1. Art and Diseño

Pharmacognosy- 1
PHG 222
Prof. Dr. Amani S. Awaad
Professor of Pharmacognosy
Pharmacognosy Department,
College of Pharmacy Salman Bin Abdulaziz
University,
Al-Kharj. KSA.
Email: [email protected]
To know Traditional Systems of Herbal Medicine
To Recognize what is Complementary and
alternative medicine
To Identify complementary medicine
To Identify alternative medicine
To differentiate between all types of alternative
medicine
Complementary
and alternative
medicine
Traditional Systems of Herbal Medicine
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.
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.
Traditional Systems of Herbal
Medicine
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.
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.
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
Complementary and
alternative medicine
Complementary and alternative medicine,”
“complementary medicine,” “alternative
medicine,” “integrative medicine
what do they really mean?
hard to define and may mean different things to
different people
Complementary and
alternative medicine
What are the major types of complementary and
alternative medicine?
NCCAM (National Center for Complementary and Alternative
Medicine) classifies CAM therapies into five categories, or
domains
1.
2.
3.
4.
5.
Alternative Medical Systems., or complete systems of
therapy and practice. e.g. Traditional Chinese Medicine and
Ayurveda
Mind-Body Interventions. or techniques designed to
facilitate the mind's effect on bodily functions and
symptoms. e.g. prayer, meditation, art, music, or dance.
Biologically Based Therapies. biologically-based systems,
including herbalism. e.g. dietary supplements & herbal
products
Manipulative and Body-Based Methods. e.g. chiropractic
manipulation & massage
Energy Therapies.
I. Biofield therapies. e.g. qi gong
II. Bioelectromagnetic-based therapies.
Complementary and
alternative medicine
What is complementary and alternative medicine
(CAM)?
• It is a group of diverse medical and health care systems,
practices and products that are not presently considered to
be part of conventional medicine.
Are complementary medicine and alternative
medicine different from each other?
Complementary medicine is used together with conventional
medicine. (using aromatherapy to help lessen a patient’s
discomfort following surgery).
Alternative medicine is used in place of conventional medicine.
(using a special diet to treat cancer instead of undergoing surgery,
radiation, or chemotherapy that has been recommended by a
conventional doctor).
Complementary and alternative medicine cont..
1-Alternative Medical Systems
*True alternative medicine is not common.
*Most people use non-mainstream approaches along with
conventional treatments.
*The boundaries between complementary and
conventional medicine overlap and change with time.
For example, guided imagery and massage, both once
considered complementary or alternative, are used regularly in
some hospitals to help with pain management.
or complete systems of therapy and practice. e.g.:
I-Traditional Chinese Medicine
II- Ayurveda
I-Traditional Chinese Medicine(TCM)
Complementary and alternative medicine cont..
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
Traditional Chinese medicine (TCM) originated in
ancient China and has evolved over thousands of
years.
TCM practitioners use
a)herbal medicines and various
b)mind and body practices, (acupuncture, tai
chi, and qi gong ), to treat or prevent health
problems
"Life Energy Cultivation"
Complementary and alternative medicine cont..
1-Alternative Medical Systems
a)TCM herbal medicines
The Chinese Materia Medica (a pharmacological
reference book used by TCM practitioners) describes
thousands of medicinal substances
primarily plants, but also some minerals and animal
products.
Different parts of plants, such as the leaves, roots, stems,
flowers, and seeds, are used.
In TCM, herbs are often combined in formulas and given
as teas, capsules, liquid extracts, granules, or powders.
I-Traditional Chinese Medicine(TCM)
Complementary and alternative medicine cont..
b) Mind and body practices
(acupuncture, Qi gong, yin and yang)
Acupuncture is a family of procedures
involving the stimulation of specific points on
the body using a variety of techniques.
involves penetrating the skin with thin, solid,
metal needles that are manipulated by the hands
or by electrical stimulation.
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
Complementary and alternative medicine cont..
b) Mind and body practices
(acupuncture, Qi gong, yin and yang)
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
Qi, the essential life force:
Qi (or Chi) permeates everything. It is transferable.
Lung
Air
It is the quality, quantity and balance of qi that
determine human’s state of health.
Blood
Qigong
Food and air affect health, so diet and
breathing exercises are very mportant.
These aspects are considered first before herbs
are introduced
Food &
Drink
Body
human qi
b) Mind and body practices
(acupuncture, Qi gong, yin and yang)
Complementary and alternative medicine cont..
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
yin and yang
describes how apparently opposite or contrary forces are
actually complementary, interconnected, and interdependent in
the natural world, and how they give rise to each other as they
interrelate to one another.
(light and dark, fire and water, and male and female) are thought
of as physical manifestations of the duality of yin and yang
balance
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
b) Mind and body practices
(acupuncture, Qi gong, yin and yang)
Complementary and alternative medicine cont..
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
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/fir
The zàng-fǔ (organs are functional entities)
They constitute the center piece of TCM's general concept of
how the human body works.
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
zàng
Heart, Liver,
Spleen, Lung,
Kidney
fǔ
Small Intestine, Large Intestine,
Gall Bladder, Urinary Bladder,
Stomach and Sānjiaō
b) Mind and body practices
(acupuncture, Qi gong, yin and yang)
yin and yang
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
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.
Complementary and alternative medicine cont..
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
Complementary and alternative medicine cont..
Causes , Diagnosis and treatments of Disease
Causes
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
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.
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
Causes , Diagnosis and treatments of Disease
Internal emotional factors
(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.
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.
Complementary and alternative medicine cont..
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
Causes , Diagnosis and treatments of Disease
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...
Treatments
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.
Complementary and alternative medicine cont..
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
Causes , Diagnosis and treatments of Disease
Complementary and alternative medicine cont..
1-Alternative Medical Systems
I-Traditional Chinese Medicine(TCM)
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
Photography
II-Ayurveda
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
What is Ayurveda?
•
Ayurveda is a system of sacred Hindu medicine,
originating in India. It is the most ancient system of
medicine still in use today.
•
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.
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
What is Ayurveda?
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 tri-dosha).
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
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
Concepts in Ayurveda
Prana
Prana, the life energy:
It 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.
Prana 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.
Concepts in Ayurveda
Prana
Our bodies are made up of invisible energy
channels that travel throughout the body. In
yoga we refer to them as nadis. These energy
channels/nadis carry prana through the body and
into the organs. Prana is the term used for vital
life-force
(think of when you’re in the bush, out of the city,
surrounded in trees and nature – that air you
breathe is rich in life force/prana).
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
Complementary and alternative medicine cont..
1-Alternative Medical Systems
Concepts in Ayurveda
II-Ayurveda
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.
Concepts in Ayurveda
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
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.
Tridosha
Tridosha
Vata, Pitta & Kapha
(The Three Humors)
When the tridosha works in harmony and functions in a
balanced manner, the result is health and a feeling of well-
being 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.
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
Tridosha
Vata, Pitta & Kapha
(the Three Humors)
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
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
Tridosha
Vata, Pitta & Kapha
(the Three Humors)
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.
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
Causes , Diagnosis and treatments of Disease
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
Treatments
Treatment may involves:
Diets
Bloodletting
Fasting
Skin applications
Enemas
Yogic breathing
Herbal treatments
Minerals
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
Causes , Diagnosis and treatments of Disease
Complementary and alternative medicine cont..
1-Alternative Medical Systems
II-Ayurveda
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
Photography
Complementary and
alternative medicine
What are the major types of complementary and
alternative medicine?
NCCAM (National Center for Complementary and Alternative
Medicine) classifies CAM therapies into five categories, or
domains
1.
2.
3.
4.
5.
Alternative Medical Systems., or complete systems of
therapy and practice. e.g. Traditional Chinese Medicine and
Ayurveda
Mind-Body Interventions. or techniques designed to
facilitate the mind's effect on bodily functions and
symptoms. e.g. prayer, meditation, art, music, or dance.
Biologically Based Therapies. biologically-based systems,
including herbalism. e.g. dietary supplements & herbal
products
Manipulative and Body-Based Methods. e.g. chiropractic
manipulation & massage
Energy Therapies.
I. Biofield therapies. e.g. qi gong
II. Bioelectromagnetic-based therapies.
3-Biologically Based Therapies
3-Biologically Based Therapies
Medical herbalism
• is the use of plant remedies in the prevention and treatment of illness.
• Today, medical herbalism, practiced by medical herbalists, draws on traditional
knowledge, but increasingly this is interpreted and applied in a modern context.
Aspects of medical herbalism
1. Herbalism takes an holistic approach.
2. Herbalists select herbs on an individual basis for each patient.
3. Herbalists aim to identify the underlying cause (e.g. stress) of a
patient’s illness and to consider this in the treatment plan.
4. Herbs are used to stimulate the body’s healing capacity, to ‘strengthen’
bodily systems and to ‘correct’ disturbed body functions rather than to
treat presenting symptoms directly.
5. Herbs may be used to provide long-term relief from the particular
condition.
3-Biologically Based Therapies
Medical herbalism
•
1.
2.
One of the tenets of herbalism is that the different
constituents of a herb act together in some way that
has beneficial effects. These could be:
Additive effect:
The combined effect of two drugs is equal to the
sum of their individual actions.
Synergistic effect:
The combined effect of two drugs is greater than
the sum of the individual effects.
3-Biologically Based Therapies
Medical herbalism
Conditions treated
Medical herbalists treat a wide range of acute and chronic conditions.
e.g.
Irritable bowel syndrome , Premenstrual syndrome Menopausal symptoms,
Eczema, Types of arthritis, Depression, Acne and other skin conditions,
Cystitis (Inflammation of the urinary bladder), Migraine, Chronic fatigue
syndrome
Herbalist’s prescriptions
Generally, a combination of several different herbs (usually 4-6) is used
in the treatment of a particular patient.
sometimes, a single herb may be given, e.g. chasteberry (vitex agnus
castus) for premenstrual syndrome and dysmenorrhea.
In generally; patient’s treatment is reviewed regularly and is likely to be
changed depending on whether or not there has been a response.
3-Biologically Based Therapies
Medical herbalism
Herbalism & rational phytotherapy
Herbalism
Rational phytotherapy
Assume that synergy or additive
effects occur between herbs.
Seek evidence that synergy or
additive effects occur between herbs.
Holistic prescribing.
No holistic.
Preparations mainly formulated as
tinctures
Preparations mainly formulated as
tablets and capsules
Mainly uses combinations of herbs
Single-herb products used mainly
Opposition towards standardization.
Using standardization
Not scientifically evaluated
Science-based approach.
3-Biologically Based Therapies
Medical herbalism
Basic categories of medicinal herbs
Generally, medicinal herbs fall into two basic categories:
tonic and stimulating.
Tonics
help cells, tissues, and organs to maintain tone, or balance,
throughout the body. Some tonics activate and invigorate bodily
processes or parts. Other tonics supply important nutrients that
cells, tissues, and organs need to function properly. Tonics
ordinarily are taken regularly for three to nine months at a time
to gently strengthen and improve overall health and/or certain
organ functions.
Stimulating herbs
have much stronger actions and are used to treat particular
ailments. They should be taken in smaller doses than tonic
herbs, and for shorter periods of time.
4-Manipulative and Body-Based Methods
4-Manipulative and Body-Based Methods
Mind-Body Medicine uses a variety of tecjnoques
designed to enhance the mind's capapcity to affect
bodily function and symtoms. for example: Patients
support groups and Co-gnitive-Behavioral Therapy,
Meditation, Prayers, Mental Healing and Therapies
that uses creative outlets such as Art, Music or
Dance.
Mind-body interventions utilize the mind’s capacity
to affect the body and its physiological responses.
They thereby influence health.
e.g.
a) massage
b)Aromatherapy
4-Manipulative and Body-Based Methods
a) Massage
Massage involves working and acting on the body with
pressure – structured, unstructured, stationary, or moving
– tension, motion, or vibration, done manually or with
mechanical aids
4-Manipulative and Body-Based Methods
b)Aromatherapy
Aromatherapy is the practice of using fragrant essential oils
distilled from plants to improve both mood and health.
Aromatherapy was used by many ancient civilizations, including
those of Egypt, Greece, Rome and China
Essential oils are either inhaled or applied to the skin. For
inhalation, a few drops of the very concentrated substances are
added to steaming water or to devices, such as nebulizers and
diffusers, that spread the oil molecules throughout the air
Essential oils are believed to act both by exerting
pharmacological effects following:
1-Absorption into the circulation.
2-The effects of their odor on the olfactory system
4-Manipulative and Body-Based Methods
b)Aromatherapy
Ways of Using Essential Oils Inhaling through
vaporization
2. Bathing
3. Compress
4. Massage
Some oils should be avoided by people with certain
conditions, such as:
High blood pressure
Epilepsy
pregnanc
Energy Therapies
5-Energy Therapies.
I-Biofield therapies.
Traditional Chinese e.g. qi gong
II) Bioelectromagnetic-based therapies
Electromagnetic therapy is a pseudoscientific form of
alternative medicine which claims to treat disease by applying
electromagnetic radiation or pulsed electromagnetic fields
(PEMF) to the body. There is no scientific evidence that
electromagnetic therapy is effective in treating any condition.
Practitioners claim that these methods can treat a wide range of
ailments, including ulcers, headaches, burns, chronic pain,
nerve disorders, spinal cord injuries, diabetes, gum infections,
asthma, bronchitis, arthritis, cerebral palsy, heart disease and
cancer.