by Eric Yarnell, ND, RH(AHG)
Last updated 10 July 2022
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Table of Contents
Clinical Highlights
Oregon grape and barberry are bitter digestive tonics, antimicrobials, insulin sensitizers, and antineoplastics.
Oregon grape and barberry are very safe, though they can aggravate an already overstimulated or inflamed digestive tract.
Oregon grape and barberry are moderately-to-strongly potent, depending on the action.
Oregon grape and barberry are very safe, though they can aggravate an already overstimulated or inflamed digestive tract.
Oregon grape and barberry are moderately-to-strongly potent, depending on the action.
Berberis aquifolium leaves (copyright 2022, E Yarnell)
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Berberis aquifolium flowers (copyright 2022, E. Yarnell)
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Clinical Fundamentals
Part Used: The inner bark of the fresh root is preferred, though the whole root and root bark of fresh and dried roots can be acceptable.
Taste: bitter, somewhat earthy
Major Actions:
In one human clinical trial of purified berberine in patients with cholera, no antisecretory effect was seen at 100 mg qid doses (Khin-Maung-U, et al. 1985).
Protoberberine alkaloids have been reported to inhibit Candida albicans by blocking 24-methyl transferase and chitin synthase (Park, et al. 1999).
Taste: bitter, somewhat earthy
Major Actions:
- Bitter digestive stimulant (thus cholagogue, laxative)
- Antimicrobial (Amin, et al. 1969)
- Insulin sensitizing
- Intestinal anti-secretory (in patients with diarrhea)
- Antineoplastic (Kim, et al. 2008)
In one human clinical trial of purified berberine in patients with cholera, no antisecretory effect was seen at 100 mg qid doses (Khin-Maung-U, et al. 1985).
Protoberberine alkaloids have been reported to inhibit Candida albicans by blocking 24-methyl transferase and chitin synthase (Park, et al. 1999).
Antimicrobial Activity of Berberis spp
| Extract/constituent | Organism | Model | MIC | Reference |
| B. aetnensis root M | Candida albicans (multiple strains) | In vitro | 8–64 mcg/ml | Iauk, et al. 2007 |
| B. aetnensis root M | Candida krusei (multiple strains) | In vitro | 2–16 mcg/ml | Iauk, et al. 2007 |
| B. aquifolium SB T | Propionibacterium acnes | In vitro | 25–50 mcg/ml | Slobodníková, et al. 2004 |
| Berberine | Propionibacterium acnes | In vitro | 5–25 mcg/ml | Slobodníková, et al. 2004 |
| Jatrorrhizine | Propionibacterium acnes | In vitro | 25–50 mcg/ml | Slobodníková, et al. 2004 |
| Jatrorrhizine | Candida albicans | In vitro | 125–250 mcg/ml | Slobodníková, et al. 2004 |
| Jatrorrhizine | Multiple human dermatophytes | In vitro | 62.5 mcg/ml | Volleková, et al. 2003 |
Notes: All constituents were isolated from Berberis spp. Abbreviations: M = methanol extract; SB = stem bark; T = tincture (hydroethanolic extract)
Major Organ System Affinities
Major Indications:
Purified berberine 100 mg qid was more effective than placebo and just as effective as tetracycline 500 mg qid at reducing symptoms and shortening duration of cholera but not non-cholera diarrhea (Khin-Maung-U, et al. 1985).
Three open trials confirmed that a 10% cream of Oregon grape root improved psoriasis (Gulliver and Donsky 2005).
Major Constituents:
Adverse Effects:
Contraindications:
Drug Interactions: There are no known, published studies on whole Oregon grape or barberry roots or extracts causing any drug interactions. However, human clinical trials on pure berberine have consistently reported effects consistent with inhibition of intestinal CYP3A4, leading to increased absorption of many drugs, and thus the potential for a dose-sparing effect. See details on this page.
Purified berberine can also displace drugs that are extensively protein bound, also augmenting their potency. Such effects have never been reported with whole Oregon grape or barberry roots or extracts.
Pure berberine was also found to interfere with tetracycline when taken simultaneously in patients with cholera or diarrhea due to enterotoxic E. coli (Rabbani, et al. 1987). This may be because berberine binds to an interferes with absorption of tetracycline. Simply separating the doses of these drugs in time by a couple of hours will circumvent this problem. No published evidence has been presented on whether whole Oregon grape or barberry roots or extracts would cause a similar problem, but for safety's sake it is recommend their doses are also separated by at least two hours.
- Gastrointestinal Tract
- Skin
Major Indications:
- Diarrhea, acute infectious
- Gastrointestinal parasitoses
- Cholelithiasis, chronic
- Atonic digestive tract
- Cancer
- Diabetes mellitus
- Psoriasis (Bernstein, et al. 2006)
Purified berberine 100 mg qid was more effective than placebo and just as effective as tetracycline 500 mg qid at reducing symptoms and shortening duration of cholera but not non-cholera diarrhea (Khin-Maung-U, et al. 1985).
Three open trials confirmed that a 10% cream of Oregon grape root improved psoriasis (Gulliver and Donsky 2005).
Major Constituents:
- Isoquinoline alkaloids, particularly berberine and berbamine
- Benzylisoquinoline alkaloids
Adverse Effects:
- Mild nausea or stomach upset (usually passes with continuous use, and countered by taking Oregon grape or bayberry with food)
- Stimulation of passage of gallstones, potentially triggering catastrophic bile duct obstruction
- Colic in breast fed infant of mother taking Oregon grape (rare)
- Pure berberine: dizziness, epistaxis, dyspnea, skin/eye irritation, nausea, diarrhea, nephritis, dysbiosis including vaginal candidiasis (with prolonged use of high doses)
Contraindications:
- Pregnancy: use judiciously
- Lactation: in very rare cases, it appears to cause colic in infant
- Neonatal jaundice
Drug Interactions: There are no known, published studies on whole Oregon grape or barberry roots or extracts causing any drug interactions. However, human clinical trials on pure berberine have consistently reported effects consistent with inhibition of intestinal CYP3A4, leading to increased absorption of many drugs, and thus the potential for a dose-sparing effect. See details on this page.
Purified berberine can also displace drugs that are extensively protein bound, also augmenting their potency. Such effects have never been reported with whole Oregon grape or barberry roots or extracts.
Pure berberine was also found to interfere with tetracycline when taken simultaneously in patients with cholera or diarrhea due to enterotoxic E. coli (Rabbani, et al. 1987). This may be because berberine binds to an interferes with absorption of tetracycline. Simply separating the doses of these drugs in time by a couple of hours will circumvent this problem. No published evidence has been presented on whether whole Oregon grape or barberry roots or extracts would cause a similar problem, but for safety's sake it is recommend their doses are also separated by at least two hours.
Pharmacy Essentials
Tincture: 1:2–1:3 w:v ratio, 30% ethanol
Dose:
Acute, adult: 1–2 ml up to q2h for 2–3 days
Chronic, adult: 1–2 ml tid
Child: as adult but adjusted for body size
Glycerite: 1:3–1:4 w:v ratio, 75%+ vegetable glycerin (definitely not as potent as tincture)
Dose:
Acute, adult: 2–3 ml up to q2h for 2–3 days
Chronic, adult: 2–3 ml tid
Child: as adult but adjusted for body size
Decoction: 2–3 g (1 heaping tsp) of root simmered, covered, in 250 ml of water for 15–30 min, the result of which makes one cup (not 8 oz, but one dose). The amount of water used can be adjusted to patient taste in subsequent cups.
Dose:
Acute adult: 1 cup up to q2h for 2–3 days
Chronic, adult: 1 cup tid
Child: as adult but adjusted for body size
Capsules:
Dose:
Acute, adult: 1–2 g up to q2h for 2–3 days
Chronic, adult: 1–2 g tid
Child: as adult but adjusted for body size
If you need help formulating with this herb, or any other, you can use the formulation tool. Remember that when using this herb in a formula, due to synergy, you can usually use less.
Dose:
Acute, adult: 1–2 ml up to q2h for 2–3 days
Chronic, adult: 1–2 ml tid
Child: as adult but adjusted for body size
Glycerite: 1:3–1:4 w:v ratio, 75%+ vegetable glycerin (definitely not as potent as tincture)
Dose:
Acute, adult: 2–3 ml up to q2h for 2–3 days
Chronic, adult: 2–3 ml tid
Child: as adult but adjusted for body size
Decoction: 2–3 g (1 heaping tsp) of root simmered, covered, in 250 ml of water for 15–30 min, the result of which makes one cup (not 8 oz, but one dose). The amount of water used can be adjusted to patient taste in subsequent cups.
Dose:
Acute adult: 1 cup up to q2h for 2–3 days
Chronic, adult: 1 cup tid
Child: as adult but adjusted for body size
Capsules:
Dose:
Acute, adult: 1–2 g up to q2h for 2–3 days
Chronic, adult: 1–2 g tid
Child: as adult but adjusted for body size
If you need help formulating with this herb, or any other, you can use the formulation tool. Remember that when using this herb in a formula, due to synergy, you can usually use less.
Other Names
Latin synonyms:
Current correct Latin binomial: Berberis aquifolium Pursh
Berberis brevipes Greene
Berberis fasciculata Schult.f.
Berberis pinnata Banks ex DC
Mahonia aquifolium (Pursh) Nutt
Mahonia brevipes Rehder
Mahonia diversifolia Sweet
Mahonia moseriana Moser ex H Martinet
Odostemon aquifolium (Pursh) Rydb
Odostemon brevipes A Heller
Odostemon nutkanus Rydb
Note: Because of intermediate forms between strict Berberis and Mahonia, and results of modern genetic studies, the species name Mahonia aquifolium is not used in this monograph. However, Mahonia aquifolium is used in Herbs of Commerce and thus is the legally correct Latin name of this plant in the United States.
English Common Names: Oregon grape, tall Oregon grape, mahonia, mountain grape, holly mahonia, holly barberry, blue barberry
Native American Common Names (grouped linguistically and geographically):
Hul̓q̓umín̓um̓ (Halkomelem, island dialect, Salish): suni’ulhp
hən̓q̓əmin̓əm̓ (Halkomelem, downriver dialect, Salish): suni’ulhp
Halq̓eméylem (Halkomelem, upriver dialect, Salish): suliyulhp
ńseĺxčiń (Colville-Okanagan, Salish): th’ô:lth’iyelhp; sćŕsiłəmĺx (shrub), sc̓əc̓ris (fruit)
Séliš (Spokane-Kalispel-Pend d’Oreille, Salish): sqʷoyu
SENĆOŦEN (North Straits Salish): səniʔíłč (shrub), səníʔ (fruit)
Snchitsu’umshtsn (Couer d’Alene, Salish): sqʷéyuʔ
sƛ̓áƛ̓y̌əmx (Lillooet, Salish): c̓úl̓:c̓əl̓, c̓úl̓:c̓l̓-aź
təw'ánəxʷ (Skokomish or Twana, Salish): suw̓i’sabši
Tsinúk (Lower Chinook, Chinookan): ik’auk’áuwiq (“wood for extracting yellow dye”)
Ktunaxa (Kootenai, isolate): nahuk ʔakwukaʔis (bush), nahuk (fruit)
Current correct Latin binomial: Berberis aquifolium Pursh
Berberis brevipes Greene
Berberis fasciculata Schult.f.
Berberis pinnata Banks ex DC
Mahonia aquifolium (Pursh) Nutt
Mahonia brevipes Rehder
Mahonia diversifolia Sweet
Mahonia moseriana Moser ex H Martinet
Odostemon aquifolium (Pursh) Rydb
Odostemon brevipes A Heller
Odostemon nutkanus Rydb
Note: Because of intermediate forms between strict Berberis and Mahonia, and results of modern genetic studies, the species name Mahonia aquifolium is not used in this monograph. However, Mahonia aquifolium is used in Herbs of Commerce and thus is the legally correct Latin name of this plant in the United States.
English Common Names: Oregon grape, tall Oregon grape, mahonia, mountain grape, holly mahonia, holly barberry, blue barberry
Native American Common Names (grouped linguistically and geographically):
Hul̓q̓umín̓um̓ (Halkomelem, island dialect, Salish): suni’ulhp
hən̓q̓əmin̓əm̓ (Halkomelem, downriver dialect, Salish): suni’ulhp
Halq̓eméylem (Halkomelem, upriver dialect, Salish): suliyulhp
ńseĺxčiń (Colville-Okanagan, Salish): th’ô:lth’iyelhp; sćŕsiłəmĺx (shrub), sc̓əc̓ris (fruit)
Séliš (Spokane-Kalispel-Pend d’Oreille, Salish): sqʷoyu
SENĆOŦEN (North Straits Salish): səniʔíłč (shrub), səníʔ (fruit)
Snchitsu’umshtsn (Couer d’Alene, Salish): sqʷéyuʔ
sƛ̓áƛ̓y̌əmx (Lillooet, Salish): c̓úl̓:c̓əl̓, c̓úl̓:c̓l̓-aź
təw'ánəxʷ (Skokomish or Twana, Salish): suw̓i’sabši
Tsinúk (Lower Chinook, Chinookan): ik’auk’áuwiq (“wood for extracting yellow dye”)
Ktunaxa (Kootenai, isolate): nahuk ʔakwukaʔis (bush), nahuk (fruit)
Interchangeability of Species
Berberis and Mahonia species are very broadly interchangeable, even between continents. For example, the famous herbalist Michael Moore considered all North American species interchangeable (Moore 2003). There is little research on their comparative potency though. It is recommended to use the most bioregional or local species possible to reduce unnecessary shipping and the pollution that inevitably comes with it.
Advanced Clinical Information
Pharmacokinetics: Berberine is very poorly orally absorbed. In one human study, only minute amounts were recovered in the urine after oral administration (Miyazaki, et al. 1978). This does not preclude that active metabolites formed from berberine do circulate at higher levels. Serum levels of 0.11 mg/L of berberine are necessary for antiarrhythmic effects (Zeng and Zeng 1999).
Additional Actions: * Refers to pure berberine.
Flavonoids in leaves inhibit drug-resistance pumps against berberine in vitro (Stermitz, et al. 2001 and 2000a and b).
Additional Indications: * Refers to pure berberine.
Additional Actions: * Refers to pure berberine.
- Antifungal
- Anthelmintic
- Antiprotozoal
- Anti-arrhythmic (Zeng, et al. 1997)
- Positive inotropic
- Antimitotic
- Hypoglycemic and insulin sensitizing
- Increases glucagon-like peptide secretion* (Lu, et al. 2009)
- Increases GLUT1 activity* (Zhou, et al. 2007)
- Insulin sensitizing* (Liu, et al. 2010)
- Intestinal permeability improver* (Gu, et al. 2009)
- Antihypertensive* (Liu, et al. 1999; Chun, et al. 1978)
Flavonoids in leaves inhibit drug-resistance pumps against berberine in vitro (Stermitz, et al. 2001 and 2000a and b).
Additional Indications: * Refers to pure berberine.
- Trachoma (topical)
- Atopic dermatitis (Donsky and Clarke 2007)
- Diabetes mellitus*
- Congestive heart failure* (Zeng, et al. 2003; Zeng and Li 2001; Zeng, et al. 2000; Marin-Neto, et al. 1988)
- Arrhythmias
- Thrombocytopenia
- Ventricular premature beats* (Zeng, et al. 1997)
Classic Formulas
Biliary Recovery Formula (Lyle 1897)
Anal Prolapse Enema (Lyle 1897)
Chronic Diarrhea Formula (Lyle 1897)
Dose 3–6 times per day
Eczema Pustulosa Formula (Lyle 1897)
Dose: 1 tsp at 9 am, 3 pm, and 9 pm
Chronic Skin Disease Formula (Lyle 1897)
Dose: 1 dessertspoonful 3–4 times a day.
Topical Skin Formula (Lyle 1897)
Specifically mentioned for eczema, scropfula, gleet, syphilis, mercurial, and cancer sores.
Compound Syrup Trifolium (Lyle 1897)
Specifically mentioned for syphilis, buboes, and suppurating glands. This bears a striking resemblance to the famous cancer formula known as the Hoxsey formula. Despite the stories Harry Hoxsey told about the origins of this formula (supposedly observing horses grazing on certain plants, which is absurd both because severe things in this formula are toxic to horses and they don't eat them, and also because they don't even grow in the same place for horses to graze), the reality is he based it on this and other similar formulas promulgated by the Eclectic physicians.
Digestive Stimulation Formula (Lyle 1897)
For "very torpid digestion and poor assimilation, with biliousness, as found frequently in cases of dropsy."
Tubercular Trachoma Formula (Lyle 1897)
Dose: 1 tsp tid
- Berberis vulgaris root 1 part
- Populus tremuloides bark 2 parts
- Prunus virginiana 3 parts
- Vinegar, a sufficient quantity
Anal Prolapse Enema (Lyle 1897)
- Populus tremuloides bark 1 part
- Berberis vulgaris root 1 part
- Chelone glabra aerial parts 1 part
Chronic Diarrhea Formula (Lyle 1897)
- Populus tremuloides bark fluid extract 2 drams
- Berberis aquifolium root fluid extract 1 dram
- Hydrastis canadensis root fluid extract 0.5 dram
- Aletris farinosa root fluid extract 1 dram
- Taraxacum officinalis root fluid extract 4 drams
- Zanthoxylum fraxineus root bark fluid extract 10 drops
- Simple syrup sufficient to make 4 oz
Dose 3–6 times per day
Eczema Pustulosa Formula (Lyle 1897)
- Picramnia antidesma (cascara amarga) bark 4 drams
- Berberis aquifolium root 2 drams
- Simple syrup sufficient to make 4 oz
Dose: 1 tsp at 9 am, 3 pm, and 9 pm
Chronic Skin Disease Formula (Lyle 1897)
- Celastrus scandens (false bitter sweet) root fluid extract 1 oz
- Berberis aquifolium root fluid extract 1 oz
- Iris versicolor rhizome fluid extract 0.5 oz
- Rheum palmatum root syrup 2 oz
- Zingiber officinale rhizome syrup 8 oz
Dose: 1 dessertspoonful 3–4 times a day.
Topical Skin Formula (Lyle 1897)
- Stillingia sylvatica 2 parts
- Cordyalis formosa 2 parts
- Berberis aquifolium 2 parts
- Zanthoxylum 1 part
- Trifolium pratense 5 parts
- Ampelopsis 4 parts
Specifically mentioned for eczema, scropfula, gleet, syphilis, mercurial, and cancer sores.
Compound Syrup Trifolium (Lyle 1897)
- Trifolium pratense 16 parts
- Stillingia sylvatica 8 parts
- Berberis aquifolium 8 parts
- Arctium lappa root 8 parts
- Phytolacca americana 8 parts
- Picramnia antidesma 8 parts
- Potassium iodide 1 part
- Zanothxylum spp 2 parts
Specifically mentioned for syphilis, buboes, and suppurating glands. This bears a striking resemblance to the famous cancer formula known as the Hoxsey formula. Despite the stories Harry Hoxsey told about the origins of this formula (supposedly observing horses grazing on certain plants, which is absurd both because severe things in this formula are toxic to horses and they don't eat them, and also because they don't even grow in the same place for horses to graze), the reality is he based it on this and other similar formulas promulgated by the Eclectic physicians.
Digestive Stimulation Formula (Lyle 1897)
- Armoracia rusticana 2 oz
- Sinapis alba 2 oz
- Juniperus communis 2 oz
- Berberis aquifolium 2 oz
- Citrus x aurantium 2 oz
- Apple cider vinegar 3 pints
For "very torpid digestion and poor assimilation, with biliousness, as found frequently in cases of dropsy."
Tubercular Trachoma Formula (Lyle 1897)
- Berberis aquifolium fluid extract 4 dram
- Lycopus virginicus fluid extract 4 dram
- Zanthoxylum spp fluid extract 2 dram
- Stillingia sylvatica Compound 4 oz
Dose: 1 tsp tid
Monographs from Eclectic Materia Medica (Felter 1922)
BERBERIS (Mahonia) AQUIFOLIUM
The root of Berberis aquifolium, Pursh (Nat. Ord. Berberidaceae). Western United States from Colorado to the Pacific coast; cultivated also for ornament among shrubbery.
Common Names: Oregon Grape, Mountain Grape.
Principal Constituents.—Berberine, the yellow alkaloid (see Hydrastis) and two white alkaloids—berbamine and oxyacanthine.
Preparation.—Specific Medicine Berberis. Dose, 1 to 30 drops.
Specific Indications.—Syphilitic dyscrasia; chronic skin diseases, with blood dyscrasia with or without syphilitic taint; profusely secreting tumid mucous membranes; indigestion, with hepatic torpor. [Modern comment: this herb is not sufficient to treat syphilis.]
Action and Therapy.—This agent is alterative, tonic, and probably corrective to syphilitic constitutions, but without any proved specific action upon treponema. It stimulates secretion and excretion, improves digestion and assimilation; it activates the lymphatic system and ductless glands; and augments the renal secretion. It is a corrector and eliminator of depraved body fluids and assists thereby in good blood-making. In this way most likely its good effects are produced in such grave constitutional disorders as syphilis. Certainly the ravages of this disease are lessened under these circumstances and aggravated by general ill-conditions. If then syphilitic dyscrasia is benefited by this drug, and clinical results seem to show that it is, it is probably due to its general alterative effects in maintaining good elimination and good metabolic action of the organs vital to nutrition.
Like hydrastis, Berberis aquifolium is an excellent peptic bitter and tonic to the gastric function, and is, therefore, a drug of much value in atonic dyspepsia, with hepatic torpor. Upon the mucosa its effects are like those of hydrastis controlling catarrhal outpouring and erosion of tissue. For this purpose it is useful in stomatitis and gastric and intestinal catarrh. Remotely it sometimes controls leucorrhoea. If these are associated with syphilis, it helps the latter to the extent that it controls these disorders.
Berberis aquifolium has won its reputation chiefly as a remedy for the syphilitic taint. The more chronic the conditions or results of the disease, the more it has been praised. Some claim that if given early it will abort the tertiary stage, but this of course depends in most cases upon the resisting powers of the body and the care the patient takes of himself. Apparently berberis fortifies the resisting powers by its alterative and reparative action. The bone, mucosa, and cutaneous disorders following in the wake of syphilis seem to clear up under its persistent use, when given in appreciable doses. Whether it has any effect on the nervous damage from this taint is not yet apparent. It does, however, relieve the night pains and the shin pain of syphilitic periostitis. Syphilitic phagedena disappears under its use, and sometimes the anemia of syphilis yields to its nutritional improvement. It should be given freely in syphilitic leucoplakia of the tongue, mouth, and throat, where the mucosa is tumid and secreting excessively, and when emaciation and weakness with yellowish parchmentlike skin are evident. At all events, though probably not a direct antisyphilitic, its general effect upon waste and nutrition is so beneficial that it should invariably be associated with other treatment in chronic syphilitic diathesis.
Other dyscrasiae seem to be influenced by this drug. It aids to some degree to mitigate the miseries of the consumptive, and in chronic skin diseases its internal use has hastened the effects from external medication. Eczema, psoriasis (temporarily at least), and herpetic eruptions have disappeared under its persistent use. The specific medicine should be given in doses of from 10 to 20 drops well diluted, every 3 or 4 hours.
BERBERIS VULGARIS
The bark of the root and the berries of Berberis vulgaris, Linne (Nat. Ord. Berberidaceae). Europe, Asia, and the United States.
Common Names: Barberry, Common Barberry.
Principal Constituents.—Berberine (see Hydrastis) is the active alkaloid; others are oxyacanthine and berbamine. The berries contain malic acid.
Preparation.—Tinctura Berberidis Vulgaris, Tincture of Berberis Vulgaris. (Barberry Bark, 8 ounces, Alcohol 76 per cent, 16 ounces.) Dose, 5 to 60 drops.
Action and Therapy.--Barberry may be used for purposes for which berberine medication is needed. It acts much like hydrastis and could be employed for many of the uses of that scarce and high-priced drug so far as the berberine effects are required. The fluid preparations are asserted to act more kindly and more efficiently than berberine itself. It was very early used in domestic medicine for sore eyes, and later by practitioners for chronic catarrhal ophthalmias. The decoction is employed for this purpose, and is equally efficient in aphthous sore mouth. It is decidedly tonic and if pushed, purgative. Used short of its cathartic action it is of value in non-obstructive jaundice and in gastric and intestinal dyspepsia. In renal catarrh, occasioned by the presence of calculi, small doses may be given when there is burning and soreness and excess of mucus in the urinary tract.
The root of Berberis aquifolium, Pursh (Nat. Ord. Berberidaceae). Western United States from Colorado to the Pacific coast; cultivated also for ornament among shrubbery.
Common Names: Oregon Grape, Mountain Grape.
Principal Constituents.—Berberine, the yellow alkaloid (see Hydrastis) and two white alkaloids—berbamine and oxyacanthine.
Preparation.—Specific Medicine Berberis. Dose, 1 to 30 drops.
Specific Indications.—Syphilitic dyscrasia; chronic skin diseases, with blood dyscrasia with or without syphilitic taint; profusely secreting tumid mucous membranes; indigestion, with hepatic torpor. [Modern comment: this herb is not sufficient to treat syphilis.]
Action and Therapy.—This agent is alterative, tonic, and probably corrective to syphilitic constitutions, but without any proved specific action upon treponema. It stimulates secretion and excretion, improves digestion and assimilation; it activates the lymphatic system and ductless glands; and augments the renal secretion. It is a corrector and eliminator of depraved body fluids and assists thereby in good blood-making. In this way most likely its good effects are produced in such grave constitutional disorders as syphilis. Certainly the ravages of this disease are lessened under these circumstances and aggravated by general ill-conditions. If then syphilitic dyscrasia is benefited by this drug, and clinical results seem to show that it is, it is probably due to its general alterative effects in maintaining good elimination and good metabolic action of the organs vital to nutrition.
Like hydrastis, Berberis aquifolium is an excellent peptic bitter and tonic to the gastric function, and is, therefore, a drug of much value in atonic dyspepsia, with hepatic torpor. Upon the mucosa its effects are like those of hydrastis controlling catarrhal outpouring and erosion of tissue. For this purpose it is useful in stomatitis and gastric and intestinal catarrh. Remotely it sometimes controls leucorrhoea. If these are associated with syphilis, it helps the latter to the extent that it controls these disorders.
Berberis aquifolium has won its reputation chiefly as a remedy for the syphilitic taint. The more chronic the conditions or results of the disease, the more it has been praised. Some claim that if given early it will abort the tertiary stage, but this of course depends in most cases upon the resisting powers of the body and the care the patient takes of himself. Apparently berberis fortifies the resisting powers by its alterative and reparative action. The bone, mucosa, and cutaneous disorders following in the wake of syphilis seem to clear up under its persistent use, when given in appreciable doses. Whether it has any effect on the nervous damage from this taint is not yet apparent. It does, however, relieve the night pains and the shin pain of syphilitic periostitis. Syphilitic phagedena disappears under its use, and sometimes the anemia of syphilis yields to its nutritional improvement. It should be given freely in syphilitic leucoplakia of the tongue, mouth, and throat, where the mucosa is tumid and secreting excessively, and when emaciation and weakness with yellowish parchmentlike skin are evident. At all events, though probably not a direct antisyphilitic, its general effect upon waste and nutrition is so beneficial that it should invariably be associated with other treatment in chronic syphilitic diathesis.
Other dyscrasiae seem to be influenced by this drug. It aids to some degree to mitigate the miseries of the consumptive, and in chronic skin diseases its internal use has hastened the effects from external medication. Eczema, psoriasis (temporarily at least), and herpetic eruptions have disappeared under its persistent use. The specific medicine should be given in doses of from 10 to 20 drops well diluted, every 3 or 4 hours.
BERBERIS VULGARIS
The bark of the root and the berries of Berberis vulgaris, Linne (Nat. Ord. Berberidaceae). Europe, Asia, and the United States.
Common Names: Barberry, Common Barberry.
Principal Constituents.—Berberine (see Hydrastis) is the active alkaloid; others are oxyacanthine and berbamine. The berries contain malic acid.
Preparation.—Tinctura Berberidis Vulgaris, Tincture of Berberis Vulgaris. (Barberry Bark, 8 ounces, Alcohol 76 per cent, 16 ounces.) Dose, 5 to 60 drops.
Action and Therapy.--Barberry may be used for purposes for which berberine medication is needed. It acts much like hydrastis and could be employed for many of the uses of that scarce and high-priced drug so far as the berberine effects are required. The fluid preparations are asserted to act more kindly and more efficiently than berberine itself. It was very early used in domestic medicine for sore eyes, and later by practitioners for chronic catarrhal ophthalmias. The decoction is employed for this purpose, and is equally efficient in aphthous sore mouth. It is decidedly tonic and if pushed, purgative. Used short of its cathartic action it is of value in non-obstructive jaundice and in gastric and intestinal dyspepsia. In renal catarrh, occasioned by the presence of calculi, small doses may be given when there is burning and soreness and excess of mucus in the urinary tract.
Botanical Information
Botanical Description: This shrubby genus can be low growing (B. nervosa) or reach up to 6 ft high (B. aquifolium and B. vulgaris) (Abrams 1934). The compound leaves of the Oregon grape have no spine at the base; they are evergreen and waxy, with sharp tips resembling the leaves of Ilex (holly), and are dark green. They are alternate and have 5–9 leaflets on each leaf (B. nervosa) or 9–15 leaflets on each leaf (B. aquifolium). The leaves of barberry are simple and alternate and are dark maroon in color. The flowers of the Oregon grape grow in terminal racemes, are small and yellow in color with tart blue-purple berries. The fruits of barberry are bright red and grow singly under the leaves along each branch. The bark is brown on the surface and yellow beneath for each of these plants. The barberry also has spines along its primary stems. The root is from 1–6 cm diameter at the base of the stem.
Native range: Oregon Grape Root is native to the western United States. It grows from Colorado to the Pacific Ocean, and is especially abundant in Washington, Oregon and northern California.
Native range: Oregon Grape Root is native to the western United States. It grows from Colorado to the Pacific Ocean, and is especially abundant in Washington, Oregon and northern California.
Predominant native range of Berberis aquifolium
Harvest, Cultivation, and Ecology
Cultivation: B. aquifolium is readily cultivated from seed or by transplanting. It can tolerate a wide range of water regimens and sun exposure (from full shade to full sun). It is widely planted for horticultural purposes throughout its native range.
Wildcrafting: Collection of the roots is still extremely common from wild stocks.
Ecological Status: Currently this shrub is extremely widespread and there is no reason to be concerned about overharvesting. The inclusion of this herb on the United Plants Savers "to watch" list is apparently based on it having a "limited range." This seems absurd as its range is enormous, and that is very readily and widely cultivated (albeit more for horticulture than medicine, growing for medicinal use could be readily ramped up if there really was any threat to wild stocks).
Wildcrafting: Collection of the roots is still extremely common from wild stocks.
Ecological Status: Currently this shrub is extremely widespread and there is no reason to be concerned about overharvesting. The inclusion of this herb on the United Plants Savers "to watch" list is apparently based on it having a "limited range." This seems absurd as its range is enormous, and that is very readily and widely cultivated (albeit more for horticulture than medicine, growing for medicinal use could be readily ramped up if there really was any threat to wild stocks).
References
Abrams L (1934) "The mahonias of the Pacific states" Phytologia 1:89–94.
Amin AH, Subbaiah TV, Abbasi KM (1969) "Berberine sulfate: Antimicrobial activity, bioassay and mode of action" Can J Microbiol 15:1067–76.
Bernstein S, Donsky H, Gulliver W, et al. (2006) "Treatment of mild to moderate psoriasis with Reliéva, Mahonia aquifolium extract–-a double-blind, placebo-controlled study" Amer J Ther 13:121–6.
Chun YT, Yip TT, Lau KL, Kong YC (1978) "A biochemical study on the hypotensive effect of berberine in rats" Gen Pharmac 10:177–82.
Donsky H, Clarke D (2007) "Reliéva, a Mahonia aquifolium extract for the treatment of adult patients with atopic dermatitis" Am J Ther 14:442–6.
Felter HW (1922) Eclectic Materia Medica, Pharmacology and Therapeutics (Sandy, OR: Eclectic Medical Publications, reprinted 1998).
Gu LL, Li N, Li QR, et al. (2009) "The effect of berberine in vitro on tight junctions in human Caco-2 intestinal epithelial cells" Fitoterapia 80:241–8.
Gulliver WP, Donsky HJ (2005) "A report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasis" Am J Ther 12:398–406.
Iauk L, Costanzo R, Caccamo F, et al. (2007) "Activity of Berberis aetnensis root extracts on Candida strains" Fitoterapia 78(2):159–61.
Khin-Maung-U, Myo-Khin, Nyunt-Nyung-Wai, et al. (1985) "Clinical trial of berberine in acute watery diarrhea" Br Med J 291:1601–5.
Kim JB, Lee KM, Ko EY, et al. (2008) "Berberine inhibits growth of the breast cancer cell lines MCF-7 and MDA-MB-231" Planta Med 74:39–42.
Liu JC, Chan P, Chen YJ, et al. (1999) "The antihypertensive effect of berberine derivative 6-protoberberine in spontaneously hypertensive rats" Pharmacology 59:283–9.
Liu LZ, Cheung SCK, Lan LL, et al. (2010) "Berberine modulates insulin signaling transduction in insulin-resistant cells" Molec Cell Endocrinology 317:148–53.
Lu SS, Yu YL, Zhu HJ, et al. (2009) "Berberine promotes glucagon-like peptide-1 (7–36) amide secretion in streptozotocin-induced diabetic rats" J Endocrinol 200:159–65.
Lyle TJ (1897) Physio-Medical Therapeutics, Materia Medica and Pharmacy (London: National Association of Medical Herbalists).
Marin-Neto JA, Maciel BC, Secches AL, Gallo L (1988) "Cardiovascular effects of berberine in patients with severe congestive heart failure" Clin Cardiol 11:253–60.
Miyazaki H, Shirai E, Ishiashi M, et al. (1978) "Quantitative analysis of berberine in urine samples by chemical ionization mass fragmentography" J Chromatogr 152;79–86.
Moore M (2003) Medicinal Plants of the Mountain West, Revised and Expanded Edition (Santa Fe: Museum of New Mexico Press).
Park KS, Kang KC, Kim JH, et al. (1999) "Differential inhibitory effects of protoberberines on sterol and chitin biosynthesiss in Candida albicans" J Antimicrob Chemother 43:667–674.
Rabbani GH, Butler T, Knight J, et al. (1987) "Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae" J Infect Dis 155(5):979–84.
Slobodníková L, Kost’álová D, Labudová D, et al. (2004) "Antimicrobial activity of Mahonia aquifolium crude extract and its major isolated alkaloids" Phytother Res 18:674–6.
Stermitz FR, Beeson TD, Mueller PJ, et al. (2001) "Staphylococcus aureus MDR efflux pump inhibitors from a Berberis and a Mahonia (sensu strictu) species" Biochem Systematics Ecol 29:793–798.
Stermitz FR, Lorenz P, Tawara JN, et al. (2000a) "Synergy in a medicinal plant: Antimicrobial action of berberine potentiated by 5'-methoxyhydnocarpin, a multidrug pump inhibitor" PNAS 97(4):1433–7.
Stermitz FR, Tawara-Matsuda J, Lorenz P, et al. (2000b) "5'-Methoxyhydnocarpin-D and pheophorbide A: Berberis species components that potentiate berberine growth inhibition of resistant Staphylococcus aureus" J Nat Prod 63:1146–9.
Turner N (1995) Food Plants of Coastal First Peoples (British Columbia: UBC Press).
Volleková A, Kost'álová D, Kettman V, Tóth J (2003) "Antifungal activity of Mahonia aquifolium extract and its major protoberberine alkaloids" Phytother Res 17:834–7.
Zeng XH, Li YY (2001) "Clinical observations of the effect of berberine for congestive heart failure" US Chinese J Angiocardiomyopathy 6:308–11.
Zeng XH, Li YY, Zeng XJ (2000) "Beneficial effects of berberine in ischemic heart failure" J Qianna Medical College Nationalities 3:132–4 [in Chinese].
Zeng XH, Zeng XJ, Li YY (2003) "Efficacy and safety of berberine for congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy" Am J Cardiol 92:173–6.
Zeng XJ, Zeng XH (1999) "Relationship between the clinical effects of berberine on severe congestive heart failure and its concentration in plasma studied by HPLC" Biomed Chromatogr 13:442–4.
Zhou LB, Yang Y, Wang X, et al. (2007) "Berberine stimulates glucose transport through a mechanism distinct from insulin" Metablism Clin Exp 56:405–412.
Amin AH, Subbaiah TV, Abbasi KM (1969) "Berberine sulfate: Antimicrobial activity, bioassay and mode of action" Can J Microbiol 15:1067–76.
Bernstein S, Donsky H, Gulliver W, et al. (2006) "Treatment of mild to moderate psoriasis with Reliéva, Mahonia aquifolium extract–-a double-blind, placebo-controlled study" Amer J Ther 13:121–6.
Chun YT, Yip TT, Lau KL, Kong YC (1978) "A biochemical study on the hypotensive effect of berberine in rats" Gen Pharmac 10:177–82.
Donsky H, Clarke D (2007) "Reliéva, a Mahonia aquifolium extract for the treatment of adult patients with atopic dermatitis" Am J Ther 14:442–6.
Felter HW (1922) Eclectic Materia Medica, Pharmacology and Therapeutics (Sandy, OR: Eclectic Medical Publications, reprinted 1998).
Gu LL, Li N, Li QR, et al. (2009) "The effect of berberine in vitro on tight junctions in human Caco-2 intestinal epithelial cells" Fitoterapia 80:241–8.
Gulliver WP, Donsky HJ (2005) "A report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasis" Am J Ther 12:398–406.
Iauk L, Costanzo R, Caccamo F, et al. (2007) "Activity of Berberis aetnensis root extracts on Candida strains" Fitoterapia 78(2):159–61.
Khin-Maung-U, Myo-Khin, Nyunt-Nyung-Wai, et al. (1985) "Clinical trial of berberine in acute watery diarrhea" Br Med J 291:1601–5.
Kim JB, Lee KM, Ko EY, et al. (2008) "Berberine inhibits growth of the breast cancer cell lines MCF-7 and MDA-MB-231" Planta Med 74:39–42.
Liu JC, Chan P, Chen YJ, et al. (1999) "The antihypertensive effect of berberine derivative 6-protoberberine in spontaneously hypertensive rats" Pharmacology 59:283–9.
Liu LZ, Cheung SCK, Lan LL, et al. (2010) "Berberine modulates insulin signaling transduction in insulin-resistant cells" Molec Cell Endocrinology 317:148–53.
Lu SS, Yu YL, Zhu HJ, et al. (2009) "Berberine promotes glucagon-like peptide-1 (7–36) amide secretion in streptozotocin-induced diabetic rats" J Endocrinol 200:159–65.
Lyle TJ (1897) Physio-Medical Therapeutics, Materia Medica and Pharmacy (London: National Association of Medical Herbalists).
Marin-Neto JA, Maciel BC, Secches AL, Gallo L (1988) "Cardiovascular effects of berberine in patients with severe congestive heart failure" Clin Cardiol 11:253–60.
Miyazaki H, Shirai E, Ishiashi M, et al. (1978) "Quantitative analysis of berberine in urine samples by chemical ionization mass fragmentography" J Chromatogr 152;79–86.
Moore M (2003) Medicinal Plants of the Mountain West, Revised and Expanded Edition (Santa Fe: Museum of New Mexico Press).
Park KS, Kang KC, Kim JH, et al. (1999) "Differential inhibitory effects of protoberberines on sterol and chitin biosynthesiss in Candida albicans" J Antimicrob Chemother 43:667–674.
Rabbani GH, Butler T, Knight J, et al. (1987) "Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae" J Infect Dis 155(5):979–84.
Slobodníková L, Kost’álová D, Labudová D, et al. (2004) "Antimicrobial activity of Mahonia aquifolium crude extract and its major isolated alkaloids" Phytother Res 18:674–6.
Stermitz FR, Beeson TD, Mueller PJ, et al. (2001) "Staphylococcus aureus MDR efflux pump inhibitors from a Berberis and a Mahonia (sensu strictu) species" Biochem Systematics Ecol 29:793–798.
Stermitz FR, Lorenz P, Tawara JN, et al. (2000a) "Synergy in a medicinal plant: Antimicrobial action of berberine potentiated by 5'-methoxyhydnocarpin, a multidrug pump inhibitor" PNAS 97(4):1433–7.
Stermitz FR, Tawara-Matsuda J, Lorenz P, et al. (2000b) "5'-Methoxyhydnocarpin-D and pheophorbide A: Berberis species components that potentiate berberine growth inhibition of resistant Staphylococcus aureus" J Nat Prod 63:1146–9.
Turner N (1995) Food Plants of Coastal First Peoples (British Columbia: UBC Press).
Volleková A, Kost'álová D, Kettman V, Tóth J (2003) "Antifungal activity of Mahonia aquifolium extract and its major protoberberine alkaloids" Phytother Res 17:834–7.
Zeng XH, Li YY (2001) "Clinical observations of the effect of berberine for congestive heart failure" US Chinese J Angiocardiomyopathy 6:308–11.
Zeng XH, Li YY, Zeng XJ (2000) "Beneficial effects of berberine in ischemic heart failure" J Qianna Medical College Nationalities 3:132–4 [in Chinese].
Zeng XH, Zeng XJ, Li YY (2003) "Efficacy and safety of berberine for congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy" Am J Cardiol 92:173–6.
Zeng XJ, Zeng XH (1999) "Relationship between the clinical effects of berberine on severe congestive heart failure and its concentration in plasma studied by HPLC" Biomed Chromatogr 13:442–4.
Zhou LB, Yang Y, Wang X, et al. (2007) "Berberine stimulates glucose transport through a mechanism distinct from insulin" Metablism Clin Exp 56:405–412.