ALLIUM AND ANTHRAX
Garlic vs Cipro???


by Jim Duke

DRAFT: We three Duke boys, chronologically, Ed, Jim and Dan, couldn't readily afford Duke University but we between us accumulated 7 or 8 degrees at the University of North Carolina (UNC). I first started UNC at Chapel Hill in 1948, as a music major, playing jazz with John Satterfield's big jazz band. I quickly switched to a botany major. By the time I finally left, in 1960, I had taken three degrees there. But I had never worn a cap and gown. I wore my first cap and gown, at the 208th birthday of the University, Oct. 12, 2001. Fortunately, for my waning career, I had been designated as a Distinguished Alumnus, sharing the podium and honors that day with three other distinguished alumni. They were, Hugh Leon McColl, a very distinguished financeer; Anthony Eden Rand, a very distinguished politician, Dr. P. Kay Wagoner, a very distinguished medical researcher, and me, Dr. James A, Duke, a nearly extinguished herbal advocate.

It was so nice to see Dr and Mrs. John Satterfield following the ceremonies at a celebratory barbecue in Lowe's Grove. John recounted how he was infuriated by the glowing advertisements for Zocor for high cholesterol. Matter of fact, John had a hypocomplimentary opinion of this hypocholesterolemic drug, one of the many statins, many of them in the billion dollar pharmaceutical category (sales over a billion a year). And he had not even read what the Felix Letter (No. 116 & 117, p. 4, 2001) had to say about the statins. "The statin story is not improving. In August the German drug-maker Bayer AG withdrew its statin drug from the market after Baycol (cervistatin) was found responsible for 31 deaths from a muscle-destroying side effect. Soon afterward, consumer watchdog Public Citizens petitioned our government 'to require manufacturers to give warning brochures to the 12 million Americans who take those medicines - statins - telling them to quit the pills at the first sign of muscle pain or weakness." (Felix Letter, 2001). [It is Bayer who may have tried to stifle competition with its patent on Cipro. That will bear watching in the month ahead. But suppose garlic juice were almost as efficacious and had fewer side effects and cost significantly les than Cipro].

But today, irrationally, we are more worried about anthrax than cardiopathy. Tobacco is probably our biggest killer, with anthrax way back there. But anthraxophobia prevails, consuming 90% of our TV news specials. Let me voice my controversial personal opinion; antiseptic and immunostimulant garlic, in combination with antiseptic and immunostimulant echinacea, could possibly do more for the prevention of anthrax than Cipro. We won't really know until they have been clinically compared. Last week, scientists said on TV that there is no statistical proof that Cipro can prevent X percent of anthrax (X could of course be 0% or 100%. I have no proof either that garlic can prevent X percent of anthrax. BUT! Garlic and echinacea will not lead to antibiotic resistance as will prolonged prophylactic use of Cipro". But you can bet a lot of Americans are already hoarding Cipro for prophylactic use. Surprisingly, a PubMed search for Cipro and Anthrax turned up only 3 abstracts, none stating that Cipro could clinically cure anthrax. True confessions: a PubMed search for garlic and Anthrax turned up no abstracts at all. Still I feel that garlic would be better than nothing for treating anthrax.

In the contagious unit at Breslau, gravediggers chewed garlic every day. Cerca 1540, Hieronymus Bock wrote "Eating garlic prevents all poisoning all tired field workers who in the heat would drink polluted soft water and therefore many a germ grow which can be overcome by garlic. When Basle suffered the great plague, the Jewish population who regularly consumed garlic, had a lower incidence of fatalities. During a breakout in Marseilles (1721), thieves robbed the sick and dead without themselves becoming sick. Four prisoners who were caught attributed their survival to regular consumption of wine, garlic, and vinegar, the so-called "Four Thieves Vinegar". This also proved useful in Bulgarian cholera epidemic in 1848.(LAW)

Yes, if garlic could prophylactically protect thieves from the plague, it might possibly help prevent successes of the bungling efforts of copy-cat terrorists trying to scare us to death with anthrax mailings, a/o public relations experts selling more of their books and newscasts by frightening the gullible American public. I hope but doubt that our anthrax tests are perfect, maybe somewhere between the accuracy of the tests for lyme disease and thyroid. But still today they talk about "presumptive positives" for anthrax, whatever that means. Makes me presume they may be right or wrong. And I fear it is equally "presumptive" that Cipro will help. I have seen no clinical data to prove that Cipro has helped anthrax in humans. Still I too would resort to Cipro and garlic if both were available to me.

Does garlic boost the immune system? Garlic tablets enhance natural killer cells in vitro which are important in fighting certain bacteria. Aqueous extracts and polar fractions increase interleukin-1 production. The thiosulfinate fraction enhanced natural killer cell activity. All three fractions increased interleukin-2 production. Echinacea is even better known as an immune booster, but not so well known as an antianthrax herb. But the early eclectics used echinacea for anthrax. Today, we discuss the garlic mentioned in the Holy Bible, an herb or spice may assume more importance in the holy war facing us. Next week I'll discuss the related onion, juices of which might also help against anthrax, both by boosting the immune system and by a battery of antibacterial compounds.

Anyone interested in learning more about the antibacillary activities of garlic should visit Koch and Lawson's great book. Though there is nothing there that specifically mentions anthrax, there are a several interesting comments. "[E]limination from crushed garlic of a class of volatile compounds called thiosulfinates, of which allicin is the most abundant, results in the removal of all or most of garlic's antibacterial effects. . . Since the thiosulfinates are very effective antibacterial and antifungal agents, it has been proposed that they 'offer the plant protection against the bulb decay induced by fungi.'. . ." Garlic can contain as much as 27,800 ppms allicin, and 40,000 ppms of its precursor alliin, as well as 278 ppms ajoene, on a zero-moisture basis..

Koch and Lawson also mention the Brazilian "garlicina" alias "Machado's garlicin" but that is just one of dozen's of garlic products, poorly defined, among many well defined garlic products that have proven antibacterial activity. I still think most highly of the whole fresh garlic than any of the derivative products. But I do enjoy cooked garlic squeezed onto olive-oil soaked whole grain bread, a real holistic wholesome heart healthy hypocholesterolemic habit. And yes, garlic is probably better at preventing heart disease than anthrax. But when it comes to antisepsis and immunostimulation, perhaps every little bit helps.

I'm not sure that Escherichia and Staph are any more (or less) sensitive than anthrax and plague to garlic and its compounds. There is an interesting comparison of the MIC (Minimum Inhibitory Concentration) levels or garlic oil and some garlic constituents. I'd still bet that whole garlic (with comparable levels of allicin) would excel an equivalent amount of pure allicin for these and other bacteria, including anthrax.

GARLIC COMPOUND STAPHYLOCOCCUS ESCHERICHIA AUREUS COLI
ALLICIN MIC=27 UG/ML MIC=27 UG/ML
AJOENE MIC=55 UG/ML MIC=150 UG/ML
DIALLYL TETRASULFIDE MIC=130 UG/ML MIC=1000 UG/ML
DIALLYL TRISULFIDE MIC=250 UG/ML MIC=1900 UG/ML
DIALLYL DISULFIDE MIC=900 UG/ML MIC=1900 UG/ML
DIALLYL SULFIDE MIC=>2,500 UG/ML MIC=>2,500 UG/ML
ALLYL MERCAPTAN MIC=>4000 UG/ML MIC=>4000 UG/ML
S-ALLYLCYSTEINE MIC=>4000 UG/ML MIC=>4000 UG/ML
S-ALLYLMERCAPTOCYSTEINE MIC=2000 UG/ML MIC=>4000 UG/ML
GARLIC OIL(STEAM-DISTILLED)MIC=80 UG/ML MIC=2000 UG/ML
ANTIBACTERIAL COMPOUNDS IN GARLIC (AFTER KOCH AND LAWSON, 1996)

Antibacterial and antifungal effects of aqueous garlic extracts are abolished when thiosulfinates are removed (with chloroform at least). Since antibiotic activity parallels allicin stability, chemical stabilization (e.g. storage in 2% vinegar) preserves the activity undiminished for up to 4 months. Even at dilutions of 1:85,000 to 1:125,000 allicin inhibits a variety of Gram(+) and Gram(-) bacteria. The antibiotic activity of one milligram allicin equals that of 15 IU penicillin.

No wonder it has been called Russian penicillin. [[Regrettably, one of the three Cipro abstracts says "Despite the sensitivity of B. anthracis to penicillin, treatment is rarely successful." Debord and Vidal, 1998) Ajoene is almost as active as allicin, and both occur in garlic and onion. The activity of the steam-distilled oil is significant against S. aureus, ca 4 times more than expected from the individual activities of the individual components, suggesting synergism. That tells me that "The whole garlic is better than isolated silver bullets derived therefrom!" If I knew I had been hit with anthrax, and was being given Cipro, I'd still also take my garlic and onion [and walnut extract (said to be more effectvie against Bacillus anthrax than B. subtilis)]. Why? Koch and Lawson tells us that "The combination of garlic extracts with antibiotics leads to partial or total synergism, mainly against aerobic bacteria. . .This is true also for other Allium species, such as for wild garlic (A. ursinum), elephant garlic (A. ampeloprasum), shallots (A. ascalonium), Chinese chives (A. tuberosum) and Japanese bunching onions (A. fistulosum) and others. Allicin also enhances "in a synergistic manner, the effectiveness of antibiotics such as streptomycin or chloroamphenicol, against, for instance, Mycobacterium tuberculosis." Pediatric cases of dyspepsia, gastroenterosis, nephrosis, pneumonia and sepsis have responded to garlic preparations. Merely eating garlic lowered the incidence of dysentery in Soviet soldiers. (LAW)

Not to minimize onion. It shares many of these antibiotic phytochemcials and others too. But I'll talk about that next week, assuming anthraxaphobia is still epidemic. There is no epidemic of anthrax, just an epidemic of anthraxophobia.

Pasteur was the first to demonstrate the antibacterial effects of onion and garlic juices. Schweitzer first treated amebic dysentery with garlic. Even acid fast bacteria, like Mycobacterium tuberculosis and M. leprae are not resistant to the antibiotic action of garlic. Raw juices of garlic and onion were highly effective against Bacillus subtilis, Candida, Escherichia coli, Klebsiella, Micrococcus, Pseudomonas, Salmonella.,and Staphylococcus aureus. Remarkably, pathogenic intestinal bacteria are more easily inhibited by garlic than those bacteria which are part of the normal intestinal flora The IC50 values of a garlic extract ranged from 1.34-3.35 mg/ml in 30 mycobacteria strains. The IC50 for six strains of M. tuberculosis was 1.34 mg/ml. Not only does garlic have "strong antibiotic properties, the complete lack of resistance of germs to garlic has been found repeatedly "(LAW). So unlike Cipro, the broad spectrum antibiotic garlic does not lead to antibiotic resistance. How many bactericides does garlic contain, in addition to those tabulated above: ajoene ;allicin ; alliin ; allistatin-i ; allistatin-ii ; ascorbic-acid ; beta-sitosterol ; caffeic-acid ; chlorogenic-acid ; chlorophyll ; citral ; diallyl-disulfide ; diallyl-trisulfide ; ferulic-acid ; geraniol ; kaempferol ; lignin ; p-coumaric-acid ; p-hydroxybenzoic-acid ; pectin ; quercetin ; rutin ; salicylic-acid ; sinapic-acid ; and vanillic-acid

Saliva and blood do not seem to deactivate garlic phytochemicals, while other body fluids (gall, gastric juices, and urine) seem to enhance the activity of the garlic constituents. Excretion of the active ingredients in urine does not occur before 6 hours after oral administration.

Not too long ago, People Magazine faxed me in the Peruvian Amazon asking me 13 questions about the 13 herbs I take most regularly. I decided at that point that these were the questions that the People-reading people or should I have said the people reading People, would be most likely to ask. That's why I took the arrival of the 13 questions as a good omen, guiding me to 13 questions, which American people are most likely to ask about the 13 herbs I take most frequently, the so-called Duke's Dozen. Here are my responses for garlic

1. What plant part(s) is(are) used? The bulbs, individually known as cloves, not to be confused with the spice called cloves. All parts of the garlic contain some active sulfureous phytochemicals, and the seeds, not usually used in modern herbalism, may be proportionately richer in phytosterols.

2. Where is the plant found? Now grown by serious gardeners around the world, garlic is probably native to the Middle East, certainly not known in America before Columbus. Garlic and onion were mentioned in the Bible.

3. What have been the traditional uses? Few herbs have more folklore attached to them, and few herbs have more phytochemicals that can rationalize the folklore.

4. What ailments does it help alleviate, cure or prevent? cancer, candidiasis, cardiopathy, colds, flu, high blood pressure, high cholesterol, high triglycerides, impotence, sepsis, etc. etc. ad nauseum, maybe even anthrax.

5. How is it beneficial? The sulfureous compounds can explain most of the proven biological activities of this marvelous, food, herb, medicine, spice

6. Do scientists generally agree that it works? This one, still heavily accepted in Europe as a phytomedicinal, probably has a slight edge over echinacea among American allopathic physicians. Herbalists, nurses, pharmacists, and european physicians are much more inclined to accept the credible studies on garlic than american allopaths. Of all the herbs mentioned in my Duke's Dozen, I think the garlic and the ginkgo have made the biggest dent in the fixed fortress of physicians,. But we have a long way to go.

7. Do you think it works? I take the echinacea and the garlic everytime I feel my immune system needs a little help, like when the grandchildren come, or when I am travelling (although I may shy from the aromatic garlic and stress the echinacea on the road to meetings, not wanting to offend my co-conventioneers. And now, I'd boost my immune system if I suspected anthrax attacks, bubonic plague, smallpox or west nile virus.

8. Why is it so popular now? It's been popular for more than 2 millennia. Some say garlic built the pyramids. None of the synthetic medicines have been with us 200 years, yet, much less 2,000 years.

9. Does it deserve such popularity? Yes. Russian penicillin ain't a bad name at all.

10. Who should take it? Who should not? I think of it as a safe immune boosting gentle antibiotic that should be taken before the hardline antibiotics of last resort. A daily clove of garlic would do more good for American than any one 5 g dose of veggie I can think of, except maybe onion. That includes many hypercholesterolemics, hyperglycemics, and hypertensives, I know people allergic to garlic and they know better than I that they should not take it.

11. How should one take it (pill, tea, tincture)? This one I prefer to take as food at home, in juices, soups and stews, and even as a spread, baked, on bread, as a food farmaceutical. On the road though, I'll take the capsules or tablets, deodorized if I have too many social obligations.

12. Are there side effects? Any risk of overdosing? Some people will react to overdoses of garlic. You can overdose on anything, even a good food farmaceutical like garlic.

13. Anything surprising or unusual? None that I know of.

And while I am talking herbal alternatives, I think, as I thought two years ago when CNN visted my home, hoping that I would bad mouth garlics hypocholesterolemic activity; I still believe that Americans, especially we senior citizens, should try whole natural garlic before we resort to statin drugs for lowering cholesterol. yes the statins almost killed Dr. Satterfield and his wife, already in their 70s, when their doctor suggested they lower their cholesterol to lower their incidence of heart attack. But this year we learn anew, that too low cholesterol is associated with a higher, not a lower incidence of cardiopathy (Schatz et al, 2001).

I don't think that natural polychemical drugs like garlic in their evolutionary context, having long coevolved with man, are as liable to develop antibiotic resistance or to have harmful side effects, as compared to synthetic monochemicals. The latter may be significantly more active for a year or two, but then comes resistance.

Here's what I said about garlic in my medicinal plants of the Bible (1983)

ALLIUM SATIVUM L.
Garlic

...We remember the fish...and the onion, and the garlick...
Numbers 11

Garlic is cultivated for the underground bulb which has a strong flavor and pungent odor. It is used fresh, dried or powdered as a seasoning, rather than as a vegetable. For most purposes it should be crushed very finely and used in moderation. If fried in fat or oil too hot, it develops an acrid flavor. Bulbs yield 0.6-0. 1% of an essential oil containing allyl propyl disulphide, diallyl disulphide and two other sulfur compounds, allicin and allisatin Hippocrates prescribed eating garlic as treatment for uterine tumors. The Bower manuscript, dating about AD 450 in India, recommended garlic for abdominal tumors. The NCI files report that cancer incidence in France is supposedly lowest where garlic consumption is greatest, that garlic eaters in Bulgaria do not have cancer, and that a physician in Victoria, British Columbia, related that he has successfully treated malignancies by prescribing garlic eating. Garlic extracts contain a powerful bactericide, allyl thiosulfinic allyl ester or allicin, formed by the interaction of a garlic enzyme alliinase and the substrate S ethyl L-cysteine sulfoxide. When enzyme or substrate was inoculated into mice with sarcoma, all animals died within 16 days; when enzyme was allowed to react with substrate, followed by administration to the tumor-bearing animals, no tumor growth occurred and the animals remained alive during a six-month observation period. Recent Italian studies suggest that feeding garlic to pigs instead of zinc bacitracin is bet- ter because its antibiotic activity is as great while it stimulates growth without affecting the organoleptic qualities of the pork.

Said to be alexiteric, amebicidal, antiseptic, ascaricidal, bactericide, carminative, cholagogue, demulcent, diaphoretic, digestive, diuretic, emmemagogue, expectorant, rubefacient, sedative, stimulant, stomachic, tonic, and vermifuge, garlic is one of the most versatile of folk medicines. It is said to be useful in alopecia, angina, anthrax, arteriosclerosis, arthritis, asthma, baldness, bilious ailments, bronchitis, bronchiectasis, bugbite, burns, calluses, cancer, catarrh, cholera, cold, colic, consumption, corns, coughs, cramps, dandruff, diabetes, diarrhea, diptheria, dropsy, dysentery, dysmenorrhea, dyspepsia, earache, eczema, egilops, epilepsy, felons, fever, flatulence, gallbladder, gangrene, gastroenteritis, heart, hematuria, hepatitis, hoarseness, hypertension, hypotension, hysteria, indigestion, itch, jaundice, leprosy, leukemia, lungs, lupus, malaria, melancholy, neurosis, oliguria, paratyphoid, parturition, phthisis, piles, pinworms, plague, polyps, prostatitis, rabies, rheumatism, ringworm, scabies, sclerosis, scrofula, senescence, sinusitis, skin, smallpox, snakebite, sores, spasms, splenitis, stings, stomach, stomachache, stones, sunstroke, thirst, thrush, tinea, toothache, trichomoniasis, tuberculosis, tumors, typhoid, ulcers, vaginitis, warts, wens, whitlow, whooping cough, worms, and wounds. Extracts of garlic have shown marked larvicidal activity. It is believed by some to be a cancer preventative. Its reputed action in alleviating problems caused by putrefactive intestinal bacteria might be useful in preventing cancer of the colon. Garlic is rather highly regarded for lowering blood pressure and counteracting arteriosclerosis. Among cancerous ailments, Hartwell mentions the following as treated by garlic in home remedies: cancer of the skin, uterus, fibroids, and neoplasms, sclerosis of the uterus, seed warts, tumor of the abdomen, bladder, glands, and uterus. Inhalations of the stalk are said to be a folk rememdy for uterine tumors, fibroids, polyps and neoplasms. A poultice of the bulb is said to help tumors (bladder, uterus), an ointment of the root to remedy cold tumors and corns. An ointment of the juice is said to correct hard swellings and skin cancer. Contains the antibiotic and antifungal allicin and has shown antitumor activity. Without citing all the evidence, M. Walker says that garlic is successful in treatment of anemia, arthritis, asthma, colds, cough, diabetes, diptheria, dysentery, gas, gastrointestinal disorder, hypotension, hypertension, intestinal putrefaction, intestinal worms, pneumonia, tuberculosis, typhus, and whooping cough. Recent studies document the fungicidal activity of garlic extracts against Candida albicans, show that low concentrations of garlic extract are both lethal and inhibitory to numerous strains of Cvyptococcus neoformans, and document a hypocholesterolaemic effect. In Science 204 (20):293 (1978) we read that garlic and onions have long been reputed to have such mystical powers as the ability to stimulate bile production, lower blood sugar, alleviate hypertension, speed healing of gunshot wounds, cure scorpion bites, freckles, and the common cold. Garlic is considered aphrodisiac, carminative, diaphoretic, diuretic, expectorant, stimulant, and stomachic. It is used in cough, fevers, and intermittent fever. The juice is rubefacient, mixed with oil, it is useful for curing skin diseases, ulcers, wounds, insect bites, and as eardrops for earache. As an expectorant, it is useful as a potent remedial agent in the treatment of TB. As an anthelmintic for tapeworms, garlic is eaten along with prescribed medicine. It acts as an anodyne in headaches, earaches and rheumatic pains. Oil of garlic is used for flavorings and medicinal uses, being known for these purposes by the ancient Hindus. Lebanese believe that eating garlic freely prevents infection, malaria and typhoid, and cures tuberculosis, mitigates stroke, and reduces blood clots, promoting virility all the while Seeds are sold in Iranian bazaars for use as a demulcent, purgative and stimulant especially in cases of typhoid fever.

And here's the chapter from my upcoming Herbal Desk reference
GARLIC (Allium sativum L.) +++

PL973 (KAB); Foom (Arabic); Lehsun (Urdu); Saum (Arabic); Seer (Farsi); Taum (Arabic); Da Suan (Pinyin)

(For much more information, see Koch & Lawson's excellent Garlic Book (KAL): I don't have time to read and rescore, but if they tabulate clinical trials demonstrating efficacy of whole garlic, it should get a 3)

ACTIVITIES (GARLIC): Acarifuge (1; KAL); Alterative (f; KAP; PED); \Alexeteric (f; KAB); Amebicide (1; APA; X11101670); Analgesic (1; BGB); Anodyne (f; DAD); Androgenic (1; KAL); Anthelminthic (1; KAL; WHO); \Antiaflatoxin (1; X1394115); Antiaggregant (3; APA; FNF; KOM; PH2; SHT); Antiallergy (1; AKT); Antiandrogenic (1; DAD); Antiarteriosclerotic (2; KAL); Antiarthritic (1; KAL); Antiatherogenic (2; BGB; WHO); Antibiotic (2; AKT; PNC; PED); Anticancer (1; KAL; SKY); Anticholinesterase (1; KAL); Antidiabetic (1; KAL; PNC); Antidote (f; WO2); Antifertility (1; KAL; WO2); Antifungal (2; KAL;SKY); Antigiardal (1; X11101670); Antihepatotoxic (1; CAN; KAL); Antihypercholesterolemic (1; WHO); \Antihyperglycemic (1; KAP); Antihyperlipidemic (1; WHO); Antihypertensive (1; SKY; WHO); Antiinflammatory (1; APA; BGB). Antiintegrase (1; KAL); Antioxidant (1; KAL; SHT; WO3); Antimycotic (2; BGB; KAL); Antioxidant (1; AKT; PH2); Antiplatelet (1; WHO); Antiprostaglandin (1; WHO); Antipyretic (1; WHO); Antirheumatic (1; KAL); Antiseptic (3; AKT; APA; PH2; PNC; SKY); Antispasmodic (1; PED; WHO); Antistress (1; KAL); Antithrombotic (1; FAY; PH2; PNC); Antithyroid (1; KAL); Antitumor (1; BGB; PNC); Antiulcer (1; X11238826); Antiviral (1; AKT; APA; KAL; SKY); Aphrodisiac (1; DAD; WHO); Bactericide (2; AKT; FAD; KOM; SKY; WHO); Cardiotonic (1; AKT; JFM); Carminative (1; PED; RIN; WHO); Choleretic (1; MAM); Decongestant (1; FAY); Detoxicant (f; AKT; FAY); Diaphoretic (f; JFM; PED; PNC); Digestive (1; AKT; PED); Diuretic (1; FAD; WHO); Edemagenic (1; WO3); Emmenagogue (1; JFM; WHO); Estrogenic (1; KAL); Expectorant (f; PED: PNC; WOI); Fibrinolytic (3; APA; KAL; KOM; PH2); Fungicide (2; FAD; KOM); (2; MAM); \Gastrotonic (f; KAB); Glutathionigenic (1; PH2); Hepatoprotective (1; BGB; JFM; WO3;); Hyperglycemic (1; PNC); Hypocholesterolemic (2; AKT; DAD; FAD; PH2; SHT); Hypoglycemic (1; DAD; KAL; PED; PNC); Hypolipidemic (1; BGB; DAD; PED; PNC); Hypoperistaltic (2; WHO); Hypotensive (2; AKT; BGB; FAD; SHT); Hypotriglyceridoc (1; AKT); Hypouricemic (f; JFM); Immunostimulant (1; AKT; BGB; CAN; FAY; PED); Insectifuge (1; KAL); Insulin-sparing (1; PNC); Interleukenogenic (1; WO3); Larvicide (1; WO2); Lipogenic (f; KAB); Lipolytic (2; KOM; PH2; SHT; WHO); Lymphocytogenic (1; AKT); Myocontractant (1; CAN); Myorelaxant (1; CAN); Nervine (PED); NKC-Enhancer (1; AKT; PH2); NO-Genic (1; KAL); \Orexigenic (f; KAB); Ovicide (1; WO3); Oxytocic (1; WO2); Parasiticide (1; AKT); Phagocytotic (1; AKT); Protisticide (1; KAL); Rubefacient (f; JFM); Sedative (1; WHO); Spermicide (1; KAL); \Tonic (f; KAB); Vasodilator (1; SHT; WHO); Vermifuge (1; AKT; APA);Vulnerary (1; PED).

INDICATIONS (GARLIC): Abscess (1; DAA; PNC); Acne (f; FAD); Adenopathy (f; JLH); Aegilops (f; JLH); Aging (1; PH2); Allery (1; AKT); Alopecia (1; WHO; WO2); Amebiasis (2; FAY; PNC); Anemia (f; DAD); Anorexia (f; FAY); Appendicitis (1; FAY; PNC); Aphthae (1; KAL); Arteriosclerosis (2; BGB; BIS; FAD; KAL; PH2); Arthrosis (1; FAD; KAL; PHR; PH2); Asthma (1; PNC; WHO); Atherosclerosis (3; AKT; APA; PHR; SHT: WHO); Athlete's Foot (2; TGP); \Bacillus (1; LAW); Bacteria (1; JFM; PH2); Bite (f; FAY; JFM); Boil (1; DAA); Bronchiestasis (1; KAL); Bronchosis (2; FAD; PHR; PH2; WHO); Burn (2; KAL); Callus (f; JFM; PH2; Cancer (2; AKT; FAD; PH2); Cancer, abdomen (1; AKT; FNF; JLH); Cancer, bladder (1; FNF; JLH; X11341051; X11238818); Cancer, breast (1; BRU); Cancer, colon (1; AKT; FNF; JLH; X11238811) ; Cancer, gland (1; FNF; JLH); Cancer, lung (1; BRU; FNF; JLH); Cancer, prostate (1; X11102955); Cancer, skin (1; FNF; JLH); Cancer, stomach (1; AKT; X11238811); Cancer, uterus (1; FNF; JLH); Candidiasis (2; CAN; KAL); Carbuncle (f; FAY); Cardiopathy (3; BGB; FAD; SKY); \Caries (1; FNF; KAB); Catarrh (1; AKT; BGB);; Celiac (1; KAL); Childbirth (f; JFM; KAB); Cholecocystosis (f; APA); Cholera (1; PNC); Chronic Fatigue (f; JFM); Coccidiosis (1; KAL) Cold (2; AKT; FAD; PHR; PNC); Colic (1; WHO); \Colosis (1; KAL; LAW); Congestion (1; FAY); Constipation (f; JFM; PH2); Convulsions (f; KAB; PHR); Corn (f; JLH; PHR); Cough (2; APA; FAD; PHR); Cramp (f; PH2); Cryptococcus (1; DAA); Cystosis (f; JFM); Cytomegalovirus (1; KAL); \Deafness (f; LAW); Debility (f; PH2); Dementia (1; X11238823); Dermatosis (1; AKT; DAA; DAD; KAL; PNC); Diabetes (1; MAM; PH2; PNC); Diarrhea (1; AKT; PNC); Diptheria (f; DAA; DAD); \Dropsy (f; KAB); Dyspepsia (1; AKT; JFM; KAL); Dysentery (2; AKT; DAD; FAD; PNC); Dysmenorrhea (f; PHR; PH2); Dyspepsia (1; BIS; PNC; WHO); Dyspnea (1; FAD; FAY); Earache (1; FAD); Edema (f; JFM; PNC); Enterosis (2; AKT; APA; FAD; PH2; WHO); Epigastrosis (2; WHO); Epilepsy (f; AKT; FAY); Escherichia (1; LAW; WO2); Felon (f; JLH); Fever (2; FAD; PHR; PH2); Fibrinolytic (SHT); Fibroid (f; DAD; JLH); Filaria (1; KAL); Flatulence (1; WHO); Flu (1; AKT; APA; KAL; PNC); Fungus (1; AKT; JFM); \Gangrene (f; KAP); Gas (f; dad; JFM; PH2); Gastroenterosis (2; BIS; DAD; FAD); Gastrosis (2; AKT; FAD; FAY; PH2; WHO); Giardia (1; KAL; X11101670); Gout (f; DEP; FAD; JFM); Headache (f; JFM); Helicobacter (1; AKT; X11238826); Hemorrhoid (f; JFM); Hepatosis (1; APA); Hepatotoxicity (Acetaminophen; 2; MAM); Herpes (1; KAL); High Bloodpressure (2; AKT; FAD; PH2; SHT; WHO); High Cholesterol (3; AKT; APA; KAL; PH2; SHT); High Triglycerides (3; AKT; APA; KAL; SHT); HIV (1; KAL); Hookworm (1; AKT; KAL; WHO); Hyperlipidemia (3; SHT; WHO); Hyperperistalsis (2; WHO); Hypoglycemia (f; FAY); Hypotension (f; DAD); Hysteria (f; JFM); Immunosuppression (2; PHR; SKY); Impotence (1; AKT; X11238821 ); Induration (f; JLH); Infection (2; AKT; JFM; SHT); Inflammation (f; JFM); Insanity (f; AKT); Insomnia (f; JFM); Intermittent Claudication (2; BGB; SHT; TGP); Keratosis (1; KAL); Lambliasis (1; KAL); Laryngosis (1; KAL; KAP); Lead Poisoning (1; PNC); Leishmaniasis (1: X11119248) Leprosy (f; JFM); Leukemia (f; JLH); \Leukoderma (f; KAB); Lumbago (f; PH2); Lupus (f; KAL); Lymphoma (f; JLH); Malaria (f; DAD; JFM); Mange (f; JFM); Melancholy (f; JFM); Meningosis (f; DAA); Menopause (f; JFM); Mucososis (1; KAL); Myalgia (f; PHR; PH2); Mycosis (1; AKT; PNC); Myofascitis (f; DAA); Nausea (1; WHO); Nephrosis (1; KAL); Neuralgia (1; KAL; PHR); Nicotinism (1; KAL); \Odontosis (f; KAB); Otitis (1; FAD; SKY); Pain (f; JFM; PH2); Palpitation (f; JFM); Paradentosis (1; KAL); \Paralysis (f; KAB); Parasite (1; AT); \Paratyphoid (f; KAP); \Paratyphus (f; LAW); Periodontosis (1; LAW); Pertussis (2; DAD; FAD; FAY; PNC); Pharyngosis (2; PHR); Pinworm (1; AKT; FAY); Pneumonia (1; DAD; KAL); Poliomyelitis (1; KAL; LAW); Polyp (f; JLH); \Pulmonosis (f; KAP); \Pulposis (1; LAW); Raynaud's Disease (2; TGP); Respirosis (1; AKT; BGB; KAL; PH2; WHO); Rheumatism (1; FAD; KAL; PH2); Rhinosis (2; BGB); Ringworm (1; APA; DAA; WHO); Roundworm (1; KAL; WHO); Salmonella (1; WO2); Scabies (1; DAA; JFM); Sciatica (f; PHR; PH2); Senile Dementia (1; KAL; X11238823); Sepsis (1; KAL); Shigella (1; LAW; WO2); Sinusosis (1; FAY); (f; Snakebite (f; FAD; FAY); Sore (1; FAD; JFM); Sore Throat (1; KAL); Soroche (f; KAL); \Splenosis (f; KAB); Sporotrichosis (1; KAL); \Staphylococcus (1; LAW); Stomachache (f; FAY); Stomatosis (2; PHR); Streptococcus (2: X9354029); Swelling (f; AKT; FAD; FAY; JFM); \Syncope (f; KAB); Tapeworm (f; JFM); \Thirst (f; KAB); Thrombosis (1; FAY); \Tonsilosis (1; LAW); Trachoma (f; DAA); Trichomonaisis (1; DAA); Trypanosomiasis (1; KAL); Tuberculosis (1; APA; JFM; KAL); Typhoid (f; DAA); Typhus (1; DAD; KAL); Ulcer (1; AKT; X11238826); Ulcus cruris (2; KAL); UTI's (1; WHO); Vaginosis (2; APA; DAA; KAL); Varicosity (f; JFM); Virus (1; PH2); Wart (f; PHR; PH2); Wen (f; JLH); Whitlow (f; JLH); Worm (1; AKT; APA; JFM); Wound (f; PHR); Yeast (2; APA; CAN; JAD; WO2).

DOSAGES (GARLIC): 1-5 cloves/day (APA); 2-4 g, 3 x day (CAN); 2-4 ml tincture (1:5 in 45% ethanol) 3 x day (CAN); 0.03-0.12 ml garlic oil/day (CAN); 2-8 ml garlic syrup (CAN); 2-4 ml garlic juice (CAN); 9-15 g fresh bulb (FAY); 1.5-6 g fresh tuber (KAP); 1-2 minims garlic oil (KAP); 4 g fresh garlic/day (KOM); one 400 mg StX/day; 3-4 550 mg capsule 3 x/day (NH); One enteric coated 400 mg tablet (StX to contain at least 3 mg allicin potential) 1 x day at mealtime (NH); 1/4-1/2 cup fresh bulb (PED); 6-12 g dry bulb (PED); 9 g dry bulb:45 ml alcohol/45 ml water (PED); 2-4 ml garlic juice (PNC); 2-8 ml garlic syrup (PNC); 600-900 mg/day coated garlic (SHT); 4 g garlic or one average clove; 5,000 ug allicin/day (SKY).

ONTRAINDICATIONS, INTERACTIONS, AND SIDE EFFECTS (GARLIC): Class 2c (AHPA, 1997). Some thiol-bearing compounds in garlic and onion and their relatives can cause acantholysis in vitro (Brenner et al, 1995) and possibly pemphigus in vivo. "More than 5 cloves a day may induce flatulence and heartburn (Castleman, 1996) and 'thin blood'" (people taking blood thinners may overthin their blood thereby). Some people are very allergic to garlic. Contraindicated in hyperthyroid (TRA); Commission E reports rare GI-disturbances, allergic reactions, change of odor of skin and breath (Commission E). Allergic reactions of contact dermatosis and severe asthmatic attacks (from inhalation of garlic powder). Topical application of garlic or garlic oil may cause local irritating effects. Nausea, vomiting, and diarrhea may occur following ingestion of fresh garlic bulbs, extracts, or oil. (AEHD1) Sulphides may irritate the GI tract or cause dermatosis (CAN). Fresh garlic is reportedly dangerous to children (AHPA). Use sparingly with children under 2 years; may irritate mouth or stomach if used too liberally (WAM). Then there is Miller and Murray's extremely cautious but not critical review. (MAM). Though possibly "useful for mild hypertension...routine use is not recommended. " After informing us that no drug-drug interactions have been reported for garlic, they feed us a long list of potential drug-drug interactions. Hasty readers, especially MDs will take this as a proven drug-garlic interactions, "Avoid concomitant use...with NSAIDS, anticoagulants and drugs that inhibit liver metabolism (e.g. cimetidine (Tagamet), ciproflaxin (Cipro), clarithromycin, diltiazem (Cardizem), enoxacin, erythromycin, fluoxetine (Prozac). fluvoxamine, itraconazole, ketoconazole, nefazodone, paroxetine (Paxil), ritonavir) "may at least additively and perhaps synergistically interact with garlic". Watch also drugs extensively metabolized by the liver (alprazolam,amitriptyline, astemizole, carbamazepine, cisapride, clozapine, corticosteroids, cyclosporine, desipramine, diazepan (Valium), imipramine, phenytoin (Dilantin), propranolol, terfenadine (Seldane), theophylline, triazolam, warfarin (Coumadin) and drugs that may be affected by liver inhibition (e.g. propranolol, diazepam) (MAM) Miller and Murray (1998) tabulate allergic contact dermatosis, burning GI sensations, diaphoresis, diarrhea, light-headedness, menorrhagia, metrorrhagia, nausea, spinal epidural hematoma, and vomiting as side effects of garlic. They even try to attribute a case of spinal hematoma to garlic. (in an 87 yr old male ingesting 2 g daily "to prevent heart disease" Perhaps they are too eager to accentuate the negative attributing the problem "to garlic's ability to inhibit normal platelet function". Still accentuating the negative they talks about rats given massive doses (50 mg/day garlic powder) developing degenerative changes in 45 days and severe testicular lesions after 70 days. (MAM). The credibility of their uncritical data is questionable; for exampel, on one page (144, they talks about 0.75 mg garlic essential oil divided in three doses a day causing anorexia, nausea, severe vomiting, diarrhea, marker weight loss, metrorrhagia and menorrhagia, yet on the following page (145) they casually discuss a dosage more than three orders magnitude higher for 20 days lowering platelet aggregation from 30.37% to 21.21%. (MAM)

At 3 x 300 mg/day coated garlic powder tablet GI discomfort was the most frequent side effect (also bloating, dizziness, headache, hypotensive circulatory reactions, outbreaks of sweating; daily doses of 900-1200 mg were associated with garlic odor. "May potentiate the effect of antihypertensive and anticoagulant medications" (SHT). No known counterindications during pregnancy and lactation (SKY).

EXTRACTS (GARLIC): Extracts >30 ml/kg orl ipr scu in mus rat. Active hypoglycemic compounds may have insulin-sparing activity, the thiol groups competing for insulin with the inactivating compounds (PNC). Ajoene antiaggregant, antilipoxygenase, antiprostaglandin (CAN; PNC); synergizes antiaggregant activity of dipyramidole, forskolin, indomethacin, and prostacyclin. Garlic (or allicin) antiseptic to Actinobacter, Aeromonas, Aspergllus, Bacillus, Candida albicans, Citrobacter, Corynebacterium, Cryptococcus, Epidermophyton, Escherichia coli, Hafnia, Herpes, Influenza, Klebsiella, Microsporum, Mycobacterium, Pasturella, Proteus , Providencia Pseudomonas, Rhodotorula, Salmonella paratyphi, Salmonella typhi, Shigella dysenterica, Staphylococcus aureus, Torulopsis, Trichomonas sp, Trichophyton, Trichosporum., and Vibrio cholera. (CAN; PNC); LD50=60 mg/kg ivn mus SHT; 120 mg/kg scu mus M11 SHT ; might be a good way to cut back on your grocery bill (except for garlic), if you believe this quote "(R)ats fed up to 2,000 mg/kg garlic extract for 6 months showed no weight loss but did show a slightly reduced food intake relative to controls. There were no changes in renal function, hematologic parameters, or selected serologic parameters, and there was no evidence of any pathologic changes in organs or tissues. Experimentally antiaggregant, bactericidal, diuretic; fungicidal, hypocholesterolemic, hypotensive (FAD; FNF). Clinical studies suggest utility if arterioscelrosis, cardiopathy, GI disorders, high cholesterol and high blood pressure (FAD).

Comm E approvals differ: Blumenthal et al (1998) approve 4 g fresh garlic or equivalent preparations "supportive to dietary measures at elevated levels of lipids in blood" and prevntative measures for age-dependent vascular changes" while Gruenwald et al (1998) approve for almost the same things for which they approve echinacea, viz. arteriosclerosis, bronchosis, cold, cough, fever, pharyngosis, stomatosis and "tendency to infection".

\DIALLYLHEPTASULFIDE: Antioxidant WO3;
\DIALLYLHEXASULFIDE: Antioxidant WO3;
\DIALLYLPENTASULFIDE: Antioxidant WO3
\DIALLYLTETRASULFIDE: Antioxidant WO3
\METHANE-SULFINOTHIOCIC-ACID-2-PROPENYL-ESTER BU Antiseptic WO3
\(E)-1-2-PROPENE-1-SULFINOTHIOCIC-ACID-S-METHYL- ESTER BU Antiseptic WO3 \2-PROPENE-1-SULFINOTHIOCIC-ACID-2-PROPENYL-ESTER BU Antiseptic WO3
\1-PROPENYL-ALLYL-THIOSULFINATE: Antiseptic WO3

Debord T, Vidal D. 1998. Pulmonary anthrax. Rev Pneumol Clin 1998 Dec;54(6):377-81

Duke, J.A. 1983. Medicinal Plants of the Bible. Conch Publications. NY. 233 pp.

(LAW) = Lawson, in Koch, H. P. and Lawson, L. D., eds. 1996. Garlic- The science and therapeutic application of Allium sativum L. and related species. Williams & Wilkins, Baltimore. 329 pp.

Schatz IJ, Masaki K, Yano K, Chen R, Rodriguez BL, Curb JD. 2001. Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study. Lancet 2001 Aug 4;358(9279):351-5


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