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''Frangula purshiana'' (cascara, cascara buckthorn, cascara sagrada, bearberry, and in the Chinook Jargon, chittem stick and chitticum stick;
syn. The Botanical and Zoological Codes of nomenclature treat the concept of synonymy differently. * In botanical nomenclature, a synonym is a scientific name that applies to a taxon that (now) goes by a different scientific name. For example, Linnae ...
''Rhamnus purshiana'') is a species of plant in the family
Rhamnaceae The Rhamnaceae are a large family of flowering plants, mostly trees, shrubs, and some vines, commonly called the buckthorn family. Rhamnaceae is included in the order Rosales. The family contains about 55 genera and 950 species. The Rhamnaceae h ...
. It is native to western
North America North America is a continent in the Northern Hemisphere and almost entirely within the Western Hemisphere. It is bordered to the north by the Arctic Ocean, to the east by the Atlantic Ocean, to the southeast by South America and the Car ...
from southern British Columbia south to central California, and eastward to northwestern Montana. The dried bark of cascara was used as a laxative in folk medicine by the indigenous peoples of the Pacific Northwest, and later worldwide in conventional medicines until 2002.


Description

Cascara is a large
shrub A shrub (often also called a bush) is a small-to-medium-sized perennial woody plant. Unlike herbaceous plants, shrubs have persistent woody stems above the ground. Shrubs can be either deciduous or evergreen. They are distinguished from trees ...
or small tree tall, with a trunk 20–50 centimetres (8–20 in) in diameter. The buds have no scales, unique for the northwest region. The thin
bark Bark may refer to: * Bark (botany), an outer layer of a woody plant such as a tree or stick * Bark (sound), a vocalization of some animals (which is commonly the dog) Places * Bark, Germany * Bark, Warmian-Masurian Voivodeship, Poland Arts, ...
is brownish to silver-gray with light splotching (often, in part, from lichens); the inner bark is smooth and yellowish (turning dark brown with age and/or exposure to sunlight). Cascara bark has an intensely bitter flavor that will remain in the mouth for hours, overpowering and even numbing the taste buds. The
leaves A leaf (plural, : leaves) is any of the principal appendages of a vascular plant plant stem, stem, usually borne laterally aboveground and specialized for photosynthesis. Leaves are collectively called foliage, as in "autumn foliage", wh ...
are simple, deciduous, alternate, clustered near the ends of twigs. They are oval, 5–15 cm (2–6 in) long and broad with a petiole, shiny and green on top, and a dull, paler green below; they have tiny teeth on the margins, and 10–12 pairs of pinnate veins. The leaves turn yellow in autumn. The flowers are tiny, diameter, with five greenish yellow petals, forming a cup shape. The flowers bloom in umbel-shaped clusters, on the ends of distinctive peduncles that are attached to the leaf axils. The flowering season is brief, from early to mid- spring, disappearing by early summer. The fruit is a
drupe In botany, a drupe (or stone fruit) is an indehiscent fruit in which an outer fleshy part (exocarp, or skin, and mesocarp, or flesh) surrounds a single shell (the ''pit'', ''stone'', or '' pyrena'') of hardened endocarp with a seed (''kernel'') ...
diameter, bright red at first, quickly maturing deep purple or black, and containing a yellow pulp, and two or three hard, smooth, olive-green or black seeds. File:Rhamnus purshiana -- “Cascara” -- leaf and buds.png, Closeup of leaf and buds File:Cascara (Rhamnus purshiana) bark.JPG, Splotchy bark File:Rhamnus purshiana, Cascara -- branch with leaves, flowers and buds.JPG, Branch with prominently veined, alternate leaves, reddish twigs, and clusters of flowers at the leaf axils File:Rhamnus purshiana -- leaves and fruits.JPG, Leaves, flower, and young fruits


Distribution and habitat

Cascara is native from northern California to British Columbia and east to the Rocky Mountains in Montana. It is often found along streamsides in the mixed deciduous-
coniferous Conifers are a group of cone-bearing seed plants, a subset of gymnosperms. Scientifically, they make up the division Pinophyta (), also known as Coniferophyta () or Coniferae. The division contains a single extant class, Pinopsida. All extant ...
forests of valleys, and in moist montane forests. Cascara is common in the understory of bigleaf maple forest, alongside red osier dogwood and red alder. In many areas, the high market demand for cascara bark has led to over-harvesting from wild trees, which may have heavily reduced cascara populations.


Ecology

It is browsed by mule deer in Oregon and
elk The elk (''Cervus canadensis''), also known as the wapiti, is one of the largest species within the deer family, Cervidae, and one of the largest terrestrial mammals in its native range of North America and Central and East Asia. The common ...
in northern Idaho, especially in the winter months. The Olympic black bear, Oregon gray fox, raccoon, and ring-tailed cat also eat Cascara foliage. The fruit is eaten by birds, bears, raccoons, and other mammals, who distribute the undigestible seeds. Cascara creates brushy stands which provide abundant thermal and hiding cover for wildlife. Cascara is usually top-killed by fire, but may resprout from the root crown. After more severe fires, it reestablishes via off-site seed beginning the second year after the fire. It typically inhabits areas with fire regimes on 30 to 150 year intervals, although it is also found in areas with fire regimes of 500+ years. The tree is shade tolerant.


Toxicity

The fruit and bark contain a bitter chemical making them inedible to humans, although there are contested medicinal uses. Until 2002, cascara was the principal ingredient in commercial, over-the-counter (OTC) laxatives in
North America North America is a continent in the Northern Hemisphere and almost entirely within the Western Hemisphere. It is bordered to the north by the Arctic Ocean, to the east by the Atlantic Ocean, to the southeast by South America and the Car ...
n pharmacies until the U.S. Food and Drug Administration (FDA) issued a final rule banning the use of
aloe ''Aloe'' (; also written ''Aloë'') is a genus containing over 650 species of flowering succulent plants.WFO (2022): Aloe L. Published on the Internet;http://www.worldfloraonline.org/taxon/wfo-4000001341. Accessed on: 06 Nov 2022 The most wid ...
and cascara as laxative ingredients. Serious
adverse effect An adverse effect is an undesired harmful effect resulting from a Pharmaceutical drug, medication or other Surgery#Definitions, intervention, such as surgery. An adverse effect may be termed a "side effect", when judged to be secondary to a main ...
s may occur from using cascara, including dehydration, loss of electrolyte levels (such as potassium, sodium, chloride), heart rhythm irregularities, and muscle weakness. There is also concern for its potential
carcinogenicity A carcinogen is any substance, radionuclide, or radiation that promotes carcinogenesis (the formation of cancer). This may be due to the ability to damage the genome or to the disruption of cellular metabolic processes. Several radioactive substan ...
. Laxatives should also not be used by people with
Crohn's disease Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distension, ...
,
irritable bowel syndrome Irritable bowel syndrome (IBS) is a "disorder of gut-brain interaction" characterized by a group of symptoms that commonly include abdominal pain and or abdominal bloating and changes in the consistency of bowel movements. These symptoms ma ...
,
colitis Colitis is swelling or inflammation of the large intestine ( colon). Colitis may be acute and self-limited or long-term. It broadly fits into the category of digestive diseases. In a medical context, the label ''colitis'' (without qualification ...
,
hemorrhoids Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term '' ...
,
appendicitis Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a r ...
, or
kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; bloo ...
problems. Use of cascara is a safety concern for pregnant or breastfeeding women, and for children.


Dietary supplement

Cascara is sold in the United States as a
dietary supplement A dietary supplement is a manufactured product intended to supplement one's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources or that are synthetic in orde ...
and commonly ingested by mouth to relieve
constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel moveme ...
. Although it may be safe for use over a few days, there is insufficient scientific evidence to assure its safety and effectiveness. Use of cascara may adversely affect the actions of various prescribed drugs, such as
digoxin Digoxin (better known as Digitalis), sold under the brand name Lanoxin among others, is a medication used to treat various heart conditions. Most frequently it is used for atrial fibrillation, atrial flutter, and heart failure. Digoxin is on ...
,
warfarin Warfarin, sold under the brand name Coumadin among others, is a medication that is used as an anticoagulant (blood thinner). It is commonly used to prevent blood clots such as deep vein thrombosis and pulmonary embolism, and to prevent ...
,
corticosteroid Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are in ...
s, and
diuretic A diuretic () is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. A diuretic tablet is sometimes colloquially called a water tablet. There are several categories of diuretics. All diuretics in ...
agents.


Phytochemistry

Numerous quinoid
phytochemical Phytochemicals are chemical compounds produced by plants, generally to help them resist fungi, bacteria and plant virus infections, and also consumption by insects and other animals. The name comes . Some phytochemicals have been used as poison ...
s are present in cascara bark. The chemicals possibly contributing to a laxative effect are the
hydroxyanthracene Hydroxyanthracenes are a class of natural phenolic compounds. They can be found in ''Cassia alata'' and ''Cassia senna ''Senna alexandrina'' (Alexandrian senna, in Arabic عشرج or عشرق or سنامكي and see below) is an ornamental pla ...
glycosides In chemistry, a glycoside is a molecule in which a sugar is bound to another functional group via a glycosidic bond. Glycosides play numerous important roles in living organisms. Many plants store chemicals in the form of inactive glycosides ...
, which include cascarosides A, B, C, and D. Cascara contains approximately 8% anthranoids by mass, of which about two-thirds are cascarosides. The hydroxyanthracene glycosides may trigger
peristalsis Peristalsis ( , ) is a radially symmetrical contraction and relaxation of muscles that propagate in a wave down a tube, in an anterograde direction. Peristalsis is progression of coordinated contraction of involuntary circular muscles, which ...
by inhibiting the absorption of water and
electrolytes An electrolyte is a medium containing ions that is electrically conducting through the movement of those ions, but not conducting electrons. This includes most soluble salts, acids, and bases dissolved in a polar solvent, such as water. Upon d ...
in the
large intestine The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in tetrapods. Water is absorbed here and the remaining waste material is stored in the rectum as feces before being r ...
, which increases the volume of the
bowel The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
contents, leading to increased pressure. The hydroxyanthracene glycosides are not readily absorbed in the
small intestine The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through t ...
, but are
hydrolyzed Hydrolysis (; ) is any chemical reaction in which a molecule of water breaks one or more chemical bonds. The term is used broadly for substitution, elimination, and solvation reactions in which water is the nucleophile. Biological hydrolysis ...
by
intestinal flora Gut microbiota, gut microbiome, or gut flora, are the microorganisms, including bacteria, archaea, fungi, and viruses that live in the digestive tracts of animals. The gastrointestinal metagenome is the aggregate of all the genomes of the gut mic ...
to a form that is partly absorbed in the colon. Some of the chemical constituents present in the bark may be excreted by the kidneys. The
extract An extract is a substance made by extracting a part of a raw material, often by using a solvent such as ethanol, oil or water. Extracts may be sold as tinctures, absolutes or in powder form. The aromatic principles of many spices, nuts ...
from cascara bark also contains emodin, which may contribute to the laxative effect.


Uses


Traditional medicine

Cascara was used in
traditional medicine Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before th ...
as a laxative. The dried, aged bark of ''R. purshiana'' used by
indigenous Indigenous may refer to: *Indigenous peoples *Indigenous (ecology), presence in a region as the result of only natural processes, with no human intervention * Indigenous (band), an American blues-rock band * Indigenous (horse), a Hong Kong racehor ...
native cultures and immigrant Euro-Americans as a laxative is similar to other
anthraquinone Anthraquinone, also called anthracenedione or dioxoanthracene, is an aromatic organic compound with formula . Isomers include various quinone derivatives. The term anthraquinone however refers to the isomer, 9,10-anthraquinone (IUPAC: 9,10-dioxoan ...
-containing herbal preparations of leaves and fruits of senna, the
latex Latex is an emulsion (stable dispersion) of polymer microparticles in water. Latexes are found in nature, but synthetic latexes are common as well. In nature, latex is found as a milky fluid found in 10% of all flowering plants (angiosper ...
of ''
Aloe vera ''Aloe vera'' () is a succulent plant species of the genus ''Aloe''. It is widely distributed, and is considered an invasive species in many world regions. An evergreen perennial, it originates from the Arabian Peninsula, but grows wild in tro ...
'', and the root of the
rhubarb Rhubarb is the fleshy, edible stalks ( petioles) of species and hybrids (culinary rhubarb) of '' Rheum'' in the family Polygonaceae, which are cooked and used for food. The whole plant – a herbaceous perennial growing from short, thick r ...
plant. Commercially, it is called "cascara sagrada" ('sacred bark' in Spanish), while in the traditional Chinook Jargon it is known as ''"chittem bark"'' or ''"chitticum bark"''. Following its introduction to formal U.S. medicine in 1877, it replaced the berries of '' R. catharticus'' as the favored laxative. The historical interest in using cascara damaged native cascara populations during the 1900s due to overharvesting.


Preparation in folk medicine

The bark is collected in the spring or early summer, when it easily peels from the tree. Once stripped from the tree, the bark must be aged for several months, because fresh cut, dried bark causes
vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteri ...
and violent
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin ...
. This drying is generally done in the shade to preserve its characteristic yellow color. This process can be quickened by simply baking the bark at a low temperature for several hours. Botanist
Julia Morton Julia Frances McHugh Morton (April 25, 1912 – September 10, 1996) was an American author and botanist. She was research professor of biology, and director of the Morton Collectanea at the University of Miami. She was elected a Fellow of th ...
suggests using a dose of 10–30 
grains A grain is a small, hard, dry fruit (caryopsis) – with or without an attached hull layer – harvested for human or animal consumption. A grain crop is a grain-producing plant. The two main types of commercial grain crops are cereals and legumes ...
, dissolved in water, or 0.6–2.0 cc for fluid extract.
James A. Duke James A. Duke (4 April 1929 – 10 December 2017) was an American botanist. He was the author of numerous publications on botanical medicine, including the '' CRC Handbook of Medicinal Herbs''. He was well known for his 1997 bestseller, ''The Green ...
suggests an effective dosage of approximately dried bark, or powdered bark.


Other uses

The fruit can also be eaten cooked or raw, but has a laxative effect. The food industry sometimes uses cascara as a flavoring agent for liquors, soft drinks, ice cream, and baked goods. Cascara honey is tasty, but slightly laxative. The wood is used by local people for posts, firewood, and turnery. It is also planted as an ornamental, to provide food and habitat for wildlife, or to prevent soil
erosion Erosion is the action of surface processes (such as water flow or wind) that removes soil, rock, or dissolved material from one location on the Earth's crust, and then transports it to another location where it is deposited. Erosion is di ...
. Due to its bitter taste, cascara can be used to stop nail-biting by applying it to the fingernails.


References


External links


Flora of British Columbia: ''Rhamnus purshiana''Jepson Flora Project: ''Rhamnus purshiana''USDA Plants Profile: ''Frangula purshiana''Documents related to FDA-1978-N-0021 (Formerly 1978N-036L): Cascara OTC
{{Authority control purshiana Trees of Western Canada Trees of the Northwestern United States Trees of British Columbia Flora of California Flora of the Cascade Range Flora of the Klamath Mountains Flora of the Sierra Nevada (United States) Flora of the West Coast of the United States Natural history of the California chaparral and woodlands Natural history of the California Coast Ranges Trees of humid continental climate Trees of mild maritime climate Medicinal plants of North America Taxa named by Augustin Pyramus de Candolle Flora without expected TNC conservation status