Family Name: Berberidaceae

Introduction

I have sentence for you. Chronic skin disease be gone. I have done a ton of work with this herb, and, psoriasis, acne, eczema, and even blepharitis is improved when this herb is used regularly. If I had to keep one herb around for chronic skin disease, this would be the one. I did a lot of work with Oregon Grape and chronic skin disease when I was running my shop and clinic in London. Its a really interesting story. It was introduced to the medical profession in the 19th century by Parke, Davis, and Company, a drug company that still exists to day. At the time, it was considered to be THE medicine for chronic skin disease. When I was running my shop, I decided it was worth a try. We made some Oregon Grape cream up and had sensational results with people with eczema and psoriasis. The incredible success of the product lead to a lot of press and a lot of people using my Oregon Grape cream. We made a lot of cream and I studied this plant up one side and down there other. Here you will find the material I en massed while I was studying Oregon Grape. There is a lot to read!

RESOURCES

Fact Sheet 1
Fact Sheet 2
Article: Oregon-Grape as a Skin Treatment
Chapter from My PhD Thesis
Notes from the Eclectic Physicians

Fact Sheet 1

Part Used: Root

In a Word: The chronic skin disease plant

Uses: Chronic skin disease including psoriasis, blepharitis, eczema, acne, acne rosacea, and auto-immune related skin diseases

Chronic skin disease, problems such as psoriasis, eczema, and acne are not life threatening illnesses, though, they do threaten quality of life. Allopathic medicines treat skin diseases symptomatically. Steroid cream quells psoriasis as long as it is applied and antibiotics quiet acne as long as they are taken. When the medication stops the condition is still in place and symptoms rebound with a vengeance. Phytotherapists prefer to use agents which address the problem that lies beneath the skin condition by using tonic plants like Oregon Grape.

Herbal medicine offers more than one effective drug in the war against chronic skin disease. Oregon grape, Berberis aquifolium, was first introduced into medical practice by a drug company still operating today, Parke, Davis, & Co. The drug was first made commercially available in 1886 and became instantly popular amongst physicians treating skin conditions. A doctor practising on the West Coast, a certain Dr. Bundy first noticed the plant’s ability to address skin disease and brought it to the attention of Parke, Davis, & Co.

At the time Dr. Bundy was practising medicine, the prevailing notion was that chronic skin disease was the external manifestation of an internal problem. Doctors felt that the skin condition was really caused by a systemic fault, a problem with the blood, as many would say. Dr. Webster, writing in 1898, had this to say of Oregon grape, “Another excellent use for this remedy is to correct a depraved condition of the skin depending upon abnormal state of the blood. Some cutaneous affections yield readily to specific skin remedies, those which selectively influence the part, while others refuse to yield to such treatment and require something to improve the condition of the circulating fluids. In such cases berberis aquifolium is the first remedy to be thought of. It seems also to possess the additional quality of exerting a plastic influence upon the skin, as some cutaneous affections, such as acne, for instance, are benefited by it when it hardly seems possible that the blood can be at fault. It is a bad case of acne that will not manifest pronounced improvement after the patient has used the remedy a few months. As important a place for this remedy, because one supplied by so few others, is chronic eczema with irritable erysipeloid inflammation; here I think this remedy promises more than any other known.”

It is interesting to note that Webster felt that the root of the problem was bad blood, or as Dr. Webster put it, a depraved condition of the blood. Today, we know that many chronic skin conditions are caused by a problem with the immune system, which indeed is a part of the blood. The doctors of the last century did not even know the immune system existed and yet they were very close in their estimation of the situation.

Contemporary practitioners reiterate what the old doctors said, Oregon grape will slowly and gradually improve chronic skin conditions. Dr. Webster gives us some valuable information regarding Oregon grape: “A point worthy of remark is the fact that the corrective influence of this drug is not obtainable in minute doses; but, as it seems only to posses a dynamical influence (exorbitant doses not producing serious disturbances of any part of the system), considerable latitude is allowable, provided the quantity be sufficient to impress the system profoundly. The dose of a saturated tincture or reliable fluid extract should range from ten to twenty drops, repeated three or four times daily. There can hardly be imagined an abnormal condition of the skin where this remedy may not be administered with advantage, if it be borne in mind that its effects are brought about slowly, and that structural changes require months for their accomplishment.”

The message is that if you want to use Oregon Grape you have to be prepared to use it for long periods of time. This is a slow acting medicinal plant and one that must be persevered with if its effects are to be felt.

Oregon grape is thought to be made active by two alkaloids, berbamine and berberine. Berbamine has been found to be anti-dandruff, antihistamine, antibacterial, and active on the immune system. These findings in part explain why it has been found effective in a number of skin conditions. Acne is caused in part by bacteria and the berbamine found in Oregon grape kills bacteria on contact. Even better, it improves immune function, which in a heightened state is better able to kill the bacteria itself. Eczema and psoriasis are inflammatory conditions and the anti-inflammatory nature of berbamine would explain why the red goes out of these conditions when it is used with regularity.

The second contributor to the Oregon grape effect is Berberine which has been shown to be anti-inflammatory, anti-fungal, an anti-ulcer, and immuno-modulatory. Both berbamine and berberine are powerful liver stimulants, that is they stimulate the liver to cleanse the blood more efficiently. The dead doctors all said that Oregon grape was a blood cleanser and it seems they were exactly right. The role the liver plays in chronic skin disease is unclear, however, one thing is certain, when a person has a diseased liver, they develop chronic skin conditions. Liver stimulants all improve chronic skin conditions and Oregon grape is definitely a liver stimulant.

Sometimes understanding how something works must take a back seat to what herbalists see on a daily basis in clinical practice. When persevered with for a year or more, chronic, obstinate skin disease improves. Oregon grape is non-toxic and apart from stimulating the digestive and excretory processes, has no known side effects. It is perfectly benign and can be safely taken for long periods of time.

Practitioners’ Advice
Oregon grape can be taken as a tincture or applied as a cream. Either treatment should be used on a daily basis for at least three months before an opinion is developed as to whether it is having any effect. Remember, it is a slow acting tonic plant! The best possible combination is to use the tincture internally and to apply the crème externally. However, if one had to choose, the tincture taken internally is probably most important part of this plan. Chronic skin disease require internal medication because the problem is not really the skin, the problem is really the body. The skin is merely mirroring a body problem. Taken the tincture internally results in the body getting the medicine it needs!

For those that have suffered with chronic skin disease for a long time, be encouraged. Many people with chronic skin disease have found relief with this simple herbal medicine.

QUICK REVIEW
History: Native American and American Colonial treatment for chronic skin disease
Science: Contains anti-inflammatory substances that make the skin less reactive
Practitioners’ Opinion: Must be used for three months before an effect is seen

Fact Sheet 2

Part Used: root

Remember This: Chronic skin disease cure

Reasonable Uses: eczema, psoriasis, acne, acne rosacea, blepharitis, allergic dermatitis, lupus, Reiters’ syndrome.

History and Traditional Uses
Native to Oregon, Oregon grape was first used by the Native Americans to treat chronic skin disease, in time the Colonials came to know and revere this remedy. Oregon grape, was first introduced into medical practice by a drug company still operating today, Parke, Davis, & Co. The drug was first made commercially available in 1886 and became instantly popular amongst physicians treating skin conditions.

Scientific Back Up
Oregon grape is made active by at least two alkaloids, berbamine and berberine. Berbamine is anti-dandruff, antihistamine, antibacterial, and active on the immune system. Acne is caused by bacteria. The berbamine found in Oregon grape kills bacteria on contact. Even better, Oregon Grape improves immune function, which means the body is better able to kill the bacteria causing the acne. Eczema and psoriasis are inflammation based conditions. The anti-inflammatory nature of berbamine explains why the red goes out of these conditions when it is used with regularity.

The second known active ingrediant in Oregon grape, Berberine, has been shown to be anti-inflammatory, anti-fungal, anti-ulcer, and immuno-modulatory. In addition, both berbamine and berberine are powerful liver stimulants, that is they stimulate the liver to cleanse the blood more efficiently. The role the liver plays in chronic skin disease is unclear, however, one thing is certain, when a person has a diseased liver, they develop skin problems. Liver stimulants improve chronic skin conditions and Oregon grape is no exception

Herbalists Use It To…
Clear Acne
Acne can be a teenage problem for some and a life time disaster for others. When used continuously, Oregon grape will clear some cases of acne. Thousands of men and women, hopeless after years of failed treatment, have found a solution with Oregon Grape. However, it takes two months to make an impact and even years to completely clear the condition. Unlike the chemical treatments for acne, Oregon grape improves liver function rather than reducing it!

Eradicate Psoriasis
Psoriasis, considered incurable by many dermatologists, not only budges with Oregon Grape, but in some cases goes away! Herbalists find that initially the condition becomes less red and less prone to flare up. In time the affected areas actually return to normal. One of the hallmarks of psoriasis is skin changes which will change back to normal when this remedy is persisted with long enough. Psoriasis patients can expect to see a change in three months and can plan on taking the remedy for years.

Battle Blepharitis
Blepharitis, chronic inflammation of the eye margin, can be a hard to treat hard to live with condition. It comes on from nowhere and causes discomfort and embarrassment for years and years. In a recent study conducted in London, an overwhelming percentage of blepharitis expereinced remission with long term usage of this herbal remedy.

Erase Ezcema
Though Oregon Grape is the least effective in treating eczema, a certain percentage of cases will be cleared with its use. Like with all of the chronic skin diseases, this is time consuming process. If its going to make a difference in eczema, it will do so in three months time. If after three months, no change is seen, discontinue the treatment.

Shopping Tips
Make certain the product is made out of the root of Oregon grape. Do not use products containing herbs.

Warning
Oregon Grape is considered an extremely safe herb and one suited to long term usage. However, pregnant women and nursing mothers should avoid it

Alternatives
Burdock (Arctium lappa)
Oregon-grape and Skin Treatment

Article: Oregon-Grape as a Skin Treatment

ABSTRACT
This article discusses Mahonia aquifolium from the historical perspective, reviewing its chemical constituents and past and present clinical records. A detailed history of the use of Mahonia aquifolium by the Eclectics is presented, as well as several modern blepharitis case histories. This evidence suggests that Mahonia aquifolium offers the modern practitioner a powerful tool in the treatment of chronic inflammatory skin disease.

Introduction
The family group Berberidaceae is filled with members traditionally used in the treatment of chronic skin disease. If one examines traditional Native American, European, Chinese, and Indian medicine, one finds various members being used to treat this group of pathologies. This has been the case since the earliest day and continues to be so as we approach the year 2000. One such member of Berberidaceae, Mahonia aquifolium, is especially efficient in the treatment of chronic skin disease.

In this article we will examine Mahonia aquifolium from the historical perspective, review its chemical constituents, and examine contemporary clinical experience with the drug. Evidence suggests that Mahonia aquifolium requires more attention than it is currently receiving by the profession both in clinical practice and in the research setting. This paper endeavours to bring Mahonia aquifolium forward as a positive treatment for chronic skin disease and as a likely candidate for additional research.

Mahonia aquifolium: Its History in Review
Mahonia aquifolium is a North American plant found growing from Colorado west to the Pacific Ocean and from northern Canada, south to southern California. The plant produces a conspicuous quantity of berries and grows abundantly in Oregon, hence its name colonial name Oregon grape. Early American ethno-botanical texts suggest it was used by the Native Americans, prior to the colonial age, for chronic skin disease and as a domestic dye.

Through Colonial/Native American interchange, Mahonia aquifolium became a domestic medicine from the moment the Colonials made their way to the American west coast. Though the plant does not appear in medical texts until the late 19th century, it was in use in domestic medicine by Colonials at that time. “History of the Vegetable Drugs of the Pharmacopoeia of the United States” , written by Uri Lloyd in 1911, makes this point clear. 1 It would be helpful to know that during the colonial age and into this century, the plant was known as Berberis aquifolium. As if often the case, plants common and scientific names are not static!

Though in use as a domestic medicine, the plant was not accepted into medical circles in the early 19 th century. We know this because Mahonia aquifolium is not mentioned in the general medical literature of that period. Neither the “American Dispensatory ” written by Cox in 1825 nor “The Eclectic and General Dispensatory” written by Towar and Hogan in 1827 reference Mahonia aquifolium. 2,3 Wooster Beach, founder of the Eclectic movement and the author of the first Eclectic medical texts, does not mention the plant in any of his books. His last book, “Beach’s Family Physician and Home Guide “, written in 1859, does not reference the plant. From this we can deduce Mahonia aquifolium had not made it into Eclectic circles as late as 1860. 4

Mahonia aquifolium was first introduced to the Eclectic and allopathic medical profession by the Eclectic Dr. Bundy. Though trained at the Eclectic Institute in Cincinnati, Bundy ventured west after graduation and practised medicine in Colusa, California. Mahonia aquifolium is a west coast plant and once removed to that locale, Bundy became acquainted with it.

According to Eclectic historical records, Bundy was sufficiently impressed with its activity in chronic skin disease to introduce the plant to Parke, Davis, and Company, a successful east coast drug company. Parke, Davis, and Company, upon further research, determined the plant warranted commercial attention and introduced it generally through their publication, “New Preparations” published in Detroit, Michigan in 1877. Mahonia aquifolium, the herbal medicine, has the unique distinction of having been introduced by a drug company. Parke, Davis, and Company remains a market leader today. 5

Despite one Eclectic’s excitement over Mahonia aquifolium and its subsequent introduction by a major drug concern, the Eclectics were slow to take it to heart. It next appears in an Eclectic text in “The American Eclectic Materia Medica and Therapeutics” written by Dr. J. M. Scudder in 1883. 6 Mahonia aquifolium is listed by Scudder as being an alterative. Scudder states that the plant stimulated the excretion of waste and was being used in the treatment of scrofula and syphilis at the time he wrote his book. Dr. Scudder was not that impressed with the plant as can be seen in his text.

“It has been extolled and widely sold as a remedy for syphilis and scrofula, but it has not fulfilled the promises made for it. Like many other things, it has had its day, an will probably pass into the list of unused medicines. If careful study should improve our knowledge of it, it will gradually find a place in this class (alteratives).”

Being the leader in the Eclectic study of Materia Medica, Scudder’s lack of support for this new remedy hindered its wide scale acceptance and use. Despite Scudder’s lack of enthusiasm, it was not forsaken entirely, as is evidenced by the mention of Mahonia aquifolium in “An Eclectic Compendium of The Practice of Medicine.” Another teaching text, this book was written by Lyman Watkins in 1895. 7

In this text we find Mahonia aquifolium recommended for the previously indicated scrofula and syphilis. We also find it mentioned and for a growing list of pathologies including chronic skin disease, indigestion, liver disease, and malfunction of the mucous membrane. This text indicates the Eclectic’s had been experimenting at least to a limited extent with the new introduction.

Twenty five years after its initial introduction by Parke, Davis, and Company, Mahonia aquifolium found a friend with another west coast Eclectic, Dr. H. T. Webster. This occurred probably as a result of his access to the drug and to its early proponent, Dr. Bundy. It was Webster that turned the tide in favor of this medicinal plant. In his popular Eclectic text, “Dynamical Therapeutics – A work devoted to the Theory and Practice of Specific Medication with special references to the newer remedies” , published in 1898, Webster reports the result of his extensive work with Mahonia aquifolium. 8 As Webster pioneered work with Mahonia aquifolium, it would pay to examine his work in great detail.

Like Scudder before him, Webster felt that Bundy held the plant in too high esteem and he makes this point plain. “Dr. Bundy extolled the remedy rather too highly in some respects, but it is a corrective of superior virtues, nevertheless.” Unlike Scudder, Webster felt that it was a worthy medicine that warranted further attention. He felt that it had the capacity to control many diseases, and especially diseases with a systemic taint and a chronic overtone.

When Berberis aquifolium was first introduced in 1873, it was used to treat syphilis. This is an interesting fact for several reasons. Firstly, Mahonia aquifolium contains several broad spectrum antibiotics, compounds such as berberine and berbamine. The presence of these compounds may explain its reported efficacy in syphilis. The Eclectics may have been naively treating the condition with an antibiotic.

Beyond this, and perhaps more importantly, syphilis was the first inflammatory disease treated by the Eclectics with Mahonia aquifolium. Syphilis is a chronic and progressive disease, which in time, involves every system. The causative organism, Treponema pallidum, has the ability to allude immune system control. The immune system is unable to eradicate the organism. Though the immune system is unable to gain control over the organism, it does react in an inflammatory manner to the organism. The general destruction of tissues, seen in syphilis, is in part due to the immunological reaction to the organism. This ability to quell destructive inflammatory processes is a recurrent theme seen with Mahonia aquifolium.

The Eclectics used Mahonia aquifolium to treat the later phases of tuberculosis. Scrofula, tuberculosis having moved into the lymph nodes, was a frequent indication for the drug. As is true with syphilis, in tuberculosis, it is the immune systems reaction to the organism that results in damage to tissues. Mahonia aquifolium was used to inhibit the inflammatory process associated with tuberculosis infection.

The Eclectics used Mahonia aquifolium in another chronic inflammatory disease, or more appropriately, disease process. After scarlet fever, the sequelae of streptococcal infection, patients sometimes develop a chronic inflammatory disease previously described as rheumatica. The joints, mucous membrane, skin, kidneys, in fact all major systems and organs can become involved in a slow, progressive, and degenerative process built upon senseless inflammation. Here again, the Eclectics found Mahonia aquifolium an effective treatment.

The Eclectics felt that in chronic inflammatory disease, diseases like syphilis, tuberculosis, and rheumatica, the constitution had become perverted in some unknown manner. They were right. However, they did not have the technology to understand that in all three cases the immune system was at the root of the problem.

What they did know, as we will see in Webster’s subsequent text, was that when the “constitution” went wrong, any system could become involved. The “perversion” could appear in the joints, on the skin, or in the mucous membranes. It could appear in the joints for a period of time, leave the joints, and move onto the skin. Wherever and however it manifested, the Eclectics knew that it stemmed from the “constitutional flaw”.

It would pay to examine the many manifestations of “constitutional perversion” noted by the Eclectics, manifestations they state were improved with the use of Mahonia aquifolium.

The Digestive System
Webster saw Mahonia aquifolium as being efficacious when the digestive system was involved in the systemic disease process. He found it of use when either the stomach or the liver were under siege. Here are his words regarding gastric function.

“Berberis is one of our most reliable agents in dyspepsia and seems to invigorate the gastric functions while it improves the power of the assimilative processes. Being a valuable blood and skin remedy, its influence as a gastric agent comes into additional service in the treatment of scrofulous and syphilitic states, where digestive disorders interfere with the proper effect of other correctives.”

Earlier, Watkins introduced the idea that Mahonia aquifolium improved the hepatic function, an idea with which Webster supports.

“Berberis has been employed with success in gastric troubles complicated with hepatic affections, frequently. In cirrhosis of the liver complicated with gastro-enteritis, it has been found of important service; also in hepatic torpor complicated with dyspepsia. It is valuable in chronic constipation, combined with cascara sagrada.”

Lymphatic System
The Eclectics noticed that these constitutional diseases were often attended with chronic inflammation of the lymph nodes. This inflammation, left unchecked, could result in the nodes ulcerating through to the surface of the body.

“This remedy exercises a pronounced effect upon the lymphatic system, as evidenced by its remarkable influence in the arresting of ulcerative action. But it also proves a reliable remedy in syphilis and scrofula, as well as for certain depravation of the blood in other cases dependant upon imperfect functional service of the lymphatic system.”

Mucous Membrane
Webster noted that these systemic diseases often led to imperfect action of the mucous membrane. The over production of mucous, under production of mucous, chronic inflammation of the membranes, and ulceration of the membranes, were treated with Mahonia aquifolium.

“One of the best places for berberis in this respect is its application to the treatment of chronic bronchitis, in syphilitic scrofulous, or senile subjects, in whom there is probably enlargement and irritation of the bronchial glands, in connection with the irritation of the mucous membrane.

I have cured some very obstinate and long standing cases of bronchorrhea of this character with this remedy. Sometimes it may be well, especially if the subject be syphilitic, to begin with a combination of this remedy with iodide of potassium, though the iodide should be employed after the first month. Ulceration of the cutaneous surface, and also of the mucous membranes, when dependant upon faulty glandular action, yields to this remedy very promptly.

One of the most important places for Berberis aquifolium is in chronic pulmonary affections attended by profuse purulent expectoration. When ulceration of the pulmonary tissue depends, to considerable extent, upon a depraved condition of the fluids of the body, it has no equal as a remedy in ulcerative pulmonary affections.”

Musculoskeletal System
Webster lists Mahonia aquifolium as being an effective remedy in treating chronic articular and muscular disease when a manifestation of a systemic flaw. What we would now call rheumatoid arthritis, psoriatic arthritis, and polymyalgia, were treated with this drug.

“This remedy sometimes succeeds marvellously as a cure for chronic muscular pain. In chronic rheumatism which has refused to yield to all other remedies it should be tried. A valuable adjuvant is the iodide of potassium, itself a useful remedy in chronic rheumatism. In the treatment of muscular pains attending the secondary and tertiary stages of syphilis, a few weeks of berberis will often banish this cause of suffering. It does not act quickly, and must be persevered with for a month or two in order that its value may be fairly estimated in any case of this kind.”

Skin
Berberis aquifolium, in Webster’s opinion, was the drug of choice when systemic disease manifested as n the skin. Webster recommended it in eczema, psoriasis, and in scrofulous and syphilitic ulceration. Beyond this, eruptive skin disease, such acne and the early eruptions of syphilis, were treated with the drug. If there was a generic treatment for chronic skin disease of a constitutional origin, it was this. As we are particularly interested in skin disease, his words on the subject are worth reviewing in their entirety.

“Another excellent use for this remedy is to correct depraved conditions of the skin depending upon abnormal state of the blood. Some cutaneous affections yield readily to specific skin remedies, those which selectively influence the part, while others refuse to yield to such treatment and require something to improve the condition of the circulating fluids.

In such cases Berberis aquifolium is the first remedy to be thought of. It seems also to possess the additional quality of exerting a plastic influence upon the skin, as some cutaneous affections, such as acne, for instance, are benefited by it when it hardly seems possible that the blood can be at fault. It is a bad case of acne that will not manifest pronounced improvement after the patient has used the remedy a few months. An important place for this remedy – because one supplied by so few others – is chronic eczema with irritable (erysipelatoid) inflammation; here I think this remedy promises more than any other known.

Berberis aquifolium is a comparatively new remedy, but it has proven one of the most reliable we have in chronic skin affections. In eczema, psoriasis , and scrofulous and syphilitic affections of the skin, of various forms, we have no more reliable remedy than this.

In the eruptions of secondary syphilis the continued use of berberis aquifolium for a few months will usually remove all traces of the eruption, and if any remain they will be trifling compared to the condition where the remedy has not be employed. In chronic changes in the skin, of long standing especially in syphilitic cases, the use of iodide of potassium in conjunction with the berberis is a commendable measure, the iodide being continued for a month or six weeks to then be discontinued, while the berberis is used uninterruptedly.”

When and How to Use Mahonia aquifolium?
The Eclectics believed in “Specific Medication”. That is they believed there was one medicine that perfectly addressed a condition. As such, their texts were specific when attributing a medicine for a condition. Webster leaves us with a specific description of when Mahonia aquifolium ought to be used. In this text we see that when the perversion of constitution was manifesting in the skin, Mahonia aquifolium was to be used.

“As the effect of berberis is always to invigorate the skin it is a useful agent to administer in any cutaneous affection of chronic character, in connection with the remedy which may seem more pronouncedly indicated. The effect of the specific remedy is thus enhanced, since the functional activity of the skin generally is improved by the berberis, while it also augments digestion and assimilation, thus improving all the functions of the body. In acne, Berberis will accomplish desirable results in many cases if continued for a long time uninterruptedly, say a year.”

Webster gives the modern practitioner useful advice. When Mahonia aquifolium is persevered with long term, it makes an impact on chronic skin disease based upon constitutional flaws. The emphasis here is long term and this is a sentiment one will find repeated in all the Eclectic texts that follow. This is not a medicinal plant that works overnight.

“There can hardly be imagined an abnormal condition of the skin where this remedy may not be administered with advantage, if it be borne in mind that its effects are brought about slowly, and that structural changes require months for their accomplishment.”

Beyond time required for an effect to be seen, Webster states that Mahonia aquifolium is best used in large doses. He felt that it had to be used in large doses in comparison to many of the other remedies used to treat chronic skin disease.

“A point worthy of remark is the fact that the corrective influence of this drug is not obtainable with the minute dose; but as it seems only to possess a dynamical influence (exorbitant doses not producing serious disturbance of any part of the system), considerable latitude is allowable, provided the quantity be sufficient to impress the system profoundly. The dose of a saturated tincture or

reliable fluid extract should range from ten to twenty-five drops, repeated three or four times daily.”

The dose recommended by Webster, converted to modern terms would be in excess of one milliliter of the fluid extract four times a day. Again, as he states clearly, this dosage was to be administered for long periods of time.

Leaving Webster
Webster studied Mahonia aquifolium in great detail and effectively conveyed that which he had discovered to the Eclectic profession. Webster felt that when a constitutional flaw was leading to a chronic inflammatory condition, Mahonia aquifolium was the drug of choice. This was especially true if the problem manifested in the skin. The drug was to be used in large doses for long periods of time. After his book came out, the role of Mahonia aquifolium in the Eclectic practice of medicine would be forever altered, as you will see from subsequent Eclectic texts.

Many of the texts that came out after Webster’s text reiterate that which Webster had said. In time, Webster’s sentiments would be validated by thousands of doctors. Beyond this, the Eclectic depth of understanding of this drug deepened with the passage of time. It would pay to continue our review of Eclectic literature to develop a deeper understanding of the drug.

Eclectic Work with Mahonia aquifolium After Webster
In 1905, Dr. F. J. Peterson wrote a book entitled ” Materia Medica and Clinical Therapeutics “. 9 This is the first Eclectic text to speak about Mahonia aquifolium after the release of Webster’s illuminating text. Peterson was another Eclectic physician working in California, in close proximity to Bundy and Webster. He said the drug was bests described as being “alterative, tonic, anti-syphilitic, slightly laxative, and diuretic”.

Peterson’s text indicates that the Eclectic understanding of this agent was deepening. He reiterates its place in the treatment of chronic skin conditions and gives us even more specific indications. “In disordered conditions of the blood and especially skin diseases, such as eczema, acne, psoriasis, chronic dermatosis, scald head, salt rheum, etc.”

Peterson adds that it is not active in young women suffering from hormone related acne, a disclosure not previously made. “It removes pimples and roughness of the skin, promoting a soft and natural skin in sensitive young ladies if the cause is not from irritation in the reproductive organs.” Peterson goes onto to say that Mahonia aquifolium is particularly effective in skin diseases of a dry and scaly nature. “In skin diseases it acts best in these of a dry and scaly nature, but is of benefit in other forms as well.”

Another Eclectic text was released in 1905, in this case ” A Handy Reference Book “, written by Dr. J. S. Neidorkorn. 10 Neiderkorn’s book, which as the title suggests, was a quick reference guide for the newly graduated physician. His book was the Eclectic equivalent to the BHP. As such, his work offers little innovation upon that which the previous Eclectics had written. It does offer us an example of the Eclectic consensus at that time. “chronic skin affections, yellowish skin, hepatic torpor, marked weakness, blood dyscrasiae, syphilitic history.”

In 1906, Dr. Finley Ellingwood released a book entitled, ” A Manual of the Eclectic Treatment of Disease designed for the many students and Practitioners. ” 11 In this text we learn that the Eclectic opinion of Mahonia aquifolium was changing and becoming more focused. The Eclectics had come to the conclusion that Mahonia aquifolium was most appropriate when the skin was manifesting the systemic or constitutional flaw. Ellingwood focuses upon its use in skin conditions. Like Webster, Ellingwood states that it was effective in both scaly and pustular skin diseases, particularly if the source of the problem was “bad blood”. “Scaly, pustular, and other skin disease due to the disorders conditions of the blood. It is the most reliable alterative when the influences of the dyscrasia is apparent in the skin. It is given freely during the treatment of skin disease where an alterative is considered an essential part of the treatment. Pimples, roughness, eczema capitis, eczema genitalis, pruritus, scaly eczema, psoriasis, pityriasis, chronic dermatosis, glandular indurations, ulcerations, syphilis.”

The Bible of the Eclectic Materia Medica, “Kings Dispensatory”, was continually revised and reissued by the latest chair of the Materia Medica department at the Eclectic Institute. In 1909, Felter and Lloyd, produced the latest edition of “ Kings Dispensatory” . 12 In this edition, Mahonia aquifolium had earned a place and was subject to further review. The Eclectics were interested enough in the drug to scrutinise it from a botanical perspective. Up to this point, the drug had been known as Berberis aquifolium. Felter and Lloyd, and more specifically, Lloyd called for the profession to rename the plant so that it more correctly fitted into the botanical scheme. Mahonia aquifolium was deemed the more appropriate and henceforth it would be known by that name.

In the latest “Kings Dispensatory” Mahonia aquifolium gets a strong recommendation. The authors remark that practitioners were having untold success using Mahonia aquifolium in the treatment of chronic skin disease. “This agent has justly been extolled as an alterative and tonic, and has been recommended in syphilitic affections, salt rheum, pityriasis, psoriasis, and other cutaneous affections, as well as in maladies supposed to be due to some mal-condition of the blood. Several stubborn cases of psoriasis (Ed. E. M. J., P. 148, 1896) have been cured by it, and it is a valuable drug in erysipelatous and chronic scrofulous affections.”

The issue dosage is addressed by these authors and once again we see a call for it to be used in large amounts. “The dose of Berberis aquifolium should be relatively large. Small doses, as required of most of our important agents, do but little good.” Work with the drug had continued and the Eclectics were ever increasingly convinced that efficacious use depended upon large doses!

In 1919, Ellingwood, issued one of the last Eclectic textbooks prior to the closure of the Eclectic Institute. His “American Materia Medica, Therapeutics, and Pharmacognosy” gives us a last window into the Eclectic use of Mahonia aquifolium. In Ellingwood’s book we find a final summary of Eclectic use of Mahonia aquifolium. Here we find that by 1919 the Eclectics had come to see Mahonia aquifolium as the specific for chronic inflammatory skin disease.

By this time the Eclectics had begun to question why Mahonia aquifolium was so effective in the treatment of chronic skin disease. Ellingwood refers to another physician, Dr. John Aulde, who felt Mahonia aquifolium addressed the systemic flaws responsible for the external manifestations observed. “John Aulde, in 1911 advised this remedy for its immediate influence upon the digestive apparatus, the blood, and the secretions. He said constipation is relieved and the bowel movements become regular and natural. The complexion clears, the muscular strength increases, and the skin and urinary organs become more active.”

Ellingwood gives us a final list of cases in which Mahonia aquifolium ought to be administered. “It has cured persistent acne for the writer, when no local treatment was used. It contributes to the removal of pimples and roughness and promotes a clear complexion, a soft, smooth and naturally moist skin in sensitive young ladies, when the cause is not a reflex one from ovarian or uterine irritation, or menstrual irregularity. It seems of especial value in scaly skin diseases and in disorders of a non-inflammatory type, and yet it works nicely in some cases of the moist variety. It has cured very many cases of salt rheum even when the symptoms were chronic in character and greatly exaggerated.

In moist eczema it has acted most satisfactorily, but has usually been given in conjunction with other treatment. Dr. Soper, in 1884, reported in the Therapeutic Gazette a most intractable case of moist eczema of an acute character covering the entire body. No other alterative was given. The case was cured in four weeks. In eczema capitis, eczema genitalis, with pruritus and in scaly eczema of all kinds, it has been given alone and has acted promptly and has cured cases of scald head, so called, in a few weeks, restoring tone and vigour to the hair. It has been often used in acne, and has worked nicely when local or reflex irritation was not the cause. In psoriasis and in pityriasis it has won the praise of many doctors. For dandruff it has been given internally and has produced cures in a number of cases. In many instances various forms of chronic dermatosis have yielded to its influence when other treatment has failed.”

Concluding Mahonia aquifolium and Its History
Introduced in 1877 by Parke, Davis, and Company, the Eclectics spent the next 42 years studying Mahonia aquifolium. At first they recommended it in chronic inflammatory disease, in time they recommended it specifically for chronic inflammatory disease of the skin. They came to know it was a specific medication for the skin diseases that were as trying for them as they are for modern practitioners. They did understand the pathophysiology of psoriasis, eczema, and blepharitis to the extent we do today, however, they did know that a systemic flaw was at the root of the problem and that Mahonia aquifolium somehow corrected this flaw.

Through trial and error they found the drug worked best when used in large doses for extended periods of time. They discovered that when the constitution became “perverted” or malfunctioned, lots of medicine for long periods of time was required to turn things around.

The fact the Eclectics said Mahonia aquifolium cured chronic inflammatory disease is quite interesting. We now understand that these diseases are caused by faulty immune function. Contemporary wisdom says that once an immune system runs amuck, either in displaying hypersensitivity reactions or loosing the ability to distinguish self from non-self, there is no way back. The theory being that once you are allergic to something, you will always be allergic to something. The Eclectics said that this was not the case when Mahonia aquifolium was used.

If the Eclectics were correct in their observation that Mahonia aquifolium actually corrected an immune system gone wrong, studying its mode of activity could result in a new type of drug which does the “impossible”. Mahonia aquifolium requires more attention from the research community than it is currently receiving.

If the Eclectics were wrong in their belief that Mahonia aquifolium cured, and in fact, it only keeps chronic inflammatory skin conditions under control, we still need to take note. Many of the allopathic treatments for chronic skin disease have undesirable side effects. Mahonia aquifolium does not. If a drug needs to be taken for a lifetime, Mahonia aquifolium would be a far cry better than cortical steroids or cytotoxic drugs. Practitioners can take advantage of all the Eclectics left behind while the research community takes a deeper look.

Phytochemistry and Pharmacology of Mahonia aquifolium
When we approach the phytochemistry and pharmacology of Mahonia aquifolium, we do so in the aim of trying to develop an understanding of how it works in chronic skin disease. As the drug is not terribly popular and very little research has been done on it, this is a challenge. Some work has been done and there is much work that needs to be done. My group is working to fill in the many gaps. This area is very much a work in progress and here you will find a progress report more than an final statement.

The study of the phytochemistry of Mahonia aquifolium begins in the Eclectic period. When Dr. Ellingwood wrote about Mahonia aquifolium in his 1906 textbook, he had little to share about the chemical constituents of Mahonia aquifolium. In the 13 years that passed between the publication that book and his last book, “American Materia Medica, Therapeutics, and Pharmacognosy” some essential constituents had been elucidated. 11,13 This author lists the alkaloids berberine, oxyaeanthine, and berbamine as being present in the drug.

The Eclectic physicians were an inquisitive lot. Their texts tell us they had a rather interesting past time. They played a game that might be called “overdose yourself with a drug while your colleagues watch.” The Eclectics felt that all medicines should be perfectly benign in nature. Any medicine that damaged the body was bad medicine and was to be rejected. When new introductions were made, they overdosed themselves with them to make certain they were safe. Here we find the result of intentional Mahonia aquifolium overdoses “In overdoses, in some cases, the agent produces tremor of the limbs, lack of muscular power, dullness of the mind, drowsiness and active diuresis. It is not a poisonous agent.” 13 This is our first toxicological report on Mahonia aquifolium and it was an important report to the Eclectics. They were recommending the drug be used in large amounts for long periods of time. They knew it was effective when used in this manner and they wanted to be certain it was safe when thus used. The resounding report was that it was a safe medicine even when taken in large amounts.

If we fast forward to the year 1992, we find a more comprehensive list of constituents in Duke’s “Handbook of Phytochemical Constitutuents of GRAS Herbs and other Economic Plants”. The majority of constituents listed being alkaloids.

According to Duke’s work, the alkaloids contained in Mahonia aquifolium include berbamine, berberine, canadine, columbamine, corydine, corylpalmine, corytuberine, hydrastine, isoboldine, isocorydine, jatrorrhizine, magnoflorine, mahonine, oxyacanthine, palmatine, tetrahydroberberine, tetrahydrojatrorrhizine. Duke also lists resins and tannins as being contained in the root bark. 14 When you go one step further and investigate the activities of these compounds the situation become interesting.

Alkaloids
Alkaloids dominate the list of established constituents of Mahonia aquifolium and these compounds are the best researched. In Duke’s “Handbook of Biologically Active Phytochemicals and Their Activities” we find some interesting activities attributed to these alkaloids.

In the first instance, many of the alkaloids contained in Mahonia aquifolium have been shown to affect the immune system and the inflammatory process. Berberine has been shown to be anti-inflammatory, anti-ulcer, and immunostimulant. Berbamine has been shown to be anti-histaminic, anti-ischemic, anti-dandruff, antiseptic, immunostimulant, and leucytogenic. Jatrorrhizine has been shown to be anti-inflammatory. Palmatine has been shown to be adrenocorticotropic and anti-inflammatory. 15 In short, the alkaloids contained in Mahonia aquifolium have been shown to be highly active on the immune system which we know to be at the root of chronic inflammatory conditions.

In the second instance, two of the alkaloids, berberine and hydrastine, have been shown to act as vasoconstictors. In inflammatory states, the capillaries, in response to chemical mediators, become more porous. Plasma leaks into the tissues and edema results. Hypothetically speaking, if these alkaloids inhibit capillary permeability through vasoconstriction, this would have an impact on the inflammatory process. 15

Resins
The nature of the resins found in Mahonia aquifolium has not been elucidated. As we do not know what these resins are, it would be impossible to say what their activity might be. However, several resins found in medicinal plants are said to incite activity of immune cells (e.g. Calendula officinalis, Commiphora molmol.). With this precedence in mind, the resins found in Mahonia aquifolium and their nature are currently being researched by my group.

Tannins
The tannins found Mahonia aquifolium have not been elucidated. However, as with resins, tannin containing barks have been established to have broad anti-inflammatory activity (e.g. Salix nigra, Hamamelis virginicus). It is possible that these tannins play a role in the activity observed be the Eclectics and modern practitioners. My group is currently investigating the nature of these tannins.

Saponins
In the process of working with Mahonia aquifolium, we noticed something that suggests a previously unnamed group of compounds might be present in Mahonia aquifolium. The compounds in question being saponins. While making hot water extraction’s of Mahonia aquifolium, a substantial and durable foam is produced. This saponification of the hot water solvent strongly suggests the presence of saponins. Saponins are often phytosterols. Many phytosterols have been established to have anti-inflammatory activity (e.g., Aesculus hippocastanum, Glycyrrhiza glabra.) My group is also conducting experiments to determine if phytosterols are present and what their nature is.

The phytochemistry and pharmacology of Mahonia aquifolium remains largely a mystery. However, as is true with all medicinal plants, the effects described by the Eclectics are probably as a consequence of all of these compounds working in unison. We feel that it pays to continue the phytochemical research for several reasons. Firstly, a better understanding of the phytochemistry and pharmacology of Mahonia aquifolium would result in a more effective medicine. If saponins are present and are an important part of the cocktail, extraction techniques need to take this into consideration. Secondly, if there is a silver bullet in Mahonia aquifolium that can cure chronic inflammatory skin disease, this would be a great discovery. In both instances, a better understanding of the component constituents is worthwhile.

Contemporary Clinical Experience
It is important to know that a medicinal plant has an extensive history and it is important to know that there is some scientific basis for the claims made by history. It is equally important to know that the drug works in clinical practice. Ideally there would be extensive clinical trials establishing efficacy for a medicinal plant, unfortunately, this is not often the case.

I have had the opportunity to use Mahonia aquifolium in chronic inflammatory skin conditions such as psoriasis, eczema, and blepharitis. In the majority of these cases, I have found it highly effective. No one drug works for every person, and I have had cases that would not yield to it. However, more often than not, Mahonia aquifolium has lived up to the Eclectic claims.

My experience has been exactly that which was described by the Eclectics. Patients rarely notice a change until they have been taking it for at least one month if not two. One of the first changes noted by chronic skin disease patients is that their lesions become less fiery and red. There is less inflammation and corresponding discomfort. The best way to describe it would be that it “takes the red out”. In time, patients notice their skin is less reactive. The flare ups are much less frequent. Flare ups occur, but the lapses between flare ups becomes greater and greater. All done and said, it is a slow process of gradual improvement.

Perhaps one of the most interesting features of Mahonia aquifolium is that in time, skin having been altered by the disease process, returns to normal. I have seen this both in cases of psoriasis and eczema. As Webster said, the structural changes require long periods of time to occur.

In recent days, I have had the opportunity to study several large groups of individuals using Mahonia aquifolium. For the last year I have been observing 247 people suffering from blepharitis who use the drug. More recently, I have begun working with 550 people suffering from psoriasis and 76 patients suffering from eczema, all of whom are using Mahonia aquifolium. These individuals are being surveyed during the course of their use of the drug as a means of monitoring its efficacy. In all three instances, my experience continues to be positive. So much so it would pay to look at one of these groups more closely.

Blepharitis
Chronic blepharitis, or inflammation of the eye lash margin, is a condition thought to be of auto-immune origin. The allopathic medical world defines this condition as being incurable. The standard allopathic treatment includes washing the eye margins with sodium bicarbonate and the occasional application of cortical steroid drops. The condition leaves the eyes scaly, red, and sore. Patients experiencing the condition complain of great discomfort, embarrassment, and substandard results of the previously described treatment protocol.

Of the 247 blepharitis sufferers using Mahonia aquifolium over 55% have had a major improvement in their condition, 20% have experienced marked improvement, and 25% have not responded positively. This result is a far cry from the “incurable” diagnosis normally given to a blepharitis patient. In this group, the patients that faithfully use the medication have the most favourable response. Those with the poorest response have been those that have not used it consistently.

A Sampling of Blepharitis Case Histories
A female patient, age 27, came to me suffering from chronic blepharitis of three years duration. The condition first presented as what appeared to be acute conjunctivitis. Three courses of antibiotic failed to clear the condition and the patient was referred to Moorfields Eye Hospital where she was diagnosed as suffering from blepharitis. She was told there was nothing that could be done for her condition. At this time, she solicited my assistance. Her blepharitis had been more or less constant for the three years with no remission. She was prescribed Tincture of Mahonia aquifolium 1:4 25% alcohol, 5 millilitres three times a day. Within the first month the severe redness of the eyes lessened and the discomfort of long standing improved. Over the space of six months, very gradually, the condition improved to the extent there was no apparent sign of blepharitis. She was able to wear contact lenses for the first time in three years. She has continued using the Mahonia aquifolium and her remission is still in place one year on.

A female patient, age 49, appeared at the clinic suffering from blepharitis of 10 years duration. Some ten years earlier she had suffered a bout of scarlet fever. Nine months after this condition subsided, her eyes began to bother her. They gradually worsened and she was initially diagnosed as having conjunctivitis. When the condition did not respond to several rounds of antibiotic therapy, she was referred to a consultant who diagnosed blepharitis. In this case, the patient had abnormalities of the tear ducts as well as blepharitis. Rather than displaying continuous blepharitis, she suffered from constant dry eyes and episodes of severe blepharitis. She was prescribed Tincture of Mahonia aquifolium 1:4 25% alcohol, 5 millilitres three times a day. There was little improvement in the first three months of treatment. In month four, the incidence of flare ups become less frequent and the dryness of the eyes began to improved. Over the next nine months the condition continued to improve to the extent life has returned to some resemblance of normality. Though not cured, the patient has improved enough to happily continue taking the Mahonia aquifolium.

A male patient, age 72, presented with blepharitis of 21 years duration. In this case, two years after having had gonorrhoea which was cleared with antibiotics, the patient developed an acute attack of what was diagnosed as conjunctivitis. The condition was treated with antibiotics on and off for 20 odd years despite the fact they seemed to have little or no effect. The patient was prescribed Tincture of Mahonia aquifolium 1:4 25% alcohol, 5 millilitres three times a day. In this case, a rather dramatic improvement occurred three weeks after the treatment began. The redness and scaliness resolved completely. Despite the apparent overnight cure, the patient was advised to continue using Mahonia aquifolium for an additional 12 months.

The evidence that Mahonia aquifolium is an effective treatment for chronic inflammatory skin disease is significant. More cases improve with its use than do not, a strong argument in favour of more research being undertaken. However, the purpose of this research should not be to prove its efficacy. This has already been demonstrated time and time again over the last 140 years. Rather, research needs to be conducted to learn more about how it works and how it should be used.

As an example, the Eclectics stated clearly that Mahonia aquifolium needed to be used long term. However, they did not say specifically what that meant. Was it to be used for years, decades, or a lifetime? Some of the patients I have seen have had their conditions clear and after a period of time they discontinue taking the medication. For others, a maintenance dose is required to keep the condition quiet. Patients naturally ask, “How long will I need to take this drug?” At present, there is no clear cut answer. Issues such as these need to be resolved in the research setting. That which we already know indicates this work is justified. As was the case with the phytochemistry of Mahonia aquifolium, in regards clinical research, there is much to learn.

Conclusion
When one reviews the history, the chemistry, and recent clinical experience, it becomes clear Mahonia aquifolium is a herbal medicine of note. The herbal medicine introduced by a drug company offers the modern practitioner a powerful tool in the treatment chronic inflammatory skin disease.

Many questions remain unanswered. We need to know what phytochemicals the raw drug contains. More than likely, most of these organic compounds will have already been researched in the context of work on another medicinal plant. If they have not, the unknown compounds need to be researched in the context of this medicinal plant. The technology required to conduct this work is ever increasingly available and thorough. This information can be used to create better medicines. We need to know whether this drug offers cure or control, and what the time frames are.

The Eclectics left us a great legacy in regards Mahonia aquifolium. We need to take that this gift and build upon it. We have tools at our finger tips which allow us to take a much deeper glance at this medicinal plant. The Eclectics used Mahonia aquifolium in a more effective manner after 40 years of work with the drug. It would be nice for someone writing one hundred years from now to be able to say the same about the phytotherapists and their work with Mahonia aquifolium. The time is now to get started.

References
• Lloyd, Uri. “History of the Vegetable Drugs of the Pharmacopoeia of the United States,” 1911.
• Coxe, John Redman. “The American Dispensatory”. Publishers H. C. Carey and I. Lea. Philadelphia, 1825.
• Tower and Hogan. “The Eclectic and General Dispensatory Comprehending a System of Pharmacy, Materia Medica.”
• Beach, Wooster. “Beach’s Family Physician and Home Guide”, 1859.
• Parke, Davis, and Company. “New Preparations.” Detroit, Michigan, 1877.
• Scudder, J. M. “The American Eclectic Materia Medica and Therapeutics,” 1883.
• Watkins, Lyman. “An Eclectic Compendium of The Practice of Medicine.”
• Webster, Herbert T. “Dynamical Therapeutics -A Work Devoted to the Theory and Practice of Specific Medication with Special References to the Newer Remedies.” Second Edition, 1898.
• Peterson, F. J. “Materia Medica and Clinical Therapeutics.” Published by the Author. Los Olivos, California, 1905.
• Neiderkorn, J. S. “A Handy Reference Book,” 1905.
• Ellingwood, Finley. “A Manual of the Eclectic Treatment of Disease Designed for the Many Students and Practitioners,” 1906.
• Felter, Harvey Wickes. “Kings Dispensatory.” Volume one and Volume two. Ohio Valley Company. Cincinnati, 1909.
• Ellingwood, Finley. “American Materia Medica, Therapeutics, and Pharmacognosy.” Ellingwood’s Therapeutist. Chicago, 1919.
• Duke, James A. “Handbook of Biologically Active Phytochemicals and Their Activities.” CRC Press. Ann Arbor, 1992.
• Duke, James A. “Handbook of Phytochemical Constitutuents of GRAS herbs and other Economic Plants”. CRC Press. Ann Arbor, 1992.

Chapter from My PhD Thesis

(Formerly Berberis aquifolium)

Part Used: Root

Chemical Constituents: Berbamine, berberine, canadine, columbamine, corydine, corypalmine, corytuberine, hydrastine, mahonine, resin, and tannin. (12)

Pharmacy: 480 grains in 1 fluid ounce alcohol (50%) Dose: one fluid dram in four ounces water, teaspoonful every 2, 3, or 4 hours. (11)

History
Mahonia aquifolium is a Native American plant found growing from Colorado to the Pacific Ocean and from northern Canada to California . The plant produces grape like fruits and is common in Oregon , hence the name Oregon grape. Mahonia aquifolium (formerly Berberis aquifolium) is not mentioned in the general medical literature of the early 19 th century. Two notable texts, “American Dispensatory” written by Cox (1825) and “The Eclectic and General Dispensatory” written by Towar and Hogan (1827) do not reference the drug.

As with the early literature of the medical establishment, early Eclectic literature does not mention Mahonia aquifolium. Wooster Beach , founder of the Eclectic movement and the author of the first Eclectic medical texts, did not mention the plant. His last book, “Beach’s Family Physician and Home Guide,” written in 1859 does not mention the drug. From this one can infer that as of 1859, Mahonia aquifolium had not made its way into Eclectic medical circles.

The first record of Mahonia aquifolium appears in a publication from Parke, Davis and Company entitled “New Preparations” published in Detroit in 1877. History reveals that the Eclectics and the general medical community learned of the drug through the work of a Dr. Bundy, an Eclectic physician working Colusa , California . Bundy became acquainted with the plant while living in California . Bundy discovered its medicinal applications and introduced the plant to the drug company Parke, Davis, and Company, who in turn made the drug available to the Eclectic and other physicians.

Eclectic Use (1–11)
Actions
Alterative, tonic, stimulant to excretion and secretion, controls secretions of the mucous membrane, stimulates digestion, absorption, waste and repair, tonic and corrective in disorders of the liver and skin, stimulates secretion of entire glandular structure of digestive tract, stomachic, alterative and tonic to mucous membrane, invigorates digestive function and increases assimilation, makes bowel movements regular and normal.

Indications
“Syphilitic dyscrasia, constitutional syphilis, with periosteal or muscular pains; chronic skin affections, with blood dyscrasia; profusely secreting, tumid mucous tissues; indigestion, with hepatic torpor; yellow skin, with marked weakness and emaciation.” (7)

General
Syphilis, tuberculosis, tissue destruction through ulceration, tertiary syphilitic symptoms, late stages of syphilis, conditions based on bad blood, constitutional syphilis and its sequelae (skin eruptions, gastric perversions, and mucous membrane abnormalities, glandular indurations and chronic ulceration), chronic malarial conditions, intermittent fevers, phagedenic ulceration depending upon dyscrasia, ulceration of the mucous membrane, chronic mucous maladies, atonic conditions of the mucous membrane with profuse secretion.

Digestive
Dyspepsia, dyspeptic conditions, poor gastric function, atonic dyspepsia, gastro-enteritis, hepatic affections, cirrhosis, cirrhosis with gastro-enteritis, hepatic torpor with dyspepsia, chronic constipation, impaired digestion with hepatic torpor, stomatitis, gastric and intestinal catarrh, dyspeptic conditions with lack of appetite, chronic diarrhoea, chronic dysentery, jaundice when not due to occluded bile ducts, intestinal dyspepsia, apthous sore mouth.

Genito-urinary
Leucorrhea, bladder disorders, burning and soreness of the genito-urinary tract.

Lymphatic
Ulceration of the lymph nodes, scrofula, enlarged bronchial glands, glandular disorders due to malaria and intermittent fevers.

Musculoskeletal
Chronic muscular pain, rheumatism, muscular pains attending secondary and tertiary syphilis, muscular pains attending spinal disease, partial loss of muscle use due to spinal disease, syphilitic bone loss, inflammation of the periosteum and muscle, severe muscle pains, poor muscle strength.

Respiratory
Chronic pulmonary affections with profuse purulent expectoration, ulceration of the pulmonic tissues, phthisis, tuberculosis, purulent bronchitis associated with syphilis, bronchorrhea, purulent bronchorrhea, pulmonic troubles, catarrh.

Skin
Scaly skin conditions due to impaired nutrition and waste excretion (blood dyscrasia), skin conditions due to abnormalities of the blood, scrofulous and syphilitic skin conditions, chronic erysipelas, general eczematic states, herpes of long standing, acne, irritable inflammatory skin, changes in skin due to chronic skin disease, saltrheum, chronic saltrheum, pityriasis, cutaneous affections, long standing phagedenic and herpetic conditions, scrofulous affections, psoriasis, stubborn psoriasis, scaly, pustular, and other skin diseases due to disordered conditions of the blood, dyscrasia apparent in the skin, chronic skin diseases due to abnormalities of the blood, persistent acne, scaly skin diseases, non-inflammatory and inflammatory skin diseases, eczema genitalis, pruritis, scaly eczema, lack of vigour of hair in scaldhead, chronic dermatitis, stomatitis.

The drug from Selye’s perspective

State of Resistance
The drug was used to raise resistance to syphilis, tuberculosis, malaria, rheumatism, chronic respiratory disease, and chronic skin disease.

State of Exhaustion
The drug was used when resistance to chronic disease failed and State of Exhaustion set in. Conditions causing State of Exhaustion , treated with the drug included tertiary syphilis, terminal malaria, terminal tuberculosis, and terminal rheumatism. Signs of State of Exhaustion , treated with the drug, included perverted skin and mucous membrane function, cirrhosis of the liver, chronic diarrhoea/dysentery, tissue destruction due to ulceration, bone destruction, catabolism, digestive abnormalities, joint disease, and temperature abnormalities.

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. It was used to raise resistance to infection and autoimmune disease. It was used when resistance could no longer be maintained and State of Exhaustion commenced. Lastly, it was used when chronic disease depressed vital energy and thereby depressed physiological function.

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

The drug is considered innocuous in 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 infection and immune disease. (1–11)

Experimentally, compounds found in the drug have been shown to increase resistance to bacterial infection (cholera, escherichia, gonorrhoea, pneumonia, Salmonella, Shigella, Staphylococcus, Streptococcus, syphilis, tuberculosis, Chlamydia, Leishmania), viral infection (flu, herpes), fungal infection (Candida), and parasitic infections including malaria, protista, trichamonas, worms, and plasmodia.

They have also been shown to increase resistance to cancer, tumours, and free radical damage. (12)

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

The drug was used to normalise the physiological abnormalities associated with State of Exhaustion . (1–11)

Experimentally, compounds found in the drug have been shown to normalise a host of physiological abnormalities including platelet stickiness, arthritis, histamine abnormalities, hypertension, inflammation, ischemia, fever, poor liver cell function, immune deficiencies, poor circulation, diarrhoea/dysentery, excessive secretion, ulcer formation, and digestive insufficiency. (12)

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

Mahonia aquifolium was introduced in 1877 as a treatment for chronic skin disease. In time, the Eclectics discovered that it was highly effective in conditions marked by perverted physiological function. When the body lost its normal orderly function, the drug made an impression. Viewing their uses of the drug from a contemporary pathophysiological perspective, one could say the drug was used to normalise immune function. This could be hypo-immunity, hyper-immunity, or auto-immunity. Contemporary research validates the use of the drug as an immune modulator. It would be easy to conclude that the drug is a defensible immune modulator and leave it there.

However, a careful review of the Eclectic literature reveals that correcting perverted immune function is only one facet of the drug. In fact, it was used to normalise many of the physiological abnormalities associated with State of Exhaustion . An alternate view would be that the drug was used to treat patients having entered into State of Exhaustion .

Potential Clinical Applications
The drug may be of use when patients are no longer able to resist chronic disease and State of Exhaustion sets in.

Future Research
• Mahonia aquifolium and its effects on the GAS. The drug should be tested out in the animal model to determine its specific effects on the GAS.
• Mahonia aquifolium and infections with debilitating sequelae. Clinically, the drug was used to treat infections with sequelae, conditions like streptococcal infection followed by rheumatic disease and gonorrhoea followed by Reiter’s syndrome. Experimental data suggests the drug normalises many of the physiological abnormalities associated with these conditions. The drugs’ ability to raise resistance to Reiter’s Syndrome and Rheumatoid arthritis should be examined.
• Mahonia aquifolium and infection. The drug was used clinically to increase resistance to a wide collection of infections. Experimentally, it has been shown to offer broad antimicrobial protection. The drugs’ ability to raise resistance to infection should be examined.
• Mahonia aquifolium and State of Exhaustion . Clinically the drug was used to treat patients in State of Exhaustion . Its role in raising resistance in that state should be examined.

Eco-availability
The drug is commonly available and readily grown.

References
• Scudder, J. M. The American Eclectic Materia Medica and Therapeutics. Published by the Author. Cincinatti.1883 P. 500.
• Watkins, Lyman. An Eclectic Compendium of the Practice of Medicine. John M.Scudder’s Sons. Cincinnati . 1895. P. 427.
• Webster, HT. Dynamical Therapeutics—A work devoted to the Theory and Practise of Specific Medication with special references to the newer remedies. Second Edition. H.T. Webster. 1898. P. 62, 97, 302, 333, 514, 541.
• Felter, Harvey Wickes and Lloyd, John Uri. Kings’ American Dispensatory. Volume one and Volume two. Ohio Valley Company. Cincinnati . 1898. P. 1029.
• Peterson, FJ. Materia Medica and Clinical Therapeutics. Published by the Author. Los Olivos , California . 1905. P. 56.
• Neiderkorn, JS. A Handy Reference Book. Published by the Author. Cincinatti.1905. P. 128.
• Ellingwood, Finley. A Manual of the Eclectic Treatment of Disease. Volume one. Chicago Medical Times Publishing Company. Chicago . 1906. P. 454.
• Fyfe, John William. Pocket Essentials of Modern Materia Medica and Therapeutics. The Scudder Brothers Company. 1903. P. 63.
• Ellingwood, Finley. American Materia Medica, Therapeutics, and Pharmacognosy. Chicago . 1919. P. 369.
• Lloyd, JU. Drugs and Medicines of North America . Bulletin of Lloyd Library. 1921. P. 31.
• Lloyd Brothers. Dose Book of Specific Medicine. Lloyd Brothers Company, Cincinnati .
1907. P. 77.
• Dr. Dukes Phytochemical and Ethnobotanical Databases. Agricultural Research Services. USDA.

Notes from the Eclectic Physicians

1883: John. M. Scudder. The American Eclectic Materia Medica and Therapeutics. Published by the Author. Cincinatti.
Preparations – Tincture Berberis Aquifolium.

Dose – From five drops to one drachm.

Therapeutic Action – This remedy slightly stimulates waste and excretion, and possesses the properties of the many other vegetable remedies classed as alteratives. It has been extolled and widely sold as a remedy for syphilis and scrofulas, but it has not fulfilled the promises made for it.

Like many other things, it has had its day, an will probably pass into the list of unused medicines. If careful study should improve our knowledge of it, it will gradually find a place in this class.

1895: Lyman Watkins. An Eclectic Compendium of the Practice of Medicine. John M.Scudder’s Sons. Cincinatti
Tumid an dprofusely secreting mucous membranes, indigestion, torpid liver, yellow skin, weakness, emaciation, one drachm to four ounces of water; teaspoonful three times a day.

1898: H.T. Webster. Dynamical Therapeutics –A work devoted to the Theory and Practise of Specific Medication with special references to the newer remedies. Second Edition. H.T. Webster.
(Antiseptics, Antizymotics, Correctives)

This is one of Dr. J. H. Bundy’s California remedies, introduced to the profession through Parke, Davis & Co., of Detroit , Mich. , about ten years ago. dr. Bundy extolled the remedy rather too highly in some respects, but it is a corrective of superior virtues, nevertheless.

It is valuable in syphilis and in scrofulous states, phagedenic ulceration depending on such dyscrasiae being favorably influenced by it, as I have often proven in practice. Erysipelas of chronic nature, even though the local manifestation of it be of many years’ standing, may be remedied with it. eczematous states, where more general than local, and herpes of long standing, sometimes yield to the constitutional effects of this remedy.

Professor Bundy was very sanguine in the belief that it would cure cancer, but I have never known of a case benefited by it. It is not improbable that Dr. Bundy’s cases were phagedenic ulcerations due to syphilitic or scrofulous condition, instead of the destructive ulceration of carcinomatous elements.

I have myself seen surprising results follow the administration of berberis in chronic syphilitic ulceration. I recollect the somewhat striking case of an elderly German woman, who presented herself at the college clinic in Oakland seven or eight years ago. She was troubled with an ulcer in the hard palate, of grayish, sloughy appearance, which was so deep as to admit a probe to the bone, and it had been in existence for more than a year, though various kinds of treatment had been employed. She told a story of a worthless and dissolute husband, who at one time had been affected with venereal disease, and admitted that she had once been troubled with sore throat and eruptions. Three weeks’ use of berberis aquifolium cured the ulcer permanently (without local application), and there has never been any other trouble of the kind. This I know, for I see the woman frequently.

One of the most important places for berberis aquifolium is in chronic pulmonary affections attended by profuse purulent expectoration. When ulceration of the pulmonary tissue depends, to considerable extent, upon a depraved condition of the fluids of the body, it has no equal as a remedy in ulcerative pulmonary affections.

I have seen well advanced phthisis, which had been given up as hopeless by physicians of experience, and in which extensive cavities existed, recover under the protracted use of this remedy. The appetite soon improves, the hectic fever subsides in a couple of months, the quantity of matter expectorated gradually becomes lessened and the cough becomes less frequent and more mild, while the patient improves in flesh and strength. In such cases an important element of success is persistency in the use of the remedy, hardly any benefit being noticeable the first month, it being necessary to continue the remedy for from four to six months uninterruptedly.

Another excellent use for this remedy is to correct depraved conditions of the skin depending upon abnormal state of the blood. Some cutaneous affections yield readily to specific skin remedies, – those which selectively influence the part, – while others refuse to yield to such treatment and require something to improve the condition of the circulating fluids. In such cases berberis aquifolium is the first remedy to be thought of. It seems also to possess the additional quality of exerting a plastic influence upon the skin, as some cutaneous affections, such as acne, for instance, are benefited by it when it hardly seems possible that the blood can be at fault. It is a bad case of acne that will not manifest pronounced improvement after the patient has used the remedy a few months. An important place for this remedy – because one supplied by so few others – is chronic eczema with irritable (erysipelatoid) inflammation; here I think this remedy promises more than any other known.

As a remedy for syphilis, berberis aquifolium stands unrivalled. It seems to neutralize the poison and fortify the system, improving the activities of the glandular and assimilative functions; syphilitic aneamia, accordingly, disappears, with other morbid manifestations, after its faithful use. Tertiary symptoms will not appear after a protracted use of this remedy, unless the subject has been previously saturated with mercury.

A medical acquaintance of the writer’s, who practices principally in venereal diseases, has asserted that he relies upon this agent almost entirely in the treatment of syphilis, especially the late stage. He has insisted that he prefers to treat chronic syphilis rather than the earlier stages, as he has no remedy for the earlier manifestations that can be relied upon like berberis in the later phases. One of the most remarkable cures of lung affectations known was made by him in a case of lung affections known was made by him in a case of purulent bronchitis, which had been given up to die by a number of physicians, but which permanently recovered upon this drug, in a few months’ time.

A point worthy of remark is the fact that the corrective influence of this drug is not obtainable with the minute dose; but as it seems only to possess a dynamical influence (exhorbitant doses not producing serious disturbance of any part of the system), considerable latitude is allowable, provided the quantity be sufficient to impress the system profoundly. The dose of a saturated tincture or reliable fluid extract should range from ten to twenty-five drops, repeated three or four times daily.

1898: H.T. Webster. Dynamical Therapeutics –A work devoted to the Theory and Practise of Specific Medication with special references to the newer remedies. Second Edition. H.T. Webster.
(digestive)

Berberis is one of our most reliable agents in dyspepsia and seems to invigorate the gastric functions while it improves the power of the assimilative processes. Being a valuable blood and skin remedy, its influence as a gastric agent comes into additional service in the treatment of scrofulous and syphilitic states, where digestive disorders interfere with the proper effect of other correctives.

Combined with iodide of potassium it permits of large doses of that agent for a considerable time without intolerance, and the system rather gains than loses in strength, as is the case where the iodide is pushed to extreme limits alone. Where iodide of potassium disagrees with the stomach, it is a good plan to combine it with berberis, as the latter agent seems to overcome the difficulty.

Berberis has been employed with success in gastric troubles complicated with hepatic affections, frequently. In cirrhosis of the liver complicated with gastro-enteritis, it has been found of important service; also in hepatic torpor complicated with dyspepsia. It is valuable in chronic constipation, combined with cascara sagrada.

Form of Administration -Parke, Davis & Co’s fluid extract.

Dose- From five to thirty drops.

1898: H.T. Webster. Dynamical Therapeutics –A work devoted to the Theory and Practise of Specific Medication with special references to the newer remedies. Second Edition. H.T. Webster.
(Lymphatic System)

This remedy excercises a pronounced effect upon the lymphatic system, as evidenced by its remarkable influence in the arresting of ulcerative action. But it also proves a reliable remedy in syphilis and scrofula, as well as for certain depravation of the blood in other cases dependant upon imperfect functional service of the lymphatic system.

One of the best places for berberis in this respect is its application to the treatment of chronic bronchitis, in syphilitic scrofulous, or senile subjects, in whom there is probably enlargement and irritation of the bronchial glands, in connection with the irritation of the mucous membrane.

I have cured some very obstinate and long standing cases of bronchorhea of this character with this remedy. Sometimes it may be well, especially if the subject be syphilitic, to begin wiht a combinatin of this remedy with iodide of potassium, though the iodide should be employed after the first month. Ulceration of the cutanous surface, and also of the mucous membranes, when dependant upon faulty glandular action, yields to this remedy very promptly.

The form for administration and dose have already been refered to.

1898: H.T. Webster. Dynamical Therapeutics –A work devoted to the Theory and Practise of Specific Medication with special references to the newer remedies. Second Edition. H.T. Webster.
(Muscles) This remedy sometimes succeeds marvellously as a cure for chronic muscular pain. In chronic rheumatism which has refused to yield to all other remedies it should be tried. A valuable adjuvant is the iodide of potassium, itself a useful remedy in chronic rheumatism.

In the treatment of muscular pains attending the secondary and tertiary stages of syphilis, a few weeks of berberis will often banish this cause of suffering. Being a valuable tonic and stimulant to digestion here it is the best agent that can be employed. It does not act quickly, and must be persevered in for a month or two in order that its value may be fairly estimated in any case of this kind.

In the severe muscular pains attending certain cases of spinal disease, with partial loss of use of the muscles, it acts efficaciously, excelling many other remedies.

Form for Administration . – The specific medicine.

Dose . – This should be large – from ten to twenty drops, repeated four or five times a day.

1898: H.T. Webster. Dynamical Therapeutics –A work devoted to the Theory and Practise of Specific Medication with special references to the newer remedies. Second Edition. H.T. Webster.
(Skin) Berberis aquifolium is a comparatively new remedy, but it has proven one of the most reliable we have in chronic skin affections. In eczema, psoriasis, and scrofulous and syphilitic affections of the skin, af various forms, we have no more reliable remedy than this.

In the eruptions of secondary syphilis the continued use of berberis aquifolium for a few months will usually remove all traces of the eruption, and if any remain they will be trifling compared to the condition where the remedy has not be employed. In chronic changes in the skin, of long standing especially in syphilitic cases, the use of iodide of potassium in conjunction with the berberis is a commendable measure, the iodide being continued for a month or six weeks to then be discontinued, while the berberis is used uninterruptedly.

As the effect of berberis is always to invigorate the skin it is a useful agent to administer in any cutaneous affection of chronic character, in connection with the remedy which may seem more pronouncedly indicated. The effect of the specific remedy is thus enhanced, since the functional activity of the skin generally is improved by the berberis, while it also augments digestion and assimilation, thus improving all the functions of the body. In acne, berberis will accomplish desirable results in many cases if continued for a long time uninterruptedly, say a year.

There can hardly be imagined an abnormal condition of the skin where this remedy may not be administered with advantage, if it be borne in mind that its effects are brought about slowly, and that structural changes require months for their accomplishment.

Form for Administration. – The fluid extract prepared by Parke, Davis & Co.

Dose. – This must be large, comparatively speaking; from ten to thirty drops.

1905: F.J.Peterson. Materia Medica and Clinical Therapeutics. Published by the Author. Los Olivos , California .
Properties: alterative,tonic,antisyph ilitic,slightly laxative, and diuretic.

Use: In disordered conditions of the blood and especially skin diseases due to above, such as eczema, acne,l psoriasis, chronic dermatosis,scald head,salt rheum, etc. It removes pimples and roughness of the skin,promoting a soft and natural skin in sensitive young ladies if the cause is not from irritation in the reproductive organs. It acts favorably on the liver and is a good tonic. A valuable remedy in syphilis, especially if combined with other alteratives. As a general tonic, to improve appetite and digestion and to purify the blood it is one of our best remedies. In uterine troubles it acts as a general and local tonic, overcoming relaxed and weakned condition. In skin diseases it acts best in thise of a dry and scaly nature, but is of benefit in other forms as well. We also think of it in chronic hepatitis, acute Bright’s disease, phthisis,coughs, dyspepsia, chronic throat troubles, etc., in conjunction with or alternated with other indicated remedies.

1905: F.J.Peterson. Materia Medica and Clinical Therapeutics. Published by the Author. Los Olivos , California .
Properties: astringent,expectorant;st imulating to mucous surfaces.

Physiological action: Taken in large and continued doses in healthy state it will produce sticking pain in the spleen, increased by motion, inability t lie on left side, enlargement of the spleen, then these same symptoms in the liver with enlargement and congestive pain worse on touch; pain in umbilical region; pain and soreness on the exterior part of thigh; loss of appetite;tongue coated with dirty white coating; emaciation and general weakness. Urine may be colored green with bile, stool clay coloured. In fact under the physiological dose long continued all the symptoms of chronic malaria will develop.

Indications: Doughy, sallow skin,expressionless face, pain in the region of the liver and spleen.

Use: An alterative which has powerful influence over the portal circulation, indicated where there is sluggish circulation and inactivity of the liver, especially if these conditions are the result of malaria. In enlargement of either spleen or liver, it is a valuable remedy and if combined with polymnia uvedalia is even more effective. Its use is confined to chronic conditions as above. Its astringency renders it of value in catarrhal conditions of the mucous surface with hyper secretion and without inflammation. In splenic pains, chilliness with splenic pains and leucorrhea, it has proved to be of value.

1905: J.S. Neiderkorn. A Handy Reference Book. Published by the Author. Cincinatti.
sp.med: chronic skin affections, yellowish skin, hepatic torpor, marked weakness, blood dyscrasiae, syphilitic history. dose: ten drops every three hours.

1906: Finley Ellingwood. A Manual of the Eclectic Treatment of Disease. Volume one. Chicago Medical Times Publishing Company. Chicago .
Scaly,pustular, and other skin disease due to the disorders conditions of the blood. it is the most reliable alterative when the influences of the dyscrasia is apparent in the skin. it is given freely during the treatment of skin disease where an alterative considered an essential part of the treatment. pimples, roughness, eczema capitis,eczema genitalis, pruritus, scaly excema, psoriasis, pityriasis, chronic dermatosis, glandular indurations, ulcerations, syphilis.

1909: Kings’ Dispensatory. Felter and Lloyd: Ohio Valley Publishing Company.
History -This is a tall shrub, native of the western section of the United States . It grows from Colorado to the Pacific Ocean, and is especially abundant in Oregon and the northern part of California . Berberis aquifolium belongs to the section Mahonia of the genus Berberis, which section is considered by some botanists a distinct genus. The following synopsis of the difference between the two sub-genera is taken from “Berberidaceae” (a pamphlet by C. G. and J. U. Lloyd, 1878):

“The Berberis proper has simple leaves clustering in the axis of a simple or 3-parted spine. The petals have two glands on the inside of each, at the base. The filaments have no teeth. Berries 2 to 3-seeded.

“Mahonia has oddly, pinnately, compound leaves, with no spine at the base, but with spiny-toothed leaflets. The petals are glandless. The stamens have a tooth on each side of the filament, near the top. Berries 3 to 3-seeded”.

The section “Mahonia” is represented in the western United States by six species, viz.: Berberis pinnata, Lag, a tall shrub with the general appearance of B. aquifolium, distinguished from it by the leaflets, which are glaucous underneath, and the lower pair approximate to the base of the petiole; Berberis repens, Lind., a small creeping plant, with leaves often ternate, and leaflets nearly orbicular, and which has been much confounded, and frequently described as Berberis aquifolium. Berberis nervosa, Pursh, a small erect shrub, with leaves often longer than the stem – it appears to be more generally distributed than the other species. The chief characteristics of this species are the leaflets are three-veined from an obliquie base, the common petiole is jointed “like a bamboo stem,” and the flowers are in slender racemes. The two other species, B. Fendleri and B. Fremonti, are of rare occurrence.

Berberis aquifolium and the other species long in use in domestic practice throughout the West, were brought into general notice a few years since by Parke, Davis & Co., of Detroit , who gave the remedy great conspicuity. Dr. Bundy, of Colusa , Cal. , wrote many papers on its therapy; these were published in their journal, “New Preparations”.

From an examination of the drug, as thrown upon the market, we find the species are confounded, several of them being generally sold as B. aquifolium. The B. nervosa is more commonly met with in these sophistications, but we have likewise noticed B. repens in considerable amount. The confusion is, perhaps, unimportant from a therapeutical point, as all the Mahonias are bitter, and seem to contain berberine in nearly the same proportion (see Related Species).

Action, Medical Uses, and Dosage – This agent has justly been extolled as an alterative and tonic, and has been recommended in syphilitic affections, saltrheum, pityriasis, psoriasis, and other cutaneous affections, as well as in maladies supposed to be due to some mal-condition of the blood. Excretion and secretion are promoted by it; digestion and assimilation improved; the lymphatic glandular system and the ductless glands are stimulated; and the renal secretions somewhat augmented. Thus it acts as a blood-maker, and is therefore a remedy to oppose depraved conditions of the body-fluids. As a tonic, it may be employed as a synonym of hydrastis, colombo , berberis, etc., possessing in addition its own peculiar virtues, in dyspeptic conditions, chronic mucous maladies, and in certain enfeebled conditions of the system, etc. Owing to its invigorating power over the gastric functions, it is a valuable remedy for atonic dyspepsia, and more particularly if associated with hepatic torpor, for which it is also an excellent remedy. A cirrhotic liver, associated with gastro-enteritis, has been benefited by it, and for chronic constipation it is a useful agent when combined with cascara sagrada. It is said to be effectual in stomatitis.

The great field for berberis aquifolium is in constitutional syphilis an dits manifold complications and sequelae. The disorders named above are more amenable to this drug when associated with a syphilitic taint than otherwise. If given early enough it will prevent tertiary phases, provided the patient has not been too thoroughly mercurialized. Its use must be prolonged in appreciable doses. It is especially adapted to long-standing cases of syphilis, the older the better, according to some of its advocates, and yet it is a remedy of much value all through the course of the disease. It is the remedy for that broken-down state so frequently following in the wake of that malady. The various eruptions give way to it, the gastric complications are subdued, and the mucous membranes are toned so that excessive secretions are restrained. The bone and periosteal, as well as the muscular, pains of syphilitics, are amenable to berberis. Its action is slow but sure, as it is also in severe muscular pains, with partial paralysis, due to spinal disease. Long standing syphilitic phagadenae and herpetic and eczematous states, yield to it better than to most agents. It should not be forgotten in syphilitic anemia. Several stubborn cases of psoriasis (Ed. E. M. J., P. 148, 1896) have been cured by it, and it is a valuable drug in erysipelatous and chronic scrofulous affections. While it has failed to cure carcinoma, as its introducer, Dr. J. H. Bundy, believed it would, it has, however, shown itself of value in the dyscrasiae due to a cancerous cachexia.

Berberis aquifolium commends itself for study in certain pulmonic troubles, on account of its excellent results in controlling secretions of the mucous tract. Cases of purulent bronchorrhoea, pronounced incurable, have been cured by it, and Prof. Webster asserts that he has seen cases of phthisis recover, even where there were extensive cavities, under the use of this agent. The appetite improved, hectic subsided, expectoration became lessened, the cough milder and less frequent, and flesh and strength were augmented. The remedy should be long continued. Berberis is of some value in leucorrhoea, and particularly when a syphilitic taint exists. owing to its remarkable power over mucous structures we would suggest its employment in gatric and intestinal catarrh. The principal uses of this drug have been developed by Dr. J. H. Bundy and Prof. Herbert T. Webster. The dose of berberis aquifolium should be relatively large. Small doses, as required of most of our important agents, do but little good.

The dose of the fluid extract is from 10 to 20 drops every 3 or 4 hours; of specific berberis aquifolium, 5, 10 or 15 drops, every 3 or 4 hours.

Specific Indications and Uses – Syphilitic dyscrasiae, constitutional syphilis, with periosteal or muscular pains; chronic skin affections, with blood dyscrasiae; profusely secreting, tumid mucous tissues; indigestion, with hepatic torpor; yellow skin, with marked weakness and emaciation.

1911: John William Fyfe. Pocket Essentials of Modern Materia Medica and Therapeutics. The Scudder Brothers Company.
Catarrhal affections of the gastrointestinal mucous membranes, incipient dyspeptic affections, with loss of appetite,facial eruptions,chronic catarrh, skin eruptions. berberis aquifolium is alterative,and tonic.

1919: Finley Ellingwood. American Materia Medica, Therapeutics, and Pharmacognosy. Chicago .
Synonyms – Oregon grape, mountain grape.

Constituents – Berberine, oxyaeanthine, berbamine, tannin, fat, resin.

Preparations – Extractum berberidis aquifolii fluidum. Fluid extract of berberis aquifolium. Dose, from five to twenty minims.

Administration – The active principle of the agent is apt to precipitate it a combination is made with theiodide of potassium, as is often done with other vegetable alteratives. To avoid this the iodide solution should be rendered slightly alkaline by adding a few drops of the liquor potassae before the combination is made.

Physiological Action – In overdoses in some cases the agent produces tremor of the limbs, lack of muscular power, dullness of the mind, drowsiness and active diuresis. It is not a poisonous agent.

Its influence upon the secretion of the entire glandular structure of the digestive and intestinal tract is steady, sure, and permanent, although not always as immediately marked as some other agents.

It stimulates all the glandular organs of the body. It stimulates digestion and absorption, and thus improves general nutrition. It materially stimulates waste and repair.

John Aulde in 1911 advised this remedy for its immediate influence upon the digestive apparatus, the blood, and the secretions. He said constipation is relieved and the bowel movements become regular and natural. The complexion clears, the muscular strength increases, and the skin and urinary organs become more active. I have foun dit indeed serviceable in syphilis an din scrofula, the general indications being peculiar to indigestion such as coated tongue, fetid breath, and a general feeling of malaise from blood disorders. This is strictly in line with our own teachings.

Specific Symptomatology – The specific action of this agent is in scaly, pustular and other skin diseases due to be disordered condition of the blood. It is the most reliable alterative when the influence of the dyscrasia is apparent in the skin. It is given freely during the treatment of skin diseases where an alterative is considered an essential part of the treatment.

Therapy – It has cured persistent acne for the writer, when no local treatment was used. It contributes to the removal of pimples and roughness and promotes a clear complexion, a soft, smooth and naturally moist skin in sensitive young ladies, when the cause is not a reflex one from ovarian or uterine irritation, or menstrual irregularity.

It seems of especial value in scaly skin diseases an din dosorders of a non-inflammatory type, and yet it works nicely in some cases of the moist variety.

It has cured very many cases of salt rheum even when the symptoms were chronic in character and greatly exaggerated.

In moist eczema it has acted most satisfactorily, but has usually been given in conjunction with other treatment. Dr. Soper, in 1884, reported in the Therapeutic Gazette a most intractable case of moist eczema of an acute character covering the entire body. No other alterative was given. The case was cured in four weeks. In eczema capitis, eczema genitalis, with pruritus an din scaly eczema of all kinds, it has been given alone and has acted promptly and surely.

It has cured cases of scald head, so called, in a few weeks, restoring tone and vigor to the hair.

It has been often used in acne, and has worked nicely when local or reflex irritation was not the cause.

In psoriasis and in pityrtasis it has won the praise of many doctors. For dandruff it has been given internally and has produced cures in a number of cases.

In many instances various forms of chronic dermatosis have yielded to its influence when other treatment has failed.

It should be prescribed in glandular indurations and chronic ulcerations both of a scrofulous and syphilitic type, giving excellent results in these cases. It is lauded highly in syphilis, though it has seldom been given alone in this condition, but usually with other vegetable alteratives, the value of which, however, it has seemed to greatly enhance. Of this fact, I am positively convinced because of the rapid disappearance of the characteristic eruption, and the marvelously smooth condition of the skin which has followed with my patients when this agent is given in this disease.

When first introduced it was recommended in chronic malarial conditions, in intermittent fevers, and in the stomach, liver, intestinal and general glandular disorders of these fevers. it was claimed that its tonic influence was conspicuous in these conditions and that in certain cases it exercised marked antiperiodic properties. it certainly acts as a tonic and corrective to disorders of the liver, an influence that has been often remarked when given for skin diseases.

1932. J.U. Lloyd. Drugs and Medicines of North America . Bulletin of Lloyd Library.
Berberis aquifolium is mentioned in the 1900 edition only. The New York edition of 1830 names “The berries of Berberis Canadensis.” The editions of 1860 and 1870 mention in their Secondary List “The bark of the root of Berberis vulgaris.” All other editions of the U.S.P. ignore Berberis completely.

The berberis officially recorded in the Pharmacopeia of the United States, Berberis aquifolium, or Mahonia, was brought to the attention of physicians by Dr. Bundy, an Eclectic physician of California, through the manufacturing house of Parke, Davis and Company, Detroit, who established it in general professional use. (467). Mahonia had previously been used throughout the Western States as a domestic remedy in the direction commended by Dr. Bundy, and in many respects it paralleled the domestic and official uses of its near relatives in the Orient and elsewhere.

The Pharmacopeia of India, under the common name Berberis, recognizes three species of barberry, all having domestic records as tonics, dating from the earliest times, and being used in decoction or infusion in inflammatory discharges, as well as in applications for various forms of ophthalmic inflammation. The Arabian physicians employed this plant. Dioscorides (194), Pliny (514), Celsus (136), Galen (254a) and others recognized it. It was one of the Indian drugs on which the Alexandrians levied duty, 176-180 A. D. Among Greek antiquities are preserved small vases of barberry, showing its value in ancient times. Among these vases is one bearing the label of a certain Heraclides of Tarentum, who is mentioned by Celsus as having a reputation for treating diseases of the eye. In formulas for eye diseases given by Galen (254a), barberry is authoritatively recognized. The natives of India use an extract made from various species growing in northern India, which is sold in the bazaars under the name “Rusot,” and used not only in affections of the eye, but as a tonic and febrifuge. The qualities of both the official drug and its foreign relatives are similar, and were thus introduced by the common people.