Herbal Medicine: Evidential, Experiential, Circumstantial
Herbal medicine: Evidential, Experiential....- Prof. Kola K. Ajibesin NIGER DELTA MEDICAL JOURNAL
HERBAL MEDICINE: EVIDENTIAL, EXPERIENTIAL, CIRCUMSTANTIAL
Prof. Kola K. Ajibesin Department of Pharmacognosy &Herbal Medicine, College of Health Sciences, Niger Delta University, Amassoma.
Presented in part at the 20th Deans Lecture on the 12 th January 2017 at the ETF Building, NDUTH, Okolobiri
Niger Delta Medical Journal 2017; 1(2):40-62
INTRODUCTION directly as patented drugs (Carney et al., 1999). As During the last few decades, there has been an indigenous cultures are closely maintained by the increase in the study of medicinal plants and their tribal and other forest dwellers throughout the traditional use in different parts of the world (Lev, world, the ethnobotanical investigation is a 2006). Herbal remedies are considered the oldest prerequisite for any developmental planning forms of health care known to mankind on this concerned with the welfare of tribal and their earth. Prior to the development of modern environment. It is an exigency to record as quickly medicine, the traditional systems of medicine that as possible all information about plants and the role have evolved over the centuries within various of tribes in conserving them. communities are still maintained as a great The objectives of plants as sources of therapeutic traditional knowledge base in herbal medicines agents are: a) to isolate bioactive compounds for (Mukherjee and Wahil, 2006). Traditionally, this direct use as drugs, e.g., digoxin, digitoxin, treasure of knowledge has been passed on orally morphine, reserpine, taxol, vinblastine, vincristine; from generation to generation usually without any b) to produce bioactive compounds of novel or written document (Perumal Samy and known structures as lead compounds for semi Ignacimuthu, 2000) and is still retained by various synthesis to produce patentable entities of higher indigenous groups around the world. activity and/or lower toxicity, e.g., metformin, Documenting the indigenous knowledge through nabilone, oxycodon (and other narcotic analgesics), ethnobotanical studies is important for the taxotere, teniposide, verapamil, and amiodarone, conservation and utilization of biological which are based, respectively, on galegine, ? 9 - resources (Ajibesin et al., 2008, 2012a). tetrahydrocannabinol, morphine, taxol, Ethnobotanical survey has been found to be one of podophyllotoxin and khellin; c) to use agents as the reliable approaches to drug discovery pharmacologic tools, e.g., lysergic acid (Fabricant and Farnsworth, 2001). Many active diethylamide, mescaline, yohimbine; and d ) to use compounds have been discovered from plants on the whole plant or part of it as a herbal remedy, e.g., the basis of ethnobotanical information, and used cranberry, echinacea, feverfew, garlic, ginkgo, St. John’s wort, saw palmetto.
Cranberry Garlic
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Feverfew St. John’s wort
Echinacea Ginkgo
Saw palmetto Saw palmetto
Source: www.google.com.ng/search?client admission of the snags of modern medicine in terms Herbal medicine is defined as a finished labeled of cost, accessibility, effectiveness and safety. medicinal product that contains active ingredients Herbal medicine - also called botanical medicine or in the aerial or underground parts of plant or other phytomedicine - refers to using a plant's seeds, plant materials or combination thereof whether in berries, roots, stem, leaves, bark, or flowers for the crude state or as plant preparation. Medicines medicinal purposes. Herbalism has a long tradition containing plant materials with chemically of use outside of conventional medicine. It is defined active substances including chemically becoming more mainstream as improvements in defined isolated constituents of plants are not analysis and quality control along with advances in regarded as herbal medicine (WHO, 1996). clinical research show the value of herbal medicine However, in some countries, herbal medicine may in treating and preventing disease. traditionally contain natural organic or inorganic active ingredients extraneous to plant origin. The Traditional medical systems current unprecedented explosion of interest Traditional medicine is defined as the total globally in herbal medicine represents an
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combination of knowledge and practices, whether (Ernst, Schmidt, and Wider 2005; Barnes, Bloom, and explicable or not, used in diagnosing, preventing or Nahin 2008). In Germany, about 600 - 700 plant- eliminating a physical, mental or social disease and based medicines are available and are prescribed by which may rely exclusively on past experience and some 70% of German physicians. observation handed down from generation to There are many different systems of traditional generation, verbally or in writing (World Health medicine and the philosophy and practice of each is Organization, 2001). Traditional medicine influenced by the prevailing conditions, (indigenous medicine) is a system of knowledge environment, and geographical area within which it first evolved (WHO 2005). However, a common that developed over generations within various philosophy is a holistic approach to life, equilibrium societies throughout the world. When practised of the mind, body, and the environment, and an outside its culture, traditional medicine is referred emphasis on health rather than on disease. to as Complementary and Alternative Medicine Generally, the focus is on the overall condition of the (CAM) (WHO 2008). In the strict sense, individual, rather than on the particular ailment or Complementary medicine is a term used to claim disease from which the patient is suffering, and the intellectual ownership over alternative medicine. use of herbs is a core part of all systems of traditional Complementary medicine means combining medicine (Engebretson 2002; Conboy et al. 2007; modern therapies with alternative therapies, while Rishton 2008; Schmidt et al. 2008). Alternative medicine is a term that refers to Traditional medicine is broadly divided into two: everything outside the realm of modern medicine. organized traditional medical system and Alternative medicine is becoming mainstream herbalism/shamanism. Organized traditional medicine as most people use it. A vast section of the medical systems hinge their practice on an population in developing countries still relies on established dynamic body of written knowledge and traditional practitioners and herbal medicines for theory. These include Ayurveda, Traditional their primary care. The World Health Chinese Medicine, Unani and Kampo which have Organization estimated that 80% of people prospered for thousands of years. These systems are still highly impacting till date due to their strength worldwide rely on herbal medicines for some part and praxis. The purport of the medical systems is the of their primary health care. In Africa up to 90% multi-component mixture they employ in treating and in India 70% of the population depend on diseases. Western medical science views these traditional medicine to help meet their health care systems as lacking credibility, but undoubtedly, needs. In China, traditional medicine accounts for these systems are patronized widely by most people around 40% of all health care delivered and more of the world. The efficacy of the plants and plant than 90% of general hospitals in China have units mixture in certain instances transcends evaluation for traditional medicine (WHO 2005, 2013). The use by Western scientific methods. However, adverse of traditional medicine is not limited to developing effects arising from the plants used may not be well countries, and during the past two decades public documented in literature. interest in natural therapies has surged greatly in industrialized countries, with expanding use of TRADITIONAL MEDICINE OF INDIA ethno-botanicals. For instance, in the last 20 years in Traditional medicine of India operates in two social streams: the US, public dissatisfaction with the cost of · The Classical Health Traditions (CHT) such prescription medications, combined with an as Ayurveda and Siddha are highly interest in returning to natural or organic remedies, organized, classified and codified, and has led to an increase in herbal medicine use. Also, in 2007, about 38% of adults and 12% of children were using some form of traditional medicine in the US
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elicit a robust conceptual and theoretical Rajas (responsible for the existence of energy in depth and philosophical explanation. matter) and Tamas (responsible for resistance and · The Oral Health Traditions (OHT) is less stability). The objective of Ayurveda is to maintain organized or codified, but it is very rich the equilibrium state of the body? s elements. The and diverse, having its knowledge treatment serves to restore a person to a state of distilled from people? s experience. It is balance by treating both the mind and the body. rife in rural areas of India. The oral folk One of the popular healing methods is massage, tradition is largely hinged on plants and is which is to a large extent, integrated into the prevalent in developing areas where Ayurvedic rejuvenation therapies. A massage modern healthcare is limited. This focuses on creating a sense of relaxation in a person. indigenous remedy has now attained a It works by reactivating the blood circulation in the lofty height in the urban and rural settings. system through a method of rubbing and kneading on the specified body part. It is this action that AYURVEDA creates the frictional heat which stimulates the It is a traditional medicine system that outstrips blood flow, reduces body fat, relaxes the muscles other systems of medicine in India. It is termed the and thereby soothes the tired flesh. Foot massage is science of life of the universe. Ayurveda was more commonly employed than any other form. formed from the Sanskrit words ? Ayu? which Another traditional system of healing the mind and means life and ?Veda? which means the body in Ayurveda is yoga. Literally meaning knowledge/science relating to humans (Lele, union, yoga seeks to unite the individual soul with 1986). theUniversalSoulorGod,notthroughanyreligious Ayurveda was brought to the fore around 600 BC. rites but through a sustained effort to control one's In contrast to modern medicine which focuses on mental and physical faculties. While many view the ailment, Ayurveda deals with the body and its yoga as a spiritual experience, for most people yoga relationship with the natural milieu and the is a form of exercise that benefits much more in the cosmos. It also relates to the psyche. The basic long run as compared to aerobics. Physically, yoga helps in cleansing the body of toxins, muscle toning, thrust of Ayurveda is prevention of diseases, improving blood circulation and correct body though it can cure diseases if they occur. posture. It is usually practised early in the morning Ayurveda deals with the science of life from micro so as to derive maximum benefit of the clean air and to macro level. Thus, Ayurveda reinforced with the early rays of the rising sun. fundamental theories, begins with the theory of The use of plants in Ayurveda is as old as the evolution of the universe (Brahmanda) with the medicine system itself. Plants are regarded as entire life forms prevailing in it (including humans, divine and as a destroyer of diseases. About 3500 plants, animals and microbes), endued with non- plant species have been described in the treatises of living things such as soil, water and minerals Ayurveda, and their uses indicated (Rajasekharan ((Savnur, 1993). According to Ayurveda, all the and Pushpangadan, 1993). living and non-living things are composed of five elementary principles ? earth, water, fire, air, TRADITIONAL CHINESEMEDICINE ethereal parts of the sky - emanating from three Traditional Chinese Medicine (TCM) originated from ancient China and has had a long history of effective energies of nature. These principles about 5000 years. It commands a profound represent the same factors constituting the basic knowledge of medical science, theory, diagnostic elements of man. The three energies of nature are methods, prescriptions and cures. It is rooted in the Satwa (responsible for conscious manifestation), ancient philosophy of Taoism.
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TCM embraces multifarious practices: growing practice around the world and is used for acupuncture, moxibustion (burning herbs over the promoting health as well as for preventing and skin as a means of applying heat to acupuncture curing diseases. TCM encompasses a range of points), Chinese herbal medicine, Chinese practices, but herbal medicine is a core part therapeutic massage (tui na), dietary therapy and (Engebretson 2002; Nestler 2002; Schmidt et al. 2008; tai chi, and qi gong (practices that combine specific movements or postures, coordinated breathing Xutian et al., 2009). Three of the top-selling botanical and mental focus) (Xue and O? Brien, 2003). products, namely ginkgo, garlic and ginseng can be TCM is based on the following philosophy: traced back to origins in TCM and are today used to treat various diseases (Li et al., 2008; Xutian et al., · The human body is a miniature version 2009). (microcosm) of the larger, surrounding universe (macrocosm). · Harmony between two opposing yet complementary forces called yin and yang supports health, and disease becomes the upshot of imbalance between these forces. · Five elements ? fire, earth, wood, metal and water ? symbolically represent all phenomena, including the stages of human life - elucidate the functioning of the body and how it changes during disease. · Qi, a vital force/energy that flows through the Ginseng body, performs multiple functions in maintaining health. A vital energy, state of blood and body fluid are the The philosophy of Chinese medicine holds that the essential substances that form the human body and human body? s life is the result of the balance of the basis for internal organs to process. They are yin and yang. Yin is the inner and negative channeled along a network within the body principle and, yang, outer and positive. The crux (O? Brien and Xue, 2003). However, research does of the philosophy is that sickness occurs due to loss not focus on these concepts but on the effect of of harmony between the two forces. Yang specific TCM practices on the body and symptom functions to protect outer harm and yin the inner management. In the US, the most common approaches employed base, provides energy for its counterpart. by the TCM practitioners are Chinese herbal Diagnosis and treatment are based on a holistic medicine, acupuncture and tai chi. National Health view of the patient and the patient? s symptoms, Interview Survey (NHIS) reported that 3.1 M US expressed in terms of the balance of yin and yang. adults used acupuncture in 2006, about 2.3 M Yin represents the earth, cold, and femininity, Americans practised tai chi and 600,000 practised qi whereas yang represents the sky, heat, and gong in the same year (Birdee et al., 2009). TCM is masculinity. The actions of yin and yang influence difficult for researchers to study because its the interactions of the five elements composing the treatment process is often intricate and is based on concepts that sharply contrast those of Western universe: metal, wood, water, fire, and earth. TCM medicine. However, more effort is geared towards practitioners seek to control the yin and yang evaluation of herbs and herbal products used in levels through 12 meridians, which bring and TCM. channel energy (Qi) through the body. TCM is a
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Chinese Herbal Medicine powders, pills, tinctures or syrups. Typically, one or Chinese herbal medicine is a major aspect of TCM, two herbs are included to exert the greatest effect on focusing on restoring a balance of energy, body the problem to treat. (University of Maryland and spirit to maintain health rather than treating a Medical Centre, 2009). particular disease or medical condition. Chinese As the popularity of herbal medicine increases, herbal medicine is not based on mainstream many Chinese herbs are now sold individually and Western concepts of medical diagnosis and in formulas. In the US, Chinese herbs and herbal treatment. It treats patient? s main complaints or formulas may be purchased in health food stores, the patterns of their symptoms rather than the some pharmacies and from herbal medicine underlying causes. Practitioners try to forestall practitioners, usually as diet supplements. Chinese and treat imbalances such as those occurring by herbal medicine became rife in the US in the 1970s. cancer and other diseases with intricate mixture of At least 40 States have licensed practitioners of herbs and combination of herbs and minerals Chinese medicine and there are about 50 colleges of (Ergil et al., 2002). Chinese herbal medicine Oriental medicine in the US (National Institutes of employs a variety of herbs such as astragalus, Health, 1994). Since 1949, the Chinese government ginkgo, ginseng, green tea and eleuthero (Siberian hasendorsed theuseofbothtraditional andWestern ginseng) in different combinations to restore medicines in an integrated fashion. balance to the body. Herbal blends help to prevent and treat hormone disturbances, infections, UNANI SYSTEM OF MEDICINE Unani system of medicine originated from Greece and is based on the teachings of Hippocrates and Gallen and it developed into an elaborate Medical system by Arabs such as Rhazes, Al-Zahravi, Ibue- Nafis and others. Unani medicine is a conglomeration of contemporary systems of traditional medicine in Egypt, Syria, Iraq, Iran, India, China and other Middle East countries (Ahmad and Qadeer, 1998). The medicine takes on Astragalus different nomenclatures in different parts of the worldwhereit ispractised? GreecoArab medicine, Arabic medicine, Tibb-e-Sunnati, Traditional Iranian medicine, Eastern medicine and Uighur medicine. This system of medicine is defined as theknowledgeofstatesofhumanbodyinhealthand decline in health. Its purpose is to preserve health and endeavour to restore it when lost (Chishti, 1990). The concept of Unani treatment is based on its natural and remarkable diagnostic method. It is Green tea mainly contingent on the temperament of the patient, hereditary condition and effects, different breathing disorders and a mammoth number of complaints and symptoms of the body, external other ailments. In China, more than 3,200 herbs observation, etc. Special treatments such as Dieto and 300 mineral and animal extracts are used in therapy, Climatic therapy, Pharmacotherapy and more than 400 different formulas. Herbal Regimental therapy make the system a unique and formulas may contain four to twelve different popular one. ingredients to be taken in the form of teas,
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Regimental therapy includes venesection, trust in this system is vitiated by some of its cupping, diaphoresis, dieresis, Turkish bath, religious and spiritual aspects and proclivity for massage, emesis, purging, etc. Dieto therapy occultism. The system is also riddled with internal involves treating certain ailments by strife, envy, quackery and distrust among the administration of specific diets or by regulating practitioners. Thus, such system is difficult to be the quantity and quality of food. subjected to scientific scrutiny. This system of Pharmacotherapy depends mainly on local herbal medicine is widely practised in Africa and South drugs. Surgery is also employed in this system, America. but only minor surgery is in vogue. It is also The use of herbal supplements has increased significant to note that this system is based on dramatically over the past 30 years. Herbal crude drug therapy in which active principle of a supplements are classified as dietary supplements drug is not isolated but allowed to co-exist with by the U.S. Dietary Supplement Health and other natural substances of the plant to counteract Education Act (DSHEA) of 1994. That means herbal the side effects. In this case, there is no direct supplements -- unlike prescription drugs -- can be attack on the causative organisms of the disease sold without being tested to prove safety and but the internal atmosphere of the body is altered effectiveness. However, herbal supplements must so that the organisms are dead or become inactive. be made according to good manufacturing Thus, many herbs act through immune practices. modulators of the body by encouraging the The most commonly used herbal supplements in defence mechanism of a person (Bala, 2007). In the U.S. include echinacea (Echinacea purpurea (L.) Unani medicine, emphasis is placed on single drug Moench and related species, Compositae), St. John's therapy viz a viz the temperament of the patients. wort (Hypericum perforatum L., Hypericaceae), Compound formulations are offered as a second ginkgo (Ginkgobiloba L. Ginkgoaceae), garlic (Allium choice for synergistic action. Standardization and sativum L., Amaryllidaceae), saw palmetto (Serenoa quality control are given a salient role in repens (W. Bartram) Small, Arecaceae), ginseng minimizing the side effects and toxicity of the (Panax ginseng C.A. Mey., Araliaceae or Asian drugs. Unani system has shown remarkable ginseng; and Panax quinquefolius L. Araliaceae or results in curing diseases such as arthritis, American ginseng), valerian (Valeriana officinalis L. leucoderma, jaundice, liver disorder, nervous Caprifoliaceae), chamomile (Matricaria chamomilla system disorder and several acute and chronic L. Compositae), ginger (Zingiber officinale Roscoe, diseases. Zingiberaceae), evening primrose (Oenothera biennis African traditional medicine embraces indigenous L., Onagraceae), and milk thistle (Silybum marianum herbalism and spiritualism. Its practice is holistic, (L.) Gaertn., Compositae). comprising herbalists, diviners, bonesetters, massagers and traditional birth attendants (TBAs). African traditional medicine practitioners (ATMP) lay claim to the cure of myriad diseases such as mental illness, cancer, hypertension, diabetes, most sexually transmitted diseases (STDs), asthma, epilepsy, etc. Herbalism employs an apprenticeship system that fosters a nexus of knowledge and information transmission to the next generation through an herbalist, curandero or shaman. Practitioners shroud the identity of plants used for treatment, offering little information to be recorded. The Goldenseal
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Often, herbs may be used together because the combination is more effective and may have fewer side effects. Many factors must be taken into account when recommending herbs, including the species and variety of the plant, the plant's habitat, how it was stored and processed, and whether or not there are contaminants (including heavy metals and pesticides). Some common herbs and their uses are discussed below. Valerian Ginkgo (G.biloba) has been used in traditional medicine to treat circulatory disorders and enhance memory. Although not all studies agree, ginkgo may be especially effective in treating dementia (including Alzheimer's disease) and intermittent claudication (poor circulation in the legs). It also shows promise for enhancing memory in older adults. Studies have shown that ginkgo improves blood circulation by dilating blood vessels and reducing the stickiness of blood platelets. By the same token, this means ginkgo Chamomile may also increase the effect of some blood-thinning medications, including aspirin. Kava kava (Piper methysticum L.f., Piperaceae) is known to elevate mood, well-being, and contentment, and produce a feeling of relaxation. Several studies have found that kava may be useful in the treatment of anxiety, insomnia, and related nervous disorders. However, there is serious concern Ginger that kava may cause liver damage. It's not clear whether the kava itself caused liver damage in a few people or whether it was taking kava in combination with other drugs or herbs. It's also not clear whether kava is dangerous at previously recommended doses, or only at higher doses. Some countries have taken kava off the market. It remains available in the United States, but the Food and Drug Administration (FDA) issued a consumer advisory in March of 2002 regarding the "rare" but potential risk of liver failure Evening primrose associated with kava-containing products.
Milk thistle Kavakava
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Saw palmetto (S. repens) is used by more than 2 concerns. million men in the United States for the treatment Used correctly, herbs can help treat a variety of of benign prostatic hyperplasia (BPH), a non- conditions and in some cases may have fewer side cancerous enlargement of the prostate gland. A effects than some conventional medications. But number of studies suggest that the herb is effective because they are unregulated, herbal products are for treating symptoms, including too-frequent often mislabeled and may contain additives and urination, having trouble starting or maintaining contaminants that are not listed on the label. Some urination, and needing to urinate during the night. herbs may cause allergic reactions or interact with However, a study observed that saw palmetto was conventional drugs, and some are toxic if used no better than placebo in relieving the signs and improperly or at high doses. Taking herbs on your symptoms of BPH (Bent et al., 2006). own increases your risk, so it is important to consult St. John's wort (H. perforatum) is well known for its a trained practitioner before taking herbal antidepressant effects. In general, most studies medicines. Some examples of adverse reactions haveshownthatSt.John'swortmaybeaneffective from certain popular herbs are described below. treatment for mild to moderate depression, and St. John's wort can cause skin to be more sensitive to has fewer side effects than most other prescription the sun's ultraviolet rays, and may cause an allergic antidepressants. But the herb interacts with a wide reaction, stomach upset, fatigue, and restlessness. variety of medications, including birth control Clinical studies have found that St. John's wort also pills, so it is important to take it only under the interferes with the effectiveness of many drugs, guidance of a health care provider. including the blood thinner warfarin (Couamdin), Valerian (V. officinalis) is a popular alternative to protease inhibitors for HIV, birth control pills, commonly prescribed medications for sleep certain asthma drugs, and many other medications. problems because it is considered to be both safe In addition, St. John's wortshould not betaken with and gentle. Some studies bear this out, although prescribed antidepressant medication. The FDA has issued a public health advisory concerning many of not all have found valerian to be effective. Unlike these interactions. many prescription sleeping pills, valerian may Kava kava has been linked to liver toxicity. Kava has have fewer side effects such as morning been taken off the market in several countries drowsiness. because of liver toxicity. Echinacea preparations (from E. purpurea and Valerian may cause sleepiness, and in some people other Echinacea species) may improve the body's it may even have the unexpected effect of over- natural immunity. Echinacea is one of the most stimulating instead of sedating. commonly used herbal products, but studies are Garlic, ginkgo, feverfew, and ginger, among other mixed as to whether it can help prevent or treat herbs, may increase the risk of bleeding. colds. A meta-analysis of 14 clinical studies Evening primrose (O. biennis) may increase the risk examining the effect of echinacea on the incidence of seizures in people who have seizure disorders. and duration of the common cold found that Some herbal supplements, especially those echinacea supplements decreased the odds of imported from Asian countries, may contain high getting a cold by 58%. It also shortened the levels of heavy metals, including lead, mercury, and duration of a cold by 1.4 days. cadmium. It is important to purchase herbal Buying standardized herbal supplements helps supplements from reputable manufacturers to ensure you get the right dose and the effects ensure quality. Herbal practitioners may be similar to human clinical trials. Doctors or consulted for more information. pharmacists well trained in herbal medicine may The herbs available in most stores come in several be in a better position to prescribe which herbal different forms: teas, syrups, oils, liquid extracts, supplements are the best choices for health tinctures, and dry extracts (pills or capsules). Teas
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can be made from dried herbs left to macerate for a learning about the positive and potentially negative few minutes in hot water, or by boiling herbs in effects of using herbal medicines to help treat health water and then straining the liquid. Syrups, made conditions. Some health care providers, including from concentrated extracts and added to sweet- doctors and pharmacists, are trained in herbal tastingpreparations,areoftenusedforsorethroats medicine. They can help people create treatment and coughs. Oils are extracted from plants and plans that use herbs, conventional medications and often used as rubs for massage, either by lifestyle changes to promote health. themselves or as part of an ointment or cream. In the early 19th century, when chemical analysis Tinctures and liquid extracts are made of active first became available, scientists began to extract and herbal ingredients dissolved in a liquid (usually modify the active ingredients from plants. Later, water, alcohol, or glycerol). Tinctures are typically chemists began making their own version of plant a 1:5 or 1:10 concentration. Liquid extracts are compounds, and over time, the use of herbal more concentrated than tinctures and are typically medicines declined in favour of synthetic drugs. a 1:1 concentration. A dry extract form is the most Now, there is spike in global interest in herbal concentrated form of an herbal product (typically medicines probably due to the natural propensity of 2:1 - 8:1) and is sold as a tablet, capsule, or lozenge. herbal medicines and cost of modern medicine. Currently, no organization or agency strictly Many factors determine how effective an herb will regulates the manufacture or certifies the labeling be. For example, the type of environment (climate, of herbal preparations. This means you can't be bugs, soil quality) in which a plant grew will affect it, sure that the amount of the herb contained in the bottle or even from dose to dose is the same as what as will how and when it was harvested and is stated on the label. Some herbal preparations are processed. standardized, meaning that the preparation is guaranteed to contain a specific amount of the Evidence based medicine active ingredients of the herb. However, it is still The efficacy (and safety) of a great deal of herbal important to ask companies making standardized medicines has been established through evidence herbal products about their product's guarantee. It based approach. The use of herbal medicines is important to talk to an expert in herbal medicine (medicinal plants), largely stimulated by ethno- about the recommended doses of any herbal medical information, has been elucidated to initiate products. drug discovery process. Thus, bioactive compounds Insomecountries in Europe- unlike the US - herbs are obtained from such useful plants and their are classified as drugs and are regulated. The current uses are correlated with the ethno-medical German Commission E, an expert medical panel, claims of the plants (Table 1). Some compounds do actively researches their safety and effectiveness. deviate in activities from the uses of herbal Herbalists, chiropractors, naturopathic medicines from which they are obtained, such as physicians, pharmacists, medical doctors and Catharanthus aureus G. Don (Apocynaceae). practitioners of Traditional Chinese Medicine, Furthermore, some herbal medicines offer greater practitioners of Indian and Unani medicines, all potency at crude extract form than when they are may use herbs to treat illness. Naturopathic separated into compounds. They tend to diminish in physicians believe that the body is continually activity as purification progresses, probably due to striving for balance and that natural therapies can synergistic effect of the crude extract. support this process. Evidence based medicine (EBM) can therefore While still not well accepted, herbal medicine is facilitate the integration of traditional and modern being introduced in medical schools and medical practices as two branches of medical pharmacy schools. More health care providers are science, with the ultimate incorporation of elements of both to form a new branch (WHO,
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2000a). On the other hand, they can be incorporated being active orally, also lowered cholesterol levels. as an integral part of a country? s formal health care system, with each being separately recognized as legitimate form of health care within the same framework. The incorporation of traditional and modern EBM as integral parts of a country? s formal health care system is most likely to be achieved and has been demonstrated to be practicable in many countries, particularly in Asian countries such as China, Japan, Korea, and India, among others (WHO, 2001). Integration or co-recognition of traditional and modern medicines is also practised in some African countries such as Tanzania, Ethiopia, Ghana, Mozambique and Mali (Sofowora, 1993). A company, Shaman Pharmaceuticals in South San Francisco, California, US, embarked on a programme to investigate plants strictly through the ethnomedical approach. Their approach was to source plants in the tropical areas and to assess firsthand the use of such plants by traditional healers. Interesting plants were collected and assessed for validity in the Shaman laboratory. Interest was at first geared toward antifungal and antiviral agents (Ubillas et al., 1994); several active compounds were discovered but were either toxic Oligomeric proanthocyanidin: n = 5Cryptolepine or failed in the clinic. Efforts were then directed toward antidiarrheal activity. SP-303, an oligomeric proanthocyanidin from Croton lechleri Mull. Arg. (Euphorbiaceae) (Sherman and Fish, 2000), was shown to be clinically efficacious and is currently marketed as a dietary supplement for diarrhea. In addition, a major effort was directed toward discovery of novel antidiabetic agents, which resulted in the discovery of several patented compounds: cryptolepine from Cryptolepis sanguinolenta. (Lindl.) Schltr. (Apocynaceae) (Bierer et al., 1998a, 1998b; Luo et al., 1998a), maprouneacin from Maprounea africana Mull. Arg. (Euphorbiaceae) (Carney et al., 1999), 3ß, 30-dihydroxylupen-20(29)- en-2-one (Inman and Reed 1997), harunganin from Harungana spp. (Hypericaceae), vismin from Vismia spp. (Hypericaceae) (Inman and Luo, 1998), and quinones SP18904 and SP18905 from Pycnanthus angolensis (Welw.) Warb. (Myristicaceae) (Luo et al., 1999). The most interesting discovery was nordihydroguaiaretic acid (ndga) from Larrea tridentata (Sessé & Moc. ex DC.) Coville (Zygophyllaceae) (Luo et al., 1998b) which, besides Maprouneacin Harunganin Vismin
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air passages in the lungs; (2) as an anti-histamine; (3) as an anti-inflammatory; and (4) as an anti- asthmatic. While each ingredient acted weakly when administered on its own, they produced a powerful cough suppression effect when used together, and without any adverse effects. With these promising results in the offing, NIRPROMP Nordihydroguaiaretic acid developed a lagundi-based cough medicine in National Integrated Research Program on tablet and syrup form (Lagundi cough tablet and Medicinal Plants (NIRPROMP) was established by Lagundi cough syrup). The development of modern Philippine? s government with a mandate to lagundi-based medicine was the result of the herbal produce cheap medicine to the poor, to propagate medicine research and development (R&D) that has the use of herbal medicines with proven medicinal beencontinuously undertakenbyNIRPROMP. efficacy and identify scientifically validated medicine that would improve the Filipino pharmaceutical industry. NIRPROMP was established to address the rising costs of imported pharmaceutical products, especially those used for frequent ailments such as the common cold, fever and headaches. At the time, the Philippine pharmaceutical industry was not self-sustaining in these medicines, and companies were spending approximately 150 million Philippine pesos (around US $22 million at the time) annually to import medicine. These imported medicines were also extortionate and out of reach of many patients. Vitex negundo Given this, NIRPROMP prioritized reducing the National Institute for Pharmaceutical Research and country? s dependence on imports and offering Development (NIPRD), Abuja, Nigeria developed people more affordable pharmaceutical products some herbal products purely from ethnobotanical through locally developed herbal medicine. information gathered from herbalists/community In 1995, through collaboration with traditional elders. medical practitioners, NIRPROMP identified Vitex Niprd -AM1 produced by NIPRD is the dry water negundo L. (Lamiaceae) as a natural source for extract of the root of Nauclea latifolia Sm (Rubiaceae) developing an effective herbal medicine (Morilla et [now Sarcocephalus latifolius (Sm.) E.A. Bruce, al., 2014). Known in the Philippines as ? Lagundi? , Rubiaceae]. The dry extract is anti-malarial, and is the plant grows in Africa and Asia and has been described as active crude extract (ACE), while the used by locals for hundreds of years to effectively crude herbal drug (CHD) is a coarsely comminuted treat wounds, headaches, ulcers, skin diseases, material that can be decocted to yield anti-malarial diarrhea, and the common cold. After successfully tisane (Ameh et al., 2014). scientifically identifying the medicinal properties Niprifan is an antifungal product that comprises the of each part of the plant, NIRPROMP developed a dry ethylacetate extract of aerial parts of Mitracarpus lagundi-derived formula for a clinically proven scaber Zucc. ex Schult. & Schult. f. [now Mitracarpus cough and asthma medicine in tablet and syrup hirtus (L.) DC. Rubiaaceae]. The dry extract is form. described as active crude extract (ACE); while the Through scientific and clinical tests, the research crude herbal drug (CHD) can be macerated or finely team identified four active ingredients of lagundi cut and applied to the skin (Ameh et al., 2014). and found the effect of each: (1) as a relaxant of the
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Conavir is the dry water extract of aerial parts of Some plants such as Senna alata L. (Leguminosae), Andrographis paniculata (Burm. f.) Nees Ageratum conyzoides L. (Compositae) and Rauwolfia (Acanthaceae). The dry extract is immune - vomitoria Afzel. (Apocynaceae) were discovered stimulant/ anti-HIV, and is described as active experientially from ethnobotany as potent crude extract (ACE); while AP, which is referred to antimicrobial agents (Ajibesin, 2012b; Alade et al., as crude herbal drug (CHD), is a coarsely 2016). Their leaves have long been used comminuted material that can be decocted to yield traditionally in Nigeria to treat skin diseases viz: an immune-stimulant/ anti-HIV tisane (Ameh et rashes, ringworm, pimples and carbuncles. At the al., 2014). Nauclea latifolia Mitracarpus scaber Department of Pharmacognosy and Herbal Andrographis paniculata Medicine, Faculty of Pharmacy, Niger Delta University, the leaves of these plants have been formulated as herbal soaps (Cagerat). The herbal soaps have exhibited potency experientially. Preliminary antimicrobial investigations of the individual plant extracts and their respective soaps were carried out and they gave varying significant antimicrobial activities. The toxicity of the products on the laboratory animal skin is being evaluated prior to its elevation to clinical trial.
Nauclea latifolia
Senna alata
Mitracarpus scaber
Ageratum conyzoides
Andrographis paniculata Rauwolfia vomitoria
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The root of Heliopsis longipes (A. Gray) Blake mortality from this parasite by 20-30%, saving (Compositae) is alleged to alleviate toothache. hundreds of thousands of lives per year. Dr. Y. Tu Placing a piece of the root in the mouth can has been honoured for this discovery jointly with produce numbness for about an hour. 50% ethanol Dr. S. Ōmura and Dr. W. Campbell, who extract of the roots was evaluated in acetic acid- discovered novel bacterial strains and their induced writhing inhibition test in mice (i.g.). Its bioactive constituents such as Streptomyces significant activity stimulated further purification avermitilis, which produced the anti-filarial drug to obtain a pure compound which was active in Avermectin. Dr. Campbell showed that this assay. The compound, an isobutylamide, Avermectin was active against the roundworm affinin (spilanthol) was proven to be responsible parasites. Avermectin and its analog Ivermectin, for the activity (Ogura et al., 1982).Affinin discovered by Dr. Campbell and colleagues, are now the standard of cure for these infections in both humans and animals and have dramatically reduced the human suffering from river blindness and elephantiasis. Due to the effects of Avermectin and its analogs, these diseases are on the verge of eradication. All the three researchers working in the field of Pharmacognosy were honoured with Nobel prize for Medicine in 2015.
Artemisia annua
CH3 Heliopsis longipes H
H3C O O O An antimalarial compound artemisinin, was H H O isolated from the plant Artemisia annua L. Artemisinin CH3 (Compositae). Artemisia annua, also known as O sweet wormwood or qīnghāo, is a plant that has been used since antiquity in traditional Chinese herbal medicines for fevers. Artemisinin, a sesquiterpene lactone identified from the leaves of the plant, proved a profoundly effective drug against malaria by rapidly killing Plasmodium parasites at an early stage in their development. Artemisinin is part of current combination therapy for malaria that has been reported to reduce the
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AvermectinB1a: R=CH 2 CH 3 2005). Chemical investigation showed that some
Avermectin B1b: R=CH 3 parts of quinine are not necessary for antimalarial In the time past, dropsy otherwise known as activity. The synthetic antimalarial drugs which failing heart was normally effectively treated in retained the activity but reduced the toxicity were England with a multi herbal potion of about 20 made. A good instance is chloroquine. Proguanil is plants. In 1785, a medical doctor cum botanist another drug developed by replacing quinoline known as William Withering examined the nucleus with pyrimidine (Albert, 1979). remedy and discovered that the activity was owed In African countries where malaria is endemic, to only one plant component, Digitalis purpurea L. many chloroquine ? resistant strains of malaria (Scrophulariaceae) (Le-Strange, 1977). Further parasite occur. Quinine is still marketed as quinine investigation of the plant and its cogeneric species hydrochloride solution or quinine or quinine D. lanata L. (Scrophulariaceae) led to the identity dihydrochloride. of bioactive constituents, cardiac glycosides showing cardiotonic activity. Digoxin and digitoxin are now used as injection and tablet in modern medicine ? Lanoxin, Digoxin BP, HO N
Digilanid. ? Prepared digitalis? tablet is also H CH2 H3CO available containing the powdered leaf diluted to Quinine standard strength with inactive leaf powder to N produce uniform biological activity.The bark of Cl N
O O OH CH3 Chloroquine NCHCH3(CH2)3N(C2H5)2
CH3 OH Digoxin NH NH NH CH3
H NH NH CH3 O Cl 3 digitoxose Proguanil
O Senna (Cassia senna or Cassia acutifolia Delile ? O Alexandrian senna, or Senna alexandrina Mill. ? H3C Tinnevelly senna, (Leguminosae) produces leaves CH3 and fruits used as laxative/purgative since 9th OH Digitoxin century (Taylor, 1965). The laxative effect was OH elicited by anthraquinone derivatives, Sennoside A- O D and a primary glycoside. 3 digitoxose Commercial preparartions of senna currently in use Cinchona species ? C. ledgeriana (Howard) are as follows: Bern.Moens ex Trimen, and C. succirubra Pavon. Senna NF (senna leaf BP) (Rubiaceae) ? is cultivated for quinine and Senna fluid extract NF quinidine. The active antimalarial constituent of Senokot tablet (powdered pod in a standardized the bark was identified as quinine, while quinidine form) was implicated to treat cardiac arrhythmia. Senna fruit Unfortunately, quinine produces toxic side effects such as impaired hearing on prolonged use (Evans,
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Hyoscine
Sennoside A Sennoside B
Hyoscyamine
periwinkle is a long term remedy in the traditional Sennoside C medicine of Madagascar and other countries such as South Africa, Philippines, Jamaica, India and Australia to treat diabetes. It is cultivated on a large scale in Madagascar for export trade and affords the country a huge foreign exchange Sennoside D (Ratsimamangar, 1980). In a bid to verify the claim on the plant as anti-diabetic, Canadian scientists (1955-1960) instead discovered constituents that gave anti-cancer effects (Taylor and Farnsworth, 1973). Further investigation sponsored by Eli Lilly Atropa belladonna L. (Solanaceae) was well known Co., resulted in the isolation of over 70 alkaloids the for its leaves for which it was introduced into the most important of which are Vincristine and London Pharmacopoeia of 1809 (Evans, 2005). Vinblastine (Evans, 2005). Vinblastine sulphate Italian ladies employed these leaves as cosmetic to (Velban) is used in modern medicine for brighten their eyes (Taylor, 1965) by introducing a Hodgkin? s disease, while Vincristine sulphate drop of the diluted juice into the eye to cause (Oncovin) treats Leukaemia (Sim, 1971b; Todd, dilation of the pupil. Thus, the plant was named 1978). beautiful lady by the Italian ladies. Vinblastine R = CH3 , Vincristine R = CHO Chemical investigation revealed the presence of Opium poppy owes its popularity to its medicinal alkaloids, hyoscyamine and hyoscine in the plant property inherent in the latex of unripe fruit and leaves. These alkaloids are now found in other OH N solanaceous plants such as Datura stramonium and C2H5 Hyosyamus niger. Today, atropine is used in N modern medicine as atropine sulphate tablet or NH injection to stimulate the central nervous system C2H5 CH300C and depress the nerve endings to the secretory OH3CN H OCOCH3 OCOCH3 glands. Hyoscine preparation as hyoscine R CH3 bromide is used to prevent motion sickness. Other pharmaceutical preparations containing capsule of Papaver somniferum L. (Papaveraceae), Belladona constituents include (Sofowora, 1993): and its use as sleep-inducing drug has been from antiquity. This plant was mentioned by Buscopan (containing hyoscine-N-butylbromide) rd by Pfizer Neutradonna (containing Belladona Theophrastus (3 Century B.C.) and Dioscorides alkaloids and other constituents) by Nicholas. who distinguished the latex of the capsule ? opos ? Donnatal (containing hyoscyamine sulphate + from the extract of the whole plant ? mekonion hyoscine hydrobromide + phenobarbitone) by (Taylor, 1965; Evans, 2005). Pharco Belladenal (containing total alkaloids of Morphine was the first alkaloid to be isolated from Belladona leaf + phenobarbitone) by Sandoz. opium poppy in 1806. Now, about 25 alkaloids Catharanthus roseus G. Don (Apocynaceae) have been isolated, but the therapeutically commonly referred to as Madagascar rose important ones are morphine, codeine, thebaine,
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papaverine, noscapine and narceine. Morphine and codeine are used in modern medicine to kill pain and induce sleep. Papaverine is used for smooth muscle relaxation. Synthetic analogues of the alkaloids employed today are pethidine, heroin and narlorphine. Morphine and heroin are drugs of addiction.
Table 1. Drugs derived from plants, with their ethnomedical correlations and sources
Drug Action or Plant source Papaverine clinical use Acetyldigoxin Cardiotonic Ehrh. Thebaine Adoniside Cardiotonic L. Aescin Anti-inflammatory L. Aesculetin Anti-dysentery Pethidine Noscapine Hance Agrimophol Anthelmintic L. Ajmalicine Circulatory disorders Afzel. Allyl isothiocyanate rubefacient (L.) Narlorphine Koch Andrographolide Bacillary dysentery Nees Anisodamine Anticholinergic
(Maxim.) Pascher Anisodine Anticholinergic
(Maxim.) Pascher Arecoline Anthelmintic L. Asiaticoside Vulnerary (L.) Urban Atropine Anticholinergic L. Berberine Bacillary dysentery L. Bergenin Antitussive Bl. Ergot, the dried sclerotium of a fungus Claviceps Bromelain Anti-inflammatory; proteolytic agent (L.) Merrill purpurea was used in childbirth by the midwives of Caffeine CNSstimulant Europe to promote and strengthen uterine (L.) Kuntze (+)-Catechin Haemostatic contraction well before its use was known in L modern medicine. Ergometrine and ergotamine Chymopapain Proteolytic; L. were the major alkaloids of therapeutic mucolytic Cocaine Local anaesthetic importance. Ergometrine injections and tablets L. became official in British Pharmacopoeia in 1973. Codeine Analgesic; antitussive L. Colchicine Antitumoragent; antigout L.
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Convallotoxin Cardiotonic Morphine Analgesic L. L. Curcumin Choleretic Neoandrographolide Bacillary dysentery L Nees Cynarin Choleretic Noscapine Antitussive L L. Danthron Laxative spp. Ouabain Cardiotonic Deserpidine Antihypertensive; Baill. tranqulizer L. Papain Proteolytic; Deslanoside Cardiotonic mucolytic L. Ehrh Phyllodulcin Sweetener Digitalin Cardiotonic (Thunb.) DC L. Physostigmine Cholinesterase Digitoxin Cardiotonic inhibitor Balf. L. Picrotoxin Analeptic Digoxin Cardiotonic (L.) L. W.&A. Pilocarpine Parasympathomimetic Emetine Amoebicide; emetic Holmes Podophyllotoxin Condylomata (Brotero) A. acuminata L. Richard Protoveratrines A & Antihypertensive Ephedrine Sympathomimetic B L. Pseudoephedrine Sympathomimetic Stapf. Stapf. Etoposide Antitumour agent Pseudoephedrine, nor- Sympathomimetic Stapf. L. Quinine Antimalarial Gitalin Cardiotonic Moens ex. L. Trimen Glaucaroubin Amoebicide QuisqualicAcid Anthelmintic DC. L. Rescinnamine Antihypertensive; Glycyrrhizin Sweetener tranqulizer (L.) glabra L. Benth ex. Kurz Reserpine Antihypertensive; Gossypol Male contraceptive spp. tranqulizer (L.) Hemsleyadin Bacillary dysentery Benth ex. Kurz Rhomitoxin Antihypertensive Diels G. Don Hydrastine Hemostatic; Rorifone Antitussive astringent L. (L.) Hochr Rotenone Piscicide Hyoscamine Anticholinergic (Aubl.) L. DC. Rotundine Analgesic; sedative Kainic Acid Ascaricide Diels (Wulf.) Agardh Salicin Analgesic L. Kawain Tranquilizer Santonin Ascaricide L. ScillarinA Cardiotonic Forst. f. (L.) Bake Khellin Bronchodilator Scopolamine Sedative L. (L.) Lamk. SennosidesA&B Laxative spp. Lanatosides A, B, C Cardiotonic lanata Silymarin Antihepatotoxic (L.) Ehrh. Gaertn. Lobeline Smoking deterrent; Stevioside Sweetener respiratory stimulant L. Bertoni Monocrotaline Antitumor agent Strychnine CNSstimulant - L. L.
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Teniposide Antitumor agent Pineapple juice acts as a substitute to gastric juice L Tetrahydropalmatine Analgesic; sedative when the latter is lacking (hypochloridia, chronic gastritis). It canexpeditethepassageoffoodthrough (Pallas) Cham. & Schltal. the stomach and enhance digestion. The active Theobromine Diuretic; constituent of the plant is bromelin, an enzyme, bronchodilator L. Theophylline Diuretic; which, like gastric juice pepsin is able to break bronchodilator (L.) proteins, thus accelerating digestion. The pineapple Kuntze juice also shows bechic (eases cough) and Trichosanthin Abortifacient L. expectorant properties. This is more likely due to the Tubocurarine Skeletal muscle sugars and organic acids it contains. Pineapple relaxant R. & P. exhibits vermifuge and mildly diuretic properties. Valepotriates Sedative Preparation and use L. Vincamine Cerebral stimulant L. One or two slices of pineapple before each meal or a Xanthotoxin Leukoderma; vitiligo L. glass of fresh juice before each meal until recovery. Yohimbine Aphrodisiac
(K.Schum.) Pierre Yuanhuacine Abortifacient Seib. & Zucc. Yuanhuadine Abortifacient Seib. & Zucc.
Functional Foods These are foods that provide nutrition as well as health benefits. Thus, the materials are used as food and medicine. Functional food is defined as any food or food ingredient that may provide a health benefit beyond the traditional nutrients it contains [Institute of Medicine? s Food and Nutrition Board Cabbage has been in use for over two thousand (IOM/FNB), 1994]. Plants serve as a rich source of years as food and medicine. Cabbage is used to heal functional foods which can prevent or treat many gastro-duodenal ulcer. This antiulcer activity has diseases including chronic diseases. Functional been attributed to little-known vitamin U found in foods can be foods fortified with a nutrient that the juice. The leaves are rich in magnesium, would not usually be present to any great extent. A mineral salts, vitamins ? vitamins A,C, U and a fewexamplesarehighlighted below. surphur-like compound similar to the one Pineapple obtainable in mustard (glucosinolate). It is also used to decrease blood sugar level in diabetic people, and can serve as diuretic and vermifuge. It can act as a cicatrizant and vulnerary by healing infected wounds, torpid ulcer, eczema and acne when applied as poultice. Preparation and use Fresh plant juice: drink from half a glass to one (100 -200 ml), three to four times daily before each meal for three weeks. The leaves (5 ? 10 g) can also be eaten raw. Poultice: prepared with either raw leaves or with cooked leaves. Ananas comosus L. (Bromeliaceae)
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adequate funding of research in traditional medicine and its promotion through establishment of institutions such as Institute of Traditional Medicine, college of herbal medicine, etc in order to achieve self sufficiency in healthcare.
REFERENCES 1. Adam, M. (2006). Systems of medicine explained: Conventional, alternative, integrative, complementary and more. http://www.naturalnews.com/019365_wes tern_medicine_conventional.html. Accessed on 15 July 2016 Pawpaw is one of the plants most appreciated for 2. Ahmad, J., Qadeer, H.A. (1998). Unani: the its fruit. The leaves and the latex of the tree contain science of Graeco-Arabic medicine. Lustre papain, an enzyme, which hydrolyses proteins. Press. Papain shows similar property to pepsin and 3. Ajibesin, K.K., Ekpo, B.A.J., Bala, D.N., Essien, trypsin, both enzymes found in the gastric and E.E., Adesanya, S.A. (2008). Ethnobotanical pancreatic juices. The latex and the leaves are used survey of Akwa Ibom State of Nigeria. for those suffering from lack of digestive juice Journal of Ethnopharmacology 115(3): 387- usually caused by chronic gastritis or pancreatitis. 408. They are also useful as a vermifuge against 4. Ajibesin, K.K., Bala, D.N., Umoh, U.F. (2012a). internal parasites, especially tapeworm. Ethnomedicinal survey of plants used by the The fruit of pawpaw contains little amount of indigenes of Rivers State of Nigeria. papain, but very rich in vitamins A and C. It Pharmaceutical Biology 50(9): 1123? 1143. strengthens and normalizes digestion and 5. Ajibesin, K.K. (2012b). Ethnobotanical survey of intestinal functioning. The fruit is good for colitis, plants used for skin diseases and related irritable bowel syndrome and chronic ailments in Akwa Ibom State of Nigeria. constipation. Ethnobotany Research and Applications 10: Preparation and use 463-522. Latex: it is derived by incision from the green fruits 6. Alade, G.O., Okpako, E., Ajibesin, K.K., and the trunk of the pawpaw tree. Take 10-20 ml Omobuwajo, O.R. (2016). Indigenous mixed with honey and water after each meal knowledge of herbal medicines among regularly. 20 g of the green fruit or partially ripe adolescents in Amassoma, Bayelsa State, fruit can also be taken or mashed with honey after Nigeria. Global Journal of Health Science, 8 each meal. Ripe fruits may also be taken regularly (1): 217-237 to forestall digestive disorder. 7. Albert, A. (1977). Selective Toxicity. Chapman Infusion: 30 gof leaves in one literof water.Drink and Hall, London. three glass cups daily. 8. Ameh, S.J., Toge, B.K., Ebeshi, B.U., Ambi, A.A., Garba, M., Alfa, J., Gamaniel, K.S. (2014). CONCLUSION Herbal Drug Development from Traditional About 80% of the world population use herbal Formulations: Refocusing Pharmaceutics and medicines. The remaining 20% which mostly Posology for Accelerated Validation. British reside in the industrialized countries still have Journal of Pharmaceutical Research, 4(12): herbal medicines feature in their healthcare. Thus, 1451-1476. genuine concerted effort should be geared toward
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