Mandrake
Botanical Description & Habitat
Podophyllum peltatum
Family
Berberidaceae
Common names
American mandrake
Duck's foot
Ground lemon
Hog apple
Indian Apple
Indian berry
Mandrake
May apple
Mayapple
Racoon Berry
Vegetable mercury
Wild lemon
Wild mandrake
Habitat
Indigenous herbaceous plant found throughout the United States, especially the northeastern USA.
Description
It grows in rounded, irregular clusters of 100 or more plants, preferring moist, shady woods and low, marshy grounds. A jointed reddish-brown root produces a pale green, simple round stem, one half to one foot in height. The leaves are large and palmate, with six or seven wedge-shaped lobes, yellowish-green on the upper surface, paler beneath, and irregularly incised at the extremity. A solitary white flower grows from the fork in the stem during May or June. The fruit is a large, yellowish berry which ripens in late September.
This is a small perennial producing solitary white flowers. When the flower drops, the developing fruit swells to the size and shape of a lemon.
It has a characteristic, unpleasant odor.
Medicinal parts
Rootstock - dried, gathered in autumn
American mandrake
Mayapple resin
Mayapple root
The dried rhizome is used for the production of resin, exclusively for external use.
Historical Properties & Uses
Mandrake is a good source of chemicals used in the treatment of certain forms of cancer. Extensive research indicates podophyllotoxin and other derivatives of the herb have extremely strong anticancer and cytotoxic properties. These characteristics are also used externally to remove warts.
Mandrake's purgative action is obvious but its other purported qualities, such as vermifuge, antibiotic and cholagogue have not been experimentally tested.
American Indians used mandrake as a purgative; interestingly, they also used it to commit suicide and murder. Overdoses of the herb are extremely toxic; mandrake should be used only under the direction of a physician.
Traditionally it was a drastic cathartic and purgative.
This herb has approval status by the German Commission E for the removal of pointed condyloma (warts).
References:
Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
Method of Action
Mandrake components have powerful anticancer properties
Several components of mandrake have strong anticancer and cytostatic properties, including podophyllotoxin, desoxypodophyllotoxin, epipodophyllotoxin VP 16213, and VM 26. The kinds of cancer effectively treated include acute leukemias, haemotosarcomas, solid tumors, malignant lymphomas, malignant intracranial neoplasms, and various experimental tumors.
The toxicity of these various components and derivatives appears to be fairly low. Compared to other chemotherapeutic agents, this podophyllotoxin derivative is relatively safe and free of harmful side effects.
Miscellaneous pharmacology of mandrake
Mandrake has some antitubercular action, and a small anti-inflammatory activity.
Lignans are the chief components of podophyllotoxin.
Drug Interactions & Precautions
There are no known interactions.
Podophyllum was an ingredient in Carter's Little Liver Pills.
Known Interactions
Due to mandrake's cathartic activity, it may potentiate anticoagulant therapy by reducing absorption of vitamin K from the gut. It may also inhibit absorption of dextrose from the intestines. Conversely, cathartic-induced hypokalemia potentiates muscle relaxants.
As a cathartic, the herb may also increase intestinal transit time of digitalis glycosides, inhibiting their absorption and cardiac action.
Cathartic-induced hypokalemia, however, increases the toxicity and potency of absorbed digitalis.
In addition to the specific interactions listed, the cathartic action of mandrake tends to hasten the passage of all oral medications through the gut, thereby inhibiting their action.
Comments
In the absence of other hard data, it may be assumed observable interactions occur between the many central nervous system drugs and the psychoactive principles in mandrake.
Safety Factors & Toxicity
Pregnancy is a contraindication for its use. Treatment for warts can cause intrauterine death. (Chamberlain, BMJ 1972, 3:391.)
There are no known side effects.
The FDA does not consider it a safe laxative.
Overdoses of mandrake can be fatal.
Mandrake alkaloids and resins cause birth defects. Pregnant women should completely avoid them, as well as any proprietary laxatives containing podophyllum alkaloids and resins.
A 25% solution of podophyllin in tincture of benzoin, applied to warts on the vagina and perineum, resulted in temporary disablement symptoms, including: semicomatose, tachycardia, and abnormal EEG. The warts, however, vanished.
Some authorities believe podophyllin is too toxic to be used as a laxative, especially since much safer laxatives are available. They point out resin laxatives are irritants and are potentially dangerous. Neither podophylum nor its components have been condoned for use by pregnant women, because they damage the fetus. Used in slimming tablets, podophyllum has led to birth defects.
The classic case study alarming the medical community concerned an 18-year old girl in the 34th week of pregnancy, who was treated for venereal warts with a 25% solution of podophyllum resin in a tincture of benzoin. Ten days later, her baby was stillborn. The girl suffered numerous side effects, but recovered. She later had a normal pregnancy and delivery.
In another study, a pregnant 18-year old was treated exactly as above. Her infection was unusually extensive, requiring a heavy application. The physicians left the prepartion on too long, resulting in the death of the fetus.
A case of hypokalemic metabolic alkalosis resulted from clandestine use of Carter's Little Pills daily for four years and the consequent 4-5 watery bowel movements a day. The patient recovered two months after ceasing to use the pills; these pills contain aloes and podophyllum resin.
A case of hairy tongue was treated with a 10% solution of podophyllum resin, first applied for about four hours and again after 24 hours. The patient's hairy tongue cleared up, but he suffered the following temporary side effects: nausea, vomiting, sore throat, and uneasiness.
Cases of dermatitis were caused by contact with podophyllum resin during grinding and sifting of the drug by workers. Irritation of normal mucous membranes occurred after 24 hours of constant application of the resin.
Preparation & Administration
TERATOGENIC: DO NOT USE DURING THE FIRST THREE MONTHS OF PREGNANCY
Three times a day
Dried rhizome
0.12-0.6 grams
Fluid extract
1:1 in 90% alcohol, 0.3-0.7 ml
This herb has approval status by the German Commission E.
Recommended daily dosages in Germany are as follows:
1.5 - 3 g root.
1.5 - 3 g fluid extract.
2.5 - 7.5 g tincture.
References:
Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
Note: This Herbal Preparation information is a summary of data from books and articles by various authors. It is not intended to replace the advice or attention of health care professionals.
References
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Azarnoff, D.L. & A. Hurwitz. 1970. Drug interactions. Pharmacol Physicians, 4(2). pp. 1-7.
Beckman, H. 1967. Dilemmas in drug therapy. Saunders, Philadelphia.
Benoit, P.S., et.al., Lloydia, 39, 160, 1976.
Bettley, F. The treatment of skin carcinoma with podophyllum derivatives. British Journal Of Dermatology, 84, 74-82, 1971.
Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
Bressler, R., M.D. Bogdonoff & G.J. Subak-Sharpe. 1981. The Physicians Drug Manual. Doubleday & Co, Inc. Garden City, NY. 1213 pp.
Cassidy, DE et al., Podophyllum toxicity: a report of a fatal case and a review of the literature. J. Toxicol. Clin. Toxicol. 1982, 19(1):35.
Chamberlain, M.J., et.al. Toxic effect of podophyllum application in pregnancy. The British Medical Journal, 3, 391-392, 1972.
Committee on Pharmocopaeia of the Am Institute of Homeopathy, The Homeopathic Pharmacopaeia of the United States. 8th ed., Vol 1. Otis Clapp and Son, Agents, Boston, l981.
Creaven, P.J., et al. Phase I clinical trial of weekly administration of 4'-demethylepipodophyllotixin 9-(4,6-o-ethylidene-B-D- glucopyranoside) (Nsc-141540; Vp-161213). Can & Chemo Rpts, 58, 1974.
Dombernowsky, P., N.I. Nissen & V. Larsen. Clinical investigation of a new podophyllum derivative...in patients with malignant lumphomas and solid tumors. Cancer Chemotherapy Rpts, 56, 71-82, 1972.
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Podophyllum peltatum
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