Botanical Name: Gentiana lutea, Gentianaceae

Common names: Yellow Gentian

Similar species: Well over 400 species of Gentiana have been identified across both the temperate, alpine and arctic regions of the northern hemisphere and all are more or less used interchangeably.  Notable species include G. purpurea, G. pannonicus G. scabra, G. punctata and G. acaulis in Europe; G. macrophylla, G. barbata, G. scabra in China; and G. puberula, G. saponaria, G. andrewsii, G. amarala, G. algida, and G. acuta in North America.  Another similar member of the Gentianaceae is the Ayurvedic herb Swertia chirata (Tikta, i.e. "bitter").

Plant description: Yellow Gentian is a perennial herb, with a stem reaching up to 1.5 m in height, with a large cylindrical, forked taproot that is brown externally and white internally. The leaves are glabrous, pale green, generally ovate to oblong and about 4-8 cm broad.  The golden star-shaped flowers are carried in whorls of cupped cordate leaves.  The flowers are large, bright-yellow, with 5-6 stamens and a conical ovary with sessile stigmas. The seeds are numerous and flattened, with thin, brownish edges.

Habitat, ecology and distribution: Gentiana lutea is native to central and southern Europe, typically in low to subalpine elevations in moist open areas, open forest, thickets, and meadows.  Gentian is now a protected species in much of Europe, and as such only cultivated or ethically wild-crafted sources should be used.

Part used: root

History: Gentian has a very long history of use and was mentioned as an important medicinal plant by both Dioscorides and Pliny. The name of the genus is derived from Gentius, the ancient King of Illyria (180-167 B.C.), who, according to Pliny, discovered its medicinal value.  The specific epithet lutea means "yellow."  During the Middle Ages in Europe, Gentian was commonly employed as an antidote to poison. Tragus, in 1552, mentions it as a means of diluting wounds. Apart from its use as a medicinal agent, Gentian has also been an important ingredient in many prized aperitifs over the years (Grieve 1971; Evans 1989, 524).

Constituents: Gentian is noted for its bitter principles, including the seco-iridoid glycoside gentiopicroside (gentiopicrin), which comprises upwards of 2% (11400 ≠ 35000 ppm) of the total constituents.  Despite traditional methods of preparation, gentiopicrin is said to decompose upon the fermentation and drying.  Nonetheless many other bitter constituents are present in the various Gentian species, albeit in lesser amounts, including the iridoids gentioside, amarogentin, and amaroswerin.  Among these glycosides are flavonoids (gentisin) and various triterpenoids.  Other constituents include pyridine alkaloids (gentianine and gentialutine), xanthones (gentisein, gentisin [gentianin] and isogentisin), as well volatile oils (linalool, carvacrol, limonene), sugars, tannin, and pectin (Newall et al 1996, 134; Duke 1992; Evans 1989, 524).

Medical Research: Although botanicals with bitter properties are an important part of traditional and modern herbal medicine, most medical researchers remain ignorant of their value.  The seco-iridoid glycosides in Gentian are well known however to exert a stimulatory effect upon the digestive receptors of the taste buds, promoting a reflex increase in the secretion of saliva and gastric juices (Bradley 1992, 110).  As a result, Gentian and bitter-tasting plants generally have an important therapeutic activity in the treatment of digestive disorders, but must be tasted in order to exert this effect.  The following represents the bulk of the medical research on the medicinal properties of the various Gentian species.
•Gastrointestinal: A methanolic extract of Gentiana kokiana was shown to exert an endothelium-independent vasodilator activity in aortic rings pre-contracted by norepinephrine (NE), with the authors hypothesizing the involvement of ryanodine-sensitive Ca2+ channels as a mechanism of action (Baragatti et al 2002). Gentiopicroside was found to inhibit the spontaneous contractions of isolated guinea pig ileum in a concentration-dependent manner, induced by histamine, acetylcholine, BaCl2 and KCl (Rojas et al 2000). An extract of Gentiana spathacea demonstrated a concentration-dependent inhibition of spontaneous contractions of the isolated rat ileum, and was shown to exert an in vitro antimicrobial activity against pathogenic enterobacteria (Rojas et al 1999).
•Antioxidant: An aqueous extract of Gentiana decumbens exhibited a strong scavenging activity for 1,1 diphenyl-2-picrylhydrazyl, superoxide and hydroxyl radicals, determined by electron spin resonance and chemiluminescence (Myagmar 2000).
•Hepatotoxicity: An ethanolic extract of Gentiana olivieri was found to prevent the elevation of plasma and hepatic malondialdehyde formation (evidence of lipid peroxidation) as well as enzyme levels (AST and ALT) in carbon tetrachloride-induced hepatotoxicity in rats (Aktay et al 2000). Gentiopicroside was tested for therapeutic effects on carbon tetrachloride-induced and lipopolysaccharide (LPS)/bacillus Calmette-Guerin (BCG)-induced hepatotoxicity. The increase in the serum levels of hepatic aminotransferases induced by carbon tetrachloride was suppressed by pretreatment with gentiopicroside at 30-60 mg/kg/day for 5 consecutive days.  An increase of these same enzymes triggered by an intravenous treatment with LPS in mice pretreated with the bacillus Calmette-Guerin (BCG) was also inhibited by gentiopicroside at the same doses.  The mode of action was determined to be the suppression of tumor necrosis factor (TNF), an important inflammatory mediator that was found to peak in the serum immediately prior to the elevation of the hepatic enzymes (Kondo et al 1994).
•Antifungal: An anthranilic acid derivative called ethyl N-docosanoylanthranilate isolated from a methanolic extract of the roots of Gentiana tibetica was found to inhibit the growth of the human pathogenic fungi Candida albicans and Aspergillus flavus in vitro (Tan et al 1998). 2-methoxyanofinic acid and its methyl ester, kurarinone and kushenol I, isolated from an aqueous-acetone extract of the roots of Gentiana macrophylla were shown to be inhibit the growth of Candida albicans (Tan et al 1996a). The carboxylic moieties of anofinic acid and fomannoxin acid isolated from an aqueous acetone extract of the whole herb of Gentiana algida were shown to be active against Candida albicans (Tan et al 1996b).
•Antibacterial: An extract of Gentiana violet was found to be active against methicillin-resistant Staphylococcus aureus (MRSA) in vitro.  In the same study, the use of an ointment containing 0.1% Gentiana violet in 12 patients with MRSA-infected skin lesions was found to completely eliminate the bacteria within 4 weeks, without any side-effects noted (Saji 1992).
•Systemic lupus erythematous: Sixty-two cases of systemic lupus erythematous (SLE) were treated concurrently with an extract of Gentiana macrophylla and 10-30 mg  prednisone per day. As a control, 19 cases of SLE were treated with prednisone alone during the same period. The results showed a complete remission in 86.46% (50/62) cases in the observation group and 31.57% (6/19) cases in the control group. Eight cases of SLE treated with Gentiana extract alone also achieved complete remission in six cases and a clinical improvement in two.  The Gentiana extract was shown to be more effective than prednisone on the improvement of nephropathy, arthralgia, and erythema.  No side effects for the Gentiana extract were observed (Yuan and Feng 1989).

Toxicity: Five cases of acute accidental poisoning were reported in France after ingestion of a homemade Gentian wine. Clinical signs included nausea, vomiting, abdominal pain, hypotension and bradycardia, suggesting the presence of an alkaloid from White Hellebore (Veratrum album), which often grows side by side with Gentian and is easy to confuse and gather by mistake (Garnier 1985).

Herbal action: bitter stomachic, sialagogue, cholagogue, hepatoprotective, emmenagogue, antimicrobial, antihelminth, antidepressant

Indications: anorexia, nausea, atonic dyspepsia, biliousness, jaundice, hepatitis, atonic constipation, gastroenteritis, chronic dysentery, parasites, amenorrhea, headache, migraine, depression, apathy

Contraindications and cautions: gastric irritability or inflammation (Felter 1922).

Medicinal uses: Although the activities of Gentian are found in many medicinal plants, it is for good reason that Cook calls Gentian root "…one of the purest bitter tonics, intense and permanent in taste and action" (1869).  For this reason Gentian has a clearly defined range of therapeutic activity, understood primarily through its stimulatory effect upon digestive function, and the resultant effects in the body.  Cook states that as a result of this property Gentian "…braces the circulation slowly but effectually, and gives firmness to the stomach, alvine canal, gall-ducts and uterus. It is best fitted for languid conditions, and states of general debility" (1869).  Gentian is among the bitter tonics, and along with others such as Oregon Grape (Mahonia aquifolium) figured importantly in early Thomsonian medicine to restore 'tone' to the digestive organs after feverish conditions had subsided or after the administration of eliminative therapies.  On both sides of the Atlantic Gentian has figured as an important remedy for indigestion, chronic biliousness, constipation, and intestinal parasites.  Stimulating secretions of the stomach and liver, Gentian works gradually to promote the action of the bowels.  Cook warns however that large doses "…over-excite the stomach and give a feeling of oppression…best avoided in irritable conditions of the stomach, bowels, or uterus" (1869).  Generally speaking Gentian is best indicated in 'lymphatic' temperaments, where a certain mental 'stickiness' or emotional congestion predominates, accompanied by a lack of enthusiasm, and feelings of depression, sadness and grief. Such states may be accompanied by a frontal headache, or aching behind the eyes, and a need for fresh air and open spaces (Boericke 1927). Applied topically Gentian is an effective application in skin infections and ulcerous conditions.  Cook advises that its intense bitter taste combines well with more aromatic herbs, but that it should not be used with astringent herbs (1869).  In the treatment of amenorrhea and menstrual disorders generally, Gentian, and bitter herbs generally, act by improving digestive assimilation and nutrition, while correcting uterine circulation by stimulating bile excretion and thereby relieving portal congestion.

Pharmacy and dosage: The gentiopicroside content destabilizes with drying and fermentation.  Non-fermented and freshly prepared extracts are preferred for medicinal usage.
•Fresh Plant Tincture: root, 1:2, 95% alcohol, 3-20 gtt
•Dry Plant Tincture: root, 1:5, 50% alcohol, 1-4 mL
•Decoction: coarsely ground root, 1:20, 30-90 mL
•Powder: finely pulverized root, 0.5-2 g

REFERENCES

Aktay G, Deliorman D, Ergun E, Ergun F, Yesilada E, Cevik C. 2000. Hepatoprotective effects of Turkish folk remedies on experimental liver injury. J Ethnopharmacol Nov;73(1-2):121-9
Baragatti B, Calderone V, Testai L, Martinotti E, Chericoni S, Morelli I. 2002. Vasodilator activity of crude methanolic extract of Gentiana kokiana Perr. et Song. (Gentianaceae). J Ethnopharmacol Mar;79(3):369-72
Boericke, William. 1927. Hom¶opathic Materia Medica. 9th ed. Digitized version available from: http://homeoint.org/books/boericmm/c.htm
Bradley, Peter R. ed. 1992. British Herbal Compendium. Bournemouth, UK: British Herbal Medicine Association.
Cook, WM. H. 1869. The Physiomedical Dispensatory.  Cincinnati: self-published.  Digitized version available from http://medherb.com/cook/home.htm.
Duke, James A. 1992. Handbook of phytochemical constituents of GRAS herbs and other economic plants. Boca Raton, FL. CRC Press. Digitized database available from http://www.ars-grin.gov/duke/.
Evans, W.C. 1989. Trease and Evans Pharmacognosy London: BailliËre Tindall.
Felter, H.W. 1922. The Eclectic Materia Medica, Pharmacology and Therapeutics. Cincinati: John K. Scudder. Digitized version available from: http://www.ibiblio.org/herbmed/eclectic/felter/main.html
Felter, HW and JU Lloyd. 1893. King's American Dispensatory. Digitized version available from http://www.ibiblio.org/herbmed/eclectic/kings/main.html.
Garnier R, Carlier P, Hoffelt J, Savidan A. 1985. Acute dietary poisoning by white hellebore (Veratrum album L.). Clinical and analytical data. A propos of 5 cases Ann Med Interne (Paris) 1985;136(2):125-8
Grieve, Maude. 1971. A Modern Herbal. New York: Dover Publications.
Kondo Y, Takano F, Hojo H. 1994. Suppression of chemically and immunologically induced hepatic injuries by gentiopicroside in mice.  Planta Med Oct;60(5):414-6
Myagmar BE, Aniya Y. 2000. Free radical scavenging action of medicinal herbs from Mongolia. Phytomedicine Jun;7(3):221-9
Newall, Carol A., Linda A. Anderson and J.D. Phillipson. 1996. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press.
Rojas A, Bah M, Rojas JI, Serrano V, Pacheco S. 1999. Spasmolytic activity of some plants used by the Otomi Indians of Queretaro (Mexico) for the treatment of gastrointestinal disorders. Phytomedicine Nov;6(5):367-71
Rojas A, Bah M, Rojas JI, Gutierrez DM. 2000. Smooth muscle relaxing activity of gentiopicroside isolated from Gentiana spathacea. Planta Med Dec;66(8):765-7
Saji M. 1992. Effect of gentiana violet against methicillin-resistant Staphylococcus aureus (MRSA). Kansenshogaku Zasshi 1992 Jul;66(7):914-22
Tan RX, Kong LD, Wei HX. 1998. Secoiridoid glycosides and an antifungal anthranilate derivative from Gentiana tibetica. Phytochemistry 1998 Apr;47(7):1223-6
Tan RX, Wolfender JL, Zhang LX, Ma WG, Fuzzati N, Marston A, Hostettmann K.
1996a. Phytochemistry Jul;42(5):1305-13
Tan RX, Wolfender JL, Ma WG, Zhang LX, Hostettmann K. 1996b. Secoiridoids and antifungal aromatic acids from Gentiana algida. Phytochemistry Jan;41(1):111-6
Yuan ZZ, Feng JC. 1989. Observation on the treatment of systemic lupus erythematous with a Gentiana macrophylla complex tablet and a minimal dose of prednisone. Zhong Xi Yi Jie He Za Zhi. Mar;9(3):156-7, 133-4