Traditional systems of herbal medicine

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Traditional systems of herbal medicine
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Oriental systems

• there is a resurgence of interest in the older
  oriental systems due to
• A dissatisfaction with conventional treatments
• The recent interest in all things natural,
  environmentally friendly and biodegradable

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• These older types of medicine are philosophically
  based, and are holistic in that they treat the
  patient as a whole rather than as the owner of
  a disease or malfunctioning organ
• Holistic medicine
• An approach to medical care that emphasizes the
  study of all aspects of a persons health,
  including physical, psychological, social, and
  economic influences on health status

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• It is necessary for pharmacist to know about the
  basic principles of the older medical systems for
  two main reasons
• to be in a position to advise patients who may
  wish to consult an alternative practitioner
• because traditional use is a common starting
  point in the ongoing search for new drugs
• Two types of traditional medicine have been
  chosen as an illustration
• Traditional Chinese Medicine (TCM)
• Ayurveda

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The diseases in traditional systems can be
classified as minor or self-limiting disorders,
or chronic or serious disorders

• Minor or self-limiting disorders
• such ailments include aches and pains, diarrhea,
  wounds or injuries, and facilitating childbirth,
  for which a common remedy will be usually offered
• The remedy would usually be an indigenous plant
  or herb or a remedy obtainable from a local
  market, and would be well known within the
  community

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• Chronic or serious disorders
• these may be fatal, life-threatening or
  debilitating conditions, or those that cannot be
  diagnosed by indigenous healers they are often
  considered to have a supernatural component
  e.g. forms of cancer and genetic or metabolic
  disorders

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The dose

• In traditional medicine, this usually means a
  lack of specific dose e.g. calabash, seashell,
  tumbler
• Traditional medicine is more concerned with how
  to take remedy rather than how much ? this
  aspect of traditional medicine is very important
  indeed because it means that highly potent plants
  are rarely part of a traditional pharmacopoeia
  and some plants which we now find useful were
  considered dangerous e.g. foxglove (Digitalis
  purpurea L.)

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Correlation of traditional use with scientific
evidence

• There may be a correlation between traditional
  usage and pharmacological action, such as the
  isolation of antipyretic principles from a
  fever remedy, but, even so, it may turn out
  different to our expectations. For example
• the periwinkle Vinca (Catharanthus) rosa was
  traditionally used for treating diabetes, but on
  further investigation yielded the powerful
  anticancer alkaloids vincristine and vinblastine

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Traditional Chinese Medicine (TCM)
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Traditional Chinese Medicine (TCM)

• The study of TCM is a mixture of myth and fact,
  stretching back well over 5000 years
• Chinese medicine is philosophically based, and as
  an holistic therapy the concept of balance and
  harmony is supremely important

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Concepts in TCM

• Qi, the essential life force
• Qi (or chi) permeates everything. It is
  transferable.
• For example
• Digestion extracts qi from food and drink and
  transfers it to the body and 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, which circulates through the body.

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Qi, the essential life force

• It is the quality, quantity and balance of qi
  that determine your state of health
• Food and air affect health, so diet and breathing
  exercises are very important
• It is considered that the original vital energy,
  qi, is gradually dissipated throughout life, so
  it is important to conserve it using diet, kung
  fu, breathing exercise and herbal medicine

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Yin and Yang

• The theory of yin and yang still permeates all
  aspects of Chinese thought. Attributes of both
  are
• Yin negative/passive/dark/female/water
• Yang positive/active/bright/male/fire

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Yin and Yang

• Yin is considered to be the stronger fire is
  extinguished by water, and water is
  indestructible. So yin is always mentioned
  before yang
• Yin and yang are always in balance

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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
• Kidneys water
• Liver wood
• Lungs metal
• Spleen earth

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The vital organs

• These do not correspond to our organs exactly
• Exact anatomy was not considered important since
  it was the relationship between the organs, the
  five elements, qi and yin and yang that mattered.
  For example
• if a person with a red complexion (fire color)
  and who laughs a lot (fire sound) may have an
  over-fired heart in this case, herbs to sedate
  the heart will be given

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The vital organs

• The organs are considered to be yin or 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 cannot be seen physically.
• Meridians 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.

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Causes of disease

• Bacteria, viruses and chemicals are not
  considered to be causes.
• If an organ is weak, it may be attacked, and
  therefore the weakness is the cause and must be
  rectified.
• The disease may be the result of external forces
  and internal emotional factors.

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Causes of disease

• The external forces are called the six excesses
• Wind
• Cold
• Summer heat
• Dampness
• Dryness
• Fire
• Most people, if healthy, are not affected by the
  six excesses but, if the body is deficient in qi
  or weather conditions are abnormal, then this may
  cause problems.

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The seven emotions

• These are considered to be the major internal
  causes of disease.
• Excessive emotional activity causes
• A severe yin/yang imbalance
• Blockage of qi in the meridians
• Impairment of vital organ function
• Excessive emotional activity will lead to damage
  of the organs and allow disease to enter from
  outside, or a minor weakness from inside to
  develop.

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The seven emotions

• The seven emotions are
• Joy
• Anger
• Anxiety
• Concentration
• Grief
• Fear (A feeling of agitation and anxiety caused
  by the presence or imminence of danger)
• Fright (Sudden intense fear)

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The seven emotions

• Once physical damage has occurred, by whatever
  cause, it will need more than emotional factors
  to cure it and herbs will be used.
• There are a few other causes, which are not
  emotional or external excesses. These are the
  exception of the rule, and include
• Epidemics
• Insect and animal bites
• Worm infestation
• Hereditary diseases

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Diagnosis

• Various methods are used
• Examination of the tongue
• Pulse diagnosis
• Palpation of internal organs (to determine
  consistency and tone)
• Massage (to detect temperature and knotted
  muscles and nerves)
• Interviewing (vital, questions are asked about
  sleep patterns, tastes in food and drink,
  stool and urine quality, fever, perspiration
  and sexual activity)

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Treatment

• the purpose is to rectify harmony, restore qi and
  the yin/yang balance.
• For example
• cold diseases, such as cold in the lungs,
  coughs, vomiting and nausea are considered to be
  a deficiency of yang and treatment would be with
  a warming herb such as a ginger.
• Once the prescription has been chosen and written
  out, the patient takes it to a Chinese herbalist
  who prepares the remedy.

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Ayurveda
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• Ayurveda is considered to be the most ancient of
  all medical disciplines.
• Ayurveda is a system of sacred Hindu medicine,
  originating in India.
• In Ayurvedic medicine, the patient is viewed as
  unique, and normality as what is appropriate
  for that particular person and this is in
  contrast to Western medicine, where populations
  are generalized and normal means what is
  applicable to the majority.

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• Ayurvedic medicine is worthy of study because
• It is the most ancient system of medicine still
  in use today.
• It has influenced so many other types.
• Philosophically, Ayurveda has similarities with
  traditional Chinese medicine (TCM)
• In TCM, there are two (yin and yang), and in
  Ayurveda there are three (the tridosha).
• There are five elements in both, but they are
  slightly different.
• Many remedies are common to both systems although
  the philosophical rationale for their application
  may be a little different

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Concepts in Ayurveda
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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 (1) kindles the bodily fire agni and (2)
  governs the functioning of the heart, entering
  the bloodstream from where it controls the vital
  organs dhatus.

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Bhutas, the five elements

• The basic elements of cosmic energy are
• the ether (space), air, fire, water and earth.
• The five elements are related to the five senses
  hearing, touch, vision, taste smell. For
  example
• 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.

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Tridosha 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 to diagnosis and
  treatment of disease is to understand the
  relationship between the humors.

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• The tridosha affects the creation, maintenance
  and destruction of bodily tissues and the
  elimination of toxins (ama) from the body.
• 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.

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• the tridosha has recently been redefined as an
  equilibrium, balance and coordination between the
  three vital body systems
• the central nervous system (CNS) ? vata
• the endocrine system ? pitta
• the immune axis ? kapha
• The tridosha can be considered to govern all
  metabolic activities
• catabolism ? vata
• metabolism ? pitta
• anabolism ? kapha

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• 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.

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• The tridosha can be described further
• Vata, affiliates to air or ether (space), is a
  principle of movement. It can be characterized as
  the energy controlling biological movement and is
  thus associated with the CNS, and governs
  functions such as breathing, blinking, heartbeat
  and nervous impulses.
• Pitta, is affiliated to fire and water, and
  governs bodily heat and energy. It is involved in
  metabolism, digestion, excretion, manufacture of
  blood and endocrine secretions and is also
  involved with intelligence and understanding.

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• Kapha, is associated with water and earth. It is
  responsible for
• Physical structure
• Biological strength
• Regulatory functions
• Immunity
• Production of mucus and synovial fluid
• Wound healing
• Vigor and memory retention

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Prakruti, the human constitution

• Humans can be divided into personality types, and
  the constitution of an individual is determined
  by the state of the parental tridosha at
  conception.
• Most people are not completely one type, but can
  be described as vata-pitta or pitta-kapha.
• As well as the vata, pitta and kapha type of
  personalities, there are three basic attributes
  (satva, rajas tamas) provide the basis for
  distinctions in human temperament, individual
  differences and psychological and moral
  dispositions.

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• Satva expresses essence, understanding, purity,
  clarity, compassion and love.
• Rajas describes movement, aggressiveness and
  extroversion.
• Tamas manifests in ignorance, inertia, heaviness
  and dullness.

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Agni, the digestive fire

• Agni governs metabolism and is essentially pitta
  in nature. An imbalance in the tridosha will
  impair agni and therefore affect metabolism.
• Agni plays a vital role in the creation and
  maintenance of dhatus (body tissues).
• Agni contains heat which helps in the digestion
  of external elements that enter our body. The
  food which enters our digestive tract is
  converted into life sap with the help of agni.
• Agni also helps in destroying ama (toxins). These
  are produced if there is an imbalance of doshas.

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Malas, the three waste products

• These are as may be expected the feces, urine and
  sweat, and production and elimination of these
  are vital.
• Their appearance and properties can give many
  indications of the state of the tridosha and
  therefore health.

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Dhatus, the seven tissues

• The human body consists of seven basic tissues or
  organs (constructing elements) or dhatus.
• When there is a disorder in the balance of the
  tridosha, the dhatus are directly affected.
• The dhatus do not correspond to our definition of
  anatomy, but are more a tissue type than an
  individual organ.

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Diagnosis

• Taking the case history involves astrological
  considerations as well as a thorough examination,
  where the appearance of the tongue, properties of
  the urine, sweat and sputum will also be
  examined.

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Treatment

• Treatment may involve
• Diets
• Bloodletting
• Fasting
• Skin applications
• enemas
• Yogic breathing
• Herbal treatments
• minerals

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Some important herbs of Ayurveda and their uses
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