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Chamomile is one of the most ancient medicinal herbs known to mankind. It is a member of Asteraceae/Compositae family and represented by two common varieties viz. German Chamomile (Chamomilla recutita) and Roman Chamomile (Chamaemelum nobile). The dried flowers of chamomile contain many terpenoids and flavonoids contributing to its medicinal properties. Chamomile preparations are commonly used for many human ailments such as hay fever, inflammation, muscle spasms, menstrual disorders, insomnia, ulcers, wounds, gastrointestinal disorders, rheumatic pain, and hemorrhoids. Essential oils of chamomile are used extensively in cosmetics and aromatherapy. Many different preparations of chamomile have been developed, the most popular of which is in the form of herbal tea consumed more than one million cups per day. In this review we describe the use of chamomile in traditional medicine with regard to evaluating its curative and preventive properties, highlight recent findings for its development as a therapeutic agent promoting human health.
Chamomile: A herbal medicine of the past with bright future
Janmejai K Srivastava1,2,*, Eswar Shankar1,2, and Sanjay Gupta1,2,3
1Department of Urology & Nutrition, Case Western Reserve University, Cleveland, Ohio 44106
2Department of Urology & Nutrition, University Hospitals Case Medical Center, Cleveland, Ohio
3Department of Urology & Nutrition, Case Comprehensive Cancer Center, Cleveland, Ohio 44106
Chamomile is one of the most ancient medicinal herbs known to mankind. It is a member of
Asteraceae/Compositae family and represented by two common varieties viz. German Chamomile
(Chamomilla recutita) and Roman Chamomile (Chamaemelum nobile). The dried flowers of
chamomile contain many terpenoids and flavonoids contributing to its medicinal properties.
Chamomile preparations are commonly used for many human ailments such as hay fever,
inflammation, muscle spasms, menstrual disorders, insomnia, ulcers, wounds, gastrointestinal
disorders, rheumatic pain, and hemorrhoids. Essential oils of chamomile are used extensively in
cosmetics and aromatherapy. Many different preparations of chamomile have been developed, the
most popular of which is in the form of herbal tea consumed more than one million cups per day.
In this review we describe the use of chamomile in traditional medicine with regard to evaluating
its curative and preventive properties, highlight recent findings for its development as a
therapeutic agent promoting human health.
chamomile; dietary agents; flavonoids; polyphenols; human health
The interplay of plants and human health has been documented for thousands of years (1–3).
Herbs have been integral to both traditional and non-traditional forms of medicine dating
back at least 5000 years (2,4–6). The enduring popularity of herbal medicines may be
explained by the tendency of herbs to work slowly, usually with minimal toxic side effects.
One of the most common herbs used for medicinal purposes is chamomile whose
standardized tea and herbal extracts are prepared from dried flowers of Matricaria species.
Chamomile is one of the oldest, most widely used and well documented medicinal plants in
the world and has been recommended for a variety of healing applications (7). Chamomile is
a native of the old World and is a member of the daisy family (Asteraceae or Compositae).
The hollow, bright gold cones of the flowers are packed with disc or tubular florets and are
ringed with about fifteen white ray or ligulate florets, widely represented by two known
varieties viz. German chamomile (Matricaria chamomilla) and Roman chamomile
(Chamaemelum nobile) (8) . In this review we will discuss the use and possible merits of
Correspondence to: Sanjay Gupta, Ph.D., Department of Urology, Case Western Reserve University, 10900 Euclid Avenue,
Cleveland, Ohio 44106, Phone: (216) 368 6162; Fax: (216) 368 0213;
*Current address: Amity Institute of Biotechnology (Mango Orchard Campus), Amity University, Lucknow Campus, Viraj Khand
5, Gomti Nagar, Lucknow, India
NIH Public Access
Author Manuscript
Mol Med Report. Author manuscript; available in PMC 2011 February 1.
Published in final edited form as:
Mol Med Report
. 2010 November 1; 3(6): 895–901. doi:10.3892/mmr.2010.377.
NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript
chamomile, examining its historical use and recent scientific and clinical evaluations of its
potential use in the management of various human ailments.
Different classes of bioactive constituents are present in chamomile, which have been
isolated and used as medicinal preparations and cosmetics (9). The plant contains 0.24%–
1.9% volatile oil, composed of a variety of separate oils. When exposed to steam distillation,
the oil ranges in color from brilliant blue to deep green when fresh but turns to dark yellow
after storage. Despite fading, the oil does not lose its potency. Approximately 120 secondary
metabolites have been identified in chamomile, including 28 terpenoids and 36 flavonoids
(10,11). The principal components of the essential oil extracted from the German chamomile
flowers are the terpenoids α-bisabolol and its oxide azulenes including chamazulene and
acetylene derivatives. Chamazulene and bisabolol are very unstable and are best preserved
in an alcoholic tincture. The essential oil of Roman chamomile contains less chamazulene
and is mainly constituted from esters of angelic acid and tiglic acid. It also contains
farnesene and α-pinene. Roman chamomile contains up to 0.6% of sesquiterpene lactones of
the germacranolide type, mainly nobilin and 3-epinobilin. Both α-bisabolol, bisabolol oxides
A and B and chamazulene or azulenesse, farnesene and spiro-ether quiterpene lactones,
glycosides, hydroxycoumarins, flavanoids (apigenin, luteolin, patuletin, and quercetin),
coumarins (herniarin and umbelliferone), terpenoids, and mucilage are considered to be the
major bio-active ingredients (12,13). Other major constituents of the flowers include several
phenolic compounds, primarily the flavonoids apigenin, quercetin, patuletin as glucosides
and various acetylated derivatives. Among flavonoids, apigenin is the most promising
compound. It is present in very small quantities as free apigenin, but predominantly exists in
the form of various glycosides (14–18).
Chamomile is known to be used in various forms of its preparations. Dry powder of
chamomile flower is recommended and used by many people for traditionally established
health problems. Medicinal ingredients are normally extracted from the dry flowers of
chamomile by using water, ethanol or methanol as solvents and corresponding extracts are
known as aqueous, ethanolic (alcoholic) and/or methanolic extracts. Optimum chamomile
extracts contain about 50 percent alcohol. Normally standardized extracts contain 1.2% of
apigenin which is one of the most effective bioactive agents. Aqueous extracts, such as in
the form of tea, contain quite low concentrations of free apigenin but include high levels of
apigenin-7-O-glucoside. Oral infusion of chamomile is recommended by the German
Commission E (19,20).Chamomile tea is one of the world’s most popular herbal teas and
about a million cups are consumed every day. Tea bags of chamomile are also available in
the market, containing chamomile flower powder, either pure or blended with other popular
medicinal herbs. Chamomile tincture may also be prepared as one part chamomile flower in
four parts of water having 12% grain alcohol, which is used to correct summer diarrhea in
children and also used with purgatives to prevent cramping. Chamomile flowers are
extensively used alone, or combined with crushed poppy-heads, as a poultice or hot foment
for inflammatory pain or congestive neuralgia, and in cases of external swelling, such as
facial swelling associated with underlying infection or abscess. Chamomile whole plant is
used for making herb beers, and also for a lotion, for external application in toothache,
earache, neuralgia and in cases of external swelling (20). It is also known to be used as bath
additive, recommended for soothing ano-genital inflammation (21). The tea infusion is used
as a wash or gargle for inflammation of the mucous membranes of the mouth and throat
(22,23). Inhalation of the vaporized essential oils derived from chamomile flowers is
recommended to relieve anxiety, general depression. Chamomile oil is a popular ingredient
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of aromatherapy and hair care (24,25). Roman chamomile is widely used in cosmetic
preparations and in soothing and softening effect on the skin (26,27).
Traditionally, chamomile has been used for centuries as an anti-inflammatory, antioxidant,
mild astringent and healing medicine (28). As a traditional medicine, it is used to treat
wounds, ulcers, eczema, gout, skin irritations, bruises, burns, canker sores, neuralgia,
sciatica, rheumatic pain, hemorrhoids, mastitis and other ailments (29,30). Externally,
chamomile has been used to treat diaper rash, cracked nipples, chicken pox, ear and eye
infections, disorders of the eyes including blocked tear ducts, conjunctivitis, nasal
inflammation and poison ivy (31,32). Chamomile is widely used to treat inflammations of
the skin and mucous membranes, and for various bacterial infections of the skin, oral cavity
and gums, and respiratory tract. Chamomile in the form of an aqueous extract has been
frequently used as a mild sedative to calm nerves and reduce anxiety, to treat hysteria,
nightmares, insomnia and other sleep problems (33). Chamomile has been valued as a
digestive relaxant and has been used to treat various gastrointestinal disturbances including
flatulence, indigestion, diarrhea, anorexia, motion sickness, nausea, and vomiting (34,35).
Chamomile has also been used to treat colic, croup, and fevers in children (36). It has been
used as an emmenagogue and a uterine tonic in women. It is also effective in arthritis, back
pain, bedsores and stomach cramps.
5.1 Anti-inflammatory and antiphlogistic properties
The flowers of chamomile contain 1–2% volatile oils including alpha-bisabolol, alpha-
bisabolol oxides A & B, and matricin (usually converted to chamazulene and other
flavonoids which possess anti-inflammatory and antiphlogistic properties (12,19,35,36). A
study in human volunteers demonstrated that chamomile flavonoids and essential oils
penetrate below the skin surface into the deeper skin layers (37). This is important for their
use as topical antiphlogistic (anti-inflammatory) agents. One of chamomile’s anti-
inflammatory activities involve the inhibition of LPS-induced prostaglandin E(2) release and
attenuation of cyclooxygenase (COX-2) enzyme activity without affecting the constitutive
form, COX-1 (38).
5.2 Anticancer activity
Most evaluations of tumor growth inhibition by chamomile involve studies with apigenin
which is one of the bioactive constituents of chamomile. Studies on preclinical models of
skin, prostate, breast and ovarian cancer have shown promising growth inhibitory effects
(39–43). In a recently conducted study, chamomile extracts were shown to cause minimal
growth inhibitory effects on normal cells, but showed significant reductions in cell viability
in various human cancer cell lines. Chamomile exposure induced apoptosis in cancer cells
but not in normal cells at similar doses (18). The efficacy of the novel agent TBS-101, a
mixture of seven standardized botanical extracts including chamomile has been recently
tested. The results confirm it to have a good safety profile with significant anticancer
activities against androgen-refractory human prostrate cancer PC-3 cells, both in vitro and in
vivo situation (44).
5.3 Common cold
Common cold (acute viral nasopharyngitis) is the most common human disease. It is a mild
viral infectious disease of the upper respiratory system. Typically common cold is not life-
threatening, although its complications (such as pneumonia) can lead to death, if not
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properly treated. Studies indicate that inhaling steam with chamomile extract has been
helpful in common cold symptoms (45); however, further research is needed to confirm
these findings.
5.4 Cardiovascular conditions
It has been suggested that regular use of flavonoids consumed in food may reduce the risk of
death from coronary heart disease in elderly men (46). A study assessed the flavonoid intake
of 805 men aged 65–84 years who were followed up for 5 years. Flavonoid intake (analyzed
in tertiles) was significantly inversely associated with mortality from coronary heart disease
and showed an inverse relation with incidence of myocardial infarction. In another study
(47), on twelve patients with cardiac disease who underwent cardiac catheterization,
hemodynamic measurements obtained prior to and 30 minutes after the oral ingestion of
chamomile tea exhibited a small but significant increase in the mean brachial artery
pressure. No other significant hemodynamic changes were observed after chamomile
consumption. Ten of the twelve patients fell into a deep sleep shortly after drinking the
beverage. A large, well-designed randomized controlled trial is needed to assess the
potential value of chamomile in improving cardiac health.
5.5 Colic/Diarrhea conditions
An apple pectin-chamomile extract may help shorten the course of diarrhea in children as
well as relieve symptoms associated with the condition (47). Two clinical trials have
evaluated the efficacy of chamomile for the treatment of colic in children. Chamomile tea
was combined with other herbs (German chamomile, vervain, licorice, fennel, balm mint)
for administration. In a prospective, randomized, double-blind, placebo-controlled study, 68
healthy term infants who had colic (2 to 8 weeks old) received either herbal tea or placebo
(glucose, flavoring). Each infant was offered treatment with every bout of colic, up to 150
mL/dose, no more than three times a day. After 7 days of treatment, parents reported that the
tea eliminated the colic in 57% of the infants, whereas placebo was helpful in only 26%
(P<0.01). No adverse effects with regard to the number of nighttime awakenings were noted
in either group (48). Another study examined the effects of a chamomile extract and apple
pectin preparation in 79 children (age 0.5–5.5 y) with acute, non-complicated diarrhea who
received either the chamomile/pectin preparation (n = 39) or a placebo (n = 40) for 3 days.
Diarrhea ended sooner in children treated with chamomile and pectin (85%), than in the
placebo group (58%) (49). These results provide evidence that chamomile can be used
safely to treat infant colic disorders.
5.6 Eczema
Topical applications of chamomile have been shown to be moderately effective in the
treatment of atopic eczema (50). It was found to be about 60% as effective as 0.25%
hydrocortisone cream (51). Roman chamomile of the Manzana type (Kamillosan (R)) may
ease discomfort associated with eczema when applied as a cream containing chamomile
extract. The Manzana type of chamomile is rich in active ingredients and does not exhibit
chamomile-related allergenic potential. In a partially double-blind, randomized study carried
out as a half-side comparison, Kamillosan(R) cream was compared with 0.5%
hydrocortisone cream and a placebo consisting only of vehicle cream in patients suffering
from medium-degree atopic eczema (52). After 2 weeks of treatment, Kamillosan(R) cream
showed a slight superiority over 0.5% hydrocortisone and a marginal difference as compared
to placebo. Further research is needed to evaluate the usefulness of topical chamomile in
managing eczema.
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5.7 Gastrointestinal conditions
Chamomile is used traditionally for numerous gastrointestinal conditions, including
digestive disorders, "spasm" or colic, upset stomach, flatulence (gas), ulcers, and
gastrointestinal irritation (53). Chamomile is especially helpful in dispelling gas, soothing
the stomach, and relaxing the muscles that move food through the intestines. The protective
effect of a commercial preparation (STW5, Iberogast), containing the extracts of bitter
candy tuft, lemon balm leaf, chamomile flower, caraway fruit, peppermint leaf, liquorice
root, Angelica root, milk thistle fruit and greater celandine herb, against the development of
gastric ulcers has been previously reported (54). STW5 extracts produced a dose dependent
anti-ulcerogenic effect associated with a reduced acid output, an increased mucin secretion,
an increase in prostaglandin E (2) release and a decrease in leukotrienes. The results
obtained demonstrated that STW5 not only lowered gastric acidity as effectively as a
commercial antacid, but was more effective in inhibiting secondary hyperacidity (54).
5.8 Hemorrhoids
Studies suggest that chamomile ointment may improve hemorrhoids. Tinctures of
chamomile can also be used in a sitz bath format. Tincture of Roman chamomile may reduce
inflammation associated with hemorrhoids (55,56).
5.9 Health Promotion
It has been claimed that consumption of chamomile tea boosts the immune system and helps
fight infections associated with colds. The health promoting benefits of chamomile was
assessed in a study which involved fourteen volunteers who each drank five cups of the
herbal tea daily for two consecutive weeks. Daily urine samples were taken and tested
throughout the study, both before and after drinking chamomile tea. Drinking chamomile
was associated with a significant increase in urinary levels of hippurate and glycine, which
have been associated with increased antibacterial activity (57). In another study, chamomile
relieved hypertensive symptoms and decreased the systolic blood pressure significantly,
increasing urinary output (58). Additional studies are needed before a more definitive link
between chamomile and its alleged health benefits can be established.
5.10 Inflammatory conditions
Inflammation is associated with many gastrointestinal disorders complaints, such as
esophageal reflux, diverticular disease, and inflammatory disease (59–61). Studies in
preclinical models suggest that chamomile inhibits Helicobacter pylori, the bacteria that can
contribute to stomach ulcers (60). Chamomile is believed to be helpful in reducing smooth
muscle spasms associated with various gastrointestinal inflammatory disorders. Chamomile
is often used to treat mild skin irritations, including sunburn, rashes, sores and even eye
inflammations (62–65) but its value in treating these conditions has not been shown with
evidence-based research.
5.11 Mucositis
Mouth ulcers are a common condition with a variety of etiologies (66). Stomatitis is a major
dose-limiting toxicity from bolus 5-fluorouracil-based (5-FU) chemotherapy regimens. A
double-blind, placebo-controlled clinical trial including 164 patients was conducted (22).
Patients were entered into the study at the time of their first cycle of 5-FU-based
chemotherapy and were randomized to receive a chamomile or placebo mouthwash thrice
daily for 14 days. There was no suggestion of any stomatitis difference between patients
randomized to either protocol arm. There was also no suggestion of toxicity. Similar results
were obtained with another prospective trial on chamomile in this situation. Data obtained
from these clinical trials did not support the pre study hypothesis that chamomile could
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decrease 5-FU-induced stomatitis. The results remain unclear if chamomile is helpful in this
5.12 Osteoporosis
Osteoporosis is a metabolic bone disease resulting from low bone mass (osteopenia) due to
excessive bone resorption. Sufferers are prone to bone fractures from relatively minor
trauma. Agents which include selective estrogen receptor modulators or SERMs,
biphosphonates, calcitonin are frequently used to prevent bone loss. To prevent bone loss
that occurs with increasing age, chamomile extract was evaluated for its ability to stimulate
the differentiation and mineralization of osteoblastic cells. Chamomile extract was shown to
stimulate osteoblastic cell differentiation and to exhibit an anti-estrogenic effect, suggesting
an estrogen receptor-related mechanism (67). However, further studies are needed before it
can be considered for clinical use.
5.13 Sleep aid/sedation
Traditionally, chamomile preparations such as tea and essential oil aromatherapy have been
used to treat insomnia and to induce sedation (calming effects). Chamomile is widely
regarded as a mild tranquillizer and sleep-inducer. Sedative effects may be due to the
flavonoid, apigenin that binds to benzodiazepine receptors in the brain (68). Studies in
preclinical models have shown anticonvulsant and CNS depressant effects respectively.
Clinical trials are notable for their absence, although ten cardiac patients are reported to have
immediately fallen into a deep sleep lasting for 90 minutes after drinking chamomile tea
(47). Chamomile extracts exhibit benzodiazepine-like hypnotic activity (69). In another
study, inhalation of the vapor of chamomile oil reduced a stress-induced increase in plasma
adrenocorticotropic hormone (ACTH) levels. Diazepam, co-administered with the
chamomile oil vapor, further reduced ACTH levels, while flumazenile, a BDZ antagonist
blocked the effect of chamomile oil vapor on ACTH. According to Paladini et al. (70), the
separation index (ratio between the maximal anxiolytic dose and the minimal sedative dose)
for diazepam is 3 while for apigenin it is 10. Compounds, other than apigenin, present in
extracts of chamomile can also bind BDZ and GABA receptors in the brain and might be
responsible for some sedative effect; however, many of these compounds are as yet
5.14 Anxiety and seizure
Chamomile has been reported in the treatment of generalized anxiety disorder (GAD). But
the reports seem contradictory as an earlier report suggests that German chamomile showed
significant inhibition of GAD activity (71). The recent results from the controlled clinical
trial on chamomile extract for GAD suggests that it may have modest anxiolytic activity in
patients with mild to moderate GAD (72). Extracts of chamomile (M. recutita) possess
suitable effects on seizure induced by picrotoxin (73). Furthermore, apigenin has been
shown to reduce the latency in the onset of picrotoxin-induced convulsions and reduction in
locomotor activity but did not demonstrate any anxiolytic, myorelaxant, or anticonvulsant
activities (16).
5.15 Diabetes
Studies suggest that chamomile ameliorates hyperglycemia and diabetic complications by
suppressing blood sugar levels, increasing liver glycogen storage and inhibition of sorbitol
in the human erythrocytes (74). The pharmacological activity of chamomile extract has
shown to be independent of insulin secretion (75), and studies further reveal its protective
effect on pancreatic beta cells in diminishing hyperglycemia-related oxidative stress (76).
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Additional studies are required to evaluate the usefulness of chamomile in managing
5.16 Sore throat/hoarseness
The efficacy of lubrication of the endo-tracheal tube cuff with chamomile before intubation
on postoperative sore throat and hoarseness was determined in a randomized double-blind
study. 161 patients whose American Society of Anesthesiologists (ASA) physical status was
I or II, and undergoing elective surgical, orthopedic, gynecological or urological surgeries
were divided in two groups. The study group received 10 puffs of chamomile extract
(Kamillosan M spray, total 370 mg of Chamomile extract) at the site of the cuff of the
endotracheal tube for lubrication, while the control group did not receive any lubrication
before intubations. Standard general anesthesia with tracheal intubations was given in both
groups. 41 out of 81 patients (50.6%) in the chamomile group reported no postoperative sore
throat in the post-anesthesia care unit compared with 45 out of 80 patients (56.3%) in the
control group. Postoperative sore throat and hoarseness both in the post-anesthesia care unit
and at 24 h post-operation were not statistically different. Lubrication of endo-tracheal tube
cuff with chamomile extract spray before intubations can not prevent post operative sore
throat and hoarseness (77). Similar results were obtained in another double blind study (78).
5.17 Vaginitis
Vaginal inflammation is common in women of all ages. Vaginitis is associated with itching,
vaginal discharge, or pain with urination. Atrophic vaginitis most commonly occurs in
menopausal and postmenopausal women, and its occurrence is often associated with reduced
levels of estrogen. Chamomile douche may improve symptoms of vaginitis with few side
effects (79). There is insufficient research data to allow conclusions concerning possible
potential benefits of chamomile for this condition.
5.18 Wound healing
The efficacy of topical use of chamomile to enhance wound healing was evaluated in a
double-blind trial on 14 patients who underwent dermabrasion of tattoos. The effects on
drying and epithelialization were observed, and chamomile was judged to be statistically
efficacious in producing wound drying and in speeding epithelialization (80). Antimicrobial
activity of the extract against various microorganisms was also assessed. The test group, on
day 15, exhibited a greater reduction in the wound area when compared with the controls
(61 % versus 48%), faster epithelialization and a significantly higher wound-breaking
strength. In addition, wet and dry granulation tissue weight and hydroxyproline content were
significantly higher. The increased rate of wound contraction, together with the increased
wound-breaking strength, hydroxyproline content and histological observations, support the
use of M. recutita in wound management (81). Recent studies suggest that chamomile
caused complete wound healing faster than corticosteroids (82). However, further studies are
needed before it can be considered for clinical use.
5.19 Quality-of-life in cancer patients
Essential oils obtained from Roman chamomile are the basic ingredients of aromatherapy.
Clinical trials of aromatherapy in cancer patients have shown no statistically significant
differences between treated and untreated patients (83). Another pilot study investigated the
effects of aromatherapy massage on the anxiety and self-esteem experience in Korean
elderly women. A quasi-experimental, control group, pretest-posttest design used 36 elderly
females: 16 in the experimental group and 20 in the control group. Aromatherapy massage
using lavender, chamomile, rosemary, and lemon was given to the experimental group only.
Each massage session lasted 20 min, and was performed 3 times per week for two 3-week
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periods with an intervening 1-week break. The intervention produced significant differences
in the anxiety and self-esteem. These results suggest that aromatherapy massage exerts
positive effects on anxiety and self-esteem (84–86). However, more objective, clinical
measures should be applied in a future study with a randomized placebo-controlled design.
A relatively low percentage of people are sensitive to chamomile and develop allergic
reactions (87). People sensitive to ragweed and chrysanthemums or other members of the
Compositae family are more prone to develop contact allergies to chamomile, especially if
they take other drugs that help to trigger the sensitization. A large-scale clinical trial was
conducted in Hamburg, Germany, between 1985 and 1991 to study the development of
contact dermatitis secondary to exposure to a mixture of components derived from the
Compositae family. Twelve species of the Compositae family, including German
chamomile, were selected and tested individually when the mixture induced allergic
reactions. During the study, 3,851 individuals were tested using a patch with the plant
extract (88). Of these patients, 118 (3.1%) experienced an allergic reaction. Further tests
revealed that feverfew elicited the most allergic reactions (70.1% of patients) followed by
chrysanthemums (63.6%) and tansy (60.8%). Chamomile fell in the middle range (56.5%).
A study involving 686 subjects exposed either to a sesquiterpene lactone mixture or a
mixture of Compositae extracts led to allergic reactions in 4.5% of subjects (89). In another
study it was shown that eye washing with chamomile tea in hay fever patients who have
conjunctivitis exacerbates the eye inflammation, whereas no worsening of eye inflammation
was noted when chamomile tea was ingested orally (90). Chamomile is listed on the FDA's
GRAS (generally recognized as safe) list. It is possible that some reports of allergic
reactions to chamomile may be due to contamination of chamomile by "dog chamomile," a
highly allergenic and bad-tasting plant of similar appearance. Evidence of cross-reactivity of
chamomile with other drugs is not well documented, and further study of this issue is needed
prior to reaching conclusions. Safety in young children, pregnant or nursing women, or
those with liver or kidney disease has not been established, although there have not been any
credible reports of toxicity caused by this common beverage tea.
Chamomile has been used as an herbal medication since ancient times, is still popular today
and probably will continue to be used in the future because it contains various bioactive
phytochemicals that could provide therapeutic effects. Chamomile can help in improving
cardiovascular conditions, stimulate immune system and provide some protection against
cancer. Establishing whether or not therapeutic effects of chamomile are beneficial to
patients will require research and generation of scientific evidence. There is a need for
continued efforts that focuses on pre-clinical studies with chamomile involving animal
models of various diseases. This may then be consequently validated in clinical trials that
will help in developing chamomile as a promising therapeutic agent. Without such evidence,
it will remain unclear whether these untested and unproven medical treatments are truly
beneficial. It is advisable that the discriminate and proper use of chamomile preparations
could be safe and provide therapeutic benefits however the indiscriminate or improper use
can be unsafe and harmful.
ACTH Adrenocorticotropic hormone
ASA American Society of Anesthesiologists
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BDZ benzodiazepine
CAM Complementary and alternative medicine
COX cyclooxygenase
5-FU 5-fluorouracil
GABA gamma-aminobutyric acid
GAD generalized anxiety disorder
LPS Lipopolysaccharide
SERM Selective estrogen receptor modulators
The original work from author’s laboratory outlined in this review was supported by United States Public Health
Service Grants RO1 AT002709 and RO1 CA108512
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... In fact, since C. nobile is widely used, drug interactions seem unlikely. 33,34 Citrus aurantium Citrus aurantium (bitter orange or Seville orange), indigenous to tropical Asia, is a citrus tree whose fruit is commonly used as a food. The bitter orange is also used as a botanical for its neurostimulating properties, attributable to one of its constituents, the alkaloid synephrine, which has adrenergic effects. ...
... 58 Chamomile tea has also shown in vivo CYP1A2 inhibition capability in rats. 34 The crude essential oil shows moderate in vitro inhibition of CYP2C9, CYP2D6, and CYP3A4 and strong inhibition of the CYP21A2 isoform. 59 The chamomile leaf extract has also shown in vitro CYP3A4 inhibition properties. ...
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In this review, we examined the top 10 nutraceutical products sold in Italian pharmacies and parapharmacies as well as hypermarkets and supermarkets; in the first, three product categories saw the greatest increase in sales (vitamins and minerals, immunostimulants, and sleep products) for the 12-month period between October 2019 and October 2020 (including first pandemic wave of SARS-CoV-2). We are investigating their respective formulas and isolating the botanicals that are used to make them. Many of these products have undergone preclinical and clinical studies. We performed a systematic literature search in the MEDLINE database using PubMed and Google Scholar from November 15, 2020 to December 15, 2020 (including studies carried out between 1980 and 2020). The search terms that were used included the complete name of the medicinal plant in English or Latin and the terms ‘‘cytochrome’’ or ‘‘drug interactions,’’ crossing, respectively, the Latin name and English common names with ‘‘cytochrome’’ and ‘‘drug interactions.’’ The search included in vitro and in vivo studies describing the effects of interaction between the plant (extract or botanical medicine) and human cytochromes. Despite their great complexity, there is decidedly limited clinical data on botanical medicine. In fact, of the 28 botanicals that were examined, only 2 (Citrus paradisi and Rhodiola rosea) show in vivo pharmacological interactions in human subjects. On the contrary, for the other botanicals, there is only weak evidence of dubious clinical significance or potential interactions shown in animal models or in vitro without clinical confirmation. This study provides a rational assessment of the most widely used products, including those used in self-medication, to simplify patient management during the Covid-19 health emergency.
... Anti-inflammatory, sedative, antiseptic, and spasmolytic properties of M. chamomilla were reported by Sharafzadeh S. et al [51]. The use of chamomile for centuries has been reported as anti-inflammatory, antioxidant, mild astringent, and sedative by Srivastava et al. [52]. It has been reported that Astragalus hamosus possesses the anti-inflammatory, and analgesic activities [53]. ...
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Shaqīqa-i-Muzmin (chronic migraine) is a type of migraine that is usually caused by cold humours (bārid akhlāṭ), specifically by phlegm (balgham) and to lesser extent by black bile (sauda). The aim of this study was to evaluate the effect of Nutul-i-Ḥār (hot irrigation) in the treatment of chronic migraine. Nutul (irrigation) therapy is widely and successfully used in diseases of head as described in Unānī system of medicine. This open, single-arm, exploratory clinical study was conducted in 30 patients of chronic migraine selected by convenient sampling method. One litre decoction prepared with 12 g each of Astragalus hamosus L. (Iklilul malik), Matricaria chamomilla L. (Babuna), Artemisia absinthium L. (Afsanteen), Origanum vulgare L. (Marznjosh) and Trigonella foenum graecum L. (Hulba) was poured over painful side of head for 45 minutes on every alternate day for a period of 30 days (15 sittings). The patients, thereafter, were followed untill 90th day of the study for various outcome measures comprising headache intensity, headache frequency, Migraine Disability Assessment Scale (MIDAS), and rescue medication. The reduction in headache frequency, MIDAS score and use of rescue medication was significant (p < 0.001) after the treatment. Reduction in headache intensity at 30th day, 60th day and 90th day was significant as compared with baseline values (p < 0.001) but not statistically significant at 90th day with respect to 60th day (p > 0.05). Statistical analysis was done using parametric (paired t-test) and non-parametric tests (Wilcoxan sign ranked test, Freidman with Dunn’s multiple comparison tests). Hot irrigation with medicated decoction was found effective in the treatment of chronic migraine.
... Although ten cardiac patients were reported to fall into a deep slumber lasting 90 minutes after consuming chamomile tea, clinical trials are absent. Other chemicals found in chamomile extracts will bind BDZ and GABA receptors in the brain which may be responsible for the sedative action; however, many of these chemicals are still unknown [27]. ...
Insomnia is one of the most common sleep disorders which affects 30-40 percent of the adult population. The present article provides a combined review on prevalence, categories of insomnia, pathophysiology, role of neurotransmitter on sleep and different types of therapies for insomnia. From this review it was estimated that hormones like melatonin, cortisol, and others produced by the hypothalamic-pituitary-adrenal axis regulate the sleep-wake cycle. Disturbance of this cycle leads to insomnia. Furthermore, Neurotransmitter like GABA-Lglutamic acid, Acetylcholine, Norepinephrine, Dopamine, Serotonin, Steroids, Orexin, and Adenosine plays a major role in sleep regulation. Any alteration or disturbance in the neurotransmitter level affects sleep. It was concluded that Mechanism of action of almost all natural and synthetic derived drugs in regulation of neurotransmitters.
... For example, chamomile tea contains the benefits of antioxidant, hypocholesterolemic, anticancer and anti-inflammatory effects. [14] The composition of herbal tea usually consists of at least one or more type of herb that is dependent on tastes, smells and compatibility between tea and each herb. The purpose of this study was to evaluate phytochemical compounds, anti-free radical and antibacterial activities from green tea, oolong tea, black teas and 14 Thai herbs. ...
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Background: Diarrhea disease was noted by WHO as the major target for control that the leading cause of diarrhea diseases are enteric pathogenic bacteria. Biological properties of tea leaf and medicinal plant which promoted the alternative way to inhibit enteric pathogenic bacteria. Objectives: To investigate antibacterial activity of tea leaf combined with medicinal plant extracts for inhibition of growth and the adhesion of enteric pathogenic bacteria on epithelial cells. Materials and Methods: Among the Camellia sinensis tea leaves; green, oolong and black tea, and 14 medicinal plants examined, aqueous and ethanolic extracts demonstrated growth inhibition against Escherichia coli, Salmonella typhi, Shigella dysenteriae, Staphylococcus aureus and Vibrio cholerae. Antioxidation, phenolics and flavonoids contents were also determined. Tea leaf and medicinal plant extracts were combined for the development of herbal tea that subsequently evaluated the inhibition of bacterial adhesion on epithelial cells. Results: The aqueous and ethanolic extracts of green tea and Garcinia cowa showed effectiveness against all enteric pathogenic bacteria, especially the fraction of ethanolic extracts that revealed the greatest bactericidal activity. Moreover, the ethanolic extract of green tea showed the highest content of phenolics and flavonoids, which also correlated with the antioxidant activity. In addition, the ethanolic extract of G. cowa had the highest flavonoid content. Hence, the combination of green tea withG. cowa extract revealed its effectiveness against enteric pathogenic bacteria and had an inhibitory effect against the adhesion of bacteria on epithelial cells. Conclusion: Herbal tea, the combination of green tea and G. cowa extract exhibited the beneficial antibacterial and antioxidant activities, which could be considered as an alternative treatment for enteric pathogenic bacteria infections and promote health benefits.
... Chamomile contains several phenolic compounds such as apigenin, quercetin, patuletin, luteolin, and glucosides. These compounds show anti-inflammatory action by reducing cytokines and PGE2, which play a role in the pathogenesis of arthritis [42]. ...
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More than 54 million Americans suffer from some form of arthritis and 23.7 million are limited in their usual activity, primarily due to pain. The study aims to highlight the concept of Arthralgia and the potential of its management in Unani Medicines. Osteoarthritis (OA) is a slowly progressive condition with a variable prognosis. In general, predicting the prognosis in patients with OA is difficult. However, pharmacological therapy can be associated with serious side effects and high costs. Therefore, alternative therapies have been under investigation. Herbal medications have shown the potential for safe and effective management of arthritis. The Unani Medicine is a rich source of classical knowledge on arthritis. OA has been mentioned as Wajaul Mafasil Balghami/Saudawi, and Unani Physicians has been treating this disease successfully with mostly single herbal drugs and their compound formulations for centuries. It has been revealed through animal, in vitro, and clinical studies that most of the single and compound Unani formulations are safe, without any side effects, and effective in OA, especially gout and rheumatoid arthritis. There is a need to conduct studies at Phase III level after analyzing 2nd Phase clinical studies of Unani medicine, so a promising safe, economic, and effective treatment can be provided to the ailing society for OA.
... Chamomile is classified as an annual plant belonging to the family Asteraceae. It is extensively used as a supplement for feed and is considered a healthy food by numerous consumers (Srivastava et al. 2010). Chamomile has long been used as a medicinal plant and is used as herbal tea in Western countries. ...
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Globally, there is increasing demand for safe poultry food products free from antibiotic residues. There is thus a need to develop alternatives to antibiotics with safe nutritional feed derivatives that maximize performance, promote the intestinal immune status, enrich beneficial microbiota, promote health, and reduce the adverse effects of pathogenic infectious microorganisms. With the move away from including antibiotics in poultry diets, botanicals are among the most important alternatives to antibiotics. Some botanicals such as fennel, garlic, oregano, mint, and rosemary have been reported to increase the poultry’s growth rate and/or feed to gain ratio. Botanicals’ role is assumed to be mediated by improved immune responses and/or shifts in the microbial population in the intestine, with the elimination of pathogenic species. In addition, modulation of the gut microbiota resulted in various physiological and immunological responses and promoted beneficial bacterial strains that led to a healthy gut. There is thus a need to understand the relationship between poultry diets supplemented with botanicals and good health of the entire gastrointestinal tract if we intend to use these natural products to promote general health status and production. This current review provides an overview of current knowledge about certain botanicals that improve poultry productivity by modulating intestinal health and reducing the negative impacts of numerous pathogenic bacteria. This review also describes the efficacy, negative effects, and modes of action of some common herbal plants applied in poultry as alternatives to reduce the use of antibiotics.
... e dried whole herb of M. chamomilla (WHMC) named as "Yangganju" is recorded in Medicine and Pharmacy of Traditional Uyghur Medicine in Xinjiang China to treat stomach upset, dysuria, skin itching, blurred vision, cystitis, and stomatitis [4]. Moreover, essential oil of M. chamomilla is used extensively in cosmetics and aromatherapy in Europe [5]. In sight of its significant therapeutic applications, a large group of active constituents have been identified from M. chamomilla by researchers [6][7][8][9]. ...
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A simple and effective method for the simultaneous quantitative analysis of six caffeoylquinic acids (CAs) in Matricaria chamomilla L. (M. chamomilla) using high-performance liquid chromatography (HPLC) with diode-array detection (DAD) was established. The chromatographic separation was performed on a Waters XBridge Shield RP C18 column (4.6 mm × 250 mm, 5 μm) with the mobile phase of acetonitrile (0.5% phosphoric acid) and water (0.5% phosphoric acid) using a gradient elution at a flow rate of 1.0 mL/min and UV detection at 327 nm. The correlation coefficients of all analytes were 0.999, and the results showed excellent linearity. The lower limits of detection (LLOD) and quantification (LLOQ) of all analytes fall within the range of 0.014∼0.017 μg/mL and 0.068∼0.086 μg/mL, respectively. The extraction recoveries of all analytes fall within the range of 100.74%∼101.55%, with relative standard deviation not exceeding 2.83%. The intraday and interday precisions fall within the range of 0.03%∼0.65% and 0.02%∼0.09%, respectively. This validated method was successfully applied to the investigation of 34 samples of M. chamomilla collected from different geographical areas. The results showed that the established method is appropriate for the analysis of the six CAs in M. chamomilla and helpful for quality assessment of capitula of M. chamomilla (CMC), whole herb of M. chamomilla (WHMC), and related herbal formulas.
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German chamomile (M. chamomilla) is recognized as a star herb due to its medicinal and aromatic properties. This plant is found across a wide range of climatic and soil conditions. Both the flower heads and blue essential oils of German chamomile possess several pharmacological properties of an anti-inflammatory, antimicrobial, antiseptic, antispasmodic and sedative, etc., nature, which makes it a highly sought after herb for use in many pharma and aroma industries. Chamomile tea, prepared from its flower heads, is also a well-known herbal tea for mind and body relaxation. Though it is a high-demand herb, farmers have not adopted this plant for large scale cultivation as a crop, which could improve their livelihood, due to the high cost in flower heads harvesting, loss in over mature and immature flower heads picking during harvesting, unavailability of varieties and agrotechnologies for machine harvesting, a lack of efficient process development of oil extraction and in the lack of improved stable varieties. There are many studies that have reported on the phytochemistry and pharmacological uses of chamomile, which further explore its importance in the medicine industry. Several studies are also present in the literature on its cultivation practices and plant ecology. However, studies on breeding behavior, genetic improvement, varietal development and mechanical harvesting are scarce in German chamomile. Hence, keeping in mind various aspects of farmers’ and researchers’ interest, earlier reports on taxonomy, floral biology, processing of oil extraction, active constituents, uses, agronomy, breeding challenges and opportunities in German chamomile are summarized in this review.
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Frederick K. Humphreys (1816-1900), founder of Humphreys Medicine Company, appeared at the rise of both greater acceptance and popularity of the homeopathy in the United States, as opposed to more orthodox medicine. Although bolstered by the relatively high cost and low success rate of traditional medicines, homeopathic remedies soon became a source of controversy due to the largely unknown ingredient lists and contradictory claims of effectiveness. Tandem mass spectrometry analysis (MS/MS) was used to pinpoint the ingredients of four “specifics” in Humphreys’ Homeopathic Remedies. Generated spectra showed similar base peak ions for each pill, leading to the hypothesis that each remedy contained the same basic ingredients. Further MS/MS analyses identified these base peak ions as adducts of sucrose (m/z 365, 381), its related ions (m/z 433, 203, 185), and apigenin (m/z 271). When placed into a historical context, the application of chemical analyses to study these early remedies can provide insight into the question of validity that evoked arguments during the late nineteenth century.
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The presence of benzodiazepine-like substances in dried flower heads of Matricaria chamomilla was investigated. After extraction and HPLC purification we tested several fractions for their ability to displace in vitro [3H]Flunitrazepam bound to its receptors in rat cerebellar membranes, [3H]Muscimol linked to GABA receptors in rat cortical membrane preparations and [3H]RO 5-4864 specifically bound to the so-called 'peripheral' benzodiazepine binding sites present in membrane preparations from rat adrenal glands. Few of these fractions displaced both central and peripheral benzodiazepine binding sites and GABA receptors, too. As regards this last activity, by further HPLC analysis we identified GABA as the main agent responsible for the displacing effect. Some of the extracted fractions, not containing GABA, were intracerebronventricularly injected in rats and produced a statistically significant reduction of the locomotor activity. Ongoing experiment by mass spectrometric technique will help in the identification of the benzodiazepine-like compounds present in the extract of Matricaria chamomilla responsible for its sedative effect.
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The major flavonoids in the white florets of chamomile (Chamomilla recutita [L.] Rauschert) were rapidly purified using a combination of polyamide solid-phase extraction and preparative HPLC. From the combined LC/MS, LC/MS/MS, and NMR data the apigenin glucosides were identified as apigenin 7-O-glucoside (Ap-7-Glc), Ap-7-(6″-malonyl-Glc), Ap-7-(6″-acetyl-Glc), Ap-7-(6″-caffeoyl-Glc), Ap-7-(4″-acetyl-Glc), Ap-7-(4″-acetyl,6″-malonyl-Glc), and a partially characterised apigenin-7-(mono-acetyl/mono-malonylglucoside) isomer. Malonyl and caffeoyl derivatives of Ap-7-Glc have not previously been identified in chamomile. The two mono-acetyl/mono-malonyl flavonoids have not previously been reported in any plant species. These acylated glucosides are unstable and degrade to form acetylated compounds or Ap-7-Glc. The degradation products formed are dependent on the extraction and storage conditions, i.e. temperature, pH and solvent.
Does Echinacea fight the common cold? Does St. John's Wort (SJW) really counteract depression? What about chondroitin for joint health? Today's healthcare professionals are increasingly confronted with questions from patients who want to use herbal supplements to treat various conditions. A critical and scientific assessment of medicinal plant research by an internationally recognized researcher and writer in the field, Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals, Third Edition combines the scientific aspects of herbal medicine, phytomedicine, and pharmacognosy with the modern clinical trials that support the rationale for using plant products in healthcare. A Decade's Worth of Updates The original edition of this volume was authored by the late Professor Varro E. Tyler, a true giant in the field of pharmacognosy and pharmacy education. Following in Tyler's footsteps, Dennis V.C. Awang, co-editor of the journal Phytomedicine, recognized the need for a revised third edition, in light of how quickly the clinical literature surrounding the dietary supplement market is growing. Millions of consumers are demanding natural treatment options from their doctors and pharmacies in a variety of forms, from herbal teas to tinctures and capsules. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals, Third Edition effectively fosters understanding in patients and practitioners of the role that herbs and phytomedicinal products can play in both self-care and healthcare.
Colic has been described using the "rule of 3": crying for at least 3 hours per day on at least 3 days per week for at least 3 weeks. The distinction can be subtle; a normal infant can cry more than 2 hours per day. This syndrome has its onset typically in the first few weeks of life. It spontaneously resolves by age 4 to 6 months. Prevalence depends on the definition used for colic; approximately 5% to 25% of infants meet some reasonable definition of colic. The cause of infantile colic is poorly understood. Although clinicians tend to focus on a likely gastrointestinal cause, neuropsychological issues, food allergy, and parenting misadventures are also potential contributing factors. There are myriad strategies-ranging from craniosacral osteopathic manipulation to car ride simulation-offered for dealing with infantile colic. Although none of these treatments has been validated in rigorous studies, the available evidence offers tentative support for 3 strategies: (1) a trial of a hypoallergenic (protein hydrolysate) formula (for formula fed infants), (2) a low-allergen maternal diet (for breastfeeding mothers), and (3) reduced stimulation of the infant. A systematic review analyzed controlled clinical trials lasting at least 3 days involving infants less than 6 months of age who cried excessively. Twenty-seven studies were included; the outcome measure was colic symptoms, typically reported as duration of crying. Two reports studying hypoallergenic (protein hydrolysate) formula in nearly 130 infants found an effect size of 0.22 (95% confidence interval [CI], 0.10-0.34) for the hypoallergenic formula. Additionally, 3 behavioral trials (involving nearly 200 infants) revealed the benefits of reduced stimulation of the colicky infant (effect size of 0.48; 95% CI, 0.23-0.74). A more recent systematic review followed a similar high-quality search strategy and identified 22 articles, and reported a number needed to treat (NNT) of 6 for the 2 hypoallergenic formula studies identified in the previous review. Because of concern regarding the quality of the behavioral studies involving infants with colic, the authors of this second review only included 1 small (42 patients) trial of decreased stimulation, which resulted in a relative risk (RR) of 1.87 (95% CI, 1.04-3.34) and a NNT of 2. There was some inconclusive evidence to suggest benefit to dietary adjustment for breastfeeding mothers (specifically, the avoidance of cow's milk and other potential allergens like nuts, eggs, and wheat). A recent randomized controlled trial confirmed the value of this approach by showing significant improvement in distress scores of infants whose mothers followed a low-allergen diet (excluding dairy, soy, wheat, eggs, peanuts, tree nuts, and fish) for 7 days. This well-designed study included 107 patients (a relatively large sample in the published research about colic), and showed an absolute risk reduction of 37% (NNT=3) for those mothers following the challenge. A small RCT (43 patients) suggested efficacy in the substitution of a whey hydrolysate formula in place of cow's milk-based formula for infants with colic (casein hydrolysate formula has been more widely studied), but there continues to be controversy regarding the preferred protein hydrolysate formula (whey vs casein) in the treatment of colic. Several medications have been tested in RCTs; only dicyclomine has shown an effect in a few small RCTs. However, there have been reports of apnea and other serious, although infrequent, adverse effects. For that reason, the manufacturer has contraindicated the use of this medication in infants aged <6 months. A small (n=68) study of an herbal tea showed reduced symptoms (RR=0.57 favoring the active tea), although the mean volume of tea consumption (32 mL/kg/d) is a nutritional concern in this age group. No adverse events were noted, but the small sample size limits the ability to detect any but the most common events.
Introduction: The common chamomile (Isocarpha Cubana Blake) is a plant commonly used by Cuban people. It has the same properties scientifically tested on the sweet chamomile (Matricaria Recutita, L.). A few studies have been related to it and none has demonstrated that the plant has the properties attributed to it. A preliminary pharmacognostic study dealt favorably with the possible similarities of both plants. It was the basis that determined the study of its pre-clinical pharmacological effects. Materials and methods: The anti-inflammatory action was evaluated by means of the model of induced inflammation by carragenin which values the acute effect. It was completed with the two other models of inflammation: that of granuloma to evaluate the chronic effect of the extract and that of auricular edema to evaluate the topic anti-inflammatory action of the cream. Taking into account the wide use of this plant by our population as an anti-diarrheic and digestive medication, its effect on the intestinal duct was also studied. Results: The fluid extract diminished the percentage of acute inflammation produced by carragenin in three dose levels, being this dose effect dependent and similar to that of indomethacin. In the same way, it inhibited significantly the production of granulomatous tissue in the model of chronic inflammation. However, the chamomile cream at 5 % was not able to diminish, in a topic way, the inflammatory effect produced by the croton oil. While studying its activity on the intestinal tract the extract acted out as an anti-diarrheic medication, being able to decrease the laxative effect of glycerin. Conclusions: The fluid extract of the common chamomile demonstrated to have acute and chronic anti-inflammatory action as well as anti-diarrheic effect while the chamomile cream at 5 % did not have anti-inflammatory effect in a topic way.