Nature's Pharmacy: Ancient Knowledge, Modern Medicine

Hypericum Perforatum
(St. John's Wort)

Legends and Folklore
Hypericum perforatum, the plant's Latin name, is derived from Greek and means "over an apparition," a reference to the belief that the herb was so obnoxious that a whiff of it would cause evil spirits to fly away. Hypericum's common name, St. John's Wort, refers to John the Baptist and carries several possible explanations drawn from folklore and legend. First, the plant flowers around the 24th of June, the date that St. John the Baptist was beheaded. Because the yellow petals bleed red when crushed, they are said to represent his bloodshed, and the translucent spots on the leaves represent the tears shed over his death. The Bible states that St. John lived on locusts and wild honey, but the Greek word for locusts may have meant both the insects, and the tops of plants on which the locusts alight. Legend says that when referring to John the Baptist's eating habits, the word "locust" includes both insect and plant, taking an additional leap to assume the plant St. John may have ingested was Hypericum perforatum. Additionally, the Knights of St. John of Jerusalem used it to treat wounds during the Crusades, and in medieval times people believed that a sprig of St. John's Wort placed under the pillow on St. John's Eve, would cause the Saint to appear in a dream, give his blessing, and prevent one from dying during the following year.

History
In addition to its colorful legends, Hypericum has had a surprising variety of uses over the last 2400 years in both European folk medicine and Native American healing. An ointment made from St. John's Wort has been used as an astringent for bruises, skin irritations, and insect bites. Native Americans used a tea brewed from the plant for treating tuberculosis and other respiratory ailments.

Historical Uses

• To treat anxiety, tension, insomnia, exhaustion, nerve illnesses, psychoses and mild to moderate depression
• To provide pain relief
• To ease symptoms of exhaustion
• Externally to sooth burns, bruises, hemorrhoids and cuts
• Internally to destroy worms and parasites
• To control diarrhea
• To treat local and peptic ulcers
• For gastritis
• To relieve nausea
• Inflammation of upper digestive tract lining
• To control cramps and colic of the viscera and uterus
• To relieve bedwetting in children

Warnings
Although many herbal treatments have varying side effects and reactions, those for Hypericum have proven to be minimal. There is currently and historically no evidence of toxicity in Hypericum in therapeutic doses, and the herb has had an excellent safety record during centuries of use in folk medicine. Its extensive use in Germany (sixty-six million daily doses in 1994) has resulted in no report of serious drug interactions or even toxicity after accidental overdose; in fact, Hypericum is considered safer than aspirin. On the other hand, cattle and sheep can develop photosensitivity if they consume the plant in large quantities, and HIV positive patients on large doses of Hypericum have reported rashes, itching and redness of skin after exposure to ultraviolet light. As a precaution, one should avoid excessive exposure to bright sunlight while taking the herb. Other side effects, which were reported in two to ten percent of users, were mild gastrointestinal irritations, mild allergic reactions, fatigue, and restlessness.

Side Effects and Cautions

• St. John's wort may cause increased sensitivity to sunlight. Other side effects can include anxiety, dry mouth, dizziness, gastrointestinal symptoms, fatigue, headache, or sexual dysfunction.
• Research shows that St. John's wort interacts with some drugs. The herb affects the way the body processes or breaks down many drugs; in some cases, it may speed or slow a drug's breakdown. Drugs that can be affected include:
  • Indinavir and possibly other drugs used to control HIV infection
  • Irinotecan and possibly other drugs used to treat cancer
  • Cyclosporine, which prevents the body from rejecting transplanted organs
  • Digoxin, which strengthens heart muscle contractions
  • Warfarin and related anticoagulants
  • Birth control pills
  • Antidepressants
• When combined with certain antidepressants, St. John's wort may increase side effects such as nausea, anxiety, headache, and confusion.
• St. John's wort is not a proven therapy for depression. If depression is not adequately treated, it can become severe. Anyone who may have depression should see a health care provider. There are effective proven therapies available.
• It is important to inform your health care providers about any herb or dietary supplement you are using, including St. John's wort. This helps to ensure safe and coordinated care.

Modern Medicinal Uses
From the viewpoint of traditional western medicine, we seem only at the threshold of Hypericum's proven usefulness. Laboratory tests have shown plant extracts to be an effective anti-inflammatory and active against the bacterium that causes Tuberculosis. In modern herbal medicine, it is the first and foremost remedy to treat depression. As the number of scientific studies on Hypericum increases, it may also gain wider acceptance within traditional Western medicine. It is currently being studied as a treatment for AIDS, several forms of cancer, skin diseases such as psoriasis, rheumatoid arthritis, peptic ulcers, and even hangover.