Transcript PHG 222 (2).ppt

Traditional Systems of
Herbal Medicine
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Definition
• Medical practice that includes diagnosis,
prevention and treatment, relying on
practical experience and observations
handed down from generation to
generation whether verbally or writing.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
It is necessary for pharmacists to know about
basic principles of traditional medicine for
two reasons:
1- To be in a position to advise patients who
may wish to consult an alternative
practitioner.
2- Traditional use is a common starting point
in the ongoing search for new drugs.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
The Diseases in Traditional
Systems are Classified into
I- Minor or Self-Limiting Disorders
Like aches, pain, flatulence, diarrhea,
wounds and facilitating childbirth, for
which plant or herb can be obtained
from a local market and would be well
known within the community.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
II- Chronic or Serious Disorders
Like cancer and some genetic or
metabolic diseases
Plant remedies will certainly be used but
they may be used as a part of a ritual
and treatment will also involve practices
such as divination to find out which
gods or ancestors have been offended
and what sacrifices may be necessary to
appease the supernatural entity.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
The Dose
Traditional Medicine (TM), usually means a lack of
specific dose, it is more concerned with How to
take the remedy rather than How much
So, highly potent plants are rarely part of a
traditional medicine pharmacopoeias.
e. g. Digitalis purpurea a drug used in treatment of
congestive heart failure with narrow therapeutic
index of the drug.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Traditional Chinese Medicine
(TCM)
Chinese medicine is philosophically
based, and as an holistic therapy the
concept of balance and harmony is
supremely important.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Concepts in TCM
Qi, the essential life force:
Qi (or Chi) permeates everything. It is
transferable. E. g. digestion extracts qi
from food and drink and transfers it to
the body. Breathing extracts qi from the
air and transfers it to the lungs.
These two forms of qi meet in the blood
and form “human qi”
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Qi, the essential life force
It is the quality, quantity and balance of qi
that determine human’s state of health.
Food and air affect health, so diet and
breathing exercises are very important.
These aspects are considered first
before herbs are introduced
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Yin and Yang
The theory of yin and yang still permeates all
aspects of Chinese thought
Yin: negative/passive/dark/female/water
Yang: positive/active/bright/male/fire
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Yin and Yang
They are always in balance,
where yin becomes weak,
yang is strong and vice
versa. Both contain the
seed of each other: their
opposites within
themselves.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
The Five Elements
The earth is divided into wood, fire, earth
metal and water. They dominate
everything on earth, and each is
associated with a vital organ of the
body:
Heart: fire
Liver: wood
Spleen: earth Lungs: metal Kidneys: water
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
The Vital Organs
The organs are also considered to be yin and
yang and are paired.
Coupled organs are connected by meridians, or
energy channels, through which qi flows.
Meridians are not associated with the nervous
system and can not be seen physically. They
are stimulated with herbs and by acupuncture
and will have a direct effect on a particular
organ as well as a toning effect on the system.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Causes of Disease
• Bacteria, viruses and chemicals are not
considered to be cause.
• If an organ is weak, it may be attacked
and therefore the weakness is the cause
and must be rectified.
• It may be a result of an external forces and
internal emotional factors
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
The external factors
“Six Excesses”
Wind
Cold
Summer heat
Dampness
Dryness
Fire
• Most people, if healthy, not affected by
the six excesses but, if the body is
deficient in qi or weather conditions are
abnormal, then this may cause
problems.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
The Seven Emotions
• These are the major internal causes of diseases, these
are:
Joy
Anger
Anxiety
Concentration
Grief
Fear
Fright
• Excessive emotional activity causes:
1- yin/yang imbalance
2- blockage of qi in the meridians and impairment of vital
organ function
3- damage of the organs and allows disease to enter
from outside, or a minor weakness from inside to
develop.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
There are a few other causes which are
not emotional or external excesses.
These are the exception not the rule, and
include epidemics, insect and animal
bites, worm infestation and hereditary
diseases.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Diagnosis
• Examination of the tongue
• Pulse diagnosis
• Palpitation of internal organs
• Massage
• Interviewing: questions are asked about sleep
patterns, stool and urine quality, fever, etc...
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Treatment
• The purpose is to rectify harmony, restore qi
and the yin/yang balance.
• Example: “cold” disease, such as cold in
lung, coughs, vomiting are considered to be
a deficiency of yang and treatment would be
with a warming herb such as ginger.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Some Important Herbs in TCM and
Their Uses
Latin name
English name
Nature
Medicinal use
Cinnamomum
cassia
Chinese
cinnamon
Pungent, sweet,
very hot, yang
Diarrhoea, tonic,
dysmenorrhoea
Ephedra sinica
Ephedra
Pungent, slightly
bitter, warm, yang
Bronchial asthma,
hayfever
Panax ginseng
Ginseng
Sweet, neutral
Tonic, aphrodisiac,
appetite stimulant
Rheum
palmatum
Rhubarb
Bitter, cold, yin
Constipation, burns,
diarrhoea, jaundice
Zingiber
officinale
Ginger
Pungent, sweet,
very hot, yang
Nausea, vomiting,
colds, diarrhoea
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
•
Ayurveda is a system of sacred Hindu medicine,
originating in India. It is the most ancient system of
medicine still in use today.
•
Ayurveda is considered to be the most ancient of all
medical disciplines.
•
In Ayurvedic medicine, the patient is viewed as
unique, and ‘normality’ as what is appropriate for
that particular person.
•
This is in contrast to Western medicine, where
populations are generalized and ‘normal’ means
what is applicable to the majority.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Philosophically, Ayurveda has similarities with
traditional Chinese medicine (TCM):
1- Parana, the life energy is equivalent to qi.
2- In TCM, there are two (yin and yang), and in
Ayurveda there are three (the tridosha).
3- There are five elements in both, but they are
slightly different.
4- Many remedies are common to both systems
although the philosophical rationale for their
application may be a little different
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Concepts in Ayurveda
Prana, the life energy:
•
Prana is the vital energy, activating both body and
mind.
•
Nutrient prana from the air gives energy to the vital
prana in the brain, via respiration, and is thus the
equivalent of qi in TCM.
•
In the body it is seated in the head, and governs
emotions, memory and other functions of the mind.
•
Prana kindles the bodily fire, governs the functioning
of the heart, entering the bloodstream from where it
controls the vital organs.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Bhutas, the five elements
The basic elements of cosmic energy are:
• Ether (Space)
Air
Fire
Water
Earth
• The five elements are related to the five senses:
hearing, touch, vision, taste & smell.
e.g.: Ether is related to hearing, since sound is
transmitted through it, and from there to the ear, the
associated sense organ, leading to speech, from the
organs of action which are the tongue and vocal cords.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Tridosha
Vata, Pitta & Kapha
(the Three Humors)
• The five elements are manifest in the human body as
three basic principles or humors known as the Tridosha.
• The three humors (Vata, Pitta, Kapha) govern all
biological, psychological and physiopathological
functions of the body and mind.
• The primary requirement for diagnosis and treatment of
disease is to understand the relationship between the
humors.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
• When the tridosha works in harmony and functions in a
balanced manner, the result is health and a feeling of wellbeing in the individual. However, in cases of imbalance
and disharmony, the result is illness or disease.
• The tridosha is responsible for psychological
phenomena, including basic human emotions such as
fear, anger and greed, and more complicated sentiments
such as understanding, compassion and love, and as
such is the foundation of the psychosomatic nature of
man.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
• The tridosha has recently been redefined as an
equilibrium, balance and coordination between the
three vital body systems:



Central nervous system (CNS)  vata
Endocrine system  pitta
Immune axis  kapha
• The tridosha can be considered to govern all
metabolic activities:

Catabolism  vata

Metabolism  pitta

Anabolism  kapha
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
For example:
•
When vata is out of balance, the metabolism
will be disturbed, resulting in excess
catabolism, which is the breakdown or
deterioration process in the body; excess
would therefore induce emaciation.
•
When anabolism is greater than catabolism
(excess kapha), there is an increased rate of
growth and repair of organs and tissues.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Diagnosis
Taking the case history involves
astrological considerations.
Examination, where the appearance of
the tongue, properties of the urine,
sweat and sputum will also be
examined.
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Treatment
Treatment may involves:
Diets
Bloodletting
Fasting
Skin applications
Enemas
Yogic breathing
Herbal treatments
Minerals
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy
Examples of Herbs of Ayurveda and
Their Uses
Botanical name English name Effect on dosha
Medical use
Nigella sativa
Black cumin
Pacifies vata
and kapha
Digestive, antiseptic
Ocimum
sanctum
Holy basil
Pacifies kapha
and vata
Expectorant, febrifuge,
immunomodulator
Piper nigrum
Black pepper
Pacifies vata
and pitta
Digestive, respiratory
disorders
Reference: Heinrich, M.; et al:
Fundamentals of Pharmacognosy