Practical

Guide to
Natural
Medicines
ANDREAPEIRCE
Forewordby John A. Gans,Pharm.D.
Introduction bv Andrew T. Weil, M.D.

PressBook
A Stonesong
W I L L I A M M O R R O W A N D C O M P A N Y .l N C . r N e w Y o r k

SOURCES:
GENERAL

Handbooks.New York: Oo,li{

Bremness,L. Herbs.lst American ed. Eyervitness
::
1994.
KindersleyPublications,
Guideto Morr'$ffi '
of Medicinal Plants:A PracticalRet'erence
Chevallier,A. TheEncyclopedia
Than 550Kq MedicinalPlantsd, Their Useslst Americaned. New York:Dorlinai..$i,
"
1996.
KindersleyPui;lications,
;_4,
,.
rr
Ingredients
Leung, A.Y., and S. Foster. Encyclopediaof Common Natural

Usedin Food

ed.NewYork:JohnWilev& Sons'1996'
andCosmetics.2nd
Drugs,
,.
TEXTCITATIONS:
l. A.Y. Leung and S. Foster,Encyclopediaof Common Ntttural IngredientsUsedin Food, .'''
Drugs,and Cosmetics,2nded. (New York: John Wiley & Sons' 1996).Y. Liu and Y. {fi&.,
Ma, Zhongcaoyao,26(8)(1995): 43740.
iW:
;f;t
2 . L e u n gJ n d F u s t c ro, P .c i t .
10(l) (1994):58-60'
3. L. Dai etal.,ZhongguoYaolixueTongbao,
.,."f
l+;
4 . Z . G e e r a l . . Z h o n g g u o Y a o l i x u e T o n g blal (o4, ) ( 1 9 9 5 ) : 3 0 3 - 5 .
5. Yan Zhang et il., Zhonggtttt\bolixue Tongbuo,10(5) ( l99a): 372-71.
6. H. Zhou et aI-, Zhongguo YrtolixueTongbao, I 0(6) ( I 99a) : 429-32.
Yaolixuelbrrtlrnrr'9(6) ( I 993): 161-67'
7' X. Liu et t'l','l'httnggrut
8. X. Wang etil^, ZhongguoYaolixLttTttngbtto,6(6)(1990):3b3-66.
9. W.G. Zhang and Z.S. Zhang, YttoxueXuebao,29(2)( 1994): 145-'18.J. Tang et al.,
2 I ( I 2) ( 1990): 54749.
Zhongcaoyao,
l0(l) (l9ll9): l't7-50
l 0 G. Wu et t'i.,Zhonugrtttlirok,'f)rr-rrr.'Xttcl-trto,
il

Leung and Foster,op. cit.

1-

t-

E
c

t:

ra1h.+

l-

Da-r.ar*in+?
,-fJt.-.,...,.-.

COMMON NAME5:

T h i s e s t e e r n enr jt i r . r t - f a r l i l vn r c n r L l c\rv e sb o r n i n . r n E n g l i s ht r c l c lo i s p c . l r m i n t
s p e r t r l n i n\t. ' ) l c t r t l ns p i c a t o )
i n t h e 1 7 0 0 si;t r c p r e s c n tas n a t L l r r lh v b r i d b e t r v e c n
) .c p p e r n l i n S
t P o r t st h c c l a s s i cs ( l u a r eS t e m s
a n d w a t e r m i n t ( , \ I o r f l r d( l q t t a t i c t t P
to ttr.alleaves,and dense spikcsof liiac-pink florvers
of the rnint frltilv, rtblor.rg
that blotlr.nin sunlnler.\arious tr';'1'5,r; peppermir.rtrtrectrltivittedaround the
world. The leaves(dricd and ticsh) and flttrveringttlps havebcen gsedmedici-

Varietiesincludethose
commonly known as black mint
(M. pipertavar. vulgaris Sole)
and white mint (M. pipertavr.

nallv for centuries.

spio,,cooling,and aromaticoil is cxtractecltiorn the lelvesand
An ir.rtenselv
t h e f i e s h o r p a r t i a l l vd r i e d a b o v c g r o u n dr t n t lt l o r v c r i n gp a r t o i t h e h c r b .l n t h e
, e n t h o l ,t i o m t h i s
l a t e 1 8 0 0 sc, h e m i s t sd i s t i l l e ctlh e a l l - i n ' r p o r t a ncto m f r o n e n tm

otficinalis Sole).

o i i ( s e eN l e n t h o lt i r r n r o r c i t t l i r r r n a t i o t r l .

SCIENTIFIC
NAME:

Mentha x piperta L. Family:

Labiatae(Lamiaceae)

What lt ls Used For:

I n t h e k i n g d o n ro f m i n t s ,p e p p r e r m i nat n c ls p e a r m i n tr e i g n a s k i n e a n d q u e e n '
Both Westernand Easterncultureshavelong brewedteaswith the peppermint
leaf to treat indigestion,sore throat, nausea,colds,cancers,gas,and cramplike
stomachand intestinaldiscomforts.(Although spearmintcontainsa volatileoil
that is responsiblefor its distinctivearoma and taste,as weil as its medicinal
properties,it doesnot contain the all-important menthol found in peppermint
The
oil and is therefbrenot considere{as diverseor potent an herbal remed,v.)
498

;*,*{:*'

T
t
{

RATING:

I =Yearsofuse and extensive,

high-qualitystudiesindicate
is very
thatthis substance
effectiveandsafewhen usedin
amountsfor the
recommended
indication(s)notedin the "Will
It Work for You?"section.
However,seethe warningsin
the"Will It HarmYou?"
section.

,*rf |*{

Englishstartedto usepeppermint medicinallyand cultivateit commerciallyin

the mid-1700s.The Americans followed closebehind. The united Statesnow
grows more peppermint than any other country in the worid.
Herbaliststoday recommend the herb internally for many of the same ailments their predecessors
did. Some tout its ability to counter motion sickness,
congestion,headache,heartburn, fever, and sleeplessness.
It is considereda
valuableantispasmodic.The leaf and extractsappear in numerous European
laxatives,bile-duct remedies,and bile-stimulatingformulations. For tension
and weariness,many sourcesrecommend a peppermint-scentedbath. Topical
formulations are suggestedfor inflammation and itching.
In addition to being popular as a flavoring, peppermint oil contains the
medicinallyactivesubstanceknown as menthol and is thereforewidely usedas
a digestionregulator,gas remedv,and antisepticand local anestheticagent in
everythingfrom cold and cough preparations(lozengesand syrups)to formulas for insect bites, hemorrhoids, toothaches,and musculoskeletalpain. It is
bcirrginr.estigated
as a treatment fbr irritable borvelsvndrome.peppermint oil
a l s oc o m m o n l ya p p e a r si n l o t i o n s ,a r o m a t i cm i s t s ,a n d a r o m a t h e r a p fvo r m u l a tions.
Forms Available lnclude:
' F o ri r r t t r r t arl r - s c : f, l\r r v o r i n qr t g c n ti n c r r n c i rc.r,r p s u l ci n, l i r s i t t n( o i d r i c d

lcaves),
lcaves(liesh and clried),krzenge,oil, svrup,tincture.A tea madc from dried
p e p p er m i n t l c a " ' c rsv i l l n o t n e c e s s a r i l l ' v i e m
l de d i c i r r acl o u c e n t r a t l o n s .
' [ : o r e f i t : r n t rll. s t ' (: ) i l , c l i r r t l n e n tt,i n c t r , r r c] '.h c o i i a p p c a r si n
m i r n vc o n r m e r c r a i t t l r t l l t r l ; . t t i o l t si t; L r s u i r l l vc o n t . l l n s s L r b s t . t n t r a n
l t o L t n t sr t t n t e n t h r t l .
S o n r e t i m e fsi r r r n r " r l a t i o n
s
c o nt a in c x t r a c t e cnl t c nt h o l o n l r ' .

P e p p e1 6 i n 1
ivlt:ntha x piptrtt

g
e
=.
=*

Dosage Commonly Reported:

T h e d r i c d l e a f i s t v p i c a l l vt a k e n i n d o s e so f I . 5 t o 3 s r a m s ,o r a n i n t u . s i o ni s
m a c i cw i t h t h a t a m o t t t . t T
t .h c s t r c n g t ho f t i n c t u r e sv a r i e sc o n s i d c r a b l a
v ,n d s t t
d o r e c o m m e n d e dd o s a g e sA
. t i n c t u r e t a k e n i n d o s e so f 2 t o 3 m i l l i l i t e r s i s
t v p i c a lw h e r .trh e r a t i o o f ; r c p p e r n . r i ntto l i c l u i di s I t o 5 , a n d c o n t a i n s4 5 p e r c e n tc t h a r r o lF. o r q r r s t r o i n t e s t i ncatlt m p l a i n t sa n r .,lr sa c h o l a q o g u (et o s t l n . t u l a t e b i l e p r o d u c t i o n ) , 3 t o 6 g r a m s o f t h e l e a v e si s t a k e n d a i l y .A t e a i s m a d e
u s i n g I t a b l e s p o o n( l . 5 g r a n r s )l e a v e sp e r c r - r po f r v a t er a n d i s d r u n k t h r c c t o
t b u r t i m c s p e r d a 1 ' b e t w c e nm c a l s .T l . r ce s s e r . r t ioaill i s t a k e n i n d o s e so f 0 . 0 5
t o 0 . 2 m i l l i l i t e r . E n t e r i c - c o a t e dc a p s u l e so f p e p p e r m i n to i l a r e t a k e n i n d o s e s
o i 0 . l t o 0 . 4 m i l l i l i t e ro r u p t o 0 . 6 t o I . 2 m i l l i l i t e r sa d a y ( t h e e n r e r i cc o a t i n g
p r o b a b l va l l o r v sf o r a h i g h e r d o s a g et l - r a n ' " v o u lbde s e e nr v i t h t l ' r ee s s e n t i aol i l
taken directly). For gallstones or irritable bowel syndrome' a common
c l o s a g ei s o n e t o t r v o e n t e r i c - c o a t e dp e p p e r m i n t o i l c a p s u l e s( 0 . 2 m i l l i l i t e r s
p e r c a p s u l e )t h r e e t i m e s a d a v b e t w e e nm e a l s .T h e u n d i l u t e d o i l i s a p p l i e d
externally as a counterirritant. A few drops of the oil are used in steam
inhalations.
lVeRNrNc;:
Neveringestpure menthol;it is poisonousand as little as a teaspoonful ( I gram per kilogram of body weight) can be fatal.
499

Will lt Work for You?What the StudiesSay:

Theprimaryhealingcomponenrin peppermintis its volatileoil, which.on**i
rich stores(50 percentor more) of menthol,a crystallinealcohol*;;;ffi4t"

E
o
a

medicinal properties. The menthol is probably responsiblefor pepperm6fi,.,

renown as a stomach-soother and gas-reducer;studies show that it calmsgp ,
smooth musciesof the digestivetract (antispasmodic)and facilitatesbelching,
Menthol and other components (probably flavonoids') also stimulat. the livei
'-. ':
t
"
production of bile, a body
( r r a ( helps
u j / fluid
, , u r u that
r r L r p J break
urLdl u
down
w w r l fats,
rd:, d
and
l l u thus
u l U S . Inheel pl sP p
sp frGo. .
,
.
.
.
.
u , . , ' . i4
-mote
^ L ^ digestion.'
) r - - - L : - - -\ ^German
- , , , ,- rhealth
r-r
,r
authorities approve of peppermint and
it . .,. i
volatile oil as an antispasmodic,especiallyfor upper digestivetract conditiongij
condido*'i$,
,{
rrri: : 't
and considerit effectivein promoting stomachsecretions.n
The FDA, on the other
hand, has declared peppermint oil ineffective as a digestiveaid and no longer
allowsit to be used for this purpose in nonprescription remedies.'Thisdecision
was reportedlybasedon a lack of convincing evidencepresentedto the agenry.
The FDA does,however,approveof peppermint oil as a common cold remedy,and botl'rpeppermint oil and menthol aloneappearin nurnerouscoughand
throat lozenges,
topical nasaldecongestants,
inhalirnts,ointments,and otherformulations.Most usersreport a clearingof congestionin the noseand sinuses.
G e r m a nh e a l t ha u t h o r i t i e sc n d o r . s e
t h e u s eo f p c p p e r n r i n o
t il for reducing
thc symptornsof irritable borvels.,'ndronre,
a condition characterizedby
colicky
a b d o r n i n apl a i n , b l o r t t i n q ,a n r l d i s t u r l r c cbl o r r ' c lh r r b i t s .T^. r l kt o v o u r c i o c t o ri f
v o u a r ei n t e r c s t c di n u s i n g p e p L r c r m i not i l f i r r t h i s p u r p o s e .
Pepperrr.rint
I'rasproved itseli as an intection llchter in variousstudies,poss i b l vj u s t i f y i n si t s t r a d i t i o n i r lu s er r si r r v o u n c l - h c l l e rI .t d c r n o n s t r a t easn t i b a c t e r ' i . , l. t t l r l. i i t t i r i i . i i t , L r r l ) e ll i e s r n i e 5 t , I L l t ) e. ) [ L r ! i l e st. ; ] e ( ) u n ( ) t \ ) n i \ i r r i s n u t n e r t l u s

b a c t e r i ab u t f l g h t sv a r i o u sv i r u s e s i,n c l u c l i n gt h e h e r p c ss i n r p l c xv i r u s e s( t , v p e s
i a n d 2 ) r e s p o n s i b l et b r c o l d s o r e sa n d g e n i t a lh c r p e s . ' l t l . r a sa p r p a r e n t nl yo t
beenwell studied fbr prircticaltreatment of thesekinds of infections,however.
lvlcnthol'sanalgesicand counterirritant prol're11ig5
are rvidelyacceptedby
t h e m e - d i c aels t a b l i s h n . r e an rt ., r db o t h m en t h o l r r n dp c ' p p c r m i not i l i n m a n vc a s e s
can be expectcdto effcctivelvnumb pain or producea coolingsensationon the
skin that helps relieveinflammatorv pair.rsuch as that caLrseci
by arthritis and
tendinitis.
Will lt Harm You? What the Studies Say:
i V l o s ta d u l t sc a n d r i n k p e p p e r m i n t t e a r e g u l a r l vw i t h o u t r v o r r y i n ga b o u t a n
adversereaction;the relative concentrationof menthol in peppermint tea is
actuallyquite low. Ivlost peppermint-relatedcomplaintsoccur rvhenthereare
high concentrationsof menthol or menthone in the preparation,or when
products rnade with high concentrations of the oil, such as menthol cigarettes,
are used.
Thkecare in giving infants or small children peppermint tea or any prepa'
rations of peppermint oil. They may be startledor evengag or chokebecause
of the intensefragranceand the menthol. There have been reportsof instant
collapsein infants who have had a menthol-containing ointment appliedto

500

their nostrils to treat cold symptoms.* Talk to a doctor before using PePPermint if you suffer from a hiatal hernia, as the oil may exacerbateyour sYmPIf you ingest peppermint oil directly in more than the typically recommended amount, you may be at risk for heartburn and acid reflux- Internal
overdosageof the oil has caused dose-dependentbrain lesions in rats.'' If
applied undiluted or in high doses,peppermint oil may irritate the skin or
mucous membranes,although even recolnmendeddosesof peppermint oil or
menthoi can causea rash or contact dermatitisin sensitiveindividuals.
Avoid all peppermint products if you are allergicto menthol, to avoid such
reactionsas headache,rash, and flushing." Severaisourcesrecommend that
people with gallstones either consult a doctor before taking peppermintcontainingpreparationsor avoid them altogether.''
SOURCES:
GENERAL
American PharmaceuticalAssociatiort.HandLtookoJ' NonprescriptionDrttgs.l lth ed'
Washington,D.(,.:American PharmaceuticalAssociation'1996'
Stuttgart:medpharm GmbH
Bisset,N.G., et7.Herbal Druts antl Phvtophumhceuticals.
ScientiflcPublishers,1994.
l]lunrenthal,rv-l.,J.Gruenwald,'f.Hall,andR.S.Rister,eds'TheComplctcOerttanContmissionE Monographs:Tlrcrapeutic Guitle to Htrbal Nledicrrrs.Bostorl: Intcgr.rtivc
N l e d i c i n eC o m m u n i c a t i o n sl,9 9 8 .
Brrdlcv, P.(-.,ed. BritisltIlcrbal Coml'tndttrnt:;\ tltttdbook crl'5cit'rrti/irIrrlbrtrtatiorrttrt
\litlelt, L'setlPldnt Dnrts, r,ol. l. B,rurnernouth (Dorset), Er.rcland:Ilritish Ilerbrl
\ lcciicinc;\ssociation,I 991.
ir/ ,\itftrri'.s
\1. 7'hcHcolirryIItbs: Tht LtltinttrttGui,lt ttt tlrc()uratit't'Porr't'r
C.rrstlcnran,
I995.
lJooks,
NervYork: Bantam
lvlcdicittcs.
Hi-s
ol Plants:r\ PrtcticdlGtrik to rlr'Sclt'rtcc',
Dolrelis,I.N.. ed. 7 [c tr.2cicunl ivtetlicine
. i . , r r . " 1 , . ' r .' r ; , r ij : , , ' , " , 1 , rl'' s , . , / \ 1 , / i ,j r ' , r 1, r ) / , t r r Ir ). l. c. : l : r t n t v i l l\c\ '.: I l c l r d t ' r ' s
Digest;\ssocirition,I 9lJb.
Serics
llotanicrrlCouncil, Lltrtrtrricel
Foster, S. Pt,ppt,rnirtt:IIt,nthttx pipr'rta.,.\rrrcriclt-t
N o . 1 0 6 .1 9 9 1 .
Hallorvell,\1. HerbulHeolific:,\ PrttcticalItrtroduL'tionttt itlcdicinalHcr|s. Garden Clitv
Park,NY, 1994.
St. I-ouis:Flcts and Conlparistlns.lulv 199()'
LLuvrtnccRcvrcryrrf r\',rturd Prodtrcts.
ol CtttrnrttttMtftrrrri Ingrtditnts Llicr/ttt ltr,rti,
Leung, A.y., and S. Foster.Encl,clopetliu
]nd ed' NervYtrrk:John lVilev & Sons,1996'
[)nrys,and Cttsmetics.
Herlrsrtrtil Nttlrii'trtst0 Strl1'l1't'i/.
Nlayell,iv1.Olf-the,shell-NttturalHeulth: l-Iox,to LI-sc
t)95.
Nerv \irrk: BantantlJooks,I
\\':
[]ingl-r.rnrtort'
Tyler,\'.E. Herbsof Choice:'fht'I'ltt'rLtptutiiL'-strl Pltt'tttrrtt'tlicirtrrls.
ProductsPress,I994'
HtrrvorthPress/Pl-rarmaceutical
Proclucts
Ilt,r!,Ltl.Binglt.tntl,rn.),'r';I l.rrr',rrihl)rtss,'Phltrtllltcctrtirlll
lJ,,rr,'..1
l-11.,
P r e s s1, 9 9 1 .
TEXTCITATION5:
l. American PharmaceuticalAssociation,Hundbook of NonprescriprionDrugs. llth
ed. (Washington,D.C.: American PharmaceuticalAssociation'1996)'
2. V.E. Tyler, The Honest Herbal (Binghamton, NY: Haworth Press/Pharmaceutical
ProductsPress,1993).
3. G.D. Bell and l. Doran, British Medicallournal,278 (1979):24.W.R. Ellis and G.D.
Bell, BrirlsftMedicallournal.282 ( l98l): 61 l.

501