Complementary and Alternative

Medicine For Clinical Pharmacy

Students

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Course title:-ALTERNATIVE AND COMPLEMENTARY MEDICINE

Course code:- PHAR 521

Credit hour:- 2CR.HRS

COURSE OBJECTIVES:

 To develop the understanding of pharmacy undergraduates on the

different forms of alternative medical practices.
COURSE DESCRIPTION:

The following topics are discussed: definitions and terminologies, methods and
techniques of alternative medical practice; standardization of herbal medicines;
scientific explanations and myths behind alternative medical practice;
advantages and disadvantages to patients; role in public health care; the
practice of traditional medicine in Ethiopia .
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1.Introduction
What is alternative medicine
Definitions
Brief historical background

2.Alternative medicine methods and techniques

3.The advantage and limitations of traditional medicine
4.Standardization of herbal potions (preparation mixtures)
5.Ethiopian traditional medicine
6.Traditional medicine and primary health care

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7. Traditional medicines of other countries
Homeopathy (Like with like)

Naturopathy

Traditional Chinese medicine

Ayurveda etc . . . .

References
Sofowora:- medicinal plants and Traditional medicine in Africa

Fullas F. Ethiopian Traditional medicine

Abebe D:- Etse Debdabe

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Introduction
What is traditional medicine?
 Traditional medicine is the ancient and cultural bound medical
practice that existed before the advent of modern medicine.
 Modern medicine, conventional medicine, allopathic medicine,
western medicine & orthodox medicine are all the same.
 “Alternative” simply designated practices considered to be
outside of mainstream medicine, or put another way, practices
not commonly taught at conventional medical schools.

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 The world health organization (WHO) defines traditional
medicine as health practices, approaches, knowledge and beliefs
incorporating plants, animal and mineral based medicines,
spiritual therapies, manual massage techniques and exercises,
applied singularly or in combination to treat, diagnose and
prevent illness and maintain well being.

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 In industrialized countries adoptions of traditional medicine
are known as complementary and /or alternative medicine
(CAM)
 The addition of the word “complementary” to the title reflected
the fact that these practices are increasingly used in conjunction
with, and adjunctive to, conventional or “allopathic” medicine.

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 The term “integrative medicine” refers to an approach to
patient care that fully utilizes both conventional and
alternative methodologies.
 CAM whole medical systems are naturopathic medicine,
homeopathy, Ayurveda and traditional Chinese medicine
(TCM) including acupuncture; these systems have evolved
over centuries to millennia.
 “Boundaries within CAM and between the CAM domain
and that of the dominant system are not always well
defined.”Why?
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 Complementary:- together with conventional medicine

 Alternative:- in place of conventional medicine. Some

providers practice both (integrated).
The process of treatment of these alternative medicines have:
ancient types of procedure,

unique features,

 unique ways of treatment of different diseases,

unique principles & laws which they follow &

 unique medicine, those totally different from allopathic

medicine.
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 Worldwide people have developed indigenous healing traditions
adapted and defined by their culture, beliefs and environment,
which satisfied the health needs of communities over centuries.
 This healing tradition is deep-rooted in a specific socio cultural
context and is known as traditional medical practice or
indigenous medical practices.
 Therefore, there are many traditional medical practices as there
are many communities.

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The traditional medical practices vary from country to
country as well as even from place to place (but there may
be overlapping characteristics).
Examples:-
In Ethiopia:- Ethiopian traditional medical practices varying
ethnically & regionally.
In India:- Ayurveda (Indian traditional medicine)
In china:- Chinese traditional medical practice (e.g. Acupuncture)
In Europe:- Homeopathy and naturaopathy
In Arab countries:- unanimedicine(Greco-Arab med.) etc
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How do the primitive people get knowledge about
traditional medical practices?
i. Trial and error
ii.Experience (migration)
iii.Serendipity:- sudden chance of discovery
iv. Doctrine of signature:- “God marked everything look at the
structure of plants and animals around” Eg. Digitalis leaves look
like heart and hence used for heart failure.
v. Divine power (supernatural power gifted)……..

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 Some examples of doctrine signature

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 Contin..

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Advantages & disadvantage of Traditional Medicine
Advantage of traditional medicine
 Traditional medicine is cheaper (doesn’t require highly
sophisticated institution and highly skilled man power )
 More accessible to the majority of the society
 More acceptable than modern medicine (goes with the socio
cultural belief of the society)……
 More than 80% the African population rely on traditional
medicine.

potential source of new and noble drugs. How?

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Example1:- Rauwolfia:- (#Resperidone#) Reserpine (major
component) (its root) used as antihypertensive, tranquillizer
(strong sedation).
In Ethiopian traditional medicine, the seeds of glinus

lotoids(Metere,in amharic) ‘metere’ has been used as

anthelmintic. (like tapeworm infestations )

More tolerated by the body.

Resistance is not a problem in traditional medicine

Example: malarial chloroquine is totally resisted but the

resistance to quinine is too low!

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 Contin..
• Example 2:Cinchons spp(its tree and been used since
1633) used as source of quinine and quinidine.
• malarial chloroquine is totally resisted but the
resistance to quinine is too low!
• Example 3: Digoxin from Digitalis
• Example 4: vincristine and vinblastine(used as
chemotherapy meds. To treat number of types
of cancer) originated from Catharanthus Spp.

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 Cont..
Atropin from Atrope belladone
Morphine and Codein from Papaller
Somniferus

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Disadvantages to Traditional Medicine
Lack of scientific proof for its efficacy
Lack of precise dose /dose standardization/
Lack of dose standardization because of biochemical variation
in the chemical constituents of plants.

Reject science and technology

Lack of hygiene in their methods

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 Some traditional healer fail to recognize their limit of
competence /they tend to handle every problem of the patient/
Some traditional medical practices are harmful to the patient
Example:- 1.bloodletting:- cutting vain or Artery,its withdrawing
blood from a persons’s vein for therapeutic reason,but it will cause
low BP,trouble breathing and loss of consciousness.(Yet still
practiced in the modern med. With the help of well qualified
physician to treat Hemochromatosis(disorded in which the body
starts to build up too much iron in the skin,heart,pancres and
joints) ,Non alcoholic fattt liver disease and Polycythemia(increased
red blood cell mass))
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 Cont..
• 2. Cautery: (“tatate”), incisions of eyelid
 Imprecise diagnosis often given by the practictoners
o Symptoms are treated rather than the cause
• Example:-Stomach trouble may be probably
indigestion, ulcer & cancer (but the traditional healers
give the same drug that may elevate the situation).

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Limitation of modern medicine
 Failure to cure some diseases such as HIV Aids, Cancer,
hemorrhoids etc
 Development of resistance
 Failure to identify patient problem
 Adverse drug reaction /unwanted and serious toxic effect/ i.e.
unintended serious toxic effect of the drug that occur at normal
dose /allergic to penicillin, peripheral neuropathy, aplastic anemia
(fatal) dead.

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Major types (Categories) of CAM
i. Biologic Based Therapies
Aromatherapy
Herbal preparations (supplementing a person's normal diet)
ii. Manipulative and body-based therapies
focus on the body's various systems and structures (massage)
iii. Mind-body interventions
 use the connection between a person's mind, body, and
spirit to enhance total well being
 Imagery
 Meditation

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iv. Energy therapies
 are meant to restore disturbances in the body's natural energy.
Healing touch
Therapeutic touch

Whole Medical Systems

 A whole medical system (or alternative medical system) consists of
a philosophy and theory about health and illness along with specific
types of treatment.
 These systems have developed independently from allopathic
medicine and are generally culturally based systems.

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Examples of whole medical systems
Ayurveda (natural system of med. Originated in india
3000years ago)
Traditional Chinese medicine
Shamanism (which includes native traditions)
Homeopathy
Naturopathy
Chiropractic medicine

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Ayurveda
 Ayurveda is the dominant herbal tradition in India.
 It still enjoys the faith of a large number of people of the country
though it is perhaps, the oldest system of healing in the world.
 It is encouraged in many countries like Japan, Germany etc
 The term “Ayurveda” is derived from two words, Ayur and Veda.
Ayur means life and Veda means knowledge or science.
 Therefore Ayurveda means science of life or way of life.
 Ayurveda considers that balance among people, the environment,
and the larger cosmos is integral to human health”
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 Central to Ayurvedic medicine is understanding the patient's basic
constitution, or DOSHA
 Ayurveda incorporates science, religion and philosophy in it.

TRIDOSHAS
 The elements (air, earth, fire and water) combine to form “Tri
Doshas” i.e Vata, Pitta, and Kappha.
 They are the “ Basic Forces ’’ and also known as the “ Pillars of
Life”
 Vata (Air principle) the elements water and air.

Pitta (Fire principle) the elements fire and water.

Kapha (Water principle) the elements earth and water.

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 According to the Ayurveda, sickness is due to the imbalance of
any one or more of the three doshas. Eg Aggravation of Pitta leads
to indigestion, skin diseases and liver problems.

Factors
 Factors responsible for imbalance of doshas are physical, mental,
spiritual and environmental may contribute for the imbalance of
doshas.

Treatment
 The importance of treatment is to restore the balance and
harmony of doshas with proper diet and drugs.
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Selection of the drugs is based upon
Rasa (Taste)
Virya (Potency) and
Vipaka (Taste after digestion)

Yoga
 Yoga “has been practiced for thousands of years in India,
Where it is a way of life that includes ethical models for
behavior and mental and physical exercises aimed at producing
spiritual enlightenment”

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Traditional Chinese Medicine
TCM as a healing system is thousands of years old.
A principle of TCM is that the interaction of people with
their environment is most significant in creating health

 The concept most central to TCM is Qi or chi

(pronounced), which is translated as energy.

Qi represents an invisible flow of energy that circulates

through plants, animals, and people as well as the earth
and sky.
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Yin and Yang(symbol of
earth,femaleness,darkness,passivity and absorption)
Qi is further viewed as either yin or yang energy.
Opposites and complementary,
 Health is present when they are in balance in a person and his or
her total environment.
 An imbalance of yin and yang is considered to be the cause of
illness

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 Conti..
• Acupuncture:- Qi is believed to flow
vertically in the body through an intricate
structure of 72 energy circuits that nourish
and support all cells and organs of the body
• Acupuncture consists of placing very thin,
short, sterile needles at particular acupoints,
believed to be centers of nerve and vascular
tissue, along a meridian

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 Acupuncture is used for a variety of reasons, including
reducing pain, promoting adherence to substance abuse
programs, and minimizing nausea and vomiting due to
chemotherapy and pregnancy, including stress
management.
Licensed acupuncturists have graduated from an
accredited acupuncture school after significant college-
level coursework and passed a licensure examination.

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Shamanism
In shamanism, illness and other forms of distress are
thought to originate in the spirit world.
The shaman or medicine man/ woman possesses the
ability to access the spirit world, which is done on behalf
of individuals or the community, and return to “ordinary
reality” with information on the proper treatment.

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Some Native American beliefs
•Healing takes time, and time contributes to healing.
• The distractions of modern life interfere with potential healing
agents.
• Modern culture encourages us to maintain a low level of
emotional awareness.
• Ceremony is important to receive guidance and assistance from
the spiritual dimension.

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Homeopathy
Homeopathy is relatively a recent system of medicine.
 The word “ Homeopathy” is derived from two Greek words;
Homois meaning similar and pathos meaning suffering.

Principle
 The cause of the disease itself can be its treatment i.e. Law of
similar.
 This is the basic principle of homeopathy.

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Homeopathic practice is based on two fundamental laws.
i. The Law of Similars states that a natural substance that produces a
given symptom in a healthy person will cure it in a sick person.
ii. The Law of Infinitesimals states that the smallest dose possible
will have the desired effect.

Treatment
The treatment is based on the concept of proving and prover.
 Prover:- The healthy person.
Proving:-The symptoms (Physical, mental, emotional changes)
that are caused by the various potencies of medicines in prover.

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For the treatment, the symptoms of the drug are compared with
the symptoms of the patient.
 In other words the selection of the drug depends upon the
symptoms of the drug and patient condition.
Homeopathy is based on the belief of supporting the body while
the symptoms are allowed to “run their course.”
Homeopaths believe that this process stimulates and
strengthens the immune system and promotes healing.

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Naturopathy(educate the person to look after their own
health and their beloved ones)
 Is not only a system of medicine but also a way of life.
 Emphasis on client responsibility, client education, health
maintenance, and disease prevention.
 It may be the model health system of the future with the
movement toward healthy lifestyles, healthy diets, and preventive
health care”
 Naturopaths believe that health is a dynamic state of being that
provides abundant energy for people to deal with life in our
complex society.
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 Much of illness can be attributed, at least in part,
 to ignoring “natural laws,” such as engaging in a sedentary
lifestyle without adequate time for exercise;
 exposing oneself to environmental toxins; eating processed,
 overcooked foods;
 engaging in negativity or harboring negative thoughts; and
 not getting adequate rest or relaxation.
 Therapies strive to support the self-healing mechanism of the
body.

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 Naturopaths employ an eclectic group of modalities, including
acupuncture, clinical nutrition, herbal medicine, hydrotherapy
(therapeutic use of water), and osteopathy (massage and
manipulation).

Chiropractic Medicine
 Investigates the relationship between the structure (the spine)
and function (mainly the nervous system) of the human body to
restore and preserve health.

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 The underlying principle is that the functions of the body are
controlled by the nervous system, mainly 31 pairs of spinal
nerves that feed all organs of the
body after branching
off the spinal column.

 The nervous system problem is sometimes

caused by a subluxation,(partial dislocation)
 By adjusting the spine the joint is brought into proper alignment
and the pressure on the nerve is released.
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Mind–Body Modalities:-
 Usually uses a variety of techniques designed to enhance the
minds capacity to affect body
function and symptoms.
Example:- meditation,(focus one’s
mind for a period of time for spiritual
purpose), spiritual therapy, prayers creative
arts such as dances, music etc

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Relaxation
 The ultimate goal is to increase the parasympathetic system
influence in the mind–body and thus reduce the effect of stress
and stress-related illness on the body.
 Several relaxation techniques,
 Including autogenic training(auto suggestion),
 biofeedback,
 body scanning,
 hypnosis,
 meditation, and
 progressive muscle relaxation.
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Guided Imagery (Help the patient visualize image of interest)
• Imagery involves using all five senses to imagine an event or body
process unfolding according to a plan.
• When all senses are involved in the experience, the imaginary
situation is more fully encoded in the body and more likely to take
place.
• A relaxation technique is frequently used to prepare the mind and
body before beginning an imagery session.

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Nursing Considerations
Health professions can work with patients using “outcome
imagery,” which might consist of using a picture or photograph
to visualize the desired outcome in a body part or in a situation.
During a painful or stressful event, such as an intravenous line
being started, the patient can “go to a favorite place” and
imagine being there with all the pleasant experiences related to
that space.

Caution: not recommended for emotionally unstable or cognitively

impaired client.

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UNANI MEDICINE
Origin & Development of Unani System
Unani system originated in Greece.
 Today the Unani system of medicine with hospitals and
educational and research institutions, forms an integral part of
the national health care delivery system certain countries.

Principles & Concepts

 According to the basic principles of Unani, the body is made up
of the four basic elements i.e earth, air, water & fire which have
different temperaments i.e. cold, hot, wet, dry.
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 After mixing and interaction of four elements a new compound
having new temperament existence. i.e Hot wet, hot dry, cold wet,
and cold and dry.

Diagnosis
 The Diagnostic process in Unani system is dependent on
observation and physical examination.
 Diagnosis involves investigating the causes of disease thoroughly
and in detail.
 For this, the physicians depend mainly on pulse reading and
examination of urine and stool.

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Physical examination
 Is carried out by the diagnosis of urinogenital disorders,
pathogenesis of blood and other humors, metabolic disorders
and liver diseases.

The following observations of urine are made:

Colour
Consistency
Clearness and turbidity (qual. Of being cloudy,opaque)
Odour
Foam or froth
Precipitates
Quantity
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The examination of stool:-
 Its colour, quantity, consistency and the presence of foreign
body help very much in the diagnosis of various diseases.
 Besides the means of pulse reading and physical examination of
urine and stool, other conventional means such as inspection,
palpitation, percussion and occultation are also used for
diagnosis purposes.

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Humor Therapy
 After watching 10 minutes of Marx Brothers (comedians) tapes
and “belly-laughing,” sedimentation rates (a measure of
inflammation in the body) decreased by at least five points
permanently.
 More recent research found that improved immune response was
correlated with experiences of “mirthful laughter.”

Aromatherapy
Use of essential oils of plants to treat symptoms.
Commonly used essential oils in a healthcare setting are ginger
or peppermint for nausea and lavender or chamomile for
insomnia.
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Humor Therapy
 After watching 10 minutes of Marx Brothers (comedians) tapes
and “belly-laughing,” sedimentation rates (a measure of
inflammation in the body) decreased by at least five points
permanently.
 More recent research found that improved immune response was
correlated with experiences of “mirthful laughter.”

Aromatherapy
 Use of essential oils of plants to treat symptoms.
 Commonly used essential oils in a healthcare setting are ginger
or peppermint for nausea and lavender or chamomile for
insomnia.
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There are two types of energy fields in our body
1. Bio field (life field):- there are life energies (vital forces) in the
body. (To think, to work . . )
 The life energy flows through the body through a certain
pathway /disruption of the path results in disease/ and the aim
of their therapy is correcting the pathway.
 The aim of the treatment is to correct energy flows.
Eg.Qi (Chi) in China, vital force, reiki etc
2. Bio – electro magnetic fields
Acceptable in modern medicine (can be proved)

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Biologically Based Practices
 Uses substances found in nature such as herbs, foods, vitamins,
minerals etc
Example:- herbal medicine (plant based medicine) (popular)
 Botanical agents (herbs) and nutritional supplements are
chemical compounds that are ingested with the hope of
achieving a therapeutic goal.
 They are becoming increasingly popular with consumers, who
can buy many of these preparations over the counter or from
company distributors.

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 Some consumers and practitioners are attracted to herbs
because they are “natural” plant products, which are perceived
as more compatible with the body than manufactured
pharmaceutical agents.
 Echinacea and goldenseal (separately or in combination) are
frequently used for respiratory infections
 Ginkgo biloba is frequently used to dilate cerebral blood vessels
and reduce symptoms of memory loss and mental confusion.
 Its best known today as way to potential keep your memory sharp

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Nursing Considerations
 Some herbs and/or supplements may interact with prescribed
medications patients are taking.
 Ginkgo biloba, the most widely sold herb in Europe and used by
many to improve memory, affects platelet function and thus
should not be used concurrently with warfarin.

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Manipulative and Body-Based Practices
Based on manipulation (correction) of bones, muscles
This group of therapies includes therapeutic massage, bone
setting as well as a variety of techniques.
The goal is to break up tension held in body structures,
promote communication between mind-body structures,
promote detoxification, and generally improve body
functioning.

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Definition of some terms
Traditional healer /indigenous healer/ traditional medical
practitioners:
A person who is recognized in the community in which he/she lives
as a competent to give health care service using plants, animals,
minerals and other methods.They include:
Herbalist; (medhanit awaki, kitel betash):-
 A traditional healer whose specialization lies on the use of herbs
to treat and/or prevent various ailment.

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 They are assumed to know compounding, dose, dosage form,
dosage requirement, adverse effect(but in reality they don’t know).

Bone setter; (wegesha):-

 A traditional healer specialized to manipulate bone and muscle
problems.

Spiritual healer:-
 A traditional practitioner who is generally believed to heal other by
using supernatural power/s/ Eg. Kalicha, Debtera, Shamans etc
 Depends on the soley believe hence they are called
psychotherapist.

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Traditional birth attendants (yelimd awalaj)
Traditional mid-wifery

Traditional surgeons:-A traditional healer who is specialized to

give surgical service

Ethno medicine:- is the study of traditional medical practice

among different ethnic groups

Acupuncture:- the insertion of thin needle at a specific point to

stimulate energy flow.
Charm:- is any formula act or object supposed to have magic power
toward off danger or to bring good luck.
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Amulet (kitab):- is any object worn as a charm
Incantations:- is a form of play on words, written or delivered
orally in poetic form to conjure up forces (efficacies) in to medicines.
Integrative medicine:- an approach to medicine that combines
modern medicine and CAM for which there is high
evidence of safety and efficacy.
Medicinal plant:- any plant which is used for therapeutic purpose
mitigation to reduce symptom
E.g Glinus lotoids (metere)
Hagnia abyssinica “kosso”
Lepidium sativicum “Feto”
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Traditional medicine: (methods and techniques)
Traditional medicine and modern medicines have the same
objectives
The aim is healing or preventing diseases
They differ in:-
Their concept about the cause of the disease
Their approach to healing and
Their healing methods used
The basic concept of modern medicine centers around the results
of experiment and the diseases is regarded as caused by
pathophysiological agents including microbes and noxious
substances
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 Many developing countries believe that disease can be due to
supernatural causes arising from the displeasure of ancestral gods,
evil spirits, the effects of witch crafts, the effects of spirit
possession, or the intrusion of an object in to the body.
 Thus traditional medicine gives much emphasis to the
psychological causes of disease.
 Traditional medicine and modern medicine can be compared on
their attitudes on the following points:-
 Etiology
Signs and symptoms
Pathology or Other aspects of medical practices
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Etiology: refers to the cause of a disease & according to
traditional medicine, there are five causes for
disease: (there can be overlapping)

These include
Physical aliments:-
 Are injurious substances that enter into the body through food,
drink and skin.
 The physical ailments may be; microorganisms helminthes,
poisons, microbial toxin etc

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Astral influences:- traditions from cosmic agents e.g Sun, moon,
stars etc may have an influence or human health.
(acceptable)
Eg. Radiation from the sun (eg. UV rays) could cause sunburn; skin
cancer, insanity is aggravated during the full moon

Spiritual causes:- evil thought, evil desires and machination by

enemies or evil telephathic massages are believed to be the
spiritual cause of diseases.

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Esoteric causes:- disease originating from the soul or
those caused by the deeds of an individual in his/her
former life
Psychological causes:-
diseases caused to man when he/she is not in harmony with the
laws of nature
Some people tend to be that they are sick when in actual fact
nothing is wrong with their system.

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Signs and symptoms
 In modern medicine the patient describes his/her symptoms to the
medical practitioners but in many cases patient says little to the
traditional practitioner.
 In modern medicine, medical practitioners use different diagnostic
equipment to determine the sign of the disease.
E.g stethoscope but in traditional medicine, the practitioner use
his/her experience and observations.

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Diagnosis
In traditional medicine the methods of diagnosis includes:-
Anamnesia:-
 is recollection of a pervious existence of the patient.
 It is simply studying patient history.
The traditional medical practitioner may ask about
Life style
Family history

Observation of the patient:- it involves watch the patients

attitude and gestures /especially important in early mental diseases/

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Biological examination:- examining biological products such as
urine, vomits, wound /wound secretion using his/her sense organs
Example:- observing the color of vomits:-
Yellowish vomits  diseases related to liver
Contains blood  ulcer
Tasting urine for sugar

Divination:- consultation of an oracle about patients problem

Involves magic or religious belief

Use of mind changing drugs:- mind changing drugs can be

given to the patient orally, rectally or by inhalation.

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 i.After taking the drug, the patient talks freely Eg. Datura
stramonium Cannabis sativa etc
•Dream analysis
Treatments
•In traditional medicine, treatment is holistic (mind, psycho, body
and spirit) & doesn’t consider only the diseased body.
The type of treatment offered varies and includes:-
•Medical treatment:- in this case, medicinal substance from
animals plants and minerals are utilized

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 i.In most cases herbal medicine is commonly utilized
ii.The plant drugs can be given in different forms which may be
iii.Liquid preparations:- infusion, Oily mixtures, Decoction etc
Solid preparation
•Powders
•Dried plant material
Gaseous preparations
•Steam inhalations
•Fumigations etc

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These medicanuts can be given by:-
•Oral route
•Inhalation
•Injection /intramuscular, subcutaneous/ applied to the outface of the
body
•Tradition cosmetics /topical /
•Therapeutic fasting and dieting
i.The traditional medical practitioner may order his/her patient:-
•To fast occasionally
•Not to eat /drink some foods/ drinks Example:- hypertensive
patients are recommended to restrict their salt, fat and alcohol
consumption
•Patients with gout are advised not to eat meat purine which
increase uric acid and urate crystals.
•Hydrotherapy:- the use of water in any form for therapeutic
purpose. ‘like treats like.’

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•Bloodletting:- this blood is assumed to be the diseased one. From
vein blood is allowed to flow.
• Massage
•Bone setting
•Psychotherapy
Standardization of herbal potions
•Herbal medicine refers to the use of plant based medicine for
preventive, curative and mitigation purposes.
•Herbal medicine could be known as botanical medicine or
phytomedicine or phytotherapy.

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One of the major criticisms levied against TMP is that
•Their potions are not standardized
•They don’t dispense to patients in specified dose
•Their practices are not strictly regulated
•The dose is not related to age or weight
•Their methods are not regulated and hygienic
•Therefore, all stages of preparations should be standardized
/amount, method, cost & safety./

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The stage that should be controlled includes:-
•The collection of the plant
•The extraction (preparation) procedure
•The final a galenicals i.e the liquid extract obtained etc
•The dosage forms
At each of this stage, adequate control must be taken before a
standardized finished product of the correct potency is obtained.

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•In some case the finished product or galenical needs to be
standardized biologically to ensure that the patient is receiving the
correct quantity of active drugs.
The various factors to be considered in attempting to achieve
standardized herbal drugs for the use of traditional medicine:
•Plant nomenclature and selections:-
Plants can have
•Common name /vernacular name/
•Scientific name /international name/ Example:- justicia
schimperiana

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A plant can have only one scientific name no two plants could
possesses the same scientific name. Using scientific name avoids
confusions  No probability of collecting wrong plants by
mistakes.
It is common for the same plant to bear different local names or
different p;ants could have the same common name and this may
lead to collection /selections/ of wrong plants because of common
name confusions.

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Cultivated source:- medicinal plants gardens wrong collections
again leads to toxicity /wrong quality/
Example:-
•Justicia shcimperiana  scientific
“sensel” “sinyza”  common (two)
•Datura stramonium  scientific
- Etse faris
- Astenasir
- Magi

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Tosign Common name
- Thymus vulgaris
- Thymus serrulatus
- Thymus chimpero
- Saturia punietate
•Even if the above four species may have similar characteristics at
least the amount of chemical is different and at most absolutely
dissimilar compounds may exist in each species.
Lack of recorded data about the actual plants used in traditional
medicines is a major problems in Africa

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•Collection of plants
•Plants can be collected from cultivated source or wild sources &
collections from cultivated sources ensure true natural sources.
During collections, the following factors should be considered:-
•The species and variety of the plants, e.g ocimum bacillum, var
bacilium; indicates the same species that may exist in different
variety.
•The plants habitat /place of plant growth/ indirectly covers soil
types, environmental conditions /climatic variation/

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•Datura stramonium growing in A.A, Gonder and Wellega will vary
in active ingredient. This is due to some climatic conditions makes
highly productive and may be inert /low/ at different climates.
Time of collections /When to collect/
The season
•The nature and the amount of active ingredient may show seasonal
variation.

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The age of the plants
•Similarly nature and amount of active ingredient varies with aging.
Some plants contain active ingredient after aging 10, 20, 30 years.
•Official part:- Medicinally acceptable part of the plant E.g 1.
Leaf-official part leaf stalk is considered as contaminant. E.g 2.
When the fruit of conium maculatum is green it gives up to 3%
coniine when fruit matures and becomes yellow it gives less than
1% coniine.
•Cinchona will not produce sufficient quninine (when the age of the
plant is less than 10 years.)

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Time of the day:
•Volatile oil bearing plants should be collected early in the morning
Whether there id contaminate or not
•It may be part of the plant other than the official parts
•Soil and sand (during root collection)
•Plant generally growing together with the official plant
•Plants with morphological similarity to the official drug etc

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•Post harvesting processing
Some plant constituents rapidly deteriorate soon after collections
because:-
•They are attached by enzymes
•They are volatile
•Quick drying may be indicated to stop enzymatic actions /if
enzymatic action is undesirable/
•Drying should be done for plant materials between 20-650C but
these range should be monitored for thermolabile drugs.

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•The storage time for plant drugs should be kept minimal for most
drugs
•To prevent insect and mold attack
•To prevent hydrolysis, oxidations

•Note:- prolonged storage may improve the quality of active

principle in some plants. E,g. cascara should be stored at least for 1
year because of important reactions taking place in the plant.

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 Preparation of galencials
•The amount of the active ingredient (constituent) in the finished
product should be standardized to ensure that each formulations
complies with the compositions simulated.
•Before a certain plant is incorporated in to a traditional medicine,
it is important that it is not toxic and will not produce undesirable
effect.
•The container used in traditional medicine must be properly
selected. The quality, safety and efficacy of the herbal drug should
be assessed before it is incorporated into modern medicines.

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Assignment(Due date :May 25,2024
sending address:- [email protected] )
Assign yourself in Group of Five and write a short
review on the listed topics
1. Introduction
2. Literature review where it is practiced
3. Principle of practice
4. Discussion
5. Your stand/ attitude towards the practice
6. Conclussion
I. African Traditional Medicine
II. Ethiopian Traditional Medicine
III. Indian Traditional Medicine
IV. Chinese Traditional Medicine
V. Homeopathy
VI. Naturopathy
VII. Unani medicine Complementary and Alternative Medicine
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