Cannabis sativae indicae summitates et resina

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 22.05.2021

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Synonym(s)

cannabis sativa; Hashish; Hemp; Ordinary hemp

Definition
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Cannabis sativae indicae summitates et resina refers to medicinal preparations from the hemp plant (Cannabis sativa and Cannabis indica).

Cannabis, hemp, is an annual herbaceous plant originally native to Central Asia. Today it is found worldwide in all temperate to tropical zones, sometimes cultivated but also running wild. The leaves of the hemp plant are large, toothed, lanceolate and covered with glands and hairs on both sides.

The glands secrete a resin, which consists for the most part of cannabinoids and essential oils; furthermore of high-polymer phenols, terpenes and waxes. At present, about 60 different cannabinoids have been analysed. Well over a hundred are suspected. Proportionally, the most represented are:

Ingredients
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The leaves of the hemp plant are large, toothed, lanceolate and covered with glands and hairs on both sides. The glands secrete a resin, which consists for the most part of cannabinoids and essential oils, as well as high-polymer phenols, terpenes and waxes.

At present, about 60 different cannabinoids have been analysed. The largest part is made up by the less psyochotropic ingredients cannabidiol (CBD) and cannabinol (CBN).

Delta-9-tetrahydrocannabinol (THC) is the best studied and is responsible for the psychotropic effects of the hemp plant. Furthermore, the substance has a vasoconstrictor effect.

The inflorescences of the hemp plant are small and inconspicuous, have the form of umbels or panicles and are located at the base of the upper leaves. Male flowers consist of 5 pendulous stamens and as many greenish bracts. Female flowers have a reduced perianth. Pollination of the flowers is by wind. The resulting fruit of hemp is called a "nut" and contains a seed.

Occurrence
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Originally probably native to Central Asia, hemp is now widespread in almost all temperate to tropical zones. In China, hemp has been used for thousands of years as a remedy against malaria and rheumatic diseases. From the Middle Ages until modern times, hemp was used to produce medicinal products, especially against pain.

In Europe, hemp and flax were important fibre plants for a long time, with applications in paper production (the Gutenberg Bible was printed on hemp paper), in handicrafts and in seafaring (hemp ropes, hemp fabrics, ship sails, etc.). Hemp seed was also used as animal feed.

Spectrum of action
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The cannabinoids contained in the cannabis plant:

  • Delta-9-Tetrahydocannabinol (Delta-9-THC)
  • and
  • cannabidiol (CBD)

are the best researched. They act through the body's own receptors. The best known cannabinoid receptors are:

  • Cannabinoid receptor 1 (CB1)
  • Cannabinoid Receptor 2 (CB2).

CB1 is expressed in the CNS and in the nervous system of the gut. The CB2 receptor is found on cells of the human defense system and on cells that regulate bone metabolism.

Cannabinoids have been used, for example, to alleviate typical side effects of chemotherapy. These include nausea, vomiting and loss of appetite. Furthermore, neuropathic pain (Lee G et al. 2018), depressive mood, weight loss, and anxiety are among the indications for cannabis therapy. In particular, delta-9-tetrahydocannabinol and its metabolites 11-hydroxy-delta-9-tetrahydrocannabinol and 11-nor-9-carboxy-tetrahydrocannabinol are responsible for the psychogenic effects of the hemp plant (Huestis MA 2005).

Field of application/use
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Hemp seed oil: Hemp seed oil is extracted from the seeds of cannabis. This is used as an edible oil and as a well-tolerated skin care oil. Hemp seeds contain only insignificant amounts of tetrahydrocannabinol. Extracts therefore have no psychoactive effect. Remark: As an alternative to hemp seed oil in skin care, borage seed oil or evening primrose oil can be used. Hemp seed oil is to be distinguished from the psychotropic essential hemp oil distilled from hemp leaves and flowers.

Hashish oil: Hashish oil, which is distilled from the resin of hemp, should also be distinguished.

Undesirable effects
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Cannabis allergy. Hemp fibres and dusts cannot be broken down by humans due to the glycosidic bond. Intensive inhalation of these dusts may lead to accumulation in the lungs (clinical picture of byssinosis).
Sensitization by cannabis products is known, at present still relatively rare, but in the future more frequent than hitherto to be expected. Allergic rhinoconjunctivitis up to anaphylactic reactions have been described, some of which were severe. Cross reactions by the lipid transfer protein Can s 3 have been described with various fruits and vegetables. Fruits and vegetables have been described (cannabis-fruit-vegetable syndrome) (Drouet M et al. 2017).

Vascular damage: Delta-9-tetrahydrocannabinol can lead to Raynaud 's syndrome and possibly to"cannabisarteritis" (El Omri N et al. 2017), a clinical picture that can be assigned to thrombangiitis obliterans, if cannabis products are consumed over a longer period of time (possibly in combination with cigarette consumption).

Note(s)
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Cannabis has been named the 2018 "Medicinal Plant of the Year". It has been used for thousands of years to relieve pain. Herbal cannabis is currently being heavily promoted by some patients and their advocates to treat any type of chronic pain (Muecke M et al 2018).

Marijuana: The dried and crushed resinous flower clusters and flower-like small leaves of the female plant are called marijuana (weed).

Hashish: resin of the shoot tips obtained by stripping from the surface of the shoot tips.

Spice: Cannabinoid-containing fashion drug.

In Germany, cannabis is the most commonly used drug.

Literature
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  1. Bakirci N et al. (2007) Natural history and risk factors of early respiratory responses to exposure to cotton dust in newly exposed workers. J Occup Environ. Med 49:853-861
  2. Bar-Lev Schleider L et al. (2018) Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer. European journal of internal medicine 49:37-43.
  3. Decuyper II et al. (2017) Cannabis sativa allergy: looking through the fog. Allergy 72: 201-206.
  4. Drouet M et al. (2017) Cannabis et allergie croisée alimentaire Cannabis and crossed allergy with food. Revue de pneumologie clinique 73:290-293.
  5. Ebo DG et al. (2013) New food allergies in a European non-Mediterranean region: is Cannabis sativa to blame? Int Arch Allergy Immunol 161:220-228 Epub 2013 Mar 15 PubMed PMID: 23549061.
  6. El Omri N et al (2017) Cannabis arteritis. The Pan African medical journal 26:53.
  7. Muecke M et al (2018) Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev 3:CD012182.

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Last updated on: 22.05.2021