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(Ginseng or Aralia or Ivy family)
This family of some 700 species in 55 genera consists mostly of trees and shrubs, but includes some twiners. Most species occur in tropical regions, particularly in Indomalaysia and tropical America. Other species are native to temperate regions, and some species have become widely distributed by horticulture and as houseplants.
A characteristic of the family is the presence of resin passages which produce an aromatic smell when crushed (Corner 1952).
Perhaps the best known temperate species is Hedera helix L., the ivy. The ritual use of ivy as the archetypal evergreen, and its popularity as a decorative covering for walls and fences and as a houseplant, brings it into unusually close contact with man.
The root of Panax ginseng C.A.Mey. is the Korean or Oriental ginseng of commerce. It is also known as Ren Shen or as Radix Panacis Gingeng. Preparations of the root are widely used as a herbal remedy for their reputed tonic and adaptogenic properties (Dixon 1976). Several other types of ginseng are derived from members of the Araliaceae, and also from totally unrelated families (Nadkarni 1976, Lui & Staba 1980):
- Acanthopanax senticosus Harms — yields Siberian ginseng
- Panax ginseng C.A.Mey. — yields Korean or oriental ginseng
- Panax notoginseng F.H.Chen ex C.Y.Wu & K.M.Feng — yields sanchi ginseng
- Panax japonicus C.A.Mey. — yields Japanese ginseng
- Panax quinquefolius L. — yields American ginseng
- Panax trifolius L. — yields groundnut ginseng
- Rumex hymenosepalus Torr., fam. Polygonaceae — yields wild American red ginseng
- Withania somnifera Dunal, fam. Solanaceae — yields Indian ginseng or ashwaganda
Allergic dermatitis following contact with species of Hedera L., Polyscias J.R.Forst. & G.Forst., Schefflera J.R.Forst. & G.Forst., and other genera has been reported, as has cross-sensitivity between genera. In addition, many species bear spines.
- Acanthopanax senticosus Harms
- (syn. Eleutherococcus senticosus Maxim.)
- Touch Me Not, Devil's Shrub, Siberian Ginseng
The plant is thorny (Brekhman 1968).
- Acanthopanax sessiliflorum Seemann
Sesamin, an allergenic principle found in sesame seed oil (Sesamum indicum L., fam. Pedaliaceae), has been isolated from the root bark of this species (Elyakova et al. 1966, Yook et al. 1977).
This species, in common with most others in the genus, is armed with prickles.
- Aralia spinosa L.
- Angelica Tree, Hercules' Club, Devil's Walking Stick
The green bark irritates the hands of those collecting it (Cheney 1887). As indicated by the specific epithet, the plant is armed with stout prickles.
- Brassaia actinophylla Endl.
- (syns Schefflera actinophylla Harms, Schefflera macrostachya Harms, Brassaia macrostachya Seemann)
- Queensland Umbrella Tree, Schefflera, Starleaf, Octopus Tree, Australian Ivy Palm
Aplin (1976) noted that in Western Australia this species was suspected of having caused an irritating rash in a person who had handled the plant. In another case, a white female homemaker aged 33 years became sensitised by cutting back Hedera during the summer. The following winter she developed several attacks of acute vesicular dermatitis affecting the hands, wrists, forearms, and face subsequent to contact with Brassaia actinophylla grown as a houseplant. A patch test with lightly crushed leaf produced a strongly positive reaction, negative in three controls. Positive patch test reactions were also observed to some other species, namely Fatsia japonica Decne. & Planchon, Hedera helix L., Polyscias fruticosa Harms, (syn. Panax fruticosum L.), and x Fatshedera Guillaumin, negative to Dizygotheca elegantissima R.Vig. & Guillaumin (syn. Aralia elegantissima Veitch) (Mitchell 1981).
Hammershøy (1981) describes a case of a 35 year old female nursery worker who developed dermatitis of the hands and forearms two weeks after starting work with Schefflera J.R.Forst. & G.Forst. species. Patch tests to Schefflera actinophylla and Schefflera arboricola Hayata (syn. Heptapleurum arboricola Hayata) leaf, stem, and ether extracts (1% in petrolatum) were positive; ten controls were negative.
- Echinopanax elatus Nakai
Lopatin & Kolesnikova (1974) reported dermatitis caused by extracts of this species. Ingestion of an infusion of the plant caused toxicoderma (one case) and urticaria (two cases).
- Hedera algeriensis Hibberd
- (syns Hedera canariensis Willd., Hedera helix L. var canariensis DC.)
- Algerian Ivy, Canaries Ivy, Canary Island Ivy
This ivy is tender in Britain, needing protection in winter, and is grown mainly as a house plant. In many parts of America and in southern Europe it grows freely in the open. Varieties and cultivars of this species are also known.
A substance causing dermatitis is present in the sap (Dorsey 1957) and is probably an allergic sensitiser. It is released only when the leaves or stems are bruised, and is present in an aqueous extract of the plant. Dermatitis is usually acquired in the process of cutting back the exuberant growth in the spring. It is commonly confined to exposed skin, and may be diffusely eczematous or in linear, often vesicular patterns (Rynes 1949, Dorsey 1959). If this plant is the cause of a skin eruption, reaction to a patch test with juice from crushed leaves will occur within 48 hours (Dorsey 1959, Dorsey 1962).
A male aged 27 years developed bullous dermatitis of the fingers, hands, forearm, neck, and face after clearing the variegated form of this ivy from his garden. Patch tests to the leaf produced a 3+ reaction (Calnan 1981).
Contact dermatitis from this ivy is rare in Britain (Calnan 1981, Hambly & Wilkinson 1978), quite common in Australia (Burry, J.N., personal communication to Calnan 1981), and reported from California (Dorsey 1957, Dorsey 1959), Southern Transvaal (Whiting 1971), Denmark (Roed-Petersen 1975), and Canada (Mitchell 1981). Roed-Petersen (1975) found three positive reactions among 138 control patients. In the case described by Hambly & Wilkinson (1978), patch test reactions were positive to Chrysanthemum L. as well as to Hedera canariensis.
- Hedera helix L.
- Common Ivy, English Ivy
Clipping or just handling the plant may result in a skin rash and even blistering and inflammation (Watt & Breyer-Brandwijk 1962). This common European ivy has long been recognised as a cause of dermatitis (Zinsser 1909, Gutteling 1922, Roed-Petersen 1975). Patients allergic to Hedera canariensis also react to H. helix. The clinical features of the dermatitis as described in case reports (Cleland 1925, Muenscher 1939) suggest that allergic sensitisation may occur. Indeed, the lesions may be linear and vesicular as in poison ivy (Toxicodendron Mill. spp., fam. Anacardiaceae) dermatitis (Goldman et al. 1956, Aplin 1966). Other similar cases have been reported by Thibierge (1909) and by Burry (1969).
An extract of the leaves, when used as a corn cure for the feet, caused dermatitis in a patient who later developed a recurrence after handling wet leaves (Munro 1900). Rothe (1968) described a gardener in a cemetery who developed eczema of the hands and forearms. A patch tests to the leaf of this ivy produced a positive reaction.
In addition to the case reports already mentioned, Maiden (1909), Maiden (1911) and Allen (1943) state that this ivy causes dermatitis only in some people. One of the authors (A.J.R.) has encountered four cases of dermatitis apparently attributable to this ivy, the clinical appearances of which were those of an irritant dermatitis. Patch tests with fragments of bruised leaf were positive only in one patient, but also positive in 3 of 10 control subjects. Highman (1924) obtained a negative patch test reaction with a leaf, but a positive reaction to an alcoholic extract of the leaves which produced no reaction in two controls. Whiting (1971) notes that H. helix has low sensitising potential.
One of four patients who were contact sensitive to this ivy was also contact sensitive to extracts of some Compositae species and to alantolactone derived from Inula helenium L. (Roed-Petersen 1975).
Several varieties of this ivy growing in Egypt have been found to contain the alkaloid emetine (Mahran et al. 1975). Emetine may produce intense skin reactions in sensitised persons (see Cephaelis ipecacuanha A.Rich., fam. Rubiaceae). The leaves and berries also contain saponins based on hederagenin. On ingestion, vomiting, diarrhoea, and nervous depression may be caused though the symptoms are considered serious only in small children (Lewis & Elvin-Lewis 1977, North 1967). A scarlatiniform eruption in a 3.5-year old boy, seemingly produced by ingested ivy leaves, has been described by Turton (1925).