Botanical Index No. 519

Horse Chestnut

aesculus hippocastanum

Medicinal Actions

Analysis pending research update.

Primary Conditions Treated

Acne Arthrosis Asthma Backache Bruise Cancer Capillary Fragility Cellulite Cold Congestion Cough Cramp Carpal Tunnel Syndrome CVI Diarrhea Discitis Dysentery Dysmenorrhea Dyspepsia Eczema Edema Enterosis Fever Flu Gastroenterosis Gastrosis Headache Hematoma Hemorrhoid Hepatosis High Blood Pressure Induration Inflammation Itch Low Blood Pressure Lupus Malaria Mastosis Neuralgia Pain Palsy Pertussis Phlebitis Proctosis Prostatosis Rheumatism Sore Sprain Sunburn Swelling Systremma Thrombophlebitis Thrombosis Tumor Ulcer Varicosis Vertigo Virus Wound Wrinkle menorrhea

General Dosage

0.2–1.0 g fruit 3 ×/day; 1–2 g dry seed/day; 1/2 tsp powdered seed/16 oz water; 2–6 ml fluid seed extract/day; 5–15 ml/day seed tincture; 2–4 ml liquid bark extract; 0.5–1.2 ml liquid fruit extract; 30–150 mg aescin/day; 90–150 mg aescin at first, then 35–70 mg; 300–600 mg StX; StX tablets to provide 40 mg escin, 2–3 ×/day; 2 capsules synergistically combined with butcher’s broom, gin- ger, and rutin), one with morning meal, one with evening meal.

Safety & Contraindications

Not covered. Seeds “poisonous” and must be specifically prepared before being used medicinally. Never consume them in any form unless a knowledgeable manufacturer has processed them properly. Children have died after ingesting untreated seed. Formerly an FDA herb of undefined safety. Strangely, APA gives the internal usage their highest rating and external usage less. Aesculin has caused contact dermatosis. The no-toxic-effect dose is ca. 8 times the recommended therapeutic dose. The results H of animal studies are corroborated by decades of use in patients with no reports of harmful effects due to overdosing. Tests for chronic toxicity showed no cumulative toxic effects or any evidence of embryotoxic or teratogenic effects. Isolated cases of GI distress, itch, and nausea are reported. Commission E reports rare GI disturbances. No con- traindications or drug-drug interactions reported. Isolated cases of renal and hepatic toxicity as well as anaphylactic reactions have been reported following intravenous administration, but these appear to be exceptional. Fleming cautions that the intake of too many horse chestnut seed can cause diarrhea, disorders of consciousness and vision, enlargement of the pupils, flushing of the face, severe thirst, and vomiting. In case of poisoning, Fleming recommends evacuation of the stomach and intestine and administration of activated charcoal. Then symptom management. Blumenthal et al. caution that other prescribed noninvasive treatments; e.g., leg compresses, support stockings, or cold water applications, must be observed under all circumstances. CAN cautions that aescin is nephrotoxic. Side effects include GI disturbance, impaired liver function, mild nausea, shock, spasm, urticaria, and vomiting. Should be avoided by patients on blood-thinning therapy, with hepatic or renal impairment, or lactating or pregnant. Large doses of saponins can be fatally hemolytic in animals. LD50s range for aescin from 134 to 720 orally in mice, rats, and guinea pigs. On ipr administration, the total saponin fraction was less toxic compared to isolated aescin. LD50 of seed extract 990 mg/kg orl mouse, 2150 orl rat, 1530 orl rbt, 130 orl dog.

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