![]() The approved modern therapeutic applications for senna are supportable based on its history of use in well establishedsystemsof traditional and conventional medicine, extensive phytochemical investigations, in vitro and in vivo pharmacological studies in animals, and human clinical studies. Modern human studies have investigated the use of senna for severe constipation (Pers and Pers, 1983), for chronic constipation in long-stay elderly patients (Kinnunen et al., 1993 MacLennan and Pooler, 1974 Passmore et al., 1993), for constipation in childhood (Perkin, 1977 Sondheimer and Gervaise, 1982), for managing morphine-induced constipation (Ramesh et al., 1998), for bowel preparation prior to intravenous urography (Bailey et al., 1991), to improve colonoscopy preparation with lavage (Ziegenhagen et al., 1991 Ziegenhagen et al., 1992), for preparation prior to radiographic examination of the colon (Brouwers et al., 1980 Slanger, 1979), in management of constipation in the immediate postpartum period (Shelton, 1980), in management of postoperative constipation in anorectal surgery (Corman, 1979), to improve the visibility of abdominal organs in ultrasound examination (Heldwein et al., 1987), for disorders characterized by slow intestinal transit time or constipation (Bossi et al., 1986), and as a laxative for terminal cancer patients treated with opiates (Agra et al., 1998). In Germany, senna leaf, Alexandrian senna pod, and Tinnevelly senna pod are licensed as Standard Medicinal Teas available only in the pharmacy, official in the German Pharmacopoeia, and approved in the Commission E monographs.They are used alone and in more than 110 prepared drugs, mostly laxatives and biliary remedies (BAnz, 1998 Bradley, 1992 Braun et al., 1997 Meyer-Buchtela, 1999 Wichtl and Bisset, 1994).In the United States, senna leaf, fruit, and extract are used in OTC laxatives (e.g., Correctol ®, ExLax ®, Senokot ®, Smooth Move ®). Today, senna leaf and fruit are official in national pharmacopeias worldwide, including those ofAustria,China, France, Germany, Great Britain, Hungary, India, Japan, Russia, Switzerland, the United States, the European Pharmacopoeia, and many others (BP, 1988 Bradley, 1992 IP, 1996 JP XII, 1993 AB, 1981 Ph.Eur.3, 1998 Ph.Fr.X, 1994 Ph.Helv.VII, 1987 Ph.Hg.VII, 1986 Tu, 1992 USP XXII, 1990 USSR X, 1973 Wichtl and Bisset, 1994). (Chevallier, 1996 Grieve, 1979 Der Marderosian, 1999 Remington et al., 1918). ![]() Its medical use was first described in the writings of Arabian physicians Serapion and Mesue in the ninth century C.E. Its name is derived from the Arabic sena. Besides its wide use in conventional Western medicine, senna leaf remains an important drug used in traditional Chinese medicine and traditional Indian Ayurvedic and Unani medicine (IP, 1996 Kapoor, 1990 Karnick, 1994 Tu, 1992). Senna is the most widely used anthranoid drug today and has been used for centuries in Western and Eastern systems of medicine as a laxative, usually taken as a tea or swallowed in powdered form (Bradley, 1992 Leung and Foster, 1996 Der Marderosian, 1999). The Tinnevelly senna of commerce is obtained mainly fromIndia, and Alexandrian is obtained mainly from Egypt and Sudan (BHP, 1996 Wichtl and Bisset, 1994). It is now cultivated on a large scale in southern and northwestern India and in Pakistan (Bruneton, 1995 Iwu, 1990 Leung and Foster, 1996 Remington et al., 1918 Wichtl and Bisset, 1994). Tinnevelly senna is native to southern India and northeastern Africa, grows wild in southern Arabia, on the coast of East Africa from Mozambique to Somaliland, and Asia. It is cultivated in the valley of the Nile in Sudan, southern China, and India. Alexandrian senna is native to northern and northeastern Africa, growing wild in semidesert and sudanosahelian zones of Africa, including Egypt, Morocco, Mauritania, Mali, and Sudan. ![]() Sennas areherbaceous subshrubs and both varieties used, Alexandrian and Tinnevelly, have desert origins (Bruneton, 1995).
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