The species
Aristolochia clematitis was highly regarded as a medicinal plant since the ancient
Egyptians,
Greeks and
Romans, and on until the
Early Modern era; it also plays a role in
traditional Chinese medicine. Due to its resemblance to the uterus, the
doctrine of signatures held that
birthwort was useful in childbirth. A preparation was given to women upon delivery to expel the
placenta, as noted by the herbalist
Dioscurides in the 1st century AD. Despite its presence in ancient medicine,
Aristolochia is known to contain the lethal toxin
aristolochic acid. The
Bencao Gangmu, compiled by Li Shi-Zhen in the latter part of the sixteenth century, was based on the author's experience and on data obtained from earlier herbals; this Chinese herbal classic describes 1892 "drugs" (with 1110 drawings), including many species of
Aristolochia. For 400 years, the
Bencao Gangmu remained the principal source of information in traditional Chinese medicine and the work was translated into numerous languages, reflecting its influence in countries other than China. In the mid-twentieth century, the
Bencao Gangmu was replaced by modern
Materia Medica, the most comprehensive source being
Zhong Hua Ben Cao (
Encyclopedia of Chinese Materia Medica), published in 1999. The
Encyclopedia lists 23 species of
Aristolochia, though with little mention of toxicity. The Chinese government currently lists the following
Aristolochia herbs:
A. manshuriensis (stems),
A. fangchi (root),
A. debilis (root and fruit), and
A. contorta (fruit), two of which (
madouling and
qingmuxiang) appear in the 2005
Pharmacopoeia of the People's Republic of China. In traditional Chinese medicine
Aristolochia species are used for certain forms of acute
arthritis and
edema. Despite the toxic properties of aristolochic acid, naturopaths claim that a decoction of birthwort stimulates the production and increases the activity of
white blood cells, or that pipevines contain a
disinfectant which assists in
wound healing. Also,
Aristolochia bracteolata is colloquially known as "worm killer" due to supposed
antihelminthic activity.
Aristolochia taxa have also been used as reptile repellents.
A. serpentaria (Virginia snakeroot) is thus named because the root was used to treat snakebite, as "so offensive to these reptiles, that they not only avoid the places where it grows, but even flee from the traveler who carries a piece of it in his hand".
A. pfeiferi,
A. rugosa, and
A. trilobata are also used in folk medicine to treat snakebites. ''
Toxicity and carcinogenicity In 1993, a series of end-stage renal disease cases was reported from
Belgium associated with a weight loss treatment, where
Stephania tetrandra in a herbal preparation was suspected of being replaced with
Aristolochia fangchi. More than 105 patients were identified with
nephropathy following the ingestion of this preparation from the same clinic from 1990 to 1992. Many required
renal transplantation or
dialysis.
Aristolochia is a component of some Chinese
herbal medicines.
Aristolochia has been shown to be both a potent carcinogen and kidney toxin. Herbal compounds containing
Aristolochia are classified as a
Group 1 carcinogen by the
International Agency for Research on Cancer. Epidemiological and laboratory studies have identified
Aristolochia to be a dangerous kidney toxin;
Aristolochia has been shown to be associated with more than 100 cases of kidney failure. Furthermore, it appears as if contamination of
grain with
European birthwort (
A. clematitis) is a cause of
Balkan nephropathy, a severe renal disease occurring in parts of
southeast Europe. In 2001 the UK government banned the sale, supply and importation of any medicinal product consisting of or containing a plant of the genus Aristolochia. Several other plant species that do not cause themselves kidney poisoning, but which were commonly substituted with Aristolochia in the remedies, were prohibited in the same order. Aristolochic acid was linked to aristolochic acid-associated urothelial cancer in a Taiwanese study in 2012. In 2013, two studies reported that aristolochic acid is a strong carcinogen. Whole-genome and exome analysis of individuals with a known exposure to aristolochic acid revealed a higher rate of somatic mutation in DNA.
Metabolites of aristolochic acid enter the cell nucleus and form adducts on
DNA. While adducts on the transcribed DNA strand within genes are detected and removed by
transcription-coupled repair, the adducts on the non-transcribed strand remain and eventually cause DNA replication errors. These adducts have a preference for
adenine bases, and cause A-to-T
transversions. Furthermore, these metabolites appear to show a preference for C
AG and T
AG sequences. ==Garden history==