MEDICINAL PLANTS

Indigenous South African Medicinal Plants

Part 4: Pelargonium sidoides
Joanet Maree and Alvaro Viljoen (PhD) Department of Pharmaceutical Sciences, Tshwane University of Technology

(and P. reniforme)

Botany:
Pelargonium sidoides DC and P. reniforme Curt., species of the Geraniaceae family, are indigenous to South Africa and abundant in the Eastern Cape Province. P. reniforme is an attractive, erect shrublet that can grow up to 1 m in height with a system of tuberous roots. It has pink to magenta flowers borne on a tall stalk. Each flower has five petals. It has grey-green velvety kidney shaped leaves. P. sidoides is morphologically similar to P. reniforme but can be distinguished by the shape of the leaves and the colour of its flowers. P. sidoides has crowded velvety, cordate, long stalked leaves with short glandular hairs.1 The flowers are very dark reddish purple to almost black. A common property of both these species is that the inside of the root is bright red.2 Pelargonium sidoides occurs throughout the Eastern Cape, Lesotho, Free State, south eastern parts of the North West Province, southern parts of Gauteng and the western parts of Mpumalanga.3

Scientific studies:
For many years the true botanical nature of this herbal medicine was debated. In 1974 the origin of the decoction was claimed to be P. reniforme. It is now speculated that identification was erroneous and that P. sidoides was used.5 A crude extract of P. reniforme showed a 96% inhibitory activity against Mycobacterium tuberculosis in a primary screen, while that of P. sidoides was inactive.1 For that reason the botanical nature and pharmacological activity of these species are still a mystery. Chemical analysis of the root extract showed that both species contain simple highly oxygenated coumarins.6 An aqueous acetone and methanol extraction of the roots of P. reniforme contains 10 simple phenolic acids, 6 coumarins, 4 flavonoids, 2 flavan-3-ols (with associated proanthocyanidins), 1 phytosterol and a rare diterpene.6 Metabolomic profiling of P. sidoides showed a similar pattern as that reported for P. reniforme.5 A study conducted on P. sidoides root extract to determine the minimum inhibitory concentration (MIC) on several Gram-positive and Gram-negative bacteria showed that the MIC varied depending on the natural origin of the sample.6 Bronchitis is reported to be one of the most frequent infections and new options for medication are a priority to avoid overuse of antibiotic.8 It is reported to be Germanys top new herbal medicine and that sales have escalated over 700%, growing faster than any other brand.4 References:
1. Kolodziej, H, 2000. Traditionally used Pelargonium species: chemistry and biological activity of Umckaloabo extracts and their constituents. Curr. Topics Phytochem, 3. 77-93 2. Lewu, FB, et al, 2006. Morphological diversity among accessions of Pelargonium sidoides DC in the Eastern Cape, South Africa. Genet. Resour. Crop. Ev., 54,1-6. 3. Van der Walt, JJA, Vorster,PJ,1988. Pelargoniums of Southern Africa. National Botanic Gardens KirstenboschI,3,129-131. 4. Anonymous, 2001. Pelargonium sidoides (Umckaloabo). Herbalafrica. Available at: <http:www.herbalafrica.co.za>. 5. Kolodziej, H, 2007. Fascinating metabolic pools of P. sidoides and P. reniforme, Traditional and phytochemical sources of the herbal medicine Umckaloabo. Phytomedicine, 14 (6), 9-17. 6. Oliver, K, Kolodziej, H, 1995. Highly oxygenated coumarins from Pelargonium sidoides. Phytochemistry, 39 (5), 1181-1185.

7. Lewu, FB, et al, 2006. The leaves of Pelargonium sidoides may substitute for its roots in the treatment of bacterial infections. Biol. Conserv., 128, 582-584. 8. Matthys, H, et al, 2003. Efficacy and safety of an extract of Pelargonium sidoides (EPs 7630) in adults with acute bronchitis. Phytomedicine, 10, 7-17.

The flowers and leaves of Pelargonium sidoides

Traditional uses:
The two species are highly valued in South Africa by traditional healers. For hundreds of years various ethnic groups have used root extracts of P. sidoides as a remedy to treat coughs, upper respiratory tract irritations and gastrointestinal conditions. In 1897 Charles Stevens came to South Africa hoping to find a cure for his tuberculosis (TB) infection. A Basutho traditional healer gave him a plant decoction that cured him. Shortly after his recovery, Charles returned to England and sold this decoction as the Stevens Consumption Cure. In 1920 Dr Adrien Sechehaye, a missionary doctor, heard of this cure of Stevens. He successfully treated 800 patients in Switzerland over a period of 9 years. The Stevens Consumption Cure became forgotten in Western medicine after the introduction of synthetic TB drugs and antibiotics. Since 1983 a root extract of P. sidoides, known as Umckaloabo, has been available in German pharmacies without prescription for the treatment of sinusitis, throat and respiratory tract infections.4

A section through the roots of Pelargonium sidoides.

Geographical distribution of Pelargonium sidoides in South Africa.

SA Pharmaceutical Journal September 2007

61