 Gen info
- Cissampelos is a genus of flowering plants in the family Menispermaceae. Many of these plants were used as curare applied as arrow poison during hunting. (51)
Botany
• Sansau is a slender, more or less hairy or nearly smooth, woody twiner. Leaves are oval or heart-shaped, 2 to 7 centimeters long, with a pointed or usually apiculate apex, cordate or subtruncate broad base, usually slightly peltate. Male panicles are slender, 3 to 6 centimeters long, hairy, usually diffuse, with very small, greenish flowers. Female racemes are 2 to 6 centimeters long, with green, kidney-shaped, 1- to 1.5-centimeters long bracts. Fruit is fleshy, nearly spherical, red, 5 to 7 millimeters in diameter, and somewhat hairy. Endocarp is transversely ridged, and tuberculate. Seeds are horse-shoe shaped.
• It is a slender tomentose climber. The leaves are peltate, 2.5–12 cm long, 2.5–11.5 cm broad, triangularly broad-ovate, or orbicular, obtuse, mucronate, base cordate or truncate, ± tomentose on both sides; petiole pubescent. Flowers are small in size, pedicels filiform. Male flowers clustered in the axil of a small leaf; sepals are 4 in number, obovate-oblong, hairy outside; petals 4 in number, united to form a 4-toothed cup, hairy outside; stamens 4, column short, anthers connate, encircling the top of the column. Female flowers clustered in the axils of orbicular, hoary imbricate bracts, on 5–10 cm long racemes; sepal 1, petal 1; carpel 1, densely hairy; style shortly 3-fid. Drupe 4–6 mm long, 3–4 mm broad, subglobose, compressed, hairy-pubescent, red when fresh, black when dry, endocarp transversely ribbed, tuberculate. Seeds are horseshoe-shaped. (52)
Distribution
- Native to the Philippines.
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In thickets at low and medium altitudes throughout the Philippines.
- Also native to Aldabra, Andaman Is., Argentina Northeast, Argentina Northwest, Aruba, Assam, Bahamas, Bangladesh, Belize, Bolivia, Borneo, Brazil North, Brazil Northeast, Brazil South, Brazil Southeast, Brazil West-Central, Cambodia, Cayman Is., China South-Central, China Southeast, Colombia, Comoros, Costa Rica, Cuba, Dominican Republic, East Himalaya, Ecuador, El Salvador, Ethiopia, Florida, French Guiana, Galápagos, Guatemala, Guyana, Haiti, Honduras, India, Jamaica, Kenya, Laos, Leeward Is., Lesser Sunda Is., Madagascar, Maluku, Mauritius, Mexico Central, Mexico Gulf, Mexico Northeast, Mexico Northwest, Mexico Southeast, Mexico Southwest, Mozambique, Myanmar, Nepal, Netherlands Antilles, New Guinea, Nicaragua, Nicobar Is., Pakistan, Panamá, Paraguay, Peru, Puerto Rico, Queensland, Rwanda, Réunion, Somalia, Southwest Caribbean, Sri Lanka, Sulawesi, Suriname, Taiwan, Tanzania, Thailand, Trinidad-Tobago, Uganda, Uruguay, Venezuela, Venezuelan Antilles, Vietnam, West Himalaya, Windward Is., Zimbabwe. (26)
 Constituents
- Main chemical constituents are alkaloids, arachidic acid, bebeerine, berberine, bulbocapnine, cissamine, cissampareine among many others.
- Roots yield pelosin or cissampeline (identical to berberine), and another alkaloid, serperine.
- Plant yields isoquinoline alkaloids; tetrandrine, the most documented of 38 alkaloids.
- A yellow, bitter matter is considered the active principle.
- Phytochemical screening yielded the presence of flavonoids, saponins, triterpenoids, alkaloids, proteins, gums, fatty oils, mucilage, carbohydrates, resins and tannins.
- Phytochemical screening of root extracts yielded terpenoids, alkaloids, tannins, amino acid proteins, and carbohydrates. (17)
- Study isolated one new isoquinoline alkaloid (7), along with six known isoquinoline alkaloids viz. magnoflorine (1), magnocurarine (2), cissamine (3), curine (4), hayatinine (5), and cycleanine (6). (see study below) (37)
- Qualitative screening of methanol extract of leaves yielded carbohydrates, proteins, lipids, flavonoids ++, phenols steroids, tannins ++, alkaloids, coumarins, glycosides, reducing sugars, and lignins, with absence of terpenoids, saponins, anthocyanins, and anthoquinone.
(46)
- Quantitative analysis of leaf constituents yielded
proteins 0.9, carbohydrates 0.06, lipids 0.27, flavonoids 0.37, phenols 0.33, tannins 0.44, and alkaloids 0.08. (46)
- Study of roots isolated one new pyrrole alkaloid, cissampeline (1) along with ten known alkaloids,
(−)-curine (2), (−)-cyclanoline (3), (+)-tetrandrine (4), (+)-obaberine (5), (+)-obamegine (6), (−)-oblongine (7), (+)-homoaromoline (8), (−)-nor-N׳-chondrocurine (9), trans-N-feruloyltyramine (10) and (+)-coclaurine (11). (see study below) (59)
 Properties
- Roots considered diuretic, emmenagogue, emetic, febrifugal, lithotriptic, pectoral and purgative.
- Leaves are considered cooling, stomachic.
- Tetrandrine considered analgesic, anti-inflammatory and febrifuge.
- Berberine considered antifungal, hypotensive and antimicrobial.
- Studies have shown antioxidant, immunomodulatory, antifertility, antidiarrheal, anticancer, antifertility, chemopreventive, cardioprotective, cognition-protective, analgesic, anti-inflammatory, anti-ulcer, diuretic, anti-trypanosomal, hepatoprotective, anxiolytic, antimalarial, antituberculosis, antipyretic, anthelmintic, antidiabetic, antibacterial, antiarthritic, hypouricemic, antiviral, anti-acetylcholinesterase properties.
Parts used
Whole vine, leaves, roots, seeds, bark.
Uses
Edibility
- Leaves used as potherb.
- Leaves, stems, roots, tubers and fruits reportedly edible, not as primary food source.
- Fruits eaten raw.
Folkloric
- Pounded leaves used for snake bites, abscesses, and wounds.
- Leaves and roots used for treatment of ulcers.
- Leaves used for scabies.
- In India, used as stomachic. Tribal people use the plant to prevent pregnancy.
- Roots used as diuretic.
- Decoction or extract of the root is used for acute and chronic cystitis.
- In Mexico, infusion of roots used for nephritic colic and vesicular calculus.
- Root used as emmenagogue; for treatment of urinary and venereal diseases.
- Used for snake bites and scorpion stings.
- Crushed leaves boiled with rice and used as tonic and for heart complaints. Fresh juice applied to eye diseases. Plant juice with jaggery and egg taken internally for minor injuries. Roots used for treating cough, dyspepsia, dropsy, urino-genital problems suchs as uterine prolapse, cystitis, hemorrhage, menorrhagia and calcular nephritis. (3)
- In Reunion and Madagascar, used to dissolve stones.
- In some places in India, commonly used as antifertility agent.
- In South America, called Midwives' herb, with its long history of use for women's ailments.
- In the Amazon, used for menstrual cramps, menorrhagia, pre- and post-natal pains, and as antidote for snake bites.
- In Guyana, poultice of leaves used topically for pain relief.
- The Creoles in Guyana soak the leaves, bark and roots in rum for use as aphrodisiac.
- In Peru, seeds used for snakebites, fevers, venereal diseases; as diuretic and expectorant. Also, leaf tea used for rheumatism and a wood-bark tea used for irregular heartbeats and excessive menstrual bleeding.
- In India, root paste applied locally in skin disease. Root paste mixed with black pepper (Kali mirch) powder use in treatment of malaria. (44) Use for treatment of menstrual irregularities and cramps, stomach pains. Leaves used for treatment of abscesses and wounds. (54)
- In the Tabora region of Tanzania, root s used for treatment of snake bites, poisoning, and stomachaches. (48)
- In Kenya, concoction made from boiled roots of Cissampelos pereira, Tabararyetab koita, is used for treatment of severe abdominal pain in women and for treatment of malaria. (49)
- Historical snippet: Pareire brava in Irritable bladder: Dr. F. P. Betton of Germantown, Pa., recommends in the Philadelphia journal, the Cissampelos pereira, called Pareira brava by the Spaniards, in cases of irritable bowel. The remedy was extolled by Helvetius as a lithotriptic, and was also much esteemed by the Brazilians who considered it a Universal Medicine. . . it was prescribed as: one ounce of the root to a quart of water, gently boiled and reduced to one half and taken a wineglassful three times daily. (New England Journal of Medicine, ca 1836) (50)
Others
- Rope: Bast fibers of the bark are made into rope.
- Fish poison: Roots are used as fish poison.
- Country liqour: Local communities of Odisha make pills using root powder and rice powder called Ranu, and the pills used for making country liquor. Roots also used as fermenting agent. (54)
Studies
• Antioxidant / Immunomodulatory / Roots: Study of the alkaloidal fraction of roots of C. pareira showed immunosuppressive and antioxidant activities. The antioxidant activity may be due to the presence of both tetrandrine and berberine. (2)
• Gastrointestinal Effects / Antidiarrheal: Study of the ethanolic extract of roots of CP exhibited a dose-dependent inhibition of castor oil induced diarrhea while also significantly and dose-dependently reducing intestinal fluid accumulation and gastrointestinal transit. (3)
• Antifertility / Leaves / Roots: Study of the leaf extract in female albino mice showed an antifertility effect, altering the pattern and prolonging the length of the estrous cycle with a significant increase in the duration of diestrus stage and significant reduction of number of litters. Hormone analysis showed altered gonadotropin release (LH, FSH and prolactin) and estradiol secretion. (4)
• Chemopreventive / Anti-Gastric Cancer / Roots: Study of the hydroalcoholic extract of roots of CP forestomach cancer and carcinogen metabolizing enzymes showed the enhanced GSH level and enzyme activities involved in xenobiotic metabolism and maintenance of antioxidant status of the cells suggest a chemopreventive efficacy of CP against chemotoxicity, including carcinogenicity. (5)
• Chemopreventive / Anti-Gastric Cancer: Study on the protective effects of CPE in mice showed a protective effect against induced gastric cancer with reduction of tumor incidence, significant reduction of mean number of tumor and significant reduction of tumor multiplicity.
• Antinociceptive / Antiarthritic: Study of aqueous extract of roots exhibited significant resistance against mechanical pain. It also showed significant dose-dependent protective effect against complete Freund's adjuvant induced arthritis. (6)
• Anti-Inflammatory: Study data indicate CP roots extract possesses significant anti-inflammatory activity without ulcerogenic activity suggesting a potential as an anti-inflammatory agent for use in inflammatory diseases. (7)
• Gastroprotective / Anti-Ulcer: Study isolated a flavonoid, quercetin, from C. pareira, and showed significant antiulcer property against gastric ulcers in different acute models. C. pareira significantly enhanced the defense factors while significantly reducing the ulcer index in ethanol-induced ulcers. (8)
• Analgesic / Anti-Inflammatory: Extract study showed significant dose-dependent activity in carrageenan testing, based on interference with prostaglandin synthesis, confirmed by arachidonic acid test. LD50 also showed low toxicity. (9)
• Tumor Inhibitors / Cytotoxicity: Study yielded a new alkaloid, cissampareine and four other bisbenzylisoquinoline alkaloids. The alkaloid compounds showed significant and reproducible inhibitory activity against human carcinoma of the nasopharynx carried in cell culture (KB). (10)
• Diuretic: In a comparative evaluation of the diuretic potential of the methanolic root extracts of C. pareira, Cyclea peltata and Stephania japonica, all the extracts showed dose-dependent diuretic effects. (C. peltata showed the highest diuretic activity). (13) Study evaluated the diuretic activity of ethanolic extract of leaves in albino rats. Results showed significant increase in urine output along with increase concentration of sodium, potassium and chloride. (13)
• Anti-Inflammatory / Roots: Study evaluated a methanolic extract of root for anti-inflammatory activity on carrageenan-induced paw edema in male albino rats. Results showed significant anti-inflammatory activity similar to ibuprofen and indomethacin. (15)
• Hepatoprotective / Carbon-Tetrachloride / Roots: Study of hydroalcoholic extract of roots showed significant dose-dependent hepatoprotective action against CCl4-induced hepatotoxicity. Standard drug was silymarin. (16)
• Cissampeloflavone / Anti-Trypanosomal / Aerial Parts: Study of aerial parts of Cissampelos pareira L. (Menispermaceae), isolated a chalcone-flavone dimer, 2-(4-hydroxy-3-methoxyphenyl)-7-(4-methoxyphenyl)-6-(2- hydroxy-4,6-dimethoxybenzoyl)-furano[3,2-g]benzopyran-4-one--named cissampeloflavone. The compound showed good activity against Trypanosoma cruzi and T. brucei rhodesiense. (18)
• Antihyperglycemic / Roots: Study of methanolic root extract exhibited dose-dependent antihyperglycemic activity in streptozotocin-induced diabetic rats. (19)
• Antioxidant: Study of ethanol root extract yielded a large amount of polyphenols. Results showed compelling antioxidant activity in vitro and against stress induced by gastric carcinogen benzo(a)pyrene in vivo. (20)
• Antipyretic: Study evaluated the methanolic extracts of important sources of the Ayurvedic drug Patha, viz. roots of Cissampelos pareira var. hirsuta, Cyclea peltata, and Stephania japonica. The methanol extract of Cissampelos pareira var. hirsuta at dose of 200 mg/kbw showed significant antipyretic activity. (21)
• PM52 / Cognitive Benefits / Alzheimer's Disease: Study evaluated the protective effect of a combined extract of Cissampelos pareira and Anethum graveolens, against age-related cognitive impairment in animal model of age-related cognitive impairment. All doses of PM52 could attenuate memory impairment and neurodegeneration in the hippocampus, possibly through suppression of AChE and decreased oxidative stress in the hipoccampus. Results suggest a potential as food supplement to protect against age-related cognitive impairment like MCI and Alzheimer's. (22)
• Antidiabetic / Leaves: Study evaluated a leaf extract for potential anti-hyperglycemic activity in fructose-alloxan-induced diabetic rats. Results showed significant reduction in serum glucose and percent glycosylated hemoglobin. There was a significantly higher percent ß-cell granulation scores in CLE-treated animals. Enhancement of macrophage phagocytosis suggests a possible role in immuno-modulation. (23) Study evaluated the in vivo hypoglycemic activity of aqueous leaf extracts of C. pareira in while male albino alloxan induced diabetic rats. Results showed hypoglycemic activity with the intraperitoneal dose more effective than oral route. On toxicity study, slight toxicity was noted at 1 g/kbw daily for 28 days. (35)
• Anthelmintic: Study evaluated the anthelmintic activity of the whole plant of Cissampelos pareira against earthworm Pheretima posthuma using alcoholic and aqueous extracts in various concentrations. Both extracts showed significant activity with the aqueous extract being more effective. (24)
• Cardioprotective / Roots: Study of C. pareira root extract for cardioprotective effect in rats showed attenuation of isoproterenol-induced cardiac dysfunction possibly through amelioration of carlcineurin activity and free radical formation, and by augmentation of enzyme activities. (25)
• Toxicological Screening: A 50% aqueous ethanolic extract was found safe in acute and subacute toxicity screening. (27)
• Antimicrobial: Study showed Cissampelos pareira has antibacterial activity against four of six tested bacteria. The highest inhibition was against S. aureus 20 mm, S. typhimurium 17 mm. K. pneumoniae 14 mm, and E. coli 9 mm. Phytochemical screening yielded alkaloids, flavonoids, tannins, terpenoids and steroids. (28)
• Anticancer / Dalton's Lymphoma Ascites: Study demonstrated C. pareira exhibited significant imputable in vitro cytotoxic and in vivo antitumor activity against Dalton's Lymphomas Ascites (CLA) cells in Swiss mice. Effect was attributable to increasing endogenous mechanisms of antioxidant property. (29)
• Anxiolytic / Leaves: Study of a 70% hydroethanolic extract of leaves of Cissampelos pareira showed anxiolytic effect using elevated plus maze test, light dark model, and forced swim test models in rats. (31)
• Antimalarial / Roots: Study of root extracts of Cissampelos pareira and stem extracts of Tinospora cordifolia for antimalarial activity showed significant inhibition of propagation of rodent parasite Plasmodium berghei in vivo. (32)
• Bioactivity Against Mycobacterium tuberculosis / Antibacterial: Study evaluated C. pareira for anti-tuberculosis activity. Results showed anti-tuberculosis activity with MIC ranging between 50 and 6.25 µg/ml among all fractions. Antibacterial activity was broad spectrum with the methanolic fraction yielding the highest activity of 28 mm in S. aureus. Activity may be attributable to phytochemicals alkaloids, flavonoids, terpenoids, anthraquinones and phenols. (33)
• Potent Antiviral Activity Against All Four Dengue Virus Serotypes: Study showed the alcoholic extract of Cissampelos pareira Linn. (Cipa extract) was a potent inhibitor of all four Dengue serotypes in cell-based assays, in terms of viral NS1 antigen secretion and viral replication. Reduction assays showed Cipa extract could decrease viral titers by an order of magnitude. There was statistically significant protection against DENV infection in the AG129 mouse model. Preliminary evaluation showed no adverse effects on platelet counts and RBC viability. It also possess the ability to down-regulate the production of TNF-a, a cytokine implicated in severe dengue disease. Furthermore, there was no evidence of toxicity in Wistar rats at doses as high as 2g/kbw for up to 1 week. (34)
• Attenuation of Age-Related
Cognitive Impairment: Study evaluated the protective effect and mechanism of PM52, a combined extract of C. pareira and Anethum graveolens, against age-related cognitive impairment in an animal model. Results showed PM52 could attenuated memory impairment and neurodegeneration in the hippocampus. Study suggests the potential for PM52 as a food supplement to protect against age-related cognitive impairments, as in mild cognitive impairment and early phase of Alzheimer's disease. (36)
• Isoquinoline Alkaloids / Cytoxicity: Study isolated one new isoquinoline alkaloid along with six known isoquinoline alkaloids. Chloroform and n-butanol fractions showed cytotoxicity against KB cells. Among the pure compounds, hayatinine (5) was found most active against KB and A549, while cycleanine (6) showed against KB cells. (see constituents above) (37)
• No Antifertility Effect / Roots: Study evaluated a methanolic root extract for antifertility effect on the estrous cycle, implantation and reproductive hormones in female rats. Results showed the CP root had no effect on extending the estrous cycle nor on implantation. Study concludes that the alkaloids, the chief chemical component present in the root, has no role in regulating fertility. (38)
• Antioxidant / α-Glucosidase Inhibitory Activity / Antidiabetic / Leaves: Study evaluated the antioxidant and α-glucosidase inhibitory activity of fresh leaves of Cissampelos pareira. Alcohol and EA extracts showed significant antioxidant properties. In vitro assay for α-glucosidase property showed an IC50 of 98.23 ± 0.47 µg/ml. Study provides evidence for antioxidant and antidiabetic properties of the plant. (39)
• Antidiabetic
/ Leaves: Study evaluated the antidiabetic action of a hydroalcoholic extract of C. pareira leaves in streptozotocin induced diabetic rats. Results showed antidiabetic activity comparable to the standard drug glibenclamide at a dose of 5 mg/kg. (40)
• Acute Toxicity Study: Acute toxicity study of C. pareira extract was investigated on female wistar rats. According to OECD 2001 guidelines, the extract was found safe up to a dose of 2000 mg/kg. (41)
• Potential Benefit in IBD (Irritable Bowel Disease): Study evaluated a methanolic extract of C. pareira on acetic acid and DSS induced colitis in rats and mice. Results showed CP exerted marked protective effects in acute experimental colitis. The effect may be due to regulations in production and expression of inflammatory mediators. Results suggest a potential use in the treatment of IBD. (42)
• Anti-Inflammatory / Roots: Study investigated methanolic extract of roots of C. pareira for anti-inflammatory activity using Carrageenan induced hind paw edema model. Results showed anti-inflammatory activity that may be attributable to inhibitory interaction of the plant extract with cyclooxygenase-2 and subsequent reduction in prostaglandin production. (43)
• Antidepressant
/ Leaves: Study evaluated the pharmacologic activity of C. pareira leaves that contain bis benzylisoquinoline alkaloids (BIA), tetrandin, bebriberin, and flavones known for their anxiolytic activity. Study evaluated the antidepressant activity of CP extract using Tail suspension test and Forced swim test and duration of immobility. Results showed significant antidepressant activity compared with standard Imipramine. (45)
• Analgesic and Anti-Inflammatory
/ Polyherbal Formulation: Study evaluated the analgesic and anti-inflammatory efficacy of a polyherbal formulation (Cissampelos pereira, Pongamia pinnata,Vitex negundo) in animal models using hot plate reaction time, acetic acid induced writhing in mice, carrageenan induced- and formaldehyde-induced-paw edema. Results showed anti-inflammatory and analgesic activities in all tested experimental animal models. The effect was attributed to inhibition of chemical mediators of pain and modulation of pain response in the CNS. (47)
• Antibacterial / Antiuropathogenic / Roots: Study evaluated the antiuropathogenic properties of C. pareira extracts using shade-dried powdered roots extracted using hexane, acetone, methanol, and ethanol. Antibacterial activity against tested organisms showed zone of inhibition diameters ranging from 7.0 to 20.8 mm. Highest inhibition was by the ethanol extract, the lowest with chloroform extract. MIC and MBC values ranged from 12.5 to 50 µg/mL and 25 to 100 µg/mL respectively. Ethanol and methanol root extracts showed presence of alkaloids, flavonoids, tannins, terpenoids, and steroids. (53)
• Antiarthritic / Antihyperuricemic / Leaves: Study evaluated the antiarthritic potential of ethanolic extract of C. pareira (CPE) and Stephania glabra (SGE) on Sprague Dawley rats using animal models like Freund;s Adjuvant (FA) induced inflammation, Monosodium Iodo Acetate (MIA)-induced osteoarthritis, and Potassium Oxonate-Induced Uricemia (POU). Dose of 200 mg/;kg of ethanolic extract was recorded as safe dose for both. CPE and SGE significantly decreased (p<0.00e) elevated paw edema in FA-induced arthritis, a significant decrease (p<0.001) in MIA-induced increased in knee diameter. CPE was found more effective than SGE. Both were significantly effective (p<0.001) in potassium oxonate-induced hyperuricemia. Results suggest potential for use to formulate novel drug formulations for above ailments. (55)
• In The News: Anti-SARS-CoV-2 Activity in-vitro: Study in India evaluated the antiviral potency of C. pareira in preventing severe acute respiratory syndromes coronavirus 2 (SARS-CoV-2) infection. Findings revealed both whole plant extracts and bioactive compounds can inhibit SARS-CoV-2 replication by modulating estrogen receptor 1 (ESR1) activity. (56)
• Antiviral: Study provided the multi-omics framework to probe the molecular basis of the C.pareira (Cipa) . Cipa treated MCF7 cells exhibited downregulation of signatures of estrogen response. Antiviral activity through ESR1 modulation was validated in the DENV-2 infection model. A 98% inhibition of SARS-CoV-2 replication in infected Vero cell cultures with the whole extract. A few pure constituents i.e., pareirarine, cissamine, magnoflorine exhibited 40-80% inhibition. Study provides novel framework for molecular links of multicomponent Ayurveda formulations and their use in treatment of disparate diseases. The novel biological targets identified in the study could be potentially applicable to more than one viral infection, such as the use of Cipa in dengue and COVID-19. (57)
• Antidiabetic / SGLT2 Inhibition / Roots: Study evaluated the antidiabetic effect of aqueous-ethanolic extract of C. pareira roots in streptozotocin-nicotinamide (STZ-NAM)-induced diabetic rats targeting SGLT2 inhibition. Extract showed α-amylase and α-glucosidase inhibitory effects with IC50s of 18.0 and 4.87 mg/mL respectively. A-498 cells viability assay showed CC50 of 0.8 mg/mL. Extract showed notable effect of SGLT2 protein expression. In vivo study showed significant (p<0.05) reduction in glucose levels at 500 mg/kbw in a 28-day study. Molecular docking study showed insulanoline and warifteine as most active compounds with docking scores of -10 and -9.9 kcal/mol-1 respectively. Results showed potential to reduce STZ-induced elevated blood glucose without affecting liver and kidney functions. (58)
• Anti-Acetylcholinesterase Activity / Anti-Human Colon Cancer (HT29) / Roots: Study of roots isolated one new pyrrole alkaloid, cissampeline (1) along with ten known alkaloids. Compound 6,
(+)-obamegine, showed highest anti-acetylcholinesterase activity with IC50 of 3.26 µM, whereas compound 8, (+)-homoaromoline, showed most potent cytotoxicity against human colon cancer (HT29) cells with IC50 of 7.89 µM. (see constituents above ) (59)
Availability
- Wildcrafted.
- Root products, powder, dried leaves in the cybermarket. |
