Types of herbal medicine systems

Use of medicinal plants can be as informal as, for example, culinary use or consumption of an herbal tea or supplement, although the sale of some herbs considered dangerous is often restricted to the public. Sometimes such herbs are provided to professional herbalists by specialist companies. Many herbalists, both professional and amateur, often grow or "wildcraft" their own herbs.

Some researchers trained in both western and traditional Chinese medicine have attempted to deconstruct ancient medical texts in the light of modern science. One idea is that the yin-yang balance, at least with regard to herbs, corresponds to the pro-oxidant and anti-oxidant balance. This interpretation is supported by several investigations of the ORAC ratings of various yin and yang herbs.

In America, early settlers relied on plants imported from Europe, and also from local Indian knowledge. One particularly successful practitioner, Samuel Thomson developed a hugely popular system of medicine. This approach was subsequently broadened to include concepts introduced from modern physiology, a discipline called Physiomedicalism. Another group, the Eclectics, were a later offshoot from the orthodox medical profession, who were looking to avoid the then current medical treatments of mercury and bleeding, and introduced herbal medicine into their practices. Both groups were eventually overcome by the actions of the American Medical Association, which was formed for this purpose. Cherokee medicine tends to divide herbs into foods, medicines and toxins and to use seven plants in the treatment of disease, which is defined with both spiritual and physiological aspects, according to Cherokee herbalist David Winston.^[66]

In India, Ayurvedic medicine has quite complex formulas with 30 or more ingredients, including a sizable number of ingredients that have undergone "alchemical processing", chosen to balance "Vata", "Pitta" or "Kapha."^[67]

In Tamil Nadu, Tamils have their own medicinal system now popularly called the Siddha medicinal system. The Siddha system is entirely in the Tamil language. It contains roughly 300,000 verses covering diverse aspects of medicine such as anatomy, sex ("kokokam" is the sexual treatise of par excellence), herbal, mineral and metallic compositions to cure many diseases that are relevant even to-day. Ayurveda is in Sanskrit, but Sanskrit was not generally used as a mother tongue and hence its medines are mostly taken from Siddha and other local traditions.

In addition there are more modern theories of herbal combination like William LeSassier's triune formula which combined Pythagorean imagery with Chinese medicine ideas and resulted in 9 herb formulas which supplemented, drained or neutrally nourished the main organ systems affected and three associated systems. His system has been taught to thousands of influential American herbalists through his own apprenticeship programs during his lifetime, the William LeSassier Archive and the David Winston Center for Herbal Studies.

Many traditional African remedies have performed well in initial laboratory tests to ensure they are not toxic and in tests on animals. Gawo, a herb used in traditional treatments, has been tested in rats by researchers from Nigeria's University of Jos and the National Institute for Pharmaceutical Research and Development. According to research in the African Journal of Biotechnology, Gawo passed tests for toxicity and reduced induced fevers, diarrhoea and inflammation

Herbal philosophy

Four approaches to the use of plants as medicine include:

1. The magical/shamanic

Almost all non-modern societies recognise this kind of use. The practitioner is regarded as endowed with gifts or powers that allow him/her to use herbs in a way that is hidden from the average person, and the herbs are said to affect the spirit or soul of the person.

2. The energetic

This approach includes the major systems of TCM, Ayurveda, and Unani. Herbs are regarded as having actions in terms of their energies and affecting the energies of the body. The practitioner may have extensive training, and ideally be sensitive to energy, but need not have supernatural powers.

3. The functional dynamic

This approach was used by early physiomedical practitioners, whose doctrine forms the basis of contemporary practice in the UK. Herbs have a functional action, which is not necessarily linked to a physical compound, although often to a physiological function, but there is no explicit recourse to concepts involving energy.

4. The chemical

Modern practitioners - called Phytotherapists - attempt to explain herb actions in terms of their chemical constituents. It is generally assumed that the specific combination of secondary metabolites in the plant are responsible for the activity claimed or demonstrated, a concept called synergy.

Most modern herbalists concede that pharmaceuticals are more effective in emergency situations where time is of the essence. An example would be where a patient had an acute heart attack that posed imminent danger. However they claim that over the long term herbs can help the patient resist disease, and that in addition, they provide nutritional and immunological support that pharmaceuticals lack. They view their goal as prevention as well as cure.

Herbalists tend to use extracts from parts of plants, such as the roots or leaves but not isolate particular phytochemicals. medicine prefers single ingredients on the grounds that dosage can be more easily quantified. It is also possible to patent single compounds, and therefore generate income. Herbalists often reject the notion of a single active ingredient, arguing that the different phytochemicals present in many herbs will interact to enhance the therapeutic effects of the herb and dilute toxicity.Furthermore, they argue that a single ingredient may contribute to multiple effects. Herbalists deny that herbal synergism can be duplicated with synthetic chemicals. They argue that phytochemical interactions and trace components may alter the drug response in ways that cannot currently be replicated with a combination of a few putative active ingredients. Pharmaceutical researchers recognize the concept of drug synergism but note that clinical trials may be used to investigate the efficacy of a particular herbal preparation, provided the formulation of that herb is consistent.

Thai chili peppers contain capsaicin

In specific cases the claims of synergy and multifunctionality have been supported by science. The open question is how widely both can be generalized. Herbalists would argue that cases of synergy can be widely generalized, on the basis of their interpretation of evolutionary history, not necessarily shared by the pharmaceutical community. Plants are subject to similar selection pressures as humans and therefore they must develop resistance to threats such as radiation, rmicrobial attack in order to survive. Optimal chemical defenses eactive oxygen species and have been selected for and have thus developed over millions of years. Human diseases are multifactorial and may be treated by consuming the chemical defences that they believe to be present in herbs. Bacteria, inflammation, nutrition and ROS (reactive oxygen species) may all play a role in arterial disease. Herbalists claim a single herb may simultaneously address several of these factors. Likewise a factor such as ROS may underlie more than one condition. In short herbalists view their field as the study of a web of relationships rather than a quest for single cause and a single cure for a single condition.

In selecting herbal treatments herbalists may use forms of information that are not applicable to pharmacists. Because herbs can moonlight as vegetables, teas or spices they have a huge consumer base and large-scale epidemiological studies become feasible. Ethnobotanical studies are another source of information. For example, when indigenous peoples from geographically dispersed areas use closely related herbs for the same purpose that is taken as supporting evidence for its efficacy. Herbalists contend that historical medical records and herbals are underutilized resources. They favor the use of convergent information in assessing the medical value of plants. An example would be when in-vitro activity is consistent with traditional use.

Role of herbal medicine in modern human society

The use of herbs to treat disease is almost universal among non-industrialized societies. A number of traditions came to dominate the practice of herbal medicine at the end of the twentieth century:

• The "classical" herbal medicine system, based on Greek and Roman sources
• The Siddha and Ayurvedic medicine systems from various South Asian Countries
• Chinese herbal medicine (Chinese herbology) (zhōngyào)
• Unani-Tibb medicine
• Shamanic herbalism: a catch-all phrase for information mostly supplied from South America and the Himalayas

Many of the pharmaceuticals currently available to physicians have a long history of use as herbal remedies, including opium, aspirin, digitalis, and quinine. The World Health Organization (WHO) estimates that 80 percent of the world's population presently uses herbal medicine for some aspect of primary health care.Pharmaceuticals are prohibitively expensive for most of the world's population, half of which lives on less than $2 U.S. per day. comparison, herbal medicines can be grown from seed or gathered from nature for little or no cost. Herbal medicine is a major component in all traditional medicine systems, and a common element in Siddha, Ayurvedic, homeopathic, naturopathic, traditional Chinese medicine, and Native American medicine.

The use of, and search for, drugs and dietary supplements derived from plants have accelerated in recent years. Pharmacologists, microbiologists, botanists, and natural-products chemists are combing the Earth for phytochemicals and leads that could be developed for treatment of various diseases. In fact, according to the World Health Organisation, approximately 25% of modern drugs used in the United States have been derived from plants.

• Three quarters of plants that provide active ingredients for prescription drugs came to the attention of researchers because of their use in traditional medicine.
  
• Among the 120 active compounds currently isolated from the higher plants and widely used in modern medicine today, 80 percent show a positive correlation between their modern therapeutic use and the traditional use of the plants from which they are derived.
• More than two thirds of the world's plant species - at least 35,000 of which are estimated to have medicinal value - come from the developing countries.
  
• At least 7,000 medical compounds in the modern pharmacopoeia are derived from plants^.

Biological background

The anthocyanins in sweet violets produce deep red, violet and blue shades.

The carotenoids in primrose produce bright red, yellow and orange shades.

All plants produce chemical compounds as part of their normal metabolic activities. These are arbitrarily divided into primary metabolites, such as sugars and fats, found in all plants, and secondary metabolites, compounds not essential for basic function found in a smaller range of plants, some useful ones found only in a particular genus or species. Pigments harvest light, protect the organism from radiation and display colors to attract pollinators. Many common weeds, such as nettle, dandelion and chickweed, have medicinal properties.

The functions of secondary metabolites are varied. For example, some secondary metabolites are toxins used to deter predation, and others are pheromones used to attract insects for pollination. Phytoalexins protect against bacterial and fungal attacks. Allelochemicals inhibit rival plants that are competing for soil and light.

Plants upregulate and downregulate their biochemical paths in response to the local mix of herbivores, pollinators and microorganisms.^[45] The chemical profile of a single plant may vary over time as it reacts to changing conditions. It is the secondary metabolites and pigments that can have therapeutic actions in humans and which can be refined to produce drugs.

Plants synthesize a bewildering variety of phytochemicals but most are derivatives of a few biochemical motifs.

• Alkaloids contain a ring with nitrogen. Many alkaloids have dramatic effects on the central nervous system. Caffeine is an alkaloid that provides a mild lift but the alkaloids in datura cause severe intoxication and even death.
• Phenolics contain phenol rings. The anthocyanins that give grapes their purple color, the isoflavones, the phytoestrogens from soy and the tannins that give tea its astringency are phenolics.
• Terpenoids are built up from terpene building blocks. Each terpene consists of two paired isoprenes. The names monoterpenes, sesquiterpenes, diterpenes and triterpenes are based on the number of isoprene units. The fragrance of rose and lavender is due to monoterpenes. The carotenoids produce the reds, yellows and oranges of pumpkin, corn and tomatoes.
• Glycosides consist of a glucose moiety attached to an aglycone. The aglycone is a molecule that is bioactive in its free form but inert until the glycoside bond is broken by water or enzymes. This mechanism allows the plant to defer the availability of the molecule to an appropriate time, similar to a safety lock on a gun. An example is the cyanoglycosides in cherry pits that release toxins only when bitten by a herbivore.

The word drug itself comes from the Dutch word "droog" (via the French word Drogue), which means 'dried plant'. Some examples are inulin from the roots of dahlias, quinine from the cinchona, morphine and codeine from the poppy, and digoxin from the foxglove.

The active ingredient in willow bark, once prescribed by Hippocrates, is salicin, which is converted in the body into salicylic acid. The discovery of salicylic acid would eventually lead to the development of the acetylated form acetylsalicylic acid, also known as "aspirin", when it was isolated from a plant known as meadowsweet. The word aspirin comes from an abbreviation of meadowsweet's Latin genus Spiraea, with an additional "A" at the beginning to acknowledge acetylation, and "in" was added at the end for easier pronunciation.^[46] "Aspirin" was originally a brand name, and is still a protected trademark in some countries. This medication was patented by Bayer AG.

Herbs in history

In the written record, the study of herbs dates back over 5,000 years to the Sumerians, who described well-established medicinal uses for such plants as laurel, caraway, and thyme. Ancient Egyptian medicine of 1000 B.C. are known to have used garlic, opium, castor oil, coriander, mint, indigo, and other herbs for medicine and the Old Testament also mentions herb use and cultivation, including mandrake, vetch, caraway, wheat, barley, and rye.
Indian Ayurveda medicine has used herbs such as turmeric possibly as early as 1900 B.C.Many other herbs and minerals used in Ayurveda were later described by ancient Indian herbalists such as Charaka and Sushruta during the 1st millenium BC. The Sushruta Samhita attributed to Sushruta in the 6th century BC describes 700 medicinal plants, 64 preparations from mineral sources, and 57 preparations based on animal sources.
The first Chinese herbal book, the Shennong Bencao Jing, compiled during the Han Dynasty but dating back to a much earlier date, possibly 2700 B.C., lists 365 medicinal plants and their uses - including ma-Huang, the shrub that introduced the drug ephedrine to modern medicine. Succeeding generations augmented on the Shennong Bencao Jing, as in the Yaoxing Lun (Treatise on the Nature of Medicinal Herbs), a 7th century Tang Dynasty treatise on herbal medicine.
The ancient Greeks and Romans made medicinal use of plants. Greek and Roman medicinal practices, as preserved in the writings of Hippocrates and - especially - Galen, provided the pattern for later western medicine. Hippocrates advocated the use of a few simple herbal drugs - along with fresh air, rest, and proper diet. Galen, on the other hand, recommended large doses of drug mixtures - including plant, animal, and mineral ingredients. The Greek physician compiled the first European treatise on the properties and uses of medicinal plants, De Materia Medica. In the first century AD, Dioscorides wrote a compendium of more than 500 plants that remained an authoritative reference into the 17th century. Similarly important for herbalists and botanists of later centuries was the Greek book that founded the science of botany, Theophrastus’ Historia Plantarum, written in the fourth century B.C.

Middle Ages
The uses of plants for medicine and other purposes changed little in early medieval Europe. Many Greek and Roman writings on medicine, as on other subjects, were preserved by hand copying of manuscripts in monasteries. The monasteries thus tended to become local centers of medical knowledge, and their herb gardens provided the raw materials for simple treatment of common disorders. At the same time, folk medicine in the home and village continues uninterrupted, supporting numerous wandering and settled herbalists. Among these were the “wise-women,” who prescribed herbal remedies often along with spells and enchantments. It was not until the late Middle Ages that women who were knowledgeable in herb lore became the targets of the witch hysteria. One of the most famous women in the herbal tradition was Hildegard of Bingen. A twelfth century Benedictine nun, she wrote a medical text called Causes and Cures.
Medical schools known as Bimaristan began to appear from the 9th century in the medieval Islamic world, which was generally more advanced than medieval Europe at the time. The Arabs venerated Greco-Roman culture and learning, and translated tens of thousands of texts into Arabic for further study. As a trading culture, the Arab travellers had access to plant material from distant places such as China and India. Herbals, medical texts and translations of the classics of antiquity filtered in from east and west. Muslim botanists and Muslim physicians significantly expanded on the earlier knowledge of materia medica. For example, al-Dinawari described more than 637 plant drugs in the 9th century, and Ibn al-Baitar described more than 1,400 different plants, foods and drugs, over 300 of which were his own original discoveries, in the 13th century.The experimental scientific method was introduced into the field of materia medica in the 13th century by the Andalusian-Arab botanist Abu al-Abbas al-Nabati, the teacher of Ibn al-Baitar. Al-Nabati introduced empirical techniques in the testing, description and identification of numerous materia medica, and he separated unverified reports from those supported by actual tests and observations. This allowed the study of materia medica to evolve into the science of pharmacology.
Avicenna's The Canon of Medicine (1025) is considered the first pharmacopoeia,and lists 800 tested drugs, plants and minerals.Book Two is devoted to a discussion of the healing properties of herbs, including nutmeg, senna, sandalwood, rhubarb, myrrh, cinammon, and rosewater.Baghdad was an important center for Arab herbalism, as was Al-Andalus between 800 and 1400. Abulcasis (936-1013) of Cordoba authored The Book of Simples, an important source for later European herbals, while Ibn al-Baitar (1197-1248) of Malaga authored the Corpus of Simples, the most complete Arab herbal which introduced 200 new healing herbs, including tamarind, aconite, and nux vomica.Other pharmacopoeia books include that written by Abu-Rayhan Biruni in the 11th century and Ibn Zuhr (Avenzoar) in the 12th century (and printed in 1491), The origins of clinical pharmacology also date back to the Middle Ages in Avicenna's The Canon of Medicine, Peter of Spain's Commentary on Isaac, and John of St Amand's Commentary on the Antedotary of Nicholas.In particular, the Canon introduced clinical trials, randomized controlled trials, and efficacy tests.
Alongside the university system, folk medicine continued to thrive. The continuing importance of herbs for the centuries following the Middle Ages is indicated by the hundreds of herbals published after the invention of printing in the fifteenth century. Theophrastus’ Historia Plantarum was one of the first books to be printed, but Dioscorides’ De Materia Medica, Avicenna's Canon of Medicine and Avenzoar's pharmacopoeia were not far behind.

Modern era
The fifteenth, sixteenth, and seventeenth centuries were the great age of herbals, many of them available for the first time in English and other languages rather than Latin or Greek. The first herbal to be published in English was the anonymous Grete Herball of 1526. The two best-known herbals in English were The Herball or General History of Plants (1597) by John Gerard and The English Physician Enlarged (1653) by Nicholas Culpeper. Gerard’s text was basically a pirated translation of a book by the Belgian herbalist Dodoens and his illustrations came from a German botanical work. The original edition contained many errors due to faulty matching of the two parts. Culpeper’s blend of traditional medicine with astrology, magic, and folklore was ridiculed by the physicians of his day yet his book - like Gerard’s and other herbals - enjoyed phenomenal popularity. The Age of Exploration and the Columbian Exchange introduced new medicinal plants to Europe. The Badianus Manuscript was an illustrated Aztec herbal translated into Latin in the 16th century.
The second millennium, however, also saw the beginning of a slow erosion of the pre-eminent position held by plants as sources of therapeutic effects. This began with the Black Death, which the then dominant Four Element medical system proved powerless to stop. A century later, Paracelsus introduced the use of active chemical drugs (like arsenic, copper sulfate, iron, mercury, and sulfur). These were accepted even though they had toxic effects because of the urgent need to treat Syphilis. The rapid development of chemistry and the other physical sciences, led increasingly to the dominance of chemotherapy - chemical medicine - as the orthodox system of the twentieth century.

Anthropology of herbalism

People on all continents have used hundreds to thousands of indigenous plants for treatment of ailments since prehistoric times. Medicinal herbs were found in the personal effects of an "ice man", whose body was frozen in the Swiss Alps for more than 5,300 years. These herbs appear to have been used to treat the parasites found in his intestines. Anthropology or anthropologists theorize that animals evolved a tendency to seek out bitter plant parts in response to illness.

Indigenous healers often claim to have learned by observing that sick animals change their food preferences to nibble at bitter herbs they would normally reject.Field biologists have provided corroborating evidence based on observation of diverse species, such as chimpanzees, chickens, sheep and butterflies. Lowland gorillas take 90% of their diet from the fruits of Aframomum melegueta, a relative of the ginger plant, that is a potent antimicrobial and apparently keeps shigellosis and similar infections at bay.

Researchers from Ohio Wesleyan University found that some birds select nesting material rich in antimicrobial agents which protect their young from harmful bacteria.

Sick animals tend to forage plants rich in secondary metabolites, such as tannins and alkaloids. Since these phytochemicals often have antiviral, antibacterial, antifungal and antihelminthic properties, a plausible case can be made for self-medication by animals in the wild.

Some animals have digestive systems especially adapted to cope with certain plant toxins. For example, the koala can live on the leaves and shoots of the eucalyptus, a plant that is dangerous to most animals.A plant that is harmless to a particular animal may not be safe for humans to ingest.A reasonable conjecture is that these discoveries were traditionally collected by the medicine people of indigenous tribes, who then passed on safety information and cautions.

The use of herbs and spices in cuisine developed in part as a response to the threat of food-borne pathogens. Studies show that in tropical climates where pathogens are the most abundant, recipes are the most highly spiced. Further, the spices with the most potent antimicrobial activity tend to be selected.In all cultures vegetables are spiced less than meat, presumably because they are more resistant to spoilage.