Herbal Antibiotics: Natural Alternatives for Treating Drug-Resistant Bacteria (19 page)

Sida acuta
—
huanghuaren
or
huang hu aren
—is used in Chinese medicine, as is
Sida rhombifolia
—
huan hua mu
—and presumably other sidas as well. I can find little on the plants even though they seem to have a longish history of use there. The plants are usually used as decoctions, with a dosage range of up to 30 grams, or about 1 ounce. The Chinese consider sida to clear heat and benefit dampness. They have found it to be antibiotic, anti-inflammatory, analgesic, diuretic, and tonic.

Sidas are commonly used for depression, bronchitis with cough and wheezing, and urinary tract inflammations. Less common uses are for dermatosis, itching, eczema of the scrotum, sores and boils, stomach pain, dysentery, gastritis, enteritis, tonsillitis, liver problems, jaundice, cervical tuberculous lymphadenitis, malaria, colds and flu, and kidney stones.

Sida (
S. rhombifolia
primarily) was apparently introduced into the United States in the nineteenth century as a fiber plant, but it wasn't much used as a medicinal. The Eclectics listed it in a tiny reference under
Althea
, a.k.a. marsh mallow, as being highly mucilaginous, useful as a poultice, and effective for respiratory complaints.

The recent focus on cryptolepine-containing plants as well as traditional malarial plants has stimulated a lot of interest in
Sida acuta
and some of the more commonly used Asian sidas. Most of the scientific studies have focused on phytochemical analysis and in vitro studies of the plants' antimicrobial actions, with a smattering of in vivo studies. The scientific exploration of these plants is still in its infancy and no clinical trials have been conducted that I am aware of.

There have been a number of studies of the antimicrobial activity of
Sida acuta
, and while they do give a good indication of its potency, nearly all the studies are flawed. Inexplicably, very few of the researchers appeared aware of the importance of proper preparation of the plant extracts. Looking only at the ethanol and water extract preparations in the studies, the problems are twofold. First, they tended to use 90 percent to 95 percent pure alcohol to make the ethanol extracts. This means that
only
the alcohol-soluble constituents would be present in the extract. (There would be a tiny amount of water-soluble constituents from the 5 percent to 10 percent water that was present in the alcohol.) Many of the most potent constituents in the plant, such as cryptolepine, are only water soluble, so the preparation method will affect the impact of the extract on microorganisms.

Second, when making the water-based extracts many of the researchers used a neutral-pH distilled water. Additionally, some made it as a cold maceration. This is problematical for several reasons. Firstly, the alkaloids in the plant, most importantly cryptolepine and its derivatives, are primarily soluble in water that is somewhat acidic. Secondly, the plant constituents are less soluble in cold water than in hot. For the studies to be truly relevant, the water extracts should have used water with a pH of from 1 to 6 to make sure they were acidic enough to extract the alkaloids and the water should have been hot. With the ethanol extracts, preparation should have been made using half water and half pure grain alcohol; the water should have been hot, the herb inserted, the mixture allowed to cool, and then the alcohol added. The differences in preparation techniques are the most likely reason that the antimicrobial actions of the plant vary as much as they do from study to study.

Nevertheless, in all studies
Sida acuta
has been shown to be potently
active against malarial parasites, staph bacteria, and TB, though beyond that there is a lot of variance. The best study took these factors into account but was exploring
only
alkaloid activity.
²
That study found more activity from the alkaloids against Gram-negative bacteria than previous research, which makes sense, as cryptolepis has been found to be active against Gram-negative bacteria simply due to the presence of cryptolepine and its derivatives. In fact the alkaloidal extract of
Sida acuta
was nearly as effective against Gram-negative as Gram-positive bacteria.

A close examination does indicate, however, that both cryptolepis and sida more easily kill Gram-positive organisms than Gram-negative. This does not mean they are not active, it simply means that the dose needs to be higher if you are dealing with Gram-negative organisms, an observation confirmed by studies on both plants. The plant should also be taken for a longer duration—the Gram-negative bacteria did need a longer exposure to the herb than the Gram-positive. The use of a synergist that enhances antibacterial activity against Gram-negative bacteria would be helpful. (See piperine monograph,
page 236
.)

In spite of the problems in the in vitro studies, tests for antimicrobial activity have borne out the traditional uses of the plants against microbial diseases. They have found sida strongly active against
Plasmodium
spp.,
Staphylococcus aureus
, and
Mycobacterium phlei
, resistant and nonresistant strains. It is highly active against
Streptococcus pyogenes
,
E. coli
,
Bacillus subtilis
,
Pasteurella multicocida
, and
Salmonella typhimurium.
It is also active against herpes simplex,
Shigella boydii
,
S. flexneri
,
S. dysentariae
, and
Listeria innocua
and less active against
Pseudomonas aeruginosa
,
Candida
spp.,
Aspergillus niger
, and
A. fumigatus
, but still effective, especially if the dosage is increased. In many instances the plant was more effective against the bacterial strains than pharmaceutical antibiotics.

Sida increases glutathione levels in the blood, increases red blood cell numbers (making it good for treating anemia), and increases total white blood cell count, indicating an immune potentiation effect that may tie in with its reported adaptogenic actions in traditional practice.

In vivo studies have found
Sida acuta
to have a strong and reliable antiulcerative effect; that is, it protects the stomach lining from the formation of induced ulcers. In vivo research has also found a strong analgesic action.

Another in vivo study found sida hepatoprotective against induced liver damage (the plant is used in India for liver disease among other things). Several compounds from the plant have been found to inhibit induced preneoplastic lesions in mouse mammary tissue. In vivo studies have also found sida to be hypoglycemic, lowering blood sugar concentrations in diabetic mice, and to be antihyperlipidemic, lowering blood cholesterol and triglyceride levels, again in diabetic mice.

An analysis of four sidas—
S. acuta
,
humilis
,
rhombifolia
, and
spinosa
—found them to have similar alkaloidal constituents, including cryptolepine.

An analysis of five sidas—
S. acuta
,
alba
(a synonym of
spinosa
),
cordifolia
,
rhombifolia
, and
urens
—found varying levels of polyphenols in the plants (see chart at bottom of page).

The antioxidant activity of the plants followed that order as well, with
Sida alba
having the highest,
S. urens
the lowest. The plants were tested for anti-inflammatory activity, exploring their lipoxygenase (LOX) and xanthine oxidase (XOX) inhibition. For LOX,
alba
inhibited 80 percent,
acuta
79 percent,
cordifolia
21 percent,
rhombifolia
52 percent,
urens
47 percent; for XOX
alba
inhibited 47 percent,
acuta
43 percent,
cordifolia
13 percent,
rhombifolia
46 percent,
urens
35 percent.

All these species of sida are successfully used to treat liver diseases including hepatitis B in Burkina Faso; the authors of the study were exploring some of the mechanisms that might explain their effectiveness.

Sida alba
(i.e.,
S. spinosa
) is fairly high in ecdysteroids, which are adaptogenic and explain, in part, the plant's use for debility in traditional practice.

Numerous studies have found
Sida cordifolia
to possess very potent anti-inflammatory and analgesic activities. An alkaloid with a tremendously long name, one of the quinazoles—a group of which cryptolepine is a member—was found to be the most potent source of the activity. In vivo studies: An aqueous extract of
cordifolia
stimulated liver regeneration in 67 percent partial hepatectomy in rats; birds treated with cyclophosphamide, which causes immunosuppression, experienced a reversal of that condition when given
cordifolia
. In vitro studies: The plant is strongly antimicrobial and acts as an antistressor/adaptogenic in stressed mice; use of the plant after myocardial injury showed significantly increased endogenous antioxidants in heart tissue; other studies found evidence of a protection from neurotoxicity caused by quinolinic acid.

Sida tiagii
during in vivo research has been found to have antidepressant and antiseizure effects in mice.

Family:
Euphorbiaceae

Common Name:
Christmas bush

Species Used:
The genus
Alchornea
is a pan-tropical group of plants comprising some 60 species, six of which are indigenous to Africa.
Alchornea cordifolia
is the main medicinal species, though
A. laxiflora
is a reliable substitute. Regrettably, there has been little study on the members of this genus other than
A. cordifolia
.

Mostly the leaves, but the stem bark, pith, root bark, roots, and fruits are all used.

Add 7 ounces of herb to 1 quart of water and boil for 20 minutes. Strain, then drink 6–8 ounces of the tea every 4 hours. Studies have shown that the tea takes about 3 hours to begin getting into the blood, and it tends to hit peak presence 1 to 2 hours after that depending on the dose; dosage presence lasts about 4 hours. This means that if you are using the tea you need to have another cup every 4 hours or so. Recommended dosage times: 8
A.M
., 12
P.M
., 4
P.M
., 8
P.M
., or beginning whenever you rise and then going to a 4-hour period.

For eye disease:
Use the cool tea as eyedrops, 1–3 drops every 3–4 hours.

1:5, 50 percent alcohol, 50 percent water; take ¼ teaspoon of the tincture every 4 hours

For wounds and infected skin, liberally sprinkle the powder on the site as frequently as needed.

None noted, and no toxicity has been found. There are no reports in the literature or by traditional practitioners of side effects, although large doses may have a sedative or depressant effect on the central nervous system.

None noted; however, large doses should not be taken along with CNS depressants or sedatives.

Note:
Some people indicate that
Alchornea castaneifolia
can be used interchangeably but I can't see this as accurate—I would never recommend using it interchangeably. See Beware of
A. castaneifolia,
opposite page.