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Journal of Drug Delivery and Therapeutics

Open Access to Pharmaceutical and Medical Research

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Open Access   Full Text Article                                                                                                                                                                               Review Article 

Saqmunia (Convolvulus scammonia L.), an important drug used in Unani system of medicine: A review

Huzaifa Ansari¹_, Athar Parvez Ansari²* , Ifra Qayoom¹, Bazilah Majeed Reshi¹_, Abdul Hasib¹, N Zaheer Ahmed², Noman Anwar² 

¹ Regional Research Institute of Unani Medicine, Srinagar (NABH Accredited), Central Council for Research in Unani Medicine, Ministry of Ayush, Govt. of India

² Regional Research Institute of Unani Medicine, Chennai (NABH Accredited), Central Council for Research in Unani Medicine, Ministry of Ayush, Govt. of India

Abbreviations: CCRUM: Central Council for Research in Unani Medicine; GC-MS: Gas Chromatography-Mass Spectroscopy; Fig: Figure; HPLC: High Performance Liquid Chromatography; HPTLC: High Performance Thin Layer Chromatography; H22: Hepato-Carcinoma Cell Line; ICP-MS: Inductively Coupled Plasma Mass Spectroscopy; LC-MS: Liquid chromatography-Mass Spectroscopy; pH: Power of Hydrogen ion; WHO: World Health Organization.

Convolvulus scammonia L. belongs to Convolvulaceae family which is also referred as morning glory family of flowering plants. This family describes around 55 genera and 1650 species of plants. Most of the plants belonging to this family are categorized as annual or perennial herbs having twining stems. Some species are classified as shrubs and trees. Convolvulus scammonia L.  is belonging to Convolvulus genus in which approximately 250 species are discussed.¹ The plants of this genus are usually found growing in tropical and temperate regions of the world. The taste of most of the plants is acrid, and they contain a milky juice which action is usually purgation. Such milky fluid is classified as resin which yields certain glucosides such as convolvulin, jalapin, scammonin, etc.² In Unani medicine, the resin of Convovulus scammonia L. by the name of Saqmunia is described in various classical literature such as Al-Jame al-Mufredat al-Adwiya al-Aghzia of Ibn al-Betar,³ Al-Qanoon fi al-Tib of Ibn Sina ,⁴ Kitab al-Hawi of Razi (865-925 AD),³³ Muheeta-i-Azam of Azam Khan,⁵ Khazain al-Adwiya of Najmul Ghani Khan,⁶ etc. Convovulus scammonia L. is a perennial herb which root is fleshy and fusiform. This medicinal plant is usually grown in the Mediterranean region.⁷ Saqmunia is considered as poisonous and toxic drug hence it is medicinally used after detoxification in Unani medicine.^4-6,8,9 It is usually prescribed as purgative for the purposes of evacuation of morbid humours particularly ṣafrāwī mādda (bilious humour) from the body which is dominant in several ailments.^5,8,10,11,33 It is also used for the treatment of bahaq (pitryasis), baraṣ (vitiligo), kalaf (melasma/ cholasma), jarab (scabies), qūbā (ringworm/ dermatophytosis), huṣr (constipation), istisqā’ (ascites), wajaʻ al-mafaṣil (joints pain), etc.⁵ According to Unani physicians, this drug produces many adverse effects such as restlessness, sadness, palpitation, nausea, loss of appetite, increase thirst, etc. It has also been observed that it may produce some serious noxious effects particularly related to heart, stomach and liver.

Nonetheless, the detailed description of Saqmunia (Convolvulus scammonia L.) regarding its morphology, temperament, pharmacological properties, medicinal uses, dose, compound formulations, etc are extensively discussed in the literature of Unani and other traditional medicines but adequate information on its pharmacognosy, standardization, phytochemistry, quality control, therapeutic validation, pharmacokinetic profile,  toxicity studies, etc are not available. The main objective of the present review is to explore varied aspects of Saqmunia (Convolvulus scammonia L.) as described in Unani and other literature which will ultimately encourage the researchers of Unani and other disciplines to carry out more scientific studies for further exploration.

On the basis of major keywords selected for this review including Saqmunia and Convolvulus scammonia L., total 34 literatures comprising Unani classical texts, botanical literature and published articles available on different search engines like Science Direct, PubMed, Research Gate and Google Scholar have been referred. The Unani literature from the period of 9^th to 20^th Century AD were reviewed to explore the botanical description, temperament, pharmacological properties and medicinal uses, dose, side effects, substitutes, detoxification methods and compound formulations of  Saqmunia. Four important botanical literatures of English language such as Materia Indica of Ainsle, Indian Medicinal Plants of Kirtikar and Basu, Trease and Evans Pharmacognosy, and Indian Medicinal Plants of Khare were also referred in the present review. The published articles from the period of 1990 to 2021 AD pertaining to botanical description, pharmacognosy, chemical constituents, pharmacological actions, etc of Convolvulus scammonia L. were also reviewed. (Table 1) The botanical names of medicinal plants cited in this article were validated through ‘World Flora’ (http://www.worldfloraonline.org).¹² The appropriate English translations of various Unani terminologies mentioned in this manuscript were used after referring the Standard Unani Medical Terminology published by the CCRUM in collaboration with the WHO.¹¹

Table 1: List of reviewed literature:

3.1 Scientific classification:

Kingdom:                                   Plantae 

Subkingdom:                             Viridiplantae 

Superdivision:                          Embryophyta

Division:                   Tracheophytes 

Subdivision:                              Spermatophytina 

Class:                                           Magnoliopsida 

Superorder:                               Asteranae

Order:                                          Solanales 

Family:                      Convolvulaceae 

Genus:                                         Convolvulus 

Species:                    Convolvulus scammonia L.¹³

3.2 Mutradifat (Vernacular name): 

Arabic: Sigmonia, Mahmoda, Helablab; English: Scammony, Syrian bind weed, Purging bind weed; French: Scammonee; German: Kleinasiatische Winde; Hindi: Sakmunia; Spanish: Escamonia; Swedish: Hartsvinda.

3.3 Botanical description: 

Convolvulus scammonia L. is categorized as perennial herb which has fleshy and fusiform root.¹⁴ The height of its twining stem is around 2 m.³⁴ The root has several branches towards the lower end with greyish in color and possesses acrid-milky juice. The stem is annual, numerous, slender, round, smooth, branched, twining, very slightly angular near the end. The leaves are arranged on long petioles, alternate, sagittate, oblong, acute, entire, quite smooth, truncate and angular at the base, spreading lobes with bright green color. The flowers are found on axillary, solitary, 3-flowered, peduncles, scarcely twice as long as the leaves. Sepals are 5 in number, rather lax, smooth, ovate, obtuse, and having a point along with covered at the edge. (Fig 1) Corolla is funnel shaped, extensively expanded and pale sulphur-yellow in color, thrice as long as the calyx, an inch or more in length; limb entire and somewhat reflex. Stamens are 5 in number, erect, converging and three times as short as a corolla. The ovary with 2 cells and 4 seeds, which support the thin stemens as long as the stamens, has 2 cylindrical stripes, straight, oblong, parallel, long, and white stigmas.¹⁴ The resin is obtained from the rhizome of Convolvulus scammonia L.,^7,14 by making a transverse or oblique incision.¹⁴

In Unani medicine, this plant origin drug is used for various therapeutic purposes.⁸ Ibn Sina (980-1037 AD) has mentioned that it is an exudate of a plant which is found growing as vegetation.⁴ Its branches are growing from the root and spread out on the land. The length of each branch is around 3-4 feet. The resinous material secretes from the branches of root when they are getting abraded or touched by hand. The morphological features of the leaf of Saqmunia resembles to the leaf of Aftimoon (Cuscuta reflexa Roxb.) with more soft, thin and dark green in color. The flower is round with hollow shape, white, acrid taste, and has a particular smell. In Unani medicine, usually the resin obtained from the root (rhizome) of Convolvulus scammonia L. is medicinally used. (Fig 2) Some Unani scholars have mentioned that its color may be khaki, grayish-black and bluish-yellow.⁸

     Fig 1: Leaf & Flower of Convolvulus scammonia L.                                           Fig 2: Saqmunia (Resin)

3.4 Methods for collection of resin: 

Usually, two methods for collection of resinous material from the branches of root (rhizome) of Saqmunia are being preferred. (i) Dioscorides (64 AD) stated that a shallow pit should be made in the ground near the root of the plant. The leaves of the plant should spread over the pit and an incision should be made in the branches of the root. The secreted resinous material is accumulated over the leaves; (ii) A shallow pit is made in the ground near the root of the plant wherein sea shells are placed. The incision is made in the bark of branches of the root from which the exudates are collected in the sea shell.⁵

3.5 Mizāj (Temperament): 

The temperament of Saqmunia is described as Hot in 3^rd & Dry in 2^nd stage^5,6,9 or Hot & Dry in 3^rd degree.^4,5,8

3.6 Afʻal (Pharmacological actions): 

The pharmacological actions of Saqmunia are jālī (detergent), muḥallil (resolvent), mushil-i-Ṣafrā (cholagogue), mukhrij-i-Janīn-o-mashīma (abortifacient), mukhrij-i-dīdān-i-amʻā’ (vermifuge/ anthelminthic),^5,9 mufattiḥ (deobstruent),⁵ mudirr-i-fuḍlāt (excretion of waste products), mudirr-i-bawl (diuretic),⁴ tiryāq (antidote),^4,5,9 muṣaffi-i-dam (blood purifier),¹⁵ muḥarriq (stimulant),⁴ hydragogue, cathartic, etc.⁷

3.7 Istemalat (Therapeutic uses): 

In Unani medicine, Saqmunia is used for the treatment of several ailments like bahaq (pitryasis), baraṣ (vitiligo), namash (naevus), kalaf (melasma/ cholasma), jarab (scabies), qūbā (ringworm/ dermatophytosis), huṣr (constipation), istisqā’ (ascites), wajaʻ al-mafaṣil (joints pain), sudaʻ muzmin (chronic headache), humma al-ghib (bilious fever), āshob-i-chashm (conjunctivitis), yarqan (jaundice), etc.

The Unani physicians prescribe Saqmunia as stand alone or along with other drugs in combination for local application and internal use both. In cases of vitiligo, pitryasis, naevus and melasma, the tilā’ (liniment) prepared with the root of Saqmunia is applied over the affected parts. The paste prepared with Saqmunia and honey is externally applied over non-healing wounds. In case of arthritis, the paste prepared with Saqmunia (1 part), barley flour (1/2 part) and vinegar is locally applied over the affected joints. The mixture prepared with Saqmunia and Gul-i-Surkh (Rosa damascena Mill. flower) is locally applied over the forehead in case of headache. Ibn Sina advised that 3.5 g of the root of Saqmunia along with Mā’ al-ʻAsal (Honey water) or plain water is useful for evacuation of balghami (phlegmatic) or ṣafrāwī (bilious) substances from the body.⁵

3.8 Miqdar Khurak (Therapeutic dose): 

According to Unani literature, the therapeutic dose of non-detoxified Saqmunia is 1.5-9 ratti (187.5- 1125 mg) whereas the dose of detoxified Saqmunia is 6-12 ratti (750-1500 mg).⁶

3.9 Muḍir va Muṣliḥ (Adverse effects and Correctives): 

The Unani physicians observed that Saqmunia may be harmful for stomach,^5,33 intestine,⁵ liver^5,33 and heart. The higher dose of Saqmunia may produce nausea, vomiting, abdominal pain, and cramps, syncope, irritability, anorexia, etc.⁵ 

In case the adverse effects produced by Saqmunia, certain drugs such as Gul-i-Surkh (Rosa damascena Mill.),^6,16 Sikanjabeen, Nishasta (starch), Kateera (Sterculia urensRoxb.), Mastagi (Pistacia lentiscus L.),⁶ Kundur (Boswellia serrata Roxb.), Anisoon (Pimpinella anisum L.),^5,6 Behi (Cydonia oblonga Mill.), Ayarij Feeqra, etc may be used.⁵ 

The Unani scholars have mentioned certain observational methods for authentication of the best quality of Saqmunia. For instances, Saqmunia which appears as sea shell with yellowish-white color is considered as best quality. Moreover, the good quality of Saqmunia does not produce corrosive effects while chewing, and is easily dissolved in water and alcohol. The adulterated and poor quality of Saqmunia is having different colors like bright-green and black with smooth edge and is easily broken into irregular pieces.^5,6

3.11 Shelf life: 

According to observational studies of Unani physicians, the shelf life of roasted and non-roasted Saqmunia is 2 and is 3 years, respectively.⁶

When Saqmunia is not available, it is advised that Ailwa (Aloe vera (L.) Burm. f.) or Halela Zard (Terminalia chebula Retz.) may be used as its substitute according to the indication.^17,18

3.13 Methods of detoxification of Saqmunia (Convolvulus scammonia L.): 

The Unani physicians asserted that Saqmunia (Convolvulus scammonia L.) should be therapeutically used after detoxification or purification for which many methods are described in Unani literature but the commonly being preferred method is ‘amal-i-tashwiya (roasting).^3-6,8,19

3.13.1 Tashwiya (roasting): In this method, Saqmunia (Convolvulus scammonia L.), apple or quince fruit and cow’s dung cakes are taken. A hollow space is made in the apple or quince fruit wherein Saqmunia (Convolvulus scammonia L.) is placed that is further covered with the piece of apple and paste of flour. Thereafter, the apple or quince fruit is placed into moderate heat of cow’s dung cakes till the color of flour gets brownish. In last, the drug is removed from the apple or quince fruit which is considered as Saqmunia mudabbar. 

3.13.2 Saqmunia (Convolvulus scammonia L.), is packed in a muslin cloth that is further placed into a hollow space of an apple followed by it is covered by applying the paste of wheat flour, and the apple is got heated in the ash. 

3.13.3 Saqmunia (Convolvulus scammonia L.)   along with the powder of Tukhm-i-Karafs (Apium graveolens L. seeds) is grounded in the apple juice. 

3.13.4 Habish Ibn Hasan and Razi avowed that Saqmunia (Convolvulus scammonia L.) is kept in a hollow space of apple that is further packed using wheat dough. The apple is roasted and the drug is removed from it.  Anisoon (Pimpinella anisum L.) and Duqu (Peucedanum grande C.B Clarke) are mixed with Saqmunia which is further fried in Roghan-i-Badam (oil of Prunus amygdalus Batsch). 

3.13.5 Saqmunia (Convolvulus scammonia L.) and Mastagi (Pistacia lentiscus L.) are pounded together and packed it in a cloth bag followed by it is kept into a hollow space of an apple that is further packed using wheat dough, and is roasted. 

3.13.6 The roasted Saqmunia is used along with Rubb-us-Soos (dried root extract of Glycyrrhiza glabra L.) and Kateera (Sterculia urens Roxb.).

3.13.7 Saqmunia is grounded in ʻArq-i-Gulab (Rose water) or Ᾱab-i-Behi (Quince fruit juice) or Ᾱb-i-Seb (Apple juice) followed by its pills are prepared.^5,6

3.14 Murakkabat (Compound preparations): 

Saqmunia (Convolvulus scammonia L.) is added as one of the ingredients in several compound preparations which are used for different therapeutic purposes. (Table 2).

Table 2: Compound preparations containing Saqmunia (Convolvulus scammonia L.)

3.15 Chemical constituents: 

The root of Convolvulus scammonia L. yields approximately 8% resin along with beta-methyl-esculetin, dihydroxy cinnamic acid, ipuranol, sucrose, reducing sugar, starch, etc. The resin is composed with glycosides and methylpentosides of jalapinolic acid and its methyl ester. An ether-soluble resin glycoside namely jalapin has been isolated from the root of scammony. The scammonic acid A is obtained through alkaline hydrolysis. Furthermore, ether-soluble resin glycosides viz. scammonin I, II, III, IV, V, VI, VII and VIII have been isolated from the root of scammony. The ether soluble extracts of the resin contain glucose and hydroxyl fatty acid. It also contains seven organic acids such as acetic, propionic, isobutyric, isovaleric, 2-methylbutyric, n-valeric and tiglic acids, and two hydroxyl fatty acids viz. ipurolic and rhamnose. In addition, ether soluble resin i.e. jalapin yields same organic acids and monosaccharides, one type of hydroxyfatty acids including jalapinolic acid. The jalapin was treated sequentially with sephadex LH-20 and silica gel column chromatography. The final purification provides two pure genuine glycosides such as scammonin I (C50H84O21), and II (C45H78O19) in which scammonin I was the major resin glycoside and obtained in a yield of 56.9% from the total resin glycoside.^14,29

3.16 Scientific studies: 

3.16.1 Anticancer activity: 

Hadi et al, 2011 evaluated the anticancer effects of aqueous and alkaline raw extracts of Convolvulus scammonia L. on mitosis and cancer cells in mice. The inhibitory effects of crude aqueous extract of Convolvulus scammonia L. was compared with crude alkaloidal extract on bone marrow cells multiplication in mice at the dose levels of 10, 20, 40, 80 and 160 mg/ kg b. w. The inhibitory effects of each extract were also compared with colchicine. The crude alkaloid extract showed significant arresting percentage of metaphase compared to the aqueous extract at small dose levels whereas the high dose level of both extracts showed 70% inhibitory effects. The study also reported that both extracts were found to be active in reducing tumor size in a dose dependent manner.³⁰ The apoptotic activity of crude alkaloidal extract obtained from the leaves of Convolvulus scammonia L. was investigated against mice hepato-carcinoma cell line (H22). The result revealed that the test drug at the concentration of 1 mg/ kg b. w. significantly inhibited H22 cell line tumor growth after three weeks of the treatment.³¹

3.16.2 Cytotoxic effect: 

Somayeh Esmaeili et al, 2015 has reported that the extract of Convolvulus scammonia L. possesses significant cytotoxic activity on Madin–Darby bovine kidney cells.³²

The resin namely Saqmunia obtained from the root (rhizome) of Convolvulus scammonia L. is illustrated in many Unani classical literatures due to its diverse pharmacological properties. Convolvulus scammonia L. belongs to Convolvulus genus in which around 250 species of plants are discussed.¹ The plants belonging to this genus including Convolvulus scammonia L. are usually found growing in tropical and temperate regions of the globe. According to Unani pharmacology, the mechanism of action of any drug is chiefly based on its temperament. In this continuation, the treatment of diseases is done on the principle of ilaj bi’l zid (heteropathy) wherein drugs act against the temperament of the diseases thus modifying the pathological states.²⁰ Since, the temperament of Saqmunia (Convolvulus scammonia L.) is hot and dry thus it is used as muhallil (resolvent),^5,9 mufattiḥ (deobstruent),⁵ jālī (detergent), mushil-i-safrā (cholagogue), mukhrij-i-janīn-o-mashīma (abortifacient), mukhrij-i-dīdān-i-amʻā’ (vermifuge/ anthelminthic), ^5,9 mudirr-i-bawl (diuretic),⁴ tiryāq (antidote),^4,5 muṣaffi-i-dam (blood purifier),¹⁵ etc for the treatment of many diseases such as bahaq (pitryasis), baraṣ (vitiligo), namash (naevus), kalaf (melasma/ cholasma), jarab (scabies), qūbā (ringworm), etc. The main pharmacological activity of Saqmunia (Convolvulus scammonia L.) is purgation hence it is also used in the treatment of istisqā’ (ascites), wajaʻ al-mafaṣil (joints pain), sudaʻ muzmin (chronic headache), humma al-ghibb (bilious fever), āshob-i-chashm (conjunctivitis) and yarqan (jaundice).⁵ In Unani medicine, it is believed that the morbid matters found in the above mentioned diseases are excreted from the body through purgation. This drug is also added in several Unani compound formulations which are used for the treatment of various ailments. Tiryaq-i-Zahab is used for the treatment of mālankhūliya marāqī (psychoneurosis), sar‘(epilepsy), judhām (leprosy), istisqā’ ziqqī (ascites) and yaraqān (jaundice).²² Qurs-i-Didān is prescribed in cases of dīdān-i-āma’ (intestinal worms) whereas Safūf-i-Suranjan is given in the treatment of wajaʻ al mafāṣil (joints pain).²⁴ The phytochemical analysis of Saqmunia (Convolvulus scammonia L.) revealed that its different parts contain many important biologically active compounds including scammonin which possesses some pharmacological activities. Some scientific studies revealed that this important drug is potential in the treatment of certain diseases including cancer. 

It is estimated that around 80% population throughout the world depends on traditional medicines for the management of several ailments. The standardization and quality control studies of herbal drugs ensure their quality and purity. The quality of any drug may be poor due to several factors which ultimately affect its therapeutic potential. In this regard, different parameters such as moisture content, ash value, pH, extractive values, microbial load, heavy metals, pesticides residue, etc should be evaluated in any herbal drugs.²⁰ Due to data lacking, the present review suggested that the pharmacognostical studies of Saqmunia (Convolvulus scammoniaL.) may be carried out through organoleptic and microscopic evaluation. In addition, physicochemical standardization and quality control studies of this useful drug may also be carried out. Since, secondary metabolites of plant materials such as alkaloids, glycosides, flavonoids, saponins, tannins, etc are important to know the pharmacological effects²⁰ thus the detailed qualitative and quantitative phytochemical evaluation of Saqmunia (Convolvulus scammonia L.) may be studied using Ultraviolet and Infrared Spectroscopy, High Performance Thin Layer Chromatography (HPTLC), High Performance Liquid Chromatography (HPLC), Liquid Chromatography-Mass Spectroscopy (LC-MS), Gas Chromatography-Mass Spectroscopy (GC-MS), Inductively Coupled Plasma-Mass Spectroscopy (ICP-MS), etc for further exploration. This review also found that extensive pharmacological studies of Saqmunia (Convolvulus scammonia L.) have not yet been carried out to evaluate its efficacy as claimed by Unani and other traditional healers. Hence, it is suggested that different therapeutic profile of this important herb may be evaluated through in-vitro, pre-clinical and clinical trials. Furthermore, it is also recommended that the safety profile of crude and detoxified samples of Saqmunia (Convolvulus scammonia L.) may also be checked in animal models so the claim of Unani scholars may be validated on the basis of today’s modern parameters. 

5. CONCLUSION: 

After going through several Unani and other literature, it has been found that Saqmunia (Convolvulus scammonia L.) is widely used in Unani and other traditional systems of medicine for the treatment of many diseases. Apart from its pharmacological activities, the Unani medicine also discussed other aspects of this plant drug such as botanical description, temperament, authentication of good and bad quality, method of detoxification, shelf-life, adverse effects and their correctives, substitutes, therapeutic dose,  compound preparations, etc. Only limited information regarding pharmacognostical evaluation, physicochemical standardization, quality control studies, phytochemical analysis, pharmacological activities and toxicological studies of this drug is available in the public domain which warrants it imperative that these studies may be carried out on scientific lines for understanding its enormous benefits deeply.

Funding Source: 

This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. 

Conflict of interest: 

All the authors have confirmed that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

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