Mother Tinctures in Phytotherapy

Presentation

A mother tincture (MT) is a liquid pharmaceutical preparation obtained by prolonged maceration of a plant — fresh or dried — in a hydroalcoholic mixture whose alcohol content is matched to the nature of the active compounds to be extracted. The term "mother tincture" originates from Hahnemannian homeopathy, where it designates the base preparation from which successive dilutions are made. In phytotherapy, the term is used more broadly for hydroalcoholic plant extracts, also called "officinal tinctures" or "alcoolatures" when prepared from fresh plants.

The history of plant tinctures dates back to antiquity. Greek and Roman physicians already used wine as an extraction solvent for medicinal plants — "medicinal wines" constituted an entire pharmacopoeia. Galen (2nd century) perfected extraction techniques, and his complex preparations (theriac, electuaries) included hydroalcoholic extracts. In the Middle Ages, Arab and European alchemists developed ethyl alcohol distillation, paving the way for high-concentration tinctures. Paracelsus (1493–1541) pioneered systematic use of alcoholic plant tinctures, which he considered the quintessence of herbal remedies.

In France, the French and European Pharmacopoeias strictly regulate mother tincture manufacture. Two main monographs coexist: the French Homeopathic Pharmacopoeia (for MTs intended for homeopathic dilution) and the European Pharmacopoeia (for officinal tinctures used in phytotherapy). Quality criteria cover residual ethanol content, density, dry residue content, marker identification by chromatography, and contaminant limits.

The French mother tincture market is driven by two main channels: homeopathic laboratories (Boiron, Lehning, Weleda) manufacturing MTs compliant with the homeopathic pharmacopoeia, and herbalist shops and phytotherapy laboratories offering officinal tinctures. The distinction between these two preparation types is fundamental as plant/solvent ratios, alcohol degrees, and uses differ significantly.

Fundamental Principles

The mother tincture principle relies on the solvent properties of ethanol and its water mixtures. Pure ethanol (96%) is an excellent solvent for lipophilic compounds — essential oils, resins, waxes, free-base alkaloids, flavonoid aglycones — while water extracts hydrophilic compounds — mucilages, glycosides, mineral salts, organic acids, polysaccharides. A hydroalcoholic mixture extracts compounds of varied polarities, offering a broader extraction spectrum than either solvent alone.

The alcohol degree is the most important preparation parameter. Common degrees include: 45% for tannin-rich plants (witch hazel, red vine), 60% for alkaloid and flavonoid plants (valerian, St. John's wort, passionflower), 70% for resinous plants (myrrh, propolis), 90% for essential oil-rich plants (rosemary, thyme, sage).

The plant-to-solvent ratio defines tincture concentration. Two systems coexist: 1:5 ratio (1 part dried plant to 5 parts solvent) for officinal tinctures, and 1:10 ratio (1 part fresh plant to 10 parts solvent) for homeopathic MTs. The 1:10 homeopathic MT is therefore half as concentrated in plant material as the 1:5 officinal tincture, impacting dosage.

Standard maceration time is 21 days at room temperature (18–25°C), with daily agitation. This duration achieves partition equilibrium for most compounds. After maceration, the mixture is filtered and the residue expressed. Filtrate and expressed liquid are combined to form the final mother tincture.

Preservation of MTs is excellent due to ethanol's antimicrobial activity. Stored in amber glass bottles away from light and heat (< 25°C), MTs have a 5-year shelf life. After opening, they remain stable throughout their validity period.

Technical and Pharmacological Aspects

Pharmacologically, mother tinctures present a specific extraction profile determined by alcohol degree and maceration conditions. The differential solubility of compounds in hydroalcoholic mixtures follows "similia similibus solvuntur" — like dissolves like. Polar compounds are better extracted by low-alcohol mixtures (< 40%), while apolar compounds require high degrees (> 70%).

Ethanol as a penetration vector gives MTs a notable pharmacokinetic advantage. Ethanol facilitates sublingual and gastrointestinal absorption by increasing cell membrane permeability. Comparative pharmacokinetic studies show that hydroalcoholic solutions produce faster plasma peaks and reduced Tmax compared to solid forms. Sublingual absorption, when drops are held under the tongue for 30 seconds, partially bypasses first-pass hepatic metabolism.

HPLC chromatography reveals a characteristic phytochemical profile for each plant. St. John's wort MT shows peaks for hypericin, pseudohypericin, hyperforin, rutin, quercetin, and chlorogenic acid. Valerian MT shows valerenic acid, valepotriates, and sesquiterpenes. Echinacea MT contains alkylamides, chicoric acid, caftaric acid, and polysaccharides.

The homeopathic vs phytotherapeutic MT distinction causes frequent confusion. In homeopathy, the MT is the starting point for successive dilutions and dynamizations. Used undiluted, the homeopathic MT functions as a phytotherapy remedy. However, homeopathic MTs are prepared at 1:10 ratio (fresh plant) with lower alcohol degrees (45–65%), while phytotherapy officinal tinctures use 1:5 ratio (dried plant) with variable alcohol degrees.

Quality analysis methods include actual alcohol content determination by densimetry, dry residue measurement (evaporation at 105°C), marker identification and quantification by HPLC-DAD or HPLC-MS, contaminant screening (heavy metals by AAS, pesticides by GC-MS), microbiological control (unnecessary above 20% alcohol), and botanical identity verification by thin-layer chromatography (TLC).

Indications and Major Mother Tinctures

• Valerian MT (Valeriana officinalis): root, 60% ethanol. Sedative and anxiolytic via GABAergic modulation. Phytotherapy dosage: 50–100 drops (2.5–5 ml) in the evening, 30 min before bedtime. May be combined with passionflower and California poppy MTs for complex insomnia
• St. John's wort MT (Hypericum perforatum): flowering tops, 60% ethanol. Antidepressant via serotonin, norepinephrine, and dopamine reuptake inhibition. Dosage: 50 drops 3 times daily for 6–8 weeks. Caution: photosensitizing, CYP3A4 inducer, numerous drug interactions
• Passionflower MT (Passiflora incarnata): aerial parts, 60% ethanol. Anxiolytic and sedative via GABA-A receptor action (chrysin, benzoflavone). Dosage: 30–50 drops 2–3 times daily. Particularly indicated for anxiety with somatic component (palpitations, chest tightness)
• Hawthorn MT (Crataegus monogyna): flowering tops and fruit, 45% ethanol. Cardiotonic, bradycardic, mild hypotensive. Mechanism: phosphodiesterase III inhibition (positive inotropic effect), anti-arrhythmic activity. Dosage: 30–50 drops 3 times daily. Prolonged use (3–6 months) for cardiovascular results
• Echinacea MT (Echinacea purpurea): whole flowering plant, 65% ethanol. Immunostimulant via macrophage and NK cell activation. Dosage: 50 drops 3 times daily from first infection signs, maximum 10 days. Contraindicated in autoimmune diseases
• Milk thistle MT (Silybum marianum): fruit (achene), 70% ethanol. Hepatoprotective (silymarin: silybin, silychristin). Dosage: 30–50 drops 3 times daily before meals
• Devil's claw MT (Harpagophytum procumbens): secondary root (tuber), 60% ethanol. Anti-inflammatory and analgesic (harpagosides). Dosage: 50 drops 3 times daily during inflammatory flares. Contraindicated in gastroduodenal ulcer
• Chasteberry MT (Vitex agnus-castus): fruit, 70% ethanol. Progesterone-mimetic via dopaminergic action on pituitary (prolactin inhibition). Dosage: 30 drops in the morning during second half of cycle, 3–6 months. Indicated for PMS and cycle disorders

Prescription Process

Mother tincture prescription in phytotherapy follows a structured methodology. After the clinical interview and examination, the practitioner prepares a personalized prescription that may include individual MTs or a complementary MT blend. The prescription specifies for each MT: Latin plant name, part used, number of drops per dose, number of daily doses, timing, treatment duration, and precautions.

MT blends are common and allow synergistic action. The practitioner composes 2–5 MT blends in a single bottle, respecting alcohol degree compatibility (avoid mixing 45% with 90% MTs — precipitation risk). Example blend for anxious-digestive syndrome: Lemon balm MT 40 ml + Passionflower MT 30 ml + Hawthorn MT 20 ml + Chamomile MT 10 ml = 100 ml. Dosage: 50 drops 3 times daily in water, 15 min before meals.

Administration is oral, diluted in water (50–100 ml) or directly sublingual for low doses. The alcoholic and often bitter taste can hinder compliance, especially in children. Palatability strategies include: fruit juice dilution, honey addition (adults), using neutral tablets soaked with MT (children). For recovering alcoholics or patients refusing ethanol, MTs are contraindicated and should be replaced with alcohol-free forms (EPS, dry extracts, infusions).

Drop-based dosing is standard for MTs. One milliliter corresponds to approximately 20 drops (varies with viscosity). Standard adult dosage is 25–50 drops (1.25–2.5 ml) per dose, 2–3 times daily, yielding 50–150 drops (2.5–7.5 ml) daily. The corresponding ethanol intake is 1.5–4.5 ml pure ethanol per day (for 60% MT), which is pharmacologically negligible.

Therapeutic follow-up includes reassessment at 2–3 weeks for acute conditions and 4–6 weeks for chronic ones. Treatment typically lasts 1–3 months for chronic conditions with one-week therapeutic windows every 3–4 weeks.

Variants and Derived Forms

• Alcoolatures: historic term for tinctures prepared exclusively from fresh plants. The cellular sap dilutes the solvent, modifying the final alcohol degree. Considered more faithful to the living plant's totum but less stable than dried plant tinctures
• Concentrated officinal tinctures (fluid extracts): prepared at 1:1 ratio (1 g plant = 1 ml extract) by percolation or re-maceration. More concentrated than standard MTs, requiring reduced dosages
• Vinous tinctures (medicinal wines): extraction by wine maceration (10–12% alcohol). Historical galenical form, nearly abandoned in pharmacy. Gentian wine and cinchona wine are commercial survivals
• Glycerin tinctures (glycerin macerates): glycerin as partial or total ethanol substitute. Alcohol-free form suitable for children and ethanol-intolerant patients. More limited extraction spectrum
• Cider vinegar tinctures (vinegarats): maceration in cider vinegar (5–8% acetic acid). Traditional form for mineral-rich plants (nettle, horsetail). Acidity promotes mineral salt solubilization. Four Thieves Vinegar: historic antiseptic preparation
• Spagyric preparations: alchemical process combining hydroalcoholic maceration, volatile compound distillation, plant residue calcination (mineral ash), and reunification of three fractions. Practiced mainly in Switzerland and Germany

Contraindications and Precautions

• Ethanol content: MTs contain 45–90% ethanol, formally contraindicating them in alcohol-dependent patients (current or abstinent), patients on disulfiram or metronidazole (disulfiram-like effect), patients with alcoholic liver disease, and children under 12 (unless specially adapted dosing). For pregnant women, daily ethanol intake should be evaluated — at standard therapeutic doses, intake is below 1 g ethanol per dose, considered negligible by most authors, but the precautionary principle applies
• Drug interactions: concentrated MTs can reach systemic concentrations sufficient for interactions. Same precautions as other galenical forms: St. John's wort MT and CYP inducers, ginkgo MT and anticoagulants, licorice MT and antihypertensives. Ethanol may potentiate benzodiazepines, sedative antihistamines, and opioids
• Gastritis and gastroduodenal ulcer: high-concentration ethanol irritates gastric mucosa. High-degree MTs (> 70%) should be diluted in at least 100 ml water and preferably taken with or after meals in at-risk patients
• Driving: at standard therapeutic doses (maximum 150 drops/day), ethanol intake is very low (< 5 ml pure ethanol/day) and does not significantly affect blood alcohol. However, sedative MT effects (valerian, passionflower) may impair vigilance
• Allergies: allergic reactions may relate to the plant itself (Asteraceae, Apiaceae allergies) or exceptionally to ethanol (ethanol intolerance, aldehyde dehydrogenase deficiency)
• Scheduled surgery: discontinue anticoagulant or antiplatelet MTs 10–14 days before surgery. Report sedative MT use to the anesthetist
• Photosensitization: St. John's wort MT is photosensitizing (hypericin). Avoid prolonged sun exposure or artificial UV during treatment