Cassia marilandica

Cassia marilandica

Synonyms

No documentation

Vernacular Name

Locust Plant, Wild Senna, Maryland Senna

Description

The leguminous Cassia marilandica grows to a height of 2m, and the erect stems tend to grow in a zigzagged pattern near the apex. The petiolate leaves of C. marilandica are ovate lanceolate in shape, and grow on 20cm long stems that protrude from the stalk at near-right angles. The leaves can grow to be roughly 5cm long and 2cm wide. The hermaphroditic flowers bloom between June and August, and are clustered at the apex of the herb. Each flower is roughly 1.5-2.0cm across and is identified by their five, yellow-green petals and their ten unequal stamens which are green at their base but gradually brown toward the tip. The fruit borne of C. marilandica are long, narrow legumes, brown in color, and 10cm in length.

Origin / Habitat

C. marilandica is an herbaceous perennial Native to the rich soils of eastern North America, often growing along rivers and lakes. Preferring large amounts of sunlight, C. maralandica ranges from New York and Massachusetts as far south and west as Florida and Texas, respectively.

Chemical Constituents

There are no studies available for substantiation of the constituents of this particular species which is the species most commonly used in Native American traditional medicine. In general, Senna species contain approximately 3% dianthrone glycosides (sennosides A, A1, B, C, D, E, F & G ); small amounts of anthraquinones including aloe-emodin and rhein 8-glucoside; approximately 10% mucilage; tannins; and flavonoids.

Plant Part Used

Leaf and Pod (2)

Traditional Use

C. maralandica has developed a role in Native American Medicine as a laxative.(1) The Cherokee viewed C. maralandica not only as a laxative, but also as a cathartic, often using an infusion for both children and adults for its purgative action.(2) C. maralandica can cause gripe, or similar symptoms thereof, so many Native American tribes use it in conjunction with some aromatic herbs in order to pacify those effects.(3)

Perhaps rivaling the use as a laxative in popularity is the use of C. maralandica in treating fever. C. maralandica is thought to be especially useful in cases of fever in which laxative action is desired.(4) The Cherokee used an infusion of the leaves in these cases, and an infusion of the root has been given to children.(2)

C. maralandica has also been used in Native American medicine externally. A poultice of the root has been used cases of suppurating sores.(2) A paste of crushed leaves and vinegar has been used in order to treat pimples and other minor skin disorders.(3)

Dosage

The dosages vary depending upon tribe, indication and preparation. Most common dosage range is 1-3g powdered herb at bedtime for use as a laxative.

Pharmacology

Pre-clinical

The studies on the pharmacology of C. maralandica species do not typically identify the specific species used.

C. marilandica has no direct references in the scientific literature. However, since many of the species are interchangeable for clinical use, general information on the pharmacology of the species is provided herein.

C. maralandica is a stimulant laxative and categorized as an anthraquinone laxative. C. maralandica is widely accepted as a stool softener and a short-term treatment for constipation. C. maralandica leaf is approved by the World Health Organization (WHO) for short-term use in occasional constipation. C. maralandica contains hydroxyanthracene glycosides, also called sennosides. Sennosides stimulate peristalsis of the colon along with altering colonic absorption and secretion of fluids, resulting in accumulation of liquids to soften the stool and increased defecation. Clinical studies suggest that senna is effective in managing constipation associated with a number of causes including surgery, childbirth, and use of narcotic pain relievers.(5),(6)

It has been thought that using anthraquinone laxatives, in particular C. maralandica, may damage the intestinal epithelial layer of the GI tract and therefore increase the risk of developing colorectal cancer. Sennosides have been found to induce acute massive cell loss in the GIT, probably by apoptosis, causing shorter crypts, and increased cell proliferation.(7) However, in a laboratory study, the isolated constituent rhein showed no cytotoxic and genotoxic effects in colon adenocarcinoma cells.(8) Of interest is that by being antioxidant, rhein actually inhibited cell proliferation via a mechanism that seems to involve the MAP kinase pathway.

Clinical

No documentation

Interaction and Depletions

Interaction with other Herbs

No documentation

Interaction with Drugs

Based on pharmacology, use with caution when taking prescription or non-prescription medications and dietary supplements. The stimulant laxatives may increase gastrointestinal transit time and decrease the absorption of drugs and supplements.

Precautions and Contraindications

Side effects

C. maralandica has been reported safe in recommended doses. As with other stimulant laxatives, C. maralandica should not be administered to patients with intestinal obstruction and stenosis, atony, dehydration, or chronic constipation.   C. maralandica should not be used in patients with inflammatory intestinal diseases, such as appendicitis, Crohn’s disease, ulcerative colitis, or irritable bowel syndrome. As with other stimulant laxatives, senna is contraindicated in individuals with cramps, gastric pain, nausea, vomiting, colic, hemorrhoids, or nephritis.

Chronic use of C. maralandica has been reported to cause hepatotoxicity, including portal vein thrombosis, in several case reports.(10),(11) Do not use in individuals with pre-existing liver or kidney disease.

Based on pharmacology, stimulant laxatives may lead to electrolyte imbalances such as increased loss of potassium. Loss of potassium may potentiate the effects of cardiotonic glycosides (digitalis). Hypokalemia resulting from long-term laxative use/abuse can also potentiate the effects of antiarrhythmic drugs, such as qunidine or calcium channel blockers. Using senna with other drugs or herbs that induce hypokalemia, such as thiazide diuretics, corticosteroids, or licorice root (Glycyrrhiza glabra), may lead to electrolyte imbalances.

Pregnancy

C. maralandica should not be used during pregnancy or lactation except under medical supervision after benefits and risks have been measured.  A review found that the use of C. maralandica in pregnancy had no association with a higher risk of congenital abnormalities.(11) C. maralandica may significantly reduce drug absorption and lessen the efficiency of any over-the-counter or prescription medications. Discontinue if allergy occurs.

Age limitation

Do not use C. maralandica in children under 10 years of age.   

Adverse reaction

No documentation

References

  1. Hatfield G. Encyclopedia of Folk Medicine: Old World and New World Traditions. Santa Barbara, CA: ABC-CLIO, Inc; 2004.
  2. Moerman DE.  Native American Ethnobotany. Portland OR: Timber Press; 2009.
  3. Hutchens, A. Indian Herbalogy of North America. Boston, MA. Shambala; 1991.
  4. Castleman M. The New Healing Herbs: The Classic Guide to Nature's Best Medicines. Emmaus, PA: Rodale, Inc; 1991.
  5. Agra Y, Sacristan A, Gonzalez M, et al. Efficacy of senna versus lactulose in terminal cancer patients treated with opioids. J.Pain Symptom.Manage. Jan1998;15(1):1-7.
  6. Kinnunen O, Winblad I, Koistinen P, Salokannel J. Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients. Pharmacology 1993;47(1):253-255.
  7. van Gorkom BA, Karrenbeld A, van Der Sluis T, et al. Influence of a highly purified senna extract on colonic epithelium. Digestion. 2000;61(2):113-120.
  8. Aviello G, Rowland I, Gill CI, et al. Antiproliferative effect of rhein, an anthraquinone isolated from Cassia species, on Caco-2 human adenocarcinoma cells. J Cell Mol Med. 16 Jun 2009. [Epub ahead of print]
  9. Acs N, Bánhidy F, Puhó EH, Czeizel AE. Senna treatment in pregnant women and congenital abnormalities in their offspring--a population-based case-control study. Reprod Toxicol. Jul 2009;28(1):100-104.
  10. Soyuncu S, Cete Y, Nokay AE. Portal vein thrombosis related to Cassia angustifolia. Clin Toxicol (Phila). Sep2008;46(8):774-777.
  11. Vanderperren B, Rizzo M, Angenot L, et al. Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides. Ann Pharmacother. Jul-Aug2005;39(7-8):1353-1357.