German chamomile is used to relieve both external and internal inflammation. Externally, it reduces swelling caused by abrasions, exposure to chemicals or radiation, fungal invasion, or subdermal spasm or infection, and targets skin, mucous membranes, gums, and ano-genital areas. Inhaled, chamomile reduces spasm and inflammation of the respiratory tract. Used internally, it relieves colic and ulcers. It has been recommended for carpal tunnel syndrome, insect bites, insomnia, gingivitis, and heartburn.

Beginning with the ancient Egyptians, Romans, and Greeks, who used chamomile flowers to relieve sunstroke, fevers, and colic, chamomile has held a prominent place in history. It is regarded by modern Europeans with a reverence similar to that given to ginseng by Asians. Germans describe chamomile as "alles zutraut," meaning that it is capable of anything. Most important, however, is that clinical studies support chamomile's broad range of use.

German chamomile is one of two chamomile species used medicinally. The hollow receptacle that lies beneath the flowers of M. recutita differentiates this species from Roman, or English, chamomile (Chamaemelum nobile), which has a solid receptacle. Both chamomiles produce similar bioactive constituents and are used for similar ailments. They also share nonmedicinal uses: chamomile extracts are added to hair dyes and shampoos to highlight hair or improve blonde tones, and chamomile oils add apple scents to soaps and perfumes.

Leaves, alternate, with thread-like divisions, grow from a light green, smooth, striated stem. From spring through summer, 10 to 20 cream-colored or silver-white petals bloom around a swollen, yellow central disk, or receptacle. Diameter of flower heads is ½ to ¹/8 of an inch. The plant can grow to 2 or 3 feet but is often found low to the ground in native Europe, Africa, and Asia, and in North and South America where it has been naturalized.

• Flower

0.25% to 1% volatile oils including alpha-bisabolol, chamazulene; 2.4% flavonoids including apigenin; 5% to 10% pectin-like mucilage; also contains coumarins (umbelliferone, methyl ether heniarin), polysaccharide, anthemic acid, tricontane. Chamazulene, present in chamomile volatile oil, is blue, and is formed from its precursor, matricin, upon steam distillation of the oil.

Crude dried flowers are available to buy in bulk. Chamomile tea is readily available, also aqueous or alcohol extracts and topical ointments. Because of its popular use with children, chamomile is also one of the most available herbs in glycerite form.

• Traditional: anti-inflammatory, diuretic, vulnerary, antimicrobial, mildly sedative, carminative, aromatic, diaphoretic, and digestive tonic; actions, according to the German Commission E monograph, include antipholigistic, musculotropic, antispasmodic, deodorant, antibacterial, bacteriostatic
• Conditions: peptic ulcers, colic, childhood sleeplessness, hemorrhoids, spasmodic cough, excess gas, abrasions of the skin; skin irritation due to chemicals, radiation, fungi, subdermal spasm, infection; for respiratory tract irritation, insomnia, gingivitis or other oral cavity inflammation and pain
• Clinical applications: inflammatory conditions of the skin, gastrointestinal, ano-genital, and respiratory tracts, including colic, ulcers, excess gas, heartburn, irritation from chest colds, slow-healing wounds, abscesses, fistulae, oral cavity/gum inflammation, skin inflammation due to X ray or other radiation (as for cancer patients), psoriasis, eczema, vaginal inflammations, and children's skin conditions such as impetigo, hives, chicken pox, infant acne, heat rash, diaper rash

Whole extract and individual constituents have been studied for topical and internal antispasmodic, anti-inflammatory, and carminative effects. Chamazulene, alpha-bisabolol, and apigenin have the highest anti-inflammatory actions against pro-inflammatory agents used on laboratory rats. Matricin, the precursor of chamazulene, demonstrates anti-inflammatory activity superior to chamazulene. Chamazulene (azulene) has been reported to inhibit histamine release, alpha-bisabolol and cis-spiroether, another component of the volatile oil, blocked carrageenan-induced rat paw edema and demonstrated muscle relaxant actions.

Alpha-bisabolol prevented the formation of indomethacin-, stress-, or alcohol-induced ulcers in laboratory animals.

In vitro tests show that chamomile oil is actively antibacterial and fungicidal at concentrations of at least 25 mg/ml, as is bisabolol at concentrations of at least 1 mg/ml. Whole extracts and isolated flavonoid and bisabolol constituents also inhibit spasm in guinea pig intestine: 10 mg apigenin reduced spasm comparably to 1 mg papaverine. Volatile oil increases bile secretion in cats and dogs.

Human studies demonstrate therapeutic efficiency for European propriety chamomile formulas used in weeping skin disorders, bedsores, contact dermatitis, eczema, and postirradiation dermatitis. Chamomile was also antispasmodic and anti-inflammatory in both human duodenum and stomach; oral extracts promoted deep sleep in 10 out of 12 patients having cardiac catheterization; and topical ointments soothed and enhanced healing in patients using chamomile as adjunctive therapy for skin infections of the leg.

• To relieve spasms or inflammations of the gastrointestinal tract: tea, 2 to 3 g herb steeped in hot water, tid or qid between meals; 1:5 tincture (5 ml tid), glycerite 1 to 2 ml tid for children
• To use as a gargle, prepare tea as above, cool, and gargle
• To use for respiratory tract inflammation, pour a few drops of essential oil into steaming water and inhale; or prepare tea and inhale steam
• For bath, to sooth inflammations of the skin, use 1/4 lb. dried flowers per bath made into a tea by slow cooking; or use essential oils in tub, instructing patient to enter tub only after sufficient water is mixed with oils.
• Douches, for vaginal inflammation, use 3% to 10% infusion
• Poultices for external application to skin inflammation, use 3% to 10% infusion
• For psoriasis, eczema, or dry, flaky skin, use creams with 3% to 10% crude drug content

The American Herbal Products Association (AHPA) gives chamomile a class 1 safety rating: safe with appropriate use. The AHPA also notes that highly concentrated tea is reportedly emetic (flower heads contain anthemic acid).

Persons allergic to members of the aster family (ragweed) may have an allergic reaction to chamomile; two cases of anaphylactic reactions have been reported, and in both cases there was a predetermined allergy to ragweed.

According to the AHPA, in Germany chamomile labels are required to warn against using infusions near the eyes.

Avoid excessive use during pregnancy and lactation.

No clinically significant interactions between German chamomile and conventional medications have been reported in the literature to date, including the German Commission E monograph (Blumenthal 1998). Although apigenin, a component of chamomile, demonstrated anxiolytic effects in mice (Viola et al. 1995), no interactions with benzodiazepines or other anxiolytic medications have been reported. Chamomile also contains coumarins; again, though, interactions with anticoagulants have not been documented (Miller 1998). Patients taking chamomile while on anticoagulant therapy should be monitored closely.

In the United States, German chamomile is a dietary supplement and generally recognized as safe in the food industry; in England, German chamomile is a licensed product; and the Commission E approves of topical and internal use for inflammatory conditions in Germany.

Achterrath-Tuckermann U, et al. Pharmacological investigations with compounds of chamomile. Investigations on the spasmolytic effect of compounds of chamomile and Kamillosan on the isolated guinea pig ileum. Planta Med. 1980;39:38-50.

Blumenthal M, ed. The Complete German Commission E Monographs Therapeutic Guide to Herbal Medicines. Boston: Integrative Medicine Communications; 1998:107.

de la Motte S, Bose-O'Reilly S, Heinisch M, Harrison F. Doppelblind-vergleich zwischen einem apfelpektin/kamillenextrakt-präparat und plazebo bei kindern mit diarrhoe. Arzneimittelforschung. 1997;47:1247-1249.

Duke JA. The Green Pharmacy. Emmaus, Pa: Rodale Press; 1997.

Foster S. Herbal Renaissance: Growing, Using and Understanding Herbs in the Modern World. Salt Lake City, Utah: Gibbs-Smith; 1993.

Glowania HJ, Raulin C, Swoboda M. Effect of chamomile on wound healing—a clinical double-blind study. Z Hautkr. 1987; 62:1262, 1267-1271.

Kowalchik C, Hylton W, eds. Rodale's Illustrated Encyclopedia of Herbs. Emmaus, Pa: Rodale Press; 1998.

McGuffin M, Hobbs C, Upton R, Goldberg A. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, Fla: CRC Press; 1996.

Miller L. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158(20):2200-2211.

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press; 1996.

Salamon I. Chamomile: A medicinal plant. Herb, Spice, and Medicinal Plant Digest. 1992;10:1-4.

Schulz V, Hänsel R, Tyler V. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin: Springer; 1998.

Viola H, Wasowski C, Levi de Stein M, et al. Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Med. 1995;61:213-216.