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Aesculus spp.

Medical Herbalism 9(4):1,21-22

We continue or series of reprints of commentary on materia medica by William E. Bloyer, professor of Materia Medica at the Eclectic Institute in Cincinnatti during the late 1800s and early 1900s. In this issue Bloyer describes the two species of Aesculus, a common remedy for hemorrhoids and varicose veins. Bloyer expands on that picture, showing possible uses in liver, gynecological, and respiratory conditions.

Aesculus hippocastanum - Horse Chestnut

The fruit is the part used in the preparation of the specific medicine.  Commercial fluid extracts are usually prepared from the bark.  The dose of the specific medicine is a teaspoonful every one to three hours, of a dilution of from ten drops to half a drachm to four ounces of water.

Aesculus hippo. Has been variously classified.  It is described as a tonic, an astringent, a febrifuge, a varcotic, an antispasmodic, etc., etc.  Eclectically, or specifically if you prefer the term, it may be said to be a remedy in any disease in which general malaise, soreness, and fullness of the blood vessels are the prominent symptoms — symptoms due to capillary stasis or congestion.  All agree that it acts specifically upon the portal circulation, and relieves to a certainty conditions depending upon hepatic engorgement.  It is a remedy for uneasiness or fullness and aching in the region of the liver, and especially so if there be a throbbing sensation.

Aesculus hippo. is unanimously a remedy for hemorrhoids and rectal irritation of a congestive type.  There is a sense of uneasiness, more or less aching or burning pain; of heat, itching, constriction, as if a foreign body were present.  The hemorrhoids, in an aesculus case, are usually large and purple; they rarely bleed; there may be present a diarrhoea, with frequent and free evacuations; or with a sense of fullness, there may be dryness, or even a spasmodic stricture of the rectum, causing a veritable proctitis, or a rectal neuralgia.  The reflex disturbances due to these rectal troubles, such as headache, backache, dyspepsia of various sorts, and peculiar asthmatic disturbances, are all overcome by the persistent use of Aesculus hippocastanum.

Aesculus hippo. is also an efficient remedy in many of the neuralgias of the internal viscera, and in many of the disturbances of the nervous system.  This is especially so when the condition of plethora and fullness above referred to is present. It is a remedy (and is said to have a specific action upon the uterine cervix, as well as upon the liver and rectum) in cervicitis and in endo-cervicitis.

It is also recommended as an efficient remedy in throat diseases of the follicular variety; but we have had no experience in this use of the remedy.  Older writers recommend it as an antiperiodic; but we have so many remedies that are far superior to it, that we do not endorse this use of it.  It should be borne in mind that it is not a remedy for active inflammatory states, but for stasis,  engorgement, congestion.    W.E.B.
 

Aesculus glabra — Buckeye

Prof. Scudder said that it was likely that this remedy was studied because of the fact that persons who carried buckeyes in their pockets were cured of piles, rheumatism, etc. whether such cures were real or imaginary, the fact is before us that buckeye is an active poison, and in overdoses will cause vertigo, blindness, wry-neck, fixed eyes, paralysis, and even convulsions. If large doses act so severely, it is reasonable to suppose that smaller doses could produce beneficial results in certain conditions.

Like in the horse-chestnut [A.hippocastanum] the fruit of the buckeye is used to make specific medicines, while commercial fluid extracts are usually prepared from the bark of the tree. The dose of the specific medicine is a teaspoonful every one to three hours of a dilution of from one to two drachms in four fluid ounces of water.

Aesculus glabra has a greater or less action upon the nervous system. It markedly influences the pneumogastric , and through it modifies asthmatic attacks that are not of the spasmodic or paroxysmal variety or type. It relieves some cases of cough, of rheumatism, of phthisis, and or paralysis. These cases all have marked precordial oppression, tightness of the chest, etc.

It is said, also, to have a certainty of action upon the circulation. In our opinion, it is not so active in this respect as is its cogener Aesculus hippocastanum. However, with this action in view it is prescribed with confidence in diseases of the liver and disturbances of the portal circulation. It relieves hepatic congestion and promotes the secretion of bile.

It, therefore, becomes an efficient remedy in certain forms of constipation and in cases of intestinal dyspepsia characterized by a lack of bile, and attended by many colicky pains about the umbilicus. It is efficient also as a pile persuader. The stimulation of the hepatic or portal circulation relieves the engorged hemorrhoidal veins, and relief, if not cure, follows. For this special use many prefer the horse chestnut.

The fullness of tissues, the engorged or congested tumid uterus, and the consequent too free and too frequent menstruation — menorrhagia — are relieved by the persevering use of Aesculus glabra. We are of the opinion that in both of these varieties of aesculus we have remedies that are as yet unworked or undeveloped.

Commentary

Medical writers of the last century universally state that A. hippocastanum is less toxic than the American relative A. glabra, a statement supported by the fact that A. glabra is toxic to grazing animals, while A. hippocastanum is used in Europe to fatten animals. The difference apparently is not enough to change the dose, with the dosages for both plants being in the range from a fraction of a drop to 10 drops. Drop fractions were acheived by adding a small amount of the medicine to four ounces of  water, and taking teaspoon doses of the resulting dilution. Doses for tinctures made from the bark, rather than the fruit itself, were much higher, up to a teaspoonful 4-6 times per day (Felter and Lloyd).
 

The bark is generally not available in contemporary commerce. A. hippo. And A. glabra are both available as tinctures, and are used interchangeable, usually as a small part of a larger formula for hemorrhoids or varicose veins. A. hippocastanum or its constituent aescin are used in standard practice medicine in Germany and Italy for various venous problems, in the form of suppositories, ointments, and also internally. Several dozen scientific articles investigating the clinical properties or mechanism of action appear on the National Library of Medicine’s MEDLINE database. For a recent  review, see the article by Greeske and Pohlman. A. hippocastanum is an approved medicine in Germany, with a monography from the Commission E. The monograph recommends a dose of standardized extract that delivers 100 mg of the constituent aescin per day. Possible side effects listed in the monograph  include nausea, gastric symptoms, and itching.

References

Bloyer WE. Eclectic Medical Journal. 1898;LVI(8):375-376

Greeske K, Pohlmann BK. Horse chestnut seed extract—an effective therapy principle in general practice. Drug therapy of chronic venous insufficiency. Fortschr Med 1996 May 30;114(15):196-200 [German language]

Felter H and Lloyd JU. King’s American Dispensatory. Portland, Oregon: Eclectic Medical Publications, 1986. Reprinted from 1898 original.
  Copyright 2001 Paul Bergner