Fritillaria is the processed bulb of Fritillaria cirrhosa, a flowering plant in the Liliaceae family. A perennial temperate herb, it grows in mountain slope and sub-alpine meadows, usually on open, stony, and moist hillsides. In the West, fritillaria is most commonly regarded as an ornamental garden plant. By contrast, it is traditionally valued as an herbal remedy in Nepal and China, where it grows in the Gansu, Qinghai, Sichuan, Xizang, and Yunnan provinces. Two related species, F. thunbergii and F. hupehensis, are also used medicinally, and in some regions, F. unibracteata, F. przewalski, and F. delavayi are used as botanical substitutes.
In traditional Chinese medicine, fritillaria is called chuan bei mu which translates as "Shell mother from Sichuan." English common names include fritillary, tendrilled fritillary bulb, and Sichuan fritillary bulb. Its pharmaceutical name, used to distinguish it as a medicine, is Bulbus Fritillariae Cirrhosae and it is one of more than 500 plants recognized as official drugs in traditional Chinese medicine.
General use
Practitioners of Chinese medicine believe that fritillaria affects the heart and lung meridians, or energy pathways in the body, and use it primarily to treat various lung conditions, including asthma, bronchitis, tuberculosis, and coughs of any type. In the traditional Chinese medical system, the white color of fritillaria is thought to indicate its usefulness for ailments of the lungs, which are associated with the color white. Fritillaria's medicinal properties are considered bitter, sweet, and mildly cold.
Fritillaria is used for many types of cough, particularly chronic cough, cough associated with difficult expectoration, and cough with blood-streaked sputum. Chinese practitioners prescribe it to moisten dry mucous membranes, resolve phlegm, and control coughing. It is thought to be most effective for coughs accompanied by reduced appetite and a stifling sensation in the chest and upper abdomen, symptoms that indicate suppressed qi, or vital energy.
Fritillaria's secondary use is as a lymphatic decongestant to reduce swellings, nodules, fibrocystic breasts, goiter, and swollen lymph glands. In China, it also is used for thyroid and lung cancer.
Research on F. cirrhosa and its botanical relatives has generally been conducted in China and has focused on pharmacological investigation. These studies show that F. cirrhosa and other related species contain compounds that have antitussive and expectorant activity because they inhibit contraction of bronchial smooth muscle and decrease secretion of mucus. Compounds responsible for this activity, as defined in Western chemistry, include several bioactive isosteroidal alkaloids (verticine, verticinone, isoverticine, imperialine, hupehenine, ebeiedine, ebeienine, and ebeiedinone) and two nucleosides (thymidine and adenosine). The discovery of a new diterpenoid ester in fritillaria was reported in 2002.
Animal research has also demonstrated central nervous-system inhibition, including prolonged decrease in blood pressure, stimulation of the heart muscle, and dysfunction of breathing.
Preparations
Fritillaria is not generally available in American health food stores but processed forms are available at Chinese pharmacies and Asian groceries. Chinese patent medicines containing fritillaria can be purchased over the Internet; typical prices are $13–$15 for a 4-oz bottle. As medicine, fritillaria is graded into four categories, based on shape and the location in which it was grown: song-pei, lu-pei, ching-pei, and ming-pei. Because the raw bulb is toxic, all medicinal forms are processed. Good quality processed powder is white and has a fine consistency. Small, white, lobed bulbs that have been boiled or steamed and dried also may be available.
The standard dose ranges from 3–12 grams daily as a decoction (strong tea) or 1–1.5 grams as powder. Pills in equivalent doses are also available, and the herb also may be applied externally as either a powder or cream.
Practitioners of Chinese medicine commonly combine fritillaria in patent formulas along with other Chinese herbs such as ma huang (Ephedra sinica) and ballanflower (Platycodon grandiflorum). It is in many cough medicine formulas in liquid form. The following are the major herbs with which it is combined and the symptoms for which the combinations are prescribed:
bitter apricot kernel (Prunus armeniaca; xing ren) for cough and wheezing with copious sputum
loquat leaf (Eriobotrya japonica; pi pa ye), dwarf lilyturf root (Ophiopogon japonicus; mai men dong) and Solomon's seal root (Polygonatum odoratum; yu zhu) for chronic cough with fatigue, irritability, and lack of appetite
thin-leaf milkwort root (Polygala tenuifolia; yuan zhi), hoelen fungus (Poria cocos; fu ling), and snakegourd fruit (Trichosanthes spp.; gua lou) for painful obstruction of the chest with palpitations and insommnia
Zhejiang fritillary bulb (F. thunbergii; zhe bei mu) for scrofula (a form of tuberculosis affecting the lymph nodes) and abscess
Precautions
The unprocessed bulb of fritillaria is toxic, although commercial sources are generally processed. Pregnant women should not use fritillaria unless under the advice of a practitioner trained in the use of the herb. Fritillaria should never be given to children. It is also contraindicated for patients with digestive weakness.
Australian authorities recommend that products containing F. cirrhosa include the following label caution: "Warning: Do not exceed the stated dose." Canadian regulations list F. thunbergii, a close relative of F. cirrhosa, as unacceptable for inclusion in non-medicinal oral products.
A general precaution to observe when using any Chinese patent medicine is to purchase only well-known brands recommended by a practitioner of traditional Chinese medicine. Cases have been reported of incorrect labeling, contamination with heavy metals, and substitution of Western pharmaceuticals for the Chinese ingredients. Any of these occurrences can present a serious health hazard.
Side effects
Side effects from fritillaria extracts used in Chinese patent medicines are rare, but this is partly because fritillaria is usually a minor ingredient in these formulae, often only 10% of the formula by weight. Even in medicines that list fritillaria as a major ingredient, it is never more than 28% of the compound. Tests of fritillaria extract in human subjects reported no side effects when the extract was taken by mouth. On the other hand, high-dosage intravenous injections of alkaloids isolated from fritillaria produced pupil dilation, tremor, slowing of the heart rate, and lowered blood pressure in human subjects.
Interactions
No interactions with standard pharmaceuticals have been described in the literature, but the absence of reported interactions may again be due to the fact that fritillaria extract is not the sole ingredient in any Chinese medicine.
Tradition dictates not to combine fritillaria with aconite root (wu tou) or qin jiao (Gentiana macrophylla).
BOOKS
Bensky, D. and Andrew Gamble. Chinese Herbal Medicine: Materia Medica. Revised ed. Seattle, WA: Eastland Press, 1993.
Fan, W. A Manual of Chinese Herbal Medicine: Principles and Practice for Easy Reference. East Lansing, MI: Shambala, 1996.
Holmes, P. Jade Remedies: A Chinese Herbal Reference for the West. Boulder, CO: Snow Lotus Press, 1997.
Reid, Daniel. Chinese Herbal Medicine. Boston, MA: Shambhala, 1996.
PERIODICALS
Atta-Ur-Rahman, Akhtar M. N., M. I. Choudhary, Y. Tsuda et al. "New Steroidal Alkaloids from Fritillaria imperialis and Their Cholinesterase Inhibiting Activities." Chemical and Pharmaceutical Bulletin (Tokyo) 50 (August 2002): 1013-1016.
Ruan, H., Y. Zhang, J. Wu et al. "Structure of a Novel Diterpenoid Ester, Fritillahupehin from Bulbs of Fritillaria hupehensis Hsiao and K.C. Hsia." Fitoterapia 73 (July 2002): 288-291.
ORGANIZATIONS
American Association of Oriental Medicine. 5530 Wisconsin Avenue, Suite 1210, Chevy Chase, MD 20815. (301) 941-1064. <www.aaom.org>.
Institute of Traditional Medicine. 2017 SE Hawthorne Blvd., Portland, OR 97214. (503) 233-4907. <www.itmonline.org>.
