Horse chestnut is an astringent, anti-inflammatory herb that helps to tone the vein walls which, when slack or distended, may become varicose, haemorrhoidal or otherwise problematic[254]. The plant also reduces fluid retention by increasing the permeability of the capillaries and allowing the re-absorption of excess fluid back into the circulatory system[254]. This plant is potentially toxic if ingested and should not be used internally without professional supervision[254]. Alterative, analgesic, haemostatic and vulnerary[165, 218]. The bark is anti-inflammatory, astringent, diuretic, febrifuge, narcotic, tonic and vasoconstrictive[4, 7, 222]. It is harvested in the spring and dried for later use[4]. The plant is taken in small doses internally for the treatment of a wide range of venous diseases, including hardening of the arteries, varicose veins, phlebitis, leg ulcers, haemorrhoids and frostbite[238, 254]. It is also made into a lotion or gel for external application[254]. A tea made from the bark is used in the treatment of malaria and dysentery, externally in the treatment of lupus and skin ulcers[4, 222]. A tea made from the leaves is tonic and is used in the treatment of fevers and whooping cough[222, 240, 254]. The pericarp is peripherally vasoconstrictive[7]. The seeds are decongestant, expectorant and tonic[7, 21]. They have been used in the treatment of rheumatism, neuralgia and haemorrhoids[4]. They are said to be narcotic and that 10 grains of the nut are equal to 3 grains of opium[213]. An oil extracted from the seeds has been used externally as a treatment for rheumatism[254]. A compound of the powdered roots is analgesic and has been used to treat chest pains[257]. The buds are used in Bach flower remedies - the keywords for prescribing it are 'Failure to learn by experience', 'Lack of observation in the lessons of life' and hence 'The need of repetition'[209]. The flowers are used in Bach flower remedies - the keywords for prescribing it are 'Persistent unwanted thoughts' and 'Mental arguments and conversations'[209]. The German Commission E Monographs, a therapeutic guide to herbal medicine, approve Aesculus hippocastanum for chronic venous insufficiency in the legs (see [302] for critics of commission E)