Myrrh Usage in Medicine and Aromatherapy - Essay Example

Myrrh (Commiphora molmol) Introduction The use of oils extracted from plants has been expanded to all sectors of medicine and aromatherapy. On the other hand, the number of plants that are appropriate for such use enhances the relevant activity. In this context, the study of Price (1999, 17) showed that ‘several hundred plant essential oils have been identified worldwide but many are not commercially available, either because the yield of distilled oil is so small that the cost is prohibitive (as in the case of lime blossom oil) or because there is no commercial demand for them; between 40 and 60 essential oils are normally used by the professional aromatherapist, and most suppliers offer in the region of 70-80; these oils generally belong to just a few of the many plant families, and the families dealt with below include the majority of plants utilized in the production of essential oils’. Current paper refers specifically to the plant commiphora molmol (or myrrh as most commonly known) and its use in the area of medicine and aromatherapy. A series of clinical data is also presented in order to support the theoretical views that are related with the use of myrrh as a basis of several remedies applied in modern medicine. Potanical The word myrrh origins from the Arabic word ‘murr’ that means ‘bitter’. In Encyclopedia Britannica (2007) myrrh is referred as a ‘bitter-tasting, agreeably aromatic, yellow to reddish brown oleoresinous gum obtained from various small, thorny, flowering trees of the genus Commiphora, of the incense-tree family (Burseraceae); the two main varieties of myrrh are herabol and bisabol’. The study of Hanrahan (2007, 1) also refers to myrrh and its origin. In the specific study it is mentioned that ‘myrrh (also known as Commiphora molmol, abyssinica, or myrrha) is a close relative and member of the Burseraceae family, native to the eastern Mediterranean, Ethiopia, the Arabian peninsula, and Somalia; myrrh is a shrubby desert tree known variously as gum, myrrh tree, guggal gum, guggal resin, didin, and didthin’ (Hanrahan, 2007, 1). The most significant characteristic of myrrh is its distinctive colour. More specifically, as it is stated in a report published by the Tillotson Institute of Natural Health (2005), ‘myrrh gum has an intense dark color, reflecting its medicinal potency; it exerts a strong and certain action against specific types of pain and swelling, such as that of rheumatoid arthritis while it is strong enough to soften hard swellings and carbuncles; like all plant resins, myrrh can also lower blood cholesterol levels by binding to lipids’. The ingredients of myrrh were examined by the West Coast Institute of Aromatherapy. The above study showed that ‘myrrh consists of 25 – 45% resins, 30 – 40 % gum and 1.5 – 17% (usually around 8%) volatile oil; this pale yellow to brown essential oil is extracted by steam distillation and contains around 40% alcohols (myrrh alcohols) and 39% sesqueterpenes (elemene, heerabolene, cadinene, copaene, curzerene, lindestrene); it has spicy, warm, balsamic odour, which has a bitter undertone’ (West Coast Institute of Aromatherapy, 2000). It should be noticed that it is due to its ingredients (as described above) that myrrh has been considered as a valuable element of many remedies around the world. Family Name In accordance with the study of Price (1998, 18) ‘myrrh belongs to the family of ‘burseraceae’ examples of which ‘include frankincense (olibanum) and myrrh; these two are available as distilled oils and as resinoids, but the distilled oils are required for therapeutic use; the family has cicatrizant properties, indicating their use for scar tissue, ulcers and wounds; they are also expectorant, and useful in catarrhal conditions’. On the other hand, Darling Biomedical Library has published a report where it is mentioned that ‘the plant’s origin has been located to Arabia, East Africa (particularly Oman, Socotra, Somalia)’ (Darling Biomedical Library, 2007). As for the particular characteristics of the family where the plant belongs, these have not been analyzed in the area of scientific researcher probably because the presentation of the plant’s characteristics and use has been considered as sufficient regarding its potential use in the areas of medicine and aromatherapy. Plant kind The characteristics of Myrrh are the same with many others that belong in the particular family. More specifically, according to a relevant study ‘gum-resin Myrrh is collected from one of 80 or so species of the Commiphora genus; the Commiphora species consist of thorny shrubs or small trees which can grow up to 10 metres in height; they are native to northeastern Africa and southwestern Asia, especially the Red Sea region; the whitish gray bark has schizogenous gum-oleo-resin cavities; in order to collect the gum, incisions are made into the bark; a pale yellow liquid extrudes from the bark but this soon hardens to form yellowish red or reddish brown tears or masses; these are then collected’ (West Coast Institute of Aromatherapy, 2000). The description of plant in the above study has been combined with the presentation of collection of gum extracted from the plant, a reference that it has been considered to be necessary in order to make the structure of the above plant more clear to understand. On the other hand, Price (1999, 180) found that ‘myrrh is thought to be an emmenagogue perhaps because it is hormonal; it is not made clear whether the plant or the essential oil is responsible for the therapeutic action’. As the above studies show, myrrh is valuable both in its natural form (as a plant) or as an oil extracted from the plant under examination. However, it has not made clear by the above studies whether the ‘healing’ effects of myrrh should be ‘attributed’ to the natural or to the liquid form of the herb. Plant use The use of myrrh has been examined a lot both in the literature and the empirical research. In this context, it has been found that ‘in ancient times, the red-brown resin of myrrh was utilized in the preservation of mummies; it was also used as a remedy for numerous infections, including leprosy and syphilis as well as for relief from bad breath and for dental conditions; in traditional Chinese medicine, it has been used for bleeding disorders and wounds’ [1]. On the other hand, the study of Price (1998, 322) showed that ‘myrrh was always present in the coffins and as salve on the bodies in ancient Egypt; Dioscorides mentioned myrrh as warming, astringent and numbing; it was to some extent used as an anaesthetic in operations while Bisabol myrrh is believed by some to be the myrrh of the Bible’. Generally, it could be stated that the plant has been used extensively in all areas of medicine and aromatherapy either alone or combined with other herbs in order to prevent the appearance or the development of a specific illness. In this context, Hoffmann (2006, 1) found that ‘myrrh is an effective anti-microbial agent that has been shown to work in two complementary ways; primarily it stimulates the production of white blood corpuscles (with their anti-pathogenic actions) and secondarily it has a direct anti-microbial effect’. Moreover, Hanrahan (2007, 1) supported that ‘taken internally in tincture or capsule form, myrrh is a beneficial treatment for loose teeth, gingivitis, and bad breath; the tincture may also be applied directly to a tooth to relieve tooth ache; it is antifungal, and has been used to treat athletes foot and candida; some research indicates that myrrh is effective in reducing cholesterol levels; it is a tonic remedy said to relax smooth muscles, increase peristaltic action, and stimulate gastric secretions’. The above uses of myrrh are just indicative. In fact this herb is related with many remedies applied in all areas of medicine. In aromatherapy also myrrh is used extensively either alone or combined with other herbs most commonly in its liquid form, i.e. as an oil although there has been no proof that the herb cannot be used directly in its natural form (plant). Furthermore, the research made by Grieve (2007, 1) showed that myrrh can be also used in the remedies against ‘chronic catarrh, phthisis pulmonalis, chlorosis, and in amenorrhoea is often combined with aloes and iron; as a wash it is good for spongy gums, ulcerated throat and aphthous stomatitis, and the tincture is also applied to foul and indolentulcers; It has been found helpful in bronchorrhoea and leucorrhoea’. Generally, Hoffmann (2006, 1) found that ‘myrrh may be used in a wide range of conditions where an anti-microbial agent is needed; it finds specific use in the treatment of infections in the mouth such as mouth ulcers, gingivitis, phyorrhoea, as well as the catarrhal problems of pharyngitis and sinusitis; it may also help with laryngitis and respiratory complaints and in the treatment of boils and similar conditions as well as glandular fever and brucellosis; it is often used as part of an approach to the treatment of the common cold while externally it will be healing and antiseptic for wounds and abrasions’. From another point of view, Ellingwood (1919, 2) supported that ‘myrrh is specifically indicated in a general sense where there is adynamia or extreme asthenia, with weak, inefficient capillary circulation, cold skin, weak pulse and deficient circulation; it increases the power and frequency of the heart and respiratory action, and conduces to a general sense of warmth and increased vigor’. The above analysis proves that myrrh has a significant value both for medicine and aromatherapy. Specifically for the former, myrrh has been found to have a primary healing role where in the latter it is used mostly as a supplementary material for the preparation of a specific aroma. Description The structure of myrrh as a plant has been studied by Grieve (2007, 1) who found that ‘the bushes yielding the resin do not grow more than 9 feet in height, but they are of sturdy build, with knotted branches, and branchlets that stand out at right-angles, ending in a sharp spine; the trifoliate leaves are scanty, small and very unequal, oval and entire; it was first recognized about 1822 at Ghizan on the Red Sea coast, a district so bare and dry that it is called Tehama, meaning hell; botanically, there is still uncertainty about the origin and identity of the various species’. Myrrh has also been examined as of its main ‘parts’ and it has been found that ‘the three main constituents of myrrh are the resin, the gum, and the volatile oil which are all important in myrrh’s activity as an herbal medicine; the resin has been shown to kill various microbes and to stimulate macrophages (a type of white blood cell); myrrh also has astringent properties and has a soothing effect on inflamed tissues in the mouth and throat’ [1]. It should be mentioned however, that the above studies do not refer to the particular ‘kinds’ of myrrh as they can be possibly observed in the countries where this plant can be found. They only present a general ‘form’ or ‘structure’ of the plant without make any comparison among its various species. Etnobotany As of its content, myrrh does not present significant differentiation among its species existed around the world. Generally it has been found that ‘myrrh is partly soluble in ethanol (30 % alcoholsoluble material) and is also partly soluble in water and inether; since antiquity myrrh has served as a constituent of incense; oil of myrrh is a valuable ingredient in perfumes (balsamic, heavy odour)’ (O’Hannus, 2005, 4). The above characteristics of Myrrh are common among all of its species and for this reason they should be used as a basis for the analysis of its use in the areas of medicine and aromatherapy as already presented above. Phytochemistry The chemistry of myrrh oil was ‘first investigated by Lewinsohn (Arch. Pharm. 244, 412, 1906), von Friedrichs (Arch. Pharm. 245, 432, 1907) and Trost and Doro (Ann. chim. Applicata 26, 126, 1936); These authors found the following constituents: α-pinene 1, dipentene [= (±)-limonene], limonene 2, cuminaldehyde 3, cinnamic aldehyde 4, eugenol 5, m-cresol 6, heerabolene (probably tricyclic sesquiterpene), cadinene, a sesquiterpene, a bicyclic sesquiterpene (C15H24), a tricyclic sesquiterpene (C15H24), formic acid, acetic acid, myrrholic acid (C16H21O3.COOH) and palmitic acid’ (O’Hannus, 2005, 4). The above ‘ingredients’ should be considered as common among all species of the specific plant without differentiations among the particular countries (where this plant can be found). Pharmacology and side effect The most important use of myrrh is in the area of pharmacology. More specifically, regarding specifically this use, myrrh has been characterized as ‘astringent, healing; tonic and stimulant; a direct emmenagogue, a tonic in dyspepsia, an expectorant in the absence of feverish symptoms, a stimulant to the mucous tissues, a stomachic carminative, exciting appetite and the flow of gastric juice, and an astringent wash’ (Grieve, 2007, 1). Moreover, Ellingwood (1919, 2) found that ‘in its influence upon the digestive apparatus Myrrh is direct in its action; it quickly increases the power of the digestive function, stimulating the peptic glands to extreme action; it also increases the appetite and promotes the absorption and assimilation of nutrition; it is given in atonic dyspepsia in the absence of inflammatory action, especially if there is excessive mucous discharge from the bowels; in some cases of catarrh of the bladder it is used internally, and in the irrigation fluid also; it is valuable in prostrating leucorrhea’. Apart from the above cases, myrrh has been considered as having a significant value in many severe illnesses and for this reason a series of empirical studies have been made in order to examine the specific effects related with the use of myrrh as a basic element of the relevant remedies. Clinical data Myrrh as already explained above is used in a series of illnesses both alone and in combination with other pharmaceutical or herbal ‘material’. A relevant case is presented by Botros et al. (2004 206) who have examined the potential antischistosomal activity of myrrh. In the specific research ‘different derivatives of the resin, including the commercial preparation Mirazid, were tested at different doses in mice and hamsters infected with Schistosoma mansoni; in mice infected with the Egyptian (CD) strain of S. mansoni, four of six groups treated with Mirazid did not show significant worm reduction, while the remaining groups showed significant but trivial reductions; in mice infected with the Puerto Rican (Mill Hill) strain of S. mansoni, a Mirazid solution was toxic for mice at high doses and produced modest or no worm reduction at lower doses’. The above clinical test has led to the assumption that the use of Mirazid cannot be suggested for the treatment of schistosomiasis in humans. However, in accordance with the clinical research made by Atta et al. (1998, 117) myrrh extract can have ‘significant anti-inflammatory and analgesic effects when used against induced, localized acute and chronic inflammation in rodents’. From another point of view, Al-Harbi et al. (1994, 337) examined specifically the ability of ‘myrrh extract to reduce tumors’. In the specific clinical test ‘myrrh compared favorably with the chemotherapeutic agent cyclophosphamide in its cytotoxic and anticarcinogenic potential and it has been found that  ‘further studies are warranted to explore its mode of action and safety for medicinal use in cancer therapy’. The role of myrrh in the treatment of schistosomiasis (as already explored above) has been examined by Sheir et al. (2001, 700). In the above research and in the ‘preliminary trial, patients with schistosomiasis (a parasitic infection) were treated with a combination of resin and volatile oil of myrrh, in the amount of 10 mg per 2.2 pounds of body weight per day for three days; the cure rate was 91.7% and, of those who did not respond, 76.5% were cured by a second six-day course of treatment, increasing the overall cure rate to 98.1%’ (Sheir et al., 2001, 700). In other words, the above study is differentiated from the one of Botros et al. (2004) as it has already developed above, regarding the healing power of myrrh in the case of schistosomiasis. The difference in their findings could be possibly explained by the possible differences in the samples used in each particular study. The use of myrrh in the treatment of schistosomiasis has been also explored in the study of Soliman et al. (2004). In the relevant study, ‘a total of 21 children with fascioliasis (8 males and 13 females) with mean age of 10.4 years, 8 children with schistosomiasis mansoni (6 males and 2 females) with mean age of 11.37 years were treated with Myrrh (Mirazid) which is an oleo-gum resin from the stem of Commiphora molmol tree (Family Burseraceae); also, ten healthly cross matched children were utilized as controls. Diagnosis was based on the detection of Fasciola hepatica or Schistosoma mansoni eggs in stool by Kato-Katz technique; Mirazid was given as 10 mg/kg/d an hour before breakfast for 3 consecutive days in schistosomiasis and for 6 days in fascioliasis; clinical evaluation and stool analysis were done initially and at 2, 4 and 12 weeks post treatment to evaluate cure.; it is concluded that Mirazid is an effective fasciolicidal and schistosomicidal drug (Soliman et al., 2004, 941). The above research verifies the results of the study of Sheir et al. (2001) as already analyzed above supporting the view that myrrh should be considered as a necessary element of the remedy applied for the schistosomiasis in humans. From another point of view Saeed et al. (2004, 81) examined ‘the irritant potentials of essential oil and seven sesquiterpenoids compounds newly isolated from the oleo-gum-resin of Commiphora myrrha’. In accordance with the above study ‘the essential oil, curzerenone, furanodiene-6-one and furanoeudesma-1, 3-diene showed potent and persistent irritant effects while others possess least irritant potentials’ (Saeed et al., 2004, 81). Moreover, Omer et al. (1999, 299) tried to examine the use of myrrh ‘in traditional medicine for the treatment of various ailments; twelve 6-mo-old male Nubian goat kids were assigned to 4 groups: undosed controls, C myrrha-dosed at 0.25 g plant resin/kg/d, C myrrha-dosed at 1 g resin/kg/d and C myrrha dosed at 5 g plant resin/kg/d; Results of hepatorenal function tests were correlated with clinical and pathological changes; The use of 1 or 5 g plant resin/kg/d caused grinding of teeth, salivation, soft feces, inappetence, jaundice, dyspnea, ataxia and recumbency; death occurred between 5 and 16 d while enterohepatonephrotoxicity was accompanied by anemia, leucopenia, increases in serum ALP activity and concentrations of bilirubin, cholesterol, triglycerides and creatinine, and decreases in total protein and albumin but the oral dose of 0.25 g plant resin/kg/d was not toxic’ (Omer et al., 1999, 299). The results of the above clinical test should be considered however as not clear regarding the role of myrrh in the treatment used in the relevant test. On the other hand, Tariq et al. (2005, 381) proceeded to a clinical test during which ‘the petroleum ether extract of the oleo-gum resin of Commiphora molmol, at a dose of 500 mg/kg body weight, produced significant inhibition of carrageenan induced inflammation and cotton pellet granuloma; the extract also showed significant antipyretic activity in mice’. However, there has been no evidence that the above treatment could be possibly effective in humans. Traditional medicine in Saudi Arabia The research made by the American Botanical Council (2007) showed that ‘myrrh gum has been used in Middle Eastern medicine for treatment of infected wounds and digestive and bronchial complaints for over a thousand years; it was also used as an embalming agent in the Middle East and Africa’. On the other hand, a report published by the Saudi Aramco World (2007) refers to the particular uses of myrrh as a remedy in the different areas of Saudi Arabia. In accordance with the above report the myrrh is used in the following cases: ‘a) myrrh is used to alleviate inflammation in the body, b) Myrrh water is an excellent mouthwash and is helpful for mouth sores or blisters, sore throats, bronchial congestion and other conditions requiring an antiseptic astringent, c) For burns, soak myrrh in a small amount of water. It is put on burns to reduce scars and to help in quickly healing wounds and to remove warts (Southern Province), d) In the past, myrrh oil was wiped on a new baby’s navel (Bahrain), e) Myrrh is very good to have if you have external cuts. It makes them get better quickly (Central Province), f) We use myrrh for so many uses, for example to treat sores, appendicitis pain after operation, boils, stomach aches and the colon. Soak myrrh stones in water. Then place the water on the area of pain for boils, or drink it (Central Province) and g) Myrrh is used to help healing of wounds, minor burns and wounds of simple surgical operations (Southern Province)’. The use of myrrh as described above in the Saudi Arabia is not restricted in the areas mentioned in the relevant report. These cases are just indicative. Myrrh can be used in all areas of medicine and aromatherapy as already explained above. Conclusion The analysis of the potential use of myrrh in medicine and aromatherapy – as presented above – can lead to the assumption that myrrh is a herb with a significant role in the treatment of many severe illnesses. However, its use should follow the principles and the ethics of medicine in order to avoid any harm on the health of humans. In this context, Lindhart (2004, 1) noticed that ‘many people thrive on the idea that an effective medicine can be used without side effects; herbs generally relieve common complaints and heal the body in a gentle, effective way, which makes them safe for all ages; however, always consult with a health care provider, because each individual is unique, with different circumstances to deal with’. Indeed, herbs should not be considered as a ‘supplement’ that could be used with no specific guidelines. In many cases, the use of herbs can lead to severe damages on health if taking place without a previous discussion with a medical consultant or doctor. On the other hand, myrrh has been proved to be valuable in the treatment of many severe illnesses, however its use should follow the principles of any ‘medical supplement’ in order to avoid any potential harm of health. 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Journal of the Egyptian Society of Paracitology, 34(3): 941-966 Tariq, M., Ageel, A., Al-Yahya, M., Mossa, J., Al-Said, M., Parmar, N. (2005). ‘Anti-inflammatory activity of Commiphora molmol’. Inflammation Research, 17(3-4): 381-382 The Tillotson Institute of Natural Health (2005) ‘Myrrh’, available at http://oneearthherbs.squarespace.com/important-herbs/myrrh-gum-commiphora-myrrha.html West Coast Institute of Aromatherapy (2000) ‘Myrrh’, available at http://www.westcoastaromatherapy.com/index.cfm?page=114 Myrrh (as in Louise M. Darling Biomedical Library, 2007) Read More