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Medicine at our doorsteps Natakaranja

Jamayet Ali

Natakaranja is an extensive climber plant; branches finely grey-downy, armed with hooked and straight hard yellow prickles. It is found in fallow lands and jungles in all parts of rural Bangla. It is also found in India, Myanmar and other tropical countries. It is an important medicinal plant. All parts of this plant are useful. The nuts are used for making into bracelets, necklaces, rosaries etc. Necklaces of the seeds strung upon red silk are worn by pregnant women as a charm to prevent abortion. The seeds are used by children in place of marbles.

Medicinal Properties: The root-bark is good for tumours and for removing the placenta. The sprouts are useful in the treatment of tumours. The juice of the leaves is anthelmintic; good in elephantiasis and smallpox; destroys the bad odour due to perspiration. The flower is bitter, heating to the body; cures "kapha" and "vata" ; the ash is used in ascites. The fruit is acrid, heating to the body; astringent to the bowels, aphrodisiac, anthelmintic; cures urinary discharges, leucorrhoea, piles, wounds. The oil from the fruit is good for indolent ulcers (Ayurveda). The seed is hot and dry; styptic, antiperiodic, anthelmintic, prevents contagious diseases; cures inflammations; useful in colic, malaria, hydrocele, skin diseases, leprosy (Yunani).

In an official report, the Madras Committee for the proposed revision of the Indian Pharmacopoeia, remark that "the seeds are very useful and cheap and antiperiodic, antipyretic, and tonic; valuable in all ordinary cases of simple, continued and intermittent fevers. They have also been found useful in some cases of asthma." In Madras, an ointment is made from the powdered seeds with castor oil and applied in hydrocele and orchitis. In disorders of the liver, the tender leaves are considered very efficacious. In Cochin China they are reckoned as a deobstruent and emmenagogue; and an oil expressed from them is given in convulsions, palsy, and similar complaints.

In Malaya, the young leaves are used in intermittent fevers, and for expelling intestinal worms. In Ceylon, they are applied for toothache, and they are also given for worms in children. In La Reunion and Madagascar, the roots are considered febrifuge and anthelmintic; they are much used as an astringent in Leucorrhoea and blennorrhagia. The seeds are considered tonic, febrifuge, anthelmintic, antiblennorrhagic; and specific in treatment of hydrocele. The oil from the seeds is used in convulsions and paralysis. The leaves are a good emmenagogue. In Guinea, the pounded seeds are considered vesicant; a decoction of the root is prescribed in fever; the boiled leaves are used as a gargle for sore throat. The powdered seeds were administered mixed with equal part of pepper powder to malarial patients and were found to possess feeble antiperiodic properties. In malignant malaria, they did not do any good.

The leaves and seeds after roasting with castor oil are applied externally to inflammatory swellings especially to inflamed piles, hydrocele, and orchitis with benefit (Koman). The seeds contain a fairly good percentage of pale yellow thick oil having an agreeable odour. It has iodine value of 96.1 and saponification value of 292.8. We could not confirm the presence of an alkaloid as noted by the previous investigators, but they contain a non-glucocidal bitter principle insoluble in water which is pharmacologically in active. According to some authors the quantity of oil varies between 20 to 25 per cent, whereas in our specimen we did not get more than 14 per cent. As the seeds to do not show any marked therapeutic properties and the reinvestigation of their chemical composition does not reveal the presence of any active principles with marked physiological action, further clinical trials were considered unnecessary (Chopra and Ghosh) (Indian Medicinal Plants, KR. Kirtikar and BD Basu, 842-44).

Medicine: The Seeds or Nuts- The seeds are viewed as possessing well-marked antiperiodic properties, and are largely used by the natives instead of quinine. For this purpose they are pounded with black pepper, from 5 to 30 grams being regarded as the proper dose. Ainslie seems first to have drawn the attention of Europeans to this powder, but even up to the present date it has not apparently taken the position which it deserves as a tonic and febrifuge. It was made officinal in the Indian Pharmacopoeia, the dose of powder being 18 to 15 grains. "In Intermittent fevers, especially in those of the natives, this remedy has been found very useful. It is best given in the following: Take of Bonduc seeds, deprived of their shells and powdered one ounce, black pepper powdered, one ounce, mix thoroughly, and keep in a well stoppered bottle. Of this the dose is from 15 to 30 grains three times a day for adults. In smaller doses it is a good tonic in debility after fever and other diseases"

Thwaites says: "Every part of the plant is used medicinally in Ceylon."

O'Shaughnessy remarks, that 'the seeds afford a powerful tonic and very valuable febrifuge." "Nitric acid reddens the nut and subsequently gives it a yellow colour." Dr. Irvine, in his Medical Topography of Ajmere says: "The seed is very bitter; used very generally as a tonic, februfuge, and deobstruent; common at Ajmere. Natives foolishly suppose the seed will cure a scorpion-sting." In an official report, the Madras Committee for the proposed revision of the Indian Pharmacopoeia remark that "the seeds are very useful and chief (antiperiodic, antipyretic, and tonic, valuable in all ordinary cases of simple, continued, and intermittent fevers. They have also been found useful in some cases of asthma. They resemble Aconitum heterophyllum in their action, but are preferable to it for cheapness. The root bark is inferior to the seeds, and the root quite useless. Fever- nut may be substituted for Pulv. Jacobi as a febrifuge, and for Valerian as antismasmodic, and for Gentian and Culumbo as a tonic. "In Persia and India the seeds are considered to be hot and dry, useful for dispersing swellings, restraining haemorrhage, and keeping off infectious diseases. They are also given internally in leprosy, and are thought to be anthelmintic." (Surgeon-Major W. Dymock, Bombay.) Dr. Ch .. Rice writes to the. author that the "seeds are used among the Malays as astringent tonics in bowel complaints. They have also been reported as facilitating child birth."

In debility after fevers and other diseases, "the bark of the root of Bonduc shrub in 10-grain doses is reported to be even more effectual than the seeds themselves." (Waring.) It would thus appear that a difference of opinion prevails regarding the properties of the root, but all authors agree in extolling the virtue of the seeds. An ointment is made from the powdered seeds, with castor oil, and applied externally in hydrocele.

The leaves- In disorders of the liver the tender leaves are considered very efficacious. Drury says that in Cochin China the leaves are reckoned as a deobstruent and emmenagogue, and that an oil expressed from them is useful in convulsions, palsy, and similar complaints. Dr. Oh. Rice informs the author that "the young leaves are used in intermittent fevers and for expelling intestinal worms" At the late Colonial and Indian Exhibition a pale orange-coloured nut was known by the West Indian Colonies as obtained from a special cultivated form of this plant. This is not in India, the nuts being all of a slaty-olive green.

Special Opinions: The kernel of the seeds is decidedly tonic and antiperiodic, but much inferior in this respect to the cinchona preparations. It is useful in dispensary practice where economy is a desideratum." (Surgeon R.D. Murray, M.B., Burdwan.) "Nata is decidedly antiperiodic, but feeble in its action, requiring 3 to 3 and half grs. of the powdered seed to check an ordinary intermittent fever." (Surgeon R.L. Dutt, M.D. Pubna.) "I have often used it as an antiperiodic, it is certainly of value. The powdered seed smoked in a hukka, in liew of tobacco, is said to be very efficacious in colic." (Surgeon-Major C.W. Calthrop, M.D. Morar.) "In doses of 5 to 20 grains, the powdered seeds constitute an efficient antiperiodic, little inferior to cinchona febrifuge." (Surgeon W. Barren, Bhuj, Cutch) "Used in charitable hospitals as an antiperiodic, but it is decidedly inferior to cinchona febrifuge, and in large doses it produces nausea." (Brigade Surgeon S.M. Shircore, Murshedabad.)" Much used as a tonic and a mild antiperiodic, in 5-grain doses, in dispensary practice" (Surgeon G. Price, Shahabad.) "The kernel, in the form of a powder, has been extensively used by me in the treatment of ague, specially the tertian and quartian varieties, and found useful in about 50 per cent of cases." (Assistant Surgeon Bhagwan Dass, Rawalpindi, Panjab.) " Its antiperiodic properties are not well marked.

I have found it useful in convalescence, after fevers." (Assistant Surgeon Shib Chunder BhuttachaIji, Chanda, Central Provinces.) "The seeds are said to be useful in colic (dose one seed), and the ash as an external application to ulcers." (Surgeon Joseph Parker, M.D. Poona.) "The burnt seeds are used with alum and burnt areca-nut as a dentifrice, useful in spongy gums, gum-boils, also in intermittent fever and debility." (Brigade Surgeon J.R. Thornton, B.A., M.B. Monghyr.) "Sometimes used as a febrifuge in doses of about 30 grains, but has a nauseous taste and does not appear to be an efficacious remedy" (Assistant Surgeon Jaswant Rai, Mooltan.) "The kernel of the seeds of Caesalpinia (Guilandina) Bonducella is a very useful and cheap drug, and is antiperiodic, antipyretic, tonic, and antispasmodic. It has been used with good results in mild cases of intermittent and continued fevers, and also in asthma and general debility. Doses 3i to 3ii as an antiperiodic and antispasmodic, from 40 to 90 grains as a tonic." (Honarary Surgeon Modeen Sheriff, Khan Bahadur, Triplicane, Madras) "A cake made of 30 grains of the powdered kernel, the contents of one egg, and fried in ghee, is taken twice a day in cases of acute orchitis, ovaritis, and scrofula. The kernel made into a paste is used locally for scorpion stings." (Surgeon W.A. Lee, Mangalore.) "The leaves, boiled with castor oil or ghi, are thickly applied on painful and swollen testicles. The tender leaves are said to be most efficacious' (Honorary Surgeon P. Kinsley, Ganjam, Madras) (Dictionary Of The Economic Products Of India).

Staying a step ahead of aging

Gina Kolata

YOU know what is supposed to happen when you grow old. You will slow down, you will grow weak, your steps will become short and mincing, and you will lose your sense of balance. That's what aging researchers consistently find, and it's no surprise to most of us.

But it is worth remembering that the people in those studies were sedentary, said Dr. Vonda Wright, a professor of orthopedics at the University of Pittsburgh.

Dr. Wright, a 40-year-old runner, decided to study people who kept training as they got older or began competing in middle age. She wanted to know what happens to them and at what age does performance start to decline.

Their results are surprising, even to many of the researchers themselves. The investigators find that while you will slow down as you age, you may be able to stave off more of the deterioration than you thought. Researchers also report that people can start later in life - one man took up running at 62 and ran his first marathon, a year later, in 3 hours 25 minutes.

It's a testament to how adaptable the human body is, researchers said, that people can start serious training at an older age and become highly competitive. It also is testament to their findings that some physiological factors needed for a good performance are not much affected by age.

Researchers say that you should be able to maintain your muscles as you age, including the muscle enzymes needed for good athletic performance, and you should be able to maintain your ability to exercise for long periods near your so-called lactic threshold, meaning you are near maximum effort.

But you have to know how to train, doing the right sort of exercise, and you must keep it up.

"Train hard and train often," said Hirofumi Tanaka, a 41-year-old soccer player and exercise physiologist at the University of Texas.

Dr. Tanaka said he means doing things like regular interval training, repeatedly going all out, easing up, then going all out again. These workouts train your body to increase its oxygen consumption by allowing you to maintain an intense effort.

"One of the major determinants of endurance performance is oxygen consumption," Dr. Tanaka said. "You have to make training as intense as you can." When you have to choose between hard and often, choose hard, said Steven Hawkins, an exercise physiologist at the University of Southern California.

"High performance is really determined more by intensity than volume," he added. "Sometimes, when you're older, something has to give. You can't have both so you have to cut back on the volume. You need more rest days."

Dr. Hawkins, who says he no longer runs competitively, adds that he tries to put his findings into practice. "I run a couple of times a week and I try to make it as fast as I can," he said. "I'm not plodding along."

He also has been amazed by some people who seem to defy the rules of aging, people he describes as "those rare birds who get faster." Some subjects in Dr. Hawkins's research study, which followed runners for nearly two decades, actually had better times when they were 60 than when they were 50.

"We really don't know why," Dr. Hawkins confessed. "Maybe they were training harder."

Then there are people like the 62-year-old man who suddenly took up running and began running fast marathons. That man's inspiration to become a runner, said James Hagberg, an exercise physiologist at the University of Maryland, was watching a lakefront marathon in Milwaukee. "He got all fired up," Dr. Hagberg recalled.

And there are people like Imme Dyson, a 71-year-old runner who lives in Princeton, N.J. She took up running when she was 48 and loved it, she says, from the moment she put on a pair of running shoes. Her daughter, who had been a college triathlete, told her how to train.

"She said, 'Mom, if your workout didn't hurt, you didn't work hard enough,' " Ms. Dyson said.

"Working consistently really is the recipe," she said. And it has made a difference for her, allowing her to run races, from 5K to marathons, so fast that she is consistently among the best in the nation in her age group. She has run a 15K cross-country race in 1:19:08, a pace of 8:29 a mile. And she ran a 10K race in 51 minutes 50 seconds, a pace of 8:20 a mile.

Not every aging athlete does so well. But Dr. Hagberg found that studies of aging athletes sometimes were distorted because they included people who had cut back on or stopped training. That's understandable; there is no reason, researchers say, to exhort everyone to maintain an intense effort decade after decade.

Managing post-traumatic stress disorder

Benedict Carey

About one in six combat troops returning from Iraq have suffered at least one concussion in the war, injuries that, while temporary, could heighten their risk of developing post-traumatic stress disorder, researchers are reporting.

The study, in The New England Journal of Medicine, is the military's first large-scale effort to gauge the effect of mild head injuries - concussions, many of them from roadside blasts - that some experts worry may be causing a host of undiagnosed neurological deficiencies.

The new report found that soldiers who had concussions were more likely than those with other injuries to report a variety of physical and mental symptoms in their first months back home, including headaches, poor sleep and balance problems. But they were also at higher risk for the stress disorder, or PTSD, and that accounted for most of the difference in complaints, the researchers concluded. Symptoms of the disorder include irritability, sleep problems and flashbacks.

Experts cautioned that the study had not been designed to detect subtle changes in mental performance, like slips in concentration or short-term memory, that might have developed in the wake of a concussion and might be unrelated to stress reactions. Many returning veterans are still struggling with those problems, which can linger for months.

The findings are in line with previous research linking concussions to post-traumatic stress disorder that develops after frightening events outside a military context, like car accidents; concussions from athletic collisions rarely lead to the disorder.

"This study is a very good first step, and an important one, but like any first step it should lead us to ask further questions about these injuries," said Brian Levine, a neuropsychologist at the Rotman Research Institute and the University of Toronto, who was not involved in the study.

Now that the prevalence of combat concussions is better known, Dr. Levine said, the next step should be to assess troops' cognitive functioning early on and track it over time, before and after combat.

In the study, military psychiatrists had 2,525 soldiers from two Army infantry brigades fill out questionnaires asking about missed workdays and dozens of kinds of physical and emotional difficulties, including symptoms of PTSD. The soldiers had been back home from Iraq for three to four months.

The questionnaires also asked about concussions and their severity. A concussion is an injury from a blow or shock to the head that causes temporary confusion or loss of consciousness, without any visible brain damage. The investigators found that 384 of the soldiers, or 15 percent, reported at least one concussion. One-third of that 15 percent had blacked out when injured.

The severity of the concussion was related to the risk of developing the stress disorder, the survey showed. Nearly 44 percent of the soldiers who had blacked out qualified for the diagnosis, about three times the rate found in soldiers with other injuries. Among soldiers who did not black out, the rate of PTSD was 27 percent, significantly higher than the 16 percent rate among veterans with other kinds of injuries.

"There's a lot we don't know about these injuries, but we do know that context is important," said the lead author, Dr. Charles W. Hoge, director of the division of psychiatry and neuroscience at the Walter Reed Army Institute of Research. "Being in combat, you're going to be in a physiologically heightened state already. Now imagine a blast that knocks you unconscious - an extremely close call on your own life, and maybe your buddy went down. So you've got the trauma, and maybe the effect of the concussion is to make it worse."

In an editorial that accompanied the study, Richard A. Bryant, a psychologist at the University of New South Wales in Australia, emphasized that concussed troops "should not be led to believe that they have a brain injury that will result in permanent damage."

On the contrary, Dr. Bryant and other experts say, the link to post-traumatic stress suggests that mild brain injuries have a significant psychological component, which can improve with treatment.

Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America, said the study, and the interest of doctors and military officials in brain trauma, were long overdue.