Gallstones

Gallstones are solid crystal deposits that form in the gallbladder, a pear-shaped organ that stores bile until it is needed to help digest fatty foods. These crystals can migrate to other parts of the digestive tract, causing severe pain and life-threatening complications. Gallstones vary in size and chemical structure. They may be as tiny as a grain of sand, or as large as a golf ball.

Description

Gallstones usually develop in adults between the ages of 20 and 50. The risk of developing gallstones increases with age. Young women are up to six times more likely to develop gallstones than men in the same age group. In patients over 50, however, the condition affects men and women with equal frequency. Native Americans develop gallstones more often than any other segment of the population, and Mexican Americans have the second highest incidence of this disease. Gallstones tend to be passed down genetically in families.

Eighty percent of gallstones are composed of cholesterol. They are formed when the liver produces more cholesterol than the digestive juices can liquefy. The remaining 20% of gallstones are composed of calcium and an orangeyellow waste product called bilirubin, which gives urine its characteristic color and sometimes causes jaundice.


People who have gallstones may remain without symptoms for an extended period, especially if the stones remain in the gallbladder. In most cases, medical treatment is only deemed necessary if the individual is experiencing symptoms. When symptoms do appear, it is usually because the stones have left the gallbladder and are stuck somewhere else within the biliary system, blocking the flow of bile. If gallstones remain stuck in the biliary system, there can be damage to the liver, pancreas, or the gallbladder itself.

Gallstones bring on several disorders including:

• Cholelithiasis: Gallstones within the gallbladder itself. Pain is caused by the contractions of the gallbladder around the stone. 
• Choledocholithiasis: The presence of gallstones within the common bile duct, which is the passage between that empties into the small intestine. Once discovered, common duct stones need to be removed in order to avoid further problems. 
• Cholecystitis: A disorder marked by inflammation of the gallbladder. It is usually caused by the passage of a stone from the gallbladder into the cystic duct, which connects the gallbladder to the common bile duct. Cholecystitis causes painful enlargement of the gallbladder and is responsible for 10–25% of all gallbladder surgery.

Causes & symptoms

Gallstones are caused by an alteration in the chemical composition of bile, which is a fluid that helps the body break down and absorb fats. It is widely held that a diet high in fats and processed foods, and low in fiber and whole foods, is a strong contributor to gallstone formation. High levels of estrogen, insulin, or cholesterol can increase a person’s risk of developing gallstones. If left untreated, the risk of developing anemia is also increased.

Gallbladder attacks usually follow a meal of rich foods, typically high in fat. The attacks often occur in the middle of the night, sometimes waking the patient with such intense pain that the episode ends in a visit to the emergency room. Pain often occurs on the right side of the body.

The pain of a gallbladder attack begins in the abdomen and may radiate to the chest, back, or the area between the shoulders. Other symptoms of gallstones include inability to digest fats, low fever, chills and sweating, nausea and vomiting, indigestion, gas, belching, and clay-colored bowel movements.

Pregnancy or the use of birth control pills slow down gallbladder activity and increase the risk of gallrestones, as do diabetes, pancreatitis, and celiac disease. This is due to an individual’s higher levels of cholesterol, insulin, or estrogen from oral contraceptives.

Other factors that may encourage gallstone formation are:

• infection 
• anemia 
• obesity 
• intestinal disorders 
• coronary artery disease 
• multiple pregnancies 
• a high-fat, low-fiber diet 
• smoking 
• heavy drinking 
• rapid weight loss

Diagnosis

When gallstones are suspected, blood tests for liver enzyme levels are often given. The levels are usually elevated when the stone cannot pass through the cystic duct or bile duct. Test results, taken together with symptom history (see above) and a physical exam, are simple and relatively inexpensive for diagnosing the presence of gallstones. However, ultrasound is the method of choice for a definite diagnosis. It has a high degree of accuracy, except in diagnosing cholecystitis (a stone in the cystic duct). Cholescintigraphy is an alternative method of diagnosis, in which radioactive dye is injected and photographed as it passes through the biliary system.

Treatment

An allergic reaction to certain foods may contribute to gallbladder attacks. These foods should be identified and removed from the diet, or at least seriously limited. Foods that might possibly bring on allergic reactions include eggs, pork, onions, chicken, milk, coffee, citrus, corn, nuts, and beans.

Other dietary changes may help relieve the symptoms of gallstones. Generally, a vegetarian diet is protective against the formation of gallstones. Recurrent attacks can be diminished by maintaining a healthy weight and a healthy diet.

Choleretic herbs encourage the liver to secrete bile. They help maintain the appropriate chemical composition of bile so that it does not form stones. These herbs include:

• A tincture of dandelion (Taraxacum officinale), 2–6 ml once daily. 
• Milk thistle seeds (Sylibum marianum), a dose equivalent to 70–210 mg of silymarin. 
• Artichoke leaves (Cynara scolymus), 150 mg three times per day. 
• Turmeric (Curcuma longa), used as a spice; 150 mg three times per day.

Use of the above herbs cause some possible reactions, such as gas, diarrhea, nausea, and indigestion.

Other therapeutic approaches that have been found to be helpful in treating gallstones include homeopathy, traditional Chinese herbal medicine, and acupuncture. Knowledgeable practitioners should be consulted.

Allopathic treatment

Watchful waiting

One-third of all patients with gallstones never experience a second attack. For this reason, many doctors advise an attitude of “wait and see” after the first episode. Changing the diet or following a sensible weight loss plan may be the only treatments required. A person having only occasional mild gallstone attacks may be able to manage them by using non-prescription forms of acetaminophen, such as Tylenol or Anacin. A doctor should be notified if pain intensifies or lasts for more than three hours; if the fever rises above 101°F (38.3°C); or if the skin or whites of the eyes have a yellowish cast.

Surgery

Surgical removal of the gallbladder, called cholecystectomy, is the most common conventional treatment for recurrent or worsening gallstone attacks. However, surgery is unecessary in most cases where the gallstones remain without symptoms. Laparoscopic cholecystectomy is the technique most widely used. It has mostly replaced traditional open surgery because of a shorter recovery time, decreased pain, and reduced scarring. However, the open surgery procedure is still used in about 5% of cases because of various complications.

Nonsurgical therapy

If surgery is considered inappropriate, gallstones can be dissolved in 30–40% of patients by taking bile acids in tablet form. Dissolution of gallstones by this method may take many months or years depending on the size. Unfortunately, though, recurrence of stones is common after cessation of the medication.

Lithotripsy uses high-frequency sound waves directed through the skin to break up the stones. The process can be combined with the use of bile acid tablets. However, lithotripsy requires special equipment and is not always readily available.

Direct cholangiography can be used to remove gallstones by contact dissolution. The procedure is used to insert a catheter to inject medication into the gallbladder. Stones are often dissolved within a few hours by this method.

Expected results

Forty percent of all patients with gallstones have “silent gallstones” that do not require treatment. If symptoms develop, however, medical intervention may become necessary. Gallstone problems requiring treatment may also develop infections that require antibiotics. In rare instances, severe inflammation can cause the gallbladder to burst, causing a potentially fatal situation. The gallbladder is not an organ that is required to retain health. It can be successfully removed, with no recurrence of stones. Fat digestion, however, becomes more difficult after surgery, since the gallbladder is no longer there to store and release bile as needed.

Prevention

It is easier, in general, to prevent gallstones than to reverse the process. The best way to prevent gallstones is to minimize risk factors. Since gallstones seem to develop more often in people who are obese, eating a balanced diet, exercising, and losing weight may help keep gallstones from forming. In addition, a diet high in dietary fiber and low in fats, especially saturated fats, is recommended. Processed foods should be replaced by complex carbohydrates, such as whole grains.

Increased intake of fluids will dilute the bile and inhibit gallstone formation. Six to eight glasses of water should be consumed daily, along with plenty of herbal teas and diluted juices.

Recent studies indicate that consumption of about two tablespoons of olive oil per day, which can be mixed with food, helps reduce cholesterol levels in the bloodstream and the gallbladder. However, large amounts of olive oil, taken as a so-called liver flush, should be avoided. This method can stress the gallbladder and lead to an emergency situation.

Gamma-linoleic acid

Gamma-linoleic acid (GLA) is an omega-6 polyunsaturated fatty acid made in the body from linolenic acid, an essential fatty acid (EFA). GLA is the product of the body’s first biochemical step in the transformation of a major essential fatty acid, linolenic acid (LA), into important prostaglandins. Prostaglandins are essential to the proper functioning of each cell. Every cell’s structure in the human body depends on fatty acids formed from GLA.

General use

Evening primrose oil, very high in GLA, has been used for decades to treat medical conditions. Native American women chewed evening primrose seeds to relieve menstrual problems. Evening primrose was also used by Native Americans and early American settlers from Europe to treat coughs and stomach problems. In the 1800s, the leaves of the plant were used to treat several skin conditions.

EPO was imported to Europe during the 1600s and 1700s, and used to treat gout, rheumatoid arthritis, headaches, and skin conditions. In animal studies gamma-linoleic acid has been shown to reduce certain inflammations and reduce joint tissue injury. Human studies showed similar findings in its anti-inflammatory effects.


GLA has also been used as a treatment option for a number of conditions, including alcoholism, asthma, attention deficit/hyperactivity disorder (ADHD), high cholesterol, diabetic neuropathy, certain cancers, eczema (a skin inflammation), hypertension (high blood pressure), premenstrual syndrome (PMS), rheumatoid arthritis, and scleroderma (a skin disease.)

There is also research data that indicates GLA in combination with other measures may help in treating people with Sjögren’s syndrome— a chronic inflammatory disease of the immune system that effects mostly older women.

Other animal studies suggest GLA may enhance calcium absorption, helping to reduce calcium loss and osteporosis. Osteoporosis is a disease occurring primarily in women after menopause in which the bones become very porous, break easily, and heal slowly. It may lead to curvature of the spine after vertebrae collapse.

Among the conditions GLA is most often used for are:

• Rheumatoid arthritis. GLA has been studied for many years for its possible effects in treating arthritis and other inflammatory conditions . GLA has been shown to be most promising in treating people with this crippling condition, due to its anti-inflammatory properties. At least three studies have shown GLA reduces inflammation and joint tissue injury, thereby reducing the pain associated with this condition. In one study, GLA reduced the incidence of tender jointsby 36%, and swollen joints by 28%.
• ADHD. Studies suggest that GLA may be helpful (combined with other therapies) for helping to alleviate ADHD symptoms in children.
• Diabetes. Some studies show that GLA can help improve nerve function and help reduce peripheral neuropathy, which causes numbness, tingling, pain, or burning in the feet, legs, and toes and hands, in diabetics.
• High cholesterol. Research indicates that high doses of GLA may improve blood lipid levels in people with high cholesterol. A late 1990 study showed that oral intake of 2 grams of GLA daily for six weeks lowered total cholesterol levels by 13% and triglycerides by 37%.
• Skin conditions. A number of studies have been done regarding GLA and eczema with contradicting results. Several studies showed GLA relieved the symptoms such as itching, redness, and scaling of the skin, to varying degrees. It has also been shown to be helpful in reducing the symptoms of scleroderma and skin inflammations, such as dermatitis.
• Cancer. Studies have shown GLA effectively killed 40 types of human cancer cells in vitro without damaging normal cells This sentence is very misleading and makes GLA sound like a cure for cancer. Other in vitro or test tube studies have also shown GLA has potential to suppress tumor growth and metastasis, the spreading of cancer from the original site to other parts of the body. Several studies have shown it may be helpful specifically in treating pancreatic, bladder, and colon cancer. It has shown promising results as a cancer therapy when combined with the anticancer drugs tamoxifen and paclitaxol. Research into its effects on cancer are in the earliest stages and there is no evidence that GLA prevents or cures any type of cancer.
• Hypertension. Several studies suggest GLA may help reduce blood pressure in some people with hypertension and thereby decrease the risk of heart attacks. Results of these studies are not considered conclusive.
• PMS. Studies show GLA is remarkably helpful in treating some PMS symptoms. One study showed that of the women who took the drug Efamol, which contains 9% GLA, 61% experienced complete relief from symptoms while 23% had partial relief. These symptoms included breast tenderness, depression, irritability, swelling, and bloating.

Gamma-linolenic acid, in combination with eicosapentaenoic acid (EPA), in the form of borage seed and fish oils, significantly reduced the need for breathing support in patients with the lung condition acute respiratory distress syndrome. It cut the average number of days a patient is in a hospital’s intensive care unit from 17.5 to 12.8, according to a study published in the August 1999 issue of Critical Care Medicine.

“The consumption of GLA may offer new strategies for treatment and prevention of certain chronic diseases. Potential candidates [such as] rheumatoid arthritis patients, will have to take GLA supplements in order to meet the beneficial dosages used in clinical studies, because GLA is not readily found in common foods,” wrote Yang-Yi Fan and Robert S. Chapkin, scientists from Texas A&M University, in the September 1998 issue of The Journal of Nutrition.

Preparations

Gammalinoleic acid is found naturally in fish, animal organs such as liver, and certain plant seed oils. The major sources of GLA are borage oil (18–27% GLA), black currant oil (15–20% GLA), and evening primrose oil (7–14% GLA.) GLA is not available as a pure extract, but only as an ingredient in combination formulas.

Dosage varies by condition it is used to treat:

• skin conditions: 360–750 milligrams (mg) daily 
• PMS: 240–320 mg daily 
• rheumatoid arthritis: 750 mg–2.8 g daily for six to 12 months 
• diabetic neuropathy: 480 mg daily 
• high blood pressure: 1.3 g daily 
• high cholesterol: Up to 2 g daily

The United States Food and Drug Administration (FDA) has not established recommended daily allowances (RDA) for gamma-linoleic acid.

Patients should consult with a heathcare professional regarding the proper dosage.

Several forms of GLA supplements are available, including a concentrated form. It is also available as evening primrose oil, borage oil, and black currant seed oil. It is also available in multi-nutrient formulas that often contain any combination of fish oil, flax seed oil, omega-6 fatty acids, and essential fatty acids. The usual amount of GLA in these is from 200–400 milligrams per capsule. The cost of a bottle of 30 capsules ranges from $8 to $15. The concentrations of GLA in these oils varies and the number of capsules needed depends on the amount of GLA.

Precautions

Gamma-linoleic acid should not be used by women who are pregnant or breastfeeding without consulting a physician. Hemophiliacs and people who take the bloodthinning drug warfarin (Coumadin) should consult a physician before taking GLA. It should also not be taken before surgery because it may increase bleeding. Persons with high blood pressure or heart or blood vessel conditions should consult a physician before taking GLA.

Side effects

There is no evidence that GLA is toxic in daily doses of up to 2.8 grams. There have been no reports of serious side effects by people taking GLA supplements. It is generally well tolerated by most people. Possible minor side effects include upset stomach, diarrhea, soft stool, bloating, and gas. Persons who take GLA and experience difficulty breathing, chest or throat tightness, chest pain, hives, rash, or itchy or swollen skin may be allergic to it. They should stop taking it and consult a physician immediately.

Interactions

No adverse interactions between gamma-linoleic acid and other medications, vitamins, or nutritional supplements have been reported.

Gangrene

Gangrene is a term used to describe the decay or death of an organ, tissue, or bone caused by a lack of oxygen and nutrients. It is a complication resulting from tissue injuries (such as frostbite), the obstruction of blood flow, or the processes of chronic diseases such as diabetes mellitus. Externally, the hands and feet are the areas most often affected by gangrene; internally, it is most likely to affect the gallbladder and the intestines. Gangrene is referred to as wet, or moist, if a bacterial infection is involved. In dry gangrene, there is no infection.

Description

Gangrene is often characterized by pain followed by numbness. The infection may first go unnoticed, especially in the elderly or those individuals with a loss of sensation. The area affected by gangrene may be cold and pale, especially early in the disease. Blisters may be apparent and the patient may experience an increased heart rate and profuse sweating. As the tissue dies, the skin begins to darken. The dead tissue gradually separates and falls away from the healthy tissue.

Dry gangrene is often seen in advanced cases of diabetes and arteriosclerosis. The tissue doesn’t become infected, rather it dries out and shrivels over a period of weeks or months. Wet gangrene progresses much more rapidly. The affected area becomes swollen and gives off a foul smelling discharge. Death may occur within a matter of hours or days. Fever, rapid heart rate, rapid breathing, altered mental state, loss of appetite, diarrhea, vomiting, and vascular collapse may occur as the infection progresses.


Causes & symptoms

The primary cause of gangrene is often an injury to the blood vessels, causing either an interruption of blood flow, the introduction of a bacterial infection, or both. Such injuries may include burns, infected bedsores, boils, frostbite, compound fractures, deep cuts, or gunshot wounds.

Gangrene can also develop due to the poor circulation and obstructions in the blood vessels associated with abnormal blood clots, torsion of organs, and diseases such as diabetes, heart disease, and Raynaud’s disease. Gangrene of the internal organs may be attributed to a ruptured appendix, internal wounds, or the complications of surgery.

The bloodstream is the body’s main transport system. When blood flow is diminished, the flow of the oxygen and nutrients needed to keep tissues healthy is greatly decreased. The white blood cells needed to fight infection are not readily available. In such an environment, invading bacteria thrive and multiply quickly. Streptococcus spp. and Staphylococcus spp. are the most common agents of external skin infection.

Gas gangrene, also called progressive or clostridial myonecrosis, is a type of moist gangrene most commonly caused by an infection of Clostridium perfringens, or other species that are capable of thriving under conditions where there is little oxygen. These bacteria produce gases and poisonous toxins as they grow in the tissues.

Gas gangrene causes the death of tissue, the destruction of red blood cells, and the damaging of the walls of the blood vessels and parts of the kidneys. Early symptoms include sweating, fear, and anxiety. Gas gangrene is a life-threatening condition and should receive prompt medical attention.

Diagnosis

A diagnosis of gangrene will be based on a combination of patient history, a physical examination, blood test results, and other laboratory findings. A physician will look for a history of recent trauma, surgery, cancer, or chronic disease. Blood tests will be used to determine whether infection is present and to determine how much the infection has spread.

A sample of drainage from a wound or obtained through surgery may be tested to identify the bacteria causing the infection and to aid in determining treatment. In the case of gas gangrene, the gas produced by the bacteria may be detected beneath the skin by pressing into the swollen areas. The crackling sounds of gas bubbles may also be heard in the affected area and the surrounding tissues.

X-ray studies and other imaging techniques, such as computed tomography (CT) scans or magnetic resonance imaging (MRI), may be helpful in making a diagnosis by showing evidence of gas accumulation or muscle tissue death. These techniques, however, are not sufficient alone to provide an accurate diagnosis of gangrene. Precise diagnosis often requires surgical exploration of the wound.

Treatment

Chelation therapy is a treatment that uses an intravenous solution containing the drug ethylenediamine tetra-acetic acid (EDTA), among other substances. In the bloodstream, EDTA binds and removes toxins and plaque formation on arterial walls. It promotes circula-

Ganoderma

Ganoderma is the name of the fungus Ganoderma lucidum. It is also called the reishi mushroom or in Chinese ling zhi. It is one of the most popular medicinal mushrooms in China, Japan, and the United States.

Ganoderma grows on logs or tree stumps. It has a shiny, hard, asymmetrical cap that ranges in color from yellow to black. The cap, spores, and mycelium are all used medicinally. Wild ganoderma is rare in Asia.

In ancient China, ganoderma was so rare and so highly prized that it was reserved for the emperors and called the “Elixir of Life.” In 1972, Japanese researchers successfully cultivated the mushroom. There are six different colors of cap: red, green, white, black, yellow, and purple. These researchers showed that all colors are the same species, and that the color variations are the result of differences in environmental conditions. Despite this, some herbalists insist that certain colors of reishi mushroom are more potent or effective in healing certain conditions than others.


General use

Ganoderma is considered one of the most important herbs in Asian healing. Its use extends to almost every system of the body. Not only is it believed to heal physical ailments, it is said to bring about a peaceful state of mind, and to increase spiritual potency energy for Taoists and other Asian spiritual seekers.

Ganoderma has been used in China for over 4,000 years. It is the primary shen tonic in Chinese herbalism. In a broad sense, it is used to help a person adapt both physically and mentally to the world. It is used to strengthen and calm the nerves, improve memory, and prevent or delay senility.

Herbalists consider ganoderma an adaptogen, or natural regulator, suppressing the immune system if it is overactive and boosting it if it is underactive. Many health claims are made on the effect that ganoderma has on the immune system. These claims are based primarily on the presence of high molecular weight polysaccharides and free radical antioxidants in ganoderma extracts. Ganoderma also contains the elements potassium (K), magnesium (Mg), calcium (Ca), and germanium (Ge).

Ganoderma is used in Japan and China to treat cancer and to stimulate the immune system after radiation or chemotherapy. It is also used to treat myasthenia gravis and systemic lupus erythematosus (SLE), both autoimmune diseases. In Japan and China, ganoderma is also used to treat symptoms of viral diseases such as colds, influenza, canker sores, and hepatitis.

Quite a few research studies on ganoderma extracts have been done at universities in Japan, China, and South Korea. Many of these are test-tube or animal studies. The results are not clear-cut, but they seem to indicate that at least in these non-human systems, ganoderma has an effect on the immune system, some anti-tumor properties, and some anti-viral activity. One group of researchers reported in 2002 that ganoderma appears to protect the liver from inflammation caused by infection.

More recent research in Asian universities has investigated the effects of ganoderma on human cells or tissues. A recent study done in Taiwan indicates that ganoderma inhibits apoptosis (cell self-destruction) in human white blood cells. This finding may help to explain ganoderma’s beneficial effects on the immune system.

Ganoderma has recently attracted the attention of Western cancer researchers. A case study report from Columbia University indicates that a Japanese dietary supplement containing ganoderma as well as genistein, a soybean derivative, may be useful in the prevention and treatment of prostate cancer.


Ganoderma is also used in treating conditions of the nervous system. It is used to calm the nerves, cure insomnia, reduce stress, eliminate nervous exhaustion, and increase determination and focus. Laboratory studies show fairly conclusively that ganoderma does act as a sedative on cells of the central nervous system and possibly has painkilling and anti-convulsive properties.

Ganoderma is frequently used to treat allergies, hay fever, bronchial asthma, and to reduce skin inflammation. Laboratory studies support these uses and show that some components of ganoderma have a strong antihistaminic effect that interrupts the development of allergic reactions.

Many conditions of the blood and circulatory system are treated with ganoderma. These include:

• altitude sickness 
• atherosclerosis 
• cardiac arrhythmia 
• coronary heart disease 
• high blood pressure 
• high blood sugar 
• high cholesterol 
• low blood pressure 
• stroke

Scientific research shows that compounds found in ganoderma do lower blood sugar and also interfere with the clotting of blood platelets. This reduction in clotting may account for ganoderma’s effectiveness against stroke and atherosclerosis.

Ganoderma is also used to treat a variety of other diseases. These uses are generally backed up by little or no scientific evidence. They include:

• gastroenteritis 
• diarrhea 
• constipation 
• gallstones 
• ulcer
• acne 
• hair loss 
• inflammation of the kidneys 
• menstrual cramps 
• erectile dysfunction 
• low sex drive

Preparations

Virtually all ganoderma available commercially are from cultivated mushrooms. Different preparations are made using the cap, the spores, and the mycelium. These preparations are available in the form of fresh and dried whole mushrooms, capsules, concentrated drips, extracts, tablets, tea bags, tea granules, and tinctures. A common dose is 1,800–2,400 mg in capsule form per day. However, doses vary hugely depending on the condition being treated and the strength and part of the mushroom being used.

Precautions

Although no toxic reactions to ganoderma have been reported, people with allergies to other mushrooms may also experience allergic reactions to ganoderma.

Side effects

Large doses (2–9 g) of ganoderma taken regularly over the course of 3–6 months may result in diarrhea, upset stomach, and dizziness. Nosebleeds from high doses of ganoderma have also been reported. Some herbalists claim that large doses of vitamin C taken with this herb will control the symptoms of diarrhea.

Interactions

Ganoderma and other Chinese herbs are often used together with no reported interactions; in fact, a new health food supplement is made from reishi mushrooms grown on herbs, in the belief that the mushrooms absorb some of the properties of the herbs on which they’re grown.

With regard to Western pharmaceuticals, ganoderma has been reported to produce negative interactions with warfarin, a blood-thinning medication. Because ganoderma extract may cause a drop in blood pressure, persons who are taking prescription antihypertensives (medications to lower blood pressure) should use ganoderma only if they are being monitored by a physician.

Gardenia

Gardenias are members of the madder, or Rubiaceae, family. Though not native to either North or South America, they were named for an eighteenth-century American physician and naturalist, Alexander Garden.

Gardenias were originally found only in China and Japan, but today there are over 200 different species of gardenia, mostly hybrid, in existence throughout the world. Gardenias are most prevalent in China, Japan, tropical regions of Southeast Asia and the Pacific islands, and South Africa. With proper conditions, gardenias grow into shrub-like bushes or small trees that can reach 5 ft (1.5 m) in height.

Most species of gardenia, however, are very tender plants that require an average temperature of at least 60°F (28.9°C), sunlight with some protection, and just the right amount of humidity. They often survive far better in greenhouses than outside.


Gardenias are often rambling plants that form mounds of glossy dark green foliage. The leaves are oval in shape and very shiny. The flowers vary in color from pale yellow with purple markings to creamy white, and they have a classic, heavy, sweet scent reminiscent of green apple.

All gardenia blossoms have an almost wax-like appearance and can be either single or double, depending on the species. Most gardenias flower in the winter or early spring, and the blossom is followed by the appearance of a large, yellowish-red, bitter-tasting berry that contains a crystalline compound called acrocetin.

The most commonly listed botanical species of gardenia include:

• Gardenia jasminoides. This species is easily the most common of these rare, fragile plants. It reaches heights of 2 ft (61 cm) and grows into a tall bushy green shrub that produces white, highly fragrant flowers. G. jasminoides is a native of China, and the gardenia most commonly used in Chinese herbal medicine. Its name comes from the fact that it was first introduced to the Western world from Cape Colony in Africa, and the aroma of its large white flowers was said to be very like the scent of jasmine. 
• Gardenia jasminoides fortunata. This plant is a hybrid version of G. jasminoides that is somewhat more hardy. 
• Gardenia nitida. This gardenia is a slightly taller plant that grows up to 3 ft (93 cm) and also produces white blossoms. 
• Gardenia radicans floreplena. This plant is a low spreading dwarf variety from Japan that grows only to heights of 18 in (46 cm), and has double-blossomed flowers. 
• Gardenia thunbergia. This gardenia grows to 4 ft (1.2 m) and is often cultivated in American greenhouses. It is found as both tree and shrub, and has white flowers with long tube-like necks. 
• Gardenia rothmania. This plant is also a particular favorite of American botanists, but does not survive well in North America outside of a greenhouse. It also exists as both tree and shrub, and has pale yellow flowers with short, tube-like necks and purple markings.

General use

Gardenias are widely used as exotic ornamental flowers in corsages, as houseplants, and in some regions, as outdoor plants. A yellow silk dye has been made for centuries from the chemical compound acrocetin extracted from the gardenia berry.

Chinese herbal medicine, however, makes the most extensive use of the gardenia. Its Chinese name is zhi zi. The traditional medicinal actions attributed to gardenia include calming irritability; cooling blood and clearing away heat (a yin/yang imbalance often characterized by deficient yin); reducing swelling; and moving stagnant blood that has congealed in one place, usually following trauma.

Gardenia is considered to be very effective as a hemostatic agent, which means that it stops bleeding; and also effective in treating injuries to the muscles, joints, and tendons. Gardenia is commonly used in Chinese herbal formulas to treat infections, particularly bladder infections; abscesses; jaundice; and blood in the urine, sputum, or stool. Because of its perceived ability to ease agitation or irritability, it is also used in formulas to treat anxiety or insomnia. It is also helpful in correcting menopausal imbalances reflected in insomnia and depression, nervous tension, headache, and dizziness.

The United States Department of Agriculture Agricultural Research Service phytochemical and ethnobotanical database lists the following species of gardenia as having specific medicinal properties:

• Gardenia gummifera. This species can be helpful in treating digestive problems, including dyspepsia and diarrhea; or used as an astringent and expectorant for nervous conditions and spasms.
• Gardenia storckii. This variety can be used in treating constipation.
• Gardenia lucida. This gardenia has antiseptic properties that can kill both bacteria and insects.
• Gardenia pseudopsidium. This species has been used to treat smallpox.
• Gardenia jasminoides. This gardenia has been found to be helpful in the treatment of pain, nose bleeds, fever, and influenza; in healing wounds and reducing swelling; and in treating mastitis, hepatitis and the hematuria that accompanies bladder infection.
• Gardenia augusta. This variety has shown effectiveness in the treatment of headaches, fever, delirium, mastitis, and jaundice related to liver problems.
• Gardenia campanulata. This plant is used in healing wounds, burns, and scalds; in reducing swelling; as a treatment for fever and influenza; in treating jaundice associated with liver problems; and in stopping bleeding.
• Gardenia labifolia. This gardenia has been found effective in treating the bites of certain snakes.

Preparations

The kernel within the gardenia berry is often removed for use in herbal poultices put on sports injuries such as sprains, pulled muscles, or inflammation of nerves. The use of gardenia poultices is particularly common in Chinese medicine. Traditional Chinese practitioners make a paste of the herb with flour and wine. The powdered berry is given in both decoctions and capsules. When gardenia is used to stop bleeding it is usually burned before it is simmered in water.

Precautions

Chinese herbalists state that gardenia should not be used when there is cold deficiency (watery) diarrhea present. It is important to remember that Chinese herbal medicine is based upon individual prescriptions developed for each patient and their unique symptoms. Chinese herbs should not be taken, either individually or in formulas, unless a practitioner of Chinese herbal medicine is first consulted.

Side effects

Gardenia has laxative properties, and can cause loose stools when taken frequently or in large amounts.

Garlic

Garlic (Allium sativa), is a plant with long, flat grasslike leaves and a papery hood around the flowers. The greenish white or pink flowers are found grouped together at the end of a long stalk. The stalk rises directly from the flower bulb, which is the part of the plant used as food and medicine. The bulb is made up of many smaller bulbs covered with a papery skin known as cloves. Although garlic is known as the “stinking rose” it is actually a member of the lily family.

The most active components of fresh garlic are an amino acid called alliin and an enzyme called allinase. When a clove of garlic is chewed, chopped, bruised, or cut, these compounds mix to form allicin, which is responsible for garlic’s strong smell. Allicin, in turn, breaks down into other sulfur compounds within a few hours. These compounds have a variety of overlapping healing properties.

Garlic also contains a wide range of trace minerals. These include copper, iron, zinc, magnesium, germanium, and selenium. The integrity of the growers and suppliers of garlic are important to the integrity of the garlic used. A soil rich with the presence of trace minerals will produce a healthful bulb of garlic, full of those minerals. Depleted soils produce a depleted product. In addition, garlic contains many sulfur compounds, vitamins A and C, and various amino acids.


General use

The ancient Indians, Chinese, Egyptians, Greeks, Romans, and other peoples have used garlic for thousands of years, as food and as medicine. One of the most famed usages of garlic was during the Middle Ages, when it was reputed to have been highly effective against the plague.

As early as 1858, Louis Pasteur formally studied and recorded garlic’s antibiotic properties. Dr. Albert Schweitzer used the herb to successfully treat cholera, typhus, and dysentery in Africa in the 1950s. Before antibiotics were widely available, garlic was used as a treatment for battle wounds during both World Wars.

Garlic can be used in the treatment of a variety of bacterial, viral, and fungal infections. It has been shown to be effective against staph, strep, E. coli, Salmonella, Vibrio cholera, H. pylori, Candida albicans, and other microorganisms. Garlic also helps prevent against heart disease and strokes. Current studies show that garlic can improve immune function and may even help in the prevention of cancer. To be of benefit in chronic conditions, garlic should be used daily over an extended period of time.

Heart disease

One of the main causes of heart disease is the buildup of plaque on the walls of the blood vessels. This plaque is mostly made up of cholesterol and other fatty substances found in the blood. When large amounts of plaque get stuck on artery walls, they block the flow of blood and cause blood clots to form. Parts of the artery wall may even be destroyed completely.

In arteriosclerosis, otherwise known as “hardening of the arteries,” the major arteries may become so stiff and clogged, that the heart cannot get necessary nutrients and oxygen. This usually causes a heart attack. High serum cholesterol levels are a major risk factor for having a heart attack.

Studies show that people who eat garlic regularly have improved serum cholesterol levels. Some people with high cholesterol have been able to get within normal levels by eating 1–2 cloves per day. In addition, low-density lipoprotein (LDL) and triglyceride levels are decreased and high-density lipoprotein (HDL) levels are increased. This correlates with an overall reduced cholesterol level. These benefits are significant in preventing heart disease as well as strokes.

While garlic’s contribution to reducing levels of harmful plaques has been known for some time, a 2003 study found that garlic also lowered levels of homocysteine, a type of amino acid that is now considered a major risk factor for heart attacks. Manufactured garlic supplements appear to be equally as beneficial as eating the fresh cloves. It takes at least one month of using garlic for laboratory results to be seen.


Hypertension

Hypertension, or high blood pressure, is also a significant cause of heart problems. It is one of the leading causes of disability and death due to stroke, heart attack, heart failure, and kidney failure. Garlic can help reduce blood pressure through the actions of its sulfur compounds and its ability to reduce the fatty substances, such as cholesterol, found in the bloodstream. Use of garlic also can help normalize low blood pressure.

Platelet aggregation

Platelets clot the blood in order to repair breaks in the blood vessel walls. When there is an injury, platelets are attracted to the damaged area and become attached to the wall and to other platelets. Platelet aggregation, as this process is called, plugs up the break and prevents further blood loss while the injury is being repaired. This is a good and necessary part of healing an injury.

However, if there are serious problems with the heart and blood vessels and there is too much injury and clotting, the vessels may become clogged with platelets. This can lead to strokes and heart disease. The sulfur compounds in garlic—particularly ajoene—give the platelets a slippery quality. They are less able to clump together, thus slowing down platelet aggregation. Garlic can be used effectively in the same way as a daily dose of aspirin to reduce or prevent platelet aggregation over an extended time.

Cancer

Studies have found that garlic blocks the formation of powerful carcinogens, called nitrosamines, which may be formed during the digestion of food. This may be why in populations where people consume a large amount of garlic, there is a decreased incidence of all types of cancer.

The antioxidants found in garlic may also contribute to this effect by protecting against the cell damage by cancer-causing free radicals. Studies show that use of garlic may also inhibit the growth of a variety of tumors. However, cancer-related studies are not conclusive and relate to consumption of raw or cooked garlic, not garlic supplements.

Infectious conditions

Eating garlic is good for helping the body’s immune system resist infections. While garlic is not as strong as modern antibiotics, it is believed to kill some strains of bacteria that have become resistant to antibiotics. Studies have shown garlic treats yeast infections, and it can kill many of the viruses responsible for colds and flu. While daily consumption of garlic was once highly recommended for HIV-positive individuals, the National Institutes of Health (NIH) reported in 2002 that garlic supplements greatly reduced levels of saquinavir, an HIV protease inhibitor, in patients’ blood. The NIH began cautioning patients who used garlic to control cholesterol levels who also used saquinavir or combination therapies, since garlic might interfere with their effectiveness.

Modern doctors have been reconsidering the causes of many diseases. They have discovered that bacteria and viruses may be the cause of sicknesses that were formerly not thought to be caused by infections. This includes gastric ulcers, colitis, and Kaposi’s sarcoma. Garlic may be useful in treating or preventing these due to its antimicrobial properties.

Diabetes

Garlic has the ability to lower and help keep blood sugar stable by helping to increase the amount of insulin available in the bloodstream. This action, together with garlic’s ability to lower cholesterol and blood pressure, make it an excellent daily supplement for people with diabetes. A 2003 report showed that long-term use of garlic helped improve the blood vessel systems of diabetic rats.

Other health conditions

Garlic is effective in the treatment of numerous other conditions. For example:

• The consumption of 1–3 cloves per day is useful for immune support and as a preventive against diseases and infection. 
• Warmed garlic oil in the ear canal can be used to treat ear infections. 
• Garlic can be used to treat respiratory complaints such as asthma and chronic bronchitis. 
• Garlic helps increase the body’s ability to handle the digestion of meat and fats. 
• Garlic can be used to help kill and expel intestinal worms in both animals and humans. 
• When added to a pet’s food, garlic helps repel fleas. 
• Garlic is helpful in getting rid of athlete’s foot. 
• Garlic relieves gas and other stomach complaints. 
• The sulfur compounds found in garlic can bind to heavy metals and other toxins and help remove them from the body. 
• Garlic can be used externally for cuts, wounds, and skin eruptions. 
• The taste of garlic in mother’s milk stimulates improved nursing. Infants eat more and nurse longer.

They appear to relish the taste of slightly garlicky milk. The components of garlic that reach the infant through the mother’s milk also may be helpful in relieving colic and infections.

Preparations

Used internally

Garlic can be eaten raw or cooked, taken as tablets or capsules, and used as a tincture or syrup. The raw cloves can be directly applied externally.

The suggested dosage for fresh whole garlic is one to three cloves per day. The cloves can be chewed and held in the mouth or swallowed. Consuming raw garlic can actually be a pleasure if the herb is crushed or grated and mixed with food or a tablespoon of honey. The dosage for tinctures is 2–4 ml or 15–40 drops taken twice daily. One tablespoon of the syrup should be taken three times a day, or as needed to relieve coughing. Garlic oil should be slightly warmed, and 1–3 drops should be put in the affected ear 1–3 times per day.

Tablets and capsules are often more convenient to use than raw garlic, and they are more likely to be tolerated by garlic-sensitive individuals. Garlic pills also minimize the garlic taste and odor. Manufacturers vary on which components of the herb are emphasized.

In general, the following dosages are appropriate, but product labels also should be consulted:

• 400–500 mg of allicin, twice daily 
• a dose equaling approximately 4,000 mcg of allicin potential, once or twice daily 
• 400–1,200 mg of dried garlic powder 
• 1,000–7,200 mg of aged garlic 
• a dose equivalent to 0.03–0.12 ml of garlic oil, three times per day

Manufactured garlic pills come in a variety of forms, and a great deal of controversy continues about what type is best. Studying the manufacturers’ literature and other information is important to make a good decision about which preparation to use. The types of garlic preparations include:

• garlic oil capsules 
• encapsulated powdered garlic 
• odorless garlic pills 
• allicin-stabilized pills 
• aged garlic extract

Used externally

A poultice can be made using grated or crushed fresh garlic. The herb material should be placed directly on the site of injury or eruption, either “as is” or mixed with enough honey to make a paste. The poultice can be held in place with a cloth or bandage.

A compress of garlic is less messy than a poultice and may be less irritating to the site of the injury. It is made by wrapping grated or crushed fresh garlic in a single piece of cheesecloth. As with the poultice, the compress is placed directly on the affected area.

Garlic oil can be made by putting a whole bulb of grated or finely chopped garlic into a pint jar of olive oil, and letting it sit undisturbed in a warm place, away from direct sunlight, for at least two weeks. Then it can be strained and refrigerated. The garlic oil will stay fresh in the refrigerator for up to two years.

A garlic suppository can be used to treat vaginal yeast or mild bacterial infections. A clove of fresh garlic should be peeled and slightly crushed or bruised. If crushed garlic irritates the vaginal tissue, an alternative that might lessen the desired antimicrobial effect is to use the whole, uncrushed garlic clove. The clove should be wrapped in a single layer of cheesecloth and inserted into the vaginal canal overnight for 5-10 days. Dental floss or a length of the cheesecloth can be used to make the suppository easier to retrieve. If the garlic causes a burning sensation, this can be eased with the insertion of plain yogurt into the vagina.

Precautions

Consumers will find a wide variety of garlic preparations on the market. Therefore, it is important to study manufacturers’ claims, talk to knowledgeable practitioners, and find out which formulations are most effective for a given condition.

Due to the high concentration of sulfur compounds in garlic, it should be avoided by those allergic to sulfur. Garlic