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1
Asia Metropolitan University, Faculty of Medicine, Johor Bahru, Malaysia.
2
Brahmanand Group of Institutions, Bulandshahr, UP, India.
3
AMU,Faculty of Medicine,JB,Malaysia.
4
AMU,Faculty of Medicine,JB,Malaysia.
5
College of Pharmacy,BGI,Bulandshahr,UP.India.
INTRODUCTION
1.1 History of Herbal Medicine
Plants had been used for medicinal purposes long before recorded history. Ancient Chinese
and Egyptian papyrus writings describe medicinal uses for plants as early as 3,000 BC.
Indigenous cultures (such as African and Native American) used herbs in their healing rituals,
while others developed traditional medical systems (such as Siddha, Ayurveda, Unani and
TCM) in which herbal therapies were used.[1] The consumption of plant-based medicines and
other botanicals in the West has increased manifold in recent years. About two centuries ago,
our medicinal practices were largely dominated by plant-based medicines. However, the
medicinal useof herbs went into a rapid decline in the West when more predictable synthetic
drugs were made commonly available. In contrast, many developing nations continued to
benefit from the rich knowledge of medical herbalism. For example, Siddha & Ayurveda
medicines in India, Kampo Medicine in Japan, traditional Chinese medicine (TCM), and
Unani medicine in the Middle East and South Asia are still used by a large majority of
people.[2]
Recently there has been a shift in universal trend from synthetic to herbal medicine, which we
can say „Return to Nature‟. Medicinal plants have been known for millennia and are highly
esteemed all over the world as a rich source of therapeutic agents for the prevention of
diseases and ailments. Nature has bestowed our country with an enormous wealth of
medicinal plants; Therefore India has often been referred to as the Medicinal Garden of the
world. Countries with ancient civilizations such as China, India, South America, Egypt, etc.
are still using several plant remedies for various conditions. In this regard India has a unique
position in the world, where a number of recognized indigenous systems of medicine viz.,
Ayurveda, Siddha, Unani, Homeopathy, Yoga and Naturopathy are being utilized for the
health care of people. No doubts that the herbal drugs are popular among rural and urban
community of India. The one reason for the popularity and acceptability is belief that all
natural products are safe. The demand for plant based medicines, health products,
pharmaceuticals, food supplement, cosmetics etc are increasing in both developing and
developed countries, due to the growing recognition that the natural products are non-toxic,
have less side effects and easily available at affordable prices.[3]
Herbal medicine is still the mainstay of about 75 - 80%of the world population, mainly in the
developing countries, for primary health care.[4] This is primarily because of the general
belief that herbal drugs are without any side effects besides being cheap and locally
available.[5] According to the World Health Organization (WHO), the use of herbal remedies
throughout the world exceeds that of the conventional drugs by two to three times.[6] The use
of plants for healing purposes predates human history and forms the origin of much modern
medicine. Many conventional drugs originated from plant sources: a century ago, most of the
few effective drugs were plant based. Examples include aspirin (willow bark), dioxin (from
foxglove), quinine (from cinchona bark), and morphine (from the opium poppy). [7]
Herbal medicine was also an effective healing method, but was viewed less
enthusiastically. [8] Herbal products were discarded from conventional medical use in the mid
20th century, not necessarily because they were ineffective but because they were not as
economically profitable as the newer synthetic drugs,[9] In the early 19th century, scientific
methods become more advanced and preferred, and the practice of botanical healing was
dismissed as quackery. In the 1960s, with concerns over the iatrogenic effects of
conventional medicine and desire for more self-reliance, interest in “natural health” and the
use of herbal products increased. Recognition of the rising use of herbal medicines and other
non-traditional remedies led to the establishment of the office of Alternative Medicine by the
National Institute of Health USA, in 1992. Worldwide, herbal medicine received a boost
when the WHO encouraged developing countries to use traditional plant medicine to fulfill
needs unmet by modern systems.[10]
believe that conventional medicine has failed them. When patient use home remedies for
acute, often self-limiting conditions, such as cold, sore throat, or bee sting, it is often because
professional care is not immediately available, too inconvenient, costly or time-
consuming.[10]
In rural areas, there are additional cultural factors that encourage the use of botanicals, such
as the environment and culture, a “man earth relationship.” People believe that where an area
gives rise to a particular disease, it will also support plants that can be used to cure it. [10] In
India vast sections of the rural population have no access to modern medicine,[12] Hundred of
primary health centers which are intended to serve rural areas, lack staffs, diagnostic
facilities, and adequate supplies of drugs. The rural population is heavily dependent on
traditional medical systems,[12] Natural plant products are perceived to be healthier than
manufactured medicine,[13] Additional, report of adverse effect of conventional medications
are found in the lay press at a much higher rate than reports of herbal toxicities, in part
because mechanisms to track adverse effect exist for conventional medicines whereas such
data for self-treatment is harder to ascertain. Even physicians often dismiss herb as harmless
placebos.[10]
Complementary medicines, US$ 17 billion was spent on traditional remedies in 2000. In the
United Kingdom, annual expenditure on alternative medicine is US$ 230 million.
The global market for herbal medicines currently stands at over US$ 60 billion annually and
it is growing steadily.
3. Difference of Herbal and Conventional Drugs & Trends in herbal medicine use
Although superficially similar, herbal medicine and conventional pharmacotherapy have
three important differences:
Herb combining
Often several different herbs are used together. Practitioners say that the principles of synergy
and buffering apply to combinations of plants and claim that combining herbs improves
efficacy and reduces adverse effect. This contrasts with conventional practice, where poly
pharmacy is generally avoided whenever possible.[14]
Diagnosis
Herbal practitioners use different diagnostic principles from conventional practitioners. For
example, when treating arthritis, they might observe, “under functioning of a patient‟s
symptoms of elimination” and decide that the arthritis results from “an accumulation of
metabolic waste products”. A diuretic, cholerectic or laxative combination of herbs might
then be prescribed alongside herbs with anti-inflammatory properties.[14]
The most recent national survey conducted in 2007 by the National Center for
Complementary and Alternative Medicine (NCCAM).[17] showed that 17.7 % of adults have
used natural products (primarily herbs) in a one year period. Complementary and alternative
medicine (CAM) was used most commonly by whites (43.1%) followed by Hispanics
(23.7%). In the El Paso region studies, use of herbs by Hispanics, including older adults was
much higher (between 59-70%).[18,19] It is possible that certain methodologies may
underestimate rates of use. In most studies, disclosure rates of herb use to providers are very
low (a major concern). We found two main reasons for such low rates: providers did not ask
about herb use or they showed displeasure with use of herbs. Our experience indicates that in
some countries, herbs more commonly used vary depending on which products are marketed
and on regional practices. Another recent trend in Western countries involves adding herbs to
energy drinks and weight loss and nutritional products.
The annual export of medicinal plants from India is valued at Rs. 1200 million. All the major
herbal-based pharmaceutical companies are showing a constant growth of about 15 per cent.
Traditional medicine has served as a source of alternative medicine, new pharmaceuticals,
and healthcare products. Medicinal plants are important for pharmacological research and
drug development, not only when plant constituents are used directly as therapeutic agents,
but also as starting materials for the synthesis of drugs or as models for pharmacologically
active compounds. A significant number of modern pharmaceutical drugs are derived from
medicinal plants. The derivatives of medicinal plants are non-narcotic with little or no side
effects.
In India, It is estimated that there are about 25,000 licensed pharmacy of Indian system of
medicine. Presently about 1000 single drugs and about 3000 compound formulations are
registered. Herbal industry in India uses about 8000 medicinal plants.
From about 8000 drug manufactures in India, there are however not more than 25
manufactures that can be classified as large scale manufactures. The annual turnover of
Indian herbal industry was estimated around US $ 300 million in Ayurvedic and Unani
medicine was about US $ 27.7 million. In 1998-1999 again went up to US $ 31.7 million and
in 1999-2000 of the total turnover was US $ 48.9 million of Ayurvedic and herbal products.
Export of herbal drugs in India is around $ 80 million.[26]
conditions or diseases more cost effectively, especially if the herb can be grown locally or
regionally.
countries for their usage of traditional medicinal preparation from various parts of the
country. Some of the important Indian medicinal plants exported to various countries.
use of herbal medicines continues to grow since Eisenberg et al. conducted the first national
study of complementary and alternative medicine use.
Additionally, as a general rule, older adult populations are more likely to use both
conventional drug therapy and herbal medicines. This population is also more likely to have a
higher incidence of chronic disease, which more often than not requires the use of
increasingly complex conventional drug therapy. As such, the potential for herb-disease and
herb-drug interactions increases with older adult populations. At present, there is a dearth of
research evaluating the use of herbal medicines, especially clinical trials. This, together with
the ongoing development of new conventional drug therapies, further compounds the number
of unknown outcomes when using elements of these two treatment approaches together. In
many countries, including the U.S., herbal medicines are not regulated as extensively as
conventional drug therapy. Also, globalization has greatly increased accessibility of herbal
medicines from all parts of the world to any single consumer. Clearly there is a great need for
coordinated efforts to conduct the necessary clinical trials to study the efficacy and safety of
herbal medicines, both alone and in conjunction with conventional drug therapies.
were nevertheless remarkably effective.[42] In a recent survey,[43] estimated that 39% of all
520 new approved drugs in 1983-1994 were natural products or derived from natural
products and 60-80% of antibacterial and anticancer drugs were derived from natural
products.[44] The penicillin that replaced mercury in the treatment of syphilis and put an end
to so many of the deadly epidemics comes from plant mold. Belladona still provides the
chemical used in ophthalmological preparations and in antiseptics used to treat
gastrointestinal disorders. Rauvolfiaserpentina(The Indian snake root) which has active
ingredient, reserpine, was the basic constituent of a variety of tranquilizer first used in the
1950‟s to treat certain types of emotional and mental problems. Though reserpine is seldom
used today for this purpose, its discovery was a breakthrough in the treatment of mental
illness. It is also the principal ingredient in a number of modern pharmaceutical preparations
for treating hypertension.
chronic diseases such as hypertension, diabetes, or hyperlipidemia as they are to treat acute,
symptomatic illness. Some argue that the concept of chronic disease is a product of ongoing
contact with biomedical systems of health care.[54] Even in the U.S „„remission of symptoms
may be considered to be a cure by people in some ethnic groups.‟‟ mixed method (qualitative
and quantitative) study, Latinos with chronic illnesses in California perceived „„each
exacerbation of symptoms as a separate illness that was unrelated to previous episodes.
Diagnosis and treatment was seen as a discrete entity with each illness event, particularly for
illnesses that had a variety of symptoms.‟‟ The authors attribute this to a lack of information
about the nature and meaning of chronic disease. In such cases, physicians seeking to educate
their patients about hypertension, for example, must be sure that the patient first understands
the ideas of chronicity and asymptomatic illness.
Table no-1- List of plants used in the treatment of chronic & acute disease
S. No. Common name Botanical name Part used Family Uses
1 Tulsi Ocimum sanctum Leaves Labiatae Antipyretic; Antitussive
2 Neem Azadirachtaindica Leaves Meliaceae Antipyretic
3 Brahmi Centellaasiatica Whole plant Umbellifera Antipyretic; Blood purifier
4 Amla Emblicaofficinalis Fruits Euphorbiaceae Antipyretic
5 Dhaniya Coriandrumsativum Leaves, seeds Umbelliferae Antipyretic; Carminative
6 Satavari Asparagus adscendens Tuberous Roots Liliaceae Antipyretic; Demulscent; Nutritive Tonic
7 Bahera Terminaliabelerica Fruits Combretaceae Antipyretic; Expectorant
8 Cinchona Cinchona officinalis Bark seed Rubiaceae Antipyretic;
9 Bhindi Abelmoschusesculentus Fruits Malvaceae Antipyretic, Diuretic
10 Imli Tamarindusindica Wood, volatile oil Caesalpiniaceae Antipyretic; Carminative
11 Swetchandan Santalum album Fruits Santalaceae Antipyretics; Sedative
12 Palwal Santalum album Roots; Flower; Fruits; Bark Cucurbitaceae Antipyretic; Laxative
13 Nirgandi Vitexnegundo Dried roots Verbenaceae Antipyretic; Astringent
14 Bish Aconitum ferox Leaves; Bark; Milky Juice Ranunculaceae Antipyretic
15 Datyuni Alstoniascholaris Stem; Leaves; Root Apocynaceae Antipyretic; Stimulant
16 Gulancha Cocculuscordifolia Stem Menispermaceae Antipyretic;Aphrodisiac
17 Jharhaldi Coscinumfenestratum Leaves, roots Menispermaceae Antipyretic; Stomachic
18 Phalakantak Daemiaextensa Dried roots Ascepidaceae Antipyretic; Expectorant
19 Kali mirch Piper nigrum Roots Piperaceae Antipyretic; Carminative
20 Chitravalli Rubiacordifolia Roots Rubiaceae Antipyretic; Astringent
21 Jwaranthakah Swertiachirata Whole Herb Gentianaceae Antipyretic; Antidot
22 Gurach Tinosporacardifolia Stem; Root Menispermaceae Antipyretic; Antidote
23 Jangalilahusan Allium sativum Bulb, oil Liliaceae Antipyretic; Antiseptic
24 Kasondi Cassia occidentalis Leaves;Seeds; Root Caesalpiniaceae Antipyretic; Purgative
25 Bhringraj Ecliptaerecta Roots, leaves Compositae Antipyretic; Emetic
26 Akasbel Cuscutareflexa Seeds; Stem; Fruits Convolvulaceae Antipyretic; Carminative
27 Aghata Achyranthesaspera Leaves, seed ,roots Amarantaceae Antipyretic;Astringent
28 Cashew Anacardiumoccidentale Fruit, seed, bark, oil Anacardiaceae Antipyretic;Irritant;
29 Ganja Cannibis sativa Leaves; Cannabaceae Antipyretic; Analgesic
DriedFlourerscence
30 Wild mint Lantana involucrate Whole herb Verbenaceae Antipyretic
31 Biiter gourd Momordicacharantia Fruit; Leaves; Seeds Cucurbitaceae Antipyretic; Stimulant
Shoot; Seeds; Roots;
32 Bamboo Bambusa vulgaris Graminae Antipytretic; Diuretic
Leaves
33 Australian fever tree Eucalyptus globules Dried leaves,gum, oil Myrtaceae Antipyretic; Carminative
34 Pan Piper betel Leaves Piperaceae Antipyretic; Carminative
35 Yellow kedar Tecomastans Wood oil Bognoniaceae Antipyretic; Sedative
36 Tulsi Ocimum sanctum All parts Labiatae Antiulcer,Antibacterial
37 Tippani Allophylusserratus Leaves Sapindaceae Antiulcer, elephantiasis
38 Shaparni Desmodiumgangeticum Root extract Leguminosae Typhoid, piles, inflammation,
asthma,Antiulcer
39 Neem Azadirachtaindica Dry bark extract Meliaceae Gastrointestinal dieses, leprosy, respiratory
Disorders
40 Indian Hemidesmusindicus Extract Asclepiadaceae Antidiarrhoeal, mucoprotective,Antiulcer
Sarsaparilla
41 Satavari Asparagus racemosus Extract of fresh root Liliaceae Anti-diarrhoeal, Antibacterial, Antiulcer
42 Triphala Terminaliapallida Plant extract Combretaceae Antiulcer,
43 Amla Emblicaofficinalis Fruit extract Euphorbiacae Antiulcer,
44 Gotu kola Centellaasiatica Fresh Juice Apiaceae Antiulcer,
45 Brahmi Bacopamonniera Fresh Juice Scrophulariaceae Antiulcer,
46 Apple bananas Musa sapientum Fruit Scitaminaceae Antiulcer,
47 Papeeta Carica papaya Seed Caricaceae Anti-helmintic,antiamebic, Antiulcer
48 Pausanto Kielmeyeracoriacea Stem Guttiferae Anxiolytic, Antiulcer
49 Brindleberry Garciniacambogia Fruit extract Clusiaceae Antiulcer
50 Winter melon Benincasahispida Fruit Cucurbitaceae Antiulcer, epilepsy
51 Wild peepal Ficusarnottiana Fruit Moraceae Antiulcer, demulcent
52 Indian devil tree AlstoniaScholaris Whole plant Apocynaceae Antiulcer,
53 Indian mulberry Morindacitrifolia Fruit Rubiaceae Antiulcer, Antidiabetic
54 Indian borage Plectranthusamboinicus Whole plant Lamiaceae Diuretic, Antiulcer
Fig-1- Popular herbal Brands for the treatment of chronic & acute disease
2). Stability
Shelf life.
3). Safety assessment
Documentation of safety based on experience and toxicological studies.
4). Assessment of efficacy
Documented evidence of traditional use and activity determination (Animals and human).
7.5 WHO efforts in promoting safe, effective and affordable traditional medicine
The World Health Organization launched its first ever comprehensive traditional medicine
strategy in 2002. The strategy is designed to assist countries:
Develop national policies on the evaluation and regulation of TM/CAM practices;
Create a stronger evidence based on the safety, efficacy and quality of the TM/CAM
products and practices;
Ensure availability and affordability of TM/CAM, including essential herbal medicines;
At present, WHO is supporting clinical studies on anti malarial in three African countries; the
studies are revealing good potential for herbal anti malarial. Other collaboration is taking
place with Burkina Faso, the Democratic Republic of the Congo, Ghana, Mali, Nigeria,
Kenya, Uganda, and Zimbabwe in the research and evaluation of herbal treatments for HIV/
AIDS, malaria, sickle cell anemia and Diabetes Mellitus. In Tanzania, WHO, in collaboration
with China, is providing technical support to the government for the production of anti
malarial derived from the Chinese herb Artemisia annua. Local production of the medicine
will bring the price of one dose down from US$ 6 or 7 to a more affordable $ 2.
prototype compounds isolated from plants. Almost, 70% modern medicines in India are
derived from natural products. The basic uses of plants in medicine will continue in the
future, as a source of therapeutic agents, and as raw material base for the extraction of semi-
synthetic chemical compounds such as cosmetics, perfumes and food industries. Popularity of
healthcare plant-derived products has been traced to their increasing acceptance and use in
the cosmetic industry as well as to increasing public costs in the daily maintenance of
personal health and well being. In the dual role as a source of healthcare and income,
medicinal plants make an important contribution to the larger development process. Though
the efficacy of herbal requires development of quality consciousness in respect of the
evaluation related evidences, supplying the demand for botanicals and herbals is a booming
business. Recently even developed countries, are using medicinal systems that involve the
use of herbal drugs and remedies. Undoubtedly the demand for plant derived products has
increased worldwide. The demand is estimated to grow in the years to come fuelled by the
growth of sales of herbal supplements and remedies. This means that scientists, doctors and
pharmaceutical companies will be looking at countries like China, India, etc. for their
requirements, as they have the most number of medicinal plant species and are the top
exporters of medicinal plants.
CONCLUSION
Herbal medicine is still the mainstay of about 75 - 80%of the world population, mainly in the
developing countries, for primary health care. This is primarily because of the general belief
that herbal drugs are without any side effects besides being cheap and locally available.
According to the World Health Organization (WHO), the use of herbal remedies throughout
the world exceeds that of the conventional drugs by two to three times. The use of plants for
healing purposes predates human history and forms the origin of much modern medicine.
Many conventional drugs originated from plant sources: a century ago, most of the few
effective drugs were plant based. Examples include aspirin (willow bark), dioxin (from
foxglove), quinine (from cinchona bark), and morphine (from the opium poppy). Medical
history from the beginning of time is filled with descriptions of persons who used herbs to
heal the sick of the society. However, parallel to the onset of the industrial revolution we
witnessed the rise of allopathic medicine. Herbal medicine was also an effective healing
method, but was viewed less enthusiastically.
Herbal products were discarded from conventional medical use in the mid 20th century, not
necessarily because they were ineffective but because they were not as economically
profitable as the newer synthetic drugs. In the dual role as a source of healthcare and income,
medicinal plants make an important contribution to the larger development process. Though
the efficacy of herbal requires development of quality consciousness in respect of the
evaluation related evidences, supplying the demand for botanicals and herbals is a booming
business.
Recently even developed countries, are using medicinal systems that involve the use of herbal
drugs and remedies. Undoubtedly the demand for plant derived products has increased
worldwide. The demand is estimated to grow in the years to come fuelled by the growth of
sales of herbal supplements and remedies. This means that scientists, doctors and
pharmaceutical companies will be looking at countries like China, India, etc. for their
requirements, as they have the most number of medicinal plant species and are the top
exporters of medicinal plants.
Hence by keeping the facts in mind I have tried to highlight the role & future of herbal
remedies so that researcher might get an idea to explore the search of new herbal based
chemical entity, as the “HERBAL AGE IS ABOUT TO COME”.
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