4.1 traditional system of herbal medicine 4.2 ... · main popular system of tm/cam • traditional...
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4.1 Traditional system of herbal medicine4.2 Complementary/ Alternative Medicine
UNIT 4.1
TRADITIONAL SYSTEMS OF
HERBAL MEDICINE
LEARNING OUTCOMESAfter completing this unit, student should be ableto:
1. To give out some examples of medicinalplants/herbs used in today’s healthcare systemsas a form of alternative medicine or healthsupplement
2. To describe how traditional herbs were usedpreviously for disease treatment and healthsupplement
Traditional Medicine
• Defined by WHO - as the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Traditional Medicine • Traditional medicine (also known as indigenous or folk
medicine) comprises knowledge systems that developedover generations within various societies before the era ofmodern medicine.
• In some Asian and African countries, up to 80% of the populationrelies on traditional medicine for their primary health care needs.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Technical Briefing Seminar, WHO Headquarters, September 2004
Traditional and Complementary/Alternative Medicine
Categories of TM/CAMMain Popular System of TM/CAM
• Traditional Chinese Medicine• Indian Ayurveda Medicine• Arabic Unani Medicine• Homeopathy• Chiropractic
Technical Briefing Seminar, WHO Headquarters, September 2004
Categories of TM/CAM
Medication
¾Medicinal plants
¾Mineral materials
¾ Animal materials
Non-medication
¾ Acupuncture¾ Chiropractic¾ Osteopathy¾Manual therapies¾ Qigong, Taiji, Yoga¾ Physical, mental and
spiritual therapies
Traditional and Complementary/Alternative Medicine
q Core disciplines which study traditional medicineinclude herbalism, ethnomedicine, ethnobotany, and medicalanthropology.
q The WHO notes however that "inappropriate use of traditionalmedicines or practices can have negative or dangerous effects"and that "further research is needed to ascertain the efficacy andsafety" of several of the practices and medicinal plants used bytraditional medicine systems.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
It is necessary for pharmacists to know about basic principles of traditional medicine for two reasons:
1- To be in a position to advise patients who may wish to consult an alternative practitioner.
2- Traditional use is a common starting point in the ongoing search for new drugs.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
The Diseases in Traditional Systems are Classified into
I- Minor or Self-Limiting DisordersLike aches, pain, flatulence, diarrhea,wounds and facilitating childbirth, forwhich plant or herb can be obtainedfrom a local market and would be wellknown within the community.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
II- Chronic or Serious Disorders
ØLike cancer and some genetic or metabolic diseasesØPlant remedies will certainly be used but
they may be used as a part of treatment that will also involve practices/techniques/steps.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
THE DOSETraditional Medicine (TM), usually means a lackof specific dose, it is more concerned with Howto take the remedy rather than How much
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Patent medicines produced in China rarelycarry instructions for timing of the doses.An examination of Clinical Handbook ofChinese Prepared Medicines (1989)shows that many of the supplementingformulas are usually suggested to betaken three times daily, as opposed tobeing taken only first thing in the morning.Timing in relation to meals is rarelymentioned.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Traditional Chinese Medicine(TCM)
Chinese medicine is philosophicallybased, and as an holistic therapy theconcept of balance and harmony issupremely important.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Concepts in TCM
Qi, the essential life force:Qi (or Chi) permeates everything. It is
transferable. E. g. digestion extracts qi from food and drink and transfers it to the body. Breathing extracts qi from the air and transfers it to the lungs.
These two forms of qi meet in the blood and form “human qi”
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Qi, the essential life force
It is the quality, quantity and balance of qi that determine human’s state of health.
Food and air affect health, so diet and breathing exercises are very important. These aspects are considered first before herbs are introduced
Yin and Yang
The theory of yin and yang still permeates allaspects of Chinese thought;üYin: negative/passive/dark/female/waterüYang: positive/active/bright/male/fire
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
FIVE ELEMENTS• Associates constituents of the natural world –wood , fire,
earth, metal and water – with other fundamental such as season , emotions, and parts of the body.
• The ancient five elements theory is used by the Chinese when writing prescription. Its associates herbs with natural world include elements, season and parts of the body. In the circular movement, each element give rise to the next such as winter give rise to spring.
• The five angled movement is a controlling one, in which each elements restraints each others.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
THE FIVE INTERNAL ORGAN SYSTEM
CORRESPOND TO THE FIVE ELEMENTS
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Causes of Disease• Bacteria, viruses and chemicals are not
considered to be cause.• If an organ is weak, it may be attacked
and therefore the weakness is the cause and must be rectified.
• It may be a result of an external forces and internal emotional factors
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
DiagnosisTHE FOUR DIAGNOSTICS SKILL 1.Questions / History taking (Chills/fever, Perspiration, Appetite, Pain, Sleep)2.Inspection (Spirit, Color of skin, body shape, movement & posture, tongue examination)3.Listening (listen to patients cough, speech, respiration) & Smelling (abnormal odor emit, excretion and secretion)4.Palpation (pulse examination, pressing the skin, hand, feet, chest, abdomens for pathological change)
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Treatment• The purpose is to rectify harmony, restore qi
and the yin/yang balance. • Health results from a deficiency or excess of
either yin and yang.• Example: “cold” disease, such as cold in
lung, coughs, vomiting are considered to be a deficiency of yang and treatment would be with a warming herb such as ginger.
• A high temperature denotes too much Yang and shivering is the result of excess Yin
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
4 TYPES OF TREATMENTS
1. Bathing and Washing Method (example: herbal foot bath to promote sleep, mouthwash for bleeding gum)
2. Herbal Medicines Therapy (example: herbal remedies to keep skin young -Dried tangerine peel (30g), water melon kernel (50g), peach blossoms (40g), grind into powder mixture, take 3 times a day, 2g each)
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
3. Massage Therapy (massage to promote the facial head & region – can invigorate mental function, refresh mind, treat headache, dizziness, insomnia, facial paralysis.)
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
4. Acupuncture & Moxibustion (to treat insomnia – body points technique)
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
CHINESE HERBS• The Divine Husbandman’s Classic Materia Of Medica
(Sheng Nong Bencaojing, 1st century AD) had listed 252herbal medicine specifying their taste and temperature.
• Today, Chinese herbalist still relates the taste andtemperature of directly to its therapeutics use.
• Sweet tasting herbs such as ginseng are prescribed totone, harmonize, and moisten.
• Bitter tasting herbs such as dan shen are employed todrain and dry excess dampness.
• Hot tasting herbs to treating cold condition and viceversa.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Some Important Herbs in TCM and Their Uses
Latin name English name Nature Medicinal use
Cinnamomum cassia
Chinese cinnamon
Pungent, sweet, very hot, yang
Diarrhoea, tonic, dysmenorrhoea
Ephedra sinica Ephedra Pungent, slightly bitter, warm, yang
Bronchial asthma, hayfever
Panax ginseng Ginseng Sweet, neutral Tonic, aphrodisiac, appetite stimulant
Rheum palmatum
Rhubarb Bitter, cold, yin Constipation, burns, diarrhoea, jaundice
Zingiber officinale
Ginger Pungent, sweet, very hot, yang
Nausea, vomiting, colds, diarrhoea
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Ephedra sinica (Ma Huang)
Rhubarb tree
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Ju hua (Chrysanthemum X morifolium) for relaxing infusion and improve vision.
Galangal (Alpinia officinarum) warming herbs used for abdominal pain.
IMPORTANCE OF CHINESE HERBAL MEDICINE
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
• Chinese Herbal medicine is not just significance in China and the surrounding regions.
• Many Chinese universities teach and research on herbal medicine and this development had revitalized herbalism worldwide during the last 20-30 years.
• Chinese herbal medicine is now practiced by trainer practioners in every continent and even have official recognition in some countries.
• For example , in 1995 French government signed an agreement with the Chinese to establish hospital in Paris, offering acupuncture and traditional Chinese herbal medicine.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
• Ayurveda is a system of sacred Hindu medicine, originating in India. It is the most ancient system of medicine still in use today.
• Ayurveda is considered to be the most ancient of all medical disciplines.
• In Ayurvedic medicine, the patient is viewed as unique, and ‘normality’ as what is appropriate for that particular person.
• This is in contrast to Western medicine, where populations are generalized and ‘normal’ means what is applicable to the majority.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Philosophically, Ayurveda has similarities with traditional Chinese medicine (TCM):
1- Parana, the life energy is equivalent to qi.
2- In TCM, there are two (yin and yang), and in Ayurveda there are three (the tridosha).
3- There are five elements in both, but they are slightly different.
4- Many remedies are common to both systems although the philosophical rationale for their application may be a little different
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Concepts in AyurvedaPrana, the life energy:• Prana is the vital energy, activating both body and
mind.
• Nutrient prana from the air gives energy to the vital prana in the brain, via respiration, and is thus the equivalent of qi in TCM.
• In the body it is seated in the head, and governs emotions, memory and other functions of the mind.
• Prana kindles the bodily fire, governs the functioning of the heart, entering the bloodstream from where it controls the vital organs.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Diagnosis
Taking the case history involves astrological considerations.
Examination, where the appearance of the tongue, properties of the urine, sweat and sputum will also be examined.
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Treatment Treatment may involves:
Diets Bloodletting
Fasting Skin applications
Enemas Yogic breathing
Herbal treatments Minerals
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Examples of Herbs of Ayurveda and Their Uses
Botanical name English name Medical use
Nigella sativa Black cumin Digestive, antiseptic
Ocimumsanctum
Holy basil Expectorant, febrifuge, immunomodulatory, lowers blood pressure
Piper nigrum Black pepper Digestive, respiratory disorders
Whitaniasomnifera
Whitania(Indian Ginseng)
Restore vitality, treat nervous exhaustion
ZingeberOfficinale
Ginger Relieving nausea and indigestion
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Holy Basil
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
Nigella Sativa
Africa Traditional Medicine
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
THE DEVELOPMENT OF AFRICA HERBAL MEDICINE
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
q The therapeutics use of medicinal plants in Africadates back to the earliest time.
q Ancient Egyptian writings confirm that herbalmedicine have been valued in North Africa forthousands years.
q The Ebers papyrus (c. 1500BC), one of the oldestsurviving medical texts, includes gentian (Gentianalutea), Aloe (Aloe vera), opium (PapeverSomniferum) covers condition ranging from chestcomplaints to crocodile bites.
ANCIENT BELIEF & INDIGENOUS HERBS
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
q In more remotes area of Africa, nomadic people such as theBerber of Morocco and the Topnaar of Namibia, have herbaltradition that remain largely unaffected by changes inmedicine in the world at large.
q Healing is linked to a magical world in which spiritualinfluence illness and death.
q In Berber culture, possession by a djinn(spirit) is a majorcause of sickness, and herbs with magical properties aregiven to restore health.
q Topnaar’s people formerly depended completely on theirenvironment for medicine, using the few medicinal plants thatgrow in such harsh and arid condition. Although they arenow greatly influenced by Western way of life, they continueto employ many indigenous plants medicinally.
AFRICA MEDICINAL HERBS
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(
ü Stem of seaweed (Ecklonia maxima) –roasted, mixed with petroleum jelly and rubbed into wound and burns to speed healing
ü Cactus (Hoodia currori) – is stripped its thorns and outer skin and eaten raw to treat cough.
ü Iboga (Tabernathe iboga) – are chewed to combat fatigue.
Examples of Herbs of Africa Medicine and Their Uses
Botanical name English name Medical use
Commiphoramolmol
Myrrh Treat sore throats
Coffee arabica Coffee Headaches, stimulant
Barosmabutulina
Buchu Urinary tract infections
Cola acuminata Kola nut headaches
Cassia senna Senna laxative
Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy
and Phytopharmacy, ( 2004(