botanical name(s): Rheum palmatum, Rheum officinale
synonyms: rhubarb, Chinese rhubarb, turkey rhubarb, rhabarber, rhubarbe de Chine, ruibarbo
part(s) used: root, rhizome
qualities: cold, bitter, dry
affinities: intestines
actions: purgative, astringent (in smaller doses), alterative, antibiotic, anthelmintic, vulnerary, astringent
dosage:
» always add carminative
» tincture: 2 - 4 ml.
» powder: 120-500 mg.
» decoction: 1 tsp. herb to one cup water; drink 1-2 cups per day
therapy: in small dosages: gastrointestinal stimulant and tonic for feeble with diarrhea; hepatic torpor, digestive imbalances, constipation
AHPA Botanical Safety Rating: 2b, 2c, 2d
toxicity: 3; see oxalate toxidrome
» overdose treatment includes calcium supplements, e.g. calcium citrate or carbonate, dark leafy greens, dairy products; limewater or dilute potassium permanganate binds the oxalate remaining in the stomach; emesis (Duke, p. 404; Theines and Haley, pp. 243-244)
» contraindicated during pregnancy due to uterine stimulant action in animal uteri (Brinker, 1996; Farnsworth)
» contraindicated for nursing mothers due to passage of anthraquinones into the milk (De Smet, Brooks)
» contraindicated in fever or intestinal inflammatory diseases such as Crohn's disease and ulcerative colitis due to the irritating effects of the anthroquinone derivatives: rhein, emodin, abe-emodin (Brinker, 1989; De Smet)
» contraindicated in patients with kidney problems, especially when related to calcium loss and kidney stone formation; dehydration induced by laxatives may aggrevate nephropathy (Duke, p. 404; Levy and Primack, pp. 71-72, De Smet)
» contraindicated in intestinal obstruction due to the cathartic effect of its anthranoid components: rhein, sennosides (Wichtl, Felter and Lloyd, De Smet)
» contraindicated for puerperal mothers and patients with hemorrhoids (Duke, Levy and Primack) due to the potential for inducing or aggravating hemorrhoidal thrombosis and/or prolapsis
» contraindicated in abdominal pain of unknown origin due to possible rupture from contraction of inflamed viscus such as the appendix (De Smet)
» contraindicated in extended use for more than 8 - 10 days due to pathological alterations to the colon smooth muscles and myenteric plexi (De Smet)
» contraindicated for children under age twelve or debilitated patients due to depletion of water and electrolytes (De Smet)
» warning: oxalates may accumulate in the kidney thereby increasing the potential for stone formation, especially in people with the genetic predisposition for oxalate stones (Levy and Primack, pp. 71-72)
» oxalic acid and oxalates may decrease the absorption of some nutrients (Libert and Franceschi)
constituents: anthraquinones, tannins, flavonoids, pectin, phytosterol
drug interactions:
» reduced absorption of oral drugs due to decreases bowel transit time (De Smet)
» overuse or misuse can cause potassium loss leading to increased toxicity of cardiac glycosides such as those in Adonis, Convallaria, Urginea, Helleborus, Strophanthus, and Digitalis (Brinker, 1996; Wichtl, De Smet)
» aggravates potassium loss from use of diuretics (De Smet)
footnotes
Brinker F. 1989. To Health With Herbs (from Eclectic Dispensatory of Botanical Therapeutics. vol. I, Alstat E (comp.)), Portland, Oregon: Eclectic Medical Publications.
Brinker F. 1996. The Toxicology of Botanical Medicines, rev. 2nd ed., Sandy, Oregon: Eclectic Medical Publications.
Brooks S (ed.). 1995. Botanical Toxicology. Protocol J Bot. Med, 1:147-58.
De Smet PAGM et al. (eds.). 1993. Adverse Effects of Herbal Drugs 2, Berlin: Springer-Verlag
Duke, J.A. 1985. C.R.C. Handbook of Medicinal Herbs. Boca Raton, FL: The C.R.C. Press.
Farnsworth NR, Bingel AS, Cordell GA, Crane FA, Fong HHS. 1975. Potential Value of Plants as Sources of New Antifertility Agents I. J. Pharm. Sci., 64:535-98.
Felter, H. W., and Lloyd, J. U. 1983. King's American Dispensatory, Vols. I and II. Portland, OR: Eclectic Medical Publications.
Levy, C.K.; and Primack, R.B. 1984. A Field Guide to Poisonous Plants and Mushrooms of North America. The Stephen Green Press.
Libert, B., Franceschi, V.R. 1987. Oxalate in crop plants. Journal of Agriculture and Food Chemistry. 35: 926-938.
Thienes, C.H., Haley, T.J. 1975. Clinical Toxicology. 5th ed. Philadelphia: Lea and Febiger.
Wichtl M (ed.). 1994. Herbal Drugs and Phytopharmaceuticals. Boca Raton, FL: CRC Press.