Hareetakee (Terminalia chebula)

Hareetakee (Terminalia chebula)


Introduction
Yasya Grihe Naasti Maataa, Maataa Tasya Hareetakee
For him Hareetakee is (foster) mother who has no (caring) mother in the house. 
An admiration well deserved for Hareetakee, playing the role of foster mother.
A mythological origin has been attributed to Hareetakee. “It is said that when Indra (the king of gods) was drinking amrita (nectar) in heaven, a drop of the fluid fell on the earth that produced the tree” On this account it is called as “Shakra-shrishta, created by Indra” [1]
Because of its multifarious health benefits Hareetakee or myrobalan was highly extolled by the ancient Hindus as a tonic. As it counters many afflictions and helps maintain the health of a healthy subject, it derives many epithets:Hareetakee (an evergreen plant), Praanadaa (life-giver), Sudhaa (nectar), Bhishakpriyaa (favorite of physicians),Pathyaa (wholesome), Abhayaa (fearless or conferring fearlessness), Amritaa (ambrosia, conferring immortality),Diwyaa (a divine herb), Medhyaa (imparting intellect), Jeewaneeyaa (vitalizer), Wayasthaa (age stabilizer, maintainer of youthfulness), Rasaayana phala (a rejuvenating fruit)
Modern science validates and extols these epithets and attributes these pleotrophic actions to the presence of active phytochemicals such as complex carbohydrates, tannins, phenols, glycosides, alkaloids, terpenoids, flavonoids etc.  [2]

Because of its extraordinary healing potency Hareetakee (Terminalia chebula) is known as ‘Mother of Medicine’ [3]

It is known as chebulic myrobalan because of the presence of chebulic acid. It has a bitter taste. Because of its uses in various diseases like chronic diarrhea, dysentery, rectal prolapse, leucorrhea, spermatorrhea, etc. it is also known as “Long life elixir”.  [4]   

Lauded to be analogous to a caring mother, Hareetakee is a highly esteemed herb in Ayurveda. 
Its use is reported in Chinese medical literature.
Because of its extraordinary power of healing in Tibetan medicine Hareetakee is known as 'King of Medicines'
Currently its anti-cancer potential is being studied

Although Black Chebula has been introduced to Singapore, it failed to acclimatize and grow there. It was also introduced to Peninsular Malaysia where it acclimatized successfully. It was cultivated successfully in the botanical garden in Bogor, Java. [5], [6], [7]

Other Names
Latin/Botanical/Scientific: Terminalia chebula Retz, Terminalia chebula (Frt), Myrobalanus chebula Gaertn.,Myrobalanus gangetica Kostel, Terminalia acuta Walp., Terminalia gangetic Roxb., Terminalia parviflora Thwaites,Terminalia reticulate Roth, Terminalia zeylanica Heruck & Muell. Arg.
Terminalia
Sanskrit: Abhayaa, Bhishk-priya, Hareetakee, Kaayasthaa, , Paachanee,  Pathya, Shiwaa, Sudhaa, Wayasthaa, Wijayaa                                                                             
English: Black myrobalan, Yellow Myrobalan, Myrobalan, Chebulic Myrobalan, Gali nut, Indian gall-nut, Ink nut
Assamese: Shilikha
Arabic: Ahlilaj asfar, halilaja
Bengali: Hareetakee, Hora
Burmese: Pangah          
Cambodia : Ssa mao tchet  
Chinese: He zi, He li le (Taiwan)
Filipino : Chebulic myrabolan
French: Badamier chebule, Myrobalan chebule, Myrobolan noir
German: Chebulische Myrobalane, Rispiger Myrobalanenbaum
Gujarati: Hirdo, Himaja, Pilo-harde, Harde, Hardee, 
Hindi: Harad, Harar, Harre, Chhotee har, Harraa, Harash, Hareer, Hareetakee
Japanese: Hareetakee, Ieroo taaminaria, Mirobaran no ki,
Kannada: Alalekai, Alale, Anile, Arataikai, Arili, Harde
Kashmiree: Halela
Lao (Sino-Tibetan)): Somz moox kh'ook
Malay: Buah kaduka, Manja lawani (Indonesia), Manja puteri (unripe fruits)
Malayalam: Katukka, Kaduk kai
Marathi: Haradaa, Hiradaa.     
Nepalese: Harro, Jangalii harro, Thuulo harro
Oriya: Haridaa, Karedha       
Persian: Halaila e zard,  Halil ahe zarda
Punjabi: Arara, Halela, Harar, Zard halela
Russian: Kharitaki, Terminalia chebula, Terminalia khebula
Sinhalese: Aralu
Spanish: Mirobalanos indicos
Tamil: Kadakkai, Kadukkai, Kadukkaya, Katukkay, Katukkay
Telugu: Karaka, Karakkai, Karakkai chettu, Karakkaya, Katukkay
Thai: Samo thai (central)
Tibetan: Arura
Turkish: Kara halile
Urdu: Harela, Harejarad
Vietnamese : Chieu lieu xanh [8], [9], [10], [11]

Taxonomic classification
Kingdom: Plantae
Subkingdom (unranked): Angiosperm
Unranked: Eudicots
Unranked: Rosids
Division: Magnoliophyta, Phanerogams
Class: Magnoliopsida, Monocotyledons
Subclass: Epigynae
Order: Myrtales, Scytaminales
Family  : Combretaceae.  [12], [13], [14]

There are several varieties of the tree, some of which are produced by cultivation. According to botanists Terminalia citrina, Roxb is a different species.    

“Bhaawaprakaasha” the valued Ayurvedic text describes seven varieties of Hareetakee (Terminalia chebula), the distinctions being founded upon the type of fruit, the shape, the color and marks on the outer covering of the fruits. Of these Wijayaa is considered to be the best for medicinal purpose.
1. Wijayaa: Found in Windhya Mountains, oval in shape, used in all diseases 
2. Rohinee: Found all over India, round in shape, useful in wound healing 
3. Pootanaa: Found in Sindh. Have small fruits and large seeds. Used for external application
4. Amritaa: Found in Champaaranya (Champaaranya means forest of magnolia trees), a village in Raajapur district in the state of Chhattisgarh, India. The fruit is bulky having thick pulp. It is used for detoxification in Panchkarma therapy.
5. Abhayaa: Found in Champaadesha (see above). The fruit has five lines or creases or ribs. Used to treat ophthalmic disorders
6. Jeewantee: Found in Saurashtra, Gujarat. The fruit is yellow in color. Used to treat all diseases
7. Chetakee: Found in Himalayas. The fruit has three lines or ribs. It is used for purgation

Traditionally however three types of Hareetakee are in vogue:
(1) Baala Hareetakee: When the mature or ripe fruit of Hareetakee falls off from the tree, the seed gets hard called ‘Baala Hareetakee’ or ‘Baala Hirdaa’. Sometimes, before the fruits fall, they are plucked and dried while the seeds have not hardened. They are also called ‘Baala Hareetakee’ or ‘Baala Hirdaa’  
(2) Chambhari Hareetakee- Rangaree Hareetakee: This is an immature fruit of Hareetakee
(3) Surwaaree Hareetakee or Surwaaree Hirdaa: This is a fully mature fruit of Hareetakee   [15]

Classification according to the size of the fruit:
1. Surawaaree harade - large, dense, heavy, about 5cm long, yellowish brown, when cut it contains yellowish or dark brown pulp and a stone.
2. Rangaaree harade - smaller, less wrinkled and less furrowed than surawaaree harade, about 2.5 cm in length; the epidermis yellow; when cut shows a yellow dried pulp and a stone. The pulp is less astringent than that of surawaree harade. 
3. Bala harade - smaller than the above two varieties, deep brown or black in color, epidermis much wrinkled, pulp dark and homogenous, without a stone
4. Jawa harade- smallest of all varieties, resemble Bala harade in other  characters

Classification according to shape:
1. Vijayaa- alabu shape (horn-shaped, gourd-shaped) habitat in Windhya Mountains, used in all diseases
2. Rohinee- round or spherical in shape, habitat in Zansi and other parts o Madhya Pradesh in India, used for treating wounds and ulcers
3. Pootanaa- shape not mentioned, habitat Sindha, size is small, mesocarp is less, seed is big, externally used
4. Amritaa- shape not mentioned, habitat Madhyapradesh and Champaarnya in India, mesocarp large, used for shodhana-karma (body cleansing)
5. Abhayaa-shape not mentioned, habitat Champaaranya, Himalaya in India, having five ribs used for ophthalmic disorders
6. Jeewantee- shape not mentioned, golden yellow in color, habitat Himalaya, used in all diseases
7. Chetakee- shape not mentioned, the fruit having three ribs, used as purgative [16]

Classification according to the growth of the fruit:
Halileh-i-Zira when the size is small as that of a cumin (zira) seed
Halileh-i-Javwi when the size of a grain of barley
Halileh-iZangi or Halileh-i-Hindi when the size resembles that of a raisin
Halileh-i-Chini when the fruit is half arrived at maturity, greenish yellow and firm
Halileh-i-Asfer when the fruit is nearing maturity
Halileh-i-Kabul when the fruit is fully matured
Of these six varieties the second, third and sixth only are in general use for medicinal purposes, the forth and fifth also known as Rangari har or hirde are used by tanners. [17]

According to different stages of maturity of fruits, Chattopadhyay and Bhattacharya classified T. chebula into:

1. Small Myrobalan- the immature fruit
2. Yellow Myrobalan- after the development of seed, the fruit nearing maturity
3. Large   Myrobalan- when the fruit is fully matured [18] 
Currently however, two varieties only are recognized, viz. the large ripe fruit called Hareetakee, and the unripe dried fruit called Jangli Hareetakee (wild Chebula) in the vernacular.
 The genus Terminalia consists of 250 species distributed in tropical areas of the world.
 I have decided to focus my attention on Hareetakee (Terminalia chebula)[19], [20]

Geographical distribution
Hareetakee is a large evergreen tree native to India and Southern Asia. It occurs naturally from the sub-Himalayan region of Nepal and northern India, through India to Sri Lanka, Burma, Thailand, Indo-China and southern China; Malaysia and Vietnam. In Thailand and Burma, it occurs scattered in teak forest, mixed deciduous forest, extending into forests of comparatively dry types. In India the tree is found in North India and South words at the height of 1000 to 3000 feet. The tree is a light-demander. It withstands some shade in youth, and may benefit then from protection from the sun. It is hardy as it tolerates frost and drought. It withstands fire well, recovering well from burning and from coppicing (crowding of shrubs and trees). It needs well drained soil in sun. [21], [22]

Plant Morphology 

       
              Tree                                       Stem                            Leaves                        

                               

                 Flowers                                                        Fruits                     
                                                               
                                                                     
                                                       Seeds
Hareetakee (Terminalia chebula)  [23]

It is a deciduous, evergreen tree (hence the epithet Hareetakee) growing to 30 m in height. The shoots are hairless or hairy only when very young. It has round crown and spreading branches.

Stem round up to 1m in diameter, younger ones glabrescent (nearly hairless) woody. The bark is dark brown with some longitudinal cracks.      
Leaves are hairless or hairy only when very young, simple, generally opposite in arrangement, distant, ovate, alternate, entire, slightly dentate, 7to18 cm long and 4.5to10 cm broad and petiole 1to 3 cm long with long rust or silvery colored hairs on the young leaves, leaf buds and branches. They are arranged on the ends of the branches (hence the nameTerminalia).  
Flowers are 2mm long, 3-4 mm in diameter, ivory to yellowish or yellowish white borne in racemes or spikes; bracts nearly glabrous (smooth, glossy, having no trichomes or bristles), 1.5-2 mm long; calyx- segments triangular; stamens 3-4 mm long; ovary glabrous, ovoid, 1 mm long; style glabrous, 2.5-3mm long    
Inflorescence is paniculate spikes, terminal and axillary; peduncles tomentose (densely matted with woolly hair); bracts (a modified specialized leaf) subacute, small, caduceus (falling off easily or before the usual time)   
Fruit is drupe like or nut-like, glabrous, ovoid from a broad base, glabrous, small, smooth or having 5 longitudinal ridges or ribs, 2 to 5 cm long and 1.2 to 2.5 cm broad, wrinkled, turning blackish when dry
Seed circular, flat one, rough, is elliptical shape, 1.0-2 cm long and 0.2-0.7 broad, enveloped by a fleshy and firm pulp and without ridges [24], [25], [26]

Microscopic Characteristics
Transverse section of the fruit shows epicarp composed of a layer of epidermal cells, the outer tangential wall and upper portion of the thick radial walls. Mesocarp, 2 or 3 layers of collenchymas followed by a broad zone of parenchyma with fibres and sclereids in groups and vascular bundles, scattered; fibres, simple pitted walls; porous parenchyma; sclereids, various shapes and sizes, mostly elongated; tannins and aggregate crystals of calcium oxalate in parenchyma; starch grains simple rounded or oval in shape, measuring 2-7 µm in diameter. Endocarp consists of thick walled sclereids of various shapes and sizes, mostly elongated.  Fibres, sclereids and vessels lignified. Testa, one layer of large cubical cells, followed by a zone of reticulates parenchyma and vessel; tegmen consists of collapsed parenchyma. Cotyledon folded and containing aleurone grains, oil globules and some rosette aggregate crystals.
Powder
Brownish in color, under microscope shows a few fibers, vessels with simple pits and groups of sclereids.[27]

Parts Used
Fruits, Roots, Bark

Phytochemistry

Terminalia chebula is very rich in tannins (32%). Tannins are of pyrogallol (hydrolysable) type. They are: Gallic acid, chebulic acid, punicalagin, chebulanin, corilagin, neochebulinic acid, ellagic acid, chebulagic acid, chebulinic acid, 1,2,3,4,6-penta-o-galloyl-b-D-glucose,  casuarinin, 3,4 6-tri-o-galloyl-D glucose and terchebulin.
It contains several phytoconstituents like flavonoids, sterols, amino acids, resins, fixed oils, anthraquinones, ethanoic acid, sennoside, 4, 2, 4chebulyl-d-glucopyranose, terpinenes and terpinenols. Triterpinoids and their glycosides have been isolated from the stem bark.
Recent studies show that Terminalia chebula contains more phenolics than any other plant. [28]

Identity, Purity and Strength
Foreign matter Not more than 1 %
Total Ash Not more than 5 %
Acid-insoluble ash Not more than 5 %
Alcohol-soluble extractive Not less than 40 % [29]
Water-soluble extractive Not less than 60 per cent

To avoid adulteration, recently the scientists have developed RAPD-SCAR marker for identification of genotype ofTerminalia chebula.

Properties and Pharmacology
Ayurvedic Properties
The fruit of Hareetakee (Terminalia chebula) which is fresh, smooth, bulky, round in shape, sinks in water and weighs at least 26g is considered ideal for medicinal use. 
Ganas (Classical Catagories)
Charaka Ganas: None 
Sushruta+Ganas: None

Energetics

Rasa (Taste): The fruit: Madhura (Sweet), Amla (Sour); The covering of the fruit: Katu (Acrid, pungent);The kernel of the fruit: Kashaya (Astringent)
The Seed: Tikta (Bitter)
Thus according to Ayurveda Hareetakee (Terminalia chebula) is pancharasaatmak herb. [30], [31]

Weerya/Virya (Energy State): Ushna (Hot)
Wipaaka/ Vipak (End result, Post digestive effect): Madhura (Sweet)
Prabhaawa/ Prabhav (Special Effect, Prominent Effect):
Note: Here I wish to clarify the meaning of these technical words:
Virya (Weerya): Potency, power, vigor
Vipak (Wipaak): After digestion change of taste. The food we take is acted upon by jatharagni (digestive activity) and the taste of the food changes. The original rasa (taste) changes to vipak (new or same taste.)
Prabhav (Prabhaawa): Effect, prominent, peculiar or special action of an herb; innate and specific property.

Guna (Qualities): Laghu (Light), Rooksha (Dry, having drying effect)
Effects on Doshas:  Tridosha (three doshas: waata-pitta-kapha)
Actions on Dhaatus (Tissues): Saptadhaatu (all tissues)
Actions on Srotas (Systems): Praanawaha (Respiratory), Pureeshwaha, (Rectum and Anal canal)
Karma (Actions): Chkshushya (beneficial to eyes), Deepana (appetizer), Anulomana (prokinetic, laxative),Hridya (beneficial to heart), Medhya (beneficial for intellectual functions), Sarwadoshaprashamana (passifies all doshas), Rasaayana (anti-aging, adaptogen) [32], [33]

Important References from Ayurvedic Texts
Bhaawaprakash:
Rasaayana: Anti-aging, Rejuvenating
Aayushya: Improves quality of life
Brinhana: Nurtures body tissues
Shwaasahara: Relieves breathlessness (bronchial asthma, COPD etc.)
Kaasahara: Antitussive, (Expectorant ?)
Pramehahara: Allays diabetes- polyuria
Arshghna: Relieves piles, fissures in ano
Kushtahara: Relieves skin diseases
Shothahara: Relieves inflammation, edema
Udarahara: Relieves ascites
Krimighna: Anthelmintic

When chewed (as masticatory) the Hareetakee fruit acts as appetizer and increases digestive power. If swallowed as paste, acts as laxative and cleanses the bowel. When steamed/boiled becomes adsorbant, binding and constipating. When roasted is stabilizer of health by stabilizing the imbalance of tridoshas.  

When taken after food, by acting as laxative Hareetakee eliminates toxins generated by undigested food. Taken with salt, Hareetakee balances Kapha (prevents catarrhal inflammation and reduces phlegm), Taken with sugar, it balances Pitta, taken with ghee it balances Waata (motility disorders)

To attain rejuvenating (Rasaayana) effects of Hareetakee (Terminalia chebula) in different seasons (ritu) it is supplemented with different ingredients. This regimen is called as ‘Ritu Hareetakee’. Here is the season wise regimen: 

Vasant Ritu (Spring): Use with Madhu (honey)
Greeshma Ritu (Summer): Use with Guda (jaggery)
Warsha Ritu (Rainy season): Use with Saindhav (rock salt)
Sharad Ritu (Autumn): Use with Sharkaraa (sugar)
Hemant Ritu (early Winter): Use with Shunthee (dry ginger)
Shisheera Ritu (Winter): Use with Pippalee – Long Pepper- -Piper longum

Sushrut Samhitaa 

Wranya: Heals wounds
Ushna: Hot
Sara: Prohinetic, Laxative
Medhya: Improves intellectual function
Doshaghna: Detoxifies poisons
Shothanut: Relieves inflammation
Kushtanut: Relieves skin diseases
Deepana: Appetizer, Improves digestive strength
Chakshushya: Improves vision, beneficial for eyes [34]

Ashtaanga Hridaya
In Sanskrit the word Hareetakee is feminine. Hence the author of Ashtaanga Hridayam has used some feminine words.
Deepanee: Appetizer
Paachanee: Digestant/ Digestive
Arochaka/Wairasya(haraa): Improves the sense of taste
Saraa: Laxative/ Prokinetic
AAyushyaa: Imparting longevity
Medhyaa: Improves intellectual function
Wayahsthaapanee: Age- stabilizer
Buddhipradaa: Beneficial for intelligence
Indriybalapradaa: Imparting strength to various organs
Kushthawaiwarny(haraa): Useful in the treatment of leprosy, and disturbances of the skin pigmentations
Puraanawishamajjwara: Useful in chronic PUO
Shiroroga: Diseases of the head
Akshiroga: Diseases of the eye
Paandu: Anemia
Hridroga: Heart disease
Kaamalaa: Jaundice
Grahanee: Chronic colitis, IBD
Shopha: Edema
Atisaara: Diarrhea
Krumi: Helminthisis
Meda: Obesity
Shwaasa: Breathlessness
Kaasa: Cough
Arsha: Piles, Fissures in ano
Pleehaaroga: Splenomegaly
Gulma: Tumors [35]

Modern view
Terminalia chebula is Antipyretic, Astringent, Appetizer, Stomachic, Prokinetic (Anulomana) Laxative, Nootropic (Medhya= improving intellect, memory etc.), Tonic and Alterative (tending to cure or restore to health). It shows anti-inflammatory, anti-oxidant, anti-bacterial, anti-fungal, hypoglycemic and lipid lowering activity.

Gallic acid

Molecular formula: C7H6O5
Structural formula:


Gallic acid is a type of phenolic acid found in gallnuts, sumac, witch hazel, tea leaves, oak bark and other plants. Salts and esters of gallic acid are termed gallates; but it does not contain gallium.
Gallic acid was first studied by the Swedish chemist Carl Wilhelm Scheele in 1786. The French chemist and pharmacist Henri Braconnot devised the method of purification of gallic acid from galls in 1818. [36]
Gallic acid shows anti-inflammatory, antioxidant, antibacterial, antiviral (especially against rhinovirus that causes common cold) and antifungal activity. It shows antimutagenic effect and anti-cancer properties. [37], [38] 
Gallic acid possesses significant anti-inflammatory properties and prevents the expression of inflammatory chemicals including cytokines and histamine. Therefore gallic acid may be used to treat allergies.
Antioxidant property of gallic acid can protect the liver from toxic effects of hepatotoxic chemicals and metabolites.
Fungi such as Aspergillus flavus and Aspergillus parasiticus produce aflatoxin. Gallic acid has the ability to inhibit the enzymes responsible for the production of aflatoxin by fungi, thereby acting as an antifungal agent.
Gallic acid can trigger the secretion of insulin by the pancreatic cells thereby helping diabetic patients.
A study published in “Pharmaceutical Research” showed that gallic acid produced apoptosis in prostate cancer cells. However the results have not been proven in actual clinical practice. [39]

Mechanism of action of Gallic acid:

Gallic acid inhibits activation of NF-kB and Akt signaling pathways along with the activity of COX, ribonucleotide reductase and GSH.
Gallic acid activates ATM kinase signaling pathways to prevent the processes of carcinogenesis. The inhibitory effect of gallic acid on cancer cell growth is mediated via the modulation of genes which encodes for cell cycle, metastasis, angiogenesis and apoptosis.
The data so far available indicates that gallic acid could be a promising agent for cancer chemoprevention. [40]

Gallotannins also known as Tannic acid

Molecular formula: C76H52O46
Structural formula:

 

Tannic acid

Gallotannin or common tannic acid is esterified gallic acid. 
In 19th and 20th centuries, in conjunction with magnesium and activated charcoal tannic acid was used for the treatment of strychnine, mushroom and ptomaine poisoning.
The introduction of tannic acid dressings for the treatment of burn injuries significantly reduced the mortality rates. Where tannic acid is not available, strong lukewarm tea is a good substitute.
Tannic acid is a good anti-tussive and anti-histaminic agent. Glycerin tannate is good throat paint for sore-throat and tonsillitis. 
Albumin tannate is used as an anti diarrheal agent.
Tannic acid can be directly applied to treat prickly heat, diaper rash, poison ivy
Tannic acid is used as vaginal douche for the treatment of leucorrhea. [41], [42]  

Ellagic acid

Molecular formula: C14H6O8
Structural formula:


Ellagic acid is a natural polyphenol antioxidant.
Ellagic acid was first discovered by chemist Henri Braconnot in 1831. Maxmillan Nierenstein prepared it from oak bark, pomegranate and myrobalans (aamalakee).
The highest levels of ellagic acid is found in oak bark, pomegranate, aamalakee, yellow myrobalan, blackberries, cranberries, raspberries, strawberries, walnuts, grapes and peach.
Ellagic acid has anti-inflammatory, anti-oxidant, anti-proliferative and chemoprotective properties. It is a useful supplement in the treatment of bacterial and viral infections.
Ellagic acid can prevent skin wrinkling.
Ellagic acid reduces blood pressure and carotid artery wall thickness, thereby preventing carotid artery stenosis.
Ellagic acid directly inhibits the DNA binding of certain carcinogens. By reducing oxidative stress ellagic acid acts as a chemoprotective agent. 
In a clinical trial ellagic acid reduced the rate of chemotherapy-associated neutropenia in patients receiving chemotherapy for prostate cancer. However ellagic acid supplementation did not improve overall progression-free survival of patients with prostate cancer in this trial
he results of supplementation of ellagic acid in cancer patients are so nebulous that the US FDA has declared ellagic acid as a “Fake cancer cure”  [43], [44], [45]

Chebulic acid

Molecular formula: C14H12O11
Structural formula:

                                                                               






 

Chebulic acid according to Lee 2010     Chebulic acid according toKlika2004

Chebulic acid is a phenolic compound. It possesses an isomer, neochebulic acid. Chebulic acid is a component of transformed ellagitannins such as chebulagic acid or chebulinic acid.  [46]
For more information see below

Chebulinic acid

Molecular formula: C41H32O27
Structural formula:


Chebulinic acid is ellagitannin found in the seeds of Euphorbia longana, in the fruits of Terminalia chebula and in the leaves of Terminalia macroptera. [47]
Chebulinic acid has antihypertensive activity. This effect is probably mediated via the decrease in cardiac output resulting from reduced left ventricular contraction [48]
Chebulinic acid has anti-secretary and cyto-protective effect. [49]
Chebulinic acid has inhibitory effect on erythroid differentiation. Chebulinic acid might influence the efficiency of some anti-tumor drugs-induced differentiation or the hematopoesis process.  [50]

Chebulagic acid

Molecular formula: C41H30O27
Structural formula:

 

Chebulagic acid is a benzopyran tannin.
Chebulagic acid is found in Terminalia chebula, Terminalia citrina and Terminalia catappa.
Chebulagic acid is antioxidant, immunosuppressive, hepatoprotective and a potent alphaglucosidase inhibitor.
Chebulagic acid is shown to be active against Staphylococcus aureus and Candida albicans. [51]
Recent study shows that chebulagic acid is COX-LOX inhibitor. Chebulagic acid shows antiviral activity against Human Enterovirus 71, Herpes simplex virus and Human Immunodeficiency Virus. [52], [53], [54]
In one in vitro study chebulagic acid was shown to be inhibitor of angiogenesis [55]
Chebulagic acid shows anti-proliferative activity. [56]

Punicalagin

Molecular formula: C48H28O30
Structural formula:


Punicalagin is an ellagitannin (For more details ref. Aamalakee-Emblica officinalis). It is found in many species ofTerminalia, pomegranates (Punica granatum) and the velvet bushwillow (Combretum molle).
It is a highly active carbonic anhydrase inhibitor. [57]
Punicalagin is potent antioxidant and antiatherosclerotic, antiproliferative-apoptotic (especially for human oral and colon cancer cells). [58]
The degeneration of articular cartilage proteins, proteoglycans and type II collagen (CII), results in cartilage destruction and arthritis. While loss of proteoglycan can be reversed, the degeneration of CII is irreversible and has been correlated with an over-expression and over-activation of matrixmetalloproteinases (MMPs).  Punicalagin (PA), ellagic acid (EA) and polyphenols inhibit MMP-13-mediated degeneration of CII in vitro. This effect is attributed to anti-inflammatory activity of PA and EA. [59]
The anti-inflammatory activity of punicalagin reduces carrageenan-induced hind paw edema in rats. [60]   
Punicalagin suppresses TNF alpha induced COX-2 protein expression. Punicalagin can play an important role in the modulation of inflammatory cell signaling in colon cancer cells. [61]
Punicalagin and punicalin isolated from Terminalia species are strong antioxidants. In one experimental study, they protected the hepatocytes from CCl4 induced toxicity in the rat liver. However the larger doses of punicalagin induced liver cell damage. [62]

Chebulanin 

Molecular formula: C27H24O19
Structural formula: 

Synonyms: Terminalic acid, Terminalic acid
Chebulanin is a very potent antioxidant, free radical scavenger. [64]

Corilagin

Molecular formula: C27H22O18
Structural formula:

Corilagin is a polyphenol, specifically a hydrolysable tannin.  It is a week carbonic anhydrase inhibitor. [65]
Corilagen inhibits ovarian cancer cell growth through blocking the TGF-beta signaling pathways [66]

Anthraquinone glycosides
Glycosides are molecules in which the glycone (a sugar part) is bound to aglycone (a non-sugar part) by O-glycosidic or S-glycosidic bond. The pericarp of the fruit of Terminalia chebula contains anthraquinone glycosides which are responsible for the laxative effect.  [67]

Terchebin

Molecular formula: C42H30O26
Structural formula:


Terchebin belongs to the class of tannins present in Terminalia chebula. Till today chemical properties and pharmacological actions of terchebin are not reported. [69]     
                                                                  
 1,2,3,4,6-penta-o-galloyl-b-D-glucose

Molecular formula: C41H32O26
Structural formula:



1,2,3,4,6-penta-o-galloyl-b-D-glucose is the pentahydroxy gallic acid gallic acid ester of glucose. It is the precursor of gallotanins. It can precipitate proteins including salivary amylase. It is used in radioprotection. [70]

Casuarinin

Molecular formula: C41H28O26
Structural formula:


Casuarinin is an ellgitannin. It is an isomer of casuarictin. It is a highly active carbonic anhydrase inhibitor. [71]  
Casuarinin a hydrolysable tannin is anti-inflammatory, anti- pyretic and antioxidant. Its anti-proliferative activity inhibits proliferation of human adenocarcinoma MCF-7 cells of the breast cancer by blocking cell cycle progression in the G0/G1 phase and inducing apoptosis. Casuarinin also inhibits human non-small cell lung cancer A549 cells by blocking cell cycle in the G0/G1 phase and inducing apoptosis. Casuarinin possesses anti-herpes simplex virus type 2 activity. [72] 
An enzyme linked immunosorbent assay showed that casuarinin increased the expression of p21/WAF1 concomitantly as the MCF-7 cells underwent G0/G1 arrest. It was suggested that induction of p21/WAF1 and the activity of Fas ligand apoptotic system may participate in the antiproliferative activity of casuarinin in MCF-7 cells. [73]  

Chebulic acid and Neochebulinic acid

Molecular formula: C14H12O11
Structural formula:


                                                                                      






Chebulic acid according to Lee 2010           Chebulic acid according toKlika 2004

From the ripe fruits of Terminalia chebula a phenolic compound Chebulic acid and its isomer neochebulinic acid in the ratio of 2:1 were isolated by Lee et al in 2007. [74]

                                                                                          
  Neo-chebulinic acid                                           Chebulinic acid                           [75], [76]

Both the compounds are free radical scavengers and antioxidants. They show hepatoprotective activity. Lee et al (2010) also reported hypoglycemic effect of these compounds. [77]
Present study shows that chebulic acid acts against endothelial cell dysfunction suggesting that this compound can be used against diabetic vascular complications. [78]

3, 4 6-tri-o-galloyl-D glucose

Molecular formula: C41H32O26
Structural formula:


1. 2.3.6-Pentagalloyl glucose is the pentahydroxy gallic acid ester of glucose. It is the precursor of gallotannins and the related ellagitannins. It can precipitate proteins including human salivary alpha amylase. It may be used in radioprotection. [79]

Ethanoic acid 

Molecular formula: CH3COOH
Structural formula:


Ethanoic acid is acetic acid or vinegar. It is food additive. [80]

Sennoside

Molecular formula: C42H38O20
Structural formula:

     [81]

 Sennosides are senna alkaloids. They are anthraquinone derivatives. The breakdown products of senna act as irritants on the colonic wall to induce fluid secretion and contraction of the colonic wall (peristalsis). They are therefore used as laxative in the treatment of chronic constipation. They may also be used to evacuate bowel prior to surgery or rectal or colonic examinations. Oral senna products produce bowel movements in 6 to 12 hours. Hence they should be taken at bed time. Rectal suppositories act within 2 hours.
Sennosides produce griping pain in the abdomen, nausea and vomiting. Regular use of senna products can lead to melanosis coli.
According to commission E of Germany senna is contraindicated in intestinal obstruction, acute abdomen, appendicitis and inflammatory bowel disease. Senna is contraindicated for the patients with a documented allergy to anthraquinones. Senna is an over the counter medicine available as liquid, tablet, granules and suppository. [82]

4, 2, 4 Chebulyl-d-glucopyranose

Molecular formula:
Structural formula:

      [83]

4, 2, 4 Chebulyl-d-glucopyranose shows antigrowth activity against HOS-1 cell line. [84]

Triterpenoids and their glycosides

Molecular formula:
Structural formula: (ChebulosideII): C36H58O11

         

           Chebuloside I                                                  Chebuloside II

They are Triterpene Glycosides- Glycosides of Aglycones of Oleanene type.[85]
Of these Chebuloside I is less studied and not much reported but ChebulosideII is much studied. They protect the liver from the toxicity caused by the administration for 12 weeks of rifampicin, isoniazid and pyrazinamide in combination. Biochemical and histological studies supported this experimental data. For want of proper and well established therapy to protect the liver from the toxicity of antitubercular drugs this information should be investigated on a large scale. [86]  

Chebulin

Chebulin is a peptide derived from the fruit of T. chebula. It reduces blood lipids without reducing weight.
By inhibiting ACE in a non-competitive manner chebulin lowers blood pressure.
Chebulin acts as a smooth muscle relaxant akin to papaverin. It thus acts as an antispasmodic agent. [87], [88]

Some Testimonials from Modern Research

General Pharmacology
Terminalia chebula administered following anaphylactic shock reduces the serum histamine level showing anti-anaphylactic activity of the herb.
In an in vivo study the alcoholic extract of the leaves of T. chebula applied to dermal wounds of rats increased the total protein and collagen content in the granulation tissue of the wounds. The levels of hexosamine and uronic acid increased up to eight days. The tensile strength of the tissues also increased. Thus the extract of the leaves of T. chebulafacilitates the wound healing. [89]
In an experimental study various organic and aqueous extract of T. chebula were tested on fibroblasts and keratinocytes. The study showed that T. chebula extracts increase cell proliferation, decrease free-radical production without affecting the normal cellular matrix. Thus these extracts enhance the rate of wound healing. [90]
Compound 48/80 is a polymer produced by the condensation of N-methyl-p-methoxyphenethylamine with formaldehyde. It promotes histamine release. To investigate the effect of aqueous extract of T. chebula on compound 48/80 induced anaphylactic shock, water soluble fraction of T. cebula (WFTC) was administered one hour before injecting the compound. With the doses of 0.01to 1g/kg the shock was inhibited to 100% and the mortality was nil. When WFTC was administered 5-10 minutes after the injection of 48/80 the mortality due to shock decreased in a dose dependant manner. The serum histamine levels also decrease in a dose dependant manner. Thus WFTC shows a strong anti-anaphylactic action. [91]  
The commonest organisms found in wound infection are: Staphylococcus aureus, Escherichia coli, Kleibsiella pneumonia, Proteus vulgaris, Pseudomonas sp and Bacillus sp. T. chebula extract arrested the growth of these organisms and facilitated wound healing. Whether the extract was used for dressing the wounds or administered orally is not mentioned in the research article. [92] 
In Ayurveda Hareeakee is included in “Rasaayana” (adaptogen, anti-aging, rejuvenating) group of drugs. In order to investigate this claim the researchers prepared the standardized extract of whole plant of Hareetakee (T. chebula). The extract was administered orally to experimental animals in a dose extrapolated from human dose. The animals were then exposed to biological, physical, chemical stressors. The extract offered protection against the stressors, as judged by objective parameters for the manifestations of stress and by using markers of stress responses. Thus researchers validated the “Rasaayana” property of Hareetakee.[93]
In various experimental studies gallic acid (GA) and chebulic acid (CA) isolated from T. chebula blocked the T-lymphocyte-mediated cytotoxicity. The ethanolic extract of T. chebula fruit exhibited the cytoprotective effect on human embryonic kidney cells (HEK-N/F cells) and against UV-induced oxidative damage. These effects were attributed to the inhibitory effect of T. chebula on the age dependent shortening of the telomere length. [94]
Antioxidant activity
The alcoholic extract of T. chebula protects the antioxidant enzymes from reactive oxygen species following gamma ray radiation. The extract shows anti-lipidperoxidation, antisuperoxide radical formation and freeradical scavenging activities. [95]
In one study six extracts and four pure compounds of T. chebula Retz were investigated for antioxidant and free radical scavenging activities. All extracts and pure compounds exhibited antioxidant and free radical scavenging activities. But the pure compounds showed specific actions. The researchers found that chebulin has the highest antioxidant activity.  [96]
Antiinflammatory activity
In an experimental study, oral administration of the aqueous extract of T.chebula  at the doses of 150mg/kg, 300mg/kg and 600mg/kg showed dose dependent inhibition of carragenan induced inflammation. The inhibitory effect was due to inhibition of prostaglandins. However even at the dose of 600mg/kg the chronic inflammation did not show regression. The dose as high as 1200mg/kg/day did not show any toxicity. [97]
The anti-inflammatory and anti-nociceptive effect of ethanolic extract of T. chebula was studied in experimental animal models (Swiss Albino mice weighing 20-25 g and Long Evans rats weighing 100-150 g of either sex). At the dose of 250mg/kg and 500mg/kg the extract showed analgesic activity and at 300mg/kg it showed anti-inflammatory effect. [98]
The standardized extract of T. chebula contains 118.5mg gallic acid equivalent/g of extract. The standardized extract ofT. chebula at 250mg/kg dose was found to cause 69.96% reduction in carrageenin induced rat paw edema and demonstrated 96.72% protective effect on human RBC membrane stability. T. chebula extract significantly reduced the formation of TBARS in carrageenan-induced inflammation in rat liver. It also showed free radical scavenging activity.
These promising findings validate the traditional (Ayurvedic) use of Hareetakee (T. chebula) in various arthritic disorders.  
[Note: Thiobarbituric acid reactive substances (TBARS) are formed as a byproduct of lipid peroxidation. They can be detected by the TBAR assay. The reactive oxygen species (ROS) have extremely short half-lives. Hence they are very difficult to measure. Instead, the measurement of products of damage such as TBARS produced by oxidative stress gives better idea of the oxidative damage.]   [99], [100]
From various studies it can be inferred that the anti-inflammatory activity of Terminalia chebula is because of inhibition of inflammatory mediators like COX, LOX and TNF α.
Immunomodulatory activity
Oral administration of 100mg/kg of alcoholic extract of T. chebula fruit increases the level of liver mitochondrial enzymes (CAT and SO) as well as GSH. The secretion of melatonon by the pineal body increases. The extract also increases the lymphocyte proliferation by the spleen. These findings confirm the immunomodulatory activity of the fruit of T. chebula. [101]
In one study Swiss albino mice weighing between 20-25 g were pretreated orally with aqueous extract of T. chebulafruit at the dose of 500mg/kg. These animals when challenged with 1x10colonies of Salmonella typhimurium injected intraperitoneally showed 100% protection. The WBC count increased by 3x103/cu mm and lymphocyte count by 4%. Thus the extract showed its protective effect against S. typhimurium through its immunomodulatory activity in mice. [102]
In experiments on rats water extract of T. chebula produced an increase in humoral antibody titer and delayed type hypersensitivity. [103]
Antibacterial activity
Terminalia chebula fruit extract is highly effective against:
Salmonella typhi, Staphylococcus epidermidis, Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, Helicobacter pylori, Clostridium perfringens, Eschrieria coli.
Biologically active compounds having antibacterial actions are:
Ethanedioic acid against Clostridium perfringens (strong activity), and Eschrieria coli (moderate activity), but no adverse effects on the growth of lactic acid producing bacteria. Ellagic acid against Clostridium perfringens, Eschrieria coli but little or no inhibition for behenic acid, β- caryophyllene, eugenol, isoquercitrin, oleic acid, α-phellandrin, β-sitosterol, stearic acid, α- terpinene, terpinolene or triacontanoic acid. [104], [105]                  
Antiviral activity
The extract of T. chebula has inhibitory effect on HIV-1 reverse transcriptase. Hot water extract shows anti-HSV activity in vivo and anti-CMV activity both in vitro and in vivo. The extract protects against cytotoxic effects caused by influenza A virus. The compounds having anti-viral activity are gallic acid and three galloyl glucoses. Recently acetone extract of the herb is found to be useful for the treatment of swine flu (influenza A) infection. [106]
Antifungal activity
The aqueous extract of T. chebula is reported show antifungal activity against Epidermophyton, Floccosum,Microsporum gypseum, Trycophyton rubrum and diploid fungus Candida albicans. Aqueous, alcoholic and acetate extract of leaves of T. chebula show activity against pathogenic fungi Aspergillus flavus, A. niger, Alternaria brassicicola, A. alternate and Helminthsporium tetramera. [107]
Antiprotozoal activity
At the dose 500mg/kg body weight of crude drug formulation of T. chebula cured caecal amoebiasis in 89% of rats. In another study in golden hamsters with hepatic amoebiasis and amoebic liver abscess; the formulation of T. chebula at the dose 800mg/kg bodyweight showed 73% cure rate. [108] 
Antiplasmodial activity
The aqueous extract of T. chebula showed antiplasmodial activity in vitro and in vivo against multidrug resistant strain of Plasmodium falciparum.
I feel this activity should be investigated on a large scale. [109]
Actions on the Nervous System
Hareetakee is said to promote wisdom, intellect and good sight. It being a good adaptogen increases the ability of an individual to fight stress. It is a good nervine tonic. [110]
In one study aqueous extract of T. chebula fruits at 780 and 1560 mg/kg showed a significant antidepressant effect. The antidepressant effect was reversed by prazosin. It seems, the effect is mediated through monoaminergic pathways. [111]
To investigate the surface anesthetic activity of T. chebula, 0.25%, 0.5% and 1% alcoholic extract of the fruit were instilled in the conjunctival sac of the right eye of albino rabbits. Light reflex, corneal reflex and papillary size were noted. There was a dose dependent local anesthetic effect. This local anesthetic activity is used to alleviate throat pain as lozenge in traditional medicine. [112] 
The petroleum ether, chloroform, ethanol and aqueous extracts of T. chebula were investigated for their analgesic activity at 200, 400 and 800 mg/kg body weight in mice. The ethanolic extract showed maximum activity. The analgesic response in chronic pain was maximum and complete on 14th day. The pain relief was dependent on the dose. The analgesic effect was elicited through opioid receptors or through modulation of several neurotransmitters involved in relevant phenomena. [113]
In another study on Swiss albino mice weighing 25-30g and Long Evans rats, the ethanolic extract of T. chebula showed anti-inflammatory and analgesic activity at both 250mg/kg and 500mg/kg body weight. [114]
Actions on CVS 
In experimental rats, pretreatment with alcoholic extract of T. chebula fruits, at the dose 500mg/kg body weight has cardioprotective effect on isoproterenol induced myocardial damage. The effect was due to the lysosomal membrane stabilization preventing myocardial necrosis and inhibition of alterations in the heart mitochondrial ultrastructure and function. [115]
Administration of isoproterenol increases the levels of lipid peroxides and iron with corresponding decrease in the activities of enzymatic and nonenzymatic antioxidants. In experimental studies pretreatment of rats with aqueous or alcoholic extract of T. chebula prevented the depletion of SOD, CAT, GSH, Vitamin C and vitamin E. This shows that the cardioprotective effects of T. chebula are due to the antioxidant activity of the herb. [115], [116]
Chebulic acid shows effects against the formation of advanced glycation end products (AGEs) and endothelial cell dysfunction. Thus T. chebula can be used in peripheral vascular diseases and microvascular angiopathies. [117]   
Pathogenesis of post-angioplasty atherosclerosis and neointima formation is a complex process. The process involves vascular smooth muscle cells migration and proliferation. Platelet-derived growth factor and tumor necrosis factor induce vascular smooth muscle cells migration and proliferation. The circulating monocytes are recruited and differentiated into macrophages. Activation of these macrophages results in inducible nitric oxide synthase (iNOS) and cyclooxygenase(COX-2) synthesis. The macrophages engulf oxidized LDL and turn into foam cells. The prostaglandins produced by the action of COX-2 and these macrophages in the intima are responsible for inflammation followed by atherosclerosis.
The aqueous extract of T. chebula having strong antioxidant activity counters lipid peroxidation, reduces NO production, INOS and COX-2 expression, inhibits platelet-derived growth factor and vascular smooth muscle cells migration. Thus the aqueous extract of T. chebula prevents atherosclerosis. [118]
Actions on RS
A polysaccharide fraction arabinogalactan protein was isolated from aqueous extract of T. chebula. This fraction was found to possess antitussive activity. At the dose of 50 mg/kg body weight its antitussive efficacy was higher than that of the   standard drug codeine. [119]
Actions on GI System
The aqueous extract of T. chebula inhibits the growth, sucrose induced adherence and glucan-induces aggregation ofStreptococcus mutans. Rinsing the mouth with 10% solution of the water extract of T. chebula inhibits the bacterial count in the saliva. The effect lasts for 90 minutes after rinsing.   
T. chebula increases gastric emptying time and protects the gastric mucosa. Thus it has anti-peptic ulcer activity.
Laxative action of T. chebula is well known. It also has antispasmodic effect on the colon. This confirms its traditional usefulness in spastic colon and other intestinal disorders.
In golden hamsters T. chebula stimulates cell mediated immune response. [120]
Actions on the Liver
For hepatoprotection against antitubercular drug toxicity see above (Chebuloside I and II)
Antioxidant compounds found in T.chebula improve body defences and protect the liver and kidneys from various toxic substances. [121]
In one study C57/BL6 mice model was used to investigate the hepatoprotective effects of aqueous extract of T. chebula. In mice acute liver toxicity was induced by using tert-butylhydroperoxide (t-BHP) injection (2.5/kg body weight). Aqueous extract of T. chebula was administrated orally at 50, 100, 200 mg/kg body weight or gallic acid at 100mg/kg body weight doses for 5 days before (t-BHP) injection. Liver enzymes, oxidative stress parameters, antioxidant compounds, inflammatory cytokines and histopathology were examined 18 hours after t-BHP injection. The adverse effects of t-BHP were attenuated by the aqueous extract of T. chebula. Histopathological study supports these findings. This shows that the aqueous extract of T. chebula prevents acute and severe liver injury. [122] 
Paracetaamol one of the most widely used drugs worldwide is notorious for hepato-toxic effects. In albino rats at 300mg/kg body weight of 1% gum acacia suspension of leaves of T. chebula significantly reduced the paracetamol-induced hepato-toxicity as proved by the study of liver enzymes. The results were compared with 100mg/kg body weight of sylimarin. [123]
Actions on Metabolism
Aqueous extract of T. chebula shows hypolipidemic activity against experimentally induced atherosclerosis and hypercholesterolemia [124]
Antidiabetic activity
To investigate the effect of ethanolic extract of T. chebula containing 29.4% chebulic acid on hyperglycemia and diabetic complications; diabetes was induced in rats by administering 40mg/kg body weight of streptozotocin. The rats were divided in two groups. Terminalia chebula extract was administered orally for 13 days. To one group at the dose of 100mg/kg body weight and to the other at the dose of 500 mg/kg body weight. There was a marked improvement in sugar levels, lipid levels, serum levels of liver enzymes and creatinine and decrease in advanced glycation end products (AEGs) in seminiferous tubules in the rats of the second group. [125] 
In another study the researchers found the oral effective dose of T. chebula extract to be 200 mg/kg body weight once a day. Given for two months it produced a fall of 55.6% in glucose level and HbA1c by 0.01. The same dose effectively controlled elevated blood lipids and decreased insulin levels and hepatic and skeletal muscle glycogen contents. [126]
In another study, on alloxan diabetic rats, 75% methonolic extract of T. chebula was administered orally at 100 mg/kg body weight dose. Within 4 hours the sugar levels returned to normal. The chloroform extract of T. chebula seeds at doses of 100, 200 and 300 mg/kg body weight produced reduction in blood sugar on dose dependent manner. These results were observed on short term and long term treatment. Further remarkable renoprotective activity was also observed in T. chebula treated rats. The treatment did not show untoward side effects even after long term treatment. [127]
Actions on Urinary system
T. chebula inhibits nucleation and growth of calcium oxalate crystals. It also has cytoprotective effect on renal epithelial cells. Hence T. chebula can be considered for the prevention and treatment of urolithiasis. [128]
The urinary tract infection is very common in women and at times can pose a serious health problem. The antibiotics are used for a long term to eradicate the pathogens and to prevent the recurrence. This can alter the bacterial flora in the GI tract and in the vagina; and increase the chances of emerging multi drug resistant pathogens. Hence herbal antibacterial agents are much sought after. Recent investigations suggest that many herbal extracts can be used to treat urinary tract infections. In most cases the infection is caused by Escherichia coli and members of Enterobacteriaceae. They are equipped with filamentous adhesive organelles known as type 1 fimbriae or pili. They attach to the uroepithelium. This is why the eradication of these pathogens from the urinary tract becomes difficult. Staphylococcus aureus, Klebsiella pneumonia, pseudomonas aeruginosa are other uncommon pathogens but they are already resistant to many antibiotics. While the ethanolic extract of T. chebula inhibits most pathogens, the aqueous and the acetone extract inhibit only certain strains. [129]
In one study the ethanol and acetone extract of T.chebula fruits was found to be effective in treating UTI caused byProteus vulgaris resistant to Ceftazidime, Ofloxacine, Norfloxacin, Tetracycline, Ampicillin, Chloramphenicol and Gentamycin. Of the two, ethanol extract was more effective. [130]
Actions on Male reproductive system:
Oral administration of aqueous extract of bark of T. chebula at the dose of 300mg/kg body weight to mice caused histological changes in the seminiferous tubules of the testis. The levels of sialic acid in the epididymis and that of fructose in the seminal vesicle were reduced. The sperm parameters were adversely affected. This showed that T. chebula has antifertility activity.  [131]
Antitumor activity
In an experimental study at the dose of 200mg/kg body weight, ethanolic extract of T. chebula fruit inhibited tumor in Ehrlich Ascites Carcinoma-induced cancer in Swiss albino mice as was evident by reduction in tumor volume, increased life span and restoration of blood parameters. [132]  
Administration of 80mg/kg of T. chebula in mice prior to whole body irradiation of mice resulted in reduction of peroxidation of membrane lipids in the liver cells and decrease in radiation-induced damage to DNA. The extract of T. chebula also protected the human lymphocytes from undergoing damage to DNA following exposure to gamma ray radiation. [133]
Gamma ray irradiation induces the lipid peroxidation in the microsomes of the liver and damage the superoxide dismutase (SOD) enzyme in the liver mitochondria. In an experiment, rats pretreated with aqueous extract of T. chebula, this damage was prevented. The extract is a potent antioxidant and an excellent free radical scavenger. This activity is attributed to the presence of antioxidants like ascorbate, gallic acid and ellagic acid. The researchers feel that the extract can be used as a radio-protector to protect humans from radiation induced tissue damage. [134]
By using various solvents extracts of T. chebula were tested for their anticancer activities against cell lines of breast cancer, prostate cancer and bone cancer (osteosarcoma) having different properties (hormone sensitivity, growth rate, tumorigenecity). At concentration 400mg/kg body weight these extracts had immediate cytotoxic effect possibly caused by an interference of cell membrane integrity or mitochondrial function in the cells. The cytotoxicity was attributed to Gallic acid, Ethyl gallate, Ellagic acid, Chebulinic acid, Leutiolin etc. [135]   
Culinary Uses
The fruit is used to prepare pickles and syrups
Medicinal Actions and Uses
Traditional Uses
It is used as digestive, carminative, laxative, astringent and expectorant
Usages in Ayurveda
As dentifrice to strengthen gums,
Aqueous extract as mouth rinse for dental caries
With rock salt as carminative, laxative
With sugar for hyperacidity, GERD
Anupaana (a substance taken in combination with) with reference to season:
In Wasanta ritu (March-April)- in combination with honey
In Greeshma ritu (May-June)- in combination with jaggery 
In Warshaa ritu (July-August)- in combination with rock salt
In Sharada ritu (September-October)- in combination with sugar
In Hemanta ritu (November-December)- in combination with shunthee (dried ginger-- Zingiber officinale)
In Shisheera ritu( January-February)- in combination with pippalee (Piper longum) [136]
According to Charaka:
Kushtha- skin diseases
Gulma- tomors,
Udaawarta- flatulent dyspepsia
Shotha- inflammations
Pandu- anemia
Mada- delirium
Arsha- fissures and piles
Shiroroga-diseases pertaining to head such as headache
Atisaara- diarrhea, dysentery
Arochaka- anorexia
Kasa- cough
Prameha- diabetes, polyuria
Anaaha- bloating of abdomen
Pleehaawriddhi-spleenomegaly
Nawaudara- recent ascites
Kaphapraseka- waterbrash, increased salivation
Vaiswrya-hoarseness of voice
Kaamalaa- jaundice
Krimi- helminthiasis
Shyawathu- edema
Shwasa- breathlessness, bronchial asthma
Tamakashwasa-status asthmaticus, cardiac asthma
Chhardee- vomiting
Klaibya- impotence
Angaawasaada- bodyache
Srotowibandha- obstructive disorders, constipation
Hridaya-ura-pralepa-stiffness, heaviness of the chest
Smriti-buddhi-pramoha-loss of memory, delusion [137]
According to Waagbhat
When hareetakee powder fried in ghee is consumed regularly with sufficient ghee in food promotes longevity and boosts energy (HAREETAKEEM BHUNXWA RAAJASWA) and memory
Hareetakee is used as laxative in chronic constipation, detoxifying agent for colon, indigestion
Usages in Modern Medicine
There is no specific mention for usages in modern pharmacopoeia but it commonly used as guided by Ayurvedic texts.
Toxicity:
Precautions: Should be used with caution by thin lean individuals, by weak individuals and during fast, people with diabetes.
Over dosages can cause gastritis.  
Safety evaluation: Ethyl acetate and ethanolic extract did not show toxicity when used as single dose or used for 14 day repeated oral dose. In the bacterial mutation assay up to 5000µg/ml concentration did not show mutagenicity. In the oral toxicity study the dose of 2000mg/kg body weight in rats did not show toxicity. [138]  
Contra indications
Though Hareetakee is used as medicine worldwide, some contraindications have been mentioned in Dhanwantari Nighantu:
Adhwa-Ati-Khinna- persons who are tired after excessive traveling
Balawarjita- persons with depleted strength
Rooksha- persons feeling emaciated and dry
Krisha- thin lean persons
Langhanakarshita- persons emaciated following fasting for long
Pittaadhikya- those having hyperacidity and allergic diathesis
Garbhawatee- by pregnant women
Vimuktarakta- After bloodletting therapy
Kshudha, Trishna, Ushnaarta-persons having severe hunger, thirst and those who are tired due to prolonged exposure to sun (sunstroke)
Ajeerna- persons having indigestion
Stree-Madya-Karshita- following excessive indulgence in sex and consumption of excess of alcohol
Mukhashosha- persons having dry mouth (dehydration)
Hanustambha- persons having trismus and stiffness of neck
Nawajjwara- in early stages of PUO [139]
Drug interactions
Not reported
Preparations and Dosages
Popular Ayurvedic preparations:
Triphalaa choorna/ Tablet: 500 mg to 1g, 45 minutes after food usually after dinner as digestive, laxative, to treat acne, to improve immunity and to lose weight
Abhayaa Modaka/ Abhayaadi Modaka/ Abhayaa watee (Tablet): for purgation one modaka early in the morning with cold water. The person will start purging till he takes hot water. The purging will stop if one takes warm/hot water. It useful for constipation, flatulent dyspepsia, edema, rheumatism, gout
Abhayaarishta: 10 to 25 ml diluted with equal quantity of water, twice a day.
Used for constipation, piles, dyspepsia, indigestion
Pathyaadi choorna/kwaatha: 10 to 20 ml once or twice a day. Usages same as above.
Gandharwa Hareetakee (Choorna /Watee-Tablet):  Choorna- 1-2 table spoon in the night with warm water before going to sleep/ Tablet -2 to 4 tablets with warm water at bed time. Used for constipation, fissures and piles, back ache    
Wyaaghree Hareetakee/ Wyaaghree Hareetakee awaleha: 5 to 10 g once or twice a day before or after food according to individual tolerance for pain in knee joints. Over dosage can cause gastritis.
Chitraka-Hareetakee Awaleha (Jam-Jelly): 5-10 ml used in bronchial asthma
Hareetakee Fruit powder: 1-6 grams
The bark of Hareetakee if chewed as masticatory improves digestion.
‘Baala Hareetakee’ is useful in fissures in ano and hemorrhoids.
The most popular combination Hareetakee+ Musta (Cyperus rutundus)+Shunthee (Zingiber officinale)+ Jaggery is useful in all GI disorders.
‘Hareetakee siddha ghrita’ is useful in chronic fever
Hareetakee Kwaath (Decoction) along with honey is useful in viral hepatitis and obesity.
Hareetakee choorna with honey and ghee is effective in anemia
Hareetakee is valuable in UTI and urolithiasis  [140]
Additional Information
Medicinal Uses
It is given as adjuvant herb in chronic fever. On long term use it is helpful in gaining weight in the emaciated persons and in losing weight in obese persons. When it is taken with meals it sharpens the intellect, increase strength, stimulates the senses, and expels the urine, stool and waste materials from the body. It is reduces the ill effects of fat rich, creamy and oil food. It is used for curing swellings, skin and eye diseases. It can be used as home remedy against fever, cough, asthma and urinary disease. This herb has the ability to stop bleeding and prevent a medical condition called Hemorrhage. Its powder used as toothpaste, it will make your teeth stronger and healthy. The paste of dried fruit is used for chronic ulcers, wounds and scalds.
It is good to increase the appetite, as digestive aid liver stimulant, as stomachic, as gastrointestinal prokinetic agent and mild laxative. It is stimulatesthe liver and protects it further by expelling the waste excretory products from the intestines. It is indicated in protracted diarrhea with hematochezia and prolapse of rectum. It is a good nervine, used in nervous weakness, nervous irritability. It promotes the receiving power of the five senses. It is helpful in renal calculi, dysurea, and retention of urine and used for treating parasitic infection. It is used as a blood purifier, gargle for sore throat, ulcerated gums, and muscular rheumatism. With sugar water it is used to treat opthalmia, skin itching and edema. It is used as an antioxidant, neuroprotective drug and treatment for heart disease, inflammation, brain dysfunction. It is used as an anti-aging agent and it is found to improvethe mental faculties. The plant also has adrenergic function and helps to recover from stress. One compound Chebulagic acid (Bharat Reddy D et al 2010) from Haritaki has shown antispasmodic action like papaverine. [141]

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