Bergner, P. Antiviral Botanicals in Herbal Medicine. Medical Herbalism (Spring 2005)14()!1"12.

#op$rig%t 2005, Pa&l Bergner

Antiviral Botanicals in Herbal Medicine
b$ Pa&l Bergner
Abstract: The human organism is an ecological domain naturally inhabited by microorganisms including
bacteria, fungi, and virus. The majority of viruses known to infect humans cause no symptoms or known disease.
The organism possesses multiple mechanisms of host defense to maintain ecological balance in the presence of
viruses. Except for the occasional use of herbal medicines as topical agents in viral infections of the skin, plant
medicines probably do not exhibit direct virucidal properties within the organism. Many plants have been used
traditionally to enhance host resistance to viral infection, and recent advances in immunology have uncovered
possible novel mechanisms for their action. These include effects on TH!"TH# balance, on expression of heat
shock protein, and interaction with tolllike receptors. These mechanisms are reviewed, along with the effect on
them of various lifestyle factors. $ variety of effects of the following plants on the viral lifecycle or antiviral
host defenses are discussed% Allium sativum; Astragalus spp; Calendula officinalis; Chamomilla recutita;
Curcuma longa; Echinacea spp; Eleutherococcus senticosus; Eupatorium spp; Ganoderma lucidum;
Glycyrrhiza glabra; Ligusticum spp; Lomatium dissectum; Melissa officinalis; Paeonia spp; Panax ginseng;
Platycodon grandiflorum; ambucus spp!; aussurea spp!; chisandra chinensis!
Introduction
&iral organisms are 'obligate host cell parasites( ) small pieces of genetic material packaged in various ways
that must infect and take over the processes of a living cell in order to reproduce. &iruses are ubi*uitous in both
the plant and animal kingdoms. Their forms, genetic content, and patterns of infection and replication are
radically varied. +ome produce symptoms of various wellknown diseases in humans, such as influen,a, herpes,
warts, chicken pox, smallpox, and so on. The majority of viruses known to infect humans, however, produce no
visible effects at all, and viruses must be viewed as natural components of the human ecology, as natural as
bacteria on the skin or in the gut. &iral infection in the human organism is opposed by sophisticated host
response mechanisms, including nonspecific immune defenses, humoral and cellmediated immunity. -on
specific immunity includes the activity of complement system chemicals, of macrophages and dendritic cells,
and the expression of heatshock proteins.
The term 'antiviral( is commonly applied to medicinal herbs by practitioners, but the term is imprecise. $s an
empirical term, 'antiviral( means 'an herb used for viral infections( and many herbs are known in herbal
traditions to be effective for various types of viral disease, for prevention or for acute or chronic infection.
.nfortunately the term implies that all such herbs or their constituents somehow kill viruses directly, rather than
enhancing host response. The term as commonly used also implies that the herb has some sort of universal
activity, and that an antiviral herb good for one condition will automatically be of benefit in others. +uch action,
if it could be demonstrated, should designated virucidal.
Virucidal action
The usual measure of virucidal activity of herbal medicines or other agents is to incubate the virus with a host
cell in a lab dish, and to measure the effect of the herb or constituent on viral replication. $ number of herbal
medicines or their constituents have been studied and found effective in their activity against viral"hostcell
colonies in the lab dish. /n some cases, the mechanism of inhibition ) the point at which the substance interferes
with the viral life cycle ) is identified, but usually not. +uch research does little to predict the activity or the herb
when taken orally in the human body, a radically different ecological system than the lab dish. $ssimilation and
distribution of the antiviral constituents of a plant must occur, with delivery to the specific cell host in sufficient
*uantities in the surrounding extracellular fluid. / have been unable to identify any line of research of herbal
medicines or their constituents which demonstrates an inhibition of viral replication in vitro, and then
demonstrates that similar levels of the substance is possible in the blood, and in fact inhibits viral replication in
the body. $ problem with this type of research is that even if an herb or constituent inhibits virus in vitro, and
even if similar levels were attainable without drastic side effects in vivo, the herb or its other constituents may
also have effects to enhance host resistance, and the actual mechanism in the human being may never be proven.
Hypericum
The herbal world was understandably excited in !011 when an animal trial appeared which indicated that
hypericum, and specifically its constituent hypericin, might be active against the H/& virus. The article
suggested that hypericin had potent antiH/& activities at doses that were completely nontoxic 2Meruelo et al.3
+ubse*uently it has been established that hypericin is active against a subset of viruses called enveloped viruses,
but not against other types of virus 2Tang et al.3 This raised speculation that it might be clinically effective
against H/&, hepatitis4 virus, influen,a$, herpessimplex 2H+&3, and many others.
+ubse*uently, a clinical trial of intravenous hypericun in H/& infecte patients showed almost universal
phototoxicity at doses that were completely ineffective against the virus, according to several methods of
detection 25ulick3. +imilarly, patients treated with hypericin for hepatitis 4 2H4&3 infection demonstrated a
high rate of phototoxicity, and no detectable effect on the virus 26acobson3. /t was later found that hypericin only
exhibited its antiviral properties when exposed to light 27ope,8a,,occhi3, which is unlikely to occur in the
human body. $nd later trials of the pharmacokinetics of hypericin in typical oral antidepressant doses showed
that the blood levels acheived were on the order of !"!999 of the levels that showed antiviral activities invitro
2:erb et al.3 The case of hypericin and its invitro virucidal properties may be viewed as an archetype for a large
amount of misinformation and misconception among contemporary herbalists in -orth $merica. /n the case of
hypericum, following the original invitro and mouse trials of hypericin, herbalist, herb companies, authors, and
others began to state that hypericum had antiviral properties, implying clinical properties. Even after the failed
clinical trials, hypericum is still listed in most herbals as an antiviral herb, and the herb student is likely to be
misguided in the appropriate clinical use of the herb.
$s a further example, an elderberry "ambucus nigra# syrup has been shown in clinical trials to be active against
influen,a infection, and its constituents have been shown to be active against !9 different strains of influen,a
virus in the lab dish 2;akay<ones, !00=3 The same researchers found that the syrup resulted in higher host
immune response to the influen,a virus> other authors have demonstrated that +ambucus products have a general
immune enhancing effect 28arak et al. #99#> 8arak et al #99!3. $ strengthening of the host resistance, rather
than a virucidal action is more likely in light of the historical use of +ambucus in acute febrile illness of many
types, not just viral illnesses, and also as an alterative in chronic systemic illness. $ny specific virucidal or virus
inhibiting action in the human remains to be demonstrated.
+imilarly, glycyrrhi,in from 7icorice root has be shown clinically to reduce viral infection in hepatitis 4
infection 2van <ossum #99!> van <ossum !0003, viral encephalitis 2+eki,awa3, and influen,a 2.tsunomiya3,
with numerous trials showing an inhibition of the viral cycle in vitro. However, it has also been shown to
stimulate interferongamma production from T4ells 2.tsunomiya3. $t this time it is impossible to say whether
its clinical effects are due to specific viral inhibition or to general strengthening of the host response to viral
infection.
/n vitro research into the antiviral properties of plants demonstrates that plants may inhibit one type of virus, but
have no activity against most others. /n one trial of !99 medicinal plants from 8ritish 4olumbia, researchers
identified twelve plants with antiviral properties at doses that were not toxic to the cells in the lab dish. These
plants were tested against seven different viruses, and most were active against one of the seven, but not the
other six. ?or instance, of the twelve antiviral plants, only two 2+ambucus and @plopanax3 were active against
respiratory syncytial virus, one "$pomopsis aggregata# was active against parainfluen,a. @ne plant best known
for its empirical activity in influen,a "Lomatium dissectum# had no activity against parainfluen,a virus,
suggesting that it acts through effects on host resistance in clinical influen,a 2Mc4utcheon3.
Heat-shock proteins
@ne recent area of research in immunity may explain the action of herbal medicines to protect against viral
infection. Heatshock proteins 2H+A3 are produced in abundance within the cell in response to various stressors.
+ee the review by Belch for a historical overview of the research and some specific roles of these proteins. Heat
shock proteins greatly enhance the efficiency of intracellular protein manufacture and transport and may enhance
immunity against viruses by improving immune surveillance of virally infected cells. The H+A expression is
enhanced by extremes of hot or cold, either locally or systemically, by exercise, and by viral infection, and by
various other forms of stress. Their expression may be one of the mechanisms to explain the beneficial effect of
fever therapy on immunity against chronic viral or spirochete infection, as well as various methods of alternating
hot and cold, locally or systemically, in hydrotherapy. Elevated serum glucose or insulin inhibit the H+A
response ) sports drinks inhibit the normal effect of exercise on H+A 2?ebbraio3 C which may in part explain
the decreased immune response after ingestion of various sugars, and chronic immune problems in Type //
diabetes.
$ number of herbs or their chief constituents have been observed to induce or to facilitate H+A response, and
such herbs may strengthen the systemic response to viral infection. $ll have been traditionally use as tonics,
adaptogens, or immunomodulators. They include% Allium savitum 2+umioka3, Curcuma longa 2Dunsmore>
8atth3, chisandra chinensis 24hiu3, Glycyrrhiza spp! 2Ean3, Paeonia spp! 2Ean3, and the 4hinese medicinal
herbs Panax notoginseng 2Eao3, Platycodon grandiflorum 27ee3 and aussurea lappa 2Matsuda3.
Toll-like receptors
.ntil very recent years, the nonspecific side of the immune system, characteri,ed by tissue macrophages,
dendritic cells, and complement system has been viewed as the poorcousin of the specific immunity produced
by the humoral and cellmediated systems. /t was thought that nonspecific immunity was primarily a local
immune response, and that the specific immunity, characteri,ed by 84ell and T4ells must be directly activated
to elicit a systemic response. The recent discovery of the role of toll%li&e receptors 2T7<3 in macrophages and
dendritic cells has shown that these nonspecific defense cells can also initiate a systemic response by
previously unknown pathways. The various types of speciali,ed T7<, which are present on the membranes and
nuclear membranes of the immune cells, detect specific chemicals that are characteristic of specific types of
organisms, such as virus, gramnegative and grampositive bacteria, and fungi. <esearch shows that some
polysaccharides from medicinal plants can trigger the expression and activity of the some T7<, and plants
containing polysaccharides may assist in the initiation of system wide enhanced immune surveillance.
Alants or plantderived polysaccharides which have been shown to initiate or enhance T7< response and
immune activation are% Astragalus membranaceus 2+hao et al> #99Fb3, Ganoderma lucidum 2+hao et al, #99Fa3,
Panax ginseng 2-akaya> Augh3 Panax 'uin'uefolius 2Augh3, Echinacea angustifolia and purpurea 2Augh3,
Eleutherococcus senticosus 2Han3, and the 4hinese herb Platycodon grandiflorum 2Eoon3! Aolysaccharides from
Eupatorium perfoliatum, Chamomilla recutita( Calendula officinalis( and )aptisia tinctoria, have been shown to
increase phagocytosis 2Bagner3, but specific connections to T7< have not been identified. -ote that
polysaccharides are insoluble in alcohol, and are not present in tinctures with greater than about G=H alcohol.
These plants must be taken as powders, infusions, or decoctions for these effects on T7< to occur.
TH-1/TH-2 Balance
The THelper 2TH3 cells are like the '*uarterbacks( of the specific immune system, and they coordinate the
escalation of both the humoral 2antibody3 and cellmediated 2macrophages, Tkiller cells3 responses. The TH
cells may be undifferentiated, or may differentiate into TH! cells, favoring cellmediated immunity, or TH#
cells, favoring antibody production. The composition of the TH pool of cells may become unbalanced, favoring
one side of the immune e*uation over the other. $ common dysregulation that can lead to viral overload is a
dominance of TH# cells. /n this case, many antibodies are produced which can tag the virus and other antigens,
but the cells to actually clear the antigens are deficient. This condition has been demonstrated in many cases of
chronic fatigue and accompanying chronic viral infection, such as Epstein8arr virus. ?or a complete review, see
:idd.
+ome proven causes of Th# dominant imbalance are% certain immuni,ations, depletion of the cellproduced
antioxidant glutathione, corticosteroid drugs or stressinduced endogenous cortisol excess with corresponding
DHE$ deficiency. Herbal medicines may be used to help restore the TH!"TH# balance, but evidence for
consistent effects on either system in humans is scarce, and it is difficult to predict clinical effects from the
suggestive invitro and invivo evidence that exists. The five herbal medicines with some evidence of being to
restore balance in a TH# dominant system are Allium sativum( Astragalus membranaceus( Ganoderma lucidum(
Grifola frondosa( and Panax ginseng! 28ergner #99Fa3
TH!"TH# imbalance may also explain the common aggravating effects of echinacea in chronic fatigue
syndrome, fibromyalgia, and some autoimmune disorders. Echinacea has a acute effect of increasing the white
blood cells, including the lymphocytes. /f the system is already unbalanced, with an excess of TH# cells, then
echinacea could acutely aggravate the condition.
irculatory !actors in acute in!ection
The expectorant and diaphoretic activity of herbs, commonly employed in acute respiratory viral infection, may
also directly increase host resistance at the surface level. /n -orth $merican vitalist herbal traditions, it is the
practice to keep the mucous membranes and the skin at least slightly moist during acute febrile illness.
Expectorants, by promoting the free flow of mucous increase surface immunity because the mucous is laden
with /g$type anti bodies. Diaphoretics are used to gently cool a fever by shifting blood to the capillaries of the
vesselrich dermis, allowing for increased heat loss through ventilation. This action also promotes circulation of
immune components at the surface. +ome traditional herbs used in febrile viral illness which possess either
expectorant or diaphoretic actions, include Allium sativum( Eupatorium perfoliatum( Glycyrrhiza spp!(
Ligusticum porteri( Melissa officinalis( and ambucus nigra.
Traditional indications
The most useful definition of the term anti%viral for the clinician may be 'traditionally used for people with viral
infections( without undue concern paid to an identified mechanism. They are probably only indirectly virucidal,
by enhancing host resistance. The most important of these herbs for acute conditions, based on traditional
indications, are% Echinacea spp; Melissa officinalis; Allium sativum; Ligusticum porteri; Eupatorium spp!; and
ambucus spp! The most important preventives or strengtheners for those with chronic infection are% Astragalus
spp; Eleutherococcus senticosus; chisandra chinensis; Glycyrrhiza glabra; and Ganoderma lucidum!
Allium sativum
5arlic 2$llium sativum3 and its many varied constituents have a wide array of medicinal effects. -otable among
the effects on the immune system are stimulation of the cellmediated immunity 2TH!3 28ergner #99Fa3. This is
the cellset which attacks virally infected cells. $llium may also enhance immunity in respiratory infection
through its expectorant or diaphoretic actions. @ne peculiarity of the pharmacodynamics of garlic may also assist
in resistance to respiratory route viral infection ) some of its immuneenhancing constituents are excreted
through the lung, directly reaching infected mucosa in the respiratory tract.
Bhile garlic must be freshly chopped or powdered to optimi,e its direct antimicrobial effects, it may be aged
somewhat for maximi,e its effects on host resistance. The allicin constituent of garlic, released upon crushing,
rapidly degrades into a number of constituents which can enhance host resistance> more than half of allicin is
converted in this way within #F hours. $ method used since the time of the <oman 5alen is to crush garlic in
wine and let it sit overnight. $nother method of delivery, which allows high doses in the fragile individual is to
deliver a wellstrained garlic preparation via bulb enema. This may be very useful in the patient with post
influen,a syndrome. 5arlic may also be eaten with food, raw or lightly cooked, during viral epidemics, as a
preventive.
Echinacea spp.
Echinacea is the topselling botanical medicine in -orth $merica today, and some forms and dosing strategies
may be useful in viral infections. <esults of scientific trials of echinacea have been mixed, however 28ergner
#99Fb3, and in the majority of recent randomi,edcontrolled clinical trials for prevention or treatment of colds,
echinacea has failed to show significant benefit. The Eclectics did not consider it a primary remedy in influen,a,
but noted that in very weak individuals it may contribute to recovery. High doses of wellmade products that
include the root, repeated fre*uently, may be necessary to obtain benefit.
The Eclectics also considered that Echinacea angustifolia was the medicinal species, and considered E!
purpurea to be inferior. 4ontemporary herbalists report mixed opinions, with about half of those surveyed
expressing the opinion that E! angustifolia is the superior medicine 28ergner !00I3. Two of three randomi,ed
clinical trials that contained E! angustifolia along with E! purpurea have been positive, a much better track
record for such trails that those using E! purpurea alone 28arret> :im> 7indenmuth3. The failed trial used a non
traditional form of echinacea ) a mixture of E! purpurea and %angustifolia as powder in capsules. -otably, in a
trial of immune activation, mixtures of the two species had a positive effect, while E! purpurea alone did not.
4ontemporary herbalists, like the Eclectics, prefer a tincture of Echinacea, but antiviral effects may be enhanced
by using a strong decoction in place of, or along with treatment by the tincture. Traditional -ative $merican use
was to chew the root, or to make a decoction 2Moerman3, and this method allows contact of echinacea
polysaccharides with the oral and gutassociated lymphatic tissues. $ large body of research in 5ermany shows
immuneenhancing activity of these polysaccharides, possibly through activation of immune surveillance via
tolllike receptors. @ne of the recent successful clinical trials of echinacea used the tea form 27indenmuth3. -ote
that tincture with greater than about G=H alcohol contain no polysaccharides. $ practical method of extracting
and delivering a dose of polysacchariderich echinacea is to put one to two ounces of echinacea root in *uart of
water and simmer it for forty minutes. The dose can be two ounces repeated fre*uently 2a tincture dose may be
added to this3, or up to the entire *uart consumed over several hours in critical cases. $djuvant herbs may be
used to cover the bad taste. / have case reports of this method being rapidly and remarkably effective in
copperhead bite, pelvic inflammatory disease, and acute kidney infection, especially in high doses. / also have
direct experience with it in Best -ile fever, strep pharyngitis, and gum infection after oral surgery.
$nother method of delivering a polysacchariderich dose of echinacea is to prepare honey pills from freshly
powdered echinacea. Hot honey is mixed with the powdered root 2add powdered osha root for extra potency3,
allowed to cool, and then shaped into pills the diameter of a ..+. tencent piece. These can be rolled in licorice
root powder for stability and stored in the refrigerator. @ne pill is chewed as needed, usually about four times
per day in acute infection.
Eupatorium spp.
8oneset "Eupatorium perfoliatum# has been considered as the primary herbal treatment for acute influen,a in the
Eastern .nited +tates at least since the mid!I99s, and was the favorite of $merican physicianherbalists in the
great influen,a epidemic of !0!J!0!1. 8oneset has also been used traditionally as a topical treatment for herpes
viral infection. Despite its fame, little scientific investigation of the plant has been conducted. Two trials have
shown an increase in phagocytosis from various extracts of boneset, including the watersoluble polysaccharides
2Bagner et al> Bagner and 6urcic3. /n the latter trial, Eupatorium polysaccharides were more potent than those of
Echinacea.
/n addition to acute influen,a, boneset was a primary remember for intermittent fever from the late !1
th
through
the early #9
th
centuries in -orth $merican medicine. 8ecause such fevers can have many causes or infectious
agents, this suggests an effect to enhance host resistance.
The earliest use of boneset by European colonists was of the decoction, either hot in acute illness, or room
temperature in chronic conditions. 7ater in the !0
th
century tinctures were introduced. The traditional water
extract contains the polysaccharides of the plant, which may be important for full effects on host resistance
against virus. -ote that higher doses can cause nausea, and the plant was traditionally used in large doses as an
emetic.
The plant has been used historically as a preventive during influen,a epidemics with at least some success, and
may also be very useful for postinfluen,a syndrome. /t combines well with Echinacea or 4eanothus in formulas.
Ligusticum porteri
The primary medicinal use of -orth $merican species of 7igusticum, especially L! grayi and L! porteri is for
upper respiratory infections. There is very little investigation of -orth $merican species for antiviral or immune
enhancing effects, with one invitro trial demonstrating only a weak antiviral effect of one constituent 28eck3.
The 4hinese species is not used for respiratory conditions and is not considered an immuneenhancer. Despite its
reputation in contemporary herbalism, this herb probably should not be considered as having specific antiviral
activity. /ts circulatory stimulating, diaphoretic, and expectorant activities may confer indirect resistance against
respiratory viruses. ?uture research into the furanocoumarin compounds in 7igusticum may uncover immune
enhancing or antiviral effects 2Tower3.
7igusticum combines well with licorice, which can balance its harsh effects and reinforce its expectorant
properties. /t also combines well with honey for the respiratory tract. 4onsider making honeypills of freshly
powdered 7igusticum.
Lomatium dissectum
8otanical varieties of Lomatium dissectum have wide use in the ethnobotany of the -ative $merican tribes in its
range. .ses for bacterial or viral respiratory infections or allergic conditions are present in most native groups.
The plant drew national attention in medical circles after the influen,a pandemic of !0!J!0!1 when a physician
from -evada reported a complete lack of influen,a mortality in a -ative $merican group taking the preparation
2:rebs3. The traditional form is the decoction, taken in large *uantities, or inhalation of the steam of the
decoction 2Moerman> :rebs3. More common in modern herbalism is the use of the tincture, but with this method
a wholebody rash is a common side effect. The rash has been observed with even modest doses of the tincture,
as a component of a larger formula. This effect has also been observed very commonly with the free,edried
form. The nature of the rash is not clear. /t does not respond to steroidal suppression. +ome herbalists have
suggested that it is due to the waste products of killed bacteria or virus, but in the absence of some positive
confirmation this must be considered speculation. /t is also possible that the rash is due to constituents which
otherwise would have been driven off by the traditional method of long decoction ) resins may be responsible.
@ther than its traditional use in respiratory viral infections, there is no evidence that lomatium or its constituents
have any general antiviral activity. @ne trial found a lomatium extract active invitro against rotavirus, but not
active against six other viruses tested, including parainfluen,a 2Mc4utcheon3. The fact that it was also used
traditionally in bacterial and allergic respiratory problems suggests either a local or a systemic enhancement of
host resistance, and possibly an antispasmodic or antiinflammatory effect. The decoction is a simulating
expectorant, and may enhance immunity in the mucosa indirectly by increased secretions of /g$ antibodies
inherent in the mucous.
Melissa officinalis
Melissa officinalis has traditionally been used as a diaphoretic in a variety of fevers. /t has gained a reputation as
a specific antiviral after invitro research led to it effective topical application in herpes infections, popular in
Europe. $ review of the research fails to show uni*ue or broad antiviral effects of the herb. /n vitro research
showing activity against herpes virus 2$llahverdiyev> Dimitrova3, supports the topical use for herpes also
demonstrated in a human trial 2:oytchev3. @ne trial showed Melissa to have antiH/& activities invitro, but in
this screening of =! herbal extracts, Melissa was in no way uni*ue. ?ortyfive other plants also showed activity.
Melissa was among those most effective, but = other plants, including Mentha piperita( *cimum basilicum( and
Prunella vulgaris ) none of them usually considered to have specific clinical antiviral activity ) were e*ually
effective. The effective dose of these extracts, at sixteen micrograms per ml, may not be practically attainable in
the human with oral doses. +ome authors have speculated that antiviral activity is due at least in part to caffeic
acid, rosmarinic acid and ferulic acid, but these constituent are widely distributed in the plant world, and are
common constituents of a variety of medicinal herbs. @ne trial showed that Melissa increased general immunity
in mice, including both humoral and cellmediated immunity 2Dro,d and $nus,ewska3.
The most common traditional use of Melissa is as a tea. The suspected active constituents are soluble both in hot
water and in alcohol. The common traditional practice of sniffing the hot tea of aromatic herbs may be an
effective way to deliver Melissa constituents to the site of respiratory infections. The tea also has circulatory
stimulating, diaphoretic, and febrifuge effects.
Sambucus spp.
Elderberry and elder flower have long traditional use in febrile illness, including influen,a. They have also been
used as an alterative or blood purifier in chronic conditions. <ecent research on an elderberry syrup 2+ambucol3
has shown it to be very effective clinically against influen,a. /t also inhibits at least ten strains of influen,a virus
invitro 2;akay<ones #99F> ;akay<ones !00=3. /ts actual mechanism in the body remains unknown, but
enhancement of host resistance are probably more important than any virucidal activity. /n one clinical trial of
+ambucol in influen,a, the researchers found higher antibody activity against the virus in patients treated with
+ambucol. /n research with healthy volunteers, they found that the product increased the production of the
immuneenhancing cytokine tumornecrosisfactoralpha by nearly =999H 28arak3.
+ambucus is traditionally taken as a tea, #F cups per day for elder flower tea, or as a tea or syrup of the berries.
Either form taken to excess can cause *ueasiness or nausea.
Astragalus spp
$stragalus is one of the primary tonic herbs in 4hinese medicine, and recent research has shown a number of
mechanisms of immune system enhancement. /t has no direct antiviral activity. /t is traditionally taken as a tea in
4hina, or often cooked in soups, stews, or medicinal rice gruel. Traditionally the 4hinese may take an alcohol
preparation of $stragalus, but then in large doses ) K to ! ounce ) when the heating and bloodmoving effects of
the alcohol are also re*uired. The $stragalus tincture products widely sold in -orth $merica are likely to be
devoid of immune enhancing or tonic effects in normal tincture doses. $stragalus may make an excellent
preventive in the weak patient who is prone to colds or flu, if taken regularly during seasons or periods of
susceptibility.
Eleutherococcus senticosus
Eleutherococcus "Acanthopanax# senticosus( or +iberian ginseng, enhances host resistance to multiple possible
stressors, including infection 2Deyama> Davydov3. /n one experiment, it was found to have direct antiviral effect
against all <-$type virus tested 25latthaar+aalmuller3. Two clinical trials have shown a preventive effect
against complications of respiratory viral infections, and one has shown activity reducing the fre*uency and
severity of herpes outbreaks 2E+4@A3. Eleutherococcus enhances host antiviral defenses, especially cell
mediated immunity 2TH!3 2+,olomicki> 8ohn3. Eleuthero may effect general immunity via its action on the toll
like receptors 2Han3.
Most of the Eleutherococcus products in the -orth $merican marketplace are of little value. The original
research bringing this medicine into medical use occurred in the former +oviet .nion. The <ussian
Aharmacopoeia product is a !%! fluid extract in G9H alcohol, taken in doses of #!= ml. The low alcohol content,
compared to standard tinctures, likely conserves constituents in the plant that are lost in the standard tinctures
mostly available in this country. 8y extrapolation, even if all the constituents were present, the dose of a
standard !%= tincture would have to be !9I= ml, or !"G to #.= ounces. The HerbAharm company of Billiams,
@regon, markets a product made according to the <ussian specifications, and further concentrated to #%! in
strength. @ther companies offer encapsulated products based on #%!, !9%!, or in one case, =9%! concentrates.
<egarding the inefficiency of other contemporary products, one herbalistauthor states that the plant must be
taken for thirty days to show any benefit, and another says that patients can take as much as they want. The
<ussian preparation results in noticeable activity within !# doses, and overdose symptoms of anxiety, insomnia,
and tension occur readily. /t is the latter sort of product that must be taken to prevent viral infection.
Ganoderma lucidum.
<eishi mushroom is clinically one of most important of the herbs discussed here for treatment for chronic viral
infection, or as a preventive during periods of threatened viral infection. /nvestigation shows that the
polysaccharide, watersoluble fraction of this medicinal mushroom increases both the numbers and the cytokine
secretion of the monocytes, macrophages, and lymphocytes. /n one trial, production of interferon, which protects
cells from viral infection, was increased by a factor of thirty 2Bang3. <eishi may act to stimulate systemic
immunity via the action of its polysaccharides on tolllike receptors. &arious constituents of ganoderma have
been found to have antiviral properties invitro, especially against herpes simplex virus and Epstein 8arr virus
2Eo> /watsuki3 . However, a trial of six constituents found none of them active against influen,a or several other
viruses 2Eo3. <eishi may be especially helpful in chronic viral conditions with dominance of the humoral
immunity 2TH#3 28ergner #99Fa3.
Two problems exist in finding effective forms of reishi. The traditional 4hinese form is a decoction, but the taste
is very unpleasant, and patient compliance is very poor. +ome extracts formed from the residue of evaporated
water extracts are available. +ome also have alcohol consituents mixed. -ote that although the 4hinese have
traditionally used many herbs in alcohol form, there is no traditional use of reishi in alcohol extract form in
4hina. $lcohol preparations also do not contain the plant polysaccharides, which are important to its action.
Much of the encapsulated reishi on the market in -orth $merica today is from the mycelium, which must be
considered inferior until some medicinal activity is demonstrated in clinical trials.
"e!erences
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