Bethroot

Scientific Name(s): Trillium erectum L. Family: Liliaceae. T. grandiflorum (Michaux) Salisb. has been used medicinally in traditional American medicine.

Common Name(s): Bethroot , trillium , birthroot , Indian balm , purple trillium , stinking Benjamin , wake-robin , trillium pendulum , ground lily , cough root , jewsharp , snake bite . 1 , 2

Uses

Although there are no studies to support these uses, trillium has been used to stop postpartum bleeding and it also may play a role in the topical control of bleeding and relief from insect bites.

Dosing

There is no recent clinical evidence to guide dosage of trillium. Classical use of trillium called for 2 to 4 g of the root given as an infusion.

Contraindications

Contraindications have not yet been determined.

Pregnancy/Lactation

Documented adverse effects (emmenagogue and uterine stimulant). Avoid use.

Interactions

None well documented.

Adverse Reactions

Although not yet clinically observed, trillium could have potential membrane-irritating effects and induce some cardiac activity.

Toxicology

Although the leaves of the plant have been considered to be edible by some, there remains the possibility of toxicity from the plant.

Botany

T. erectum is a low-growing perennial that reaches a height of 40 to 45 cm and is native to North America. It has 3 dark green diamond-shaped leaves, each about 18 cm long. From April to June it produces a solitary, odiferous, yellow to reddish-brown flower. The unpleasant smell is the reason for the name stinking Benjamin. T. erectum produces only 1 fruit per plant. 3 , 4

History

Various trillium species have been used by American Indians to treat gynecological conditions including irregular menstrual periods, menstrual pain, excessive vaginal discharge, and to aid childbirth (hence the name birthroot), as well as for diarrhea and as an expectorant. Topical preparations were used to relieve insect bites and skin irritations. T. erectum is a popular folk remedy for bleeding, snakebites, and skin irritations. The leaves have been used as a potherb or salad green. 3

Chemistry

Review of the scientific literature reveals little to no data about the chemistry of this plant. Tertiary literature documents trillium species containing a fixed and volatile oil, a saponin (trillarin, which is a diglycoside of diosgenin), a glycoside resembling convallamarin, tannic acid, a resin, and considerable starch. 3 , 5 , 6

Uses and Pharmacology

There is limited pharmacological data in the scientific literature on T. erectum . Review of tertiary literature suggests the medicinal component of the plant is the rhizome. Although trillium has been used for many years as an herbal means of controlling postpartum bleeding as well as other uterine bleeding problems, a clear mechanism for this systemic effect has not been identified. 1 , 7 The plant may have astringent properties that account for its ability to limit topical bleeding and irritation. This action also was the basis for its historic use in diarrhea. 2 , 7 No chemical basis has been identified for its traditional use as an expectorant. There is no evidence to support the use of trillium for the treatment of snoring.

The saponin glycosides have been shown to have antifungal activity. 6

Animal/Clinical data

Research reveals no animal or clinical data regarding the use of trillium for any condition.

Dosage

There is no recent clinical evidence to guide dosage of trillium. Classical use of trillium called for 2 to 4 g of the root given as an infusion. 8

Pregnancy/Lactation

Documented adverse effects (emmenagogue and uterine stimulant). Avoid use. 4

Interactions

None well documented.

Adverse Reactions

Although not yet clinically observed, trillium could have potential membrane-irritating effects and induce some cardiac activity.

Toxicology

Although the leaves of the plant have been considered to be edible, there remains the possibility of toxicity from the plant. The saponin could have potential membrane-irritating effects and the convallamarin-like glycoside could induce some cardiac activity, although neither of these events have been observed clinically. 5

Bibliography

1. Dobelis IN, ed. Magic and Medicine of Plants . Pleasantville, NY: Reader's Digest Association, 1986.
2. Meyer JE. The Herbalist . Hammond, IN: Hammond Book Co., 1934.
3. Chevallier A. The Encyclopedia of Medicinal Plants . New York, NY: DK Publishing Inc.; 1996.
4. Lapointe L. Fruit development in trillium. Plant Physiol . 1998;117:183-188.
5. Spoerke DG, Jr. Herbal Medications . Santa Barbara, CA: Woodbridge Press; 1980
6. Hufford CD, Liu SC, Clark AM. Antifungal activity of Trillium grandiflorum constituents. J Nat Prod . 1988;51:94-98.
7. Osol A, Farrar GE Jr, eds. The Dispensatory of the United States of America . 25th ed. Philadelphia, PA: J.B. Lippincott; 1955.
8. PDR for Herbal Medicines . Montvale, NJ; Thomson Healthcare, 2000.

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