PDR for Herbal Medicines

HERBAL MONOGRAPHS

Squill

Urginea maritima

DESCRIPTION

Medicinal Parts: The medicinal parts come from the bulbs of

the white latex variety collected after flowering and the

fresh, fleshy bulb scales of the white variety and of the red

variety.

Flower and Fruit: The flowering stem is erect and 50 to 150

cm high. It is often a washed purple color and glabrous. The

flowers, which often number 100, are arranged in richly

flowered, dense racemes up to 60 cm long. The bracts are

membranous and pointed. They are shorter than the pedicles

and drop early. The pedicles are up to 3 cm long, thin and

smooth. The flowers are white, radial and star-shaped. The

ovary is ovate to oblong triangular. The capsule is ovate to

oblong, 3-valved, obtuse or almost pointed. Each chamber

has 1 to 4 seeds, which are elongate, flattened, smooth,

glossy and winged.

Leaves, Stem and Root: The plant is a perennial bulb plant.

The bulbs are pear-shaped, about 15 to 30 cm in diameter.

They are rarely sold whole commercially, as they tend to

start growing. The fracture is short, tough and flexible.

Characteristics: The taste is bitter and acrid.

Habitat: Indigenous to the Mediterranean and is cultivated

there too.

Production: Squill consists of the sliced, dried, fleshy middle

scales of the onion of the white variety of Urginea maritima,

harvested during the flowering season. It is collected mostly

from uncultivated regions.

Other Names: Scilla
ACTIONS AND PHARMACOLOGY
COMPOUNDS ,
Cardioactive steroid glycosides (bufadienolides, 1-3%):
chief components glucoscillarene A, proscillaridin A, scillar-
ene A; including among others, scillicyanoside,
scilliglaucoside
Mucilage
EFFECTS
The drug is inotropic on myocardial work capacity and
negatively chronotropic. The overall effect is economy of
heart action. There is a lowering of increased, left ventricular
diastolic pressure and pathologically elevated venous
pressure.
INDICATIONS AND USAGE
Approved by Commission E:

• Cardiac insufficiency NYHA I and If

SQUILL /717

• Arrhythmia


• Nervous heart complaints


• Venous conditions

Unproven Uses: Squill is used for reduced kidney capacity.

In folk medicine it is used for catarrhal conditions of the

upper respiratory tract, bronchitis, asthma and whooping

cough, also for wounds and fractures, back pain and

hemorrhoids and for the disinfection of septic wounds.

CONTRAINDICATIONS

The drug and pure glycosides, among others, should not be

administered in the presence of second or third degree

atrioventricular block, hypercalcemia, hypokalemia, hyper-

trophic cardiomyopathy, carotid sinus syndrome, ventricular

tachycardia, thoracic aortic aneurysm or WPW-syndrome.

PRECAUTIONS AND ADVERSE REACTIONS

General: No health hazards are known in conjunction with

the proper administration of designated therapeutic dosages.

Because of the narrow therapeutic range of cardioactive

steroid glycosides, side effects could appear even with

therapeutic dosages. Side effects include tonus elevation of

the gastrointestinal area, loss of appetite, vomiting, diarrhea,

' headache and irregular pulse.

Contact with the juice of the fresh bulb can lead to skin

inflammation (squill dermatitis). The administration of pure

glycoside is preferable due to the difficulties of standardizing

the drug (proscillaridin A).

Drug Interactions: Increase of effectiveness and thus also of

side effects is possible with concomitant administration of

quinidine, calcium, saluretics, laxatives and extended therapy

with glucocorticoids.

Squill potentiates the positive inotropic and negative chrono-

tropic effects of digoxin.

The simultaneous administration of arrhythmogenic sub-

stances (sympathomimetics, methylxanthines, phosphodies-

terase inhibitors, and quinidine) increases the risk of cardiac

arrhythmias.

OVERDOSAGE

Besides the already-mentioned symptoms, overdosage can

lead to cardiac rhythm disorders, life-threatening .ventricular

tachycardia, atrial tachycardia with atrioventricular block,

stupor, vision disorders, depression, confused states, halluci-

nations and psychosis. Fatal dosages lead to cardiac arrest or

asphyxiation.

Treatment of poisoning includes gastric lavage and instilla-

tion of activated charcoal. All other measures are to be

carried out according to the symptoms. In case of potassium

loss, careful replenishment; for ectopic impulse formation in

the ventricle, administration of phenytoin as antiarrhythmic