liver crisis ("mal fwa")

Annona squamosa

(In territories with significant traditional TRAMIL use)

Cuba:

  • anón

Martinique:

  • pomm kannel

Antigua and Barbuda:

  • sugar apple
Significant uses found by the TRAMIL surveys

 leaf, decoction, orally1

Recommendations Preparation and Dosage References

According to the information available:

The use for liver crises (“mal fwa”) is classified in the REC category based on the significant traditional use documented in the TRAMIL surveys and the toxicity studies.

If deterioration is observed in the patient or the liver crisis persists for more than 3 days, seek medical attention.

The use for stomach pain, wind and colds is classified in the REC category based on the significant traditional use documented in the TRAMIL surveys, the toxicity and validation studies and the scientific information published.

If deterioration is observed in the patient or the stomach pain persists for more than 3 days, seek medical attention.

Considering the possible risk of neurotoxicity, due to the presence of neurotoxic compounds present in the leaf of some species of the Annonaceae family, related to the appearance of atypical parkinsonism4, avoid prolonged use (longer than a year).

Not for use during pregnancy because it can cause miscarriage, nor while breastfeeding or in children under 12 years of age.

For stomach pain:
prepare a decoction with 30 grams of buds in 4 cups (1 litre) of water, boil for 5 minutes in a covered vessel. Leave to cool, strain (filter) and drink 1 cup 3 or 4 times a day.

For wind and cold:
prepare a decoction with 50 fresh leaves (10 grams) or 30 grams of previously washed aerial parts, in 4 cups (1 litre) of water, boil for 10 minutes in a covered container. Leave to cool, strain (filter) and drink 1 cup 3 or 4 times a day.

Preparations must never be stored for more than 24 hours, even if refrigerated.

1 LONGUEFOSSE JL, NOSSIN E, 1990-95
Enquête TRAMIL. Association pour la valorisation des plantes médicinales de la Caraïbe AVPMC, Fort de France, Martinique.

2 CARBALLO A, 1990
Encuesta TRAMIL. Centro de investigación de fitoterapia y medicina tradicional de Topes de Collantes, Trinidad, Cuba.

3 O'REILLY A, 1992
TRAMIL survey. Chemistry & Food Technology Division, Ministry of Agriculture, Dunbars, Antigua & Barbuda.

4 CAPARROS-LEFEBVRE D, 2003
Atypical parkinsonism in the tropics: from Pacific to the Caribbean and evaluation of isoquinoline derivatives toxicity. In: The 9th meeting of the International Neurotoxicology Association (INA-9) abstracts book. Dresden, Germany:p19.

5 MOREJÓN Z, VICTORIA MC, MOROÓN F, MÉNDEZ G, 2005
Tamizaje fitoquímico de la decocción de hoja fresca y extracto fluido de hoja seca de Annona squamosa L. Informe TRAMIL. Laboratorio Central de Farmacología, Facultad de Ciencias Médicas "Dr. Salvador Allende", La Habana, Cuba.

6 JOSHI HD, BAXI GA, BAXI AJ, 1992
Free amino acids and sugars of Annona squamosa Linn. Asian J Chem 4(1):49-52.

7 MOORE BD, ISIDORO E, SEEMANN JR, 1993
Distribution of 2-carboxyarabinitol among plants. Phytochemistry 34(3):703-707.

8 YADAV D, SINGH N, DEV K, SHARMA R, SAHAI M, PALIT G, MAURY R, 2011
Anti-ulcer constituents of Annona squamosa twigs. Fitoterapia 82(4):666-675.

9 SHARMA RK, BEHARI M, 1992
Screening of the compounds isolated from the leaves of Annona squamosa for antibacterial activity. Acta Cienc Indica Chem 18(3):249-252.

10 SHARMA RK, 1993
Phytosterols: wide-spectrum antibacterial agents. Bioorg Chem 21(1):49-60.

11 SHARMA RK, BEHARI M, 1992
Screening of the compounds isolated from the leaves of Annona squamosa for antibacterial activity. Acta Cienc Indica 27C(3):249-252.

12 YANG HJ, LI X, ZHANG N, CHEN JW, WANG MY, 2009
Two new cytotoxic acetogenins from Annona squamosa. J of Asian Natural Products Research 11(3):250–256.

13 JOHNS T, WINDUST A, JURGENS T, MANSOR SM, 2011
Antimalarial alkaloids isolated from Annona squamosa. Phytopharmacology 1(3):49-53.

14 VILA-NOVA NS, DE MORAIS SM, FALCÃO MJ, MACHADO LK, BEVILÁQUA CM, COSTA IR, DE SOUSA BRASIL NV, DE ANDRADE JÚNIOR HF, 2011
Leishmanicidal activity and cytotoxicity of compounds from two Annonacea species cultivated in Northeastern Brazil. Rev Soc Bras Med Trop 44(5):567-571.

15 WAGNER H, REITER M, FERSTL W, 1980
New drugs with cardiotonic activity. I. Chemistry and pharmacology of the cardiotonic active principle of Annona squasmosa L. Planta Med 40:77-85.

16 SEETHARAMAN TR, 1986
Flavonoids from the leaves of Annona squamosa and Polyalthia longifolia. Fitoterapia 57(3):198-199.

17 SONI H, SHARMA S, PATEL SS, MISHRA K, SINGHAI AK, 2011
Preliminary phytochemical screenig and HPLC analysis of flavonoids from methanolic extract of leaves of Annona squamosa. International Research J of Pharmacy 2(5):242-246.

18 BALBAA SI, HAGGAG MY, TAHA KF, 1977
Study of volatile oil content of the leaves of Annona squamosa growing in Egypt. Egypt J Pharm Sci 18:1-8.

19 RAI C, MUTHANA MS, 1954
Essential oil from the leaves of Annona squamosa. J Indian Inst Sci 36:117.

20 MARTÍNEZ I, MORÓN FJ, VICTORIA MdC, BRITO G, ACOSTA L, FUENTES V, 2011
Efecto antipirético oral de la decocción 30% de hojas frescas de Annona squamosa (anón) en ratas. Informe TRAMIL. Facultad de Ciencias Médicas “Dr. Salvador Allende”, Laboratorio Central de Farmacología, La Habana, Cuba.

21 VICTORIA MC, MORÓN F, MARTÍNEZ MC, PINEDO Z, BOUCOURT E, MOREJÓN Z, FUENTES V, 2006
Actividad analgésica de la decocción de hoja fresca de Annona squamosa L. en contorciones inducidas por ácido acético en ratones. Informe TRAMIL. Laboratorio Central de Farmacología, Facultad de Ciencias Médicas "Dr. Salvador Allende", La Habana, Cuba.

22 MORÓN F, VICTORIA MC, MARTÍNEZ MC, PINEDO Z, BOUCOURT E, MOREJÓN Z, FUENTES V, 2005
Actividad antiinflamatoria de la decocción de hoja fresca de Annona squamosa L. en ratas. Informe TRAMIL. Laboratorio Central de Farmacología, Facultad de Ciencias Médicas "Dr. Salvador Allende", La Habana, Cuba.

23 PUAPATANAKUL O, 1980
Clinical studies of Annona squamosa seeds and leaves for treatment of head lice. J Pharm Ass Thailand 34(2/3):91-105.

24 MOHAMED SALEEM TS, CHRISTINA AJM, CHIDAMBARANATHAN N, RAVI V, GAUTHAMAN K, 2008
Hepatoprotective activity of Annona squamosa Linn. on experimental animal model. Int J Applied Research in Natural Products 1(3):1-7.

25 PALANISAMY A, RAJESH V, PERUMAL P, VAMSI B, 2011
Anti ulcer activity of ethanolic extract of Annona squamosa leaves. Int J of Pharmaceutical Research and Development 4(1):162–167.

26 MARTÍNEZ MJ, MOREJÓN Z, LÓPEZ M, BOUCOURT E, BARCELO H, LAYNEZ A, FUENTES V, MORÓN F, 2003
Clases Tóxicas Agudas (CTA) de decocción cogollo fresco de Annona squamosa L. en ratas. Informe TRAMIL. Laboratorio Central de Farmacología, Facultad de Ciencias Médicas “Dr. Salvador Allende”, La Habana, Cuba.

27 MARTÍNEZ MJ, MOREJÓN Z, LÓPEZ M, BOUCOURT E, BARCELO H, LAYNEZ A, FUENTES V, MORÓN F, 2003
Clases Tóxicas Agudas (CTA) de decocción de hoja fresca de Annona squamosa L. en ratas. Informe TRAMIL. Laboratorio Central de Farmacología, Facultad de Ciencias Médicas “Dr. Salvador Allende”, La Habana, Cuba.

28 MARTÍNEZ MJ, MOREJÓN Z, LÓPEZ M, BOUCOURT E, BARCELO H, LAYNEZ A, FUENTES V, MORÓN F, 2003
Clases Tóxicas Agudas (CTA) de decocción de partes aéreas secas de Annona squamosa L. en ratas. Laboratorio Central de Farmacología, Facultad de Medicina “Dr. Salvador Allende”, Informe TRAMIL. La Habana, Cuba.

29 MARTÍNEZ MJ, MOREJÓN Z, LÓPEZ M, BOUCOURT E, FUENTES V, MORÓN F, 2005
Clases tóxicas agudas (CTA) de extracto fluido de hoja seca de Annona squamosa L. en ratas. Informe TRAMIL. Laboratorio Central de Farmacología, Facultad de Ciencias Médicas “Dr. Salvador Allende”, La Habana, Cuba.

30 BARROS GSG, MATOS FJA, VIEIRA JEV, SOUSA MP, MEDEIROS MC, 1970
Pharmacological screening of some Brazilian plants. J Pharm Pharmacol 22:116.

31 MISHRA MB, TEWARI JP, MISHRA SS, 1966
Studies in indigenous uterotonic drugs (a preliminary note). Indian J Physiol Pharmacol 10:59.

32 SHIRWAIKAR A, RAJENDRAN K, DINESH KUMAR C, BODLA R, 2004
Antidiabetic activity of aqueous leaf extract of Annona squamosa in streptozotocin–nicotinamide type 2 diabetic rats. J Ethnopharmacol 91(1):171-175.

33 BHAKUNI OS, DHAR ML, DHAR MM, DHAWAN BN, MEHROTRA BN, 1969
Screening of Indian plants for biological activity. Part II. Indian J Exp Biol 7:250-262.

34 CAPARROS-LEFEBVRE D, ELBAZ A, 1999
Possible relation of atypical parkinsonism in the French West Indies with consumption of tropical plants: a case-control study. Lancet 354(9175):281-286.

Curcuma longa

(In territories with significant traditional TRAMIL use)

Haiti:

  • curcuma
  • safran

Saint Lucia:

  • indian saffron
  • tjitjima
  • turmeric
Significant uses found by the TRAMIL surveys

  rhizome, aqueous maceration, orally2

Recommendations Preparation and Dosage References

According to the information available:

The use for abscesses is classified as REC based on the significant traditional use documented in the TRAMIL surveys and the toxicity studies.

If deterioration is observed in the patient or the abscess persists for more than 5 days in adults and 3 days in children, seek medical attention.

The use for jaundice and liver disorders is classified as REC based on the significant traditional use documented in the TRAMIL surveys, the toxicity and validation studies and the scientific information published.

Due to the health risk of jaundice and liver conditions, an initial medical assessment is recommended. The use of this resource must be considered complementary to medical treatment, unless contraindicated.

If deterioration is observed in the patient or if the liver symptoms persist for more than 5 days in adults or 3 days in children under 5 years of age, seek medical attention.

This resource is contraindicated for people with bile duct obstructions, such as calculi, unless they are under medical supervision, have a history of hypersensitivity to the plant or are immunodeficient.

Rhizome dust can produce reactions on contact with the skin.

Not for use by women intending to become pregnant, during pregnancy, while breastfeeding or in children under 3 years of age.

The rhizome of Curcuma longa is a condiment of relatively widespread human consumption and an industrial source of essential oil.

For abscesses:
prepare a decoction with 20 grams of rhizome in 4 cups (1 litre) of water, boil
for 10 minutes in a covered vessel. Leave to cool, strain (filter) and drink 1 cup 3-4 times a day.

For jaundice or liver disorders:
crush 20 grams of rhizome and add them to 4 cups (1 litre) of boiled water, leave to stand for 12 hours. Strain (filter) and drink the preparation in several doses over the course of the following 12 hours38.

Preparations must never be stored for more than 24 hours, even if refrigerated.

1 JEAN-PIERRE L, 1988
TRAMIL survey. St. Lucia National Herbarium, Castries, St. Lucia.

2 WENIGER B, ROUZIER M, 1986
Enquête TRAMIL. Service Oecuménique d'Entraide SOE, Port au Prince, Haïti.

3 OGBEIDE ON, EDUAVEGUAVOEN OI, PARVEZ M, 1985
Identification of 2-(hydroxymethyl) anthraquinone in Curcuma domestica. Pak J Sci 37(1/4):15-17.

4 SU HCF, HORVAT R, JILANI G, 1982
Isolation, purification, and characterization of insect repellents from Curcuma longa L. J Agric Food Chem 30:290-292.

5 OHSHIRO M, KUROYANAGI M, UENO A, 1990
Structures of sesquiterpenes from Curcuma longa. Phytochemistry 29(7):2201-2205.

6 CHEN YH, YU JG, FANG HJ, 1983
Studies on Chinese Curcuma. III. Comparison of the volatile oil and phenolic constituents from the rhizome and the tuber of Cucurma longa. Chung Yao T'ung Pao 8(1):27-29.

7 MOON CK, PARK NS, KOH SK, 1976
Studies on the lipid components of Curcuma longa. I. The composition of fatty acids and sterols. Soul Taehakkyo Yakhak Nonmunjip 1:132.

8 YASUDA K, TSUDA T, SHIMIZU H, SUGAYA A, 1988
Multiplication of Curcuma species by tissue culture. Planta Med 54(1):75-79.

9 SCHULTZ JM, HERRMANN K, 1980
Occurrence of hydroxybenzoic acids and hydroxycinnamic acid in spices. IV. Phenolics of spices. Z Lebensm-Unters Forsch 171:193-199.

10 PARK SN, BOO YC, 1991
Cell protection from damage by active oxygen with curcuminoids. Patent-Fr Demande-2,655,054.

11 TODA S, MIYASE T, ARICHI H, TANIZAWA H, TAKINO Y, 1985
Natural antioxidants. III. Antioxidative components isolated from rhizome of Curcuma longa L. Chem Pharm Bull 33(4):1725-1728.

12 JENTZSCH K, SPIEGL P, KAMITZ R, 1970
Qualitative and quantitative studies of curcuma dyes in different Zingiberaceae drugs. 2. Quantitative studies. Sci Pharm 38(1):50-58.

13 KARIG F, 1975
Rapid identification of curcuma rhizomes with the tas (thermomicroseparation and application) process. Dtsch Apoth Ztg 115(10):325-328.

14 GONDA R, TOMODA M, TAKADA K, OHARA N, SHIMIZU N, 1992
The core structure of ukonan A, a phagocytosis-activating polysaccharide from the rhizome of Curcuma longa, and immunological activities of degradation products. Chem Pharm Bull 40(4):990-993.

15 WOO WS, CHI HJ, YUN HS, WOO LK, 1977
Phytochemical screening of Korean medicinal plants (II). Korean J Pharmacog 8:103-108.

16 DE SOUSA M, MATOS ME, MATOS FJ, MACHADO MI, CRAVEIRO AA, 1991
Constituintes químicos ativos de plantas medicinais Brasileiras. Laboratorio de produtos naturais, Fortaleza, Brasil: Ceará Edições UFC.

17 YANG M, DONG X, TANG Y, 1984
Studies of the chemical constituents of common turmeric (Curcuma longa). Chung Ts'ao Yao 15(5):197-198.

18 ZHAO DY, YANG MK, 1986
Separation and determination of cucurminoids in Curcuma longa L. and its preparation by HPLC. Yao Hsueh Pao 21(5):382-385.

19 KISO Y, SUZUKI Y, WATANABE N, OSHIMA Y, HIKINO H, 1983
Antihepatotoxic principles of Curcuma longa rhizomes. Planta Med 49(3):185-187.

20 GONDA R, TOMODA M, SHIMIZU N, KANARI M, 1990
Characterization of polysaccharides having activity on the reticuloendothelial system from the rhizome of Curcuma longa. Chem Pharm Bull Tokyo 38(2):482-486.

21 DUKE JA, ATCHLEY AA, 1986
Handbook of proximate analysis tables of higher plants. Boca Raton, USA: CRC Press. p56.

22 SOLIS PN, RODRIGUEZ N, ESPINOSA A, GUPTA MP, 2004
Estudio antimicrobiano de algunas plantas TRAMIL con usos en Martinica. Informe TRAMIL. Centro de Investigaciones Farmacognósticas de la Flora Panameña CIFLORPAN, Facultad de Farmacia, Universidad de Panamá, Panamá, Panamá.

23 JOYEUX M, FLEURENTIN J, DORFMAN P, MONTIER F, 1988
Recherche d'une activité hépatotrope et antiradicalaire de plantes médicinales de la caraïbe. Rapport TRAMIL. Laboratoire de pharmacognosie, Centre des Sciences pour l'Environnement, Metz, France.

24 CHANG IM, WOO WS, 1980
Screening of Korean medicinal plants for antitumor activity. Arch Pharm Res 3(2):75-78.

25 KOSUGE T, YOKOTA M, SUGIYAMA K, YAMAMOTO T, NI MY, YAN SC, 1985
Studies of antitumor activities and antitumor principles of Chinese herbs. Yakugaku Zasshi 105(8):791-795.

26 ITOKAWA H, 1988
Research on antineoplastic drugs from natural sources, especially from higher plants. Yakugaku Zasshi 108(9):824-841.

27 4 WHO, 2002
WHO monographs on selected medicinal plants. Volume 1. www.who.int/medicines/library/trm/medicinalplants/pdf/259to266.pdf (28Feb2003).

28 DONATUS IA, SARDJOKO, VERMEULEN NPE, 1990
Cytotoxic and cytoprotective activities of curcumin. Effects on paracetamol induced cytotoxicity, lipid peroxidation and glutathione depletion in rat hepatocytes. Biochem Pharmacol 39(12):1869-1875.

29 PAZOS L, COTO T, GONZALEZ S, 2006
Toxicidad oral subcrónica, dosis repetida, en ratón, del extracto de rizoma fresco de Curcuma longa. Informe TRAMIL. Laboratorio de Ensayos Biológicos, LEBi, Universidad de Costa Rica, San Pedro, Costa Rica.

30 DESHPANDE SS, LALITHA VS, INGLE AD, RASTE AS, GADRE SG, MARU GB, 1998
Subchronic oral toxicity of turmeric and ethanolic turmeric extract in female mice and rats. Toxicol Lett 95(3):183-193.

31 POLASA K, SESIKARAN B, KRISHNA TP, KRISHNASWAMY K, 1991
Turmeric (Curcuma longa) - induced reduction in urinary mutagens. Food Chem Toxicol 29(10):699-706.

32 CHAVALITTUMRONG P, CHIVAPAT S, RATTANAJARASROJ S, PUNYAMONG S, CHUTHAPUTTI A, PHISALAPHONG C, 2002
Chronic toxicity study of curcuminoids in rats. Songklanakarin J Sci Technol 24(4):633-647.

33 YEGNANARAYANA M, SARAF AP, BALWANI JH, 1976
Comparison of anti-inflammatory effect of various extracts of Curcuma longa. Indian J Med Res 64(4):601-608.

34 GILANI AH, SHAH AJ, GHAYUR MN, MAJEED GK, 2005
Pharmacological basis for the use of turmeric in gastrointestinal and respiratory disorders. Life Sciences 76(26):3089-3105.

35 QURESHI S, SHAH AH, AGEEL AM, 1992
Toxicity studies on Alpinia galanga and Curcuma longa. Planta Med 58(2):124-127.

36 MIQUEL J, MARTINEZ M, DIEZ A, DE JUAN E, SOLER A, RAMIREZ A, LABORDA J, CARRISON M, 1995
Effects of turmeric on blood and liver lipoperoxide levels of mice: lack of toxicity. Age(Chester Pa) 18(4):171-174.

37 SEETHARAM KA, PASRICHA JS, 1987
Condiments and contact dermatitis of the finger-tips. Indian J Dermatol Venereol Leprol 53(6):325-328.

38 ALBORNOZ A, 1993
Medicina Tradicional Herbaria. Caracas, Venezuela: Editorial Instituto Farmacoterápico Latino S.A. p227.