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Boneset

Scientific Name(s): Eupatorium perfoliatum L. Family: Asteraceae (daisies)

Common Name(s): Boneset , thoroughwort , vegetable antimony , feverwort , agueweed , Indian sage , sweating plant , eupatorium , crosswort , thoroughstem , thoroughwax , wild Isaac

Uses

Boneset has chiefly been used to treat fevers.

Dosing

There is no recent clinical evidence to guide dosage of boneset. Traditional use was at a dose of 2 g of leaves and flowers. Internal use should be tempered by the occurrence of hepatotoxic pyrrolizidine alkaloids in this plant.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Documented adverse effects, including cytotoxic constituents. Avoid use.

Interactions

None well documented.

Adverse Reactions

The FDA has classified boneset as an “Herb of Undefined Safety.”

Toxicology

The ingestion of large amounts of teas or extracts may result in severe diarrhea. The identification of pyrrolizidine alkaloids in related Eupatorium species is cause for concern until detailed phytochemical investigations are carried out on boneset. This class of alkaloids is known to cause hepatic impairment after long-term ingestion. While direct evidence for a hepatotoxic effect from boneset does not exist, there is sufficient evidence to indicate that any plant containing unsaturated pyrrolizidine alkaloids should not be ingested.

Botany

Boneset is a ubiquitous plant found growing in swamps, marshes, and shores from Canada to Florida and west to Texas and Nebraska. The plant is easily recognized by its long, tapering leaves that join each other around a single stout stem giving the impression of one long leaf pierced at the center by the stem. Hence its name perfolia, meaning “through the leaves.” The plant grows from July to October to a height of about 1 meter. It flowers in late summer with white blossoms that appear in small upright bunches. The entire plant is hairy and light green.

History

Boneset has been used as a charm and as a medicinal remedy for centuries by indigenous North Americans. As a charm, the root fibers were applied to hunting whistles with the belief that they would increase the whistle's ability to call deer. As an herbal remedy, American Indians used boneset as an antipyretic. 1 The early settlers used the plant to treat rheumatism, dropsy, dengue fever, malaria, pneumonia, and influenza. The name boneset was derived from the plant's use in the treatment of breakbone fever, a term describing the high fever that often accompanies influenza. 2 Boneset was official in the US Pharmacopeia from 1820 to 1900.

Chemistry

Boneset leaves and roots contain a variety of sesquiterpene lactones 3 , 4 as well as a number of sterols and triterpenes, including sitosterol and stigmasterol. 5 The flavonoids quercetin, kaempferol, and eupatorin and their glycosides also have been identified in the plant. 6 , 7 Boneset has not been shown to definitively contain alkaloids; however, 2 of 7 samples screened in 1 program tested positive. 8 A number of related species of Eupatorium have been shown to contain unsaturated pyrrolizidine alkaloids of the type that can cause serious liver damage. 9 More recently, acidic polysaccharides containing principally xylose and glucuronic acid have been elucidated. 10

Uses and Pharmacology

Based on data from early medical compendia, boneset is believed to have diuretic and laxative properties in small doses, while large doses may result in emesis and catharsis. 7 The “usual” dose of boneset was the equivalent of 2 to 4 g of plant administered as a fluid extract. When used as a household remedy, the plant has been taken as a tea ranging in concentration from 2 teaspoonfuls to 2 tablespoonfuls of crushed dried leaves and flowering tops steeped in a cup to a pint of boiling water. Boneset had been used by physicians to treat fever, but its use was supplanted by safer and more effective antipyretics. It is not known which components of boneset reduce fever or how effective the plant is as an antipyretic.

An ethanolic extract of the aboveground parts of the plant was found inactive in a carrageenan-induced rat paw model of inflammation. 11 The isolated polysaccharides and an extract of E. perfoliatum combined with other herbs have been shown to stimulate phagocytic activity in vitro by a carbon particle clearance technique. 12 , 13

Animal data

Research reveals no animal data regarding the use of boneset.

Clinical data

Compared with aspirin, a small double-blind clinical trial of a homeopathic preparation of boneset (N = 53) found the herbal treatment as effective in reducing symptoms of the common cold. 14 The ethanol extract of boneset leaves was shown to have modest antibacterial and cytotoxic activity; however, no fractionation to identify the constituents responsible for the activity was reported. 15

Dosage

There is no recent clinical evidence to guide dosage of boneset. Traditional use was at a dose of 2 g of leaves and flowers. Internal use should be tempered by the occurrence of hepatotoxic pyrrolizidine alkaloids in this plant.

Pregnancy/Lactation

Documented adverse effects, including cytotoxic constituents. 16 Avoid use.

Interactions

None well documented.

Adverse Reactions

Although few reports of adverse effects have been reported with the use of boneset, the FDA has classified this plant as an “Herb of Undefined Safety.”

Toxicology

The ingestion of large amounts of teas or extracts may result in severe diarrhea. The identification of pyrrolizidine alkaloids in related Eupatorium species is cause for concern until detailed phytochemical investigations are carried out on boneset. This class of alkaloids is known to cause hepatic impairment after long-term ingestion. While direct evidence for a hepatotoxic effect from boneset does not exist, there is sufficient evidence to indicate that any plant containing unsaturated pyrrolizidine alkaloids should not be ingested.

Bibliography

1. Erichsen-Brown C. Medicinal and Other Uses of North American Plants: A Historical Survey with Special Reference to the Eastern Indian Tribes . NY: Dover Press; 1989:262-264.
2. Bolyard JL. Medicinal Plants and Home Remedies of Appalachia . Springfield, IL: Thomas; 1981:59-60.
3. Bohlmann F, Mahanta PK, Suwita A, et al. Neue sesquiterpenelactone und andere inhaltstoffe aus vertretern der Eupatorium -gruppe. Phytochemistry . 1977;16:1973-1981.
4. Herz W, Kalyanaraman PS, Ramakrishnan G. Sesquiterpene lactones of Eupatorium perfoliatum . J Org Chem . 1977;42:2264-2271.
5. DomInguez XA, Gonzalez Quintanilla JA, Rojas P. Sterols and triterpenes from Eupatorium perfoliatum . Phytochemistry . 1974;13:673-674.
6. Wagner H, Iyengar MA, Hörhammer L. Flavonol-3-glucosides in eight Eupatorium species. Phytochemistry . 1972;11:1504-1505.
7. Herz W, Gibaja S, Bhat SV, Srinivasan A. Dihydroflavonols and other flavonoids of Eupatorium species. Phytochemistry . 1972;11:2859-2863.
8. Raffauf RF. Plant Alkaloids: A Guide to Their Discovery and Distribution . NY: Food Products Press; 1996:49-57.
9. Locock RA, Beal JL, Doskotch RW. Alkaloid constituents of Eupatorium serotinum . Lloydia . 1966;29:201-205.
10. Vollmar A, Schafer W, Wagner H. Immunologically active polysaccharides of Eupatorium cannabinum and Eupatorium perfoliatum . Phytochemistry . 1986;25:377-381.
11. Benoit PS, Fong HH, Svoboda GH, Farnsworth NR. Biological and phytochemical evaluation of plants. XIV. Antiinflammatory evaluation of 163 species of plants. Lloydia . 1976;39:160-171.
12. Wagner H, Proksch A, Riess-Maurer I, et al. Immunostimulating action of polysaccharides (heteroglycans) from higher plants [in German]. Arzneimittelforschung . 1985;35:1069-1075.
13. Wagner H, Jurcic K. Immunologic studies of plant combination preparations. In-vitro and in- vivo studies on the stimulation of phagocytosis [in German]. Arzneimittelforschung . 1991;41:1072-1076.
14. Gassinger CA, Wunstel G, Netter P. A controlled clinical trial for testing the efficacy of the homeopathic drug Eupatorium perfoliatum D2 in the treatment of common cold [in German]. Arzneimittelforschung . 1981;31:732-736.
15. Habtemariam S, Macpherson AM. Cytotoxicity and antibacterial activity of ethanol extract from leaves of a herbal drug, boneset ( Eupatorium perfoliatum ). Phytother Res . 2000;14:575-577.
16. Newall CA, Anderson LA, Phillipson JD, eds. Herbal Medicines: A Guide for Health-Care Professionals . London: Pharmaceutical Press; 1996.

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