Traditional use of Rauwolfia vomitoria

The generic name Rauwolfia, commemorates a 16th century German physician, Leonhart Rauvolf, who travelled widely to collect medicinal plants. The specific designation vomitoria refers to the purgative and emetic properties of the bark.

Rauwolfia vomitoria belongs to the family apocynacea. It is a shrub or small tree up to 26 feet (8 m). The parts that are commonly used for herbal remedies are roots, root bark, leaves and stem-bark. Roots may be harvested non-destructively annually by cutting them 4 inches (10 cm) from the taproot, allowing for fair-trade commercialization of this traditional remedy.

Modern science has studied the phytochemical constituents of Rauwolfia since the middle of the 20th century. The main alkaloid present is called reserpine and was first discovered by Swiss scientists, Schiller and Muller of CIB Pharmaceuticals in Switzerland in 1952.  Reserpine is commonly used as a marker to identify Rauwolfia.

Rovol Medecinal-Plants-in-tropical-Countries-Rauwolfia-Vomitoria-2

Source: Medicinal Plants in tropical Countries – ed Thieme

Reserpine, according to Okpako (1991), is a major constituent of antihypertensive drugs. Taken orally, Reserpine tablets treat the symptoms of high blood pressure (1) and psychotic illnesses such as schizophrenia. Reserpine lowers blood pressure by lowering certain chemicals in the blood stream, relaxing and widening the blood vessels. Potentially serious side effects of this medication include uncontrollable movement of the legs, arms, or hands, an irregular heartbeat, or heart failure .(2) Symptoms of heart failure include a sudden weight gain of at least five pounds (2.3 kilograms), chest pain, or swelling in the legs and ankles.



Traditional Use of Pao Pereira

Pao pereira (Geissospermum vellosii, or Geissospermum leave velloso), also spelled Pau pereira, is a well-known tree, native to South America. This plant, which has been used in traditional medicine for centuries, is also very much a part of South American popular culture.

Use of this plant extract spans a period of over three centuries, and information about its traditional use in South America, North America and Europe has been featured in a number of important publications.

Pao Pereira traditional use

Monographie of 1848
©The Beljanski Foundation, Inc.


On December 7, 1848, Ezequiel Correa Dos Santos presented his thesis “Monographia do Geissospermum vellosii vulgo Pao pereira” at the Faculty of Medicine of Rio de Janeiro. This document has come to be regarded as the first official monograph on the benefits of Pao pereira. In the third part of the study (p.17 “Therapeutica”), Dos Santos presented twenty-one cases of therapeutic use of Pao pereira. Before outlining the details of each case history, Dr. Dos Santos summarized his study with the following statement: “The administration of the Pao pereira bark was beneficial in cases of induration of cellular tissues, chronic diarrhea, passive hemorrhage, asthenia, as well as erysipelas.”

The subject was revisited in 1879 by the journal Medical Times (Vol. X p. 276 – Philadelphia) which published a two-page article devoted to Pao pereira. After a description of the method of extracting the alkaloid pereirina, Dr. Torres Homem, Professor of Clinical Medicine at the Academy of Rio de Janeiro states, “There is not a doctor in Brazil who has not obtained good results from the use of this bark in the treatment of intermittent fevers.” He mentions in particular the case of a patient for whom quinine was ineffective but who was cured after daily baths and oral administration of the Pao pereira bark extract.

Pao pereira botanic

Pao pereira
©The Beljanski Foundation, Inc.

The article “Antimalarial remedies in French Guiana: A knowledge attitudes and practices study” published in the Journal of Ethnopharmacology [98 (2005) 351-360], details a study on 117 people from five different ethnic groups and backgrounds, taking the alcoholic extract of Geissospermum (Pao pereira) at the onset of fevers.

For example it was quite a surprise to see that one of the most renowned antimalarial Amazonian species, Geissospermum spp., was so poorly employed as curative, but on the contrary, used much more in favor as preventive.” (p. 358.) According to a questionnaire submitted by the authors, the main reason for using this traditional medicine was to “stay healthy.” (p. 355)

In line with the decline in the number of cases of malaria, Geissospermum continues to be considered very useful, though for a different purpose.

Pao pereira bark

Pao pereira bark, used for extracts, is naturally renewable

A Brazilian journal on medicinal plants, “Revista Da Flora Medicinal, (No. 9, September 1942, Rio de Janeiro), offers a botanical illustration (p. 463) and description of the tree (p. 464-465). It says that the “precious bark” can be found on “one of the most common and wellknown trees in Brazil” and “is available for all herbalists” and concludes that, “the inner bark of Pao pereira is considered as one of the best tonic and febrifuge of the Brazilian flora.”

In “Livro verde das plantas medicinais e industriais do Brasil” (1965), the therapeutic usage of the Pao pereira is described as follows: “It is an excellent tonic and powerful remedy against intermittent fevers.” It is also recommended for digestive problems, lack of appetite and constipation.

It is most likely that the Pao pereira extract made its way to Northern America and Europe around the time of the big universal exhibitions, at the end of the 19th century.
Pao pereira was exhibited at the Universal Exhibition in Philadelphia and was included in the brochure: The Empire of Brazil at the Universal Exhibition of 1876 in Philadelphia—Medicinal Plants (p. 61).

It is interesting to note that the distinction between Geissospermum vellosii, and a somewhat similar botanical called Aspidosperma, was already made in 1876. In 1895, The American Journal of Pharmacy recommended Pao pereira as an anti-fever tonic, especially to combat the periodic fevers. In 1907, The Merck Index indicates that the roots of Geissospermum vellosii have anti-peristaltic and anti-fever effects.


Pao pereira voucher
©The Beljanski Foundation, Inc.

Europe also showed early interest for Pao pereira. In “Notes, Queries and Replies” (p. 443 of “The Medical Times” London) published in 1884, Richard G. Daunt comments: “the efficacy of pereirina is extraordinary, and I have often observed its success after the failure of quinine.”

The same year in France, Dr. Tibiriça indicates in “La revue des journaux” (l’Union Médicale p.429 – Paris), “The Pereirine (extract from the bark of Pao pereira, Geissospermum leaf) fulfills the indication in a more satisfactory way than the quinine. It doubles the therapeutic action at the same time as it prevents the bad effects when pushed to a higher dose.

Belgium made Pao pereira an official “new remedy”: in 1887 in “le Journal de Médecine, de Chirurgie et de Phamacologie” (Bruxelles) published in “Nouveaux remèdes” the following note: “the alkaloid pereirine would be more effective than quinine against malarial fevers. The dose of 2 g of hydrochloride is to be taken four hours prior the access.

In 1933, in Milan, Italy, Pao pereira is listed in the dictionary of drugs “Medicamenta, Guida Teorico-pratica per Sanitari” (Dizionario dei Medicamenti p. 2389) included in the description are instructions for the pharmaceutical preparation and dosage: Internal, Decoction (30 gr: 1000) 1-2 glasses a day. Pereirine Chloride 2gr.
European scientists soon became interested in analyzing this valuable product with the means of modern chemistry.
In Belgium in 1959, Puisieux published and article on the nature of some of the alkaloids from Geissospermum (Ann Pharm Fr 1959 Oct-Dec; 17:626-33).