India is known for its traditional medicinal systems—Ayurveda, Siddha, and Unani. Medical systems are found mentioned even in the ancient Vedas and other scriptures. The Ayurvedic concept appeared and developed between 2500 and 500 BC in India . The literal meaning of Ayurveda is “science of life,” because ancient Indian system of health care focused on views of man and his illness.
It has been pointed out that the positive health means metabolically well-balanced human beings. Ayurveda is also called the “science of longevity” because it offers a complete system to live a long healthy life. It offers programs to rejuvenate the body through diet and nutrition. It offers treatment methods to cure many common diseases such as food allergies, which have few modern treatments. However, one should be aware that Ayurvedic nutrition is not a “magic bullet” system but requires the full participation of the patient to succeed. It is an interactive system that is user-friendly and educational. It teaches the patient to become responsible and self-empowered. Ayurveda is not a nutritional system for those seeking an escape or excuse to further abuse their body or mind. It is a system for empowerment, a system of freedom, and long life.
Food is the major source for serving the nutritional needs, but with growing modernization some traditional methods are being given up . Hence, the modern food habits are affecting the balanced nutrition . There is an ever widening gap in nutrient intake due to which normal life is no longer normal. However, affluence of working population with changing lifestyles and reducing affordability of sick care, in terms of time and money involved, are some of the forces that are presently driving people towards thinking about their wellness.
The first documented knowledge about medicines in India is found in the Rig Veda (Oshadhi Sooktam) and the Atharva Veda, which are believed to be more than 5000 years old. In addition to providing mantras against diseases and information about useful plants and herbs, the Atharva Veda says that diseases are caused by organisms called yatudhana, kimidin, krimi, etc.
The term “medicinal plant” include various types of plants used in herbalism (“herbology” or “herbal medicine”). It is the use of plants for medicinal purposes, and the study of such uses.
The word “herb” has been derived from the Latin word, “herba” and an old French word “herbe”. Now a days, herb refers to any part of the plant like fruit, seed, stem, bark, flower, leaf, stigma or a root, as well as a non-woody plant. Earlier, the term “herb” was only applied to non-woody plants, including those that come from trees and shrubs. These medicinal plants are also used as food, flavonoid, medicine or perfume and also in certain spiritual activities.
Over the following centuries, the study of medicine grew more systematic, and became known as Ayur Veda (Life Science). Three important foundation texts of Ayurveda were compiled in the first millennium BCE: Atreya Samhita, Susruta Samhita, and Charaka Samhita. These texts cover all the branches of modern medicine, and describe over 600 drugs of animal, plant and mineral origin.
According to Ayurveda, an individual can enjoy good health only if the body, mind and soul are all properly nurtured. The human body, like the entire universe, is composed of five elements: Prithvi (earth), Apas (water), Tejas (energy/ fire), Vayu (air), and Akasa (empty space). When these are properly balanced, the body is said to be healthy. People are classified into three doshas or types — Vata, Pitta and Kapha. Vata has the qualities of air and space, and regulates all the movements of the body. Pitta has the qualities of fire and water, provides energy to the body and regulates our digestion, metabolism, temperature, sense organs and understanding. Kapha is composed of earth and water, and gives stability and structure to the skeleton and all the organs of the body. Depending on which of these elements are predominant in a person, cures are suggested.
Plants have been used for medicinal purposes long before prehistoric period. Ancient Unani manuscripts Egyptian papyrus and Chinese writings described the use of herbs. Evidence exist that Unani Hakims, Indian Vaids and European and Mediterranean cultures were using herbs for over 4000 years as medicine. Indigenous cultures such as Rome, Egypt, Iran, Africa and America used herbs in their healing rituals, while other developed traditional medical systems such as Unani, Ayurveda and Chinese Medicine in which herbal therapies were used systematically.
Traditional systems of medicine continue to be widely practised on many accounts. Population rise, inadequate supply of drugs, prohibitive cost of treatments, side effects of several synthetic drugs and development of resistance to currently used drugs for infectious diseases have led to increased emphasis on the use of plant materials as a source of medicines for a wide variety of human ailments.
Among ancient civilisations, India has been known to be rich repository of medicinal plants. The forest in India is the principal repository of large number of medicinal and aromatic plants, which are largely collected as raw materials for manufacture of drugs and perfumery products. About 8,000 herbal remedies have been codified in AYUSH systems in INDIA. Ayurveda, Unani, Siddha and Folk (tribal) medicines are the major systems of indigenous medicines. Among these systems, Ayurveda and Unani Medicine are most developed and widely practised in India.
Recently, WHO (World Health Organization) estimated that 80 percent of people worldwide rely on herbal medicines for some aspect of their primary health care needs. According to WHO, around 21,000 plant species have the potential for being used as medicinal plants.
As per data available over three-quarters of the world population relies mainly on plants and plant extracts for their health care needs. More than 30% of the entire plant species, at one time or other were used for medicinal purposes. It has been estimated, that in developed countries such as United States, plant drugs constitute as much as 25% of the total drugs, while in fast developing countries such as India and China, the contribution is as much as 80%. Thus, the economic importance of medicinal plants is much more to countries such as India than to rest of the world. These countries provide two third of the plants used in modern system of medicine and the health care system of rural population depend on indigenous systems of medicine.
Treatment with medicinal plants is considered very safe as there is no or minimal side effects. These remedies are in sync with nature, which is the biggest advantage. The golden fact is that, use of herbal treatments is independent of any age groups and the sexes.
The ancient scholars only believed that herbs are only solutions to cure a number of health related problems and diseases. They conducted thorough study about the same, experimented to arrive at accurate conclusions about the efficacy of different herbs that have medicinal value. Most of the drugs, thus formulated, are free of side effects or reactions. This is the reason why herbal treatment is growing in popularity across the globe. These herbs that have medicinal quality provide rational means for the treatment of many internal diseases, which are otherwise considered difficult to cure.
Medicinal plants such as Aloe, Tulsi, Neem, Turmeric and Ginger cure several common ailments. These are considered as home remedies in many parts of the country. It is known fact that lots of consumers are using Basil (Tulsi) for making medicines, black tea, in pooja and other activities in their day to day life.
In several parts of the world many herbs are used to honour their kings showing it as a symbol of luck. Now, after finding the role of herbs in medicine, lots of consumers started the plantation of tulsi and other medicinal plants in their home gardens.
Medicinal plants are considered as a rich resources of ingredients which can be used in drug development either pharmacopoeial, non- pharmacopoeial or synthetic drugs. A part from that, these plants play a critical role in the development of human cultures around the whole world. Moreover, some plants are considered as important source of nutrition and as a result of that they are recommended for their therapeutic values. Some of these plants include ginger, green tea, walnuts, aloe, pepper and turmeric etc. Some plants and their derivatives are considered as important source for active ingredients which are used in aspirin and toothpaste etc.
Apart from the medicinal uses, herbs are also used in natural dye, pest control, food, perfume, tea and so on. In many countries different kinds of medicinal plants/ herbs are used to keep ants, flies, mice and flee away from homes and offices. Now a days medicinal herbs are important sources for pharmaceutical manufacturing.
Recipes for the treatment of common ailments such as diarrhoea, constipation, hypertension, low sperm count, dysentery and weak penile erection, piles, coated tongue, menstrual disorders, bronchial asthma, leucorrhoea and fevers are given by the traditional medicine practitioners very effectively.
Over the past two decades, there has been a tremendous increase in the use of herbal medicine; however, there is still a significant lack of research data in this field. Therefore since 1999, WHO has published three volumes of the WHO monographs on selected medicinal plants.
Ayurveda is an alternative medicine system with historical roots in the Indian subcontinent.The theory and practice of Ayurveda is pseudoscientific.The Indian Medical Association labels Ayurvedic practitioners who claim to practice medicine as quacks.Ayurveda is heavily practiced in India and Nepal, where around 80% of the population report using it.
Ayurveda therapies have varied and evolved over more than two millennia. Therapies include herbal medicines, special diets, meditation, yoga, massage, laxatives, enemas, and medical oils. Medicines are typically based on complex herbal compounds, minerals, and metal substances (perhaps under the influence of early Indian alchemy or rasa shastra). Ancient Ayurveda texts also taught surgical techniques, including rhinoplasty, kidney stone extractions, sutures, and the extraction of foreign objects.
The main classical Ayurveda texts begin with accounts of the transmission of medical knowledge from the gods to sages, and then to human physicians. In Sushruta Samhita (Sushruta’s Compendium), Sushruta wrote that Dhanvantari, Hindu god of Ayurveda, incarnated himself as a king of Varanasi and taught medicine to a group of physicians, including Sushruta. Ayurveda has been adapted for Western consumption, notably by Baba Hari Dass in the 1970s and Maharishi Ayurveda in the 1980s. Some scholars assert that Ayurveda originated in prehistoric times, and that some of the concepts of Ayurveda have existed from the time of the Indus Valley Civilization or even earlier. Ayurveda developed significantly during the Vedic period and later some of the non-Vedic systems such as Buddhism and Jainism also developed medical concepts and practices that appear in the classical Ayurveda texts.
In Ayurveda texts, Doṣa balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness. Ayurveda treatises describe three elemental doṣas viz. vāta, pitta and kapha, and state that balance (Skt. sāmyatva) of the doṣas results in health, while imbalance (viṣamatva) results in disease. Ayurveda treatises divide medicine into eight canonical components. Ayurveda practitioners had developed various medicinal preparations and surgical procedures from at least the beginning of the common era.
There is no good evidence that Ayurveda is effective for treating any disease. Ayurvedic preparations have been found to contain lead, mercury, and arsenic, substances known to be harmful to humans. In a 2008 study, close to 21% of U.S. and Indian-manufactured patent Ayurvedic medicines sold through the Internet were found to contain toxic levels of heavy metals, specifically lead, mercury, and arsenic. The public health implications of such metallic contaminants in India are unknown.
In rural India, siddhars have learned methods traditionally through master-disciple relationships to become local “healers”. Siddhars are among an estimated 400,000 traditional healers practicing medicine in India, comprising some 57% of rural medical care. Siddha practitioners believe that five basic elements – earth, water, fire, air, sky – are in food, “humours” of the human body, and herbal, animal or inorganic chemical compounds, such as sulfur and mercury, used as therapies for treating diseases.
The Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy of the Government of India regulates training in Siddha medicine and other traditional practices grouped collectively as AYUSH. Practitioners are called siddhars (vaithiyars in Tamil), and may have formal training with advanced degrees, such as BSMS (Bachelor in Siddha Medicine and Surgery), MD (Medical Doctor, Siddha) or Doctor of Philosophy (PhD). The Central Council of Indian Medicine, a statutory body established in 1971 under AYUSH, monitors education in areas of rural Indian medicine, including Siddha medicine.The Indian Medical Association regards Siddha medicine degrees as “fake” and Siddha therapies as quackery, posing a danger to national health due to absence of training in science. Identifying fake medical practitioners without qualifications, the Supreme Court of India stated in 2018 that “unqualified, untrained quacks are posing a great risk to the entire society and playing with the lives of people without having the requisite training and education in the science from approved institutions”.The Tamil Nadu state runs a 5.5-year course in Siddha medicine (BSMS: Bachelor in Siddha Medicine and Surgery). The Indian Government also gives its focus on Siddha, by starting up medical colleges and research centers like National Institute of Siddha. and Central Council for Research in Siddha. Commercially, Siddha medicine is practiced by siddhars referred in Tamil as vaithiyars.
The Hellenistic origin of Unani medicine is still visible in its being based on the classical four humours: phlegm (balgham), blood (dam), yellow bile (ṣafrā) and black bile (saudā’), but it has also been influenced by Indian and Chinese traditional systems. The Indian Medical Association (IMA) estimated in 2014 that approximately 400,000 practitioners of Indian traditional medicine (Unani, Ayurveda and Siddha medicine) were illicitly practicing modern medicine without having the qualifications to do so; the IMA regards such practices as quackery. Practitioners of any medical system, including Unani medicine, are not authorized to practice medicine in India unless trained at a qualified medical institution, registered with the government, and listed as physicians annually in The Gazette of India. Referring to unqualified practitioners of all medical systems, the Supreme Court of India stated in 2018 that “unqualified, untrained quacks are posing a great risk to the entire society and playing with the lives of people without having the requisite training and education in the science from approved institutions”.
According to Unani medicine, management of any disease depends upon the diagnosis of disease. Proper diagnosis depends upon observation of the patient’s symptoms and temperament.
Unani, like Ayurveda, is based on theory of the presence of the elements in the human body. According to followers of Unani medicine, these elements are present in fluids and their balance leads to health and their imbalance leads to illness.
According to Unani practitioners, the failure of the Quwwat-e-Mudabbira-e-Badan, or the body’s ability to maintain its own health, may lead to derangement of the normal equilibrium of the body’s akhlat (humors). Abnormal humors are believed to lead to pathological changes in the tissues at the affected site, creating the clinical manifestations of illness. The theory postulates the presence of blood, phlegm, yellow bile and black bile in the human body. Each person’s unique mixture of these substances determines his mizaj (temperament). A predominance of blood gives a sanguine temperament; a predominance of phlegm makes one phlegmatic; yellow bile, bilious (or choleric); and black bile, melancholic.
Ancient medicinal plants
The oldest written evidence of medicinal plants’ usage for preparation of drugs has been found on a Sumerian clay slab from Nagpur, approximately 5000 years old. It comprised 12 recipes for drug preparation referring to over 250 various plants, some of them alkaloid such as poppy, henbane, and mandrake.
The Chinese book on roots and grasses “Pen T’Sao,” written by Emperor Shen Nung circa 2500 BC, treats 365 drugs (dried parts of medicinal plants), many of which are used even nowadays such as the following: Rhei rhisoma, camphor, Theae folium, Podophyllum, the great yellow gentian, ginseng, jimson weed, cinnamon bark, and ephedra.The Indian holy books Vedas mention treatment with plants, which are abundant in that country. Numerous spice plants used even today originate from India: nutmeg, pepper, clove, etc.
The Ebers Papyrus, written circa 1550 BC, represents a collection of 800 proscriptions referring to 700 plant species and drugs used for therapy such as pomegranate, castor oil plant, aloe, senna, garlic, onion, fig, willow, coriander, juniper, common centaury, etc.According to data from the Bible and the holy Jewish book the Talmud, during various rituals accompanying a treatment, aromatic plants were utilized such as myrtle and incense.In Homer’s epics The Iliad and The Odysseys, created circa 800 BC, 63 plant species from the Minoan, Mycenaean, and Egyptian Assyrian pharmacotherapy were referred to. Some of them were given the names after mythological characters from these epics; for instance, Elecampane (Inula helenium L. Asteraceae) was named in honor of Elena, who was the centre of the Trojan War. As regards the plants from the genus Artemisia, which were believed to restore strength and protect health, their name was derived from the Greek word artemis, meaning “healthy.” Herodotus (500 BC) referred to castor oil plant, Orpheus to the fragrant hellebore and garlic, and Pythagoras to the sea onion (Scilla maritima), mustard, and cabbage. The works of Hippocrates (459–370 BC) contain 300 medicinal plants classified by physiological action: Wormwood and common centaury (Centaurium umbellatum Gilib) were applied against fever; garlic against intestine parasites; opium, henbane, deadly nightshade, and mandrake were used as narcotics; fragrant hellebore and haselwort as emetics; sea onion, celery, parsley, asparagus, and garlic as diuretics; oak and pomegranate as adstringents.
Theophrast (371-287 BC) founded botanical science with his books “De Causis Plantarium”— Plant Etiology and “De Historia Plantarium”—Plant History. In the books, he generated a classification of more than 500 medicinal plants known at the time. Among others, he referred to cinnamon, iris rhizome, false hellebore, mint, pomegranate, cardamom, fragrant hellebore, monkshood, and so forth. In the description of the plant toxic action, Theophrast underscored the important feature for humans to become accustomed to them by a gradual increase of the doses. Owing to his consideration of the said topics, he gained the epithet of “the father of botany,” given that he has great merits for the classification and description of medicinal plants.
In his work “De re medica” the renowned medical writer Celsus (25 BC–50 AD) quoted approximately 250 medicinal plants such as aloe, henbane, flax, poppy, pepper, cinnamon, the star gentian, cardamom, false hellebore, etc.
In ancient history, the most prominent writer on plant drugs was Dioscorides, “the father of pharmacognosy,” who, as a military physician and pharmacognosist of Nero’s Army, studied medicinal plants wherever he travelled with the Roman Army. Circa 77 AD he wrote the work “De Materia Medica.” This classical work of ancient history, translated many times, offers plenty of data on the medicinal plants constituting the basic materia medica until the late Middle Ages and the Renaissance. Of the total of 944 drugs described, 657 are of plant origin, with descriptions of the outward appearance, locality, mode of collection, making of the medicinal preparations, and their therapeutic effect. In addition to the plant description, the names in other languages coupled with the localities where they occur or are grown are provided. The plants having mild effect are dominant, but there are also references to those containing alkaloid or other matter with strong effect (fragrant hellebore, false hellebore, poppy, buttercup, jimson weed, henbane, deadly nightshade). Dioscorides’ most appreciated domestic plants are as follows: willow, camomile, garlic, onion, marsh mallow, ivy, nettle, sage, common centaury, coriander, parsley, sea onion, and false hellebore). Camomile (Matricaria recucita L.), known under the name Chamaemelon, is used as an antiphlogistic to cure wounds, stings, burns, and ulcers, then for cleansing and rinsing the eyes, ears, nose, and mouth. Owing to its mild carminative action, it is particularly appropriate for usage with children.
Dioscorides deemed that it had abortive action, on which he wrote, “The flower, root, and the entire plant accelerate menstruation, the release of the embryo, and the discharge of urine and stone, provided that they are used in the form of an infusion and baths.” This untrue belief was later embraced by both the Romans and the Arabs; hence the Latin name Matricaria, derived from two words: mater denoting “mother,” i.e. matrix, denoting ‘uterus’. Dioscorides differentiated between a number of species from the genus Mentha, which were grown and used to relieve headache and stomach ache. The bulbs of sea onion and parsley were utilized as diuretics, oak bark was used for gynaecological purposes, while white willow was used as an antipyretic. As maintained by Dioscorides, Scillae bulbus was also applied as an expectorant, cardiac stimulant, and antihydrotic. It is worth underscoring that Dioscorides pointed to the possibility of forgery of drugs, both the domestic ones such as opium forged by a yellow poppy (Glaucium flavum) milk sap and poppy, and the more expensive oriental drugs, transported by the Arab merchants from the Far East, such as iris, calamus, caradmomum, incense, etc.Pliny the Elder (23 AD-79), a contemporary of Dioscorides, who travelled throughout Germany and Spain, wrote about approximately 1000 medicinal plants in his book “Historia naturalis.” Pliny’s and Dioscorides’ works incorporated all knowledge of medicinal plants at the time.
The most distinguished Roman physician (concurrently a pharmacist), Galen (131 AD–200), compiled the first list of drugs with similar or identical action (parallel drugs), which are interchangeable—“De succedanus.” From today’s point of view, some of the proposed substitutes do not correspond in a pharmacological context and are absolutely unacceptable. Galen also introduced several new plant drugs in therapy that Dioscorides had not described, for instance, Uvae ursi folium, used as an uroantiseptic and a mild diuretic even in this day and age.
In the seventh century AD the Slavic people used Rosmarinus officinalis, Ocimum basilicum, Iris germanica, and Mentha viridis in cosmetics, Alium sativum as a remedy and Veratrum album, Cucumis sativus, Urtica dioica, Achilea millefolium, Artemisia maritime L., Lavandula officinalis, Sambuci flos against several injurios insects, i.e. louses, fleas, moths, mosquitos, and spiders and Aconitum napellus as a poison in hunting.
In the Middle Ages, the skills of healing, cultivation of medicinal plants, and preparation of drugs moved to monasteries. Therapy was based on 16 medicinal plants, which the physicians-monks commonly grew within the monasteries as follows: sage, anise, mint, Greek seed, savory, tansy, etc.
Charles the Great (742 AD–814), the founder of the reputed medical school in Salerno, in his “Capitularies” ordered which medicinal plants were to be grown on the state-owned lands. Around 100 different plants were quoted, which have been used till present days such as sage, sea onion, iris, mint, common centaury, poppy, marsh mallow, etc. The great emperor especially appreciated the sage (Salvia officinalis L.). The Latin name of sage originates from the old Latins, who called it a salvation plant (salvare meaning “save, cure”). Even today sage is a mandatory plant in all Catholic monasteries.
The Arabs introduced numerous new plants in pharmacotherapy, mostly from India, a country they used to have trade relations with, whereas the majority of the plants were with real medicinal value, and they have persisted in all pharmacopoeias in the world till today. The Arabs used aloe, deadly nightshade, henbane, coffee, ginger, strychnos, saffron, curcuma, pepper, cinnamon, rheum, senna, and so forth. Certain drugs with strong action were replaced by drugs with mild action, for instance, Sennae folium was used as a mild laxative, compared to the purgatives Heleborus odorus and Euphorbium used until then.
Throughout the Middle Ages European physicians consulted the Arab works “De Re Medica” by John Mesue (850 AD), “Canon Medicinae” by Avicenna (980-1037), and “Liber Magnae Collectionis Simplicum Alimentorum Et Medicamentorum” by Ibn Baitar (1197-1248), in which over 1000 medicinal plants were described.
For Macedonia, St Clement and St Naum of Ohrid’s work are of particular significance. They referred to the Nikeian pharmacological codex dating from year 850, and transferred his extensive knowledge on medicinal plants to his disciples and via them to the masses.
Marco Polo’s journeys (1254-1324) in tropical Asia, China, and Persia, the discovery of America (1492), and Vasco De Gama’s journeys to India (1498), resulted in many medicinal plants being brought into Europe. Botanical gardens emerged all over Europe, and attempts were made for cultivation of domestic medicinal plants and of the ones imported from the old and the new world. With the discovery of America, materia medica was enriched with a large number of new medicinal plants: Cinchona, Ipecacuanha, Cacao, Ratanhia, Lobelia, Jalapa, Podophylum, Senega, Vanilla, Mate, tobacco, red pepper, etc. In 17th century, Cortex Chinae, yielded from quinine bark Cinchona succirubra Pavon, under the name countess’ powder, since the Countess of Chinchon was the first one who used it, was introduced to European medicine. Quinine bark rapidly overwhelmed England, France, and Germany despite the fact that there was many an opponent to its use among distinguished physicians—members of a range of academies.
Paracelsus (1493-1541) was one of the proponents of chemically prepared drugs out of raw plants and mineral substances; nonetheless, he was a firm believer that the collection of those substances ought to be astrologically determined. He continuously emphasized his belief in observation, and simultaneously supported the “Signatura doctrinae”—the signature doctrine. According to this belief, God designated his own sign on the healing substances, which indicated their application for certain diseases. For example, the haselwort is reminiscent of the liver; thus, it must be beneficial for liver diseases; St John’s wort Hypericum perforatum L. would be beneficial for treatment of wounds and stings given that the plant leaves appear as if they had been stung.
While the old peoples used medicinal plants primarily as simple pharmaceutical forms—infusions, decoctions and macerations—in the Middle Ages, and in particular between 16th and 18th centuries, the demand for compound drugs was increasing. The compound drugs comprised medicinal plants along with drugs of animal and plant origin. If the drug the theriac was produced from a number of medicinal plants, rare animals, and minerals, it was highly valued and sold expensively.
In 18th century, in his work Species Plantarium (1753), Linnaeus (1707-1788) provided a brief description and classification of the species described until then. The species were described and named without taking into consideration whether some of them had previously been described somewhere. For the naming, a polynomial system was employed where the first word denoted the genus while the remaining polynomial phrase explained other features of the plant (e.g. the willow Clusius was named Salix pumila angustifolia antera). Linnaeus altered the naming system into a binominal one. The name of each species consisted of the genus name, with an initial capital letter, and the species name, with an initial small letter.
Early 19th century was a turning point in the knowledge and use of medicinal plants. The discovery, substantiation, and isolation of alkaloids from poppy (1806), ipecacuanha (1817), strychnos (1817), quinine (1820), pomegranate (1878), and other plants, then the isolation of glycosides, marked the beginning of scientific pharmacy. With the upgrading of the chemical methods, other active sub
stances from medicinal plants were also discovered such as tannins, saponosides, etheric oils, vitamins, hormones, etc
In late 19th and early 20th centuries, there was a great danger of elimination of medicinal plants from therapy. Many authors wrote that drugs obtained from them had many shortcomings due to the destructive action of enzymes, which cause fundamental changes during the process of medicinal plants drying, i.e. medicinal plants’ healing action depends on the mode of drying. In 19th century, therapeutics, alkaloids, and glycosides isolated in pure form were increasingly supplanting the drugs from which they had been isolated. Nevertheless, it was soon ascertained that although the action of pure alkaloids was faster, the action of alkaloid drugs was full and long-lasting. In early 20th century, stabilization methods for fresh medicinal plants were proposed, especially the ones with labile medicinal components. Besides, much effort was invested in study of the conditions of manufacturing and cultivation of medicinal plants.
On account of chemical, physiological, and clinical studies, numerous forgotten plants and drugs obtained thereof were restored to pharmacy: Aconitum, Punica granatum, Hyosciamus, Stramonium, Secale cornutum, Filix mas, Opium, Styrax, Colchicum, Ricinus, and so forth. The active components of medicinal plants are a product of the natural, most seamless laboratory. The human organism accepts the drug obtained from them best in view of the fact that man is an integral part of nature. There are scores of examples of this kind; perhaps they will instigate serious research into the old manuscripts on medicinal plants, which would not be observed out of curiosity about history but as potential sources of contemporary pharmacotherapy.
In present days, almost all pharmacopoeias in the world—Ph Eur 6, USP XXXI, BP 2007—proscribe plant drugs of real medicinal value. There are countries (the United Kingdom, Russia, Germany) that have separate herbal pharmacopoeias. Yet, in practice, a much higher number of unofficial drugs are always used. Their application is grounded on the experiences of popular medicine (traditional or popular medicine) or on the new scientific research and experimental results (conventional medicine). Many medicinal plants are applied through self-medication or at the recommendation of a physician or pharmacist. They are used independently or in combination with synthetic drugs (complementary medicine). For the sake of adequate and successfully applied therapy, knowledge of the precise diagnosis of the illness as well as of medicinal plants, i.e. the pharmacological effect of their components is essential. Plant drugs and phytopreparations, most commonly with defined active components, verified action and, sometimes, therapeutic efficiency, are applied as therapeutic means. In the major European producer and consumer of herbal preparations—Germany, rational phytotherapy is employed, based on applications of preparations whose efficiency depends on the applied dose and identified active components, and their efficiency has been corroborated by experimental and clinical tests. Those preparations have been manufactured from standardized plant drug extracts, and they adhere to all requirements for pharmaceutical quality of drugs.
With the new Law on Drugs and Medical Devices dated September 2007 and enacted in the Republic of Macedonia, dry or sometimes fresh parts of medicinal plants (herbal substances) may be used for preparation of herbal drugs, herbal processed products, and traditional herbal drugs. Herbal substances may also be utilized for manufacture of homeopathic drugs, which are stipulated in the current law, too. In the Republic of Macedonia herbal preparations are dispensed without a medical prescription, as “over the counter” (OTC) preparations.
Use of medicinal Plants
Evidence exists that plants were used for medicinal purposes some 60,000 years ago. A burial site of a Neanderthal man was uncovered in 1960. Eight species of plants had been buried with him, some of which are still used for medicinal purposes today.
By 3500 BC, Ancient Egyptians began to associate less magic with the treatment of disease, and by 2700 BC the Chinese had started to use herbs in a more scientific sense. Egyptians recorded their knowledge of illnesses and cures on temple walls and in the Ebers papyrus (1550 BC), which contains over 700 medicinal formulas.
Hippocrates, 460-380 BC, known as the “Father of Medicine,” classified herbs into their essential qualities of hot and cold, moist and dry, and developed a system of diagnosis and prognosis using herbs. The number of effective medicinal plants he discussed was between 300 and 400 species.
Aristotle, the philosopher, also compiled a list of medicinal plants. His best student, Theophrastus discussed herbs as medicines, the kinds and parts of plants used, collection methods, and effects on humans and animals. He started the science of botany with detailed descriptions of medicinal plants growing in the botanical gardens in Athens.
The most significant contribution to the medicinal plant descriptions was made by Dioscorides. While serving as a Roman army physician, he wrote De Materia Medica in about AD 60. This five-volume work is a compilation concerning approximately 500 plants and describes the preparation of about 1000 simple drugs. Written in Greek, it contains good descriptions of plants giving their origins and medical virtues and remained the standard text for 1,500 years.
The earliest Ayurvedic texts on medicine from India date from about 2,500 BC. In Ayurvedic theory, illness is seen in terms of imbalance, with herbs and dietary controls used to restore equilibrium. Abdullah Ben Ahmad Al Bitar (1021–1080 AD) an Arabic botanist and pharmaceutical scientist, wrote the Explanation of Dioscorides Book on Herbs. Later, his book, The Glossary of Drugs and Food Vocabulary, contained the names of 1,400 drugs. The drugs were listed by name in alphabetical order in Arabic, Greek, Persian or Spanish.
Galen, a physician considered the “medical pope” of the Middle Ages, wrote extensitvely about the body’s four “humors” — the four fluids that were thought to permeate the body and influence its health. Drugs developed by Galen were made from herbs that he collected from all over the world.
The studies of botany and medicine became very closely linked during the Middle Ages. Virtually all reading and writing were carried out in monasteries. Monks laboriously copied and compiled the manuscripts. Following the format of Greek botanical compilations, the monks prepared herbals that described identification and preparation of plants with reported medicinal characteristics. At this time though, healing was as much a matter of prayer as medicine. Early herbalists frequently combined religious incantations with herbal remedies believing that with “God’s help” the patient would be cured.
With time, pracitioners began to focus on healing skills and medicines. By the 1530s, Paracelsus (born Philippus Theophrasts Bombastus von Hohenheim, near Zurich in 1493), was changing Europes attitudes toward health care. Many physicians and apothecaries were dishonest and took advantage from those they should be helping. Paracelsus was a physician and alchemist who believed that medicine should be simple and straight forward. He was greatly inspired by the Doctrine of Signatures, which maintained that the outward appearance of a plant gave an indication of the problems it would cure. This theory is sometimes surprisingly acurate.
In 1775, Dr. William Withering was treating a patient with severe dropsy caused by heart failure. He was unable to bring about any improvement with traditional medicines. The patient’s family administered an herbal brew based on an old family recipe and the patient started to recover. Dr. Withering experimented with the herbs contained in the recipe and identified foxglove (Digitalis purpurea) as the most significant. In 1785, he published his Account of the Foxglove and Some of Its Medical Uses. He detailed 200 cases where foxglove had successfully been used to treat dropsy and heart failure along with his research on the parts of the plant and harvest dates that produced the strongest effect. Withering also realized that theraputic dose of foxglove is very close to the toxic level where side effects develop. After further analysis, the cardiac glycosides digoxin and digitoxin were eventually extracted. These are still used in treating heart conditions today.
In 1803, morphine became one of the first drugs to be isolated from a plant. It was identified by Frederich Serturner in Germany. He was able to extract white crystal from crude opium poppy. Scientists soon used similar techniques to produce aconitine from monkshood, emetine from ipecacuanha, atropine from deadly nightshade, and quinine from Peruvian bark.
In 1852, scientists were able to synthesize salicin, an active ingredient in willow bark, for the first time. By 1899, the drug company Bayer, modified salicin into a milder form of aectylsalicylic acid and lauched asprin into our modern world.
The synthetic age was born and in the following 100 years, plant extracts have filled pharmacy shelves. Although many medicines have been produced from plant extracts, chemists sometimes find that the synthetic versions do not carry the same therapeutic effects or may have negative side effects not found when using the whole plant source.
A full 40 percent of the drugs behind the pharmacist’s counter in the Western world are derived from plants that people have used for centuries, including the top 20 best selling prescription drugs in the United States today. For example, quinine extracted from the bark of the South American cinchona tree (Cinchona calisaya) relieves malaria, and licorice root (Glycyrrhiza glabra) has been an ingredient in cough drops for more than 3,500 years. The species native to the United States, Glycyrrhiza lepidota, has a broad range from western Ontario to Washington, south to Texas, Mexico and Missouri. Eastward, there are scattered populations. The leaves and roots have been used for treating sores on the backs of horses, toothaches, and fever in children, sore throats and cough.
Medicinal interest in mints dates from at least the first century A.D., when it was recorded by the Roman naturalist Pliny. In Elizabethan times more than 40 ailments were reported to be remedied by mints. The foremost use of mints today in both home remedies and in pharmaceutical preparations is to relieve the stomach and intestinal gas that is often caused by certain foods.
Consumers routinely assume that the medications they take and the food they ingest have been scrupulously studied by the U.S. Food and Drug Administration (FDA). They assume that many of these products are safe because they are natural. However, many herbals have never been seriously tested for efficacy or toxicity. The Dietary Supplement Health and Education Act of 1994 eliminated the authority of the FDA to regulate vitamins, herbs and other food-based products, and therefore the United States Food and Drug Administration (FDA) does not regulate the use of any herbal supplement.
Here are some common medicinal herbs. Most herbs have not been completely tested to see how well they work or to see if they interact with other herbs, supplements, medicines, or foods. Products added to herbal preparations may also cause interactions. Be aware that “natural” does not mean “safe.” It’s important to tell your healthcare providers about any herb or dietary supplement you are using.
Considered by some to be a cure-all, chamomile is commonly used in the U.S. for anxiety and relaxation. It is used in Europe for wound healing and to reduce inflammation or swelling. Few studies have looked at how well it works for any condition. Chamomile is used as a tea or applied as a compress. It is considered safe by the FDA. It may increase drowsiness caused by medicines or other herbs or supplements. Chamomile may interfere with the way the body uses some medicines, causing too high a level of the medicine in some people.
Chamomile for the skin (topical) may be used to treat skin irritation from radiation cancer treatments. Chamomile in capsule form may be used to control vomiting during chemotherapy.
(Leaf, stalk, root)
Echinacea is commonly used to treat or prevent colds, flu, and infections, and for wound healing. Many studies have looked at how well echinacea works to prevent or shorten the course of a cold, but none were conclusive. Some studies do show some benefit of using echinacea for upper respiratory infections.
Short-term use is advised because other studies have also shown that long-term use can affect the body’s immune system. Always check with your healthcare provider about any interactions with medicines that you are already taking. People allergic to plants in the daisy family may be more likely to have an allergic reaction to echinacea. The daisy family includes ragweed, chrysanthemums, marigolds, and daisies.
Feverfew was traditionally used to treat fevers. It is now commonly used to prevent migraines and treat arthritis. Some research has shown that certain feverfew preparations can prevent migraines. Side effects include mouth ulcers if the leaves are chewed and digestive irritation.
People who suddenly stop taking feverfew for migraines may have their headaches return. Feverfew should not be used with nonsteroidal anti-inflammatory medicines because these medicines may change how well feverfew works. It should not be used with warfarin or other anticoagulant medicines.
Garlic has been used all over the world in cooking and for its many medicinal properties. The compounds isolated from garlic have been shown to have antimicrobial, cardioprotective, anticancer and anti-inflammatory properties. These properties may play a role in the belief that garlic helps lower cholesterol and blood pressure. Unfortunately, the evidence is conflicting.
The FDA considers garlic safe. But it can increase the risk of bleeding and should not be used with warfarin, a blood thinner. For the same reason, large amounts should not be taken before dental procedures or surgery.
Ginger is most commonly known as an herb for easing nausea and motion sickness. Research suggests that ginger may relieve the nausea caused by pregnancy and chemotherapy.
Other areas under investigation in the use of ginger are in surgery and as an anticancer agent. It’s wide range of actions may be due in part to its strong anti-inflammatory and antioxidative effects.
Reported side effects may include bloating, gas, heartburn, and nausea in certain people.
Ginkgo leaf extract has been used to treat a variety of conditions such as asthma, bronchitis, fatigue, and tinnitus. It is also used to improve memory and to prevent dementia and other brain disorders. Some studies have supported its slight effectiveness. But exactly how gingko works isn’t understood. Only extract from leaves should be used. Seeds contain ginkgo toxin.
This toxin can cause seizures and, in large amounts, death. Because some information suggests that ginkgo can increase the risk of bleeding, it should not be used with nonsteroidal anti-inflammatory medicines, anticoagulants, anticonvulsant medicines, or tricyclic antidepressants.
Ginseng is used as a tonic and aphrodisiac, even as a cure-all. Research is uncertain how well it works, partly because of the difficulty in defining “vitality” and “quality of life.” There is a large variation in the quality of ginseng sold. Side effects are high blood pressure and tachycardia.
It’s considered safe by the FDA. But it shouldn’t be used with warfarin, heparin, nonsteroidal anti-inflammatory medicines, estrogens, corticosteroids, or digoxin. People with diabetes should not use ginseng.
Goldenseal is used to treat diarrhea and eye and skin irritations. It is also used as an antiseptic. It is also an unproven treatment for colds. Goldenseal contains berberine, a plant alkaloid with a long history of medicinal use in both Ayurvedic and Chinese medicine.
Studies have shown that goldenseal is effective for diarrhea. But it’s not recommended because it can be poisonous in high doses. It can cause skin, mouth, throat, and gastric irritation.
Milk thistle is used to treat liver conditions and high cholesterol, and to reduce the growth of cancer cells. Milk thistle is a plant that originated in the Mediterranean region. It has been used for many different illnesses over the last several thousand years, especially liver problems.
Study results are uncertain about the actual benefits of milk thistle for liver disease.
Saint John’s wort
Saint John’s wort is used as an antidepressant. Studies have shown that it has a small effect on mild to moderate depression over a period of about 12 weeks. But it is not clear if it is effective for severe depression.
A side effect is sensitivity to light, but this is only noted in people taking large doses of the herb. St. John’s has been shown to cause dangerous and possibly deadly interactions with commonly used medicines. It is very important to always talk with your healthcare provider before using this herb.
Saw palmetto is used to treat urine symptoms from benign prostatic hypertrophy (BPH). But recent studies have not found it to be effective for this condition. Side effects are digestive upset and headache, both mild.
Valerian is used to treat sleeplessness and to reduce anxiety. Research suggests that valerian may be a helpful sleep aid, but the evidence is not consistent to confirm it. In the U.S., valerian is used as a flavoring for root beer and other foods. As with any medicinal herb, always talk with your healthcare provider before taking it.