The herbal drugs are divided into groups according to their medicinal action: demulcent, expectorant, antitussive, spasmolytic, anticatarrhals and immunostimulant. Demulcents - The major respiratory demulcent herbs are Althaea officinalis root or leaves, mallows flowers, Ulmus spp., licorice and comfrey. - Respiratory demulcents are herbs contain mucilage and have a soothing and antiinflammatory action on the lower respiratory tract. Indications for respiratory demulcents: Dry, non-productive, irritable cough Application: Best taken before meals.

1. Herbal medicine
Respiratory system
By
Dr. Mostafa Mahmoud Hegazy ( PH.D.)

2. Respiratory system
The herbal drugs are divided into groups according to their medicinal action: demulcent,
expectorant, antitussive, spasmolytic, anticatarrhals and immunostimulant.
Demulcents
- The major respiratory demulcent herbs are Althaea officinalis root or leaves, mallows flowers,
Ulmus spp., licorice and comfrey.
- Respiratory demulcents are herbs contain mucilage and have a soothing and antiinflammatory
action on the lower respiratory tract. Indications for respiratory demulcents:
Dry, non-productive, irritable cough
Application:
Best taken before meals.

3. Marsh mallow (Althaea officinalis)
‫الخطمية‬
Constituents: The dried root contains up to 35% of mucilage; starch.
Action and uses: Typical demulcent cough remedy.
Preparations: Cold maceration for several hours to ensure that the mucilage and not the starch is
extracted (the starch does not dissolve in cold water).

4. Expectorants
- Expectorants are cough remedies that liquefy viscid sputum so that it can be cleared by
coughing.
- Expectoration is effected by the fine hairs (cilia) of the ciliated epithelium, which push the
mucus in waves towards the outside. By clearing abnormal mucus or by changing its character
and making it more demulcent.
- Expectorants include
1- Stimulating (reflex) expectorants:
2- Warming expectorants
3- Warming expectorants with Respiratory antiseptic effect

5. 1- Stimulating (reflex) expectorants:
These are remedies that provoke increased mucociliary activity by reflex stimulation of the
upper digestive wall. The classic examples were originally used as emetics in sub-emetic doses.
ex. ipecacuanha, squills, Primula, saponaria and senega.
Stimulating expectorants should be kept under review in cases of:
- Dry and irritable cough - Asthma - Young children
- Dyspeptic conditions.
Application: Stimulating expectorants are best taken in hot infusions or fluid extracts. Long-term
therapy is usually acceptable.
3- Warming expectorants with respiratory antiseptic effect:
Scabwort roots (Inula helenium), Thyme (Thymus vulgaris), Guajava Leaf (Psidium guajava)

6. 2- Warming expectorants (mucolytics) include:
A- Aromatics: fennel, anise, cinnamon and Angelica.
B- Pungent spices: ginger probably includes increased blood flow to the respiratory mucosa, a
reflex irritation of the upper digestive mucosa (as with the stimulating expectorants)
C- Sulfur-containing herbs: garlic and mustard family, a decrease in the thickness of mucus by
altering the structure of its mucopolysaccharide constituents.
Indications for warming expectorants:
- Productive cough associated with cold, bronchitis, emphysema, profuse catarrhal conditions,
- Congestive chronic infections and inflammatory conditions.
Contraindications:
In gastroesophageal reflux.
Applications:
Warming expectorants are particularly effective taken in hot aqueous infusions. Long-term
therapy is usually acceptable.

7. Ipecacuanha, Ipecac,
(Cephaelis ipecacuanha)
‫عرق‬ ‫جذور‬‫الذهب‬
Constituents:
Alkaloids: emetine and cephaeline.
Action and uses:
- A typical expectorant (0.4 mg emetine = 20 mg root powder).
- High doses of the alkaloids in ipecac root have an emetic effect (0.5-2 g roots and rhizomes).
Mechanism of action:
- Low doses stimulate the gastric mucosa, lead to reflex effect on the bronchial mucosa, via the
gastrobronchial vagus reflex, again leading to hypersecretion, i.e. increased amounts of sputum.
- High doses have emetic properties.

8. Primula, cowslip (Primula officinalis)
oxlip (Primula elatior)
Constituents:
Triterpenoid saponins (5-10%);
salicylic acid glycosides (primulaverin and primverin)
volatile oil.
Action and uses:
Expectorant - Analgesic
Mechanism of action:
- The expectorant effect of the saponins is mainly due
to stimulation of the mucosal linings and the resultant
triggering of parasympathetic reflexes.
- Its content of salicylic acid derivatives, is responsible
for analgesic effect.

9. Senega (Polygala senega)
‫جذور‬‫السينيجا‬
Constituents:
Terpenoidal saponins (senegin, 6-10%)
Salicylic acid and its methyl ester 0.1-0.2%.
Action and uses:
- Expectorant
- Emetic

10. Soapwort, Saponaria
(Saponaria officinalis)
‫الصابونية‬ ‫الحشيشة‬‫عرق‬ ‫أو‬‫الحالوة‬
Constituents:
Soapwort roots contain 5% saponin.
Action and uses:
Expectorant
Ivy leaves (Hedera helix)
‫الهيدرا‬ ‫لبالب‬
Constituents:
Triterpenoid saponins and falcarinol,
Action and uses:
Expectorant Secretolytic Antispasmodic

11. Fennel (Foeniculum vulgare )
‫ثمار‬‫الشمر‬
Constituents:
1- Volatile oil composed of anethole, fenchone and estragol (methyl
chavicol).
2- flavonoids: kaempferol, quercetin, iso-quercetin and rutin.
Uses and action
1- Flavoring agent
2- Carminative
3- Mild expectorant

12. Anise (Pimpinella anisum )
‫ثمار‬‫الينسون‬
Active constituents:
- Volatile oil (2-3%) composed of (80-90%) anethole.
Uses and action
1- Flavoring agent
2- Carminative
3- Expectorant
Star Anise (Illicum verum )
‫النجمى‬ ‫الينسون‬ ‫ثمار‬
Active constituents:
- Volatile oil (5%) composed mainly of anethole.
Uses and action
1- Flavoring agent
2- Carminative
3- Expectorant

13. Thyme leaf (Thymus vulgaris or Thymus zygis )
‫الزعتـــر‬
Active Constituents:
1- Volatile oil: thymol, carvacrol, linalool
2- Flavonoids: Apigenin, luteolin
Action and uses:
- For dyspepsia, flatulence
- Expectorant and antiseptic for respiratory tract and in cough
mixtures.
- Spasmolytic, secretolytic, secreto-motor, broncholytic
- Inflammation of throat, laryngitis and tonsillitis (as gargle)
-Antiseptic
Mechanism of action:
When administered orally, thyme oil is largely eliminated by the
pulmonary alveoli. Hence, concentrated drug effects occur at the
site of disease.

14. Guajava Leaf (Psidium guajava )
‫أوراق‬‫الجوافة‬
Active Constituents:
Volatile oil (cineol, Limonene, Pinene and
Cadinol).
Flavonoids (Quercetin).
Glycosides (Aircularin and Guaiavein).
Uses:
Expectorant and antiseptic for respiratory tract
and in cough mixtures.

15. Antitussives
The term 'antitussive' is often used to refer to remedies that
depress the cough reflex.
Indications for antitussives:
Non-productive, dry, severe or persistent cough
Nervous cough,
Cough due to external irritation or obstruction
Application: Antitussives are best taken before meals.
Opium poppy
(Papaver somniferum)
Codeine is generally used in the form of the water-soluble
codeine phosphate. Codeine is a typical sedative cough remedy.
Codeine has two actions.
- Depressant effect on the cough center,
- General sedative and analgesic properties.

16. Cough remedies for external use
(inhalation, chest rubs)
The vapors of selected drugs can also be administered by inhalation, a popular method of
therapy.
Chamomile infusions are most commonly used for inhalation.
method: The infusion is prepared by placing a handful of chamomile flowers in a pot and pouring
boiling water onto them. The patient should breathe in the vapors, thereby using a towel draped
over the head and around the pot.
It may also be helpful to add other herbs to enhance the effects of the infusion. e.g. thyme,
eucalyptus oil, camphor, methyl salicylate, peppermint oil and pine oil.
Action: Local antiseptic, secretolytic and expectorant.

17. Preparations:
Rx Chamomile flowers
Thyme herb
Marjoram herb equal parts to make 100.0
1 tablespoon to half a liter of boiling water, for inhalation.
Rx/ Peppermint oil
Dwarf pine oil
Eucalyptus oil in equal parts to make 10.0.

18. Respiratory spasmolytics
Selected herbal drugs can be recommended as adjuncts for use in the intermission
period between attacks e.g. khella (Ammi visnaga), ephedra, belladona, stramonium,
coleus (Coleus forskohlii) and lobelia (Lobelia inflate).
Indications for respiratory spasmolytics:
- Tight, breathless,
- Non-productive cough
- Wheezing and other asthmatic symptoms.
Contraindications for respiratory spasmolytics:
In the case of solanaceous plants: glucoma, urinary retention, paralytic ileus, intestinal
atony and obstruction.
In the case of ephedra:
appetite disorders, glucoma, prescription of MAO-inhibitors.

19. Khella (Ammi visnaga)
Constituents:
Furanochromones such as khellin and visnagin
pyranocoumarins such as visnadin, samidin, and dihydrosamidin.
Action and uses:
- Angina - Renal colics -Bronchodilator
Ephedra
Ephedrine is an indirect sympathomimetic, it stimulates the release of norepinephrine, thereby
causing bronchodilation.
- It relieves the spasm of bronchial muscle that underlies the asthmatic state.
- Allergic conditions of all types also respond well, hayfever
- Decongestant in rhinitis and sinusitis

20. Anticatarrhals
Plant remedies used as anticatarrhals are:
Euphrasia spp, verbascum, Sambucus nigra, Solidago virgaurea, Hydrastis canadensis,
pseudoephedrine and gentian.
Indications for anticatarrhals:
Catarrhal conditions, especially in the upper respiratory tract, sinusitis, otitis media, allergic
rhinitis and other hypersensitivity conditions.
Immunostimulant
Immune-enhancing herbs such as Echinacea, picrorrhiza, black seed (Nigella sativa), astragalus
Elder flowers (Sambucus nigra), Tilia, Linden, Lime blossom , Lime flowers
Elder flowers (Sambucus nigra)
Constituents: Flavonoids, phenolic acids, steroids, and triterpenes.
Action and uses:- Immunostimulant - Anticatarrhals

21. Tilia, Linden, Lime blossom , Lime flowers
Constituents: Flavonoids, tannins, and mucilage.
Action and uses: - Immunostimulant - Smooth muscle relaxant
Vitamin-rich medicinal plants
vitamin C resistance to disease.
Lemon juice is the best known source of vitamin C; it also contains P vitamins, such hesperidin.
This explains why lemon juice was more effective in treating scurvy than pure vitamin C
preparations.
Many plants are rich in vitamin C, especially the Rose hip (Rosa canina).

22. Acute bronchitis
- Immune-enhancing herbs such as Echinacea, picrorrhiza, nigella sativa and astragalus.
- Respiratory antiseptic herbs which also have expectorant or mucolytic properties are
particularly indicated, such as Thymus vulgaris and Allium sativum.
- During the dry, unprotective cough phase, demulcents such as althaea should be prescribed.
- Expectorant herbs, which include Thymus vulgaris, polygala and other saponin-containing
herbs, foeniculum (fennel), pimpinella (aniseed) can be prescribed throughout the course of the
disorder.
- Antitussive herbs especially at night
- Anticatarrhal herbs, especially Verbascum and hydrastis
- Antibiotics are hardly suitable for the treatment of acute bronchitis. In most cases these are, at
least initially, virus infections.
- Mucolytic herbs such as Allium sativum

23. Chronic bronchitis and emphysema
- Bronchial irritation must be avoided. A change in occupation or climate may be necessary.
- Mucus-producing foods such as dairy products and bananas should be reduced.
- Immune-enhancing herbs and respiratory antiseptic herbs
- During the dry, unprotective cough phase, demulcents should be prescribed.
- Expectorant herbs
- Antitussive herbs especially at night
- Anticatarrhal herbs, especially Verbascum and hydrastis
- Inhalation of peppermint and eucalyptus oils
- Bronchodilating herbs such as coleus and lobelia may be helpful. Ephedra should probably be
avoided.
- Anti-inflammatory herbs such as glycyrrhiza may be of value, as well as omega-3 fatty acids (as
found in linseed oil).
- Support for the heart and general circulation with crataegus and ginkgo may be required.

24. Acute and chronic sinusitis
- Immune-enhancing herbs such as Echinacea, picrorrhiza, nigella sativa and astragalus.
- Respiratory antiseptic herbs which also have expectorant or mucolytic properties are
particularly indicated, such as Thymus vulgaris and Allium sativum.
- Inhalation of peppermint and eucalyptus oils
-- Mucolytic herbs such as Allium sativum
-- Anticatarrhal herbs, especially Verbascum and hydrastis