Family Name: Gentianaceae

Introduction

Yellow gentian is the mother of all bitter tonics, used to stimulate the digestive tract into vibrant action and the body to renewed vigor. It makes its way into many of the classic European liquers due to its vitality boosting powers.

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Chapter from My PhD Thesis
Eclectic Physician’s Commentaries

Gentian Chapter from my PhD Thesis

Part Used: Root

Chemical Constituents: Significant phytochemicals include gentialutine, gentiamarin, gentianine, gentianose, gentiin, gentiobiose, gentioflavoside, gentiopicrin, and gentioside. (11)

History
Gentiana lutea is indigenous to the mountainous parts of Middle and Southern Europe and is found growing in the Pyrenees, the Islands of Sardinia and Corsica, the Alps , and elsewhere. Gentian is mentioned by both Pliny and Dioscorides and is one of the oldest European digestive tonics. Indeed, its name comes from Gentius, the name of the King of Illyria around 180 BC. During the Middle Ages it was used as a domestic medicine and as an antidote to poisons. In 1633 Gerard recommended the drug be used in sluggish digestion and as an antidote for poisonous bites of snakes, insects, and mad dogs. He strongly states that whenever poison was involved, Gentian had a place. In addition, in cases where there was a lack of vitality, in cold conditions as they were called, the drug stimulated vital action. (13)

The British Colonials brought the drug to North America . It remained a domestic remedy and article of medicine from that day forward. Consistent with its European use as an anti-poison drug, the early Americans used the drug as an antidote to tobacco poisoning. Indeed, in 1865 the most popular tobacco antidote on the market consisted of three parts liquorice and 1 part gentian. When the Eclectic movement began, the drug was a widely used and well understood. The drug was official in all editions of U.S.P. from 1820 to 1910 and was primarily recommended as a bitter tonic. (10)

Eclectic Use (1–10)
Actions
Bitter, stomachic bitter, powerful tonic, stimulant, laxative, excites appetite, invigorates digestion, increases circulation and body temperature, effective after fevers where the powers of life are depressed and recovery depends upon the ability to assimilate food, rapid restorative to the system following administration of quinine.

Indications
“Atony of the stomach and bowels, with feeble or slow digestion, diarrhoea, with relaxation of mucous membranes, chronic malarial poisoning, atonic dyspepsia, with mental and physical depression, general debility and exhaustion.” (7)

General
Exhaustion, debility, gout, tuberculosis, systemic tuberculosis, intermittent fevers, malaria, chronic malaria, splenic enlargement associated with malaria, exhausting illnesses of malarial origin, diseases of phlegmatic or torpid nature, in the decline associated with protracted fevers where recovery depends upon the patient taking in food, enfeeblement caused by protracted illness.

Cardiovascular
Anaemia complicating malarial disease.

Digestive
Dyspepsia, diarrhoea, worms, irritable conditions of the stomach, atony of the stomach and the bowels, with feeble slow digestion, chronic and atonic digestive diseases when an increase in tone is desirable, dyspepsia of people of a gouty diathesis, dyspepsia of the aged, gastric inefficiency of infants and children, catarrhal diarrhoea, dyspepsia associated with chronic or protracted disease, vomiting of pregnancy.

Genito-urinary
Amenorrhoea.

Nervous
Hysteria.

The drug from Selye’s perspective

State of Resistance
The drug was used to raise resistance to malaria, tuberculosis, and gout.

State of Exhaustion
The drug was used when resistance failed and the State of Exhaustion set in. Signs and symptoms of State of Exhaustion treated with this drug, included exhaustion, debility, atonic dyspepsia, chronic digestive abnormalities, phlegmatic or torpid habits, nervous failure, temperature abnormalities, and enfeeblement. The drug was also used in the young and the old, when resistance was insufficient.

Adaptation Energy
From Selye’s perspective, the drug was used to augment the GAS, which suggests it increases adaptation energy. Evidence to this effect includes the following. The drug was used to increase resistance to chronic bacterial infection. The drug was used when resistance failed and State of Exhaustion set in. The drug was used when vital energy ran low and physiological functions were thereby depressed. “ In small doses it is valuable to relieve irritation, and improve the appetite and digestion after protracted fevers when the powers of life are low .” (12) Lastly, the drug was used to augment vitality in the young, the old, and the ill.

Brekhman’s Adaptogen Criterion
An adaptogen should be innocuous and cause minimal disorders in the physiological functions of an organism.

The drug is considered safe by Eclectic and contemporary literature. (1–12)

The action of an adaptogen should be non-specific i.e. it should increase resistance to adverse influences of a wide range of factors of physical, chemical, and biological nature.

Clinically the drug was used to increase resistance to chronic infections (malaria and tuberculosis), tobacco poisoning, and to quinine intoxication. (1–10)

Experimentally, the drug was determined to act as a free radical scavenger. (14) It was also found to increase swimming time in a mouse endurance test. (13) Compounds found in the drug have been shown to increase resistance to bacterial infection (meningitis, tuberculosis, Shigella, Staph. and Strep), viral infection, fungal infection, malaria, cancer (breast and colon), and liver damage. (11)

An adaptogen may possess normalising action irrespective of the direction of the foregoing pathological changes.

Clinically, the drug was used to normalise the physiological abnormalities associated with State of Exhaustion . It was also used when protracted illness depressed vital energy and physiological functions were thereby depressed. It was specifically used to stimulate function of the digestive tract in cases of anorexia, gastritis, atony of the stomach and the bowels (1–10)

Experimentally, compounds found in the drug have been shown to normalise gastric glandular function, blood sugar abnormalities, immune function, diarrhoea, arthritis, allergic reactions, abnormal inflammation, and blood pressure. (11)

Discussion
The drug exhibits properties consistent with Brekhman’s definition of an adaptogen. It is innocuous, it raises resistance to a wide range of biological threats, and it normalises aberrant physiological function.

Gentiana lutea was a well-known and widely used digestive stimulant long before the Eclectic movement came into existence. When the Eclectics were trawling the pharmacopoeia for useful European drugs, this is one they quickly brought into the Eclectic pharmacopoeia.

On the surface, the Eclectics used the drug to stimulate depressed digestive function. However, a more comprehensive investigation reveals the drug was used when vital energy was low and physiological functions were thereby depressed. When depressed digestion was a result of flagging vitality, the drug was used. Alternatively, when there was sufficient vital energy, the drug was contra-indicated.

To summarise the Eclectic uses of this drug, it can be said that it was used whenever there was deficient vital energy. The elderly, the sickly young, and the ill, patients displaying a lack of vitality, were often treated with the drug. Quite often the drug was used when chronic disease had robbed a patient of vitality to the point they were facing constitutional collapse. From Selye’s perspective, the drug was used when State of Exhaustion occurred.

Potential Clinical Applications
The drug may be of use when chronic disease has robbed a patient of vitality and physiological functions are performed in a depressed manner. It may also prove useful in geriatric complaints rooted in lack of vitality.

Future Research
• Gentiana lutea and its effects on the GAS. The drug should be tested out in the animal model to determine its specific effects on the GAS.
• Gentiana lutea and exposure to toxic chemicals. Historically, the drug was used to increase resistance to toxins. Research indicates it protects the liver from chemical damage. Its effect in raising resistance to chemical exposure should be investigated.
• Gentiana lutea and its effect on endurance. Historically, the drug was used to increase endurance and stamina. A mouse study demonstrated the drug has an anti-fatigue activity. (13) Its effect on endurance should be investigated.
• Gentiana lutea and geriatric complaints. The drug was used to raise resistance to geriatric complaints. Its role in resisting resistance to ageing should be established.

Eco-availability
The drug is widely available.

References
• King, John. The American Eclectic Dispensatory. Moore , Wilstach, and Keys. Cincinnati . P. 492.
• 1854. Dyer, D. The Eclectic Family Physician A scientific System of Medicine on Vegetable Principles Designed for Families. 1855.
• Scudder, J. M. Specific Medication and Specific Medicines. Revised. Fifth Edition. Wilstach, Baldwin and Company. Cincinnati . 1874. P. 145.
• Scudder, J. M. The American Eclectic Materia Medica and Therapeutics. Published by the Author. Cincinnati . 1883. P. 450.
• Felter, Harvey Wickes and Lloyd, John Uri. Kings’ American Dispensatory. Volume one and Volume two. Ohio Valley Company. Cincinnati . 1898. P. 924, 1925.
• Felter, Harvey. Syllabus of Eclectic Materia Medica and Therapeutics. Compiled from notes taken from the lectures of F.J.Locke. Edited with pharmacological additions by H.W.Felter. Second edition, with appendix. Scudder Brothers Company. Cincinnati.1901. P. 155.
• Lloyd Brothers. Dose book of Specific Medicines. Lloyd Brothers, Cincinnati . 1907. P. 139.
• Fyfe, John William. Pocket Essentials of Modern Materia Medica and Therapeutics. The Scudder Brothers Company. 1903. P. 132.
• Ellingwood, Finley. American Materia Medica, Therapeutics, and Pharmacognosy. Ellingwood’s Therapeutist. Chicago . 1919. P. 267.
• Lloyd, John Uri. Origin and History of all the Pharmacopoeial Vegetable Drugs, Chemicals and Preparations. Volume 1: Vegetable Drugs. The Caxton Press. Cincinnati . 1921. P. 152.
• Dr. Dukes Phytochemical and Ethnobotanical Databases. Agricultural Research Service. USDA.
• Johnson, Gerard. The Herbal or General Historie of Plantes. London . 1633. P. 434.
• Ozturk et al. Effects of Gentiana Lutea on the central nervous system of mice. Phytotherapy Research 2002 Nov; 16(7): 627–31. From PubMed abstracts.
• Calliste CA. Free radical scavenging activities measured by electron spin resonance spectroscopy and B16 cell antiproliferative behaviours of seven plants. J Agric Food Chem 2001 Jul; 49(7): 3321–7. From PubMed abstracts.

Notes from the Eclectic Physicians

GENTIANA LUTEA

GENTIANACEAE

GENTIAN

1854: JOHN KING – GENTIANA LUTEA – GENTIAN
Properties and Uses – A powerful tonic, excites the appetite, invigorates digestion, and moderately increases the circulation and temperature of the body. Used in cases of debility and exhaustion, and in all cases where a tonic is required, as dyspepsia, gout, amenorrhea, hysteria, scrofula, intermittents, diarrhea, worms, etc. Dose of the powder, from ten to thirty grains; of the extract, from one to ten grains; of infusion, one or two fluidounces; of tincture, one or two fluidrachms. When taken in large doses, it is apt to oppress the stomach, irritate the bowels, and even produce nausea and vomitting. Its adminstration is contra-indicated where gastric irritability is present.

Dr Kuchenmeister believes the impure and uncrystallised gentianin is the most vaulable substitute for quinia, acting as rapidly, and as efficaciously on the spleen, in dosed of from fifteen to thirty grains twice a day.

1855; Dyer (Vegetable Principles) – GENTIANA LUTCA – GENTAIN
This is used as a bitter, it excites the appetite and invigorates the power of digestion. No medicine equals this as a tonic in any case of debility. It enters the tonic bitter. Many physicians of note use it alone as a bitter. See Tinet. of Gentain.

1874: J.M. SCUDDER (tonic) – GENTIANA LUTE – (Gentian)
The Gentian is an excellent stomachic bitter, and resembles, in its medicinal action, our Hydrastis. I do not think, however, it has the same kindly influence in irritable conditions of the stomach.

A very fine preparation may be made by taking five parts of Gentian, and on part of Podophyllum; and making a tincture by percolation, using dilute Alcohol. It is one of the most efficient remedies I have ever used in atony of the stomach and bowels, with feeble or slow digestion.

1883: Scudder:(Tonic)
The root of gentiana lutea ‑ Europe . Preparation: Tincture of Gentian. Dose: From five drops to half a drachm. Therapeutic Action:

Gentian is tonic, stomachic, slightly stimulant and feebly laxative. The latter properties are as feeble as to rarely receive any especial notice. It possesses all the tonic and stomachic powers of the simple bitters in a high degree, and is remarkably well adapted to all states of the system requiring their use. It proves most valuable in cases of phlegmatic and torpid character,but is contraindicated in febrile diseases; not is it adapted to cases of irritation or inflammation of the gastro-intestinal mucous membrane. It is, however, very extensively employed, and is t be regarded as an efficient tonic.

1898: Felter and Lloyd: GENTIAN (U.S.P.) – GENTIAN
Action, Medical Uses, and Dosage – A powerful tonic, improves the appetite, strengthens digestion, gives more force to the circulation, and slightly elevats the heat of the body. When taken in large doses it is apt to oppress the stomach, irritate the bowels, and even produces nausea and vomiting, as well as fullness of pulse and headache. Its administration is contraindicated where gastric irritability or inflammation are present. Uses in cases of debility and exhaustion, and in all cases where a tonic is required, as dyspepsia, gout, amenorrhoea, hysteria, scrofula, intermittents, diarrhoea, worms, etc. A tincture made by percolation of 1 part of podophyllum and 5 parts of gentian, diluted alcohol being the menstruum, was prized by Prof. Scudder as one of the most efficient remedies for “atony of the stomach and bowels with feeble or slow digestion” (Spec. Med.). Gentian is valuable to relieve irritation an dincrease the appetite, after protracted fevers, where the powers of life are depressed and recovery depends upon ability to assimilate food. Dose of the powder, from 10 to 30 grains; of the extract, from 1 to 10 grains; of infusion, 1 to 2 fluid ounces; of tincture, 1 or 2 fluid drachms; of specific gentiana, 5 to 40 drops.

Dr. Kuchenmeister believes that impure and uncrystallized gentianin (see previous editions of the Amer. Disp.) is the most valuable substitute for quinine, acting as rapidly and as efficaciously on the spleen, in doses of from 15 to 30 grains twice a day.

Specific Indicatins and Uses – “Sense of depression referred to epigastric region, and associated with sense of physical and mental weakness” (Scudder, List of Specific Indications).

1901 : Harvey W Felter (Tonics) – GENTIANA – GENTIAN
BOTANICAL ORIGIN – The root of Gentiana lutea , Linne; Nat. Ord., Gentianeae . Mountainous elevations of Southern Europe .

This is the perennial plant, a native of the Alps . In market the root comes in pieces from a few inches to two feet long. It is yellow or light-coloured and had an unpleasant odor and bitter taste. It is a pure and simple bitter tonic, being very slightly stimulating. In moderate doses Gentian improves the appetite and produces no constipation. In large doses it generally causes fullness of pulse, impaired digestion, headache, etc. It is a very good remedy in chronic and atonic conditions of the digestive organs when an increase of tone is desirable. It is especially good in the dyspepsia of persons of a gouty diathesis, but all cases of dyspepsia are benefitted by its use. It acts as a tonic unless the food be oppressive. Give specific Gential five drops. It is contra-indicated by inflammation.

In the decline of protracted fevers the patient’s recovery depends upon his ability to take and appropriate food. In these cases Gential removes the gastric irritation and increases the appetite.

Before quinine was introduced this remedy was used in intermittent fevers. In some cases of chronic ague after the disease has been broken by quinine this is a very good secondary drug. Use the infusion, the tincture, or specific Gentian. Make a tincture of the strength of eight ounces of the root to sixteen fluid ounces of the dilute alcohol. Dose, a teaspoonful. When the alcoholic preparation is too irritating use the infusion. Make the infusion on one ounce of the root to one pint of hot water. Dose, one or two tablespoonfuls. The dose of specific Gentian is from five to twenty drops.

We have a native Gential ( Gentiana ochroleuca ), called Marsh Gential growing in moist places in our Middle States. It is tonic and antiseptic. It is a very good agent in the declining stage of dysentery, and also in chronic diarrhoea, attended with malarial troubles.

In troubles of the stomach and liver, attended with atony, this is a good remedy. It is an excellent stimulating tonic to the reproductive organs of the female. In such troubles as atonic amenorrhoea it may be given with iron. Chronic ague is benefited by its use.

1911: Fyfe
Atony of the stomach and bowels, with feeble or slow digestion, diarhea, with relaxatin of mucous membranes, chronic malarial poisoning, atonic dyspepsia, with mental and physical depression, general debility and exhaustion.

Gentiana lutea is tonic and stomachic. In very large doses it irritates the stomach and bowels, and causes vomiting. It is contraindicated where there is gastric irritability.

1911: LLOYD
Gentian (Gentiana lutea is indigenous to the mountainous parts of Middle and Southern Europe, being found in the Pyrenees, the Islands of Sardinia and Corsica, the Alps, and elsewhere. It is not, however, found in the British Islands . It is mentioned by both Pliny (514) and Dioscorides (194), its name being derived from Gentius, a king of Illyria , B.C. 180. Throughout the Middle Ages gentian was used as a domestic medicine and to antidote poisons, and in recent times it has been commended as an antidote or substitute for tobacco. Tragus (650) employed the root A.D. 1552 for the purpose of dilating wounds.

1919: Ellingwood – GENTIANA, GENTIANA LUTEA
Synonyms – Gentian, Yellow Gentian.

Constituents – Gentiopierin, gentisic acid.

Preparations – Extractum Gentianae, Extract of Gentian. Dose, from two to ten grains.

Extractum Gentianae Fluidum, Fluid Extract of Gentian. Dose, from five to thirty minims.

Specific Medicine Gentian. Dose, from five to thirty minims.

Physiological Action – Tonic in large doses, irritant, causing nausea, vomiting and diarrhoea. The fresh root is more active than the dry.

Therapy – This is a popular stomachic tonic in cases where enfeeblement has occurred as the result of protracted disease. It has long been given in combination with other tonics or in wine, as an agent in the dyspepsia of the aged, or of gouty patients, and in the gastric inefficiency of infants and children, and to a good advantage in catarrhal diarrhoea.

As a tonic to the stomach, and the other organs of digestion and appropriation, in those cases where the system is greatly debilitated by protracted disease, it is one of the best remedies, especially by exhausting fevers of malarial origin. It is of much value in malarial conditions generally and has been used to a great extent instead of quinine.

When the periodicity has been overcome by quinine this is a rapid restorative to the system.

The tincture of gentian is given freely in conjunction with other tonics and with alteratives. It is given with the tincture of iron in the treatment of anaemia complicating malarial disease. It is given in conjunction with the iodide of potassium where a tonic and alterative is demanded, and given alternately with hydrocyanic or hydrochloric acid, it is sometimes of great value in the vomiting of pregnancy.

This agent is perhaps the most valuable of this class. It can be depended upon as a bitter tonic and constant use will establish a confidence in it.