PLANT PROFILE
Pyracantha commonly called Firethorn, is a genus of thorny shrubs that are mostly evergreen and produce lots of beautiful showy berries, that stay on it's stems for long months making those plants very ornamental. All Pyracantha species are tall robust shrubs, and except for small differences in width or length of leaves or berries color (different shades of red, orange or yellow), all species looks much alike, and are hard to distinguish. As a wild plant it grows in many parts of Europe (mostly southeast) and Himalaya region, some species can be also found in other parts of Asia and Japan and Taiwan. But for at least two hundred years those plants has been planted as a ornamental plants in Europe and North America, and nowadays it is very popular garden plant in most of temperate climate regions, and even can be found in subtropical areas. It is said to get naturalized in some southeast parts of Australia.
Although the plants used as a ornamental are mostly descendants of Southern-European Pyracantha coccinea or East-Asian Pyracantha fortuneana species, for years it was often hybridized with other Pyracantha species to achieve more spectacular fruiting or different shade of fruits.
Although very little known as such, Firethorn berries are edible and posses medicinal values. It's fruits, flowers and leaves are traditionally used in some parts of Asia (especially Himalaya region) and very rarely nowadays also in southern Europe, in the same way as those of Hawthorn. Which is very popular in western herbalism as a cardiac tonic, and also diuretic and digestive remedy. In fact Pyracantha plants are very closely related to Hawthorns - Crataegus species. So close that Pyracantha crenulata and Pyracantha coccinea can be sometimes found under the names Crataegus crenulata and Crataegus coccinea. It's other botanical synonyms Cotoneaster crenulatus and Cotoneaster coccinea is indicating also it's close relationship with Cotoneaster species, of which many has also edible berries with medicinal values (for example Cotoneaster horizontalis).
Pyracantha leaves are sometimes used not only as a folk medicine, but simply to make a beverage, for example Pyracantha crenulata leaves in Himalayas. Which makes such a good tasting tea, that after trying it I wanted to learn more about values of those plants, so popular as a ornamentals and so underutilized as a medicinal herbs. And found out that among many health benefits of different parts of Firethorns, leaves tea is a brain tonic.
Firethorn plants are appreciated in gardens not only for it's beautiful berries and nice flowers, but also for it' functionality as a impenetrable living fence. It is often planted as a hedges walls due to it's dense branches grow and nasty long sharp and hard thorns, providing great protection from human and animal intrusion into a garden.
I remember that in early 90's Firethorn plants were a rare view in gardens and parks in Poland, and just ten years later was one of the most common ornamental shrubs. It was the reverse effect with popularity of Hawthorn plants, which was for few decades often planted in Polish gardens and parks for pretty look of it's fruits and flowers (especially cultivars with big pink or red flowers). And in 90's most people seen Hawthorn species as a too common, parks and roadsides plants, looking for more original elements to plant in their gardens. In the same time there was significant decline in number of wild Hawthorn plants, mainly due to loss of it's habitat caused by rapid urbanization of poor class sandy soils which Crateagus species likes the most.
This huge shift in population of Firethorns and Hawthorns haven't been fallowed yet by shift in popularity in herbalism. Hawthorn is still one of the most commonly used herbs for cardiac problems in Poland, while no one heard there yet about medicinal applications of Firethorn. Probably exactly the same situation is in whole north of Europe, where Hawthorn dried berries, flowers, leaves or it's preparations are widely available in herbal shops and even pharmacies. While Firethorns stays being only popular ornamental plants unknown to herbalists. Which is a huge shame considered it's wide availability, and enough of sources reporting Firethorns traditional medicinal uses and modern phytochemical studies to give directions for it's easy and safe use.
After all Pyracanthas are one of not many herbs that has very old traditions of medicinal uses in all three oldest, most advanced medicine systems. Western Herbalism (that developed mostly from Greek and Egyptian traditions) - Pyracantha coccinea, Ayourveda - Pyracantha crenulata and Traditional Chinese Medicine - Pyracantha fortuneana.
CULTIVATION AND HARVESTINGAll Pyracantha species has the same growth habits, and very similar look. It only differ a bit when it comes to lenght and width of it's generally oblong-eliptic leaves, and shade of fruits, that range from dark red threw orange to yellow, and intensity of fruiting. It all grows as a perennial robust bushes usually up to around 3m height, but occasionally even up to 6m and so in width. It often have a quick growth of over 80cm a year. It's tops stems grow generally upright but have tendency to bent, often as a result of heavy weight of multiple fruits on it. But it's wood is very hard, which makes it often very hard to prune or cut. That is why in Asia it is often used to make a tools handles, walking sticks or other useful things.
Firethorns has more or less of sharp, hard and up to 4cm long thorns and often also sharp tips that change into new stems. So be very careful with your hands when picking berries or pruning Pyracantha. And watch your steps when near the bush, because if you step on it's branch it can sometimes even pierce shoe sole. Dispose well or burn cut-off branches as it's wood is very hard and durable so even after long time it might not decompose an it'd thorns can be threat.
The advantage of those thorns is of course big when it comes to it's function as a protection from intrusion. And so Firethorns are often planted as a dense live fence, impenetrable for humans and any big animals. But it should be considered as a serious threat for young children, that might get easily and seriously hurt attracted to Pyracantha bush by it's shiny fruits.
The fruits, especially of commonly sold cultivars of those plants, are very showy due to it's bright colors and huge number. But it's main advantage from ornamental point of view, is that it stays on branches for long months with attractive appearance. It looks beautiful in cold climate areas, during the winter, contrasting with gray surrounding or whiteness of snow.
There are different opinions about the leaves of different species, although all Pyracantha species are generally considered to be evergreen, some people call it deciduous. What I observed myself in Poland and England on commonly planted cultivars, is that Firethorns can be totally evergreen, but when the strong frosts will come, then not only it's green leaves but also young tender tops of stems will get frozen (young seedlings can be even killed by frosts). This lead to cosmetic problem in gardens located in very cold areas. I saw the plants giving it's nice greenery to winter surrounding until heavy february frosts, after which all the leaves was turning ugly dark brown but still clinging strongly to the stems. It often persist on the plants even after first new leaves develop from buds in late spring. So to get rid of those unattractive brown leaves and dead stem tops or sometimes even fruits that are already so old that it turn black, often due to mould, but still hold on the stems, early spring pruning is adviced.
Firethorns cope well with heavy pruning and strong cutting, it can be entirely reshaped despite the age of the plant, without any risk to it's health. It can be grown as a showy stand-alone wide bush, small or tall hedge, or it can be let to crawl on walls. It likes sunny positions, and even though it can cope with shade it's growth will be poor and look unattractive if planted in dark places. Older plants are strongly drought resistant. It likes well-drained sandy, chalky, loamy or clay soils. It tolerate any pH of soil and atmosferic pollution. It grows well on unfertile and rocky lands, it's root system is extensive and can help protect soil erosion and landslides. It's strong resistant wood makes it a good windshield plant. Probably all Firethorn species can be grown successfully at high elevations like Pyracantha crenulata (endemic to Himalaya 1000-2500m). The plants can be quite easily propagated from seeds or threw cuttings. Pyracantha species are often attacked by Fire blight disease caused by the bacterium Erwinia amylovora, and scab fungus.
Firethon plants frowers generally from late april to june and the fruits get ripe in autumn. But in other places than temperate climate northern hemisphere it might by much different. For example in the high moutains of the Philippines I see Pyracantha crenulata producing flowers and fruits almost all year round, but in scarcity instead of abundance. The flowers are valuable sources of nectar for the bees. Many kinds of birds are particularly attracted to the Firethorn berries. Although called a berries, Pyracantha fruits are actually pommes in structure, it's like a tiny apples and so it tastes like.
Make sure that the berries that you are about to pick are not fermented or have no fungus mould on it. Firethorn fruits stay hold on to stems for month, and sometimes even though look still good are no longer good for consumption. The berries taste best when just ripe, but are still good for preserves or drying when overripe but not yet fermented.
CULINARY USES Firethorn fruits can be eaten raw but only in moderate quantities, as it's seeds contain cyanogenic glycosides, which can cause mild gastro-intestinal problems if consumed in bigger dose. Cooking or drying is said to neutralized this mild toxicity. When just ripe Pyracantha fruits flesh taste quite like apples (both plants are far cousins). But from sour-sweet and juicy it turns to quite tasteless, insipid and dry when overripe. On the other hand if picked to early it can be quite astringent. The seeds are rather crunchy than hard, and has a bit bitter taste when bitten threw.
Firethorn berries are rich in vitamin C and contain pectins, and are good for making jellies, preserves, sauces and wine. It was used for such in the past in southern Europe and by early settlers and Indians in North America. But in recent decades it become almost entirely forgotten as an edible fruit. In some parts of Asia, especially Himalaya regions Pyracantha berries are still commonly consumed in rural communities, and even sold on local markets. But as to my knowledge it is considered there more like remedy than food. For example dried and powdered Firethorn fruits are mixed with yoghurt and eaten for the treatment of bloody dysentery in Nepal, where preserves from the fruits are also sometimes made. .
Firethorn leaves can be used both fresh chopped or dried and crushed to make a tea. Pyracantha crenulata leaves tea is drunk as a normal beverage in Himalaya regions and I personally like it's taste very much. It is quite mild with nutty-like character.
Pyracantha coccinea seeds have been used in Spain as a substitute for coffee.
MEDICINAL USESAlthough Pyracantha plants are more popular as a ornamental plants in Europe than anywhere else, it is almost entirely unknown there as a medicinal plant. But some are saying that it's medicinal use in Europe can be traced back to Dioscorides times (c. 40-90 AD), as the plant that he described as “Oxuakantha” was Pyracantha species plant and not Crateagus species like most later authors wrote. But it is also very possible that ancient European herbalists simply considered both Firethorns and Hawthorns as a one group of plants. And with no distinction used both for the treatment of the same ailments, just like folk healers in Himalaya regions do nowadays. Pliny the Elder (23–79AD) wrote in his Naturalis Historia, that drink from Pyracantha berries (according to later french translation) was taken against the bites of snakes.
According to my research (which has linguistic and other limitations), nowadays Pyracantha species are used for medicinal purposes mostly in folk medicine of different communities in Himalayan regions and in eastern parts of China, but some records of medicinal uses of Firethorns in south of Europe, north of Africa or Caucasus can also be found.
Beside scarce number of ethnobotanical research papers that contain information of traditional medicinal uses of Pyracantha species. There is a few scientifical studies on it's phytochemistry and pharmacological effects, that has been made in such a different countries as India, Italy, Turkey, Algeria, Iran and China. Those studies results are showing close similarities in chemical compositions not only between different Pyracantha species, but also between Pyracantha and Crateagus species. Validating traditional beliefs that Firethorn berries, flowers and leaves can be used just like those of Hawthorn, as an effective cure for many different cardiac ailments and as a digestive and diuretic.
Underneath I had put all the medicinal information that I've found about any of the Pyracantha species. Although I kept it separate for informative insight to compare, I have no doubts that all Firethorn species can be used interchangeably for the same therapeutic purposes.
Pyracantha coccinea - Firethorn
Ognik szkarłatny (Polish), Mittelmeer-Feuerdorn (German), Espino de fuego (Spanish), Piricanto (Portugese), Ates dikeni (Turkish)
In European countries the fruits have been used in traditional medicine as a cardiac to soothe the heart and as a diuretic and tonic. The fruits are a good source of natural antioxidants, it contains fatty acids, vitamins, phytosterols and phenolic compounds, including : δ-Tocopherol, α-tocopherol, vitamin K, vitamin D, β-sitosterol, ergosterol, stigmasterol, linolenic acid and palmitic acid. The extracts obtained from fresh P. coccinea fruits, especially the hot ethanolic extracts, showed strong antibacterial activity against Gram-positive bacteria : S. aureus, S. epidermidis and S. pyogenes.
In folk medicine in Turkey, decoction of firethorn leaves has been used for the treatment of diarrhea (for humans and animals). It contain flavonoids [''In the vegetative phase there are flavonoids (flavanones, flavones, and flavonols) only in the aerial parts and they appear gradually during the plant life. These secondary metabolites are detectable in the roots exclusively in the reproductive phase.'']. One study showed that methanolic extract of Pyracantha coccinea possesses potent antidiabetic activity.
Pyracantha fortuneana syn. Pyracantha crenato-serrata - Fortune Firethorn
Chinese Firethorn, Yunnan Firethorn (English), Hongziye (leaves as a herbal drug in Chinese), Hongzigen (roots as a herbal drug in Chinese), Huo ji (dried fruits in Chinese)
In Traditional Chinese Medicine Pyracantha fortuneana dried fruits are described as bitter and pungent, and are used to activate blood and stop bleeding, and improve the functions of stomach. A decoction of the fruit is used in the treatment of fevers. It contain biphenyl glycosides (fortuneanosides A - E), fortuneanoside D possessed inhibitory activity against tyrosinase, potency IC50 value of 0.07 mM. That finding can suggest usefulness of this fruit in prevention of conditions related to the hyperpigmentation of the skin, such as melasma and age spots. The fruits are sometimes sold in China as whole dried or in form of flakes (whole fruits are sqeezed flat and then dried).
The leaves can be harvested throughout the year and used fresh, it is described as bitter and cool, clearing heat-toxin and relieving hemorrhage. It is indicated mainly for anthracia and swelling pain, dysentery, hemafecia, and hemorrhage caused by trauma. A decoction of the leaves is also used in the treatment of fevers. The fresh leaves are crushed and applied externally to boils and abscesses. For severe acute conjunctivitis leaves are smashed and applied onto eyelids. The leaves contain rutin, miscanthoside, isoquercitrin and quercetin. Standard oral administration is 10-30g in decoction.
The roots are described as sour and cool, clearing heat and cooling blood, eliminating stasis for suppressing pains. It is mainly indicated for hectic fever and night sweat, discharging fresh blood stools, metrorrhagia and metrostaxis, swelling pain induced by conjunctival congestion, anemogenous toothache, injuries from falls, lumbago and impairment caused by overstrain, hemorrhage caused by trauma.
Pyracantha crenulata syn. Crataegus crenulata
- Nepal Firethorn, Himalayan Firethorn, Indian Hawthorn (English), Ghigharu, Ghangara, Ghingaroo, Gheeanghroo (Uttarakhand, India), Ghangaru (Nepal), Chhota seb (Hindi).
In Ayurvedic medicine P. crenulata fruit is highly respected as a heart tonic, often used in Uttarakand and Nepal in the treatment of cardiovascular disorders (cardiac failure, myocardial weakness, paroxysmal tachycardia, hypertension, angina, arteriosclerosis and Buerger's disease). And also for diabetes, hepatic, stomach and skin diseases.
The anti-oxidants present in fruits are helpful in reducing the ill-effects of free-radicals in our body, maintain blood-pressure and reduce cholesterol. The fruits are eaten as a appetizer, it helps in constipation. In Nepal it is consumed as a remedy for dysentery, often dried and powdered mixed with yoghurt, preserves are also made. The fruits are consumed by aged people for rejuvenation and to reduce joint pains. It is also given as a good nutrition to anemic and anorectic people. A beverage of the berries is taken to relieve anxiety, insomnia and neurasthenia. Ayurvedic preparations of the fruits are mostly infusions, water extracts and tinctures.
Pyracantha crenulata fruits actions are described as : tonic, cardiotonic, coronary vasodilator, hypotensive, hypoglycemic, anti-inflammatory, antioxidant, depurative, diuretic, lithontripic and antiurolithogenic, antimicrobial, antirheumatic, antispasmodic, appetizer, nutritious and sedative.
Study has showned that juice and alcohol extract of fruit of P. crenulata may reduce precipitation of calcium oxalate, with improvement of kidney function as well as cytoprotective effect. The ethanolic extract of Pyracantha crenulata fruit pulp showed significant activity against food poisoning bacteria (Shigella flexneri, Escherichia coli and Streptococcus pyogenes). Authors of other study states that '' Pyracantha crenulata may be recommended as supplementary food material for the diabetic patients due to adequate protein and carbohydrates and lower sugar content. It could be taken in powder as well as converted into juice form.'' Yet another that '' Even at low concentrations, these plant species contained potent nutritional value and also showed high antimicrobial and antifungal activity nearly equal to that of the commercial fungicide used as a positive control.''
Here are some details of nutritional tests resoults :
Fruits biochemical constituent : Quantity Protein 1.8%, Total Sugar 59.18%, Calcium
3.08%, Magnesium 1.4%, Sodium 1.00%, Potassium 1.43%, Vitamin A 0.38 mg/100g, Vitamin B1 0.50 mg/100g, Vitamin B2 17.7 mg/100g, Vitamin C 55mg/100g, Vitamin E 272 mg/100g, Flavonoides 2.9 %.
Pyracantha crenulata accounted lower (8.47g/100g)protein with high (80.71g/100g) total carbohydrates. Sugar (7.16 g/100g), Reducing sugar (2.29 g/100g), Total Fat (0.54 g/100g) , Energy value 361.58 Cal/100g.
Pyracantha crenulata : nitrogen 1.35%, phosphorus 45.26%, calcium 54.50 (mg/100g).
The fruits have been found to rich in nutrients such as crude protein 5.13%, crude fiber 7.40%, crude fat 1.00% and carbohydrates 24.88%. Total saponins 1.56%, total phenolic 1.83%, total flavonoid 3.12%, total tannins 0.66%, total alkaloid 0.15%.
The juice consist 25% of fruits weight. Biochemical analysis of fruit juice quantified 0.11% protein, 0.08% calcium, 0.022% magnesium, 0.43% potassium, 73% moisture, 1.006% flavonoides, 0.38 mg/100g Vitamin ‘A’, 101 μg/100g vitamin B12, 1.2 mg/100g Vitamin ‘C’, 17.5 mg/100g Vitamin ‘E’.
The flowers and leaves are used as general potent heart tonic for all heart ailments. It's regular use proved to be effective in strenghtening heart muscles and normalizing blood pressure. It is reported to be used in treatment or irregular heartbeat, high blood pressure, chest pain, hardening of arteries, paroxysmal tachycardia, Buerger's disease, inflammation, arteriosclerosis, nervous heart problems and old age heart related problems, and to reduce risk of heart failure.
The leaves contains : leucocyanidins flavonoids principle - vitexin-4rhamnoside, vitexin glycoside, oligomeric leucoanthocyanidin and polymeric flavone (apigenin, luteoin); rutin, tannins, saponins, beta-sitosterol, cis-3,4-dioxyethylene-5-methoxycinnamic acid, cranulanostenoic acid.
The flowers yield phenyl ethylamine, O-methoxyphenyl ethylamine and tyramine. The plant possessed 2-phenylchromones and chlorogenic acid.
The bark of this shrub is used in prevention of heavy bleeding during menstrual cycles. The stem bark is useful in fevers, especially malaria. Bark extract is applied topically to protect skin from sunburn, and all body organs from frostbite.
Pyracrenic acid was isolated from the bark.
The Roots decoction is used in baths to alleviate body pains.
CONTRAINDICATIONS
Consumption of large quantities of fresh Pyracantha berries can have negative side effects, due to cyanogenic glycosides from its seeds. It is said to be possible cause of minor stomach discomfort like diarrhoea or vomiting, especially in small children that often like Firethorn berries taste. Crushing and drying, boiling or prolonged soaking helps to neutralize cyanogenic compound from seeds, leaves or roots.
Pyracantha crenulata
Sources
'' Medicinal and Aromatic Plants of Himachal Pradesh '' - Narain Singh Chauhan, Indus Publishing, 1999
'' New Age Herbals: Resource, Quality and Pharmacognosy '' - Brahma Singh, K.V. Peter, Springer 2018
PLINE L'ANCIEN HISTOIRE NATURELLE. TOME SECOND. LIVRE XXIV Traduction française : É. LITTRÉ
Evaluation of Antihypertensive Effect of Fruit Beverage of Crataegus crenulata Roxb. : A wild Shrub of Himalayan Hills - P.S. Negi, Ranjit Singh and S.K. Dwivedi
Antibacterial and Antitumor Activities of Some Wild Fruits Grown in Turkey - Arzu Ucar Turker, Arzu Birinci Yildirim & Fatma Pehlivan Karakas
Flavonoid distribution in Pyracantha coccinea plants at diferent growth phases - Gelsomina Fico, Anna R. Bilia, Ivano Morelli, Franca Tome
Evaluation of Pyracantha crenulata Roem for Antiurolithogenic Activity in Albino Rats - Y.M. Bahuguna, M.S.M. Rawat, V. Juyal and K. Gusain
Determination of nutritional potential of five important wild edible fruits traditionally used in Western Himalaya - Rana YS, Tiwari OP, Krishan R and Sharma CM
ANTIOXIDANT CAPACITY AND RELATED PHYTOCHEMICALS ANALYSIS OF METHANOLIC EXTRACT OF TWO WILD EDIBLE FRUITS FROM NORTH WESTERN INDIAN HIMALAYA - R.S.PAL, R.ARUN KUMAR, P.K.AGRAWAL AND J.C.BHATT
ANTIBACTERIAL AND ANTIOXIDANT PROPERTY OF SELECTED MEDICINAL PLANTS OF DAMAN VDC, MAKAWANPUR DISTRICT - Usha Adhikari
In Vitro Antimicrobial Activity, Nutritional Value, Antinutritional Value and Phytochemical Screening of Pyracantha crenulata Fruit - Sarla Saklani, Subhash Chandra
The Cytotoxic Effect of Methanolic Extract of Pyracantha coccinea M. Roemer Fruit on Hela cell line, Antioxidant Capacities and Total Phenol Contents of Methanolic and Aquatic Extract of this fruit - Leila Vahabi, Ramesh Monajemi, Seyed Ahmad Hosseini
Investigation of the Antimitotic and Antimutagenic Effects of Methanolic Extracts of Pyracantha coccinea - Mehmet Cengiz KARAĠSMAĠLOĞLU
Pharmacognostical and phytochemical screening of leaf and fruit extract of Pyracantha crenulata
Antiradical activities and phytochemical compounds of firethorn (Pyracantha coccinea) fruit extracts.
Keser S.
Antidiabetic activity of Pyracantha coccinea extract in alloxan-induced diabetic rats - Samah Djeddi
EVALUATION OF ANTI-INFLAMMATORY EFFECTOF PYRACANTHA CRENULATA (D.DON) - M. ROEMER BY IN-VITRO METHODS
Biphenyl Glycosides from the Fruit of Pyracantha fortuneana - Yi Dai, Guang-xiong Zhou, Hiroshi Kurihara, Wen-cai Ye, and Xin-sheng Yao
Wild Fruits of Uttarakhand (India): Ethnobotanical and Medicinal Uses - Ishwar Prakash Sharma, Chandra Kanta, Satish Chandra Semwal and Nisha Goswami
Traditional knowledge on medicinal plants among rural women of the Garhwal Himalaya, Uttaranchal - Bhagwati Uniyal and Vandana Shiva
Ethnobotanical study of wild fruits in Pabbar Valley, District Shimla, Himachal Pradesh - Chauhan PP, Amrita Nigam, Virender Santvan K
Traditional herbal medicine in Far-west Nepal: a pharmacological appraisal - Ripu M Kunwar, Keshab P Shrestha and Rainer W Bussmann
Medicinal Plants of the Shimla hills, Himachal Pradesh: A Survey - Kamal Jit Singh and Anil Kumar Thakur
An assessment of ethnomedicinal plant diversity in Haat Kali Sacred Grove in Kumaun Himalaya, Uttarakhand, India - Harsh Singh, Priyanka Agnihotri, Veena Dixit, P.C. Pande and Tariq Husain
A Review of Cyanogenic Glycosides in Edible Plants - Islamiyat Folashade Bolarinwa, Moruf Olanrewaju Oke, Sulaiman Adebisi Olaniyan and Adeladun Stephen Ajala
http://libproject.hkbu.edu.hk/was40/detail?channelid=1288&lang=en&searchword=herb_id=D00598
http://zhanjo-com.sell.everychina.com/p-107252947-pyracantha-fortuneana-maxim-li-fortune-firethorn-fruit-medicinal-material-huo-ji.html
https://www.accessdata.fda.gov/scripts/plantox/detail.cfm?id=1349
https://www.terrain.net.nz/friends-of-te-henui-group/plants-toxic-if-eaten-by-man.html
https://www.christopherhobbs.com/library/articles-on-herbs-and-health/hawthorn-for-the-heart/
http://winemaking.jackkeller.net/pyracantha.asp
http://www.db.weedyconnection.com/firethorn/
https://www.chowhound.com/post/pyracantha-firethorn-jelly-581076?page=2
http://temperate.theferns.info/viewtropical.php?id=Pyracantha+coccinea
http://temperate.theferns.info/viewtropical.php?id=Pyracantha+crenato-serrata
https://en.wikipedia.org/wiki/Pyracantha
http://herbariovirtualbanyeres.blogspot.com/2013/01/pyracantha-coccinea-espino-de-fuego.html
http://cms.herbalgram.org/herbalgram/issue22/article463.html?ts=1533545614&signature=2b4807958267228c1948208351b23267&ts=1554210447&signature=8b47d5b4eb785338822b1dd869e17594&ts=1567884925&signature=289696398c72a9a1ef39f96c9492e189
