Stimulating Reflex Expectorants

<p>These are remedies that provoke increased mucociliary activity be reflex stimulation of the upper digestive wall. The classic examples were originally used as emetics. It was noted that this drastic action was accompanied by a noticeable expectoration. In fact, traditional practitioners in Britain used emesis as a technique to clear the lungs in asthma and chronic bronchitis until quite recent times. Application of these remedies in sub-emetic doses was thus a consistent feature in all major herbal traditions. Herbs such as ipecacuanha, squills and Lobelia have been standards in Western medicine. There is some limited modern investigation of mechanisms involved. For example, ipecac-induced emesis is thought to be mediated through both peripheral and central 5-Ht3 receptors. Other plants have been used as stimulating expectorants, although not used as emetics; members of the Primula, Bellis, Saponaria and Polygala genera are often included in this category in Western traditions. High saponin levels seem to be a common feature of this group and saponins are certainly nauseating in high doses.</p>

<h2>Plant remedies traditionally used as stimulating reflex expectorants</h2>

<p>Cephaelis (ipecacuanha), <em>Lobelia inflata</em> (Lobelia), Uriginea (squills), <em>Primula veris</em> (cowslip), Bellis (daisy), Saponaria (soapwort), <em>Polygala senega</em> (snakeroot).</p>

<h2>Indications for stimulating expectorants</h2>

<ul>

<li>Cough linked to bronchial congestion, especially where mucus is thick and tenacious or where there is unproductive cough.</li>

<li>Bronchitis, emphysema</li>

</ul>

<h2>Other traditional indications for stimulating expectorants</h2>

<ul>

<li>In some cases as emetics in higher doses</li>

</ul>

<h2>Contraindications for stimulating expectorants</h2>

<p>Although there is no firm evidence of unsuitability, as gastric irritants they can transiently upset some individuals (immediately relieved by withdrawing or changing the remedy). In addition, the use of stimulating expectorants should be kept under review in cases of:</p>

<ul>

<li>Dry and irritable conditions of the lungs</li>

<li>Asthma</li>

<li>Young children</li>

<li>Dyspeptic conditions</li>

</ul>

<h2>Application</h2>

<p>Stimulating expectorants are best taken in hot infusions or as tinctures or fluid extracts, before food.</p>

<p>Long-term therapy with stimulating expectorants is appropriate in the management of chronic bronchial conditions as long as digestive functions are not affected.</p>

<p>Source (Bone & Mills)</p>