Ginger
The most common medicinal use of ginger is as a remedy for
digestive complaints. It has been used for
thousands of years in Asian medicine to treat indigestion, nausea, diarrhea, and
stomachache
(Blumenthal et al., 2000) and in Ayurvedic medicine to treat flatulent
intestinal colic (Karnick, 1994). It is used
cautiously during pregnancy in Chinese medicine, usually in combination with other herbs,
to treat nausea and vomiting (Blumenthal et al., 2000; Bone,
1997). Women in India have also used ginger to counteract
morning sickness for hundreds of years, but they use it with care and only for nausea and
vomiting (Reading, 1995). It has been a
valuable medicinal and culinary plant in Europe and North America for centuries. Ginger was used by the Eclectic physicians to
relieve nausea, intestinal disorders, and painful menstruation (Felter and Lloyd, 1992).
Ginger rhizome contains phenolic compounds, mucilage,
gingerols, and volatile oils (Bartram, 1998). “Its
efficacy is thought to be due to its aromatic, carminative, and absorbent properties”
(Murphy, 1998:152).
In recent years, ginger has gained popularity in Western
allopathic medicine as a natural remedy for morning sickness. Over 50% of women in Western societies experience
nausea and vomiting in early pregnancy (Murphy, 1998).
Most popular herbals recommend ginger as a safe alternative to synthetic drugs,
which most women shy away from in the wake of the thalidomide tragedy of the early
1960’s.
Ginger has a wide range of other medicinal applications,
particularly in traditional Chinese medicine. In
a clinical trial, fresh ginger paste applied at Zhihying acupoint was found to have a
significant effect in correcting breech position. Correction
of fetal position occurred in 77.4% of the 133 women who received treatment, as compared
to 51.6% of the 238 women who were not treated (Cai et al., 1990).
With regards to its application as a remedy for morning
sickness, ginger has been the subject of a series of clinical trials. One double-blind, randomized trial of ginger for
treatment of severe nausea and vomiting of pregnancy showed promising results (Fischer-Rasmussen
et al., 1990). 30 participants were given 1
gram of powdered ginger in capsules daily for four days or a placebo (lactose), then after
a two-day break, they were given the alternate treatment.
70% of the women showed preference for the period in which they were given ginger. More recently, a second randomized controlled
trial of ginger for nausea and vomiting of pregnancy has been conducted
(Vutyavanich et
al., 2001). This study demonstrated that
ginger was indeed effective in reducing nausea and vomiting.
Some researchers have expressed concerns about the mutagenic
activity of a constituent of ginger, 6-gingerol (Nakamura and Yamamoto,
1982b). These concerns have
largely been dismissed. The whole rhizome
does not appear to have a mutagenic effect; it also contains the substance zingerone that
suppresses the mutagenic activity of 6-gingerol (Nakamura and Yamamoto,
1982a; Nakamura and Yamamoto, 1982b; Qian and Liu, 1992).
Ginger has been shown to inhibit platelet aggregation by
inhibiting thromboxin formation (Guh et al., 1995) and to decrease serum thromboxane
levels by 37% in humans (Srivastava, 1986). Backon
(1991) cautioned that ginger is a potent inhibitor of thromboxin synthetase, with an
effect on testosterone binding. It could
theoretically affect testosterone receptor binding and sex steroid differentiation of the
fetus (Backon, 1991). However, there is no
clinical evidence to back this up (Murphy, 1998).
Some herbalists caution women against using large doses of ginger,
because it has a reputation as an emmenagogue (menstrual promoter) (Burch and Sachs, 1997; Foster, 1999; Fulder and Meir,
1996; Grieve, 1971; Lipo, 1996; Romm, 1997; Weed, 1986)."
Ginger increases the flow of blood to the uterine area
(Campion, 1996; Weed, 1986) and
inhibits platelet aggregation
(Guh et al., 1995; Schulick, 1995), possibly explaining
ginger’s emmenagogic effect. Ginger is contraindicated in labour because it
can increase the possibility of postpartum hemorrhage
(Campion, 1996;Weed,
1986).
Possession of
Cannabis is presently illegal in Canada, though the laws are gradually relaxing around
medicinal use of the herb, and there are a number of licensed users. In spite of its illegal status, Cannabis is very
easy to come by on the black market, particularly in British Columbia where it is a major
cash crop and a popular recreational drug. Cannabis
has gained a positive reputation as an anti-emetic, used primarily by chemotherapy and
anti-HIV drug patients.
Cannabis and its derivatives have been used for several
decades to treat chemotherapy-induced nausea. The
active constituent delta-9-tetrahydrocannabinol (THC) was isolated in 1964, and used to
treat chemotherapy patients in the 1970s (Vincent et al., 1983).
Since then, THC and other natural and synthetic cannabinoids have been subjected to
a number of clinical trials, though never in the smoked form (Tramer et al., 2001). A review of
30 such trials found that cannabinoids are considered more effective than conventional
anti-emetic drugs, but they have more side-effects, some positive, some negative (Tramer et al., 2001). In another
paper, six US state trials of cannabis therapy for nausea and vomiting in cancer
chemotherapy patients were reviewed. These
previously unpublished trials included smoked Cannabis, which gave 70-100% relief, whereas
THC capsules gave 76-88% relief from symptoms (Musty and Rossi, 2001).
A survey of
oncologists found that many recommended Cannabis to patients, and they considered it more
effective in smoked form as compared to synthetic THC (Doblin and Kleiman, 1991). A second survey showed that oncologists considered
Cannabis to be 50% effective as an anti-emetic for chemotherapy patients; unpleasant side
effects were said to happen 25% of the time (Schwartz and Beveridge, 1994). Cannabis is also considered effective in treating nausea
and anorexia in AIDS patients, according to a review of case reports
(Bayer, 2001).
The detrimental effects of smoking Cannabis regularly
include an elevated risk of head and neck cancers (Carriot and Sasco, 2000). Vaporizers
have been developed; these heat the plant to temperatures that liberate the volatile,
medicinally active compounds while leaving more harmful constituents (such as tar) behind (Bayer, 2001). These vaporizers are of considerable interest for
medicinal Cannabis use, since Cannabis appears to be more effective when used as a whole,
compared to isolated THC or synthetic cannabinoids (Doblin and Kleiman, 1991; Gorter,
1999; Musty and Rossi, 2001). This
may be due to the presence in the plant of non-psychoactive components such as
cannabidiol, which was found to have anti-emetic properties in laboratory experiments (Mechoulam and Hanu, 2002;
Parker et al., 2002).
Though its
medicinal use in pregnancy is not publicly advocated, a casual poll of women reveals
widespread knowledge of the herb’s use as an anti-emetic and appetite stimulant in
pregnancy. Curry conducted a small,
underground pilot study of Cannabis therapy for hyperemesis gravidarum (Curry, 2002). Her work suggests that Cannabis may be a safer and
more effective treatment for this condition than any of the interventions currently
offered by the medical community.
Cannabis may be
smoked during pregnancy to relieve nausea- one or two puffs once or twice a day will
usually be sufficient (Curry, 2002). The
tincture should not be used during pregnancy, as it is a powerful oxytocic and may
stimulate uterine contractions (Russo, 2002). Weed
(1986) lists it as an emmenagogue, and notes that smoking the herb- as opposed to using a
tea or tincture- can most carefully control the dosage.
Levels of pregnancy-specific hormones appear to be normal in Cannabis users (Braustein
et al., 1983).
Due to the
popularity of Cannabis as a recreational drug, considerable amounts of data have been
collected on the effects of prenatal exposure. Some
studies have shown a correlation between cannabis use by pregnant women and slightly
reduced birth weight (Kline et al., 1987). Other researchers have found no connection between
Cannabis use and birth weight, when controlled for other variables (Shiono et al., 1995). A meta-analysis
of 32483 births found inadequate evidence that recreational use of cannabis causes lowered
birth weight (English et al., 1997). There is no
correlation between maternal Cannabis use and rates of perinatal mortality or morbidity
(Greenwood
and McCaw, 1994).
One study found
that recreational Cannabis use among white women
increased the odds of having a lower birth weight baby, SGA baby, or premature labour, but
the relationship didn’t hold for non-white mothers (Hatch and Bracken, 1986). In another
small study, 25% of regular users of Cannabis gave birth prematurely (Gibson et al., 1983). However, a
large, multi-site American study found no association between Cannabis use and prematurity
(Shiono et al., 1995).
Some problems appear to be specific to heavy maternal use
of Cannabis. One small study showed that
babies exposed to Cannabis in utero had no more minor anomalies than controls, though two
anomalies were found only in the babies of heavy users of Cannabis: true ocular
hypertelorism and severe epicanthus (Connell
and Fried, 1984). One researcher pointed out that Cannabis-exposed
babies have symptoms of nervous system anomalies (Fried, 1980),
including more tremors and startles, and poor habituation to visual stimuli
(Fried and Makin, 1987). In older
children, it is apparent that IQ was not affected by prenatal Cannabis exposure (Fried, 1995),
but prefrontal lobe function may be affected, as indicated by deficits in verbal ability,
memory (Fried and Smith, 2001), and inattention problems (Goldschmidt et al., 2000). In one
study, Cannabis use in the 2nd trimester of pregnancy led to more commission
errors and fewer omission errors (attention measures) in 6 year olds (Leech et al., 1999). Nonetheless,
adverse effects on intellectual development of Cannabis-exposed children are reportedly
not significant when home conditions were factored in (Connell and Fried, 1984). Interestingly,
an ethnographic study in Jamaica found that Cannabis-exposed babies were developmentally
equal to controls at birth, but were more advanced at 1 month of age (Dreher et al., 1994).
In short, though Cannabis has been well-scrutinized as a
potential teratogen, there appear to be no serious detrimental side-effects to its use in
light or moderate doses. Because of the
minute doses of Cannabis used as an anti-emetic, it is unlikely to have any adverse
effects on the baby. Until there is evidence to the contrary, Cannabis may be
considered safe for use as against nausea in pregnancy.
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