Preparations of garlic have a wide variety of beneficial effects in laboratory disease models, and some of these benefits have been demonstrated in laboratory animals. Extracts of garlic have antimicrobial properties, inhibit liver cell synthesis of cholesterol, inhibit enzymes that affect blood pressure (angiotensin converting enzyme) and act to reduce the activity of the blood clotting cascade. Given these effects one would predict that garlic would have readily proven benefits in the treatment of human cardiovascular disease. Unfortunately clinical trials to confirm this have been of disappointing quality and although the studies indicate the possibility of benefits, these are far from proven. A central difficulty in extrapolating the laboratory data to humans is the bioavailability of the beneficial constituents – not all of the active ingredients of garlic are water soluble or readily digestible. Overall the benefits of garlic on cardiovascular disease remain unproven, although the evidence is sufficient to allow active promotion of their benefits without the risk of unwelcome legal attention. For those taking conventional blood thinning agents (warfarin) garlic may enhance the efficacy of the medication leading to undesirable bleeding. Historically garlic has been used as a carminative and, again, there are low grade studies suggesting the plant may be some value. GR Foster November 2018

Medicinal uses: uses supported by clinical data. As an adjuvant to dietetic management in the treatment of hyperlipidae-mia, and in the prevention of atherosclerotic (age-dependent) vascular changes (5, 27–31). The drug may be useful in the treatment of mild hypertension (11, 28). Uses described in pharmacopoeias and in traditional systems of medicine. The treatment of respiratory and urinary tract infections, ringworm and rheumatic conditions (1, 4, 7, 9, 11). The herb has been used as a carminative in the treatment of dyspepsia (32). Uses described in folk medicine, not supported by experimental or clinical data. As an aphrodisiac, antipyretic, diuretic, emmenagogue, expectorant, and sedative, to treat asthma and bronchitis, and to promote hair growth (6, 9, 13). Contraindications Bulbus Allii Sativi is contraindicated in patients with a known allergy to the drug. The level of safety for Bulbus Allii Sativi is reflected by its worldwide use as a seasoning in food.