reference: heinrich, m.; et al: fundamentals of pharmacognosy and phytopharmacy, (2004) traditional...

Reference: Heinrich, M.; et al: Fundamentals of Pharmacognosy and Phytopharmacy, (2004)

Traditional Systems of Traditional Systems of Herbal MedicineHerbal Medicine


DefinitionDefinition

• Medical practice that includes diagnosis, prevention and treatment, relying on practical experience and observations handed down from generation to generation whether verbally or writing.


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.


The Diseases in Traditional Systems are Classified into

I- Minor or Self-Limiting Disorders

Like aches, pain, flatulence, diarrhea, wounds and facilitating childbirth, for which plant or herb can be obtained from a local market and would be well known within the community.


II- Chronic or Serious Disorders

Like cancer and some genetic or metabolic diseases

Plant remedies will certainly be used but they may be used as a part of a ritual and treatment will also involve practices such as divination to find out which gods or ancestors have been offended and what sacrifices may be necessary to appease the supernatural entity.


The Dose

Traditional Medicine (TM), usually means a lack of specific dose, it is more concerned with HowHow to take the remedy rather than How much How much

So, highly potent plants are rarely part of a traditional medicine pharmacopoeias.

e. g. Digitalis purpurea a drug used in treatment of congestive heart failure with narrow therapeutic index of the drug.


Traditional Chinese Medicine(TCM)

Chinese medicine is philosophically based, and as an holistic therapy the concept of balance and harmony is supremely important.


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”


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 YangYin and Yang

The theory of yin and yang still permeates all aspects of Chinese thought

Yin: negative/passive/dark/female/water

Yang: positive/active/bright/male/fire

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Yin and Yang

They are always in balance, where yin becomes weak, yang is strong and vice versa. Both contain the seed of each other: their opposites within themselves.


The Five Elements

The earth is divided into wood, fire, earth metal and water. They dominate everything on earth, and each is associated with a vital organ of the body:

Heart: fire Liver: wood Spleen: earth Lungs: metal Kidneys: water


The Vital Organs

The organs are also considered to be yin and yang and are paired.

Coupled organs are connected by meridiansmeridians, or energy channels, through which qi flows. MeridiansMeridians are not associated with the nervous system and can not be seen physically. They are stimulated with herbs and by acupuncture and will have a direct effect on a particular organ as well as a toning effect on the system.


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


The external factors“Six Excesses”

Wind Cold Summer heat

Dampness Dryness Fire

• Most people, if healthy, not affected by the six excesses but, if the body is deficient in qi or weather conditions are abnormal, then this may cause problems.


The Seven Emotions• These are the major internal causes of diseases, these

are:Joy Anger Anxiety ConcentrationGrief Fear Fright

• Excessive emotional activity causes:1- yin/yang imbalance

2- blockage of qi in the meridians and impairment of vital organ function

3- damage of the organs and allows disease to enter from outside, or a minor weakness from inside to develop.


There are a few other causes which are not emotional or external excesses.

These are the exception not the rule, and include epidemics, insect and animal bites, worm infestation and hereditary diseases.


Diagnosis• Examination of the tongue

• Pulse diagnosis

• Palpitation of internal organs

• Massage

• Interviewing: questions are asked about sleep patterns, stool and urine quality, fever, etc...


Treatment

• The purpose is to rectify harmony, restore qi and the yin/yang balance.

• 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.


Some Important Herbs in TCM and Their Uses

Latin nameEnglish nameNatureMedicinal use

Cinnamomum cassia

Chinese cinnamon

Pungent, sweet, very hot, yang

Diarrhoea, tonic, dysmenorrhoea

Ephedra sinicaEphedraPungent, slightly bitter, warm, yang

Bronchial asthma, hayfever

Panax ginsengGinsengSweet, neutralTonic, aphrodisiac, appetite stimulant

Rheum palmatum

RhubarbBitter, cold, yinConstipation, burns, diarrhoea, jaundice

Zingiber officinale

GingerPungent, sweet, very hot, yang

Nausea, vomiting, colds, diarrhoea


• 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.


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


Concepts in Ayurveda

Prana, 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.


Bhutas, the five elements

The basic elements of cosmic energy are:

• Ether (Space) Air Fire Water Earth

• The five elements are related to the five senses: hearing, touch, vision, taste & smell.

e.g.: Ether is related to hearing, since sound is transmitted through it, and from there to the ear, the associated sense organ, leading to speech, from the organs of action which are the tongue and vocal cords.


TridoshaVata, Pitta & Kapha(the Three Humors)

• The five elements are manifest in the human body as three basic principles or humors known as the Tridosha.

• The three humors (Vata, Pitta, Kapha) govern all biological, psychological and physiopathological functions of the body and mind.

• The primary requirement for diagnosis and treatment of disease is to understand the relationship between the humors.


• When the tridosha works in harmony and functions in a balanced manner, the result is health and a feeling of well-being in the individual. However, in cases of imbalance and disharmony, the result is illness or disease.

• The tridosha is responsible for psychological phenomena, including basic human emotions such as fear, anger and greed, and more complicated sentiments such as understanding, compassion and love, and as such is the foundation of the psychosomatic nature of man.


• The tridosha has recently been redefined as an equilibrium, balance and coordination between the three vital body systems:

Central nervous system (CNS) vata Endocrine system pitta Immune axis kapha

• The tridosha can be considered to govern all metabolic activities:

Catabolism vata Metabolism pitta Anabolism kapha


For example:

• When vata is out of balance, the metabolism will be disturbed, resulting in excess catabolism, which is the breakdown or deterioration process in the body; excess would therefore induce emaciation.

• When anabolism is greater than catabolism (excess kapha), there is an increased rate of growth and repair of organs and tissues.


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.


Treatment

Treatment may involves:

Diets Bloodletting

Fasting Skin applications

Enemas Yogic breathing

Herbal treatments Minerals


Examples of Herbs of Ayurveda and Their Uses

Botanical nameEnglish nameEffect on

doshaMedical use

Nigella sativaBlack cuminPacifies vata and kapha

Digestive, antiseptic

Ocimum sanctum

Holy basilPacifies kapha and vata

Expectorant, febrifuge, immunomodulator

Piper nigrumBlack pepperPacifies vata and pitta

Digestive, respiratory disorders

reference: heinrich, m.; et al: fundamentals of pharmacognosy and phytopharmacy, (2004) traditional...

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