Pharmacognosy- 1 PHG 222 - PSAU · book used by TCM practitioners) describes thousands of medicinal substances primarily plants, but also some minerals and animal products. Different

Prof. Dr. Amani S. Awaad

Professor of PharmacognosyPharmacognosy Department,

College of Pharmacy Salman Bin Abdulaziz

University,

Al-Kharj. KSA.

Email: [email protected]

Pharmacognosy- 1

PHG 222

To know Traditional Systems of Herbal Medicine

To Recognize what is Complementary and

alternative medicine

To Identify complementary medicine

To Identify alternative medicine

To differentiate between all types of alternative

medicine

Complementary

and alternative

medicine

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

Definition

Traditional Systems of Herbal Medicine

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.

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

The Dose

Traditional Systems of Herbal

Medicine

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.

I- Minor or Self-Limiting Disorders

The Diseases in Traditional

Systems are Classified into

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

Complementary and alternative medicine,”

“complementary medicine,” “alternative

medicine,” “integrative medicine

what do they really mean?

hard to define and may mean different things to

different people

Complementary and alternative medicine

What are the major types of complementary and alternative

medicine?

NCCAM (National Center for Complementary and Alternative

Medicine) classifies CAM therapies into five categories, or domains

1. Alternative Medical Systems., or complete systems of therapy and practice. e.g. Traditional Chinese Medicine and Ayurveda

2. Mind-Body Interventions. or techniques designed to facilitate the mind's effect on bodily functions and symptoms. e.g. prayer, meditation, art, music, or dance.

3. Biologically Based Therapies. biologically-based systems, including herbalism. e.g. dietary supplements & herbal products

4. Manipulative and Body-Based Methods. e.g. chiropractic manipulation & massage

5. Energy Therapies.

I. Biofield therapies. e.g. qi gong

II. Bioelectromagnetic-based therapies.


• It is a group of diverse medical and health care systems, practices and products that are not presently considered to be part of conventional medicine.

What is complementary and alternative medicine

(CAM)?

Are complementary medicine and alternative

medicine different from each other?

Complementary medicine is used together with conventional

medicine. (using aromatherapy to help lessen a patient’s discomfort

following surgery).

Alternative medicine is used in place of conventional medicine.

(using a special diet to treat cancer instead of undergoing surgery,

radiation, or chemotherapy that has been recommended by a

conventional doctor).


1-Alternative Medical SystemsComplementary and alternative medicine cont..

*True alternative medicine is not common.

*Most people use alternative medicine along with

conventional treatments.

*The boundaries between complementary and

conventional medicine overlap and change with time.

For example, guided imagery and massage, both once considered

complementary or alternative, are used regularly in some hospitals

to help with pain management.

or complete systems of therapy and practice. e.g.:

I-Traditional Chinese Medicine

II- Ayurveda

I-Traditional Chinese Medicine(TCM)

1-Alternative Medical Systems

Complementary and alternative medicine cont..


Traditional Chinese medicine (TCM) originated in

ancient China and has evolved over thousands of years.

TCM practitioners use:

a)herbal medicines and

b)mind and body practices, (acupuncture, tai

chi, and qi gong ), to treat or prevent health

problems

"Life Energy Cultivation"



I-Traditional Chinese Medicine(TCM)a)TCM herbal medicines

The Chinese Materia Medica (a pharmacological reference

book used by TCM practitioners) describes thousands of

medicinal substances

primarily plants, but also some minerals and animal

products.

Different parts of plants, such as the leaves, roots, stems,

flowers, and seeds, are used.

In TCM, herbs are often combined in formulas and given as

teas, capsules, liquid extracts, granules, or powders.



I-Traditional Chinese Medicine(TCM)b) Mind and body practices

(acupuncture, Qi gong, yin and yang)

Acupuncture is a family of procedures

involving the stimulation of specific points on

the body using a variety of techniques.

involves penetrating the skin with thin, solid,

metal needles that are manipulated by the hands

or by electrical stimulation.




b) Mind and body practices


Qi, the essential life force:

Qi gong

Food &

DrinkBody

AirLung

Bloodhuman

Qi

They said that: It is the quality, quantity and balance

of Qi that determine human’s state of health.

Food and air affect health, so diet ,breathing

exercises are very important.

These aspects are considered first before herbs are

introduced

Qi (or Chi) permeates everything. It is transferable.






Describes how apparently opposite or contrary forces are actually

complementary, interconnected, and interdependent in the natural world,

and how they give rise to each other as they interrelate to one another.

(light and dark, fire and water, and male and female) are thought

of as physical manifestations of the duality of 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

balance

yin and yang






yin 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/fir

The zàng-fǔ (organs are functional entities)

They constitute the center piece of TCM's general concept

of how the human body works.

zàng

Heart, Liver,

Spleen, Lung,

Kidney

fǔ

Small Intestine, Large Intestine,

Gall Bladder, Urinary Bladder,

Stomach

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





(Acupuncture, Qi gong, yin & yang)

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

The Vital Organs:

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

Coupled organs are connected by meridians, or energy channels, through which Qi

flows. Meridians 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.

yin & yang




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.

Causes , Diagnosis and treatments of Disease

Causes




Internal emotional factors

(The Seven Emotions)

These are the major internal causes of diseases, these are:

Joy Anger Anxiety Concentration

Grief 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.





Examination of the tongue

Pulse diagnosis

Palpitation of internal organs

Massage

Interviewing: questions are asked about sleep patterns,

stool and urine quality, fever, etc...

Diagnosis


Treatments

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 (yin).



I-Traditional Chinese Medicine(TCM)Causes , Diagnosis and treatments of Disease

Some Important Herbs in TCM and Their Uses

Latin name English name Nature Medicinal use Photography

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

II-Ayurveda



II-Ayurveda

• Ayurveda is a system of sacred Hindu medicine,

originating in India. It is the most ancient system

of medicine still in use today.

• 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.

What is Ayurveda?



II-AyurvedaWhat is Ayurveda?

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 tri-dosha).

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



II-AyurvedaConcepts in Ayurveda

Prana, the life energy:

It 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.

Prana 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.

Prana



II-Ayurveda

Concepts in Ayurveda

Our bodies are made up of invisible energy

channels that travel throughout the body.

In yoga we refer to them as nadis. These

energy channels/nadis carry prana through the

body and into the organs. Prana is the term

used for vital life-force

(think of when you’re in the bush, out of the

city, surrounded in trees and nature – that air

you breathe is rich in life force/ prana).

Prana



II-Ayurveda

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.




II-AyurvedaTridosha

Vata, 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.


Tridosha



II-Ayurveda

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 dis-harmony, 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.

Tridosha

Vata, Pitta & Kapha(The Three Humors)



II-Ayurveda

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

Tridosha




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.

II-AyurvedaTridosha




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

Diagnosis


Treatments

Treatment may involves:

Diets Bloodletting

Fasting Skin applications

Enemas Yogic breathing

Herbal treatments Minerals

II-Ayurveda




Examples of Herbs of Ayurveda and Their Uses

Botanical name English name Effect on dosha Medical use Photography

Nigella sativa Black cumin Pacifies vata

and kapha

Digestive, antiseptic

Ocimum sanctum Holy basil Pacifies kapha

and vata

Expectorant, febrifuge,

immunomodulator

Piper nigrum Black pepper Pacifies vata

and pitta

Digestive, respiratory

disorders

II-Ayurveda

3-Biologically Based Therapies

• is the use of plant remedies in the prevention and treatment of illness.

• Today, medical herbalism, practiced by medical herbalists, draws on traditional knowledge, but increasingly this is interpreted and applied in a modern context.


Medical herbalism

1. Herbalism takes an holistic approach.

2. Herbalists select herbs on an individual basis for each patient.

3. Herbalists aim to identify the underlying cause (e.g. stress) of a patient’s illness

and to consider this in the treatment plan.

4. Herbs are used to stimulate the body’s healing capacity, to ‘strengthen’ bodily

systems and to ‘correct’ disturbed body functions rather than to treat presenting

symptoms directly.

5. Herbs may be used to provide long-term relief from the particular condition.

Aspects of medical herbalism


Medical herbalism

• One of the tenets of herbalism is that the different constituents of a herb act together in some way that has beneficial effects. These could be:

1. Additive effect: The combined effect of two drugs is equal to the sum of their individual actions.

2. Synergistic effect:

The combined effect of two drugs is greater than the sum of the individual effects.


Medical herbalism

Conditions treated

Medical herbalists treat a wide range of acute and chronic conditions.

e.g.

Irritable bowel syndrome , Premenstrual syndrome Menopausal symptoms,

Eczema, Types of arthritis, Depression, Acne and other skin conditions,

Cystitis (Inflammation of the urinary bladder), Migraine, Chronic fatigue

syndrome

Generally, a combination of several different herbs (usually 4-6) is used

in the treatment of a particular patient.

sometimes, a single herb may be given, e.g. chasteberry (vitex agnus

castus) for premenstrual syndrome and dysmenorrhea.

In generally; patient’s treatment is reviewed regularly and is likely to be

changed depending on whether or not there has been a response.

Herbalist’s prescriptions

Medical herbalism


Medical herbalism

Herbalism & rational phytotherapy

Herbalism Rational phytotherapy

Assume that synergy or additive

effects occur between herbs.

Seek evidence that synergy or

additive effects occur between herbs.

Holistic prescribing. No holistic.

Preparations mainly formulated as

tinctures

Preparations mainly formulated as

tablets and capsules

Mainly uses combinations of herbs Single-herb products used mainly

Opposition towards standardization. Using standardization

Not scientifically evaluated Science-based approach.


Medical herbalism

Basic categories of medicinal herbs

Stimulating herbs have much stronger actions and are used to treat particular ailments. They should be

taken in smaller doses than tonic herbs, and for shorter periods of time.

Generally, medicinal herbs fall into two basic categories:

tonic and stimulating.

Tonics help cells, tissues, and organs to maintain tone, or balance, throughout the

body. Some tonics activate and invigorate bodily processes or parts. Other

tonics supply important nutrients that cells, tissues, and organs need to

function properly. Tonics ordinarily are taken regularly for three to nine

months at a time to gently strengthen and improve overall health and/or certain

organ functions.

Medical herbalism

4-Manipulative and Body-Based Methods

Mind-Body Medicine uses a variety of tecjnoques

designed to enhance the mind's capapcity to affect

bodily function and symtoms. for example: Patients

support groups and Co-gnitive-Behavioral Therapy,

Meditation, Prayers, Mental Healing and Therapies

that uses creative outlets such as Art, Music or

Dance.

Mind-body interventions utilize the mind’s capacity

to affect the body and its physiological responses.

They thereby influence health.


e.g.

a) massage

b)Aromatherapy


a) Massage

Massage involves working and acting on the body with

pressure – structured, unstructured, stationary, or moving

– tension, motion, or vibration, done manually or with

mechanical aids


b)Aromatherapy

Aromatherapy is the practice of using fragrant essential oils

distilled from plants to improve both mood and health.

Aromatherapy was used by many ancient civilizations, including

those of Egypt, Greece, Rome and China

Essential oils are either inhaled or applied to the skin. For

inhalation, a few drops of the very concentrated substances are

added to steaming water or to devices, such as nebulizers and

diffusers, that spread the oil molecules throughout the air

Essential oils are believed to act both by exerting

pharmacological effects following:

1-Absorption into the circulation.

2-The effects of their odor on the olfactory system


b)Aromatherapy

Ways of Using Essential Oils Inhaling through

vaporization

2. Bathing

3. Compress

4. Massage

Some oils should be avoided by people with certain

conditions, such as:

High blood pressure

Epilepsy

pregnanc

Energy Therapies

5-Energy Therapies.

Electromagnetic therapy is a pseudoscientific form of

alternative medicine which claims to treat disease by applying

electromagnetic radiation or pulsed electromagnetic fields

(PEMF) to the body. There is no scientific evidence that

electromagnetic therapy is effective in treating any condition.

Practitioners claim that these methods can treat a wide range of

ailments, including ulcers, headaches, burns, chronic pain,

nerve disorders, spinal cord injuries, diabetes, gum infections,

asthma, bronchitis, arthritis, cerebral palsy, heart disease and

cancer.

II) Bioelectromagnetic-based therapies

I-Biofield therapies.

Traditional Chinese e.g. qi gong

Documents

Pharmacognosy- 1 PHG 222 - PSAU · book used by TCM practitioners) describes thousands of medicinal substances primarily plants, but also some minerals and animal products. Different