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Pau d'Arco (Tabebuia impetiginosa, T avellanedae)
Pau d'arco is the Portuguese name for various species of tall, flowering, evergreen trees native to Brazil and other tropical parts of South and Central America. Herbal preparations are derived in particular from the inner bark of a tree also known to native Indians as lapacho and taheebo. Pau d'arco has been used for centuries in South America topically to heal wounds and taken orally to promote overall health and vigor, much as tonics are used in Asia. It was introduced to North American consumers only since the early 1980s but has slowly gained in popularity here and in Europe due to its broad clinical applications, including antibacterial, antiviral, and anti-inflammatory properties.

Traditional uses
Native South American tribes have probably used pau d'arco for its medicinal properties for thousands of years. It is widely respected among traditional healers for its ability to reduce the pain and inflammation of snakebites, insect stings, and infected wounds. The tea or extract is taken as a blood purifier and immune enhancer. It has been used to help prevent or treat malaria, the common cold, flu, fever, and various digestive ailments. It is also a folk remedy for cancer, diabetes, and ulcers.

• arthritis
• peptic ulcer
• chronic fatigue syndrome

Recent findings

• Extracts of the leaves and stem barks of four plants including a Tabebuia species showed "variable but remarkable broad spectrum antimicrobial activity," according to the authors of a 1994 study. Analysis of the plants revealed tannins, flavonoids, alkaloids, quinones, and traces of saponins.
• In a screening of 132 plants used in Argentine folk medicine for antimicrobial activity, pau d'arco was among the dozen plants that produced the more active extracts.

Do scientists know how it works?
The chemical constituent of pau d'arco that has most attracted the attention of researchers is a napthaquinone called lapachol. It was first isolated in the early 1880s and synthesized in 1927. A number of human and animal studies have determined that lapachol and related derivatives found in pau d'arco bark and wood can suppress or shrink tumors in the lungs, breast, colon, and elsewhere. Scientists at the National Cancer Institute in the late 1960s also observed anti-tumor effects from lapachol but dismissed any further inquiry into it or pau d'arco because of the apparent toxicity of lapachol. Proponents of pau d'arco claim that the whole inner bark preparation is less toxic and may still be effective as an anti-cancer remedy. Pau d'arco is also known to contain anthraquinones, flavonoids, beta-sitosterol, and other compounds. The quinones are thought to account for the laxative effect. Pau d'arco's medicinal effects may also be due to an ability to increase cellular oxygen supply, enhance immune function, stimulate the production of red blood cells in bone marrow, and act as an antioxidant.

Types of products
Pau d'arco is available in capsules, tablets, liquid extracts, and teas. It is sometimes combined with other herbs, such as burdock. Pau d'arco is a common ingredient in formulas for:

• heart, immune enhancement, circulation, and antioxidants

Safety
Large doses of the isolated compound lapachol may cause vomiting or inhibit the activity of vitamin K in the body (and thus have an anticoagulant effect that increases bleeding time). Side effects seem to be very minor, on the other hand, with use of the whole herb. Nausea and diarrhea are the most common adverse effects from use of pau d'arco. Even so, pregnant and lactating women should avoid use of pau d'arco.

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