Aesculus hippocastanum                  Common name: Horse chestnut
Family: Hippocastanaceae

Part used: Seed/Fruit, bark

Constituents: Coumarins (esculin, aesculetin) & coumarin glycoside (aesculin), saponins (aescin = escin), flavonoids (quercitin, rutin, kaempferol), tannins (condensed & hydrolyzable), fatty acids, sterols, allantoin

Medical actions:  Venotonic, vascular protective, inflammatory modulator, anti-spasmodic, anti-edematous, anti-inflammatory, astringent, vasodilator, bitter, diuretic

Medical uses: Is a trophorestorative and antioxidant for venous tissue. It stimulates contraction of venous valves, increases venous pressure, stimulates lymphatic flow, improves and tones connective tissue and circulation. Will remove venous congestion and is indicated in acute thrombophlebitis, varicose veins, swelling with bruises, fracture, brain trauma and strokes. External applications of Aesculus are used in the forms of ointments and gels for edema from sports injuries, hemorrhoids, rheumatism, backaches, neuralgia and restless leg syndrome.

Pharmacology:

• Saponin aescin/escin is anti-inflammatory and a venous tonic. It inhibits hylauronidase, improves capillary permeability and are analgesic, anti-inflammatory and anti-exudative. 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 altered capillary permeability and resistance. Aescin reduces fluid leakage and strengthens capillary cell membranes, thereby controlling bruising & edema. Aescin is a registered drug in Germany and is 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 altered capillary permeability and resistance.
• Flavonoids are anti-inflammatory and strengthens capillaries.
• Aesculin (coumarin glycoside) found on the seeds needs to be removed from extracts as is toxic.

Pharmacy: Tincture: (1:5, 40%), 1-4 ml TID. Infusion: 2 tsp/cup water, infuse 10-15 min TID. Topical wash. Note: Short term or pause dosing, 6 weeks on 4 weeks off, due to hydrolyzable tannins.

Contraindications: Known allergy, high or long term doses, children under 4, anticoagulant therapy (theoretical), acute kidney inflammation, gastric ulcer, topical on broken skin, IM injection of aescin.

Toxicity:  Aescin has hemolytic properties, though such property 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 being used in children. High doses internally can cause nausea, GIT irritation and reflux.

Interactions: May interfere with the binding of drugs to plasma proteins.

Research:

• Escin reduces the localized edema associated with inflammation and acts by reducing capillary permeability to water, thus decreasing exudation into intercellular spaces. The antiexudative activity of escin may be mediated by prostaglandin F 2-alpha. Parenteral administration of escin into rats indicated the antiexudative activity to be the result of an influence on the small pores of the capillary wall through which fluid is exchanged. Tests conducted on adrenalectornized and hypophysectornized animals indicate that normal production of corticosteroids is necessary for its antioedema activity. Escin thus mimics and relies upon the activity of corticosteroids.
• In a randomized, double-blind, placebo-controlled crossover study, the influence of oral doses of escin on capillary resistance was tested on 12 healthy subjects. After 7 days of treatment with escin, capillary resistance was significantly improved as measured by the petechiae test. There was no effect from the placebo.
• Pharmacological and clinical studies indicate that oral administration of horsechestnut extract improved the tone of connective tissue and improved circulation by toning the veins. In a double-blind, placebo controlled study, a decrease in the vascular capacity (i.e. increased flow) and in filtration coefficients was observed in volunteers with healthy circulation treated with standardized horsechestnut extract (600 mg per day, containing 100 mg escin). The antioedematous activity demonstrated by standardized horse-chestnut extract in chronic venous insufficiency was mainly dependent on the inhibition of proteoglycan degradation and lysosomal enzyme activity.
• The effect of oral administration of horsechestnut extract (total of 360 mg, containing 90 mg escin) to 14 healthy volunteers on the venous tone of a segment of the lower leg was compared to placebo controls. Horsechestnut resulted in significant reduction of the pressure-dependent vein capacity (p<0.02), which is an indication of reduced deformation of the veins and an increase in vein tonus. An intravenous infusion of escin did not result in a noticeable change.
• A single dose of standardized horsechestnut extract (600 mg containing 100 mg escin) prevented or significantly reduced the increase in ankle and foot oedema (p<0.05) in healthy humans during a 15-hour air flight. The study was of randomized, double-blind design and the oedema was compared to the preflight circumference.
• The inhibitory effects of plant constituents on the activity of the connective tissue enzymes elastase and hyaluronidase was investigated in vitro. Saponin constituents from horsechestnut showed inhibitory effects on hyaluronidase. The activity was mainly linked to escin.

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Priest and Priest. Herbal Medication. Fowler. 1982

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Andrew Chevallier. Encyclopedia of Medicinal Plants. Readers Digest. 1996

H.W. Felter. Eclectic Materia Medica. Eclectic. 1922