoyacu (SA) Brazil, Ceará (SA) Stem Snakebites. Root Intermittent fever and is cited for usage in malaria. Several uses including menstrual colic and inflammation of the uterine. Perry and Metzger (1980) Duke and Ayensu (1985) Chevaillier (2001) Schultes and Raffauf (1990) Milliken (1997) Albuquerque et al. (2007) Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) Aristolochia kaempferi Willd (Aristolochia heterophylla Hemsl) Aristolochia klugii O.C. Schmidt Aristolochia klugii O.C. Schmidt Aristolochia labiata (Aristolochia brasiliensis Mart and Zucc) Aristolochia labiata (Aristolochia brasiliensis Mart and Zucc) Aristolochia liukiuensis Hatus n.a. (AS) Fruit, leaf, whole plant Root Aristolochia longa L = Aristolochia sp. (7) Aristolochia longa L = Aristolochia sp. (8) N. America (NA) Root Not stated. MediterraneanIran (AS) Ireland (EU) Root Antidote for snakebites. n.a. Aristolochia longa L = Aristolochia sp. (9) Aristolochia macrophylla Lam = Aristolochia sp. (10) Aristolochia manshuriensis Kom Germany (EU) n.a. Given to women for abortive purposes for its ability to remove the dead child. Other uses are to remove all fluids in thw womb after childbirth and can also be used to promote menstration and urination. Also given to children for rickets. To prevent arthiritis, as a stimulant and an ammenagogue. N.E. India (AS) Root Applied externally for the treatment of swollen feet and legs. China (AS) Stem Aristolochia manshuriensis Kom Korea (AS) Stem and shoot Used for treating problems relating to the urine and the bladder region. Can be used for individuals with dribbling urine or where the urine is dark urine because of heat in the heart and scanty urine as well as for pain in the bladder region where this is associated with damp heat due to pathogens. Other uses are in the treatment of the sexually transmitted disease, gonorrhea and will aid in promoting ‘galactation’ Other uses are for sore mouth, restlessness, and arthritis whether this is rheumatoid or rheumatic. Diuretic and antipyretic. Aristolochia manshuriensis Kom China (AS) Vine Stimulating circulation, for the treatment of amenorrhea, galactogue, diabetes as well as dropsy. Aristolochia manshuriensis Kom China (AS) n.a. Aristolochia manshuriensis Kom China (AS) n.a. Aristolochia manshuriensis Kom China (AS) Stem Aristolochia manshuriensis Kom China (AS) Stem Aristolochia manshuriensis Kom China (AS) Stem Aristolochia manshuriensis Kom Japan & N. China (AS) Stem Promote urine, to cure oedema and acting as an expelling agent for swelling. Can also be used for jaundice. Used to help with urination, for damp heat strangury, swelling associated with water. Also used by women to promote breast milk and menstruation. Oedema and pain associated with rheumatism. Species functions as a diuretic and also to reduce fever and inflammation. Used in a variety of factors such as in combating heat, promoting milk secretion, urethra infections. Mouth and tongue ulcers, urinary system (Acute infections), Amenorrhoea. Used in fevers and in the treatment of diabetes. Other uses includes an increase in the flow of urine and also to increase menstrual bleeding and stimulation of milk flow after labour. Aristolochia longa L = Aristolochia sp. (9) Brazil, N.E (SA) As an antiphlogistic, detoxicant and anodyne. Wu et al. (2004) Williamson (2003) Lewis and Elvin-Lewis (2003) K’eogh (1986) Millspaugh (1887) Duke (1986) Wu (2005) Perry and Metzger (1980) Perry and Metzger (1980) Ling (1995) Yen (1992) Tang and Eisenbrand (1992) Huang (1993) Craker and Simon (1989) Wee (1990) Author's personal copy 131 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia manshuriensis Kom Japan (AS) n.a. As a renal remedy. Aristolochia manshuriensis Kom China (AS) Stem Aristolochia manshuriensis Kom China (AS) n.a. Aristolochia manshuriensis Kom China (AS) Vine Aristolochia manshuriensis Kom China (AS) Stem Diuretic and for its anti-inflammatory properties so can be used in rheumatism and to help with swelling. Relieve dysuria and to promote urination and lactation. Can also used to clear heat and purge fire. Diuretic and therefore used in oedema and has anti-inflammatory properties so is used in rheumatism. Stimulate circulation and in the treatment of amenorrhoea, diabetes and dropsy. Hashimoto et al. (1999) Lans (2007b) Aristolochia manshuriensis Kom China (AS) n.a. Aristolochia manshuriensis Kom China (AS) Stem Aristolochia manshuriensis Kom Aristolochia manshuriensis Kom China (AS) Korea (AS) n.a. Stem and shoot Aristolochia maurorum Linn. (11) Jordan, Melka, Wadi, Al-Arab (AS) n.a. Wounds, skin diseases and leprosy. Aristolochia maurorum Linn. Iraq (AS) n.a. Hepatic and diuretic purposes. Other uses are as an astrigent, detergent and antiscorbutic. Aristolochia maxima Jacq. Mexico to Venezuela (CA) Root Antidote for snakebites. Aristolochia maxima Jacq Venezuela (SA) Leaf Used in fevers when placed in an external bath. Aristolochia maxima Jacq n.a. (n.a.) Root Intermittent fever. Aristolochia maxima Jacq Mexico, Maya (CA) Root and whole plant Aristolochia maxima Jacq Mexico, Maya (CA) Root Aristolochia maxima Jacq Mexico, Nahua (CA) n.a. Gastrointestinal complaints by those who are ‘hot’ and drink a cold drink causing them to become ill. Also used by those with air in the stomach, dystentry and also for treating diarrhoea. Also used in women’s health: for menstruation complaints including pain associated with menstruation, dark blood and to aid fertility. Used in feminine problems and in conditions relating to the gastrointestinal tract. Gastrointestinal complaints. Aristolochia maxima Jacq Mexico, Maya (CA) n.a. Aristolochia maxima Jacq Honduras (CA) Flower, leaf and stem Aristolochia maxima L. Stem n.a. Diarrhoea. Leaf Stomachaches. Aristolochia mollisima Hance Colombia and Venezula (SA) Venezuela, Coro (SA) Guatemala, Huehuetanango (CA) China (AS) Gastrointestinal complaints—most commonly for air in the stomach, indigestion, diarrhoea and dystentery. Less commonly Aristolochia maxima is used for nausea, vomitting, green diarrhoea, stomachaches, cramps and colic. Used for a variety of conditions such as in digestive problems and dystentery as well as in bites from snakes or other insects. Other uses are in fevers and in the treatment of aches and pains. Snakebites To treat gout. Aristolochia mollisima Hance China (AS) Whole plant Whole plant Aristolochia mollisima Hance China (AS) Flower Aristolochia mollisima Hance China (AS) Whole plant Aristolochia mollisima Hance China (AS) Whole plant Aristolochia maxima L. Aristolochia mollis Stand & Stey It has been shown to be able to stimulate the myocardium and to have antibacterial effects. It has been used to ‘combat extensive heat’ as by women to increase or promote secretion of milk. Oher uses are in urethritis, nephotic edema and obstruction of the mammary gland. Used to dredge the meridian passage, to cure rheumatism and arthiritis. Nephritic stones and urosis. Decrease fever and to treat diabetes. Treatment of pain for individuals with stomachaches, toothaches and joint pains as well as dysfunction of the tendons, bones and treating wounds. Acts as a diuretic. For aches and pains associated with rheumatoid arthiritis as well as reducing general pain. Can also be used in treatment of flactulence, cancer and to reduce swelling. Treatment of cancer. Yip et al. (2005) Padua et al. (1999) Duke and Ayensu (1985) Huang (1993) Ling (1995) Ling (1995) Duke and Ayensu (1985) Karim and Quraan (1985) Al-Rawi and Chakravarty (1964) Lewis and Elvin-Lewis (2003) Milliken (1997) Milliken (1997) Ankli et al. (1999) Ankli et al. (2002) Heinrich et al. (1998) Heinrich et al. (1998) Lentz et al. (1998) Morton (1981) Morton (1981) Morton (1981), Kufer et al. (2005) Kong et al. (2000) Wu (2005) Duke and Ayensu (1985) Duke and Ayensu (1985) Graham et al. (2000) and Duke and Ayensu (1985) Author's personal copy 132 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia mollissima Hance China (AS) n.a. Used for its anti-cancer, anti-inflammatory and in the treatment of pain. It is given by practitioners in the treatment of rheumatism, stomachaches and abdominal pain. Aristolochia mollissima Hance Aristolochia moupinensis Franch China (AS) China (AS) n.a. n.a. Aristolochia ocbiculans Duchr (nom. illeg.) possibly Aristolochia orbicularis Aristolochia odoratissima L. Mexico, Teenek Tsabaal (CA) Root Venezuela, N. (SA) Stem Aristolochia odoratissima L. Venezuela, N. (SA) Leaf Gastritis-like disorders. Uses not specifically mentioned but contains aristolochic acid which is known to increase phagocytosis and improve body’s ability to fight bacterial infections. In respiratory problems or the treament of coughs by loosening up the phlegm and also for wheezing. Also acts to warm the body. Diabetes, to increase appetite, to help with colds, stomachaches, to treat bites of different animals, used by women as an emmenagogue, has a verminfuge action and used for a diarrhoea. Disorders of the liver. Yu et al. (2007) and Jiangsu New Medical College (1977) Li et al. (2005) Duke and Ayensu (1985) Alcorn (1984) Aristolochia ovalifolia Duch. Mexico, Zapotec nr. M. Romero (CA) México, Popoluca (CA) México, Popoluca (CA) México, Popoluca (CA) Tanzania, Dar es Salaam (AF) Morocco, Taounate (AF) Portugal, Sierra de São Mamede (EU) n.a. For increasing the speed of labour. n.a. It is an aromatic bitter used in the treatment of stomachaches and vomiting. Other uses include snakebites, colic and vertigo. Stomachaches and for vomiting. Aristolochia paucinervis Pomel Aristolochia ovalifolia Duch. Aristolochia ovalifolia Duch. Aristolochia ovalifolia Duch. Root Root and vine Root To counteract the bites of black widow. Fruit Used in a magical way and in pacifying children. Root Used in a decoction for snakebites. Also, shown to be effective for Vipera latastei Boscá bites. Morocco (AF) n.a. Has antibacterial properties. Aristolochia paucinervis Pomel Morocco (AF) Rhizome Skin infections. Aristolochia paucinervis Pomel Morocco (AF) Rhizome Upper abdominal pain and upper respiratory tract infections. Aristolochia pentandra Jacq. Mexico, Yucatán (CA) Root and stem Aristolochia pentandra Jacq. Leaf Aristolochia philippinensis Warb Mexico, Yucatán (CA) Philippines (AS) Given as a tonic, as a febrifuge, for its antirheumatic actions, as an emmenagogue, gout and used for its actions on the nevous system since it will relieve neuralgia. Snakebites. Root Stomachic and emmenagogue properties. Aristolochia philippinensis Warb Philippines (AS) Root Stomachic and emmenagogue properties. Aristolochia philippinensis Warb Philippines (AS) Root Stomachic and emmenagogue. Aristolochia philippinensis Warb Philippines (AS) Root Carminative, febrifuge, ennenagogue, for the treatment of stomachaches. Similar to that of Aristolochia sericea. Aristolochia philippinensis Warb Philippines (AS) Root Used as a violent abortive, as an uterine tonic and for gastralgia. Aristolochia parensis Engl. ex. Peter Aristolochia paucinervis Pomel (Aristolochia longa L) Aristolochia paucinervis Pomel Epilepsy. Morton (1981) Morton (1981) Frei et al. (1998) Leonti et al. (2002) Leonti et al. (2001) Leonti et al. (2001) Moshi et al. (2005) El-Hilaly et al. (2003) CamejoRodrigues et al. (2003) Gadhi et al. (2001a,b), Bellakhdar (1997), Merzouki et al. (1997), Gadhi et al. (1991) Gadhi et al. (1991), Charnot (1945), Bellakhdar (1997), Merzouki et al. (1997) Gadhi et al. (1991), Bellakhdar et al. (1991), Benchaabane and Abbad (1997), Bellakhdar (1997) Morton (1981) Morton (1981) Quisumbing (1951) Quisumbing (1978) Padua et al. (1999) Perry and Metzger (1980) Perry and Metzger (1980) Author's personal copy 133 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia pilgeriana O.C. Schmidt Aristolochia pilosa Kunth. Amazon, Loretoyaca (SA) Colombia, N.W. (SA) Panama, Guaymi Indians (CA) Spain, Pallars, Pyrenees, Catalonia (EU) S. Europe (EU) n.a. Use not specified. Root Snakebites. n.a. Snakebites. Schultes and Raffauf (1990) Otero et al. (2000) Gupta (1995) Aerial parts Hepatobiliar inflammation. Agelet and Vallès (2003) n.a. Similar uses to Aristolochia serpentaria. Thailand (AS) Root Used for longevity. USA & Mexican West (NA) USA & Mexican West (NA) Nigeria (AF) n.a. Used in the treatment of sores and for ‘empacho’. Millspaugh (1887) Chuakal et al. (1997) Kay (1996) Root Used for ‘empacho’. Kay (1996) Root Treatment of diabetes. UK (England) used in England in 1632, incl in Pharmacopeia Londoniensis, 1650) (EU) Also USA, S.W. American Indian (NA) India (AS) USA Texas (NA) Rhizome Stimulant and tonic properties—local and general effects. Nervous, despondent and excitable conditions. Can be used in low fevers and febile states. Sodipe and Sofowara (1986) Wallis (1960) n.a. Root Use not specified. Gastric stimulation and dyspepsia. Aristolochia reticulata Nutt. USA, collected in Texas, Louisiana, Arkansas and Oklahoma (NA) Aromatic bitter (helps with digestion) described for use in commercial preparations. Aristolochia reticulata Nutt. Aristolochia reticulata Nutt. USA, from Lousiana to Texas (NA) USA, C. & S. (NA) Stem (rhizomes) with some subaerial Stems and roots remaining n.a. Aristolochia reticulata Nutt. USA, Texas (NA) Aristolochia reticulata Nutt. USA, incl. US Pharmacopoeia (NA) Root Aristolochia ringens Vahl S. America (SA) n.a. Given to individuals as a stimulant and as a tonic as well as possessing diuretic properties. In the past it was used in the treatment of dyspepsia and fevers but is now known to be toxic. Snakebites, fever, ulcer, colic. Aristolochia ringens Vahl Senegal (AF) Root Antidote for snakebites. Aristolochia rodriguesii Hoehne Brazil (SA) Aristolochia rotunda L. (13) Iran (AS) Root, aerial pts n.a. As an abortifacient and anti-inflammatory; treatment of snakebites. Tonic. Aristolochia rotunda L. (14) Egypt (AF) n.a. Aristolochia rotunda L. Root Aristolochia rotunda L. UK and other European countries (EU) Spain, Montseny (EU) Italy (EU) It is pressumed that this species is used in the treatment of snakebites. Several uses including as an antitumour, immunomodulating and antifertility agent. Aristolochia rotunda L. Aristolochia pilosa Kunth. Aristolochia pistolochia L Aristolochia pistolochia L Aristolochia pothieri Pierre ex Lec Aristolochia quercetorum Standl Aristolochia quercetorum Standl Aristolochia repens Mills Aristolochia reticulata Nutt. (12) Aristolochia reticulata Nutt. (12) Aristolochia reticulata Nutt. Aristolochia rotunda L. Rhizome and roots n.a. Niir (2005) Lewis and Elvin-Lewis (2003) Evans and Trease (1996) Diaphoretic, a tonic and stimulaant. It can also be used as a bitter, a general tonic and in the treatment of low fever. An aromatic bitter and is used in the treatment of snakebites. Coon (1979) Not stated. Millspaugh (1887) Foster (1995) Aerial parts Anti-inflammatory of the billiary. n.a. Specific conditions not stated, used medicinally for sheep. Italy, Tuscany (EU) n.a. Antihypertensive. Aristolochia rotunda L. S. Europe (EU) Root Aristolochia rotunda L. (cult) Ireland (EU) Root Ulcers and various skin complaints such as eczema. It has antitussive, bronchosedative. Vulvenary and emmenagogue properties. For the prevention of convulsions and for clearing phlegm and the bowel as well as for ulcers and splinters. Used by women to promote menstuation and during childbirth. Can also be given externally in the treatment of aches and bruises. Nelson (1951) Van Wyk and Wink (2004) Neuwinger (2000) Wu et al. (2004) Van Wyk and Wink (2004) Manniche (1989) Evans and Trease (1996) Bonet and Vallès (2007) Viegi et al. (2003) Manganelli et al. (2000) Chiej (1984) K’eogh (1986) Author's personal copy 134 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia rotunda L. (cult) Britain (EU) Root Aristolochia rotunda L. (cult) Germany (EU) n.a. Amenorrhoea to induce the menstruation, used for its purgative action and also to induce abortion. To prevent arthiritis, as a stimulant and an ammenagogue. Aristolochia rotunda L. (cult) USA, C. & S. (NA) n.a. Bianchini et al. (1979) Millspaugh (1887) Grieve (1974) Aristolochia rugosa Lam Trinidad and Tobago (CA) Trinidad and Tobago (CA) Whole plant Root Aristolochia rugosa Lam West Indies to Trinidad (CA) Root Aristolochia rugosa Lam Trinidad and Tobago (CA) n.a. Aristolochia rugosa Lam Trinidad and Tobago (CA) Trinidad and Tobago (CA) Root Aristolochia rugosa Lam Aristolochia rugosa Lam Root Used in the treatment of digestive disorders such as increasing the appetite and to tone the digestive organs. Other uses are as a stimulant, as a tonic and additionally as a diaphoretic and a diuretic. Used in the treatment of diabetes and hypertension. Used for snakebites and in scorpian stings, as well as for amenhorrhoea and dysmenorrhoes. Other uses are in indigestion, heat, jaundice and pospartum depurants. Given as a tea or an infusion in the treatment of indigestion, heat or the absence of the menstrual bleeding (amenorrhoea) and dymennorrhoea. Other uses are in snakebites and scorpian stings as well as in liver problems such as in jaundice and in postpartum depurants. It can also be used to control blood pressure. Used in the treatment of various problems relating to the reproductive system. This includes infertility, childbirth, menstrual pain and complaints that are unspecified. Other uses include abortions and the removal of the placenta. Stomach pains, colic and for poisoning. Used by women after giving birth and also for menstruation disturbances. Other uses are in urinary burning, treating snakebites, scorpian stings, jaundice and burning when urinating. Antidote for snakebites. Aristolochia rugosa Lam (Aristolochia barbata Jacq) Brazil (SA) Rhizome Aristolochia rumphii Koster Lesser Sudan Island, S.W. Sulawesi and Moluccas (AS) Used in stomachaches, spasm and in constipation as well as in intermittent fevers. Aristolochia rumphii Koster Indonesia (AS) Root but twigs also sometimes used although less powerful Root Aristolochia saccata Wall India (AS) Rhizome Aristolochia saccata Wall E. Indian Himalaya (AS) E. Indian Himalaya (AS) Cyprus (EU) n.a. Various stomach complaints including pain of the stomach. Other uses are in internal heamorrhage, disorder of the spleen and urinary complaints. Use not specified. n.a. Use not specified. Root, rhizome and leaf n.a. Tinnitus, clearing the white region of the eye and also watering of the eye, menstruation problems—either absent or delayed, headache and migraine. As an alexiteric. Will aid in reducing a fever as well as posessing carminative and emmagogue properties. Pain associated with the stomach or abdominal region, has abortive actions, a uterine tonic. In fevers, as a carminative. Also as an emmenagogue. Aristolochia saccata Wall (Aristolochia cathcartii Hook) Aristolochia sempervirens L. Intermittent fevers, stomachaches and constipation. Seaforth et al. (1983) Seaforth et al. (1983) Ayensu (1981) Lans (2007a,b) Lans (2007b) Morton (1981) Lewis and Elvin-Lewis (2003) Padua et al. (1999) Perry and Metzger (1980) Jain and DeFilipps (1991) Samant et al. (1998) Samant et al. (1998) Lardos (2006) Millspaugh (1887) Quisumbing (1978) Quisumbing (1978) Padua et al. (1999) Padua et al. (1999) Aristolochia sempervirens Linn (15) Aristolochia sericea Benth. (16) Colombia (SA) Aristolochia sericea Benth (16) Philippines (AS) Whole plant Root Aristolochia sericea Benth (16) Philippines (AS) Fresh plant Aristolochia sericea Benth (16)/Aristolochia imbricate Mast. Aristolochia sericea Benth (16)/Aristolochia imbricate Mast. Aristolochia sericea Benth (16)/Aristolochia imbricate Mast. Aristolochia sericea Benth Philippines (AS) Roots Gastralgia and is also given as an uterine tonic to women after childbirth. Acts also as a violent abortive. Philippines (AS) Whole plant Carminative, emmenagogue and febrifuge properties. Quisumbing (1951) Philippines (AS) Root Gastralgia, as a uterine tonic and as an abortive. Quisumbing (1951) Mexico (CA) n.a. Known to have hypoglycaemic effects. Mexico (CA) Flower Known to have hypoglycaemic effects. Andrade-Cetto and Heinrich (2005) Andrade-Cetto and Heinrich (2005) Aristolochia sericea Benth (Aristolochia malacophylla Standl.) Philippines (AS) Author's personal copy 135 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia serpentaria L N America (NA) n.a. Fever Remedy. Aristolochia serpentaria L USA (NA) Used for medicinal purposes. Aristolochia serpentaria L USA, E. Mississippi (NA) Rhizome and roots Rhizome and roots Chevaillier (2001) Youngken (1918) Wallis (1960) Aristolochia serpentaria L N. America (NA) n.a. Aristolochia serpentaria L USA (NA) Root Aristolochia serpentaria L n.a. (n.a.) n.a. Coughs, toothaches and snakebites. Other uses are in the treatment of pain as well as cold related symptoms such as headaches, coughs, fever and sore throats. Additionally, can be used in the treatment of rheumatism, intestinal worms and has antiseptic and antitumour activity. To stop the effect of serpent’s bites. Aristolochia serpentaria L Canada (NA) Root Prevention of serpent bites. Aristolochia serpentaria L (17) United Kingdom (EU) n.a. Aristolochia serpentaria L Leaf Aristolochia serpentaria L (17) USA, N. & S. Carolina, Georgia. N. Florida (NA) Egypt (AF) Aristolochia serpentaria L (17) Egypt (AF) n.a. Aristolochia serpentaria L USA, Virginia (NA) Rhizome Given as a tonic and a diaphoretic. Other uses as a antispasmodic and treating pain. It will help to reduce fevers and additionally has actions on the nervous system. For sprains. In America, it used used form the treatment of snakebites, as a tonic, a stimulanf and in the treatment of fevers, small pox, pneumonia and open wounds. It is unknown whether this particular species is used, although it is presummed that this is true and is used as a tonic and diaphoretic. Other uses are in the treatment of infectous diseases and for snakebites. Given to children in the treatment of smallpox and to promote sweating. Gastric stimulation and dyspepsia. Aristolochia serpentaria L USA, Alleghenies (NA) N. America (NA) Various countries (EU) USA, West region to Kansas and North region to Connecticut (NA) USA, Georgia (NA) n.a. As a tonic. Manniche (1989) Lewis and Elvin-Lewis (2003) Kamm (1938) Root n.a. For serpent bites. As a tonic, useful in sore throats and in fevers. Graves (1990) Graves (1990) Rhizome and roots Used for its properties as a diaphoretic, a tonic and stimulaant. It can also be used as a bitter, a general tonic and in the treatment of low fever. Coon (1979) Leaf Heart problems. Root and rhizome Leaf Used to check vomitting and is used for snake and spider bites. Root Fevers and as a vermifuge. Aristolochia serpentaria L USA N. American Indians (NA) N. American Indians (NA) USA, S. Carolina (NA) n.a. (NA) Root Smallpox, pneumonia, malaria and also in typhus fever. Aristolochia serpentaria L (17) Europe (EU) n.a. To promote sweating. Aristolochia serpentaria L USA, Virginia (NA) n.a. Used in folk medicine to treat cancer. Aristolochia serpentaria L Root Snakebites. Aristolochia serpentaria L USA, Cherokees (NA) USA/Canada (NA) n.a. Bitter tonic. Aristolochia serpentaria L USA, Cherokee (NA) n.a. Aristolochia serpentaria L n.a. Aristolochia serpentaria L USA, S. Carolina, used by American Slaves (NA) also French West Indies USA/Canada (NA) Combined with other products in the treatment of pain and is used alone in the treatment od skin conditions and snakebite remedies. Pneumonia. Bolyard (1981) Bolyard (1981) Bolyard (1981) Bolyard (1981) Bhattacharjee and Micheal (1998) Sumner (2004) Sumner (2004) Sumner (2004) Sumner (2004) Garett (2003) n.a. Used as a gargle and for individuals with bilious vomitting. Aristolochia serpentaria L N America (NA) n.a. Not mentioned but used as a ‘local medicine’. Aristolochia serpentaria L Aristolochia serpentaria L (17) Aristolochia serpentaria L Aristolochia serpentaria L Aristolochia serpentaria L Aristolochia serpentaria L Aristolochia serpentaria L Root As a timulant and for its tonic properties—local and general effects. Nervous, despondent and excitable conditions. Can be used in low fevers and febile states. Snakebites and dyspepsia. Treatment of chills. Van Wyk and Wink (2004) Still (1998) Stephenson and Churchill (1834) Stephenson and Churchill (1834) Stephenson and Churchill (1834) Mitchell (1978) Manniche (1989) Laguerre (1987) Stephenson and Churchill (1834) Padua et al. (1999) Author's personal copy 136 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia serpentaria L USA, C. & S. (NA) Aromatic bitter and is used in the treatment of snakebites. Nelson (1951) Aristolochia serpentaria L USA/Canada (NA) Rhizome and roots Root Millspaugh (1887) Aristolochia serpentaria L Aristolochia serpentaria L N. America (NA) USA, Appalachia (NA) USA (NA) n.a. n.a. For the alimentary tract which then can be used to determine blood to abdominal viscera. Used for various gastric problems such as nausea and vomitting and for flactulence. Snakebites. As a spasmoidal, diaphoretic and additionally as an emmenagogues. Will help in dyspepsia. To prevent poisoning. Aristolochia serpentaria L USA various locations (NA) Root Aristolochia serpentaria L UK, E. Anglia (EU) n.a. Aristolochia serpentaria L USA, Eastern States to Mississippi (NA) Root Aristolochia serpentaria L USA, incl. Texas (NA) Root Aristolochia serpentaria L (17) Europe (EU) n.a. Aristolochia serpentaria L USA (NA) Root Aristolochia serpentaria L N. America (NA) n.a. Used by individuals in a febile state ad those presenting with low fever. It also acts as a stimulant and additionally has tonic properties as well as being nervous despondent. Acts to promote sweating and the appetite as well as an expectorant. It is useful in fevers and various disorders of the gastrointestinal system such as in indigestion and for stomachaches. Other uses are in sore throats, fevers, for the treatment of snakebites and for women to promote the menstruation cycle. Rarely used but was in the past used for rattlesnake and dog bites associated with rabies and was used as a diaphoretic. To increase the appetite and for infectous diseases. Other uses are as a stimulating tonic, a diaphoretic, anodyne and was once used in the treatment of snakebites. It can also be used in infectous diseases that are still in their initial stages. It is used as a bitter and as a vehicle for tonics. Aristolochia serpentaria L USA, Mohegan (NA) Root Wounds. Aristolochia serpentaria L USA, Choctaw (NA) Root Stomachaches. Aristolochia serpentaria L Root Intestinal parasites. Aristolochia serpentaria L USA, Nanticoke (NA) USA, Natchez (NA) Root To reduce fevers. Aristolochia serpentaria L USA, Delaware (NA) Root Given as a tonic. Aristolochia serpentaria L (17) Europe (EU) n.a. Given as a remedy for snakebites. Aristolochia serpentaria L USA (NA) n.a. Aristolochia serpentaria L n.a. Root To help with digestion. Root To help with digestion. n.a. Increasing good health since it acts as a strengthing agent. Aristolochia serpentaria L USA, S. Carolina (NA) USA Menominee (NA) USA, Chippewa (NA) USA, Montagnais (NA) USA/Canada (NA) Given as a tonic and a stimulant and can be used to reduce fever and is a diuretic. Used to reduce fever. n.a. Aristolochia serpentaria L USA (NA) Wood Aristolochia stahelii O.C. Schmidt French Guinea (SA) Stem Used for its antiseptic properties in the treatment of open wounds and ulcers. In the past, it was used for various different forms of fevers including remittents and intermittents. Additionally used for tyhphoid and thypus fevr, for smallpox, erysipelas and amenorrhoea. Acts as a stimulating diaphoretic and for pneumonia. Used as an aromatic stimulant and tonic. It also acts as a gastric mucosa stimulant. Drunk cold and used in malaria but country not stated. Aristolochia serpentaria L Aristolochia serpentaria L Aristolochia serpentaria L Aristolochia serpentaria L n.a. Snakebites and as a stimulant. Where an individual is presenting with ‘offending matter’ this plant is also shown to be useful in removing it by promoting sweating. It is used for disorders of the gastrointestinal system such as dyspepsia, flactulence, to improve digestion and appetite. Other uses are in croup, sore throats, scarlet fever, smallpox, congestion of the kidney and renal toper. It also acts on the nervous system and is given to women to promote menstruation. Emmenagogue properties. Lipp (1996) Krochmal et al. (1971) Krochmal and Krochmal (1975) Hutchen (1991) Allen and Hatfield (2004), Hartfield and Joice (1994) Greenish (1933) Foster and Duke (1977) Chevailler (1996) Chevailler (1996) Bellamy and Pfister (1992) Moerman (1998) Moerman (1998) Moerman (1998) Moerman (1998) Moerman (1998) Moerman (1998) Moerman (1998) Moerman (1998) Moerman (1998) Moerman (1998) Moerman (1998) Millspaugh (1887) Sayre (1917) Milliken (1997) Author's personal copy 137 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia stahelii O.C. Schmidt Aristolochia stuckertii Speg. French Guiana (SA) Stem Curing or in the prevention of malaria. Argentina, Sierra de Comechingones (SA) Mexico, Sinaloa (CA) Root Root Used in the prevention of hepatic affections and for the prevention of rheumatic pains and has properties acting as a disinfectant, as a diuretic and a diaphoretic. An antidote for snakes. Vigneron et al. (2005) Goleniowski et al. (2006) Aristolochia taliscana Hook. et Arn. Aristolochia theriaca Mexico (CA) n.a. Cutaneous disease and shown to have antibacterial effects. Brazil (SA) Root An antidote for snakes. Aristolochia tomentosa Sims (Aristolochia sipho L’Her) Aristolochia tomentosa Sims n.a. (n.a.) n.a. Alexiteric. USA (n.a.) n.a. Alexiteric. Aristolochia tomentosa Sims USA, incl. Texas (NA) n.a. Aristolochia tonduzii O.C. Schmidt Panama, Teribe and San San rivers Province of Bocas del Toro (SA) Panama, Guaymi Indians (CA) Brazil, mainly in Rio Grande do Sur (SA) Stem Acts to promote sweating and the appetite as well as an expectorant. It is useful in fevers and various disorders of the gastrointestinal system such as in indigestion and for stomachaches. Other uses are in sore throats, fevers, for the treatment of snakebites and for women to promote the menstruation cycle. However, effects are not as strong as Aristolochia serpentaria L. Used where there is inflammation and pain. n.a. Snakebites and for shortness of breath. Gupta (1995) n.a. Mors et al. (2000a) Aristolochia triangularis Cham Argentina (SA) n.a. Can be used internally and externally. Externally, it is used for skin diseases as well as alcers. When used in a bath, this is used in the prevention of orchitis which is a pain in the joints, Other uses externally includes as an emmenagogue, a tonic, stimulant or as a diuretic. Internally, this plant is used in the treatment of oedema, where there is inflammation of the bladder (cystitis), malaria as well as for parasites where there are intestinal worms. Hypertension. Aristolochia triangularis Cham. Brazil S. (SA) Dysentery and diarrhoea. Aristolochia triangularis Cham n.a. (SA) Leaf and stem n.a. Aristolochia triangularis Cham n.a. (SA) Bark Aristolochia triangularis Cham Argentina (SA) Bark Aristolochia trilobata L. (Aristolochia macroura Gomes) Aristolochia trilobata L Argentina (SA) Whole plant An antidote as well as an abortive. Other uses are as an emmenagogue, antiseptic and antirheumatic. An antidote as well as an abortive. Other uses are as an emmenagogue, antiseptic and antirheumatic. Treatment of snakebites and rheumatism; as a circulatory stimulant, anti-inflammatory, antiseptic and abortive. French Guiana (SA) Leaf Fevers. Aristolochia trilobata L Belize (CA) Leaf Use not specified. Aristolochia trilobata L Caribbean and Northern part of S. America (SA) Peru (SA) Leaf Use not specified. n.a. Negative screening for anti-malaria, plant is inactive against Plasmodium gallinaceum, Plasmodium cathemerium and Plasmodium iophurae in chicken and ducklings. Hysteria, an antifebrile abortive and also to stop diarrhoea. Functions as an excitant, a bitter tonic and as a stomachic antiseptic. In gastralgia, for dandruff conditions as well as in orchitis (testes inflammation) (Oxford Consise edical dictionary) and chronic ulcers. Mixed with absinthe in the treatment of gripe and stomach pains. Aristolochia taliscana Hook. et Arn. Aristolochia tonduzii O.C. Schmidt Aristolochia triangularis Cham Aristolochia trilobata L Aristolochia trilobata L Brazil, Amazon to Bahia (SA) Root Aristolochia trilobata L Brazil, Amazon to Bahia (SA) Leaf Aristolochia trilobata L W. Indies—from the British Honduras to Panama. (CA) Vine (stem?) Medicinal purposes. Lewis and Elvin-Lewis (2003) Yasunaka et al. (2005) Lewis and Elvin-Lewis (2003) Millspaugh (1887) Millspaugh (1887) Foster and Duke (1977) Gupta et al. (2005) Lorca et al. (2002) De Souza et al. (2004) Muschietti et al. (1996), Zardini (1984), Toursarkissian (1980), Ahumada (1967) Ciccia et al. (2000) Mongelli et al. (2000) Wu et al. (2004) Milliken (1997) Milliken (1997) Milliken (1997) Milliken (1997) Mors et al. (2000a) Mors et al. (2000a) Honychurch (1986) Author's personal copy 138 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia trilobata L W. indies—from the British Honduras to Panama (CA) W. Indies—from the British Honduras to Panama (CA) Guadeloupe, Marie Galate (CA) Guadeloupe, Marie Galate (CA) India, Shimoga District of Karnataka (AS) Belize (CA) Whole plant Snakebites. Honychurch (1986) Root To intoxicate a snake and make the snake harmless for a period of time. Honychurch (1986) n.a. Used to cause vomiting in poisoning. Leaf n.a. Used for ritual purposes, used against bad luck. Various different species used. Used but pharmacological effects have no direct evidence. Honychurch (1986) Honychurch (1986) Mahishi et al. (2005) n.a. Wounds: superficial and also deep wounds. Aristolochia trilobata L Trinidad and Tobago (CA) n.a. Aristolochia trilobata L Trinidad and Tobago Dominica (W. Indies) Brazil (SA) (Ceará) Root Used in the treatment of various problems relating to the reproductive system. This includes infertility, childbirth, menstrual pain and complaints that are unspecified. Other uses include abortions and the removal of the placenta. Stomach pains, colic and for poisoning. n.a. Intestinal worms. Root Intermittent fever. Leaf Fevers. n.a. Used in combination with absinthe in the treatment of gripe and in stomach pains. Used to promote vomiting where there is poisoning. Aristolochia trilobata L Brazil (SA), Amazonas West Indies to Trinidad, Dominica, Guadeloupe, Marie Galante, Martinique Belize Root Fevers. Aristolochia trilobata L Honduras (CA) n.a. Aristolochia trilobata L Brazil (SA) n.a. Aristolochia trilobata L Trinadad (CA) Leaf Aristolochia trilobata L Nicaragua, E. (CA) Aristolochia trilobata L Martinique (CA) Leaf, whole plant and root Leaf Colic, for spasmodic vomitting, diarrhoea and in the treatment of dystentery. Used by women to get rid of unwanted pregnancy and for its actions as an emmenagogue. Also acts as a stimulant. Diabetes, hypertension, snakebites and used by women to assist with menstruation and during childbirth. Snakebites-both as an antidote and to treat effects as a result of the bite. Aristolochia trilobata L Aristolochia trilobata L Dominican Republic, West Indies (CA) America (–) Aristolochia trilobata L Aristolochia trilobata L Aristolochia trilobata L Aristolochia trilobata L Aristolochia trilobata L Aristolochia trilobata L Aristolochia trilobata L Aristolochia trilobata L Aristolochia trilobata L Aristolochia trilobata L Colic pains. n.a. Intestinal worms. Has wound healing properties. n.a. (n.a.) Leaf and bark n.a. Aristolochia trilobata L Guyana (SA) n.a. Emmenagogue. Aristolochia trilobata L French Guiana (SA) Leaf Aristolochia trilobata L (Aristolochia macroura Gomes) Aristolochia trilobata L (Aristolochia macroura Gomes) Aristolochia trilobata L (Aristolochia triloba Salsib) Aristolochia trilobata L. (Aristolochia macrota Duch.) Aristolochia truncate Fielding & Gardner Aristolochia tuberose C.F. Liang & S.M. Hwang Aristolochia virgiana (nom. illeg.) possibly Aristolochia serpentaria Argentina (SA) n.a. Brazil (SA) n.a. Curing or in the prevention of malaria and also as an alcolohic bitter. Abortifacient, as well as for its inflammatory actions and is used in rheumatism and to stimulate the circulatory system. It can also be used in snakebites. As an alexiteri.c French Guiana (SA) n.a. Surinam (SA) Stem n.a. n.a. Used in combination with other plants in curing or prevention of malaria. Used by women to help during childbirth and also used for gastrointestinal disorders such as colic and stomachaches. Malaria and in fever. China (AS) Root Sore throats, venomous snakebites, and tuberculosis. USA & Mexican West (NA) n.a. Same as with other species and is additionally used as a rattlesnake antidote. To provide energy. Camporese et al. (2003) Lans (2007a) Lans (2007b) Quinlan et al. (2002) Milliken (1997) Milliken (1997) Ayensu (1981) Morton (1981) Morton (1981) Morton (1981) Morton (1981) Coe and Anderson (2005) Longuefosse and Nossin (1996) Quinlan et al. (2002) Sosa et al. (2002) Millspaugh (1887) LachmanWhite et al. (1987) Vigneron et al. (2005) Ruffa et al. (2002) Millspaugh (1887) Vigneron et al. (2005) Morton (1981) Milliken (1997) Wu et al. (2004) Kay (1996) Author's personal copy 139 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia vitiensis A.C. Smith W.A. Sou Aristolochia watsonii Wooton & Standl Fiji (AU) n.a. Not stated. USA, W. Arizona to W. Texas (NA) Root Aristolochia westlandii Hemsley Vietnam (AS) n.a. Used by individuals who have been ill for a long period of time, those with fevers and those suffering from hypertension since it decreases vasoconstriction as well as for dry mouths by increasing the amount of saliva being produced. Other benificial uses are to improve meatbolism of amino acids and proteins and is additionally used for the immune system by increasing phagocytosis. Oedema because of its diuretic properties and also for dysuria. Parham (1943) Moore (1989) Aristolochia westlandii Hemsley Taiwan, Kwang hung & Kwangsi (AS) China (AS) n.a. Swollen feet, an itch and rashes. Root Aristolochia westlandii Hemsley Japan & N. China (AS) Root Aristolochia westlandii Hemsley Vietnam (AS) Root Aristolochia wrightii Seem Resin Root Fevers. Kay (1996) Aristolochia yunnanensis Franch Mexico, Tarahumara (CA) Mexico, Tarahumara (CA) China (AS) To promote urine, to cure oedema and acting as an expelling agent for swelling. Can also be used for jaundice. Various skin complaints such as rashes and itches. Is also used in ‘beri-beri aches’, numbness and in the treatment of swollen feet. Acts as a diuretic and is prescribed to patients in the treatment of oedema and dysuria. Stomach complaints. Root Aristolochia zollingeriana Miq. China (AS) Fruit, root Aristolochia zoellingeriana Miq. (Aristolochia kankauensis Sasaki) Aristolochia sp. Taiwan (AS) Fruits, roots Treatment of gastrointestinal diseases, trichomoniasis, and various pains. Expectorant, painkiller, antitussive, antiasthmatic, and analgesic; treatment of snakebite Expectorant, antitussive, analgesic and antiasthmatic. Wu et al. (2004) Wu et al. (2004) Wu et al. (2004) Amazona (SA) n.a. Snakebites and scorpian stings. Aristolochia sp. Ecuador (SA) Plant Stomachache. Aristolochia sp. USA & Mexican West (NA) USA & Mexican West (NA) USA, Appalachia (NA) Root In the treatment of wounds and ulcers. Schultes and Raffauf (1990) Schultes and Raffauf (1990) Kay (1996) Herb and root Root Toothaches. Kay (1996) Bolyard (1981) Aristolochia sp. China (AS) Stem Aristolochia sp. Egypt (AF) n.a. Used medicinally for many purposes and which includes as a tonic, as a diaphoertic and a diuretic. Other uses as an alexipharmic and also as a stimulant. It may also be given in the treatment of epidemic diseases and various types of fevers such as typhus fever and other malignant fevers. Additionally, it is used as an anodyne, an aromatic, in chorosis, pneumonia, vomitting, as a renal torpus, for croup, dyspepsia, antispasmodic and emmenagogue. Used by women after giving birth for the treatment of puffy swelling and can be given to help supress a cough and acts as an carminative. Used to treat women when in confinement. Aristolochia sp. Brazil, N.E. (SA) Aerial parts Erysipela. Aristolochia sp. Israel (AS) Vomiting. Aristolochia sp. Guyana (SA) Stem and root Stem Aristolochia sp. Ottoman al-Sham. (historical use) (SA) n.a. Aristolochia sp. Mexico, Oaxaca (CA) Mexico to western Panama (CA) Root and aerial parts n.a. Used in animal bites and for poison, used for various internal diseases and in inflammation and heat as well as for pain. It is also useful for teeth and where there are wounds and burns as well as hemorrhoids and for sexual diseases. Male and female genito-urinary problems. Root Aristolochia sp. Argentina, N.W. (SA) Brazil (SA) Leaf Aristolochia sp. Brazil, S.E. (SA) n.a. Aristolochia westlandii Hemsley Aristolochia wrightii Seem Aristolochia sp. Aristolochia sp. Aristolochia sp. Aristolochia sp. In respiratory diseases and treating coughs. Analgesic and for the stomach complaints. It can be given for female complaints and menstrual pain. Can also be used as a contraceptive. Inability to urinate, for presence of blood in urine, against hepatic affections and vagnal mycosis. Nausea and vomitting and other stomach complaints. Also used in hepatic problems. Used for many purposes which includes diuretic, to aid in sleeping, as a sedative, stomachic, an antiseptic to help fight bacteria, diaphoretic and emmenagogue and against asthma, fever, pruritus and eczemas Padua et al. (1999) Perry and Metzger (1980) Ling (1995) Wee (1990) Duong (1993) Kay (1996) Wiseman and Ye (1998) Schauenberg (1977) Albuquerque et al. (2007) Lev and Amar (2006) Mohagheghzadeh et al. (2006) Lev (2002) Frei et al. (1998) Lans (2007a) Hilgert (2001) Di Stasi et al. (2002) Oliveira et al. (2007) Author's personal copy 140 M. Heinrich et al. / Journal of Ethnopharmacology 125 (2009) 108–144 Appendix A (Continued ) Species (name given in orignal sources) Country (continent) Part used Illnesses/conditions treated and other relevant uses reported Source Aristolochia sp. Argentina, Calchaquí Valley Salta (SA) Israel (AS) Stem To treat pains around the waist region. Martínez et al. (2004) Used by women in the treatment of dysmenorrhoea as well as in the treamtment of hard swellings, dysuria and wind warts. Boils and in hard inflammation. Lev (2007) Mexico, Teenek Tsabaal (CA) n.a. (n.a.) Stem and root Leaf n.a. Gets rid of birth and afterbirth. Andes (SA) n.a. Used as an amulet as well as in various treatments. Treatment examples includes paralysis, rheumatism and gout. Other uses are in headaches and dizziness as well as for swollen feet. Can also be used in problems relating to the respiratory system such as for sinus, throat infections and tonsillitis. Culpeper (1995) Bastian (1987) Aristolochia sp. Aristolochia sp. Aristolochia sp. (‘Long species’) Aristolochia pragantissimi (nom. illeg.) (possibly Aristolochia fragrantissima) Alcorn (1984) Abbreviations used in the appendix: AF: Africa; AS: Asia; AU: Australia; CA: Central America and Mexico; EU: Europe; n.a.: (data) not available; NA: North America; SA: South America. (1) It is suggested that this is Aristolochia albida and not Aristolochia acuminata, as Aristolochia acuminata does not occur on Madagascar, see deGroot et al. (2006). (2) Originally reported as Aristolochia tagala and here listed under Aristolochia acuminata. (3) Aristolochia baetica is only known from Spain, Portugal, Morocco. The reference might be to Aristolochia clematitis as a cultivar. (4) Not known from China. It can not be established what species the authors might refer to. (5) Two totally different species. (6) Name does not exist, from Nigeria only Aristolochia bracteolata and Aristolochia albida are known, might also refer to a Pararistolochia species. (7) Does not occur in N. America but in Algeria, may be different species. (8) Does not occur in Iran but only in Algeria, may be different species. (9) Does not occur in north temperate Europe but in Algeria, possibly a commercial product or a different species. (10) Sp. does not occur in India may be mixed up with similar species from Asia. (11) May be misidentified and is Aristolochia clematitis instead. (12) Not known to occur naturally here, only known to be present in USA. (13) Neither known in the wild nor as a cultivated plants in Iran. (14) Not known from Egypt or refers to one of the two species occurring in Egypt (Aristolochia maurorum, Aristolochia bracteoloata). (15) A Mediterranean species not known from Colombia. (16) Only known from Mexico and not from the Philippines. (17) Only known from N. America. (18) Only known from Asia. References Abubakar, M.S., Musa, A.M., Ahmed, A., Hussaini, I.M., 2007. 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