Aesculus hippocastanum

Aesculus hippocastanum                  

Common name: Horse chestnut

Family: Hippocastanaceae

Part used: Seed/Fruit, bark

Constituents:

• Coumarins (esculin, aesculetin) & coumarin glycoside (aesculin)
• Triterpene saponins (aescin = escin)
• Flavonoids (quercetin and kaempferol), proanthocyanidin A2
• Tannins (condensed & hydrolyzable)
• Fatty acids
• Sterols
• Allantoin

Medical actions:

• Anti-inflammatory
• Antispasmodic
• Anti-edematous
• Astringent
• Diuretic
• Vasodilator
• Venotonic & Vascular protective

Medical uses: 

• The Eclectics used Aesculus primarily for cardiovascular stasis & congestion indicated by capillary engorgement with vascular fullness and sense of soreness, throbbing, and general malaise, as well as rectal disorders such as hemorrhoids. Was also considered a valuable topical application in neuralgic and rheumatic conditions.

Pharmacology:

• Aescin/escin is anti-inflammatory and a venous tonic. It inhibits hylauronidase, reduces fluid leakage and strengthens capillary cell membranes, thereby controlling bruising & edema. Other mechanisms include allowing improved entry of ions into channels, thus raising venous tension in both in vitro and in vivo conditions, release of PGF(2) from veins, antagonism to 5-HT and histamine, and reduced catabolism of tissue mucopolysaccharides.
• Note: Aescin is a registered drug in Germany and the active ingredient in a number of preparations used either topically or orally for the treatment of peripheral vascular diseases, in particular those related to capillary permeability and resistance.
• Flavonoids are anti-inflammatory and strengthen capillaries.
• Aesculin (coumarin glycoside) found on the seeds needs to be removed from extracts as is toxic.

Pharmacy: 

• Capsules: 200-250 mg BID (standardized to minimum 20% aescin)
• Infusion: 2 tsp/cup water, infuse 10-15 min TID.
• Tincture: (1:2, 40%), 2-5 ml QD, 35 ml weekly max.
• Topical: wash, oil, cream, lotion, or poultice.
• Note: Short term or pause dosing required, 6 weeks on 4 weeks off, due to hydrolyzable tannins.

Toxicity:

• High doses internally can cause nausea, gastrointestinal irritation and reflux.
• Aescin has hemolytic properties, though is minimal within therapeutic doses. Past reports of acute renal failure from injection of b-aescin have revealed to be due to dosages much greater than manufacturer recommendations.

Contraindications:

• Avoid in known allergy, high or long-term doses, in children under 4, acute kidney inflammation, gastric ulcer, topical on broken or ulcerated skin (due to irritant effects of saponins), and IM injection of aescin.

Interactions:

• May interfere with the binding of drugs to plasma proteins.
• Aspirin or anticoagulants due to antiplatelet activity (theoretical).
• With cardiac glycosides & phenopyrazine may cause calf spasm, fatigue, flushing, and pseudolupus.

References:

• Find a complete list of references for this monograph as well as images and a review of its evidence based applications in Dr. Marciano’s Herbal Textbook.