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piper methysticum L.
The generic name comes from the Greek word methyskomai, 'to stupefy oneself.'
Common names – Kava Kava., Ava, Ava pepper, Awa, Kew, Kawa, Intoxicating pepper, Sakau, Tonga, Yangma.
Names in other languages – Polish – Pieprz kawakawa
German – Kawa-pfeffer, Rauschpfeffer, Wurzelstock.
Mother Tincture Q
Plantae; Spermatophyta, Angiospermae - Flowering Plants; Dicotyledonae; Polycarpicae (Magnoliidae); Piperales; Piperaceae
Proved and introduced by Griswold, Hughes: Manual of Pharmacodynamics, 931; Clarke: A Dictionary of Practical Mat. Med., Vol. III, 829.
Description of the substance
The root of Piper methysticum, Forster (Macropiper methysticum, Miquel).
COMMON NAMES: Ava, Kava-kava, Intoxicating long pepper, Ava pepper shrub.
Botanical Source and History.-This is a shrub about 6 feet high, somewhat resembling the bamboo in growth, a native of and common in cultivation in the South Sea Islands. It was discovered by James Cook, the celebrated explorer, in 1769, in the Tahiti Islands. The leaves (see illustration in Pharm. Jour. Trans., 1876, p. 149) are alternate, cordate, with a wavy, entire margin, and an abrupt, acute point. The petiole is about an inch long, dilated at the base, and furnished with linear, erect stipules. The veins are prominent, about 12, diverging from the base of the leaf-blade. The flowers are small, apetalous, and arranged on slender spikes. Those bearing male flowers are axillary and solitary. The female spikes are numerous. This shrub is known in its native country under the names Kava, Ava, Arwa, Ava-kava, Kava-kava, etc., and is the "Intoxicating Long Pepper," from which a disgusting drink is prepared by the natives, and even by the whites, of these islands. This drink is invariably made by chewing the root of the plant to a pulp, covering this with water, macerating a short time, and then straining it through "fow,'' a fibrous material obtained from the bark of a certain native tree. The taste is said to resemble soap-suds and tannin. (For the methods of its preparation by the natives and its uses, see an interesting illustrated paper by Dr. R. H. True, in Pharm. Review, 1896, p. 28; also see T. R. N. Morson's abstract from Mariner's History of the Tonga Islands, in Pharm. Jour. Trans., Vol. III, 1844, p. 474; and Dr. Beeman's Letters from the Fiji Islands, in the Althenaeum, 1861.) The leaf is chewed with the betel-nut, and the dried root, under the name pipula moola, forms an article of commerce in India.
Description.-The root is the part recommended for use in medicine. Of the lot inspected by us, the main root seems to have grown horizontally beneath the surface of the ground, sending up stalks at intervals of from 2 to 4 inches. Each stalk is from 1/2 to 3 inches in diameter at the base, and is hollow. The cavity extends through the main root, thus giving to a longitudinal section of the root the appearance of several separate roots having grown together. Externally, the main root is brown, and covered with a thin bark. From the sides and lower part are secondary roots, about 1/2 to 3/4 of an inch in diameter. These appear to be arranged about the bases of the stalks; in some cases they are quite long, and commence to send out rootlets at a distance of 6 inches from the main root. Internally, the large root is covered with a network of fibers beneath the bark. Coarse medullary rays compose the body. The root breaks with a fibrous fracture; it is frequently much worm-eaten internally, though, to an external examination, apparently sound. After chewing a little of it, a peculiar, acrid, benumbing sensation is imparted to the parts of the mouth with which the pulp comes in contact. This property is possessed in a much greater degree by the small rootlets.
The first Europeans to observe the kava plant and its ritualistic consumption by natives of Oceania were Dutch explorers Jacob Le Maire and William Schouten. In 1616, they encountered the plant in the Hoorn Islands, now a part of the French territory Wallis and Fatuna. Later travelers in the Pacific region provided a wealth of detail regarding this highly valued and widely used pepper plant.
Long cultivated and known by a number of common names, including kava-kava, ava, yagona, and yangona, the plant is now classified by botanists as Piper methysticum, meaning "intoxicating pepper." In religious and social rituals that naturally vary somewhat from island to island, the rhizome of the plant is grated (originally chewed by young people with sound teeth), mixed with water in a bowl, strained, and the resulting beverage drunk to produce a feeling of well-being.
Observers and even scientists long disagreed on the effects of kava. Captain James Cook, who observed its use during his world voyage of 1768-1771, thought the symptoms resembled those of opium. Lewis Lewin, a pioneer pharmacologist in the field of mind-altering drugs, referred to it in the 1880s as a narcotic and sedative, but noted these effects followed a period of quiet euphoria. Modern authorities call kava a psychoactive agent; it reduces anxiety much like the potent, synthetic benzodiazapines (e.g., Valium) and is a potent muscle relaxant. Kava does promote relaxation and sociability, but its effects are very different from those produced by either alcohol or synthetic tranquilizers. It does not produce a hangover, and, even more significant, it does not cause dependency or addiction.
Naturally, people were interested in finding out how kava produced these interesting effects. It was once thought that chewing the root converted its starch into sugar which then fermented to produce alcohol. Although this sounds far-fetched, chicha, a corn-based beer brewed by natives in Peru and Bolivia, is prepared in just this fashion. Lewin said a resinous material was the active component. Finally in the 1950s and 60s, two teams of German scientists headed by H.J. Meyer in Freiburg and R. Hänsel in Berlin found that the various activities of the kava plant were due to some 15 different chemical compounds known as pyrones. Collectively named kavapyrones or kavalactones, the compounds were found to increase the sedative action of barbiturates, to have both analgesic and local anesthetic effects, to cause muscles to relax, and to have antifungal properties.
Shortly after these findings, preparations of kava extract began to appear on the European market, usually standardized to provide a daily dosage in the range of 60-120 mg of kavapyrones. German Commission E, the group responsible for evaluating the safety and efficacy of botanical medicines, reviewed the data on kava and, in 1990, approved its use for conditions such as nervous anxiety, stress, and restlessness. It is frequently marketed as an anxiolytic. Use of kava is contraindicated during pregnancy, nursing, and in cases of depression caused by internal factors.
With an herb as potent as this one, there is naturally concern about side effects. Observations on 4,049 patients consuming 105 mg of kavapyrones daily for 7 weeks noted 61 cases (1.5%) of undesired effects. These were mostly mild and reversible gastrointestinal disturbances or allergic skin reactions. A 4-week study of 3,029 patients taking 240 mg of kavapyrones daily produced a slightly greater incidence (2.3%) of similar side effects. This would be expected because of the larger dosages used.
Long-term consumption of very large quantities of kava may result in a yellow coloration of the skin, nails, and hair, allergic skin reactions, visual and oculomotor equilibrium disturbances. For this reason, Commission E recommends that kava not be consumed for longer than 3 months without medical advice. Driving and operating machinery during consumption should be avoided.
The results of 5 controlled, double-blind clinical trials carried out with a total of 410 subjects over periods ranging from 28 to 84 days, using daily doses of kavapyrones between 30 and 210 mg, were all positive. For example, in 1995, 100 patients suffering anxiety and stress symptoms were given 210 mg of kavapyrones daily. After 8 weeks, the treated subjects were clearly improved in comparison to those receiving a placebo. As for side effects, 15 persons receiving the placebo reported them in comparison to only 5 taking kava extract.
Kava products have been steady but unspectacular sellers in Europe for several decades. Until recently, no one in the United States seemed much interested in them. Ironically, when the Food and Drug Administration began to express concern over the safety of ephedra, a stimulant herbal product, herb marketers became enthusiastic about kava, a depressant. Both herbs have psychoactive properties, but the effects are almost exactly opposite.
Kava and its contained pyrones are, without question, effective medications. They are also subject to abuse. The kava scenario in this country is just beginning. It is too early to predict whether it will continue to be marketed freely or will eventually be subjected to rigid controls.