ACKNOWLEDGMENT - healthpromo.doh.gov.ph · What are the five criteria in selectingplants to be promoted 3 as herbal ... variety of medicinal plants that are now being used ... medicinal

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III

Manual for VolunteerHealth Workers

Module'6

Herbal Medicines PreparationH26.47 •

'M31e :

MilZD04----

Unified GTZ Support to the Philippine Health Sector §)2nd Floor, Building 3, Department of Health ~

Rizal Avenue, Sta. Cruz, Manila ~~

Tel 7320121, c-mail-gtzreprorgidoh.gov.ph '

Department of Health German Technical Cooperation

© 2002 DOH- Unified German Support to the Philippines HealthSector. Any part of this document may be reproduced or adaptedto meet local needs without prior permission from DOH- UnifiedGerman Support to the Philippines Health Sector provided DOHUnified German Support to the Philippines Health Sector isacknowledged. Please send a copy of all adaptations from thismanual to:

DOH- Unified German Support to the Philippines Health Sector2nd Floor, Building 3, Department of Health.

Rizal Avenue; Sta. Cruz, Manila.

This Trainee's Manual was made possible through the assistance ofthe German government (PN: 2001.2086.5) and the Departmentof Health

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Project Management and Staff

ACKNOWLEDGMENT

01108,~~6_,~M~~ M~ ~04 '-.Man~~~volu~~rhe~h ,,:,~rke~-,

Principal Advisor, German Support to thePhilippine Health Sector/Program ManagerAdvisor, FP/RH ComponentAdvisor, Pharmaceutical ComponentFormer Projeci Officer for Luzon, FAMUS,Pharmacist, Main Warehouse, QuezonProvince, FAMUS

\\\111111\\1\1111111\\\11111

Dr. Christian JahnMs. Fe RemotigueMs. Ma. Victoria LiwanagMs. Leonila M. Reserva

Dr. Claude Bodart

The development of the Family and Reproductive Health TrainingCurriculum is an ongoing process and the result of collaboration amongmany individuals. Dr. Gerardito F. Cruz, FP/RH Specialist, started thedevelopment process of this curriculum with the DOH-GTZ FAMUSProject and carried on to the DOH-Unified German Support to thePhilippine Health Sector..

With the help of colleagues at DOH-GTZ, the NationalPharmaceutical Foundation, the staff of the DOH Health Human ResourceDevelopment Bureau, the Center for Family and Environmental Health,and NGO partners, this curriculum, especially tQe FHlRH and SocialFranchise/New Systems modules, has been improved, expanded, andupdated to its present form. Thanks are due' colleagues who havereviewed these modules, rewritten some sections, and provided invaluablecomments and suggestions. These reviewers include the following:

The entire comprehensive training curriculum was developed andwill be used mainly to train the \lolunteer Health Workers at the "HealthPlus" Social Franchise Outlet in 2002 onwards under the DOl-l-GermenSupport to the Philippine Health Sector. The project covers areassupported through the DOH Centers for Health Development in Regions4,6,7,8,9, 10, 11, and CARAGA; Local Government Units in Bukidnon,Cavite, Leyte, Negros Oriental, Misamis Oriental, Butuan City, Bacolod

. City, and partner NGOs - Medical Ambassadors of the Philippines(Bukidnon and Luzon), Bukluran Sa Kanluran (BSK Bacolod City), PHC,and CCc.


Volunteer Health Workers (VHWs) from Lucena City also providedinvaluable insights during the focus group discussion for the pretesting ofthe modules. The nine VHWs were Abysenia C. Baay, Swanie L.

.Hermoso, Raquel S. Almoguera, Evelyn B. Eleazar, Susana P. Dallo, AliceJ. Lingcoran, Elsie G. Uave, Anabella E. Pangilinan, and Ma. Teresa LRai!. .

Special mention goes to the College of DevelopmentCommunication, University of the Philippines Los Banos (CDC-UPLB) forpackaging the manuals to make them reader-friendly. Packaging entailedediting, preparation of visuals, lay-out, and pre-testing of the draftmodules. CDC-UPLB's quality circle for these tasks was composed of Dr.Ma. Theresa H. Velasco (project coordinator), Dr. Cleofe S. Torres andDr. Nora C. Quebral (editors), and Victor Orlando G. Perez, Remi E. deLeon, and Maggie Rose B. Almoro (rnodule developers).


Department of Health

Dr. Loreto Roquero Jr.

Dr. Florence Apale

Dr. Kenneth G. Ronquillo

.Dr. Alfonso T..Lagaya

LGU/ NGO Trainers

Ms. Stephanie FloresMr. Nestor Reyes

Ms. Edeliza Salem-Lacson

Ms. Shirley GuicoMs. Erlinda Milloria

Ms. Gesela Cuento

Mr. Hernani Villanueva, Sr.

Mr. Job SarmagoMr. Jerome Viduya

Director lll, Center for Family and EnvironmentalHealthFP Coordinator, Center for Family andEnvironmental HealthOfficer-in-Charge, Health Human ResourceDevelopment BureauDirector General, Philippine Institute of Traditionaland Alternative Health Care

CEO, National Pharmaceutical FoundationLogistic Officer, National PharmaceuticalFoundationBSK Designated CEO, Negros OccidentalPharmaceutical FoundationCoordinator, Main Warehouse, CaviteCoordinator (PHN 1I), Butuan City HealthOffice Main WarehousePHN ll, Provincial Health OfficeCounterpart, Quezon ProvinceNurse Coordinator, Cagayan de Oro .Capitol College, Cagayan de oro, MisamisOrientalCoordinator, Kauswagan, Cebu CityTrainer, Botika Binhi


TABLE OF CONTENTS

Page

INTRODUCTION 1

OBJECTIVES 1

HERBAL MEDICINES: A TRADITION AND 2A RENEWED SCIENCE

What are. the 10 medicinal plants currently endorsed by 3 .the PITAHC-DOH?

GENERAL PRINCIPLES IN THE USE OF 3. HERBAL MEDICINES

What are the five criteria in selecting plants to be promoted 3as herbal medicines?

GENERAL GUIDELINES IN PREPARING HERBAL MEDICINES 4

GENERAL GUIDELINESON THE PROPER HANDLING OF 5MEDICINAL PLANTS AND THE PREPARATION OF HERBALMEDICINES

Identification 5Harvesting 5Post Harvest Handling 6What are. the general guidelines in preparing herbal 7medicines?What are the different ways of preparing herbal medicines? 8

I. Water Extraction 8II. Oil Extraction 10III. Instant Powder 13

·IV. Tablets 14V. Herbal Soaps 14VI. Other Herbal Preparations 15

What herbal preparations are applicable to 17medicinal plants?

Indications for Use and Dosages 18Lagundi 18Sambong 19


Tsaang GubatYerba BuenaUlasimang BatoBayabasAmpalayaAkapulkoBawangNiyog-niyogan

How are medicine bottles and other containers sterilized?

ESTABLISHING A HERBAL GARDENWhat should be considered in choosing the site?What should we remember about planting?What are the care and maintenance considerations?How are medicinal plants propagated?What is an enclosure?What are the prerequisites for establishing Medicinal

plantationReferences for Propagation and Cultural Requirements ofMedicinal Plants

GLOSSARY

2021212222232324

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262627272829

3030

31


6Herbal Medicine Preparation

(itNTRODUCTION

Welcome to your sixth and second-to-the-last module! If the last one was a bitheavy for you, we are sure this module will be both light and enjoyable reading especially ifyou are a gardening enthusiast. Imagine, you can find a cure for themost common ailments in plants that you yourselves can grow in your own .backyards. And think of how much you can help your clients by sharing with themyour knowledge of herbal medicines.

The Philippines is blessed with a widevariety of medicinal plants that are nowbeing used by the Philippine Institute ofTraditional and Alternative Health Care(PITAHC)- Department of Health (DOH)and some local pharmaceutical companiesto produce herbal medicines. These herbalmedicines have been proven scientificallyeffective in the treatment of certain diseases.The DOH is promoting the use of at least 10medicinal plants, which can be preparedright in the homes of potential users.

@OBJECTIVES

This module is designed to help you accomplish the following:

1. Explain the general principles and rational use of herbal medicine;2. Explain the general guidelines in the proper handling and preparation of

medicinal plants;

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Module 6. Herbal MedicineTrainee's Manual

3. Discuss the indications for use and dosages of 10 medicinal plantsrecommended by DOH for use in the Philippines;

4. Demonstrate the steps in preparing raw materials to formulate someherbal products; and .

5. Discuss the steps and procedures in establishing a herbal garden.

HERBAL MEDICINES: A TRADITION ANDA RENEWED SCIENCE

The use of herbal medicines in thePhilippines is an old tradition handed downfrom generation to generation. For mostFilipinos, medicinal plants have become morethan just an alternative to costly commercialdrug preparations. They are now accepted aslogical and practical sources of medicines, whichcan provide symptomatic relief for commonailments.

Modern medicine, which we call"Western medicine," also started with herbalmedicine during the time of the great Greekphysician, Hippocrates, who is considered the

father of medicine. He described several herbal remedies for certain diseases orillnesses that are still used in modern pharmacology.

There is a little difference, however.jn how Western and Oriental medicinelook at the use of plants. In Western medicine, the active ingredients (the chemicalcomponents of a drug which have medicinal effect) are usually extracted andpurified to be used as the drug. The drug or medicine then acts as the "magic bullet"that kills the invading germs causing the disease, without greatly affecting the normalfunctioning of the body. However, 'the medicine may not have any effect at all onthe invading germs because the human body is actually capable of healing ordefending itself. It is only when the body's defenses are overwhelmed that webecome ill.

In traditional or Oriental medicine, the cure focuses on strengthening thebody's defenses, or restoring the equilibrium, balance, and harmony of the body'sfunctioning. Thus, using plants does not focus on isolating a specific substance thatwould kill the invading germs and cause the least harm to the body. In the context ofherbal medicine, the plant is the drug itselfand herbal medicine is not some kind of amagic bullet to kill an offending organism.

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What are the five criteria In selecting plants to be promoted as herbalmedicines? .

Adapted from Handbook on Philiipine Medicinal PlantsVolume 3 (de Padua, et al., 1987)

Trainee's Manual

1. Lagundi2. Sam bong3. Tsaang gubat4. Verba buena5. Ulasimang bato6. Bayabas7. Ampalaya8. Akapulko9. Bawang10. Niyog-niyogan

What are the 10 ·medicinal plantscurrently endorsed by the PITAHCDOH?

1. Relevance to the health problemsof the country

Is the plant good for the prevailingillnesses of relatively rare conditions?

Is the plant common enough? Can itbe grown in several parts of thecountry, preferably in one's ownbackyard?

2. Availability of the plant

There are many health problems that can be addressed by herbal medicines.The first question is: What plants are good for what conditions? There could beseveral varieties of the same plant, some of which could be harmful. A given plantmay also be known by several names or a given name may refer to different plantsin another part of the country. Moreover, there are thousands of plants that couldhave medicinal value. As such, certain criteria need to be observed in selecting plantsto be promoted as herbal medicines.

GENERAL PRINCIPLES IN THEUSE OF HERBAL MEDICINES

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3. Extent of work done

Has there been enough scientific study done on the plant, particularly onits safety and efficacy? .

4. Feasibility for commercial production

Can we produce enough herbal preparation for many people and not justfor the few who can afford it?

5. Safety and efficacy

Can it be handled and processed safely so that it will not be harmful tousers?

GENERAL GUIDELINES IN PREPARINGHERBAL MEDICINES

Herbal treatment sometimes fails for several reasons. One, we may be usingthe wrong plant for the wrong condition. And two, even if we are using the right drugfor the right indication, we may be using the wrong preparation. For instance, wemay be using a decoction (herbal preparation obtained by boiling or simmering)when we should be using an ointment. And finally, we may not be giving enough ofthe right drug because we probably did not use enough ingredients in thepreparation or we did no! prepare it properly.

1. There is a need to standardizethe preparation of herbal'medicines. This will enable us tostandardize the dosage or howmuch of the herbal medlctne willbe given to the patient. But don'tthink that the right preparationcan only be done in thelaboratory! You can producequality herbal medicines in yourown homes using kitchenmeasurements and implements.

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.3. Avoid using metallic implements, especially aluminum, which may react withor neutralize the active ingredients of the plants.

4. Herbal medicine may be used together with synthetic pharmaceuticals.Experience has shown that if synthetic drugs fail, it may be beneficial andproper to shift to herbal medicine.

GENERAL GUIDELINES ON THE PROPER HANDLJNG OFMEDICINAL PLANTS AND tttt: PREPARATION OFHERBAL MEDICINES

Trainee's Manual

2. Avoid harvesting the morning aftera heavy rain. Much of the usefulsubstances tend to leach into thesoil after a heavy rain. As a generalrule, it is best to harvest on a sunnymorning, especially if it did.not rainheavily the day before.

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3. If you need the seeds, wait for thefruit to ripen. If you need the fruit,there is no need for it to ripen as

1. If you have to use flowers, harvestthe buds and moM7Je iIull~ oJllemeal"11bloom. The plant in the process offlowering consumes much of theuseful. substances. If you have touse roots, collect them before theflowers open.

ill

Plant parts require different methodsof collection.

Know the right time to collect themedicinal plant materials. Majorityof the plant materials are bestcollected before or after the rainyseason.

Harvesting

Be sure that you have the right kind ofplant. There are names that refer tomore than one kind of plant.

Identification

2. The Kitchen Technology or Kitchen Laboratory approach to herbal medicineis necessary because very few people have access to laboratory facilities. Notevery household, for instance, may have clocks or stop watches, but you canapproximate preparation time by other means. For example, "you could boiluntil one-half is left."

5. Herbal medicine advocates the use of ingredients individually so that thedesired and adverse effects of a plant can be monitored. If several herbs areused in combination, we may not know which is producing a desired or anadverse effect.

Module 6. Herbal Medicine




long as it is mature.

To harvest underground parts, loosensoil away from the main roots. Takecare not to damage the roots.

Post Harvest Handling

1. Sort and select the harvestedmedicinal plant materials,removing the dirt and other foreignmatters.

2. If washing is necessary, do it asquickly as possible after harvesting.

3. When collecting plants fortransporting, use newspapers forwrapping. Label the packagesoutside and inside, if possible, tomake sure the plants are identifiedproperly. Indicate the name of theplant, the date, and place of origin.Don't leave the plants sealed inplastic bags overnight. If they havebeen stored in plastic bags, openthe bags as soon as possible andexpose the plants usingnewspapers as mats.

4. Use the most convenient methodfor drying --air drying or ovendrying.

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•

• For air-drying, it is best to layplants on wire platforms(screen) at a distance from theground. The plants may also bestored in screen bags and hungon clotheslines not exposeddirectly to the sun. Air-drying isbest done in a shady, dry place,with good ventilation'.

e

• For oven drying, it is importantnot to r~~cQ the temperaturethat will destroy the activeingredients of the plant. Ingeneral, do not exceed 40°C.For plants with volatile oils, donot exceed 25° C.

• Never put the plants directly ona concrete floor or galvanized

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. Module 6. Herbal Medicine

iron roof when drying. Thismay destroy the medicinalsubstances in the plants. Ensurecleanliness and avoid dustyareas and those exposed toexhaust fumes from the streets.

5. Keep the dried plant materials inplastic or bottle containers,preferably in brown-coloredbottles. Cover tightly and keep in acool dry place away from sunlight.Put small pieces of charcoal insidethe container to absorb themoisture. Properly label thecontainer with the name of theplant and the date it was collected.

6'. Well-dried and well-stored plantmaterials can be used up to 6months from the date of collection.

7. Discard the plant materials if thereare molds.or other signs that theyare beginning to rot.

What are the general guidelines Inpreparing herbal medicines?

1. Be sure that you are using the rightplant. Use only one plant drug at atime and use only therecommended' plant parts.

2. Follow the recommended methodof preparation,

3. When using dried plants/leaves,I

use' only half the amountprescribed for fresh plants.

4. In the absence of a weighing scale,use the tablespoon-to measure the'amount of plant materials needed.Chop the plant materials first. One

Trainee's Manual'

tablespoonful of the plant materialswould mean one heaping scoop.

5. In general, the active ingredients ofthe plant may be extracted bywater or.oil. The whole plant mayalso be taken whole as in selads.Dried drugs may also be powderedand made into capsules or eventablets.

6. Decoction and infusion extractwater-soluble ingredients, whileointments and liniments extract oilsoluble ingredients.

7. A given plant may have different·active ingredients with differenteffects and may be extracted indifferent ways. For example, adecoction of ginger extracts awater-soluble ingredient that iseffective for sore throat. Gingerliniment extracts the oil-solubleingredient for muscle aches andpains.

8. Infusions and decoctions should befreshly prepared. A day's dose maybe prepared and kept fresh inthermos bottles.

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What are the Different Ways of PreparingHerbal Medicines?



9. Use containers made of inertmaterials, like clay pots, enamellined containers, pyrex, etc., notmetallic or plastic utensils.

I. Water Extraction

Decoction (Plnaglagaan)

• Materials:

Cooking potsLadle (sandok)Measuring cupStoveStrainer, cheeseclothThermosLabelsHerbal plantsWater

IP Proportion:

1cup fresh herbal leaves(chopped) to 2 cups water

1cup dried herbal leaves(chopped) to 4 cups water

.,

Procedure: .• In an uncovered pot,

boil the herbal plant(leaves) for about 15

minutes or until the water

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Wooden ladle and brown/ambercolored bottles are recommendedfor herbal products.

10. Observe care and cleanliness at alltimes.

reaches the half-way mark.When using a wooden ladle, youcan label the starting level andthe half-mark.

• It is best not to boil vigorouslySimmering makes the time ofextraction longer.

• Cool and strain.

• Put the decoction in a containerlike a thermos.

• Decoctions should be takenupon preparation, but it can stillbe used for 2 days

Syrup-_ Materials:

• .Same as in decoction plus honeyor sugar and medicine bottles

IP Proportion:• 1 cup decoction to 1/3

cup sugar or honey


Module 6. Herbal Medicine. Trainee's Manual

infusions should always be takenfresh.

• Procedure 2 - Put chopped orpowdered dried herbal plant into atea bag and seal. Submerge it in ameasured proportion of water,then bring to boil for 15 minutes ormore.

II. 011 Extraction

Ointment

1. The Cold Process

,. Materials:

Fresh chopped leaves95% ethyl alcoholGlass jar with coverStrainer/ cheese clothShallow bowlWhite petrolatum Mortar and

pestle,Mixing bowlSpoon and ointment jars

_~ Procedure:

~ • Macerate/soak the leaves inethyl alcohol in the glass jar for 4days or a week. Cover and setaside. Add more alcohol to keep

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-r.

the leaves always submerged inalcohol. .

• On the 4th day,filter the extractthrough a cleanpiece ofcheesecloth.

. The result is atincture. Thiscan last indefinitely, as long as thecontainer is kept well sealed andprotected from direct sunlight.

• Put your enamel cupor dipper{tobo) contalning the extract) in abig kettle with water. Using thiswater bath, let the solvent (ethylalcohol) evaporate. When there isno longer any' sign of boiling in thecup, that means that the alcoholhas evaporated. At this point, itwould be safe to increase the heatof the water bath until it is boiling,not just simmering. (Remember:alcohol is flammable). Continueboiling until what is left in the cupis a dark, sticky residue. Removethe kettle from the fire. Take carenot to burn the sticky residue.

• Remove the extract from the waterbath when the desired consistencyis reached.

• The thick extract weighs about15 gm per tablespoon. Mix 1 .tablespoon of the extract with100 gm of white petrolatum,·also known as vaseline or

Trainee's Manual

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Proportion: .

• After frying, strain the oilextract in cheesecloth. Takecare not to burn yourself. Waita while for the oil to cool a littlebit, or use a ladle to transfer theoil to the strainer. Rememberthat very hot boiling oil canmelt plastic containers andimplements.

• To 1 cup oil extract, add 2sperma # 5 candles that have

1 cup fresh leaves to 1 cupvegetable oil

• Be sure not toburn the leaves.

'~:~dW"the chopped r....-~---,.~

leaves untilcrisp, but arestill slightlygreenish.

• Dried drug (leaves) may also beused. This may yield moreactive substances than thesame amount of fresh drug.

• If95% ethyl.alcohol is notavailable, brandy or lambanogmay be used. Try to get 190proof if possible. Note that thepercentage of alcohol is half theproof. Less than 95% alcoholmay still extract the activeingredient but to a lesser extent.

petroleum jelly. (This isavailable in 100-gm bottles).Blend well using mortar andpestle.

2. The Hot Process

• The resulting mixture is a 15%ointment, which can betransferred to plastic ointmentcups or jars. Take care, though,to sterilize the ointment jars toavoid contamination andthereby prolong the shelf life.Label properly.

• Materials:

Fresh chopped leavesVegetable oilCandle (sperma)Frying panStrainerOintment jars

Module 6, Herbal Medicine




been grated. If sperma is notavailable,add 1/3 cup gratedcandle to 1 cup oil extract.

• Heat until all the candles aremelted. Mix well.

• Cool a bit and transfer themixture to plastic ointmentcontainers/tins.

• Further cool until the mixturehardens, then cover. Labelproperly.

LInIment

A liniment is a liquid medicinalsubstance that is applied to theskin. It may be an oil extractionas in capsicum liniment whichuses ripe siling labuyo fruits.

,. MaterIals

Capsicum (siling labuyo) fruitsVegetable oilWide-mouthed glass jar with

coverMedicine bottles

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• Select the siling labuyo fruits andmake sure you discard any fruitthat shows signs of rotting.

• Macerate siling labuyo fruits inenough vegetable oil to cover allthe fruits for one week. Keep thejar covered.

• One week after maceration, strainto separate the fruits from the oil.(The macerated fruits may bediscarded. You may also leave the.maceration mixture in the jar andjust decant portions of the oil asneeded from time to time).

• The resulting product is turbid(cloudy) due to water or moisture.If left in the mixture, this maycause the liniment to becomerancid.

• To remove the water from theliniment, put the mixture in aceramic glass or enamel cup andimmerse in a water bath. Heat thewater bath until it simmers.Bubbles will then start to risethrough the oil. These are the'water droplets that areevaporating.

• See to it that the water does notboil vigorously and make sure thatthe oil does not boil. The activesubstance in capsicum liniment is

Module 6. Herbal Medicine.

strainer, cheesecloth, thermos,labels, herbal plants, water

The same as decoction plusbrown sugar, mortar and pestle

• Remove from stove .

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• Label properly. This instantpowder can be used to make tea .by adding the powder to hot wateras desired.

• In tea bags, put 2 teaspoons ofpowdered leaves.

• Grind dried herbal leaves usingmortar and pestle or a grinder.Pass through a sieve for uniformpowder size.

Trainee's Manual

• Continue stirring until granularpowder forms.

Note: tablet making at home is beingdiscouraged because the GoodManufacturing Process (GMP)requirements of BFAD cannot be metusing home technology.

_~ Procedures:

~ Procedure A

• Dissolve sugar in the decoction ona stove with medium heat, stirringgently until sticky.

lV. Herbal Tablets

.,Procedure B

Proportion:

1 cup decoction to 1 cup brownsugar

volatile and can be destroyed orevaporated if the oil boils. After awhile there will be no morebubbles and no more visible waterdroplets. Take the oil from thewater bath, cool, and transfer toglass bottles. Label properly.

Ill. Instant Powder

• Materials:

Cooking pots, ladle (sandokl,measuring cup, stove,

IP


Ingredients:

Group 2 for Skin Diseases

• Akapulko leaves• Bayabas leaves• Kakawati leaves

,

PailPlastic or wooden ladleMolding cupsMeasuring cup

AdaptedfromHandbook onPhilippine MedicinalPlants Vol~me 1 (de Padua, et al.. 1977)

Materials:

• Upon reaching the desiredconsistency (like that ofcondensed milk), transfer themixture into the plasticmolders.

• Remove from molders after 4-5hours. Arrange on table top orshelf for the aging period of 30days before packaging. Labelproperly.

• Mix the caustic soda 'solutionwith the cooking oil, stirringgently only in one direction.This ensures a smoothconsistency of the herbalproduct. Gently add the extractjuice, stirring continuously.

,.

,. Materials:

PailPlastic or wooden ladleMolding cupsMeasuring cup

Caution: Caustic soda may causeburns upon contact with the skin.In case of emergency, washthoroughly with running water orvinegar immediately. Whiledissolving caustic soda in waterwear, wear a protective mask toavoid inhalation.

Group 1• Papaya leaves - moisturizer• Pipino fruits - moisturizer• Kalamansi fruits - for oily skin• Kamias fruits - for bleaching

Ingredients:1 glass caustic soda3 glasses of water5 glasses of cooking oil1/2 glass of extract/juice of

herbal plant


14/DOH-GTZ

V. Herbal Soaps

.fit Procedure:

• Slowly dissolve the caustic sodain water using a plastic orwooden ladle. Allow to cool.




1 cup caustic soda3 cups decoction of the

herbal plant.~ 5 cups of vegetable cooking oil

~ Procedure:

• Dissolve 1 cup caustic soda in3 cups decoction, taking all thenecessary precaution as inGroup l.

• Add the cooking oil to themixture of caustic soda andcooked decoction.

• Upon reaching the desiredconsistency (like that ofcondensed milk), transfer themixture into the plasticmolders.

• Proceed following the steps inGroup l.

V. Other Herbal Preparations

Ginger (Luya) Lozenges

Medicated candies prepared fromrhizomes of ginger, Zingiber

.officinale Roscoe, for sore throat,for cough, and as breath freshener,dissolved on the tongue as needed

..& Materials:

~ Ginger rhizomes, powderedConfectioners' sugarGum Arabic powder, US.P.CornstarchWater

Trainee's Manual

Mortar and pestleSpatulaSpoon, knife, rolling pin, tray,

., W~ I"'P", aluminum foil

Procedure:

• Mix powdered ginger,confectioners' sugar(proportion: 2 tbsp. powderedginger for every cup ofconfectioners' sugar) with alittle gum Arabic powder inmortar.

• Add water, a few drops at atime, enough to form €I

mass/ball on the starch-linedtray.

• Line a tray/plate withcornstarch lightly. Transfer the

. mass/ball to the cornstarchlined tray.

• Flatten the mass/ball to desiredthickness with the rolling pin,which should have beenpreviously dusted withcornstarch.

• Divide the flattened mass intoequal portions, about 2 sq. cm.each. Form these portions intoflattened discs.

• Allow the discs to dry, thenwrap each lozenges inaluminum foil.

15/DOH-GTZ

•••••••••••I

••II

•••I

••


Luyang Dilaw Tincture(TumerlclYellow Ginger)

• Ingredients:

1 cup powdered luyang dilaw2 cups 70% rubbing alcohol or a

bottle of gin

., Proce'.'"

• Macerate the powdered yellowginger in alcohol for 1 week.

• Stir or shake well everyday.

• Use as needed for wounddressing.

16/ DOH-GTZ

17/DOH-GTZ

As a general rule, any plant that can be made into a decoction can also bemade into an infusion or tea.

To ensure optimum extraction, it may be best to grind the dried leaves beforemaking it into tea.

I

Trainee's Manual

NONO

NONO

NO

NO

Whole LinimentOintment

BawanAkapulko

UlasimangBatoBa abasAm ala a

NiyogNi 0 an

Yerba Buena


The following table shows the preparations applicable to 10 medicinal plantscommonly used in the Philippines and being advocated by the Department ofHealth. These are herbs whose efficacy and effectiveness have been studied

.. . extensively in clinical and community settings.

~", .

Several herbs can be made into a decoction. Most of these can also be made intosyrup. Some, however, should not be made into syrup. For instance, bayabas cannotbe made into syrup mainly because it is intended for use as an antiseptic wax.Ampalaya is intended for internal use, but is indicated for diabetes. Making it intosyrup defeats its purpose, which is to lower blood sugar.

What herbal preparations areapplicable to medicinal plants?


Indications for Use and Dosages


Ointments and liniments are intended for external use. In o.ur formulary, wewill advocate only sili for liniment. Bayabas, akapulko, and kakawati arerecommended for ointment and soaps. These three can also be used as a decoction,Bear in mind, though, that following the principle of specific solvents for specificingredients, the active substance of bayabas ointment may be different from that ofbayabas decoction. This may apply well as well to akapulko and kakawati. The,

, medicinal substances, extracted differently, may vary only slightly, however, and theeffect or indication for use may still be the same.

• Children - Take 1tablespoonful 3 to 4 times aday continuously for 3 to 5days.

• Adults - Take 2 tablespoonfuls3 to 4 times a day continuouslyfor 3 to 5 days.

• Children up to 12 years old Give V2 the adult dosagecontinuously for 3-5 days,

Syrup

• Decoction

• ,It is also a pain reliever and it isgood for fever.

• Adults - Divide 1 cup ofdecoction into 3 or 4 parts.Take 1 part 3 to 4 times a daycontinuously for 3-5 days.

Dosage:

,. Lagundi is good for cough,colds, and asthma-Someclinical trials have shown thatlagundi decoction may be aseffective as salbutamol in anacute asthmatic attack.

Indications:

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LAGUNDI (Vitex negundo L.)Tugas (Cebu), Molave-aso,'Magupay (Sulo), Dangla, Lino-Iino(Iiokano), Dabatan (!fugao), Lingei(Bon), Sagarai (Baguio), 5-leavedChaste Tree (English)




Tablets

• Adults - Take 2 .tablets 3 to 4times a day continuously for 3to 5 days.

• Children (7-12 years oldl >

Take 1 tablet 3 to 4 times adaycontinuously for 3 to 5 days.For small children havingdifficulty taking tablets, it maybe necessary to pulverize thetablet and mix it with sugar andwater. It is not practical to givetablets to infants less than 2years old.

SAMBONG [Blumea balsamifera (L.)DC] ..

Alibhon, Alimon (P. Bis.), Ayoban,Bukadkad, Gabuen, Gintin-gintin,Haliban, Kambihon, Lalakdan,Lakdanbulan (Bisaya), Dalapot (c.Bisaya), Labulan, Sambun (Sulu),Sob-sob (Ilokano), Kaliban,Sambong (Tagalog), Takamain(Baguio), Blumea camphor, Ngaicamphor (English).

Trainee's Manual

Indications:

• It has diuretic properties, whichmake it a good drug for .hypertension", Diuretics are the firstline of treatment for hypertension.

• Studies have shown that sambongcan also dissolve kidney stones.

• Dosages:

Decoction

• Divide 1 cup decoction into 2.or 3 parts. When using it as adiuretic or as treatment forhypertension, it is morepractical to be conservative bystarting with 1/3 to '/2 cupdecoction in the morning andmonitoring the blood pressure.If the BP decreases onlyslightly, then you may increasethe dosage to twice a day. Thenext dose should be taken inthe afternoon.

• When using sambong fortreatment of kidney stones, take1/3 cup 3 times daily, Monitorfor sandy particles passed outin the urine.

Syrup• Adults - Take 2 tablespoonfuls

3 timesa day.

Tablet• As diuretic take 1- 2 tablets

" (250mg:) 3 to 4 times per

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• For Kidney stones take 4 tablets(250mg.) 3 times a day.

Precaution:

Diuretics may cause depletion ofpotassium. But Sambong has beenproven to have potassium sparingproperties based on research studies

TSAANG GUBAT (Camona refusaVahl. Masam.)

Alibangog (Bisaya), Malatadiang(Gadang), Kalabonog, Maragued(Ilokano), Taglokot, Talibunog,Lalimunog, Tsa (Tagalog)

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Indications:

• It contains tannin, which iseffective in decreasinggastrointestinal motility. It istherefore recommended forabdominal spasms, colic, orstomach ache.

• Tsaang gubat is also a rich naturalsource of fluoride. It can thereforebe used as a mouthwash toprevent tooth decay.

• It has also been found that tsaanggubat is a rich source offlavonoids, a substance thatprevents the development ofischemic heart disease.

• It is'also rich in catechin, asubstance rich in green tea, whichis effective in lowering bloodcholesterol levels.

Dosages:

Decoction

Divide decoction into 2 or 3 parts.Drink decoction every 4 hours, especiallyfor stomachache.

Syrup,Adults - Take 2 tablespoonfuls 3 timesa day.

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• It can also be made into tea bysimply putting some leaves in acup of boiling water. Mint tea canbe prepared using the leaves.

• It is effective for lowering uric acidin the blood in patients with goutyarthritis. This condition is usuallyfound in the toes, ankles, andknees and common among thosewho drink a lot of beer and eat lotsof pulutan, especially the internal

Indication:

Identification:• Be careful that you identify yerba

buena correctly. There are severalspecies of mint, and many of whatare commonly known as yerbabuena are not the true mint. Youwill know it is the real yerba buenawhen you crush the leaves and 'they smell like the popular "DoubleMint" chewing gum.

Trainee's Manual

ULASIMANG BATO [Peperomlapellucida (L.)]

Pansit-pansitan (Tagalog), Sinawsinaw, Bihod-bihod (Bisaya)

Hierba Buena, Hibas (Davao,Leyte, Samar), Ablebana (!fugao),Malipuen (Aklan), Mint,Peppermint (Eng.)

Dosage:\

• Yerba Buena can be taken as adecoction or syrup. in the samedosage as Lagundi.

• Yerba buena is the plant fromwhich mentholis derived.

• Menthol has anesthetic properties,which is why menthol candies areeffective in relieving sore throat.

• It also has pain relieving propertieswhen taken internally. Its pain'relieving properties have beenproven to be equivalent tomefenamic acid or paracetamol.


Indications:

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YERBA BUENA (Menthci xcordifolia Opix ex Fresen)




organs or laman-loob - liver,intestines, heart, lungs, etc.

Dosage:• It can be taken as a decoction or

syrup, in which case the samedosage as in lagundi is followed.

• It can also be made into tea orsalad, mixi~g it with choppedonions, ginger, and tomatoes andvinegar dressing with a sprinklingof salt. The leaves and stems of theplant are used.

• It is not indicated for loweringblood pressure or cholesterol.

BAYABAS (Psldium guajava L.)Guayabas, Kalimbahin, Tayabas(Tagalog), Bagabas (lqorot),Bayabo (lbanag), Bayawas (Bikol,Pangasinan), Biabas (Sulu),Gaiyabat, Gaiyabit (!fugao),Geyabas (Bontoc), Guyabas(llokano)

Indications:

• Decoctions may be used asantiseptic for wounds and asmouthwash for infection of oral

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gingivitis, dental carries, andcavities.

• As ointments for wound dressing

• Dosage

• Wounds may be washed 2 to 3times daily.

• The leaves are used for makingbayabas ointment and soap.

AMPALAYA (Momordlcacharantia L.)

Amargoso (Spanish), Margoso,Ampalaya (Tagalog), Apalia(Pampanga), Apape (Ibn), Apapet(lin), Palia (Bis, Bin, IL), Paria(Bis, Ban, If, Ilk), Pubia (Sub),Suligum (SuI.), Balsam Apple,Balsam Pear, Bitter Gourd (Eng.)

Indication• Mild, non-insulin dependent

Diabetes mellitus

Dosages• Decoction of leaves. Take 1/3 cup

decoction 3 times daily, after everymeal.



• Alternatively, the dried leaves canbe ground into powder, which maybe sprinkled on food. Ifyou grind1/2 cup of dried leaves, divide it intothree parts. Sprinkle 1 part on eachmeal (breakfast lunch, anddinner).

• If available and if you areproficient with the technique, thepowder can be packed in 250 or500 mg capsules and swallowedwith water.

AKAPULKO (Cassia alata L.)Bayabas-bayabasan, Kapurko,Katanda, Katandang <lSO.

Pakagonkon, Sonting (Tagalog),Andadasi, Andadasi-adakdakel,Andadasi-bugbugtong (I1k.),Adadasi (Ting), Ancharasi (Ig.),Aldalan (Sul.), Bayabasin, (Bikasbikas (Bik., Tag .. Bisa.), Kasitas(Bik.. Bis.], Sunting, Palo china(Bis.), Pakayomkom kastila (Bis.),Ringworm bush or shrub (Eng.)

Indication:

Akapulko ointment is effective forfungal infections.

Dosage:

The leaves are used to makeointment either by ·the hot or coldprocess. The ointment is applied 2to 3 times daily to affected areas.This is continued until the lesionsare completely healed.

Trainee's Manual

Akapulko leaves can also be madeinto a decoction or soap for ,washing the affected areas beforeapplying the ointment It may begood as a foot bath to treatathlete's foot .

BAWANG (Allium sativum L.)Ajos (Span., Bis.)Garlic (Eng.)

Indication:

Sawang is good for lowering bloodcholesterol levels.

Dosage:

The dosage of bawang is 2-4cloves a day. It may be taken

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How are Medicine Bottles andOther Containers Sterilized?

Chew very well and swallow. Thesame dose may be repeated afterone week if necessary.

2. Using a bottle-brush, clean thebottles with soapy water. Rinsevery well and allow to dry.

8-10 kernels6-7 kernels5-6 kernels4-5 kernels

Adults9-12 yrs old6-8 yrs old3-5 yrs old

1. When using recycled bottles, soakthem first in soapy water with a fewdrops tol tablespoonful of sodiumhypochlorite solution (Clorox),depending on the number ofbottles to be cleaned. Soak at leastovernight.

Sterilizing medicine bottles and othercontainers is very important. New andrecycled medicine bottles must besterilized before use as follows:

The main determinant of shelf life isthe absence of contamination whenpreparing the syrup. It is important toalways maintain hygiene andsanitation when preparing herbalproducts, even when handling freshand dried drugs. Always sterilizecontainers properly. Also, there is lessdanger of spoilage as long as we donot produce more than we consume.

whole or chopped and mixed withfood. It is important to remember,however, that fresh, raw garlic cancause gastrointestinal cancer. It isimportant to cook the garlic, eitherby frying or blanching, to destroythe substance that causes cancer.

Balitadhan, Pinones, Pinion Bonor(Bis.), Bawe-bawe (Pamp.),Kasumbal, Talolong, Tanglon,Tangulo, Tataraok (Bik.,),Tagarau, Tagulo, Tanolo,Totoraok (Tag.), Talulong (Ibn.},Tartarau (Ilk.), Taurigon (Mbo),Burma creeper, Chinese honeysuckle, Liane vermifuge (Eng.)

Take the prescribed number ofkernels 2 hours after supper:

It is used to treat parasitism,specifically ascariasis.

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Dosages:

Indication:


NIYOG-NIYOGAN (Qulsquallsindica L.)


Trainee's Manual

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3. Drainage - A number ofmedicinal plants can survive onpoor, stony ground, but veryseldom in water-logged soil. Toimprove drainage of heavy soils,adding compost gives a morefibrous texture, better drainage tothe soil, and nutrients too. In areasprone to water-logging, consider

There are several things to considerwhen establishing a herbal garden:

2. Shade - There aremedicinal plantsthat toleratemore than'half a dayof shade,like themints.If shady site would be good forthese plants; at the same time, theyshould also get some sunfor proper growth.

1. Sunshine - Mostmedicinal plantsneed plenty of sun,so the garden sitemust be as sunnyas possible.However, many plants thrive wellwhere the sun shines for up to halfof each day only. This is oftengood enough for medicinalpurposes. In places where it ismostly cloudy, select the sunniestplace possible.

What Should be Considered inChoosing the Site?

I((

5. Use the sterilized bottlesimmediately.

Medicinal plants are among the easiestplants to cultivate because they areadaptable to most conditions and arerarely attacked by diseases. Manymedicinal plants are not only usefulbut they are also attractive or fragrantarid can be appealing features in thegarden.


ESTABLISHING A HERBALGARDEN

4. Sterilize by heating the wrappedbottles and bottle-caps in a doubleboiler for at least 20 minutes.

3. Wrap each bottle with a cleanpiece of paper.



Module 6. 'Herbal MedicineTrainee's Manual

making raised beds.

4. Soil- Although medicinal plantsare adaptable to most situations,the soil is considered veryimportant. It should be ofmoderate fertility and well drained.Very sandy or thin son should beenriched with organic matter, suchas compost and moderate amountof manure, before planting. A lightsandy soil does not hold water andis low on nutrients.

5. Weeds r It is wise practice to getrid of persistent weeds andundesirable plants while preparingthe soil for planting. Dig up weedswith taproots, taking care not tobreak off any of the root or it willsprout. Do not throw the pulledweeds nearby or on the compostheap; that will be just a way oftransplanting them.

6. Accessibility - The garden siteshould be within reach of visitors.The plants or plant beds should bespaced to allow visitors to examinethem at close range. Provisions toavoid muddied shoes are alsonecessary. An overlay of woodchips or volcanic cinder cansubstitute for expensive tiles orbricks on the pathways..

7. Garden size - The size of the areafor the herbal garden will

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determine the number of speciesand also the kinds of plants to becultivated. For a relatively smallarea, it would be best to grow theplants that are needed most in thecommunity. For educationalpurposes, however, an area whichcan accommodate all the plants forcommon ailments would be veryuseful.

If garden space is a problem, awide variety of containers can beused, such as pots of all sizes, plantboxes, tubs, etc., especially forherbs and smaller plants. There area number of advantages to thismethod of growing herbs. Theplants can be moved easily to a'shady place, if necessary. The soilpreference of the plants can befollowed. Or the plants can also bebrought indoors.

What Should We RememberAbout Planting?

The best time for planting is during therainy season, although here in thePhilippines, planting could be doneanytime during the year.

Provide conditions similar to thosewhere the plants were originally found.

A suitable distance between plants isthat equal to half the ultimate height ofthe mature plant. Provide sufficientspace apart to allow full development.Tall, thin species can be plantedcloser; wide-spreading ones fartherapart.



What are the Care andMaintenance Considerations?

Once planting is completed, watch outfor pests and diseases.

. Maintenance of an herbal gardensimply requires weeding and wateringin dry weather those species that needa regular supply of moisture.

For plants grown for their leaves,removal of spent flower heads, regularharvesting of leaves, and pruning willpromote the growth of plenty of freshleaves.

Giving the plants a good start, theproper position, and the correct soilshould contribute to faster growth.Plant care and common sense are themain requirements for maintaininghealthy plants. Fortunately, medicinalplants are mainly disease-free, butsome physical conditions, such asovercrowding or too much water, needto be guarded against.

Problems withpests anddiseases, if theyshould occur,can be takencare of by using organic insecticideslike Derris or a decoction ofchamomile flowers, or couch grassrhizome or horse tail. Planting Tagetes,erecta among medicinal plants wouldtake care of certain pests. Companionplanting benefits the growth of nearbyplants.

Trainee's Manual

How are Medicinal PlantsPropagated?

Most medicinal plants are propagatedby seeds, by cuttings, or by division,depending on the species. Someplants readily self-seed onceestablished.

Mark each row with the name of theplant and the date of sowing. As soonas the seed leaves are fully expandedand the first true leaf shows, thinningor pricking off some of the' plants isoften necessary for proper spacing.This is done carefully so asnot to disturb the plants that remain ..Thinning can be about 5 em. apart.

Seed- All annual herbs, some of thetender perennials, and most seedbearing shrubs and trees are grown

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only from seeds. There are two waysof raising medicinal plants from seeds:1) sowing on site, in the ground wherethe plants are to grow and mature; or2) in seed beds.

On site, sow seeds thinly, about 4.cm.apart each way. If crowded together;there is less chance of them sprouting.:

Water with a fine spray. CuttingsThere are three main types of cuttings:softwoods; cuttings from leafy shootswhich have not yet hardened; andsemi-hardwood, from woody shrubs ortrees. Cuttings are takenjust below a leaf nodeand are about10 to 30cm.

long. Use a sharp knife or pruningscissors to make a clean cut, leavingno rugged edges. Gently remove thelower third leaves, taking care not totear the stem. Cuttings may be planteddirectly on open ground or in plasticpots, with about three-fourths of thelength of the cuttings covered with soil.Cuttings are planted in a slanting .position. Partial shade should beprovided to protect them from heavyrains or excessive heat. As soon ascuttings show-signs of growth, putthem in a sheltered, sunny position

28/DOH-GTZ

and add plant nutrients. When newleaves have developed, the cuttingsshould be conditioned to stay in fullsunlight, then transplanted after onemonth or more in the prepared area.Cuttings may also be made from otherparts of the plant, like leaves, roots;and rhizomes.

Plant division - Many herbs benefitfrom being divided; they becomehardier. Dig up the plant when it is·donnanl. Remove old flower stemsand carefully separate the plant intoindividual sections, each having agrowing point and some roots.Replant, nurture, and water theseplants until there are signs of newgrowth.

Layering - For difficult-to-rootcuttings, layering could be done. Newsections of the plant are encouraged toroot while still attached to the parentplant.

Peg a stem to the ground so itsunderside is in contact with the soil.When new roots are developed,separate the new plant from its parent.

Mound layering could also be done bycovering the plant's woody center, withsoil until only tlie young shoots show.Roots will form on many of the shootsin a few months, and these shoots canbe taken from the parent plant and

. transplanted.

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What Is an Enclosure?

An enclosure, usually in the form of ahedge, is an important aspect ofestablishing a herbal garden. Thisreduces wind damage, raises the overall average temperature, createsprivacy, and retains the fragrance ofaromatic herbs. It can be permanentor temporary, considering upkeep andexpense. Many shrubby herbs makegood hedges; these are the easiest and

.most long-term enclosure fortraditional herbal gardens.

What are the Prerequisites forEstablishing MedicinalPlantations?

Forplantationscale, the.criteria forplantselectiondiscussedearlier inthis manual would apply. Most of all,the plants to be grown in plantationshould have a market.

The following prerequisites must bemet in establishing a plantation formedicinal plants:

1. Nursery -In any massiveplantation scheme, a nursery playsa vital role.

Immediate production of anadequate supply of good quality

Trainee's Manual

planting stocks is very necessary.The nursery should be establishedwithin the plantation site,preferably near a creek, river, orany water source. This will ensuresurvival of the planting stocks.

Site Selection - Medium altitudeunder a secondary growth forest ismost preferred for'aplantation site.The area must be cleared ofunnecessary undergrowth anddebris before planting. Thestandard spacing is 4 m. for trees,3 m. for shrubs and 2 m. for herbseach way . Trellises are providedfor vine species.

2. Maintenance - Cultural practices,such as.weeding and cultivation,don~ regularly will eliminateproblems of competition for soilnutrients and growth. The removedweeds can be placed at the base ofthe plants to serve as mulch.

3. Replanting is usually done duringthe following rainy season afterestablishment.

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References for Propagation andCultural Requirements ofMedicinal Plants:

Beckett, K.A. 1984. The GardenLibrary. HERBS. Book ClubAssociates, London

Bremness, L. 1990, OK PocketEncyclopedia. HERBS. DorlingKindersley, London

Generalao, M. 1982. How to GrowMedicinal Plants. FORI-MNR. College,Laguna.

GLOSSARY

Active substance - the chemicalcomponent of a drug which has atherapeutic effect

Anesthetic - a substance thatproduces loss of sensation with orwithout loss of consciousness

Annual - a plant that is grown fromseed, flowers, then dies within a singlegrowing season

Antibiotic - a substance thatprevents/inhibits the growth ofmicroorganisms/destroys life

Anti-neoplastic -'anti-tumor, anticancer

.Antiseptic - a substance thatprevents the growth of pathogenicmicroorganisms on living tissue

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Aromatic - having a strong smell,usually fragrant

Arthritis - inflammation of the joints

Asthma - a condition of laboredbreathing, accompanied by wheezing,coughing, or gasping, a sense ofconstriction in the chest

Athlete's foot - ring worm of thefoot

Bronchitis - acute or chronicinflammation of bronchial tubes

Capsaicin - a phenolic amide fromvarious Capsicums

Capsule - a gelatin shelf enclosingmedicine'

Cholesterol - a steroid alcoholpresent in animal cells and body fluids,important to physiological processes,implicated as a factor inarteriosclerosis/hardening of thearterIes

Chronlc- marked by frequentrecurrence over a long time and oftenby slowly progressing seriousness

Colle - acute abdominal pain in mancaused by spasm, obstruction, ortwisting

Compost - a mixture composed oflargely decaying organic matter usedfor fertilizing and conditioning land

Decoction - a herbal preparationobtained by boiling or simmering,

•



representing the water-solubleconstituents of the plant

Diabetes - abnormal conditioncharacterized by increased sugar in theblood and excretion of excessiveamount of urine.

Diuretic - a substance which helpsthe body dispose of excess water byincreasing the amount of urineproduced

Double-boiler - a cooking utensilconsisting of two saucepans fitting intoeach other so that the contents of theupper can be cooked by boiling waterin the lower; improvised sterilizer

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ACKNOWLEDGMENT - healthpromo.doh.gov.ph · What are the five criteria in selectingplants to be promoted 3 as herbal ... variety of medicinal plants that are now being used ... medicinal