Marshmallow root: A medicinal plant with a great tradition

Background and aim:

There is an increasing popularity of natural treatment options in patients and consumers worldwide. This is not only true e.g. for Chinese and Indian traditions, but also for European traditions, leading to an increasing use of such products all around the globe [1]. This is also true for root extracts from Marshmallow (Althaea officinalis L.), which are successfully used for maintaining respiratory health resp. in mucosal irritations of the respiratory tract and irritative cough, as new study data show [2, 3], which are therefore of specific interest also from a historical perspective.

Methods:

Based on textbooks and monographs, cross referencing and hand searching, also via internet, a survey was conducted to retrieve historical texts on its medicinal use.

Results:

Althea officinalis L. has a wide spread natural range in Eurasia, and nowadays occurs worldwide in temperate climates. While from the early advanced civilizations of the middle east no evidence of its use could be found, it is mentioned in the Greco-Roman literature by Hippokrates of Kos and, among others, the Cilician physician Dioscurides, who mentions its use in anuria, diarrhoea, lithiasis, internal injuries, nerve pain etc. The first clear evidence for its use for the treatment of the respiratory tract is Plinius's Naturalis historia (ca. 77 AD). The plant is then also mentioned in European medieval texts. Paracelsus describes its use as abscess emollient and cleanser [4, 5]. The plant is also mentioned in the pharmacopoeias of the 19th and 20th century, e.g. Deutsches Arzneibuch 1926, British Pharmaceutical Codex 1949 [6, 7] and in medical and pharmaceutical textbooks from that time on, e.g. Madaus 1938, Hänsel et al. 1993, Blaschek 2015 [8 – 10]. In these textbooks also its traditional preparations, i.e. aqueous root macerates, are described. The cough syrup STW 42 is accordingly a typical example complying with this tradition. This is in line with its descriptions in modern European herbal monographs, as those of Commission E, ESCOP and HMPC, which are accepted today as references for its use, also in many non-European countries worldwide. Recent research has proven that this preparation has not only immediate protective physical effects [2, 3, 11], but also beneficial pharmacological effects on the irritated pharyngeal mucosa [12].

Conclusion:

For Marshmallow root, a long tradition could be proven, which well supports its use in patients and consumers worldwide, and is an adequate base for its positive image as a plant well supporting respiratory health and offering fast relief in respiratory complaints.

Acknowledgement:

Many thanks to Florian Eidam-Weber, Frankfurt, for stimulating discussions.

References:

[1] Kelber. Symposium of Kooperation Phytopharmaka, Köln 2017

[2] Fasse et al. Paed 2005; 11:3 – 8. 4

[3] Fink et al. Complement Med Res 2018; 25: 299 – 305

[4] Benedum et al. Arzneipflanzen in der Traditionellen Medizin. Kooperation Phytopharmaka, 2000

[5] Leonti et al. J Ethnopharmacol 2017; 199: 161 – 167

[6] Deutsches Arzneibuch, R. v. Decker, Ausgabe 6, 1926

[7] British Pharmaceutical Codex, The Pharmaceutical Press, 1949

[8] Madaus. Lehrbuch der biologischen Heilmittel. Georg Thieme Verlag Leipzig, 1938

[9] Hänsel et al. Lehrbuch Phytotherapie. Springer Berlin, 1993

[10] Blaschek. Wichtl – Teedrogen und Phytopharmaka. WVG Stuttgart, 2015

[11] Rouhi and Ganji. Pakistan J Nutr 2007; 6: 256 – 258

[12] Deters et al. J Ethnopharmacol 2010; 127: 62 – 69