Crataegus, Hawthorn, Shan Zha 山楂

Oxyacantha, White Thorn
Shan Zha (TCM)

Dioscorides Materia Medica, Mathias, 1563

C. oxyacantha
Flora von Deutschland (25), Kohler, 1886

C. monogyna
Flora von Deutschland (25), Kohler, 1886

Chinese Hawthorn fruit slices (Adam, 2017)

Botanical name:

Crataegus spp.
In Europe:

C. laevigata (formerly C. oxyacantha); Branched Hawthorn
C. monogyna; Single Hawthorn
C. pentagyna; Five-headaed Hawthorn
C. nigra; Black or Dark Hawthorn
C. azarolus; Italian Medlar

In TCM:

C. cuneata
C. oxycantha var. pinnatifida

The Chinese and European species can be used synonymously.

Parts used:

Fruit; also the leaf, seed and flower

Temperature & Taste:

Warm, Dry. Sour and Sweet

Classifications:

H. Nourish the Heart
O. Promote Digestion

Uses:

1. Moves the Blood, Clears Blood Stasis, Regulates the Circulation, Eases Pain (West, TCM):
-Heart disease, Heart pain including Angina Pectoris, Hypertension and Hypotension, Atherosclerosis, Arteriosclerosis, paroxysmal Tachycardia and various disturbances of Heart rhythm as well as disorders such as Pericarditis.
-absent or prolonged first sound or murmur, with a fast, intermittent and irregular pulse;
-Irregular Pulse with Chest Pain or Restlessness are good indications for the flower and berry.
-degenerative Heart conditions, and in the aftermath of Heart attack.
-clinically useful where there is intolerance of Digitalis.
-seeds are decocted in wine and taken for internal pain associated with blood stagnation.
-recommended it for Asthma (esp. of Cardiac origin). (Ellingwood)

2. Nourishes the Heart, Settles the Spirit (West):
-calms the mind and Spirit when the Heart is unsettled. (esp. flower)
-insomnia, palpitations with anxiety and nervousness.
-Menopausal symptoms associated with Heart disease or blood stagnation, and is good for despondency, and fear of death related to Heart deficiency.
-‘general curative effect upon the functional action of the Central Nervous System’ (Ellingwood).
-It gives a sense of Well-being to those anxious due to Heart weakness.
-It has also been used for Vertigo and Dizziness etc. (Flowers, or Flowers and Fruit are often combined)

3. Moves the Blood, Benefits the Womb (West, TCM):
-Prevents Miscarriage (low dose)
-Postpartum abdominal pain and to return the uterus to its normal position after birth. (full doses, TCM)
-Amenorrhea from blood stasis

4. Promotes Digestion, Clears Food Stagnation:
-food accumulation, particularly due to excess meat and fat consumption with abdominal pain, distention and diarrhea.
-indigestion in infants due to improper nursing.
-Irritable Bowel Syndrome and Gall Bladder deficiency (Berries are stir-fried until yellow to enhance this function) (TCM).
-‘The appetite increases, assimilation and nutrition improve’ (Ellingwood’s Therapeutist, March, 1909)
-also useful to help reduce weight and reduce Cholesterol.

5. Promotes Urine, Clears Stones:
-retained fluid, as well as edema, especially cardiac edema
-‘the seeds in the berries beaten to powder being drunk in wine are good against the Stone and Dropsy’ (Culpeper)
-traditionally also used for Gout; also occasionally used for Leukorrhea.
-inguinal Hernias, as well as swollen, painful testicles or scrotum. (TCM)
-Gall Stones. (TCM)

6. Others Uses:.
-Exopthalmic Goiter (Ellingwood)
-some older writers commended it for Epilepsy

7. Stops Leakage:
-The charred fruit is used for diarrhea, chronic dysentery and bleeding from food stagnation, or damp heat (TCM)
-in Europe the leaves were also given for various Leakages.
–Dioscorides used the Berries for diarrhea, excessive Menstruation, and other Bloody Fluxes.
-‘The distilled Water of the flowers stays the Lax’. (Culpeper)
-It has been used as an aid in Diabetes Insipidus (especially in children with poor circulation and cold extremities)

Dose:

Fruit, Flower or Leaf in Infusion: 1–2 teaspoonful (3–6 grams)
Decoction of the Fruit: 6–15 grams daily (up to 20 or 30 grams)
Decoction of the Carbonised Fruit: 5–15 or 20 grams.
Fruit in Powder: 1–4 grams
Seed in Powder: 1–3 grams
Tincture of the Fruit, Fruit and Flower, or Leaf and Flower (1:5): 2–5 mls., 2–3 times daily.
Fluid Extract of the Fruit (1:1): 10–25 drops; 30–50 drops, or up to 1 teaspoonful hourly in Angina Pectoria.

Preparation:

1. Dried Hawthorn:
To prepare the fruit for drying, they are dipped into boiling water for 1 minute, then sliced and dried (TCM)
2. Stir-Fried Hawthorn:
The Fruit is sti-rfried untill yellow. This is primarily used for Food Stagnation in TCM.
3. Unripe Hawthorn:
The unripe fruit is more astringent and stronger for Diarrhea.
4. Charred Hawthorn.
The dried fruit is stir-fried until Charred. This is hemostatic and astringent, used for Diarrhea, Dysentery and Bleeding.

Comment:

1. Hawthorn in the East and West can be considered largely synonymous. While traditional indications are different, Modern TCM uses Hawthorn for Heart and circulatory conditions based on Western usage.
2. Hawthorn Leaf (C. pinnatifida) is listed in the Chinese Pharmacopoeia. It has the effect of moving the Blood and regulating the flow of Qi. Used for Chest constriction, Palpitation, Amnesia, Vertigo and Tinnitus from Qi and Blood stagnation. Dose: 3–10 grams in Decoction.

Main Combinations:

1. Heart diseases, Hawthorn berry with Lily of the Valley
2. To strengthen Heart and Circulation:
i. Hawthorn berry with Rosemary, Rosehip, Motherwort, Calendula
ii. Hawthorn berry with Mistletoe, Dandelion, Motherwort, Fumitory, Couch grass, Balm, Rue, Yarrow, Shepherd’s Purse (Treben)
3. Hypertension:
i. Hawthorn berry with Mistletoe, Balm
ii. Hawthorn berry with Linden flower
iii. Hawthorn berry with Motherwort, Rosemary, Angelica, Hyssop, Nettle
4. Hypotension, Hawthorn, Camphor
5. Angina Pectoris:
i. Hawthorn berry with Mistletoe and Valerian
ii. Hawthorn berry with Valerian and Camphor
6. High cholesterol and Hypertension, Hawthorn berry with Mistletoe and Garlic (modern combination)
7. Arteriosclerosis, Hawthorn berry with Mistletoe, Valerian, Horsetail
8. Post Stroke, Hawthorn, Notoginseng San Qi, Ligusticum Chuan Xiong, Safflower (Hong Hua)
9. Varicose veins:
i. Hawthorn berry with Yarrow and Horse Chestnut
ii. Hawthorn flowers, Yarrow, Calendula
10. Anxiety with Palpitations, Nervous exhaustion, Hawthorn flowers, Balm, St. Johns wort, Valerian
11. Restlessness and Insomnia in Children, Hawthorn berry, Camomile, Rose
12. Nervousness in Children, Hawthorn berry, Balm, Rosehip
13. Food stagnation with abdominal distention, fullness, belching, poor appetite:
i. stir-fried Hawthorn fruit (Shan Zha), Radish seed, Malted Barley (Mai Ya) (TCM)
ii. Hawthorn, Medicated Leaven (Shen Qu), Malted Barley (Mai Ya), all charred and powdered (as in Jiao San Xian, the ‘Three Charred Miracles’ of TCM).
14. Childhood nutritional impairment with Fever and poor appetite, Hawthorn berry (Shan Zha) with Atractylodes Bai Zhu, Picrorhiza (TCM)
15. Lower Cholesterol, reduce Weight, Hawthorn, Perilla Zi Su Ye, Calamus (Shi Chang Pu), Water Plantain (Ze Xie) (TCM)
16. Obesity, Hawthorn, Citrus Chen Pi
17. Inguinal Hernia, Hawthorn berry with Fennel seed (TCM)
18. Edema:
i. take equal parts of powdered Hawthorn seed and Honey, mix and take in teaspoonful doses twice daily.
ii. Hawthorn berry, Birch leaf, Strawberry leaf, Horsetail, German Camomile, Corn Silk. (this was found to be an effective diuretic: see here)

Major Formulas:

Cooling Exhilarating Electuary (Unani)
Letificans Cooling Electuary (Unani)
Da Shan Zha Wan
Bao He Wan
Eight Treasure Congee
Jiao San Xian

Cautions:

1. Use cautiously in those with marked digestive weakness (add Qi tonics).
2. Avoid in those with Gastric Ulcers.
3. Hawthorn Herb Increases the Risk of Bleeding after Cardiac Surgery: An Evidence-Based Approach.

Drug Interactions:

May potentiate Cardiac Glycosides (such as Digitalis)

Main Preparations used:

GENERAL / REVIEW
–Botanical, Phytochemical, Anti-Microbial and Pharmaceutical Characteristics of Hawthorn (Crataegusmonogyna Jacq.), Rosaceae.
–Optimizing Water-Based Extraction of Bioactive Principles of Hawthorn: From Experimental Laboratory Research to Homemade Preparations.
–[Prescription rules of preparations containing Crataegi Fructus in Chinese patent drug].
–Phytochemical and Pharmacological Activity Profile of Crataegus oxyacantha L. (Hawthorn) – A Cardiotonic Herb.
–Crataegus pinnatifida: chemical constituents, pharmacology, and potential applications.
–Comparative analysis of Tunisian wild Crataegus azarolus (yellow azarole) and Crataegus monogyna (red azarole) leaf, fruit, and traditionally derived syrup: phenolic profiles and antioxidant and antimicrobial activities of the aqueous-acetone extracts.
–A review of the chemistry of the genus Crataegus.

ANTIBACTERIAL
–Chemical composition, antioxidant and antibacterial activity of Crataegus monogyna leaves’ extracts.
–Chemical composition, antibacterial activity and action mechanism of different extracts from hawthorn (Crataegus pinnatifida Bge.).

ANTI-INFLAMMATORY
–Crataegus orientalis Leaves and Berries: Phenolic Profiles, Antioxidant and Anti-inflammatory Activity.

ANTIOXIDANT
–Chemical composition, antioxidant and antibacterial activity of Crataegus monogyna leaves’ extracts.
–Crataegus orientalis Leaves and Berries: Phenolic Profiles, Antioxidant and Anti-inflammatory Activity.

IMMUNOMODULATOR
–Hawthorn (Crataegus monogyna) Phenolic Extract Modulates Lymphocyte Subsets and Humoral Immune Response in Mice.

CARDIOPROTECTIVE
–Hawthorn revisited: time- and dose-dependent cardioprotective action of WS-1442 special extract in the reperfusion-induced arrhythmia model in rats in vivo.
–The Protective Effect of Crataegus aronia Against High-Fat Diet-Induced Vascular Inflammation in Rats Entails Inhibition of the NLRP-3 Inflammasome Pathway.
–Cardioprotective effect of resistance training and Crataegus oxyacantha extract on ischemia reperfusion-induced oxidative stress in diabetic rats.
–Hypolipidemic and cardioprotective benefits of a novel fireberry hawthorn fruit extract in the JCR:LA-cp rodent model of dyslipidemia and cardiac dysfunction.

CARDIOVASCULAR
–Standardized extracts from hawthorn leaves and flowers in the treatment of cardiovascular disorders–preclinical and clinical studies.

VASODILATORY / VASORELAXANT
–Development of a quantified herbal extract of hawthorn Crataegus mexicana leaves with vasodilator effect.
–Vasorelaxant effects of Crataegus pentagyna: Links with arginase inhibition and phenolic profile.
–Vasorelaxing effect and possible chemical markers of the flowers of the Mexican Crataegus gracilior.

ANTI-COAGULANT
–The hypocoagulant effect of Crataegus aronia in rats entails vitamin K-dependent and vitamin K-independent effects.
–Polyphenolic-polysaccharide conjugates from flowers and fruits of single-seeded hawthorn (Crataegus monogyna Jacq.): Chemical profiles and mechanisms of anticoagulant activity.

ANTITHROMBOTIC / ANTI-PLATELET AGGREGATION
–Antiplatelet aggregation and antithrombotic benefits of terpenes and flavones from hawthorn leaf extract isolated using the activity-guided method.
–Two new compounds from Crataegus pinnatifida and their antithrombotic activities.
–Antithrombotic effects of ethanol extract of Crataegus orientalis in the carrageenan-induced mice tail thrombosis model.

BLOOD STASIS
–Therapeutic effects of different polar fractions of hawthorn extract on blood stasis model rats revealed by liquid chromatography-mass spectrometry metabolomics.

ARRHYTHMIAS
–Protective effects of Hawthorn (Crataegus oxyacantha) extract against digoxin-induced arrhythmias in rats.

ANTI-HYPERTENSIVE
–Effect of Flavonoids in Hawthorn and Vitamin C Prevents Hypertension in Rats Induced by Heat Exposure.
–Flavonoid extract of hawthorn (Crataegus oxyacantha L.) fruit alleviates oxidative stress, inflammation and vascular dysfunction in L-NAME-induced hypertensive rats.
–Plants Used as Antihypertensive.
–The protective role of hawthorn fruit extract against high salt-induced hypertension in Dahl salt-sensitive rats: impact on oxidative stress and metabolic patterns.
–Antihypertensive Effects of Hydroalcoholic Extract of Crataegus Azarolus Subspecies Aronia Fruit in Rats with Renovascular Hypertension: An Experimental Mechanistic Study.

HYPOTENSION
–The combination of hawthorn extract and camphor significantly increases blood pressure: A meta-analysis and systematic review.
–Blood Pressure and Cognitive Performance After a Single Administration of a Camphor-Crataegus Combination in Adolescents with Low Blood Pressure.

CHOLESTEROL
–Hepatoprotective, Antihyperlipidemic and Radical Scavenging Activity of Hawthorn (Crataegus oxyacantha) and Rosemary (Rosmarinus officinalis) on Alcoholic Liver Disease.
–Untargeted Metabolite Profiling of Adipose Tissue in Hyperlipidemia Rats Exposed to Hawthorn Ethanol Extracts.

ATHEROSCLEROSIS
–Roles and Mechanisms of Hawthorn and Its Extracts on Atherosclerosis: A Review.
–Hawthorn Extract Alleviates Atherosclerosis through Regulating Inflammation and Apoptosis Related Factors: An Experimental Study.
–Hawthorn fruit attenuates atherosclerosis by improving the hypolipidemic and antioxidant activities in apolipoprotein e-deficient mice.
–Effects of an aqueous extract of Crataegus pinnatifida Bge. var. major N.E.Br. fruit on experimental atherosclerosis in rats.

HEART FAILURE
–Ethanol Extract of Chinese Hawthorn (Crataegus pinnatifida) Fruit Reduces Inflammation and Oxidative Stress in Rats with Doxorubicin-Induced Chronic Heart Failure.
–Evaluation of the Efficacy of Crataegus oxyacantha in Dogs with Early-Stage Heart Failure.

NEUROPROTECTIVE
–Seven new neuroprotective sesquineolignans isolated from the seeds of Crataegus pinnatifida.
–Seven new sesquineolignans isolated from the seeds of hawthorn and their neuroprotective activities.

ALZHEIMER’S DISEASE
–The fruit of Crataegus pinnatifida ameliorates memory deficits in β-amyloid protein-induced Alzheimer’s disease mouse model.
–Neurologically Potent Molecules from Crataegus oxyacantha; Isolation, Anticholinesterase Inhibition, and Molecular Docking.

AMYLOID AGGREGATION INHIBITION
–Two new sesquineolignans from the seeds of Crataegus pinnatifida and their β-amyloid aggregation inhibitory activitiy.
–Lignans from the seeds of Chinese hawthorn (Crataegus pinnatifida var. major N.E.Br.) against β-amyloid aggregation.

Crataegus, Hawthorn, Shan Zha PRO