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Kalam et al Journal of Drug Delivery & Therapeutics. 2023; 13(12):270-277
ISSN: 2250-1177 [270] CODEN (USA): JDDTAO
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Open Access Full Text Article Review Article
Khatmī (Althea officinalis L. and Althea rosea): Medicinal importance in the
perspective of Unani medicine and pharmacological studies
Mohd Afsahul Kalam*1, Riyaz Ahmad2, Mohammad Avid2, Abdur Rahim3, Abdul Habib2
1 Research Officer Unani SL-2, Regional Research Institute of Unani Medicine, University of Kashmir, Srinagar, J&K 190006 India.
2 PG Scholar Department of Ilmul Advia, Regional Research Institute of Unani Medicine, Kashmir University, Srinagar-190006 J&K- India.
3 Research Officer Unani SL-4, Central Council for Research in Unani Medicine, New Delhi. India.
Article Info:
_____________________________________________
Article History:
Received 18 Sep 2023
Reviewed 07 Nov 2023
Accepted 26 Nov 2023
Published 15 Dec 2023
_____________________________________________
Cite this article as:
Kalam MA, Ahmad R, Avid M, Rahim A, Habib A,
Khatmī (Althea officinalis L. and Althea rosea):
Medicinal importance in the perspective of Unani
medicine and pharmacological studies, Journal of
Drug Delivery and Therapeutics. 2023;
13(12):270-277
DOI: http://dx.doi.org/10.22270/jddt.v13i12.6155
_____________________________________________
*Address for Correspondence:
Mohd Afsa hul Kalam, Research Officer Unani,
Regional R esearch Institute of Unani Medicine,
University of Kashmir, Hazratbal, Srinagar,
190006, J&K, India
Abstract
__________________________________________________________________________________________________________________
Althea officinalis L. is an important Unani Medicinal plant belonging to the family Malvaceae. The
herb is commonly known as Khatmī and Marsh-mallow. All parts of the plant such as seeds, leaves,
root and flowers are mainly used as medicine in Unani Medicine. It is used for many pharmacological
actions like diuretic, lithotriptic, deobstruent, anti-inflammatory, emmenagogue which makes it
useful in treatment of kidney stone jaundice, menstrual disorder, hepatitis, headache etc. Many
scientific studies are done on the pharmacological actions of this herb. In this chapter both modern
and Unani perspective of pharmacological properties of Althea officinalis L. along with its
Phytochemistry and pharmacological studies are included.
Keywords: Althea officinalis L.; Khatmī; Malvaceae
Introduction
Khatmī is a common drug used in Unani System of Medicine
which is obtained from two sources namely Althea officinalis L.
(marsh-mallow) and Althea rosea (garden hollyhock) of
Malvaceae family. The generic name of the plant derived from
Greek word “Altaia” which means “rich in benefits” and the
specific name officinalis means “found officially”. Commonly it
is known as Khatmī and marsh-mallow. Mainly its leaves, seeds
and roots are used medicinally to cure various common
diseases. The root is said to be better when used before one
year, seeds before three years and flowers before seven days,
after that their medicinal properties become weak. All parts
have lubricant, sticky, relaxant, anti-inflammatory, analgesic,
astringent, expectorant, anti-catarrh, laxative, diuretic,
emmenagogue activities etc., which make it useful for the
treatment of various diseases such as Nazla (catarrh), Zukām
(nasal obstruction), Su’āl (cough), Warm-i-Am’ā (enteritis),
Ishāl (diarrhoea), Zahīr (dysentery), Sozish-i-Bawl (urinary
tract infection), Fālij (hemiplegia), ‘Irq al-Nasā (sciatica),
Warm-i-Pistān (mastitis), Ra’sha (tremor), Ihtibās-i-Ḥayḍ
(amenorrhea) and Ihtibās-i-Bawl (retention of urine) etc. 1,2,3,4,5.
The plant and its different parts have various bioactive
compounds such as flavonoids include kaempferol, quercetin
and diosmetin glucosides; polyphenolic acids include syringic,
caffeic, salicylic, vanillic and p-coumaric acids which are
responsible for its pharmacological actions. Various
experimental studies have been done on this plant which have
proved the claims of Unani physicians.
Materials and Methods
All materials available on printed, electronic and online were
used to prepare this review. For its description, identification,
temperament, pharmacological investigations, actions,
therapeutic uses etc. both modern, Unani books were consulted
and published articles and research papers were searched from
Pub Med, Google scholar, Science direct, Scopus etc. The detail
about the plant and its parts were searched by the key words
Khatmī, Althea officinalis Malvaceae
The detail of various aspect of the plant is as follow:
1. Distribution
Native to Eastern Europe and Western Asia; in India it is found
in Kashmir, Uttar Pradesh, Punjab, Rajasthan and Himachal
Pradesh6.
Kalam et al Journal of Drug Delivery & Therapeutics. 2023; 13(12):270-277
ISSN: 2250-1177 [271] CODEN (USA): JDDTAO
2. Botanical description
It is a downy perennial herb, up to 3 m tall, erect, hardy and
velvety plant. Stem is hairy, up to 3 to 4 feet high, simple, or
putting out only a few lateral branches, die down in the autumn;
leaves are large, obovoid, rough, rugose (wrinkled), base
scarcely cordate, 5-7 lobed or wavy angled, soft and velvety on
both sides, due to a dense covering of stellate hairs; flowers are
rosy in axillary clusters, crenate, nearly sessile (resting on the
surface) in long racemes or spike, 7-8 cm in diameter; corolla
are five heart shaped of all shaded of rose, purple, white or
yellow, single or double, appears in July to October; carpels
many on a small torus ultimately separating, forming mericarps
each containing a seed. Stamens numerous united into a tube
with kidney-shaped and one-celled anthers. roots are 0.2 to 3
cm in diameter, long thick, tapering (smaller and thinner
towards one end), light brown in colour, strongly longitudinally
furrowed, often spirally twisted; fracture short, texture rough,
internally yellowish white; odour, pleasant; taste, sweet and
mucilaginous; fruits flat, round 5-8 mm, breaks up into the
mericarps, which are downy on the outside and have fine,
branched and radiating ribs, fruiting occurs in November-
December; seeds small to moderate size; approximately 6 mm,
usually brownish-black, kidney shaped with rugose, hairy at
margins and somewhat compressed. It becomes mucilaginous
when soaked in water 7,8,9,10.
3. Taxonomical classification13,31
Kingdom: Plantae
Division: Magnoliophyta
Class: Magoliopsida
Order: Malvales
Family: Malvaceae (mallow family)
Genus: Althea
Species: Althaea officinalis
4. Description in Unani Literature
The plant of Khatmī is up to 3 m in height; leaves rounded,
rough; flowers beautiful bell shaped, white to reddish or bluish
colour; fruits appear after shedding of the flowers, bear black
and flat multiple seeds. The roots are Reshadār (fibrous) so
called Resha-i-Khatmī, it is yellowish white in colour. According
to Ibn Sina some species of marshmallow bear white flowers
while some bear red flowers. The species which has red flowers
are more detergent2. Different parts of the plant such as flowers
(Gul-i-Khayrū), leaves (Barg-i-Khatmī) and roots (Bīkh Khatmī
or Resha Khatmī) are used for the treatment of various
ailments. Its seeds and roots both give mucilage when soaked
in water. Roots are more mucilaginous than seeds. In Unani
System of Medicine the drug has been used medicinally since
the time immemorial2,3,4,5. Dioscorides (1st Century) mentioned
the plant first time in his book De Material Medica. According to
Kalam et al Journal of Drug Delivery & Therapeutics. 2023; 13(12):270-277
ISSN: 2250-1177 [272] CODEN (USA): JDDTAO
Unani literatures the different aspects of the plant are as
follows:
5. Mutarādifāt (Vernacular names):
Khatmī is obtained from the Althea officinalis of family
Malvaceae. The plant is used by different vernacular names in
Unani Medicine as: 6,13.
Arabic: Bazr al-Khatmī, Kathir al-Manfi’at
Chinese: KeZhi Gen
Danish: Altae
Dutch: Heemst
English: Marsh Mallow, Sweet Weed, Hollyhock
French: Guimauve
German: Eibisch, Ibisch
Greek: Altaia, Hibiscos
Hindi: Khatmī, Khyra
Italian: Bismalva
Kashmiri: Sazkul, Sazmūl, Sazposh
Persian: Tukhm-i-Khatmī, Resha-i-Khatmī
Portuguese: Malvaisco
Rumanian: Nalba mare
Russian: Altei, Dikayaroja
Spanish: Malvavisco
Swedish: Altea
Tamil: Shimaithuthi
Turkish: Hatmi, Herbamalvae
Urdu: Khatmī, Khitmī, Gul-i-Khayrū
6. Ajzā-i-Musta’mala (Parts used):
Seeds (Tukhm-i-Khatmī), flowers (Gul-i-Khayrū) and root (Bīkh
Khitmī or Resha Khitmī) are used medicinally in Unani System
of Medicine.4
7. Mizāj (Temperament):
Cold and wet in 1st degree, but in Advia Nafisi it is mentioned to
have hot temperament. According to Ibn Rushd its leaves and
branches are hot and dry in 1st degree; roots hot and dry in 2nd
degree; Galen told it cold and dry while Ibn Sina told
moderately hot2,14,15,16.
8. Miqdār Khūrāk (Dose): 4–7 g 4, 6–9 g, 5–7 g5.
9. Af’āl (Action):
Root: Muzliq (lubricant), Mugharrī (sticky), Murkhī (relaxant),
Muḥallil-i-Awarām (anti-inflammatory), Musakkin (analgesic),
Ḥābis (astringent), Ḥābis-i-dam (haemostatic), Mujaffif
(desiccant), Māni’-i-Surfā (antitussive), Mufattit-i-Ḥasāh
(lithotriptic); Seed: Munaffith-i-Balgham (expectorant), Māni’-i-
Nazla (anti-catarrh), Nāfi’-i-Su’āl (antitussive), Mulayyin
(laxative), Rādi’-i-Mawād (divergent), Jāli (cleanser), Mulattif
(demulcent), Munḍij-i-Balgham (concoctive of phlegm),
Murkhī-i-Mi’da wa Adlāt (emollient for stomach and tissues),
Mudirr-i-Bawl (diuretic), Mudirr-i-Ḥayḍ (emmenagogue);
leaves: Muḥallil-i-Awarām (anti-inflammatory); flowers:
Mufarriḥ (exhilarant), Muqawwi-i-Qalb (tonic to heart), Qābiḍ
(astringent), Nāfi’-i-Suda’ (analgesic for headache), Nāfi’
Nafakh-i-Shikam (anti-flatulence) etc. 2,3,4,5,15.
10. Iste’mālāt (therapeutic uses):
Due to the Mulattif (demulcent), Mugharrī (sticky) and
Musakkin (analgesic) effects of root and seeds, they are used to
cure Nazla (catarrh), Zukām (nasal obstruction), Su’āl (cough),
Waram-i-Am’ā (enteritis), Ishāl (diarrhoea), Zahīr (dysentery),
Sozish-i-Bawl (urinary tract infection) etc. due to the Jāli
(cleanser) effect it has been found useful in Bahaq (pytriasis).
Resha Khitmī has been also found effective in the treatment of
Fālij (hemiplegia), Irq al-Nasā (sciatica), Waram-i-Thadi
(mastitis), and Ra’sha (tremor). The decoction of roots is useful
in Ḥurqa al-Bawl (burning micturition), ‘Usr al-bawl (dysuria),
Ḥurqa al-Am’ā (burning sensation of intestine) and Warm-i-
Maq’ad (anal swelling), which is attributed due to its Mugharrī
(lubricant) and Murkhī (relaxant) effects. Leaves are used
locally as a paste to cure Waram al-Thadī (mastitis). Many other
diseases such as Waram-i-Raḥim (metritis), Waja’ al-Mafāsil
(arthritis), Ḥasāh al-Kulya (renal calculus), Nafth al-dam
(haemoptysis), Shahīqa (whooping cough), Niqris (gout), Dhīq
al-Nafas (asthma), Dhāt al-Riyā (pneumonia), Dhāt al-Janb
(pleurisy), Qurūh (wound), Qūlanj (colitis), Ihtibās-i-Ṭamth
(amenorrhea), Ihtibās-i-Bawl (retention of urine) etc. are also
have been cured by using various parts of the plant 2,3,4,5,15.
11. Tarkīb-i-Iste’māl (Method of administration):
Mode of administration of drug in various diseases is as follows:
Amrāḍ-i- A’sab wa Dimāgh (Diseases of Nerve and Brain)
Laqwa (Bell’s palsy): A massage with Roghan-i-Khatmī on
cervical vertebrae is very useful, when applied in case of bell’s
palsy which occurs due to Yubūsat (dryness)17.
Amrad-i- Ḥalaq (Diseases of throat)
Warm-i-Ghudda-i-Nakaf (Parotitis): A Ḍimād (paste) of marsh-
mallow is applied to remove the swelling of parotid glands 2.
Amrad-i-Ri’a (Diseases of lungs)
Dhāt al-Janb and Dhāt al-Riyā (Pleurisy and pneumonia): The
leaves are incorporated in plasters for pleurisy and pneumonia
2.
Amrad-i-Mi’da w Am‘ā’ (Diseases of stomach and intestine)
Ḥurqa al-Am’ā (burning sensation of intestine): The decoction
of its root is useful in Ḥurqa al-Am’a (burning sensation of
intestine) and Warm-i-Maq’ad (inflammation of anus) 2.
Ishāl (diarrhoea): Its leaves are used in severe diarrhoea 2.
Amrad-i-Kulya, Ḥālibayn, Mathāna, wa Raḥim (Diseases of
kidney, ureters and urinary bladder )
Ḥurqa al-Bawl and Sozish-i-Bawl (burning micturition or
urethritis): The decoction of its root is useful in Ḥurqa al-Bawl
and Sozish-i-Bawl 2.
Hasāh al-Kulya (renal calculus): Oral intake of decoction of root
with wine is useful in dysuria and calculi in urinary tract 2,18.
Salābat-i-Rahim (hardening of uterus): It is used as a
suppository with the gum of Baṭam (terbinth) in uterine
hardness 2,18.
Amrad-i-Jild wa Mafāṣil
Bahaq (Pytriasis): A paste of Tukhm Khatmī is painted over with
vinegar and then the patient is exposed to sun light 2.
Awarām, Buthūr wa Khanāzīr (Swellings, furuncles and
scrofula): Its local application softens and prevents swellings. It
dissolves hematoma, mature furuncles, and helps in relieving
flatulent swellings and scrofula. It is applied with Sulphur on
scrofula 2.
Kalam et al Journal of Drug Delivery & Therapeutics. 2023; 13(12):270-277
ISSN: 2250-1177 [273] CODEN (USA): JDDTAO
Waja’al-Mafāsil (joints pain): It mitigates joints pain specially
when used with goose fat 2,18.
Tasmīm (poisoning)
To remove pain due to insect bite, it is applied as liniment with
vinegar or olive oil. Same is used also for honey bee sting 2,18.
12. Medicinal uses in Kashmir Folklore
Root is used as abortifacient, for this purpose cervix is first
slightly dilated and then the root of Khatmī is kept in the cervix
for some time, due to its mucilaginous property without
causing ulceration or irritation the cervix get dilated to the
extent that the abortion takes place7.
13. Maḍarrat (Toxicity, side effect and adverse
effect)
Khatmī (Althea officinalis) may cause harmful effects on lungs
and stomach if taken excessively.1
14. Musleh (Correctives)
Shahad (honey) and Bādiyān (Foeniculum vulgare-fruits),
Zarishk (Berberis vulgaris-Berries) are the correctives of
Tukhm-i-Khatmī (Althea seeds)1 they are recommended to use
along with Khatmī (Althea officinalis) to prevent from side
effects.
15. Badal (Substitutes)
The following drugs are mentioned in the Unani text as
substitutes for Tukhm Khatmī, they are Khubāzī (Malva
sylvestris L. Fruits), Nilofar (Nymphaea lotus Flower); for roots
(Malva sylvestris L. roots)1 Behman Surkh (Salvia haematodes L.
Roots), Samagh-i-Arabī (Acacia arabica Wild. Gum) and
Tabāshīr (Bambusa arundinacea-Manna).
16. Compound formulations
Arq-i-Ambar, Arq ma al-Laḥm Mako Kasniwala; Dawā al-Misk
Mu’tadil Jawāharwāli; Dayaqūza; Ḥabb-i-Shahīqa; Itrīfal
Muqawwi-i-Dimāgh; Khamīra Abresham Sāda, Khamīra
Gāozabān Ambarī, Khamīra Gāozabān Ambarī Jadwar Ood Salib
wala Khamīra Gāozabān Sāda, Khamīra Murakkab, Khamīra
Nazlī Jawāharwālā; Labub-i-Saghīr, La’uq Nazlī , La’uq Khyar
shambar, La’uq Sapistan, La’uq Sapistan Khyar Shambarī;
Ma’jūn Muqawwi wa Mumsik; Marham Dakhilyun; Matbukh
Nazla; Sharbat Aijaz, Sharbat Khashkhāsh, Tiryāq-i-Nazla,
Qayrūti Arad Bāqla, Qayrūti Bābunawali, Qayrūti Karnab,
Qayrūti Ma’mul; Qurs Dhāt at al-Janb, Sharbat-i-Aijaz, Ḍimād
Waram Kulya Qawī 8,14,19,20.
Table 1: Compound formulations having Althea officinalis seeds or flowers as one of the ingredient, with their dose, method of
administration, action and uses
S.N
Name of the compound
Parts
used
Dose and method of
administration
Action and uses
1
Dawa-ul Misk Mu’tadil
Jawahar Wali21
Flowers
5 g/orally
It has astringent and cardio-tonic properties and
used and used to strengthen vital organs (heart,
brain and liver), it also used to cure palpitation and
general weakness.
2
Itrīfal Muqawwi Dimāgh21
Flowers
10 g/orally
It is brain tonic, eye tonic and used in mental
disorders, cold, coryza and headache.
3
Khamīra Abresham Sāda21
Flowers
10 g/orally
It is cardio-tonic, and brain tonic used for cerebral
weakness and Palpitation.
4
Khamīra Gāozabān Ambarī21
Flowers
5-10 g/orally
It is cardio-tonic, and brain tonic used in cerebral
weakness and Palpitation.
5
Khamīra Gāozabān Ambarī
Jadwar Ood Salīb Wala21
Flowers
5 g/orally
It is vital tonic so useful in in Epilepsy, infantile
convulsion and hysteria.
6
Khamīra Gāozabān Ambarī
Jawāhar Wala21
Flowers
5 g/orally
It is cardio-tonic, and brain tonic used for cerebral
weakness and Palpitation.
7
Khamīra Gāozabān Sāda21
Flowers
10 g/orally
It is cardio-tonic, and brain tonic used for cerebral
weakness and Palpitation.
8
Khamīra Marwārīd
Banuskha Kalan21
Flowers
3-5g/orally
It is cardio-tonic, exhilarant and used for
palpitation, anxiety, cardiac weakness, general
weakness which occurs due to typhoid, measles
and smallpox.
9
Khamīra Murakkab21
Flowers
5 g twice a day.
It is cardio-tonic, and brain tonic used for cerebral
weakness and fasciculation.
10
Khamīra Nazlī
Jawāharwālā21
Flower
5 g/orally
It is cardio-tonic, and brain tonic used for cerebral
and nerve weakness and chronic catarrh, cold, and
general weakness.
11
Kundri21
Seeds
Adult - 6 g twice a day,
Children - 3 g twice a day
It lesser the frequency of micturition and
strengthen the bladder and kidney so useful in
polyuria and urinary incontinence.
Kalam et al Journal of Drug Delivery & Therapeutics. 2023; 13(12):270-277
ISSN: 2250-1177 [274] CODEN (USA): JDDTAO
12
Lauq Khyār shambar21
Khitmī
Siyāh
(seeds)
10 g with warm water
twice a day
It has expectorant, concoctive, and laxative
properties and used for cold, catarrh and wet
cough.
13
Lauq Nazlī8
Seeds
10 g thrice a day
It has expectorant property and useful in cold,
catarrh.
14
Lauq Sapistan Khyar
Shambarī8
Seeds
10 g thrice a day
It is antitussive and used for cold, catarrh and wet
cough.
15
Marham Dakhilyūn
Murakkab21
Seeds
15 g Marham mixed with
Roghan-i-Gul, 25 ml and
egg albumin properly
and used as vaginal
suppository.
It has anti-inflammatory, uterine tonic, properties
and used for metritis, fibroid of uterus, uterine pain
and weakness.
16
Qayrūti Arad-i-Bāqla18
Flowers
5-10 g for local
application
It is anti-inflammatory and useful for pleurisy.
17
Qayrūti Babūna Wālī18
Seeds
Local application
It is analgesic, anti-inflammatory and useful for
pleurisy and ribs pain
18
Qayrūti Karnab18
Mucilage
of flowers
For local application
It is emollient and useful for cracked lips and
cracked skin of hand
19
Qayrūti Ma’mūl18
Flowers
for local application
It is anti-inflammatory and useful for pleurisy,
chest pain and ribs pain
20
Qurs Dhāt-al-Janb18
Seeds
5-10 g for local
application
It is anti-inflammatory and useful for pleurisy
21
Sadri 21
Flowers
3 g with lukewarm water
twice a day
It has antitussive, expectorant properties and used
for cough, and asthma.
22
Sharbat Nazla21
Seeds
20 ml twice a day
It has anti-catarrh property and used for cold,
catarrh and wet cough.
23
Ḍimād Waram Kulya Qawī18
Seeds
Local application
It is anti-inflammatory and useful for nephritis
17. Bioactive Compounds
• Flavonoids: Leaves, roots and flowers contains ypolaetin-8-
glucoside, Isoquercitrin, kaempferol. 22
• Polysaccharides: Seeds, leaves and flowers contains
hemicelluloses, which is composed of D- xylose, 4-O-
methyl-D-glucoronic acid and traces of D-galactose, L-
arabinose, 23,24 Pectins25.
• Phytosterols: Leaves, flowers and seeds contain β-Sitosterol
and Stigmasterol. 24
• Fatty acids: The fatty acid fractions of seeds were found
dominating in linoleic and petroselinic acid. 24,26
• Saturated fatty acids: Flowers and seeds contain stearic
acid, Palmitic acid, Lauric acid, Myristic acid. 24
• Fatty oil: In seeds (15.30%)- Oleic acid- 30.80%, linoleic
acid- 52.90%, linoleic- 2.50%, palmitic- 9.70%, stearic-
9.70%. 26
• Unsaturated fatty acids: In seeds Linoleic acid. 24
• Mucilage: Mucilage (found in Seeds Leaves, flowers and
roots), β-asparagine.2 Mixture of colloidally soluble
polysaccharides, particularly galacturonicrhamnans,
arabinogalactans, arabans, glucans, acidic
heteropolysaccharide.25 Althaea officinalis contained
pectin’s 11%, starch 25-35%, mono-, and di-saccharide,
saccharose 10%, mucilage 5%. Mucilage polysaccharides
contents reached 5- 11.6%. They were consisted of the
mixture of colloidally soluble polysaccharides, particularly
of acid arabinanogalactans, galacturonicrhamnans, arabans
and glucans acidic heteropolysaccharide. Mucilage is
present in root.22
18. Pharmacological studies
1. Wound healing properties
The wound healing property of Althea officinalis flower
mucilage in the form of eucerin base ointment in with different
concentrations (5%, 10%, and 15%) was studied on full
thickness wound model in rabbit. AFM 15% ointments were
found to reduce wound healing time without any significant
difference with the phenytoin 1% ointment revealed by
Valizadeh R et al. (2015)27
2. Antitussive activity
The antitussive activity of polysaccharide obtained from the
flower and plant of Althaea officinalis was studied in cough
induced cats of both sexes. The results revealed that the tested
polysaccharide exhibited statistically significant cough
suppressing activity due to the presence of higher proportion
of uronic acid, which was noticeably higher than that of the
nonnarcotic drug used in clinical practice revealed by Sutovska
et al. (2007) 28. Another study of Sutovska M et al., revealed the
Antitussive Activity of polysaccharides rhamnogalacturonan.
Result showed that rhamnogalacturonan isolated from Althaea
officinalis mucilage possesses very high cough suppressive
effect in guinea pig a test system which is shortened in
conditions of experimentally induced airways allergic
inflammation.29
Kalam et al Journal of Drug Delivery & Therapeutics. 2023; 13(12):270-277
ISSN: 2250-1177 [275] CODEN (USA): JDDTAO
3. Antioxidant activity
Sadighara P et al. (2012) examined three colours of petals of
Althaea officinalis flowers, i.e., pink, reddish pink, and white for
total antioxidant activity and flavonoids content. The reddish
pink flowers of A. officinalis have more antioxidant activity
(reddish pink > pink > white).30 The antioxidant activity of aq.
and hydro alcoholic extracts of A. officinalis root were assessed
using ABTS+ (2,2’-azino-bis (3-ethylbenzothiazoline-6-
sulphonic acid), hypochlorous acid scavenging assay and iron-
induced lipid per oxidation. The results showed that the extract
prepared with water as extraction solvent did not possess
antioxidant activity, whereas the extracts obtained using
ethanol: water showed well pronounced antioxidant activity. In
particular, the extracts obtained at low concentration of
ethanol in the mixed solvent (50:50 and 70:30, v/v) showed
higher scavenging activity for ABTS+ radicals and hypochlorite
ions than the extract obtained with the higher ethanol
concentration (90:10 v/v). These results correlated very well
with phenolic and flavonoid content of the extracts. The
extracts did not show cytotoxic effect on human BV-173
leukemic cells but may have immunomodulating effect due to
their antioxidant properties 31. Tabarsa M et al. (2017) evaluate
the Rhamnan-rich polysaccharide gum from A. officinalis flower
and found that the gum displayed negatively charged carboxyl
groups and high antioxidant activity. 32
4. Antimicrobial activity:
An in-vitro study of methanolic extract from marshmallow root
has been done by European Medicines Agency on periodontal
pathogens resident in the oral cavity. The study shown to
possess an inhibiting activity on Porphyromonas gingivalis,
Prevotella spp. Actinomyces odontolyticus, Veilonella parvula,
Eikenella corrodens, Fusobacterium nucleatum,
Peptostreptococcus spp. Antimicrobial activity against
Pseudomonas aeruginosa, Proteus vulgaris and Staphylococcus
aureus has also been documented for chloroform and
methanolic extracts of marshmallow roots33. The hexane
extracts of flower and root of Althaea officinalis exerted
antimicrobial activity against Gram-positive and Gram-
negative bacteria (Escherichia coli, Pseudomonas aeruginosa,
Klebsiella pneumoniae, Bacillus subtilis, Enterococcus faecalis,
Staphylococcus aureus and Staphylococcus epidermidis), as well
as three fungi (Aspergillus niger, Candida albicans and
Saccharomyces cerevisiae)34 Rashidi et al. also found that 80 %
ethanolic A. officinalis extract was active against Aspergillus
niger, Aspergillus fumigatus and Aspergillus flavus species. MIC
of Althaea officinalis 80 % ethanolic extract 50-100mg/ml35
However, ethanol, water and hexane extracts of the dried seed
at a concentration of 10.0 mg/ml, were inactive on Candida
albicans and Candida tropicalis. 36
5. Anti-inflammatory:
Aq. extracts of the A. officinalis roots stimulated phagocytosis,
and the release of oxygen radicals and leukotrienes from
human neutrophils cytokines, interleukin-6 and tumour
necrosis factor from human monocytes in vitro. Thereby
exhibiting anti-inflammatory and immune stimulant activity. A
polysaccharide fraction (500mg/ml) isolated from a root
extract had anticomplement activity in human serum in vitro37.
Marshmallow mucilage polysaccharides administered
intraperitoneally to mice at a dose of 10 mg/kg produced a 2.2-
fold increase in phagocytic activity of macrophages in the
carbon-clearance test36. Hypolaetin 8-glucoside has been tested
for its anti-inflammatory, analgesic and anti-ulcer activity in
rats. This flavonoid (30, 60 and 90 mg/kg i.p.) was more potent
than phenylbutazone (30, 60 and 90 mg/kg i.p.) in suppressing
the acute phase of adjuvant carrageenan-induced inflammation
but had less effect in the prolonged inflammatory phase. In
contrast to phenylbutazone, it did not cause gastric erosions.
Analgesic activity of hypolaetin 8-glucosid has been found to be
lower than the one of phenylbutazone. Hypolaetin 8-glucoside
was also more potent than troxerutin (both at the doses of 100,
200, 300 and 400 mg/kg s.c.) in inhibiting histamine induced
capillary permeability in rats33. An ointment containing an
aqueous marshmallow root extract (20%) applied topically to
the external ear of rabbits reduced irritation induced by UV
irradiation or by tetrahydrofurfuryl alcohol. The ointment has
been compared to pure dexamethasone 0.05% ointment and a
combined marshmallow and dexamethasone product. The anti-
inflammatory effect of marshmallow ointment was lower than
that of a dexamethasone ointment. The combined product had
higher anti-inflammatory effect than the ointments with the
individual ingredients33.
6. Immunomodulatory effects:
Althaea-mucilage O, an acidic polysaccharide isolated from
marshmallow root, has been possesses anti-complement
activity on normal human serum in concentrations of 100 –
1000 ug/ml 37. An extract (extraction medium 45 % 1, 3-
butylene glycol solution) of marshmallow root was found to
inhibit intracellular calcium mobilisation in normal human
melanocytes activated by endothelin-1, and to strongly inhibit
endothelin-1-induced proliferation of melanocytes. The extract
can diminish the physiological effect of endothelin-1 on normal
human melanocytes following UVB irradiation33. Scopolamine
produced dual action on tumoral lymphocytes exhibiting both
a cytostatic and a cytotoxic effect on the cell, and also exert
apoptosis. Proliferation of normal T lymphocytes was found
due to the interaction with kinase C (PKC) protein. It indicates
that scopoletin may be a potential anti-tumoral compound 38.
7. Demulcent and soothing:
The demulcent effects of Radix Althaeae are due to its high
content of polysaccharide hydrocolloids, which form a
protective coating on the oral and pharyngeal mucosa, soothing
local irritation and inflammation39. However, weak inhibition
(17%) of mucociliary transport in isolated, ciliated epithelium
of the frog oesophagus was demonstrated after treatment of the
isolated tissues with 200 ml of an aqueous root macerate (6.4
g/140 ml)40. Polysaccharides from marshmallow root showed
moderate adhesion to epithelial tissue of porcine buccal
membranes.
8. Effect on Thyroid Hormones
Effect of Marshmallow's root extract on Thyroid Hormones
concentration in Broilers was studied by Roshangar et al.
(2014). Results showed that the concentration of T3 hormone
was decreased significantly (p < 0.05) whereas the
concentration of T4 hormone was not affected by treatments. 41
9. Hepatoprotective activity
The hepatoprotective activity of ethanolic extract of Althaea
officinalis against carbon tetrachloride induced hepatotoxicity
in rats was done by Ali Mohd et al. (2011). The serum
biochemical analysis showed significant protective effect from
hepatic damage in CCI4 induced hepatotoxicity model. 42
10. Neuroprotective property
Neuroprotective activity of Althaea officinalis L. extract (10
mg/kg) against 6-OHDA-induced hemi Parkinsonism in rats
revealed by Rezaei et. al. (2014)43 It is also reported that
Hollyhock leaf compress combined with performing routine
interventions for breast engorgement can improve breast
engorgement. 44
11. Toxicity study
This study was conducted to evaluate the effects of
marshmallow extract (A. officinalis L.) administration on blood
Kalam et al Journal of Drug Delivery & Therapeutics. 2023; 13(12):270-277
ISSN: 2250-1177 [276] CODEN (USA): JDDTAO
cells and biochemical parameters of carp liver. A total of 150
carps (Cyprinus carpio, initial body mass of 37.7 ± 4.4 g) were
fed diets containing 0.0 (control diet), 2.5, 5, and 10 g
marshmallow extract for 60 days. On days 30 and 60 of the
experiment blood samples were collected and haematological
parameters and liver enzyme activities—aspartate
aminotransferase (AST), alanine amino transferase (ALT),
lactate dehydrogenase (LDH), and alkaline phosphatase (ALP)-
were measured. A significant increase was observed in AST,
ALT, ALP, and LDH levels in livers of fish fed with extract 10 g,
which may be attributed to cytotoxicity.45
Conclusion
The present review reveals that there is the tremendous scope
of Unani single drugs Khatmī in management of resolvent of
hard swelling, dysentery, intestinal Colic, ulcer and obstacle of
intestine, bilious diarrhoea, dry cough and dysuria and it can
also be utilized as a potent conventional traditional Unani drug
due to its diverse and related beneficial pharmacological
activity and suggest that further phytochemical, clinical and
advance research should be done on this medicinal plant for the
benefit of mankind.
Acknowledgement
The authors are very thankful to Assistant director I/C RRIUM
Srinagar for providing necessary facilities at the institute. I am
also thankful to my librarian for providing best possible
facilities to carry out present review work in RRIUM Srinagar,
University of Kashmir.
Conflict of interest
The authors declare no any conflict of interest.
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