Neem - The Ultimate Herb

Published by
Nutraceutic.com, Inc.
Gainesville, Florida

Copyright, 1998, by
Neem Association
1780 Oakhurst Ave.
Winter Park, FL 32789  USA

Reproduction in whole or in part of this booklet without written authorization is prohibited.

The author and publisher do not intend for the information provided in this book to be used for medicinal purposes. It was not intended to take the place of conventional medical treatment. We strongly urge that you seek the best medical resources available to help you make informed decisions.

More than half of all modern drugs -- ranging from aspirin to the newest, most beneficial drug for treating breast cancer -- are based on ingredients from plants. Medical practitioners on the Indian subcontinent have produced a wealth of plant-based medical knowledge that is unequalled in the world. While modern medicine has largely ignored the Ayruvedic medical tradition, recent reviews of the proven efficacy of ancient natural treatments are finally gaining respect both internationally and in the U.S.

Among the thousands of plants used in Ayruveda, one plant in particular is generating intense scrutiny as traditional uses for the remarkable neem tree are verified and expanded. Even as this booklet is being written, new discoveries are being made for preventing and curing human illnesses with neem. Neem is proving to be more than just the "village pharmacy" of ancient India; it is becoming the "ultimate herb" of today and tomorrow.

TABLE OF CONTENTS

ACKNOWLEDGEMENTS                 1
SUMMARY                                         2
INTRODUCTION                                 3
THE HISTORY OF NEEM                 5
NEEM IN AYRUVEDA                         6
CURRENT USES OF NEEM, INDIA 7
Manufactured Products with Neem        8
Major Indian Neem Products                  8
Health and Beauty Aids                         8
Medicines and Pest Control                 9
NEEM AS A MEDICINAL HERB        9
First Aid                                                 11
Infectious Diseases                                 12
Bacterial                                                 12
Viral                                                 13
Fungal                                                 14
Sexually Transmitted Diseases        16
Skin Diseases                                         19
Periodontal Diseases                         22
Heart Disease                                         23
Blood Disorders                                 24
Digestive Disorders                         25
Nervous Disorders                                 26
Parasites                                                 27
General Conditions                                 29
HOW NEEM WORKS ON A BIOCHEMICAL LEVEL         34
IS NEEM SAFE?                                 35
Historical Perspective                         35
Toxicological Perspective                 35
MAJOR ACTIVE CONSTITUENTS 36
Neem Leaves                                         37
Neem Bark                                         38
Neem Oil                                                 39
OBTAINING QUALITY NEEM OIL 39
Methods for Obtaining Neem Oil 39
Improved Methods for Obtaining Neem Oil 40
COMPARISON TO OTHER HERBS 41
NEEM IN EUROPE AND NORTH AMERICA 42
Neem Products Available in Europe 42
Neem Products Available in North America 43
CAUTIONARY STATEMENT 45
NON-MEDICINAL USES OF NEEM 45
Insect Repellent 45
Agricultural Insect Control 46
Agricultural Fungicide 48
Plant Viruses 48
Soil Amendment - Neem Cake 48
BOTANICAL DESCRIPTION AND CULTIVATION 49
OTHER SPECIES OF NEEM 50
A. siamensis 50
A. excelsa 51
GROWING NEEM FOR HOME USE 51
GLOSSARY 53

AUTHOR'S DISCLAIMER 54

BIBLIOGRAPHY 55

I wish to extend my thanks to the following people who contributed to this book.

Doctor H.S. Puri, a world-renowned pharmacognosist specializing in natural preparations used in the traditional Indian systems of medicine, primarily Ayruveda. Dr. Puri earned his Ph.D. degree in botany (pharmacognosy) in 1973 from Punjab University, Chandigarh, India. He subsequently received postdoctoral training at the University of Bath (United Kingdom) and Helsinki (Finland). He was awarded an INSA-Royal Society fellowship to work with Dr. W.C. Evans, the famous author of textbooks on pharmacognosy, at the University of Nottingham, (UK). Dr. Puri is a registered Medical Practitioner of Ayruveda, an honorary member of the National Institute of Medical Herbalists (UK) and a consultant to the American Herb Association.

Dr. Puri provided the traditional treatments and use levels of neem.

Robert Larson, who provided the impetus for introducing neem to the United States.

Vicki Parsons, editor of The Neem Newsletter and organic grower of neem trees in Brandon, Fla.

Marc Ketchel, former president of NeemAura Naturals, maker of many fine neem-based health and beauty aids.

SUMMARY

This booklet presents the most current information about neem, one of the most ancient and widely used herbs on earth. A major herbal ingredient in Ayruvedic preparations, neem has been revered in India for over 4,000 years, yet is almost unknown to the West.

Neem has historically been used to help the body fight both temporary and chronic conditions. However, it is in profound diseases often resistant to traditional treatment, like AIDS, cancer, psoriasis, ulcers and diabetes, that neem can be particularly effective.

This booklet provides easy-to-understand instructions for using neem and credible scientific evidence as to its effectiveness. After finishing this booklet, you will understand and appreciate the amazing qualities found in neem. You will also be able to more intelligently select quality neem products for your own use.

INTRODUCTION

Although neem is one of the most ancient and most widely used herbs on earth, intense scientific investigations of the properties of this amazing plant are only now being undertaken. These studies are quickly verifying the efficacy of its traditional uses -- and finding even more uses for neem. This illustrates again that traditional wisdom can guide the efforts of modern science in discovering remedies for human ailments.

From almost the very beginning of recorded human history, people have taken advantage of the remarkable neem tree. Even before ancient herbalists discovered the analgesic qualities of the willow tree -- from which aspirin is derived -- people used branches, fruit and leaves from the neem to cure many illnesses. Its medicinal qualities are outlined in the earliest Sanskrit writings and its uses in Hindu medicine date back to very remote times. Even today, rural Indians refer to the neem tree as their "village pharmacy" because it cures diseases and disorders ranging from bad teeth and bedbugs to ulcers and malaria.

Modern scientists are finding even more uses for this remarkable tree. The seeds, bark and leaves contain compounds with proven antiseptic, antiviral, antipyretic, anti-inflammatory, anti-ulcer and antifungal uses. Although major studies to conclusively prove neem's effectiveness are limited by financing and the general lack of knowledge in the West about it, preliminary studies suggest exciting uses for neem:

A key advantage to using neem, as opposed to some medical treatments and other herbs, is its compliance with the first tenant of the Hippocratic Oath taken by all physicians: "First, cause no harm." Over thousands of years, neem has been used by hundreds of millions of people and no hazards have been documented at normal dosages. Only at very high levels may neem be toxic to infants and small children, a fact of life that can be true of anything taken internally.

Many of the disorders that neem has proven to be effective in treating include heart disease, diabetes, psoriasis, acne, malaria, herpes, ulcers, Candida and gum disease. These diseases do not always respond to even the most advanced treatments available through modern medicine. Neem offers its users the ability to effectively treat and other seemingly intractable diseases with a safe and time-proven herb.

THE HISTORY OF NEEM

Shortly after Julius Caesar established the Roman Empire, Pliny the Elder issued a public complaint: the ever-increasing volume of medicines imported from India was causing a serious drain on the Roman gold treasury.

By that time, medical practitioners on the Indian subcontinent had been studying and documenting the effects of hundreds of botanical compounds for more than 2,500 years. As early explorers traveled to India to trade for gold, silks and spices, carefully compiled Indian medicines were also brought back to Persia, Mesopotamia, Egypt, Greece and Rome.

The first indication that neem was being used as a medical treatment was about 4,500 years ago. This was the high point of the Indian Harappa culture, one of the great civilizations of the ancient world. Excavations at Harappa and Mohenjo-Daro in northwestern and western India that date to that period found several therapeutic compounds including neem leaves in the ruins.

Although the ancient methods for developing new drugs were crude, in some ways they were remarkably similar to the complex scientific techniques used today. Rather than laboratory studies, however, Indian Vedic medical practitioners moved directly to clinical trials. They tested different drugs on different patients to learn and document successful treatments and potential side effects. Of course, these tests took dozens of scientists hundreds of years to complete. However, they had the luxury of time -- stockholders in pharmaceutical companies weren't rushing to get new products to market and attorneys weren't filing malpractice suits.

Among the most ancient surviving documents that have been translated are the Caraka-Samhita (approximately 500 B.C.) and Susruta Samhita (approximately 300 A.D.). These books are the foundation of the Indian system of natural healing, Ayruveda. In these ancient texts, neem is mentioned in almost 100 entries for treating a wide range of diseases and symptoms, most of which continue to vex humanity. Long revered for its many healing properties, neem came close to providing a cradle-to-grave healthcare program and has been a part of almost every aspect of life in many areas of the Indian subcontinent up to modern times.

The reliance on neem is clear in the Sarira Sthanam, which recommended that newborn infants should be anointed with herbs and oil, laid on a silken sheet and fanned with the branch of a neem tree with ample leaves. As children grew, they were given neem for many illnesses and bathed in neem tea to treat cuts, rashes and the lesions of chicken pox. Daily brushing with neem twigs helped prevent cavities and gum disease. At wedding ceremonies, neem leaves were strewn on the floor of the temple and the air fanned with neem branches. During adulthood, neem bark was burned to make a red ash used for religious decoration of the body and neem branches were waved at the front of religious processions. Neem oil lit the night in small oil lamps. The wood was used to cook daily meals of beans and grains that had been protected from insects by mixing them with powdered neem leaves. Ayruvedic preparations with neem were given for illnesses and neem wood used to make the roof of the house. And at the time of death, neem branches covered the body and neem wood was burned in the funeral pyre.

Neem was so much a part of Indian life that most people were not even conscious of how many ways neem impacted their lives. It has really only been since the dramatic interest in neem by the people of Europe and the United States that Indians have come to realize its significance. A movement to protect the relatively few neem trees in India and the products they provide is growing as the people of India see the possibility that richer Western nations will create a large demand and increase the price of neem products.

To address this potential problem, the Indian government is considering legislation that would ban the export of neem seeds -- now regarded as a national treasure -- and limit foreign sales to seed oil and manufactured products.

An ill body is both physically and mentally draining. To alleviate illnesses, Ayruvedic herbalists have developed a vast store of knowledge and diverse medicinal preparations over the thousands of years that they have been healing their patients. Where the modern system of medicine emphasizes fighting pathogens inside the body, the ancient Indian system of medicine prescribed particular healing herbs that also helped the body develop a strong resistance to disease-causing agents. Neem is considered a major element in preventing and healing diseases among Ayruvedic practitioners.

The Indian subcontinent has a tremendous number of plant materials from a wide variety of climates. There are tropical rain forests, arid plains, hot deserts, temperate valleys and ice-covered mountains. These areas have been scoured continuously for thousands of years by healers from a civilization that is among the oldest on earth. Their vast array of herbal preparations and medicinal herbs provides remedies for almost every human illness or malady (Rao, et al., 1986); (Van der Nat, et al., 1986)

It is the neem tree that provided Indian herbalists with one of nature's greatest natural factories for different healing products. They use the roots, bark, gum, leaves, fruit, seed kernels and seed oil for preparations that heal and prevent disease throughout the human body. More than any other Indian herb, neem has proven to be useful in helping the body resist diseases and restoring the proper balance to the body's systems. The large number of conditions treated with neem are the result of eons of work by Indian herbalists and healers. They have been supported by modern scientific studies which continue to provide evidence of the effectiveness of neem in preventing and treating illness and disease (Siddiqui and Mitra, 1945); (Lavie, et al., 1971).

Centuries of proven effectiveness against many diseases have given neem an esteemed place in the culture of India. Neem still touches the daily life of almost every Indian, from the poorest peasant who snaps off a twig to use as a toothbrush to wealthier individuals who purchase manufactured neem-based toothpastes, soaps and medicines. Therefore, when manufacturers in India applied for government approval of a new neem capsule to be used to treat diabetes, it was granted in under 24 hours. After almost 4,500 years of continuous use, even the Indian equivalent of the Food and Drug Administration apparently believes that "anything from neem has got to be good" (Larson, 1993).

Villagers with easy access to neem trees have developed many innovative uses for neem products. It is a common practice for villagers to wash wounds in water boiled with neem leaves. They put fresh leaves under their mattresses and in stored grain to repel insects. They feed their children neem leaves and oil to treat or prevent a variety of ailments including intestinal worms, malaria, encephalitis and meningitis. A paste made from neem leaves is used to treat scabies, external fungi, smallpox and head lice. Adults eat neem leaves to control diabetes, epilepsy, ulcers, headaches and fevers.

Twigs of the neem tree are used daily in India, Pakistan and Bangladesh by about 600 million people as a natural tooth brush. After chewing on the end of the twig to make bristles, the "brush" is used to clean their teeth with great efficiency. A material in the twig called datun is under study by several major university dental schools who are trying to isolate the active compounds that prevent cavities and gum diseases (Larson, 1993). Neem leaf extracts and neem seed oil also have been shown to be effective at reducing cavities and healing gum diseases such as thrush and periodontia (Zeppenfeldt).

Even in major Indian cities, where modern medicinal products are easily obtained, neem products are popular. Soap made from neem has antibacterial properties and leaves the skin cool and refreshed. Neem shampoo controls dandruff and itchy scalp while keeping the hair looking healthy, shining and easy to manage. Neem toothpastes provide an easy and effective way to take advantage of neem's ability to fight cavities and gum disease without having to hunt down a suitable twig every day.

Skin creams incorporating neem oil can control psoriasis, eczema, acne and other skin problems better than almost any other known product. Face packs and bath salts with neem leaf powder are used to refresh and invigorate the skin after a day in the dry heat of India. A mixture of neem and tulsi powders in corn starch is used as a baby powder and by adults to prevent prickly heat and other skin rashes (Puri, 1993).

Based on the proven ability of neem to prevent fungal infections, topical medicinal powders incorporating neem leaf extracts or powdered neem leaf are common throughout India. There are baby powders, body talcs, foot powders and deodorant powders that are highly regarded for their ability to protect users from the discomfort and suffering that fungal infections can inflict.

MANUFACTURED PRODUCTS WITH NEEM

In India, household products used by most of the population are either made in the home from locally obtained raw ingredients or purchased from small cottage industries employing only a few relatives.

Price rather than quality is the primary competitive strategy for these small companies. For that reason, the raw materials used in their manufacture are often crude and are not inspected for purity. A lack of inspection for sanitation holds true for the manufacturing facilities as well. The equipment is often old, in disrepair and may not be adequately cleaned (Puri, personal communication).

Since there are thousands of manufacturers of these products, brand names also number in the thousands. Although many products share the same name, they are not necessarily made by the same manufacturer. Using a brand name for any standard of quality over time is therefore a problem. Dependence on local and seasonal supplies of raw materials creates another problem. A high-quality product might become a very poor-quality product as the raw materials used in its manufacture changes with the seasons.

MAJOR INDIAN NEEM PRODUCTS

In India, neem is extensively used in medicines and health and beauty aids. There are a few mid-sized Indian manufacturers of products made with neem that have achieved a fair standard of quality. These products can be found in most major Indian metropolitan areas. There are many manufacturers of medicines, health and beauty aids and pest controls that incorporate neem and neem extracts into their products. Only a few of the main types of commercial products containing neem are listed below.

While several American companies import large amounts of neem-based insect control products, there are currently no large multinational corporations manufacturing or marketing neem-based health and beauty aids. This is primarily because health and beauty aids that contain neem are relatively unknown outside Southeast Asia and India. A few of the mid-sized manufacturers approach Western quality standards and have been selected to manufacture products for export. Many of these products are exported to Indian markets and specialty stores in Europe and Canada and a few may be found in the United States. Still, care must be taken in selecting from those products that do make it to Europe and North America. Many are below the quality and purity standards expected in Western markets because they were made by small companies that have little or no oversight for sanitation or safety. The products may be made from crude raw materials and may even contain ingredients no longer acceptable or permissible for cosmetic or health products. Those products that are of high quality can frequently be found in health food stores where they have been selected by discerning store owners.

For neem-based health and beauty aid products to become widely available and acceptable in Europe and North America, more of the products must be made to exacting quality and purity standards. They must use pure raw ingredients, have sanitary manufacturing facilities and must meet the stringent requirements of government inspections.

NEEM AS A MEDICINAL HERB

While the modern system of medicine focuses on fighting pathogens inside the body, the ancient Indian system of medicine, Ayruveda, prescribed particular herbs to help the body develop a strong immunity against the disease-causing agents and regain its internal balance. Some herbs, known as immuno-stimulants increase the body's responses, and neem is one of the most potent immuno-stimulant herbs currently available.

Along with proven antibiotic, antiviral and antifungal properties, neem assists the body in fighting infections on two fronts, strengthening both the antibody and the cell-mediated response to pathogens.

The cell-mediated immune response is the body's first form of defense and neem appears to enhance protection from infection at the cellular level (Upadhyay et al., 1990, 1993a); (Sen et al., 1993). Neem contains compounds that stimulate cell-mediated immunity (Talwar et al., undated). Neem also contains polysaccharides that induce secretions of cytokines, particularly interferon, which can fight intercellular infections.

By strengthening the cellular immune response at its first level of defense, many pathogens can be eliminated before they cause symptoms typically associated with disease. This mechanism also may help in diseases that involve the immune system, like AIDS.

Only when the cell-mediated immune response fails and is unable to stop an infectious onslaught does the more massive immune system become involved (Beardsley, 1992). Neem has high levels of immunomodulatory polysaccharide compounds which appear to increase antibody production and the number of plaque-forming cells in the spleen (Chiaki et al., 1987); (Kores et al., 1993).

Taking neem leaf or bark powder every other day or drinking a mild neem tea will enhance antibody production and the body's cell-mediated immune response, helping to prevent infections. However, never to take neem for more than three weeks without at least a one-week break.)

While neem should be taken internally for diseases of the organs, the immune system, the circulatory system and other problems inside the body, neem can be used topically and supplemented, if necessary, with oral administration, for diseases affecting the skin. However, neem should not be taken internally for more than two weeks. In severe cases, oral administration may be resumed after one week in a continuing cycle, preferably under the direction of a medical professional specializing in natural treatments.

Following are recommendations for specific conditions.

Neem can be used when people have accidents and need a remedy for minor medical problems. With antibacterial, antiviral, antipyretic and anti-inflammatory compounds, neem provides an arsenal of healing properties we can use in these instances (Chopra et al., 1952); (Rao et al., 1969); (Bhargava et al., 1970); (Rao et al., 1986); (Singh and Sastry, 1981); (Khattak et al., 1985).

Cuts/abrasions:

Neem's antiseptic and healing properties make it an excellent first aid for minor cuts and abrasions. Neem has also been shown to be an excellent wound healer (Tanden et al., 1988); (Gogte, 1991). Neem has the ability to increase blood flow and help the body to rapidly create collagen fibers to close to wound (Thakur and Anjaria, 1986).

Neem has been used for centuries to treat problems of the skin and to prevent infection (Singh et al., 1979). Burns are treated very effectively with a neem-based cream spread lightly on the affected area. Neem reduces the pain, kills bacteria that can cause infection and promotes rapid healing with reduced scarring.

Immediately after receiving the burn, apply a neem-based cream to the burn with an ice cube. Continue to apply the cream until the burn has healed completely. Sunburns may also be treated with neem-based creams.

Sprains and bruises may be treated with neem to reduce swelling and pain. Neem as a topical preparation also helps increase blood flow to the bruised area. This helps remove the discoloration and promote healing.

Earache:

Neem acts to relieve the localized pain receptors, reduce inflammation and kill bacteria that can cause earaches (Puri, 1993).

Neem contains compounds similar to aspirin (prostaglandin inhibitors); (Prassad et al., 1993); (Pillai, 1978b) for the relief of pain. Neem also helps reduce blood pressure and open constricted blood vessels, (Thompson and Anderson, 1978) which often are the cause of many headaches, including migraines.

Neem has antipyretic (fever reducing) compounds (Pillai, 1978b); (Okpanyi, 1981); (Khattak et al., 1985) that have traditionally been used to reduce fevers. Studies have shown that nimbidol to be antipyretic while nimbin reduces the secondary rise in fever (Narayan, 1969); (Singh et al., 1987).

To reduce fevers in adults, drink two to four cups of neem leaf tea made with five neem leaves. Since some of the compounds in neem resemble those found in aspirin, oral applications of neem are not recommended at this time by small children.

INFECTIOUS DISEASES

Neem extracts have been found to be antiseptic, (Thaker and Anjaria, 1986) antifungal (Bhowmick and Choudhary, 1982) and antiviral (Rai and Sethi, 1972); (Rao et al., 1969). This combination of healing properties makes neem an extremely effective remedy for infections caused by a variety of pathogens. One gram of neem extracts, particularly the nimbidines, was equal to 800 units of penicillin or .5 grams of streptomycin sulphate (Singh and Sastry, 1981).

Preliminary studies in laboratories have shown that there have been significant effects on several bacteria strains (Rao et al., 1986); (Chopra et al., 1952); (Basak and Chakraborty, 1968). The bacteria staphylococcus aureus that can cause peritonitis, cystitis and meningitis is killed or weakened by small doses of leaf extract (Thaker and Anjaria, 1986). The bacteria m. tuberculosis, b. paratyphosum, streptococcus pyogenes, cornebacterium and E. coli were adversely affected by neem extracts (Chopra et al., 1952); (Thaker and Anjaria, 1986). Another bacteria, salmonella typhosa, that causes typhoid, food poisoning and blood poisoning, is similarly affected in other studies (Patel and Trivedi, 1962). There has been no conclusive explanation for the actions against these bacteria, but research continues to seek the active compounds and mode of action.

Sore throats may be caused by either viral or bacterial infections. Neem has a major advantage over most other treatments in that it affects both types of infection (Murthy and Sirsi, 1958). Neem compounds have been shown to surround viruses and prevent them from causing infection (Rai and Sethi, 1972). Combined with the antibacterial compounds, neem helps heal and soothe sore throats better than almost any other product.

Salmonella bacteria, the major culprit in food poisoning, has been shown to be killed by neem extracts (Patel and Trivedi, 1962). Although prevention is the best way to avoid food poisoning, once it has been ingested, neem is a viable option for reducing the length and severity of the attack.

Neem is one of just a few known antiviral agents. In a study on neem's effectiveness as an antiviral agent, neem seemed to interact with the surface of cells to prevent infection by the virus thereby inhibiting multiplication of the virus (Rai and Sethi, 1972). Similar results have been observed in studies of other viral pathogens indicating a unique property of neem to prevent viral disease (Rao et al., 1969).

Chicken pox is a viral disease that has been traditionally treated with a paste of neem leaves -- usually rubbed directly onto the affected skin (Puri, 1993). Water extracts of neem leaf have reduced pock formation and actually destroy the virus in as little as five minutes after contact (Rao et al., 1969). Neem also alleviates the main problems associated with chicken pox -- the intense itching and scarring.

Tests in Germany show that neem extracts are toxic to the herpes virus and can quickly heal cold sores (Vietmeyer, 1992). By inhibiting replication of the virus few cells are destroyed. This reduces damage to the tissue and the severity of the eruption.

At the first indication of an eruption, a mild neem leaf tea after breakfast and dinner, combined with topical application of a neem-based cream or leaf extract to the affected area, is recommended. Continue both oral and topical applications until the eruption has peaked. Then continue with the only topical applications until the sore has healed.

Believed to be caused by the same virus that causes chicken pox, shingles attack nerve endings, creating a painful burning sensation. Neem's ability to surround viruses and prevent them from entering and infecting cells makes neem one of the only agents capable of relieving shingles (Rao et al., 1969).

Caused by a variety of viruses, colds are better prevented than cured. Neem is very effective at attacking the virus soon after the infection begins (Rai and Sethi, 1972). Neem also has interferon-like activity against the virus that can counter the infection once it sets in (Babbar et al., 1982).

Like the common cold, influenza is caused by viruses. Usually more severe and longer lasting, the flu can lead to pneumonia if proper care is not taken to promote healing. Neem can reduce the severity of the flu by keeping the virus in check and by enhancing the body's immune system.

Drinking neem tea regularly will relieve some of the symptoms and speed recovery. Inhaling steam from boiled neem leaves will help the respiratory system and nasal passages fight secondary bacterial infections.

Strengthening the immune system and keeping fevers inside a manageable range are two methods which neem can help.

Hepatitis can be transmitted through blood or by ingesting contaminated food or water. Studies have indicated that neem extracts can block infection by the virus that causes it (Vietmeyer, 1992).

Neem extracts are some of the most powerful antifungal plant extracts found in Indian pharmacopeia against certain fungi (Khanna and Chandre, 1972); (Bhowmick and Choudhary, 1982); (Chary et al., 1984). In particular, research has shown that the compounds gedunin, quercetin and nimbidol found in the neem leaf control several fungi which attack humans, including those that cause athlete's foot, ringworm, and even control Candida, an organism that causes yeast infections and thrush (Thind and Dahiya, 1977); (Murthy and Sirsi, 1958); (Khan et al., 1991); (Kher and Chaurasia, 1977); (Basak and Chakraborty, 1968).

Neem oil extracts have been compared to standard antifungal agents against fifteen types of fungi pathogenic to plants and animals (Kher and Chaurasia, 1977). One of them, nimbidol, is as effective as salicylic acid against severe skin fungi (Narayan, 1965). Two researchers, basing their study on the ancient tradition of using neem smoke to purify the air around the sick, have found that smoke from burning neem leaves significantly suppressed fungal growth and germination (Upadhyay and Arora, 1975).

Neem seed oil and leaf extracts have been used for centuries to prevent fungal infections in the tropical regions where neem is found. It has been shown to be an excellent antifungal agent for use on skin, hair and nails (Thind and Dahiya, 1977).

Using a neem-based powder will dry the area, kill the fungus and reduce the itching. If the skin is reddened, a neem-based lotion can be substituted.

Neem extracts have been found to be effective against tinea pedia, the fungus that causes athletes foot (Prasad et al., 1993). Fungal infections of this type affect nine out of ten people in the United States at some time during their lives. Untreated, this fungus can attack the toenails and even cause secondary infections throughout the body.

The fungus that causes ringworm is effectively controlled with neem extracts ( Narayan, 1965). In trials, symptoms that had failed to respond to treatment with salicylic acid and benzoic acid cleared up in two to three days after using neem extract on the areas (Singh et al., 1979). Affecting the smooth skin and scalp, these infections are often accompanied by profound itching. This fungus produces circular ring lesions up to six inches in diameter on the skin and can cause loss of hair in patches of the scalp.

Neem oil and leaf extracts have been shown to inhibit the growth of Candida albicans (Talwar et al.); (Vietmeyer, 1992). Candida is a form of yeast that normally lives peacefully within the human body. But when the growth becomes excessive, many physical problems result that neem may be useful in correcting.

Caused by Candida, thrush can cause painful inflammations. Neem promotes healing and reduces the pain and inflammation.

Neem baby powders and neem oil have been an important part of child care in much of south Asia. When simple talc was no longer keeping the baby free of the painful effects of diaper rash, mothers usually turned to neem to correct the problem. With antifungal, antibacterial and skin-healing properties, neem was a good choice for the baby.

SEXUALLY TRANSMITTED DISEASES

Neem has been a traditional treatment for sexually transmitted diseases. Gonorrhea, syphilis and vaginal infections were treated with decoction of neem leaf and topical applications of neem oil. To attack the disease internally, both men and women drank neem tea and pills containing neem oil. Women would douche with a decoction of neem leaves and neem oil. These practices survive even today to supplement the more modern antibiotic treatments.

Studies show that a neem-based cream used as a vaginal lubricant is effective against organisms such as Trichomonas, Candida, and Giardinella vaginalis that cause vaginal infections (Garg et al., undated). Other studies have indicated neem can be effective against the types of bacteria that cause syphilis and gonorrhea (Bhandari, 1959); (Vietmeyer, 1992). Other STDs like chlamydia, vaginal warts, herpes and now AIDS have all been studied for neem's effects on them. While these studies are only preliminary, they show promising results and additional research is underway.

Neem has immuno-stimulating properties for both the cell-mediated and lymphocytic immune systems (Sen et al., 1993). Neem bark and neem leaf extracts significantly reduced the P-24 viral proteins and induced in vitro production of IL-1 interferon (Upadhyay et al., 1993a). The National Institutes of Health report encouraging results from in vitro tests for an AIDS cure using neem leaf and neem bark extracts (Larson, 1993). Another possible effect neem may have on combating the AIDS virus is its apparent ability to enhance the cell-mediated immune response to infection as suggested in studies on birth control (Upadhyay et al., 1990).

Believed to be the first line of defense against HIV infection, (Beardsley, 1992); (Caldwell, 1994) neem's ability to enhance the cell-mediated immune response may provide protection from vaginal contraction of the disease if neem is used as a vaginal lubricant before intercourse. And even if it even only partially successful in preventing the spread of AIDS, until scientists develop a cure, neem could save countless lives.

In cases where HIV has not advanced to full-blown AIDS, some of the patients appear to have the enhanced cell-mediated immune responses (Caldwell, 1994) that neem can help produce. In Africa, prostitutes that have had hundreds or even thousands of exposures to the AIDS virus have not developed AIDS and do not show positive for HIV antibodies. Testing these individuals indicates that they have greater then normal cell-mediated immune responses. Apparently, if the HIV virus is successfully repelled by a strong cell-mediated immune response, the current tests would not show HIV antibodies (Caldwell, 1994). Until an HIV vaccine can be developed, cell-mediated immunity appears to be a key factor in halting the spread of this deadly disease.

Neem creams used as a vaginal lubricant or birth control method also may help control the gonococcus bacteria (Garg et al., undated). Lubricating creams containing at least 25 percent neem oil were used in tests, so lesser percentages may not provide the protection witnessed in clinical trials.

Neem has antispirochaetal properties so that it works as both as a preventative measure and in the treatment of primary, secondary and tertiary stages of syphilis (Siddiqui and Mitra, 1945); (Bhandari and Mukerjii, 1959); (Puri, 1993). Neem's proven ability to enhance the body's immune response could also be responsible for preventing infection aside from any direct action against the disease organisms.

A neem-based cream clears up Chlamydia trichomatous infections in one to three weeks (Garg et al., undated) (Talwar et al., undated). Chlamydia is implicated in many cases where women are unable to conceive due to scarring of the fallopian tubes. Again, neem may be useful in preventing infection if used as vaginal lubricant during intercourse.

Neem has been shown to prevent infection by the herpes virus (Vietmeyer, 1992). This may be due to both neem's antiviral and immune-stimulating compounds.

Neem-based creams have been effective against the human papilloma virus (HPV), a highly contagious sexually transmitted disease that is difficult to treat and can cause cervical cancer and genital warts (Garg et al., undated). There are estimates that 25 percent of sexually active people in the United States are afflicted at any one time and that up to one million people are infected each year. HPV passes from skin to skin contact and not through an exchange of fluids. Condoms and barrier methods of birth control will not prevent an infection by HPV for this reason.

Neem oil and leaf extracts are effective treatments for candidiasis (Talwar et al., undated); (Garg et al., undated).

Neem's antibiotic and antiviral properties can can stop infections of the urinary tract. Neem kills the infecting agent and reduces inflammed tissues.

SKIN DISEASES

According to Ayruveda, skin diseases are caused by the excess of sugary substances in the body. To counteract them, the opposite of sugar -- bitter -- is prescribed (Puri, 1993). Neem is an herb of choice for skin diseases because of its bitter principles and has proven to be highly effective in treating chronic disorders like psoriasis, acne, eczema, itching, dandruff and warts (Ghosh, 1987) (Sharma et al., 1985).

Neem has been used for treating diverse skin problems for thousands of years and is considered to be equal to or even superior to all other herbs in its healing properties (Puri, personal communication). There probably is not one south Asian who has not had some form of skin problem healed with a simple bath in neem leaves or by rubbing leaves and oil on the afflicted area. Neem is part of most skin and hair preparations made in India, Pakistan or Bangladesh. Scientists have seen what neem can do for skin conditions and have verified the marvelous healing properties of neem.

Neem oil is probably the best product currently available for treating psoriasis. It moisturizes and protects the skin while it helps heal the lesions, scaling and irritation. Experiments and reports from patients with psoriasis have shown topical treatment with neem extracts and neem oil to be as effective as coal tar and cortisone in treating psoriasis (Rajaseklbaran et al., 1980).

Compared to "modern" methods of treatment, neem is clearly superior. The usual treatment for psoriasis involves either coal tar or cortisone. Coal tar products are messy, have a strong odor and are carcinogenic. Cortisone is absorbed into the body, can cause side effects and can thin the skin after repeated use. Neem can also take the place of currently prescribed oral medications and injections that may have even stronger side effects than coal tar and cortisone. Many suppress the immune system and cause liver damage or birth defects.

Until recently, there was no real alternative for treating psoriasis except these potentially dangerous products. Neem has no side effects and usually stops the itching and redness very quickly, while improving the condition of the skin for the duration of treatment. Topical applications of neem are easy and inexpensive, and since it is usually oil- or cream-based, neem lubricates the skin. There are no unpleasant smells or stains on clothing, and its antibacterial and antiviral compounds help prevent infections. It also can be used for extended periods of time without side effects, although neem often results in a complete disappearance of the condition in a relatively short time.

The broad range of beneficial effects neem has on skin makes it one of the better treatments for eczema (dermatitis). Though neem oil is preferred because of the concentration of active compounds, topical applications of even the weaker leaf extracts have cured acute eczema (Singh, 1979). Two daily applications of neem extract cured all test cases in ten days with no recurrence for three months. It is possible that the immunostimulatory properties of neem are the underlying factor in neem's skin healing properties (Van der Nat, 1987).

Creams or lotions containing neem oil can be used to prevent wrinkles by providing natural moisturizers to the skin. The same neem compounds that treat psoriasis and eczema also help healthy skin retain its suppleness (Puri, 1993). The skin's improved ability to ward off infection and to repair damage retards the appearance of aging. Wrinkles are often caused when collagen loss results in the loss of elasticity. Neem encourages the formation of collagen and can help skin retain its suppleness. After washing and drying the skin, rub a few drops of neem-based cream on areas that are particularly susceptible to drying and wrinkles.

Neem kills the bacteria that cause acne and reduces the inflammation that makes it so noticeable. Neem-based creams have even improved the appearance of scarred and reddened skin from acne which actually occurred years ago.

To prevent and heal acne, first wash with neem soap, then use a neem face pack to soothe and tighten the skin. Finally, apply a neem-based lotion or cream to moisturize and condition the skin. This regime also will reduce the size and appearance of scars after two months of daily use.

Neem is a natural vegetable oil that is quickly absorbed by the skin without clogging pores. Neem helps maintain a moisture balance in the skin that petroleum-based creams and lotions cannot. For mildly dry skin wash with neem soap, then apply a neem lotion as a moisturizer. For severe dry skin, after washing, apply neem cream and repeat several times daily until the skin has recovered its natural balance.

Patchy, discolored skin is often caused by structural defects in the skin. These can be genetic or the result of advancing age. Neem leaves have traditionally been prescribed internally for such conditions (Nair et al., 1987); (Basu, 1956). Four grams of neem leaves were to be eaten one hour before meals for 90 days while various herbs were placed on the patchy skin. In 30 percent of the cases there was complete relief by the end of the treatment, with 75 percent showing at least some return to normal skin color. If the neem was not taken, herbs placed on the skin produced no change in color.

In several recent conversations with people who have been using neem indicate that age spots also disappear with topical treatment. These people had not been taking leaf internally, but the use of a neem-based cream as a moisturizer was highly effective.

As with other forms of dermatitis, neem is the herb of choice for controlling dandruff. Usually associated with imbalance in hormones, infections or a diet rich in fats and sweets, dandruff can only be controlled, not cured. Internally, neem compounds counteract excessive sweets and seem to provide balance to hormones (Puri, 1993).

Itchy scalps can be caused by any number of conditions, ranging from allergies and dandruff to mites. Washing the scalp with a neem shampoo and applying a small amount of neem lotion to the scalp afterwards can relieve each of these problems.

Treating skin ulcers was a primary use of neem in ancient Ayruveda. Water extract of neem leaves was used to wash the ulcer and purify the skin. Neem killed the infection and promoted rapid healing.

Neem absorbs viruses and prevents them from infecting cells. Since warts are caused by viruses, neem is effective in treating them.

PERIODONTAL DISEASE

Neem has been used in India and all of south Asia for thousands of years as the preferred method for maintaining healthy teeth and gums. The people of India chew a neem twig until the end becomes bristles then brush with the natural "toothbrush" to clean their teeth after meals. The bark and sap within the twig help clean the teeth and protect the mouth from disease (Halde, 1986).

For those not inclined to chew neem twigs, toothpastes and mouthwashes containing neem are now available. Neem toothpastes and mouthwashes prevent cavities, heal gum diseases and rejuvenate the tissues of the mouth, verifying the Ayurvedic practice of prescribing neem for dental care.

Pyorrhea is characterized by an inflammation of the gums and membranes that cover the roots of the teeth. More teeth are lost by people over age 35 because of this disease than any other cause. In a German study, 70 patients with pyorrhea in varying stages showed significant improvement after just 5 to 10 treatments with a neem-based toothpaste and mouthwash. Bleeding gums had healed and the secretion from pockets around the teeth had stopped. The bluish-colored gums returned to a healthy pale pink color ( Zeppenfeldt, undated).

It is believed that neem enhances the immune system in the mouth, kills bacteria and reduces the inflammation of the gums. No matter how it works, neem can be a easy and painless way to avoid severe dental problems.

Gingivitis has been prevented or even reversed with regular use of neem toothpaste and mouthwash (Siddiqui and Mitra, 1945). One person even reported a reversal of the loss of gum tissue by chewing fresh neem leaves. Scientists believe that antibacterial compounds and neem's ability to improve the immune response in the gums and tissues of the mouth account for these results.

Neem extracts have helped millions of people in south Asia avoid cavities despite limited access to modern dental care. Brushing with neem twigs and chewing neem leaves and seeds after each meal has been a traditional practice in this area. With available modern preparations, many people are now using commercial products that contain the same basic neem compounds.

Neem's pain-relieving compounds will temporarily reduce the discomfort of a toothache. The vasodilation and anti-inflammatory compounds will also reduce the pressure on nerves that can cause the toothache.

HEART DISEASE

High blood pressure, blood clots, high cholesterol levels and arrhythmic heart action are major causes of heart attacks. Neem leaf extracts have been shown to act as a diuretic, reduce clotting, lower blood pressure and cholesterol, slow rapid heartbeat and inhibit irregularities of the rhythms of the heart. Occasional use of neem tea or leaves as a spice may help maintain good circulation and regular heart rhythms (Shah et al., 1958); (Thompson and Anderson, 1978); (Pillai and Santhakumari, 1984b).

There are also reports that some compounds can provide effects similar to mild sedatives, thus reducing anxiety and other emotional and physical states that can precipitate a heart attack (Singh, et al., 1987); (Pillai and Santhakumari, 1984b). The effect may similar to that witnessed with other herbal teas, or it may be the psychological result of physiological effects of blood vessel dilation and lower blood pressure.

The antihistamine properties of nimbidin in leaf extracts cause blood vessels to dilate and may be responsible for the way neem reduces blood pressure (Thompson and Anderson, 1978); (Pillai and Santhakumari, 1984b). Another neem leaf extract, sodium nimbidinate, administered to people with congestive cardiac failure was an effective diuretic (Shah et al., 1958).

Neem contains prostaglandin inhibitors similar to those found in aspirin. These compounds can reduce blood clotting which often closes blood vessels and causes heart attacks. Neem can also keep the blood free of toxins and avoid vascular damage caused by infections.

Neem leaf extracts reduced cholesterol levels significantly in recent studies (Chattopadhyay et al., 1992a).

Neem leaf extract has an anti-arrhythmic effect and patients taking neem show a marked decrease in abnormally rapid heart rates (Thompson and Anderson, 1978).

BLOOD DISORDERS

Neem has been a major blood tonic and blood purifier in the systems of medicine found in India and Pakistan (Singh and Singh, 1985). In an analysis of 36 plant drugs attributed with blood- purifying properties, neem was found to have the widest range of beneficial effects (Vohora, 1986). It is believed to remove toxins from the blood and promote a healthy circulation (Chattopadhyay et al., 1992a). Small amounts of neem leaf extracts have been found to protect the liver from damage when toxic agents were used to induce hepatocellular necrosis (Chattopadhyay et al., 1992b). Neem also can oxidize the blood to promote healing (Iwu et al., 1986).

Poor circulation starves the body of needed oxygen and nutrients. Neem leaf extracts can force the blood vessels to dilate (Thompson and Anderson, 1978) allowing increased circulation to the extremities. It also increases oxygen levels in the blood.

Neem is one of the most powerful blood purifiers in the Ayurvedic and Unani systems of medicine (Vohora, 1986). Caused by bacterial infections that have infected the blood, blood poisoning is relieved by neem's antibacterial compounds and by neem's ability to strengthen the body's immune system. (Patel and Trivedi, 1962).

Neem helps the kidneys filter out the body's toxins and fulfill their role as guardians of the blood's purity. When filtering out tremendous amounts of toxins after an illness, the kidneys can become overworked. They can also be adversely affected by high blood pressure and infections in the blood. As a vasodilator and immune enhancer, neem helps the kidneys cope with increased toxins or damage.

DIGESTIVE DISORDERS

Neem is regularly taken to prevent and correct problems with the stomach and bowels. Neem promotes a healthy digestive system by aiding digestion (Halde, and Jsohi, 1986), protecting the stomach, improving elimination and removing toxins and harmful bacteria.

An elderly man in the Bahamas had been suffering with chronic digestive problems for over 20 years. Every time he ate, his stomach would burn and he would feel bloated and somewhat ill. After hearing about neem, he began eating a few leaves from a tree planted during British rule. After just three days of eating the leaves, he was able to eat whatever he pleased without discomfort. He now only eats the leaves occasionally since his problem has all but disappeared.

Neem leaves are often used to treat heartburn and indigestion. They are effective because some neem extracts reduce the concentration of hydrochloric acid in the stomach and increase mucus secretions within the stomach lining. Other compounds with apparent prostaglandin-inhibition capabilities may also play a part in reducing gastric secretions.

Peptic/duodenal ulcers:

Compounds in neem have been proven to have anti-ulcerative effects (Garg et al., 1991); (Pillai et al., 1978a). Oral doses of neem leaf extracts have given significant protection against peptic ulcers, duodenal ulcers and enhanced the healing process of gastric lesions (Garg, G.P. et al., 1993). Studies in India have shown that nimbidin from seed extracts taken orally prevented duodenal lesions and peptic ulcers (Pillai et al., 1978a). Neem seed extracts also showed significant healing effects from this compound for existing lesions. Similar compounds have been found in leaf extracts in lesser concentrations.

Neem extracts reduce the concentration of acid in the stomach (Garg et al., 1991 & 1993) and have antibacterial and anti-inflammatory properties that make them among the best herbal products for treating gastritis.

Neem helps patients avoid hemorrhoids by soothing the bowel and promoting elimination of waste. If hemorrhoids already exist, neem cream or extract of neem bark applied topically to external hemorrhoids is a soothing and lubricating salve that also helps control bleeding. It provides the antibacterial, anti-inflammatory and pain-relieving properties desirable when treating hemorrhoids.

NERVOUS DISORDERS

Nervous disorders are a relatively recent area of treatment with neem. Scientific research shows neem has a mild, dose-dependent central nervous system depressant effect (Pillai and Santhakumari, 1984b). Neem can reduce stress in lab animals and seems to have a depressant effect on the autonomic nervous system (Singh, 1987); (Garg and Bhakuni, 1984).

One component, nimbidin, has a mild suppressive effect on the central nervous system (Pillai and Santhakumari, 1984b). Neem leaf extracts have shown to produce lower activity, respiratory rate and muscle tone passivity as well as dose-dependent hypothermia (Gandhi et al., 1988); (Singh, 1987). The active compounds may be limonoids, because most seem to be able to pass the blood-brain barrier.

Neem leaves may help control epilepsy (Larson, 1993). A Philadelphia doctor has reported that a patient with uncontrollable epilepsy ate neem leaves for 30 days and suffered no serious attacks over the next five months. Some research indicates as much as a 60 percent inhibition of spasms when nimbidin was administered in tests. These results may be due to neem's effects on the central nervous system or its ability to increase blood flow through vasodilation.

To reduce the effects of epilepsy take one neem leaf capsule daily for one month.

Usually associated with antigens, hives may also be caused by nerves. Neem's antihistamine compounds and other compounds that affect the central nervous system treat hives in both situations (Pillai and Santhakumari, 1984b). The leaves have been shown to contain a hypotensive compound that can have a calming effect that may reduce one possible cause of the hives (Garg and Bhakuni, 1984).

PARASITES

Historically, neem has been used to rid the body of all forms of parasites. Scientists have since proved that neem quickly kills external parasites and may kill internal parasites as well (Singh et al., 1979); (Obaseki and Jegede-Fadunsin, 1986); (Rochanakij et al., 1985). There are numerous Ayurvedic preparations and home remedies using neem for this purpose throughout India. In fact, simple water extracts of neem leaves are preferred over more modern treatments for lice and scabies.

Neem extracts have hormone mimics that interfere with the life cycle of parasites, inhibit their ability to feed and prevent the eggs from hatching.

Neem affects Itch mites the same way it affects lice (Larson, 1993). Studies using neem lotions found scabies to be effectively cured in just three days. Previous treatments with benzyl benzoate and sulpha drugs had failed to cure these same patients (Singh et al., 1979).

Neem teas are regularly used throughout the tropics to rid the body of intestinal worms (Bhattari, 1992). There have been conflicting reports as to its effectiveness, but few who use neem for intestinal worms doubt its efficacy.

Chagas disease:

Common to many parts of South America, Chagas disease is called the "American sleeping sickness." Its effects on the body, including the slow loss of energy, mimics the dread disease of Africa. Neem extracts prevent the deadly Chagas disease (Beard, 1989) by preventing the parasite that causes it from surviving in its host, the biting kissing bug.

Malaria affects hundreds of millions of people worldwide and kills over two million people every year. It has even made an occasional appearance in North America due to introduction of new mosquito strains and travelers from malarial regions.

A large number of studies on neem have been done with various results. Some experiments with mice showed no effect while others showed significant protection. The disparity of results is usually attributed to the use of different extracts in different concentrations. However, centuries of use by indigenous peoples who use neem to successfully fight malaria tell the real story. If it hadn't worked well, it would have been discarded as a treatment centuries ago.

One recent experiment showed the neem leaf extract substantially increased the number of red blood cells and their oxidation levels, preventing normal development of the malaria plasmodia (Iwu et al., 1986).

Additionally, an ingredient in neem leaves, called Irodin A, is toxic to resistant strains of malaria, with 100 percent of the plasmodia dead in 72 hours with only a 1:20,000 ratio of active ingredients. (Abatan and Makinde, 1986).

Two other compounds found in neem leaves -- the limonoid gedunin and quercetin, a flavonoid -- are at least as effective as quinine and chloroquine against malaria (Iwu et al., 1986); (Obaseki and Jegede-Fadunsin, 1986); (Rochanakij et al., 1985). Several studies show that neem extracts are effective even against chloroquine-resistant strains of the malaria parasite (Bray et al., 1990).

The antimalarial effects of neem appear to be greater in the body than on a petri dish. This has led some to speculate that stimulation of the immune system is a major factor in neem's effectiveness against malaria. (Obasiki and Jegede-Fadunsin, 1986). Neem also lowers fevers and increases the appetite of patients, thereby strengthening the immune system to suppress the parasite (Abatan and Makinde, 1986).

An outbreak of Japanese encephalitis in India was apparently ended when children were dosed twice a day with crushed neem leaves. These children were being treated with the leaves as a preventive measure so it is not clear if the leaves gave them immunity from the disease or they simply helped repel the mosquitoes (Larson, 1993).

GENERAL CONDITIONS

Neem works against a wide range of diseases and chronic conditions. Most of them have not responded well to medications currently available. Though not a panacea, neem can be a major factor in preventing and treating these problems, some of which have been successfully treated with neem for centuries. Prescription medicines made from neem extracts, approved by the Indian equivalent of the FDA, are used to treat a number of these conditions.

Neem leaf is a traditional herb for treating diabetes (Alam et al., 1989); (Upadhyay, 1984); (Singh and Singh, 1985) and has been scientifically proven effective in both treating and preventing diabetes (Sharma et al., 1983); (Murty et al., 1978); (Chakrabartty and Podder, 1984); (El-Hawary and Kholief, 1990). Drinking a cup of mild neem leaf tea or neem leaf capsules three times per day significantly reduces the need for insulin (Siddiqui and Mitra, 1945); (Shulka and Bhandari, 1973). Oral doses of neem leaf extracts significantly reduced insulin requirements for nonkeytonic, insulin-fast and insulin-sensitive diabetes but the effect is dependent upon the presence of functioning pancreatic beta cells (Pillai and Santhakumari, 1981b); (Luscombe and Taha, 1974); (Murty and Sirsi, 1958).

Neem leaf extracts reduce insulin requirements of diabetics by lowering the blood glucose level. This may be the result of increased glucose use, increased levels of insulin or even the prevention of glucose resorption by the kidney (Dixit et al., 1986). Different studies show insulin requirement reductions of between 20 percent and 60 percent for those who take five grams of dried neem leaf capsules daily (Saraf and Joglekan, 1993, unpublished); (Shulka et al., 1973). There are even anecdotal reports of diabetics chewing a single neem leaf daily who have been able to eliminate insulin injections completely.

Based on the many studies of neem's effects on insulin requirements, the Indian government has approved the sale by pharmaceutical companies of neem tablets for diabetics. (Some of these preparations are really nothing more than powdered neem leaves.)

Phenolic compounds found in neem reduce the inflammation and swelling associated with arthritis (Van der Nat et al., 1991). Neem also helps create a balance in the immune system which directly affects progression of the disease (Kores et al., 1993); (Van der Nat et al., 1987). There have been numerous studies on the ability of neem leaf extracts to reduce the inflammation caused by arthritis (Bhargava et al., 1970) (Okpanyi and Ezeukwa, 1981); (Wali et al., 1993). Other compounds, like nimbidin, which is extracted from the seed with alcohol, also showed significant effects against arthritis (Pillai and Santhakumari, 1981a) as have methanol extracts of the bark (Van der Nat et al., 1991).

These compounds work in a number of ways. Several leaf compounds have been shown to be more potent inhibitors of prostaglandin than aspirin -- without causing gastric ulcers (Prasad et al., 1993). Limonoids in the leaf and seed and anti-inflammatory agents called catechin, known to possess anti-inflammatory properties, may provide additional beneficial effects. Other possible explanations for neem's effectiveness may include an inhibition of the release of mediators of acute inflammation. An antihistaminic effect of nimbidin (underlying its antigastric ulcer activity) has been reported (Pillai and Santhakumari, 1984b). Also, a modification of the immune response appears to reduce the generation of inflammation-producing chemicals (Van der Nat et al., 1987, 1991). In any case, the long history of using neem leaf, bark and seed extracts to relieve inflamed joints is borne out by the recent scientific investigations.

Treatment for arthritis is traditionally a mild neem leaf tea coupled with rubbing a warmed neem-based cream on the stiff or painful areas as needed.

The active constituents in neem leaves have outstanding anti-inflammatory activity, comparable even to the well-known modern drugs phenyl butazone and cortisone (Puri, 1993). They relieve pain by acting on the prostaglandin mechanism and significantly reduce acute paw edema (Shah et al., 1958); (Obaseki et al., 1985). Nimbidin has significant anti-inflammatory activity and reduces swelling (Pillai and Santhakumari, 1984a, 1984b).

Neem extracts have proven effective against both the viral infections and the fungal infections that are suspected of causing chronic fatigue syndrome (Cook, 1978); (Rao et al., 1969); (Thind and Dahiya, 1977). Neem extracts inhibit the growth of Candida albicans, a fungus considered a likely suspect in causing many cases of chronic fatigue (Talwar et al., undated). Neem also works against the herpes group of viruses, one of which is the Epstein-Barr, also a suspect in causing chronic fatigue. Neem's ability to enhance the immune response on a cellular level makes the body more effective in fighting disease-causing agents which can cause fatigue (Kores et al., 1993); (Chaiki et al., 1987); (Upadhyay et al., 1993a).

A compound called sodium nimbinate found in neem leaves has been shown to provide significant relief to inflamed tissue (Bhargava et al., 1970). Other compounds such as nimbin, nimbinin and nimbidol are comparable to cortisone acetate in reducing inflammation (Shankaranarayan, 1978); (Wali et al., 1993); (Tandan et al., 1990). One study showed that 400 mg of leaf and bark extract was equal to 50 mg of aspirin in anti-inflammatory activity (Okpanyi and Ezeukwa, 1981).

Inhibition of prostaglandin synthetase by limonoids (and/or polysaccharides) may reduce perceived pain, and neem leaf and bark extracts have been shown to be a more potent inhibitor of prostaglandin synthetase than acetylsalicylic acid (aspirin) (Pillai, 1978b); (Tandan, et al, 1990). Neem also limits the activity of the central nervous system, which reduces perceived pain.

Neem has a proven ability to prevent pregnancy (Juneja and Williams, 1993); (Sharma, 1959). Years of study in India by some of the world's leading scientists resulted in the development of a neem-based polyherbal vaginal cream that has both spermicidal and anti-microbial action. The cream combines 25 percent neem seed extract with extracts from the soap nut and quinine hydrochloride. Based on the success of these experiments, a neem-based contraceptive cream was developed by a pharmaceutical company in India.

Tests of its effectiveness showed that it compared favorably with the chemical-based foams and gels. It was easier to use, caused no irritation or discomfort, and was therefore used more frequently than foam or gel spermicides. The effect does not appear to be hormonal and it is considered a safe and effective alternative to other methods that use hormones (Prakash et al., 1988); (Mateenuddin et al., 1986); (Talwar et al., unpublished).

The studies leading to the development of these products proved that neem oil killed sperm in the vagina within 30 seconds and remained effective for up to five hours. Most spermicide creams must be reapplied at least every hour (Sinha et al., 1984).

Another important effect of neem oil in the vagina was that it seemed to increase the antigen-presenting ability of the uterine tract. This activation of the local immune cell population has a direct spermicidal effect without apparent side effects. Neem has the added benefit of preventing vaginal and sexually transmitted diseases (Upadhyay et al., 1993a); (Garg et al., 1993); (Lal et al., 1987); (Sinha et al., 1984).

The vaginal creams and suppositories resulting from these studies are quickly becoming the birth control method of choice in India. (Paranjape and Paranjape, 1993); (Garg et al., 1993); (Garg, undated); (Riar et al., 1988, 1993). They are non-irritating and easy to use while almost 100 percent effective (It's important to note that even toxic spermicides are not 100 percent effective.) (Khare et al., 1984); (Lal et al., 1987); (Riar et al., 1988); (Sinha et al., 1984).

Other researchers injected neem oil in uterine horns and found that pregnancy could be blocked for up to six months with one small injection. There were no apparent side effects and normal conception rates returned after the test period (Garg et al., 1993); (Upadhyay et al., 1993b).

Neem was also found to prevent implantation and may even have an abortifacient effect similar to pennyroyal, juniper berries, wild ginger, myrrh or angelica. The effects were seen as many as ten days after fertilization in rats though it was most effective at no more than three days. (Sinha et al., 1984); (Lal et al., 1985).

Neem may become the first truly effective birth control "pill" for men (Riar et al., 1988). Neem leaf tablets ingested for one month produced reversible male antifertility without affecting sperm production or libido.   (Deshpande, 1980) (Sadre, 1984).  In India and the United States, exploratory trials show neem extracts reduced fertility in male monkeys without inhibiting libido or sperm production (Sharma et al., 1987); (Deshpande et al., 1980); (Khar, et al., 1984).

In a test with members of the Indian Army, daily oral doses of neem seed oil reduced the ability of the sperm to migrate toward the egg, thereby preventing pregnancy. The effect took six weeks to become 100 percent effective, it remained effective as long as the oral doses were being taken and was reversed six weeks after the subjects stopped taking the pill. During this time the men experienced no adverse side effects and retained their normal capabilities and desires (Vietmeyer, 1992).

The active principal has yet to be determined. Crude neem oil should not be ingested in any quantity or for long periods. At present neem is not used as a male birth control agent but future investigations may provide the sought for ingredient.

The neem tree has been used successfully for centuries to reduce tumors by herbalists throughout southeast Asia (Vohora, 1986). Researchers in India and Europe discovered that polysaccharides and limonoids found in neem bark, leaves and seed oil reduced tumors and cancers (Fujiwara et al., 1982); (Prassad et al., 1993).

The reduction was not due to a directly toxic effect on the cancer cells. It appears as though cell proliferation was reduced through inhibition of protein and RNA synthesis (Prasad et al., 1993); (Banerji and Nigam, 1983). Neem has also shown to be effective against lymphocytic leukemia (Pettit et al., 1983). Injections of neem extract around tumors showed remarkable reduction in size in just a few weeks.

Neem oil and its isolate nimbidol has shown antitubercular activity in sensitized guinea pigs (Murthy and Sirsi, 1958a). Another isolate, nimbidin, controlled Mycobacterium tuberculosis (Chopra et al., 1952).

Bronchitis is an acute inflammation of the respiratory system that sometimes fails to respond to modern medicines.

Neem treatments for bronchitis are a combination of oral doses of neem leaf/bark tea twice a day and inhalation of neem leaf steam. The steam contains volatile oils and aromatic compounds that, when inhaled, reduce the inflammation and attack the disease agents directly. The oral doses of neem will provide the entire body with fever-reducing and disease-fighting compounds.

Conjunctivitis is a painful and unsightly inflammation of the eye.

Neem inhibits allergic reactions when applied externally or consumed internally (Vohora, 1986). Neem compounds inhibit the stimulus produced by histamine and may be helpful in skin rashes and bronchial allergy.

The usual reason for chronic bad breath is bacteria or infections. Neem toothpastes and mouthwashes contain proven antibacterial and antiviral compounds that can stop bad breath where it originates.

The headaches, stomach upset and general ill feeling of a hangover can be relieved by neem tea. Neem "resets" the blood glucose levels, opens constricted blood vessels, reduces blood pressure and counteracts the body's reaction to the alcohol.

Neem has been shown to have stress-relieving effects on the body and helps build up the immune system damaged by stress (Sen et al., 1993)(Jaiswal, et al, 1994). The central nervous system is slowed and blood pressure reduced by lowering heart rates and opening blood vessels. Neem also counteracts the effects of stress by strengthening the immune system.

Stress is usually the cause of insomnia. Nimbidin, a neem leaf extract, has been shown to help initiate sleep up to 74 percent faster than the control group (Pillai and Santhakumari, 1984b). A warm neem and chamomile tea shortly before bedtime should produce a calming effect conducive to sleep.

Nimbidin has produced up to a 90 percent blockage of the spasmodic effect and some blockage of the hypertensive effects of nicotine (Pillai and Santhakumari, 1984b). Neem's calming action on the nervous system may also reduce the anxiety and desire for nicotine as well as counter the effect nicotine has on the body. Neem extracts offer a method for reducing the effects of nicotine and enable smokers to stifle the addiction.

HOW NEEM WORKS ON THE BIOCHEMICAL LEVEL

Because neem is new to Western scientists, the number of pharmacological studies on neem has been somewhat limited. In those studies that have been made, the general conclusion is that neem not only kills some infectious organisms directly but also boosts the immune response on several levels. This increases the body's ability to fight bacterial, viral and fungicidal infections itself.

This combination is more effective in the long run because chemicals toxic enough to eliminate all microbes often harm healthy body tissue and cause undesirable side effects. An improved immune system can selectively wipe out the invading microbes without adversely affecting other cells.

When invaded by microbes (or anything else the body recognizes as foreign), the immune system releases antibodies that lock onto and neutralize the intruder. Neem not only enhances antibody production but also seems to improve the cell-mediated immune response in which white blood cells are unleashed to kill the invaders.

In this type of immune response, special scavenger cells in the blood called macrophages devour the microbes and present bits of them along with their own surface molecules. It is only after macrophages (or other antigen-presenting cells) present bits of the microbe as antigens that helper T cells recognize the antigens. These helper T cells then release chemical messengers called cytokines that galvanize other cells of the immune system into a counter-attack (Upadhyay et al., 1990).

By enhancing the body's first line of defense, neem helps the immune system more quickly respond to infections that might otherwise gain a strong foothold and would then be more difficult to overcome.

IS NEEM SAFE?

The first proof that neem is safe is its extensive use in India for at least the last 4,000 years by humans and animals. The leaves are eaten by animals as forage (Koul et al., 1990) while the fruit is eaten by both birds and man (Larson, 1993). Seed kernels and leaves are occasionally used as a bitter spice in some of the hotter Indian foods. Mahatma Gandhi regularly ate a chutney with neem leaves for general health (Vietmeyer, 1992). After meals many people eat one or two neem seed kernels to aid digestion and to kill bacteria in the mouth.

Neem products have touched the daily lives of almost every Indian from its earliest prehistoric periods until today. Neem leaves are incorporated into stored grains and beans to keep bugs from eating them during storage. In contract, Western nations typically use synthetic pesticides to protect stored crops.

Neem oil has been used for illness much the way castor oil was used by mothers in America. A teaspoon was given to children for almost every complaint (Sinniah and Baskaran, 1981). (Neem tastes much worse than castor oil so children in India had to be really sick before they dared tell their mothers.) Though studies now show that this may not be a safe practice for infants and very small children, neem oil is still routinely given by mothers for a variety of illnesses.

Bathing with neem leaves in the hot water is another routine practice in India. Whenever there are conditions of the skin, from allergic reactions to severe skin diseases, bathing with neem is the general practice. There has not been a report of any problems with putting neem on the skin, either oil or leaf. In fact, whenever neem is applied topically, it seems to cure just about every dermatological problem. The safety of neem applied outside the body has never been a question. For any skin disease or skin allergy, neem is considered the ultimate cure.

Numerous studies of possible toxicity in the U.S. and other countries have resulted in a determination that leaf and bark are very low in toxicity, especially when taken orally (Saraf and Joglekan, 1993); (Chattopadhyay et al., 1992a); (Khattak et al., 1985); (Sinniah and Baskaran, 1981); (Sinniah et al., 1983); (Pillai and Santhakumari, 1984b); (Bhargava et al., 1970); (Singh et al., 1987).

However, large doses of neem leaves taken internally have caused some side effects in some animals (Sinniah et al., 1983); (Okpanyi and Ezeukwa, 1981); (Ibrahim et al., 1992); (Obaseki et al., 1985). It appears that neem should not be taken in large doses for extended periods of time, which is true of almost any medicinal herb.

Extensive research has been conducted on neem oil extracts for regulatory agencies in several countries, including the United States, and it has been found to be safe in limited dosage for short periods of time (Khare et al., 1984); (Talwar et al., undated); (Sinha et al., 1984). Tests on animals required by the U.S. Environmental Protection Agency showed that alcohol extracts of the seed produced no external irritation in rabbits and no toxic effects on mice when taken internally, even in very large quantities (Larson, 1987). Some people taking neem oil internally experienced nausea and general discomfort (Puri, 1993) which is the case with many oils containing sulphur compounds. Excessive consumption of raw neem oil has been implicated in reduced liver functioning and problems with the central nervous system (Prakash et al., 1991); (Gandhi et al., 1988); (Thompson and Anderson, 1978); (Okpanyi and Ezeukwa, 1981); (Sinniah et al., 1983).

However, the adverse effects of neem oil consumption in small quantities has been disputed by some researchers. They believe contamination with aflatoxin or inadvertent additions of the oil of the chinaberry tree, a related species to neem which is known to be toxic, caused the adverse effects rather than the neem itself (Rochanakij et al., 1985); (Sinniah and Baskaran, 1981). One researcher even showed that small amounts of pure neem oil actually protect the liver from damage (Chattopadhyay et al., 1992b).

Neem oil taken orally or vaginally after intercourse has been found to possess anti-implantation and abortifacient effects. Since the oil is extremely bitter, it is doubtful if anyone would chose to ingest it, but pregnant women or those trying to conceive should never ingest neem oil and should avoid using it intra-vaginally.

There is no definitive answer regarding the toxicity of ingested neem oil, but caution should be exercised whenever taking it internally. Neem oil, though consumed frequently in small doses in India, is not recommended for internal consumption until final toxicology studies are completed using pure neem oil. Past studies have not always used neem oil prepared with the same care given to food oils. In fact, darker oil was shown to be more toxic than lighter oil in recent studies. The darker oil is usually made from older seeds that have been contaminated with fungi, usually producing aflatoxin.

The leaves appear to be safe to consume in small quantities. However, neem has many powerful compounds and should not be categorized with milder herbs. Like any substance, there are those who will be intolerant of neem. Most people living in India have grown up with neem in their foods, as medicine and for hygiene. Some people in India eat tremendous amounts of neem leaves and frequently drink neem oil without any apparent ill effect.

However, for those not familiar with neem, it should be used judiciously until a determination can be made about an individual level of tolerance or intolerance. In any case, whenever any herb or food product produces undesirable effects it should be avoided or the level of use reduced. This holds true for neem as with any other substance.

Figuring out exactly how an herb works and which compound or combination of compounds are making it work is difficult. Herbs may contain hundreds of compounds, some active and others not, and they are usually analyzed for their most active compound. This is done by systematically isolating each compound and determining its structure. This analysis determines the compound's chemical class and can indicates what type of effect it can be expected to have. With complex molecules, this process is very time-consuming, very expensive and often frustrating.

Neem trees have many unique compounds that have been identified and others that are as yet unidentified. The more common and therefore the most analyzed compounds are as follows:

nimbin - anti-inflammatory, antipyretic, antihistamine, anti-arthritic, antiviral, antifungal

nimbidin - antibacterial, anti-ulcer, analgesic, anti-arrhythmic, antifungal, antiviral

nimbidol - antitubercular, antiprotozoan, antipyretic, antifungal

gedunin - vasodilator, antimalaria, antifungal, immune stimulator

sodium nimbinate - diuretic, spermicide, anti-arthritic

quercetin - antiprotozoal, antibacterial, antifungal

salannin - insect repellent

azadirachtin - insect repellent, antifeedant, antihormonal

Chemical Structures

drawings of a few chemical structures

Neem leaves are about 20 percent fibre, 50 percent carbohydrates, 15 percent proteins, 5 percent fat, 8 percent ash, 2 percent calcium and contain essential amino acids (Dakshinmurti, 1954); (Mitra and Misra, 1967). The known amino acid content of the leaf and the percentages are: alanine, 1.2; aspargine, 3.4; aspartic, 2.7; cystine, 3.3, glutamic acid, 3.1; isoleucine, 1.0; phenylaline, 3.2; proline, 2.1; threonine, 2.4; tryptophan, 1.4; taurine, .7; and valine, 2.9. There are reports that neem leaf also contains carotenoids and ascorbic acid (Bhandari and Mukerjii, 1959).

Major concentrations of the active compounds are found in the seed and oil though most are also found in the leaf and bark in lesser amounts. Historically, neem leaves and neem bark have been the primary neem ingredients in the medicinal preparations because of their availability throughout the year and the ease of extracting the compounds.

Most of the bitter active compounds are soluble in alcohol and water. Therefore, tinctures using 50 to 80 percent alcohol capture the majority of the medicinal compounds. Making a tea using hot but not boiling water will quickly capture them as well though excessive heat may damage some of the compounds.

Neem leaves should be gathered only from organic or wild trees. This will ensure the best complement of natural elements and reduce possible contamination by environmental toxins. They should be washed after harvest with pure water and dried in a dust-free environment. Grinding the dried leaves into fine powder will allow a greater surface area for the release of beneficial compounds. The fine neem powder can be used to make tincture, teas or used as a bitter spice on foods.

For external use, the powder can be incorporated into cosmetics, face masks or herbal preparations.

The bark of the neem tree is considered equal to the leaf in healing properties in the Ayurvedic system. It is used in many preparations to improve general health but is generally known for its marvelous powers of preventing and healing gum diseases and other dental problems. The bark is now known to possess large numbers of catechins and powerful immunomodulatory and immuno-stimulating compounds.

The bark has been found to contain 3.43 percent protein, 0.68 percent alkaloids and 4.16 percent minerals. The percentage of amino acid composition of the total protein generally found by the research was arginine - 0.125, aspargine - 0.375, aspartic acid - 0.288, cysteine 0.500, glutamic acid - 0.239, isoleucine - 0.057, methionine - 0.125, norleucine - 0.138, phenylalanine - 0.088, proline - 0.300, threonine - .625, tryptophan - 0.456. Some of the important active compounds reported are; nimbin, nimbinin, nimbidin, nimbosterol, and a margosine bitter principal (Bhandari and Mukerjii, 1959); (Vashi and Patel, 1988).

Some of the research done on the bark extracts has found the following interesting medicinal effects:

Polysaccharides in neem bark extracts have been found to possess antitumor and interferon-inducing qualities as well as an ability to reduce inflammation (Van der Nat et al.,1991)(Fujiwara et al., 1982).

Neem bark contains gallic acid, (+)- gallocatechin, (-) epicatechin (as a 2:1 mixture) (+)- catechin and epigallocatechin. These phenolic compounds in the bark are considered to be the active principals involved in the anti-inflammatory activity (Van der Nat et al., 1991).

Neem bark increased cellular immunity by the stimulation of the lymphocyte function as shown by an increase in MIF, a lymphokine which, in the body, attaches macrophages to monocytes at their sites of action (Van der Nat et al., 1991). The immunostimulatory property of neem bark might by the underlying factor in the general stimulating and skin-healing properties of neem.

NEEM OIL

The neem seed kernel is very rich in fatty acids, often up to 50 percent of the kernel's weight. Neem seed oil is very bitter with a garlic/sulfur smell and contains vitamin E and other essential amino acids (Skellon et al., 1962). Studies of the various components of the oil have found the percentages of the following fatty acids; oleic acid - 56.0, stearic acid - 14.6, palmitic acid - 16.2, linoleic acid - 9.0 and various lower fatty acids - 3.4. The percentages vary from sample to sample depending on place and time of collection of the seeds. The active compounds are numerous and related.

Primary compounds are oxidized to form new compounds which are in turn oxidized to form still others. The age of the seeds and storage conditions can determine the relative concentrations of the active compounds (Lavie et al., 1971); (Siddiqui, and Mitra, 1945).

Neem oil is an excellent moisturizing oil that contains compounds with historical and scientific validity as medicinals. Use of the oil for cosmetics and medicines has been limited by its strongly bitter taste and sulfur/garlic smell. Neem oil has usually been a dark, unpleasant smelling and bitter oil. Only when it was made into soaps was it acceptable use by most people. It is no wonder the leaves have been substituted for the oil to get the benefits of neem.

OBTAINING QUALITY NEEM OIL

To bring the many therapeutic effects of neem oil to all the people who could benefit from them requires a major change in neem oil's quality. From picking the fruit to storing the oil in drums, careful attention to quality is the only way to get the premium oil demanded by Western users.

It is now known that if the neem seed is not dried and stored properly and the oil is not pressed correctly, the oil will be very dark, have a foul odor and may contain dangerous contaminants (Mitra, 1961).

The first thing to consider is the collection of the seeds. Neem is not considered a plantation tree in India so the seeds must be gathered from wild trees growing on the fringes of farms, along hillsides and roadsides, and shade trees planted around homes in rural villages. Collection of the seeds is a seasonal affair that has historically been organized by cooperatives that press the oil from the seeds for soap manufacture.

As the ripe fruit falls to the ground, it is gathered from around the trees. Some of the fruit will have been eaten by birds and the seeds excreted. Other fruit may have been on the ground for weeks, covered with mold or simply rotting. The collected fruit is then carried to a water supply to wash away the fruit covering the seed. After washing, the seeds are set out to dry in the sun. The dry seeds are bagged and sold to village merchants who later sell them to an oil processing facility.

There are three main processes for extracting the oil from the seed kernels with some companies using combinations. The one used since antiquity is the mechanical press method. Neem seed kernels are placed in a tub and either a screw or some form of press is used to squeeze the kernels under pressure until the oil is pressed out and collected.

The second method uses steam and high pressures to extract the oil. The kernels are heated with steam to increase the oil flow, then squeezed under high pressure. Most of the oil is extracted from the kernels but it is dark and smelly with many of the active compounds destroyed by the high temperatures.

The third and newest method is solvent extraction. This method is used by most seed oil processors since almost all of the oil is removed from the kernels. The neem seed kernels are finely ground and placed into a container along with a petroleum solvent, usually hexane (white gasoline). The neem oil is captured by the solvent and is pulled out of the kernels. The solvent/neem oil mixture is then put into a vat where most of the solvent is recovered leaving the neem oil and minute traces of the solvent behind. Sometimes seed cake obtained after mechanical pressing is further extracted using this method. Many of neem oil's active compounds are not soluble in hexane and are left behind in the solvent extraction process.

Once the oil has been extracted, it is usually put into metal drums for storage and shipment. Since neem oil is used primarily for soap manufacture by small manufacturers, there has been no demand for pure or clean neem oil. Therefore, inexpensive second-hand drums are used to store the oil. With used drums, there is the possibility of contaminating the neem oil with dangerous chemicals that could have been previously stored in the drums. Purchasing neem oil in the open marketplace will usually provide the purchaser with a very low quality oil that is potentially contaminated.

The best method for obtaining quality neem oil with a majority of the active compounds intact is using the cold-press technique. Cold-pressing oil is lighter in color and has a milder odor (Ramakrishna and Prassad, 1993). There is also the elimination of any potential residual solvents in the oil that could pose health hazards to the consumer. The downside is that high-quality, cold-pressed neem oil is more expensive to produce than solvent-extracted oil and is much harder to obtain. Few processors are willing to forego the loss of any of the oil that could have been extracted by solvent and have quit using cold presses.

Experiments with the collection, storage and extraction procedures have disclosed that the main reason the oil was typically bad was the very procedures traditionally used. The seeds were often old and rancid before they were even collected. Storing the seeds in the hot, humid Indian summer made them even worse. By the time they were processed, the kernels were black and smelly which resulted in black, smelly oil.

A better method requires the collection of seeds specifically for the manufacture of quality health and beauty aid products. Light green kernels from fresh seeds yield a light oil with only a slight odor and a tolerable bitter taste. To get this high-quality oil, neem fruit has to be picked from the trees rather than gathered off the ground.

The fresh fruit then has to be taken to a facility where it is washed to remove the fruit from the seeds and the clean seeds quickly air-dried. Dried seeds are then de-husked and the kernels cold pressed. The kernels should only be pressed once to obtain "virgin" oil, guaranteeing only the oil is removed leaving the waxy and tar-like substances behind. The light neem oil must then be stored in new drums for shipment to the manufacturing facility. This method produces high-quality neem oil suitable for use in any health and beauty aid product.

COMPARISON TO OTHER HERBS

There are a select few herbs that have been revered for many centuries for their curative powers. Over the ages these herbs have become critical parts of the medical tradition of the cultures that use them. Though separated by vast distances and variations in customs, the people who used these herbs found each to possess almost miraculous powers to prevent and heal illnesses long before they could begin to understand how they worked.

Depending on the plant materials available to the practitioner, the herbs used varied from culture to culture. Each culture's herbalists discovered the properties of plants that they had access to and developed their healing preparations from the available supply. Neem, which is native to southern Asia, has not been a part of any major Western herbal traditions and remains almost unique to Ayruveda.

Neem remains unique to Ayruveda and other tropical cultures in part because the seeds remain viable for a very short period and neem grows only in tropical climates. Wherever temperatures drop below freezing, neem cannot be grown except in greenhouses.

These limitations restrict much of the world from growing neem, and to most Western herbalists, neem is still an unknown quantity.

Despite the tremendous advances that have been made in science and technology, a clear understanding of the mechanisms that enable herbs to provide their curative actions remains elusive. In fact, after thousands of years as a mainstay in Western medicine, scientists still don't know exactly why or how aspirin (originally from willow bark) works. What can be determined is that many herbs provide relief from many ailments -- they're used because the work. A few herbs are particularly effective for a broad range of ailments and seem to stand out above others.

In the United States, chaparral from the southwest, echinacea from the plains states and neem from India are considered to be the most effective herbs from their respective medical heritages. Each seems to impart an ability to ward off diseases, to lessen the severity of existing conditions and to heal those who use them.

COMPARISON OF HERBAL EFFICACIES

Chaparral Echinacea Neem

_______________________________________________________

Antibacterial yes yes yes

Antifungal yes yes yes

Antiseptic yes yes yes

Antiviral yes yes yes

Anti-inflammatory yes yes yes

Antipyretic no no yes

Anticancer yes yes yes

Analgesic yes no yes

Neem is not well known in either Europe or North America. However, in Europe within the last few years there is some familiarity with neem, especially in England since contacts between India and England have been established for centuries. Products containing neem are imported from India regularly for the sizable south Asian populations living there, and are available in many specialty shops. The list of available neem products in England and Canada is almost identical. They include most of the products listed earlier except for the drugs and insect control products. These have not been approved for use by the necessary regulatory agencies. The available products are from the larger manufacturers and are relatively well made.

German researchers were the first Western scientists to discover the efficacy of the many compounds found in neem, starting the worldwide interest in neem. German scientists and herbalists, therefore, are more familiar with neem and some Indian products made with neem are sold there. German researchers have patented a process to extract compounds from neem that are made into high-quality toothpastes by German manufacturers. They are popular for their proven ability to fight cavities and gum disease.

In Canada, like England, there are sizable Indian communities where people are familiar with neem and demand easy access to products containing neem. Specialty shops in Canada import neem soaps, toothpastes, mouthwashes and shampoos from India to satisfy that need. Canadians can find a variety of products containing neem made in India and a few shops carry the German toothpastes.

In the United States, the Indian communities are smaller and more dispersed than in England or Canada. Some products containing neem can be found at isolated specialty shops but the selection is usually limited to bar soaps. For those who want larger selections of neem products, relatives and friends still in India are often asked to send packages from home.

There are few references on neem in books dealing with natural healing, encyclopedias or dictionaries in the United States although stories of the "miracle tree from India" can be found in some newspapers, science magazines and environmental newsletters. For the most part, neem is a new and unknown herb to most people.

Products made with neem that are available in the United States are limited. The following is a list of the most commonly available neem products.

• Tinctures/extracts - Several companies are currently selling tinctures of neem leaves in health food stores and through mail order. This will definitely change as people become more aware of the benefits neem can provide and as businesses try to satisfy the demand.
• Toothpastes - American-manufactured product containing neem extracts and seed oil are only now beginning to make their way to health food stores. Some neem-based toothpastes are being imported into the U.S. from India. German manufacturers also offer a toothpaste using neem bark extracts but few stores carry the product.
• Mouthwash - No companies are currently selling a mouthwash containing neem but one company is planning to release this product soon.
• Soaps (Bar) - One company sells several American-made varieties of handmade, vegetable oil bar soaps in health food stores. There are a few neem-based soaps imported from India which are sold primarily in specialty shops that cater to Indian and Pakistani communities.
• Shampoos - Only one company is currently selling an American-made neem-based shampoo which can be found in many health food stores. A number of other companies are planning to market neem-based shampoos in the near future.
• Creams and lotions - One company sells American-made skin creams and body lotions primarily through health food stores. There are some other products imported from India which can be found in specialty stores.
• Powdered neem leaves - One American company is selling a vegetarian capsule containing certified organic neem leaves. An Indian company is also selling imported capsules which probably contain neem oil and leaf extract. Some health food stores carry crushed neem leaves to be used for tea or spice. Sometimes a species of Murraya is which is known in India as "sweet neem" is confused with neem. These leaves are not bitter in taste but have a mild spicy aroma. They are used to flavor soups and curry. The do not have any of the curative properties of true neem leaves.
• Medicines - There have been no medicines approved by the FDA that have neem extracts or compounds included as an ingredient. Some medicinal preparations containing neem are imported from India for application on skin diseases, as a blood purifier or for diabetes. Some of these may be found in specialty shops.
• Insect repellents - Outdoor sprays sold by two American companies contain neem oil and leaf extracts along with other repellent herbs and oils and are available in health food stores.
• Pet care - There are no neem-based pet care products currently available but several companies are planning to manufacture shampoos, dips and sprays for pets in the near future. These promise an effective, natural and non-toxic alternative for the control of pests like fleas and ticks as well as mange and other skin diseases.
• Insect control - Two American companies have received food crop approval for their azadirachtin-rich products after extensive research and testing. Both products are marketed to commercial growers in large and very expensive gallon containers. For the home gardener, another company sells both quart containers and small individual-use tubes. Other products made from neem oil and extracts are being tested for approval against plant fungi and nematodes.

CAUTIONARY STATEMENT

While neem is generally considered an extremely safe product, caution should be used if it is to be taken internally.

Even after centuries of daily ingestion in India, no danger has been documented. Children in India and Africa eat neem fruit with great enjoyment during its fruiting season. Rats treated with neem oil in laboratory studies actually gained weight instead of showing ill effects. A German study using oil from clean neem seeds showed no toxicity at doses in excess of 5,000 milligrams per kilogram of body weight (Vietmeyer, 1992).

Tests undertaken for the U.S. Environmental Protection Agency before the approval of a commercial neem product, Margosan-O, showed no or limited toxicity to rats, ducks, rabbits and bees. Throughout south Asia, fresh neem leaves and neem seeds that have been through oil presses are used to supplement regular animal feed because of its high protein content. In limited quantities, neem is considered a safe addition to animal feed with the added benefits of few problems with internal parasites in the animals (Chakraborti et al., 1988); (Koul et al., 1990).

However, while consuming large amounts of neem is traditional in Asian and African cultures, caution is still recommended until further research is complete. Its safe use for thousands of years throughout south Asia may be a result of patients carefully following the directions of medical practitioners long familiar with neem.

NON-MEDICINAL USES OF NEEM

Neem extracts are proving to be one of the most effective natural, non-toxic methods of controlling insects on food and ornamental crops. Historically, neem has been used for thousands of years to protect food crops and homes from insect pests. Neem leaves are added to rice and sugarcane fields to increase production and reduce pest populations. The natural protection from fungi, bacteria and viruses that neem provides plants is astounding plant scientists everywhere.

Neem also can protect animals and people from insects. Insect repellents made with neem are being used in many tropical countries and have made their way to the United States recently.

One compound found in neem leaves, seeds and seed oil (salannin) is a more effective insect repellent than the widely used chemical ingredient called DEET® (N,N-diethyl-m-toluamide) currently found in most commercial repellents (Vietmeyer, 1992). Neem has been used since antiquity as an insect repellent for stored grains and in the home against crawling bugs and bed bugs. Neem soap made from neem oil and leaf extracts have long been recognized for its ability to keep biting insects away from bathers who used it.

Neem is a desirable alternative to synthetic insect repellents. Neem oil is a safe, natural vegetable oil used daily for centuries cosmetically to moisturize and soften skin in India. This marvelous skin protectant and moisturizer also repels annoying and dangerous insects. Salannin in the neem oil and leaf extract provides repellency from insects while protecting and moisturizing the skin. Neem oil with salannin will be an alternative to synthetic repellents containing DEET® for the following reasons:

It is in agriculture that we find most of the research on neem being conducted today. After studying over 250 plants that exhibited insecticidal properties, the consensus of world scientists was that neem proved to be the most effective and most environmentally friendly of all. Pesticidal products made from neem are just now attracting attention from the public and can be purchased at agricultural supply houses or ordered through the mail from well-known garden supply manufacturers. Neem promises to provide a truly natural alternative to synthetic insecticides.

In 1990, over 30 million pounds of synthetic insecticides were applied to residential gardens and lawns in the United States. Usually, these insecticides were quick-acting nerve toxins designed to kill any insect, including beneficial insects like bees, on contact. Although they are targeted at insects, these broad-spectrum insecticides can harm any creature that lives in or passes through areas in which they have been sprayed. This includes earthworms, birds, squirrels, dogs, cats and even people. In fact, many manufacturers of insecticides used in the yard recommend waiting three days before walking barefoot on the sprayed areas and keeping pets and children away for at least that long. As a safety precaution in many cities, signs must be posted to warn the public that a hazardous chemical has been applied.

People living as far as a quarter mile away from the insecticide application can be affected by evaporated insecticide and aerosols drifting in the air. In some individuals, this can result in severe reactions like headaches and numbness in the limbs. In others, it can cause less noticeable effects that might never be connected with the true cause of the reaction: toxic insecticides being applied somewhere in the neighborhood.

Applying insecticides is the easiest and most dangerous way to come in contact with them. In south Florida, a man spraying a common yard insecticide went into convulsions and eventually a coma when a wind gust forced the spray back into his face. The nightly news showed a toxic cleanup crew hosing down the area while paramedics in gas masks attended the man laying in his yard.

Had this been a banned product being used by an overzealous individual, it might have been expected. But this was simply a commercial garden insecticide purchased at a local garden supply store; one that was supposed to be safe for anyone to use.

Neem's natural properties pose no danger of toxic reactions. The seeds and leaves of the neem tree are the source of a new class of "soft" pesticides. The term "soft" pesticide is used because no other word quite fits this remarkable product. The main mode of action is as an antifeedant. Insect pests usually refuse to eat any plant covered with neem and do so until they starve to death. Other effects are as a repellent and a reducer of an insect's ability to reproduce.

Elimination of the insect pest occurs not by quick poisoning, but by starvation and drastic reductions in offspring. Birds and beneficial insects, which are not affected by neem, then feed on the remaining weakened pests and the small number of remaining offspring. The result is an almost-immediate halt to plant damage -- without poisoning the environment.

Neem is non-toxic to animals or people. Areas sprayed with neem do not need to be avoided for days as are those sprayed with the typical synthetic insecticides. Neem is also a natural, biodegradable product. Only insects that eat sprayed plants are affected by neem, leaving honeybees, earthworms and other beneficial insects essentially unharmed. In fact, in those areas sprayed with neem, the average size and number of earthworms is greater than in unsprayed areas.

The most active insecticidal compound found in neem is azadirachtin which acts as an antifeedant. Azadirachtin causes insects to refuse to eat plants sprayed with neem. Insects will land and crawl on the plants but will refuse to eat as long as the azadirachtin is on the plant. In early tests of neem extracts, the desert locust, which is known for its voracious appetite, refused to eat any plants sprayed with neem and eventually starved to death surrounded by its favorite food.

As important as azadirachtin is, neem's true effectiveness comes from the interaction of all of the compounds which affect different aspects of an insect's life. Other compounds act as insect repellents, cause insects to lay sterile egg cases, prevent molting, or simply enhance the effects of other compounds.

The number and complexity of the compounds found in neem that affect insects make resistance to neem highly unlikely. This is extremely important as insects are rapidly developing resistance to the major synthetic insecticides. More and more insects are even developing resistance to natural bacterial controls like Bacillus thuringensis (Bt).

Here in the United States, a stable concentrate of azadirachtin was perfected by Robert Larson in 1985 after more than a decade of work. A more concentrated product is now being marketed to commercial growers. These products have at least a one-year shelf life if stored properly. Because the product is so new and the supply limited, the commercial preparations are relatively expensive, about $30.00 per pint. However, the higher price of the neem product should be weighed against the reduced harm to the environment that it represents. Synthetic pesticides are less expensive in the short run, but factoring in their total impact dramatically increases their true long-term cost.

Agricultural fungicide:

Neem provides plants and animals with protection from many types of fungi (Murthy and Sirsi,, 1958); (Bhowmick, 1982). In several tests, spraying neem oil on plants prevented the outbreak of powdery mildew better than popular commercial products. It seems to work best as a preventive rather than a cure once the fungus has become established.

Neem leaf extracts have also been proven effective against one of the world's most dangerous substances: aflatoxin (Bhatnagar and Zeringue, 1993). Produced by the Aspergillus flavus species of mold, aflatoxin is common to grains and nuts (like wheat and peanuts). Only twenty parts per billion are allowed in food products sold in the U.S. due to its highly carcinogenic nature. Neem leaf extracts sprayed on the grain inhibited the mold from producing the aflatoxin, a finding which could help ensure safer foods and a larger food supply.

Plant infections caused by viruses are difficult to prevent or cure. Recently, however, tests by researchers in India and the United States have shown neem extracts can prevent many types of viral infection and reduce the severity of any damage once there is an outbreak (Rai and Sethi, 1972). The effect is probably a combination of neem's pest control properties and its recognized antiviral compounds.

Pests flying from an infected plant can carry viruses to uninfected plants, thereby spreading the disease. Reducing the number of disease-carrying insects can therefore help reduce the spread of the virus. Neem also actively inhibits viral diseases. Just as it does with viruses that attack humans and animals, neem prevents the virus from being able to survive outside an infected cell and may also strengthen a plant's ability to fight the infection.

Crops can be protected from viral diseases in two ways. First, the field the crops are to be planted can be covered with neem cake which is plowed into the soil. This provides long-term and systemic protection for seedlings. Secondly, the plants can be sprayed with neem extracts whenever problems begin to appear. This directly attacks any disease organisms or insects and allows the leaves to quickly absorb the effective compounds.

After the oil has been pressed from the seed kernels, the remaining material is called "neem cake." This material has been used for many centuries throughout India as a soil amendment. Experience has taught farmers there that working the left-over neem cake into the soil of a garden produces larger, healthier plants that have few problems with insect pests.

Several studies were done to find out why plants grew better in soils mixed with neem cake. The studies discovered that neem cake was richer in plant nutrients than manure, killed damaging nematodes, promoted larger populations of earthworms, helped keep nitrogen in the soil available for the plants and provided significant protection from insects. This combination of effects provides an almost ideal growing condition for the plants (Koul et. al., 1990); (Vietmeyer, 1992)

By killing nematodes in the soil, a major plant pest is eliminated. Nematodes suck the juices from the roots of plants to the point where they are unable to supply sufficient nutrients to the plant. The plants look sickly, fail to grow and may eventually die despite sufficient food, water and care. On the other hand, by promoting larger populations of earthworms, neem cake helps keep the soil loose so that water and nutrients can more easily be absorbed by the roots. Earthworms also enrich the soil by creating readily absorbable nutrients as they feed on decaying plant material. Neem cake also reduces the nitrification rate of the soil by suppressing nitrifying bacteria such as nitrosomonas and nitrobacter bacteria. This reduces the need for applications of external nutrients. Some studies have shown that mixing neem cake with regularly scheduled applications of manure can almost double crop yield over manure alone.

By protecting young plants from insect pests, neem cake allows the plants to develop sufficiently to build up their own natural defenses. Neem compounds are also slowly absorbed into the plant to augment these natural defenses with the proven nutritive, antifungal and insect repelling properties of neem.

The neem tree (Azadirachta indica) is a tropical evergreen related to mahogany. Native to east India and Burma, it grows in much of southeast Asia and west Africa. A few trees have recently been planted in the Caribbean and several Central American countries. Outdoors, in locations where temperatures don't drop much below freezing, it may reach up to 50 feet tall. It will grow where rainfall is as little as 18 inches per year and thrives in areas that experience extreme heat of up to 120 degrees F. They are reported to live for up to 200 years.

Its blooms are small, white flowers with a very sweet, jasmine-like scent. Its edible fruit -- loved by children in Africa -- is about 3/4 of an inch long. The fruit, though small, contains a large amount of vitamin C (Brahmachari and Sharma, 1958). Neem fruit is one of the few sources of this important vitamin in many desert areas where neem grows. A neem tree generally begins bearing fruit at three to five years old, and can produce up to 110 pounds of fruit annually when mature.

Since neem is a tropical tree, it must be protected from hard freezes. In northern climates, it may be grown in pots with the same care and appearance of the more-common ficus tree. Neem makes an ideal indoor plant because it grows well with a minimum of maintenance. For optimum growth, neem should be placed near a sunny window during the winter and moved outside during summer months. However, they will survive indoors even if they don't receive any natural light at all.

Neem trees also should be grown in a pot as large as possible or their growth will be stunted to remain proportionate with their root system.

Whether grown indoors or out, neem trees must have well-drained soil. While they survive in soil with low fertility levels, they grow more rapidly when provided with relatively heavy applications of organic fertilizers, such as fish emulsion, bone meal and kelp. If leaves on higher branches begin to turn yellow, the tree has been given too much fertilizer or water, but older leaves will naturally turn yellow as they age.

Although neem trees are evergreen, they often lose their leaves in very dry periods or after a hard frost. Neem trees will quickly revive with regular watering or the onset of warm summer days.

Few pests attack the neem tree and most problems with neem are directly related to over-watering. Several different types of fungal diseases can cause die-back, and slugs that thrive in soggy spaces will eat the bottom leaves of small trees.

Picture - NEEM HOUSEPLANT

There are two other known distinct species of neem. These are Azadirachta siamensis (Syn. A. azadirachta var. siamensis) and Azadirachta excelsa. There are also different ecotypes of each species and crosses between species. For the most part the compounds found in each species of neem tree are the same, though the relative percentages of each compound may vary. However, there are compounds found in each that are unique to the individual species. Further research probably can better define these differences.

In Thailand, the seeds and young leaves of this species, called "sweet" neem, are used as additions to many foods as spices. The A. siamensis compounds are similar to those of the Indian neem but the leaves, which are about twice as large as A. indica, are less bitter. The seeds are also considerably larger and the kernels are an emerald green rather than white. The characteristic garlic-like smell is still there and so is the very bitter taste. However, A. siamensis has a spicy, hot tinge that supplements the taste of the seed.

The medicinal uses of A. siamensis in Thailand are similar to those of A. indica in India. Much of the Indian tradition of medicine has been exported to Thailand and the rest of southeast Asia by merchants and emigrants over the thousands of years that these ancient cultures have been trading with each other. Neem did not attain the religious significance that it did in India and was not a pervasive influence on the daily life of the Thai people. However, it was recognized for the qualities of healing and good health that neem is known for everywhere (Lee, personal communication).

There is one other recognized species of neem that grows in remote areas of Malaysia and the Philippine islands called Azadirachta excelsa. This species grows up to 160 feet tall deep in the mostly inaccessible rainforests. The tree is protected by the government from logging and the distribution of the seeds is strictly controlled. Due to its rarity and location in remote areas, only scientific or conservation use is permitted and few seeds are allowed out of the country. Because of its scarcity, this species of neem is not used extensively for commercial products. It is used in some indigenous medicines for such problems as stomach ulcers, skin problems, malaria and as a general tonic against illness.

As in Thailand, some of the Indian medical traditions were transferred to these areas by travelers over the centuries. Neem became a part of the combined medical culture of the peoples of these countries.

Though the three species of neem trees differ in appearance, the usefulness of the medicinal compounds in each species was recognized and used by healers throughout southeast Asia. As researchers in these countries begin understanding the true possibilities of these trees, greater emphasis is being placed on protecting the available varieties. They are also promoting the establishment of plantations of neem trees to be able to supply the growing demand for the commercial products that can be obtained from them (Lee, personal communication).

Neem seedlings and indoor plants can be obtained from several growers in Florida and California. Neem will have to be grown as an indoor plant in areas where hard freezes occur often. Outdoors, neem trees have to be protected from frosts until they are at least two years old, even in warmer areas. The tree will only get as large as the container will allow, so a minimum ten-gallon container is recommended.

Neem grown at home for personal medical use should be organically cultivated, picked fresh and stored as carefully as possible. The leaves can be dried and stored in a powdered form and used as such or as extracts made from an alcohol tincture.

Neem trees that are pruned regularly for their leaves and twigs will become short and bushy. If pruned in early spring, the number of flowers and fruit produced may be reduced. Therefore, it is recommended that pruning branches or picking large numbers of leaves should be postponed until after the fruit has ripened. Any extra leaves picked during the remainder of the growing season can be dried and stored for use during the winter and early spring.

To obtain the rich neem oil, the fruit should be picked when the fruit starts changing color from light green to pale yellow. The pulpy fruit can then be cleaned and eaten. The fruit can also be made into a paste or jelly by removing it from the seed and boiling it with sugar. The remaining neem seed should then be cleaned thoroughly to remove all traces of fruit and dried.

Next, remove the seed husk by either shelling or crushing the seeds with a rolling pin between two layers of cloth. Finally, put the kernels into a closed container in the refrigerator and throw the husks into the garden.

The kernels can then either by pressed with a strong screw or hydraulic press or macerated with sesame oil for two weeks. The two oils can then be added to a lotion and used as directed in the earlier chapters.

GLOSSARY

analgesic: Pain relief.

antigen: A substance capable of creating an immune response.

anthelminthic: Kills or prevents the growth of parasites and intestinal worms.

anti-inflammatory: Reduces inflammation in tissues.

antipyretic: Fever reducing.

antiseptic: Kills or prevents the growth of bacteria.

antiviral: Kills or prevents the growth of viruses.

arrhythmic: Irregularity of the heartbeat in either force or timing.

Ayurvedic: Natural healing system of India.

catechin: Plant substance with astringent properties.

cornucopia: Indicating something in abundance.

corticosteroid: Hormone important in protein and carbohydrate metabolism.

cystitis: Inflammation of the urinary bladder.

decoction: Extraction obtained by boiling.

epidermal: Outer layer of the skin.

extract: A substance obtained with and contained in a solvent.

flavonoid: Aromatic compound.

histamine: Dilates and increases permeability of blood vessels.

hypertension: Abnormally high blood pressure.

immunomodulatory: Ability to change the immune response.

immunosuppressive: Retard the effects of the natural immune response.

intrauterine: Situated within the uterus.

in vitro: Outside a living body.

in vivo: Inside a living body.

limonoids: a type of bitter, steroid-like compound in neem.

meningitis: Bacterial disease causing inflammation of the membrane around the brain and spinal cord.

peritonitis: Bacterial disease causing inflammation of the membrane lining the abdominal cavity

phenolic: A type of organic compound.

polysaccharides: A complex carbohydrate.

poultice: Heated medicinal material placed over sores and held with a bandage.

prostaglandin: Fatty acid that performs hormone-like actions.

protozoa: Single celled animals which are often parasites to humans.

spermatogenesis: Formation of sperm inside the male.

tincture: Medicinal substance in an alcoholic solution.

vasodilation: Enlargement of the blood vessels to allow greater blood flow.

AUTHOR'S DISCLAIMER

The information contained in this book was prepared for educational purposes only and is not meant to prescribe any treatment for any ailment. If you have a serious or recurring illness, please see a competent natural health practitioner or physician. The statements made in this book, unless specifically referenced, could be the author's opinion, based upon extensive research and personal experience.

In the Indian Ayurvedic tradition, no single herb or preparation is abused. Balance is maintained in the body, the mind and in any measures taken to correct imbalance. It is in that environment that the safety and efficacy of neem have been evaluated.

Neem is an herb with a wide-range of properties that can affect different people in many different ways. It should be used only for short periods of time and only as long as necessary.

Since everyone's body is different and reactions to products can vary from extremely positive to extremely negative, use of any product or even food should be curtailed immediately if any side effects or changes in bodily function appear. This holds true for neem and any other herb or new food.

Test your own tolerance or sensitivity to neem in small incremental steps, first on the skin, then in minute quantities orally. Again, if any signs appear of an intolerance for neem, stop its use immediately.

Neem can help prevent or correct the following: