Introduction

Herbal medicine is the use of plants-their leaves, stems, bark, flowers, fruits, and seeds to prevent or cure disease. Four billion people or about 80% of the world's population uses herbal medicine today as part of health care. Different cultures use herbs located in their geographical locations for curing common illnesses. They have been successful to a certain extent and over many centuries, some of the herbal cures have proved to be far more useful than allopathic drugs. What exactly is herbal medicine? One can loosely describe it is a natural form of healing or alternative therapy where herbs and plants are used in the form of extracts, pills, syrup or powder to cure ailments or diseases of human beings and in some cases of animals too. The administration of herbal medicines has been on a profile until now. But failure of some allopathic drugs and its side effects have prompted some patients to go back to ancient healing methods which use herbal medicines to give relief. ₁,₂

Figure 2

Figure 2

Origins

Herbal medicines are also called as herbalism. Ancient Indians, Chinese and Europeans discovered origins of medicinal herbs. They have been using them for curative purposes successfully. The records are available in ancient texts. In India itself, there are more than 1100 medicinal plants grown all over the wild forests. Of these, some 60 genuses are used immensely in medicinal preparations. Despite their demands today, they are not grown in a controlled manner. Rather tribes use them as their livelihood in some belts where they are grown in the wild. Unlike India, in China, the spurt in demand for traditional medicines has made the government to allow growth of these plants for further research and development. About 100 units have nearly 600 plant types, grown for their medicinal value. Herbal medicines are used in Ayurveda, Naturopathy, and Homeopathy, traditional and Native American medicines. About 74 plant types are used in modern medicines. They are bought from rainforests. With due importance, healthcare is being given worldwide, it is strange that herbal medicines are being used quietly without the consultations of a practitioner. They are bought over the counter or from unqualified people who make them. As they hardly have, any side effects patent medicines are few in circulation, especially in India and China. If general physicians and doctors combine them with allopathic drugs for patients with chronic problems, it could be a positive step towards healthcare. As they are cost effective, they fall within the budget of patients needing long-term care. ₃,₄

With the development of chemistry and the refinement of laboratory methods, herbal medicine gave way to the modern pharmaceutical industry where many drugs are created in test tubes. Still, plant-based ingredients are found in almost half of all prescription and over-the counter medications used in conventional medicine, including aspirin, digitalis, and atropine, as well as several anticancer medications. Herbal medicine in China has for centuries been a well organized system of knowledge based on observations, experiments, and clinical trials, and the effectiveness of a significant number of these remedies has been verified by modern science. Elsewhere, the latest effort in plant codification has been undertaken by a consortium of medical researchers, pharmaceutical companies, and herbalists who are investigating the flora of the rain forests in the hope of discovering new plant resources that might yield cures for heart disease, cancer, AIDS, and other deadly disease. ₄

Practitioners

Herbal medicine is the specialty of people who call themselves herbalists. It is also part of homeopathy, naturopathy, and aromatherapy, as well as the mainstay of self-styled holistic healers, some with acceptable credentials, and many without. Chinese herbal medicine is being popularized in the West by acupuncturists and other practitioners of Eastern medicine. Many salespeople in health food stores also consider themselves qualified to recommend the use of herbal extracts. Finally, many home remedies rely upon herbal preparations.

When it is used

For practitioners of herbal medicine, especially Chinese herbalists, there is a plant remedy for almost every disorder. In general, herbs are effective for treating minor ailments such as digestive problems, flu, cough, headache, and rash.

How it Works

Herbal medicines that bring about a desired result are found in laboratory analyses to contain substances that trigger specific biochemical responses. For example, the inner bark of a certain type of willow tree chewed by Native Americans to alleviate headaches and other pains contains salicylic acid, the active ingredient of aspirin. Some herbalists still recommend white willow to treat headaches, arthritis, and other painful conditions, contending that it is less likely to produce stomach upset and other adverse effects of aspirin. Unlike conventional drugs, herbal remedies per se do not have the supervisions of the Food and Drug Administration (FDA).Therefore, the consumer has no way of knowing whether an herbal product has been subjected to scientific testing to measure its safety and effectiveness.FDA rules require that herbal products be marketed as foods or food additives and that their labels not make specific medical claims or provide dosage information. Hence, people who use herbal remedies usually turn to books or rely upon the advice of an herbalist or other alternative practitioners. ₄

What to expect

After asking questions about the nature of a problem, an herbalist will prescribe a specific plant and give instructions on how to use it. For medical purpose, dried herbs are usually recommended because their increased concentration makes them more potent than the fresh plants. Leaves and flowers are dried in an airy, shady place; sun bakes out their oils and may also damage other medicinal ingredients. Roots and heavy stems are cleaned, chopped, dried, and then stored in glass jars or other non-metallic containers in a cool, dry place until they are used. Medicinal herbs are most often steeped in boiling water and consumed as a tea. These teas, which can be unpleasantly bitter or strong-tasting, should not be confused with the pleasant, commercially available herbal teas, which contain only a small fraction of the herbs used in a medicinal brew.

Precautions

Many plants are poisonous. Make sure that you know exactly what is in an herbal remedy before you take it internally. Before using any herbal remedy for a child's illness, consult a paediatricians or paediatric nurse. Take only the recommended dosage. Herbal products that are safe in small amounts can produce severe side effects when taken in larger doses. For example, a plant substance that may be an effective laxative in small quantities can often provoke severe diarrhoea when taken in a larger dosage. Monitor yourself for possible side effects. If you develop a widespread rash, dizziness, difficulty breathing, or other signs of a severe reaction, call a doctor or go to your nearest emergency room because you may be having anaphylactic reactions.

Poisonous Herbs

Many herbs are highly toxic, even in small doses. Be cautions of homemade remedies, and if you gather wild herbs, be sure you know what you are picking. The following herbs can be fatal: Aonite, Arnica, Beladonna, Yohimbe, Lobelia etc.

Figure 3

Table 1: Examples of common herbal remedies

Herbal Recipes

Figure 4

Figure 3

Herbal preparations are taken in many forms-alcohol tinctures, fluids extracts, essential oil, syrups, vinegars, capsules, and pills. Lay people are generally advised to obtain these preparations from reliable herbalists or reputable commercial outlets. If you prefer to make your own, herbalists recommend freshly made infusions (tea) or decoctions using the following recipes. ₅,₆

Standard infusion: Place 1 ounce of dried herb or 3 ounces of fresh herb in a teapot or other non-metallic container, and pour in 1 pint of boiling water. Let it steep for 10 minutes, strain out herb, and drink while still fresh. Some remedies may call for stronger or milder teas; adjust recipe according to instructions.

Decoction: Place 1 ounce of herb in a glass, enamel, or stainless steel pan(not aluminium), add 3 cups of water and bring to a boil; lower heat and simmer for 10 minutes or until the liquid is reduced by one-third. Strain and drink the recommended amount while the liquid is still hot. Decoctions are usually made from roots or woody herbs.

Compresses: Soak gauze or fine cloth in an infusion or decoction and apply to skin.

Poultice: Boil or cook herb or other recommended substance for example oatmeal, wrap in gauze, press out excess fluid, and apply while still hot.

Bach flower remedies

Figure 5

Figure 4

Of the several variations on herbalism, one of the best known is the system of Dr.Edward Bach, an English bacteriologist and homeopath who created and used flower essences as an alternative to conventional drug remedies. His preparations were made by immersing flowers in water and then exposing this combination to heat or to sunlight. He believed that these essences, individually and in combination, would restore the mental and emotional balance essential for physical well-being. The best-known of the Bach concoctions is the Rescue Remedy, a combination of five different formulas, which is reserved for especially trying situations such as the death of a loved one. Other Bach remedies include agrimonies to relieve anxiety; impatiens to reduce emotional irritability; and a combination of larch, holly, and mustard flower essences for asthma. ₇

Aromatherapy

The history of aromatherapy essential oils dates back to centuries ago to ancient civilizations such as those of Egypt, India, China and Greece. Different cultures had different uses for essential fragrant oils and while aromatherapy candles had not yet been developed, ancient aromatherapy products India included herb-based incense sticks that were used for religious practices. The phrase, 'essential oils' itself however was not coined till sometime in the sixteenth century in some part of the Western world. It was in that era that a German physician catalogued the main essential oils that we know of today. Public interest in the healing properties of essential oils was revived in the early twentieth century in France when a French chemist accidentally discovered the soothing properties of lavender oil while working in his laboratory. The chemist had burnt his hand and dipping it instantaneously into lavender oil, which just happened to be lying close at hand, not only helped to soothe his pain but also prevented scarring. This motivated the French chemist, named Gattefosse to research and write on the subject of Aromatherapy.

Figure 6

Figure 5

Aromatherapy or the use of essential natural oils to heal the body and spirit is an ancient practice which was appreciated by many cultures of the world. Historical records reveal that the use of fragrant oils to treat ailments was popular in the ancient civilizations of India, China, Egypt, Rome and Greece to name a few. However, each culture used different methods to derive aromatherapy benefits. For example, in India the traditional use of essential oils was in the form of massage oils and medicinal concoctions while Egyptians used essential oils for bathing and in ancient Greece records one can even read about the use of aromatherapy incense. Today, items like aromatherapy diffusers and a variety of aromatherapy oils and candles are manufactured to use essential oils to their maximum advantage. Essential oils that are popular today include the following.

• Angelica essential oil - used to treat digestive and respiratory ailments

• Bay Laurel oil - used to treat problems associated with the lymphatic system

• Basil oil - strengthens and supports the nervous system

• Bergamot oil - relieves depression and has calming properties

• Pepper oil - improves digestion and stimulates circulation

Today, the health benefits of essential oils is well-documented and these oils are used in many different ways such as one may use aromatherapy candles or incense sticks, while others may prefer to use massage oils. This form of therapy is also available for children and aromatherapy for babies can offer relief from colds and fever even at the stage when pharmaceutical medicines are not advisable.

Aromatherapy essential oils refer to oils that are extracted from plant sources and these oils must contain potent, aromatic compounds. Such oil is usually extracted from the plant source through the process of distillation, expression or solvent extraction. There has been enough archaeological evidence to suggest that such oils have been used for their aroma- therapeutic value since ancient times by various cultures of the world.

However research also shows that while most cultures appreciates the value of these oils in the form of massage oils they were also used in different ways by people of different cultures. In modern times, these uses have been experimented and perfected and aromatherapy essential oils are now available in newer forms such as in the form of candles.

Pure essential oils are the ideal essential oils for candle-making and for this purpose usually no added fragrance or perfume is employed in the manufacturing process. However this point should be clarified before purchasing aromatherapy candles. Such candles are available in many different styles such as pillar candles, candles tins and jars and can be made from many different oils such as lavender essential oils, peppermint oil or sweet basil oil for instance, no added fragrance or perfume is employed in the manufacturing process.

For healing purposes, it is best to use the pure unadulterated essential oils only and hence one should specifically ask for organic essential oils for such uses. Always check the ingredients listed on the cover to ensure that the manufacturer has really not added any outside ingredient. Wholesale essential oils are also available but only make sense to buy is you plan to manufacture or sell aromatherapy products.

However, many people often make the mistake of purchasing essential oils carelessly, confusing all essential oils available for organic aromatherapy essential oils. Since many aromatherapy products are available over-the-counter, one tends to believe that they are all considered absolutely safe. This is not always the case and one must equip oneself with sufficient knowledge about aromatherapy and essential oils before purchasing such oils. Improper use of such oils can in fact lead to health problems and hence caution must be exercised before purchasing pure essential oils aromatherapy benefit products.

Many essential oils products available today are manufactured purely for the sake of the aroma or fragrance as opposed to for therapeutic use. Since these oils are going to be absorbed into your skin if you plan to use them for therapeutic use - through processes like inhaling or massage - one must be careful about the amount, if any, of toxic materials that may be contained in readily-available oils.

Today, with the great demand for essential oils and aromatherapy products, there has been a wide range of products that claim to provide health benefits through aromatherapy which have arrived in the consumer market. These products range from anything like pure essential oils aromatherapy benefit products to aromatherapy cleaning products. There are a wide range of aromatherapy products candles, aromatherapy beauty products, aromatherapy skin care products and a variety of different kinds of aromatherapy kits and aromatherapy supplies that are available in the Indian market today. For the purpose of aromatherapy, certain products like organic essential oils are probably your best choice as these are truly authentic and pure essential oils with no additives or fragrance-lending ingredients. Hence these products are unlikely to spark off allergic reactions. Consumers must be careful to choose products that are contain only all-natural, non-toxic and top-of- the-line-ingredients.

The best aromatherapy cleaning products should be completely made from plant extracts. These will not only be effective cleaning agents but also lend your home a good fragrance. The best part about using such products is that you do not have to worry about children playing with them or getting near them. Genuine plant-based products cannot seriously harm anyone and hence both children and pets are safe around them. While purchasing aromatherapy oils, one should remember the difference between pure essential oils and fragrant oils. Pure acacia oil, for instance can be extremely soothing, while pure Indian lime scent or orange essences can leave your home smelling fresh and clean for hours. Lavender oil also has a calming effect on frayed nerves. ₈,₉

Ayurvedic and Chinese Herbal Medicine

Ayurveda, the ancient tradition of India, is often translated as the science of life. Ayurvedic medicine has some relevance to Chinese traditional medicine. Both systems are instructional, rather than scientific, and are fundamentally aimed at enhancing life. Both are additionally focused at treatment of specific diseases that plagued ancient societies for centuries. Nearly half of the most commonly-used herbs in each of these two Asian medical systems (India and China) are the same or similar and their actions are described in somewhat overlapping terms. For example, in both systems, herbs are described according to the symptoms they treat, their warming or cooling nature, and their influence on the body humors. What differs is the basic set of categories of disharmony: the diagnostic and therapeutic groupings. In traditional Chinese medicine the correspondence systems of yin and yang and the five elements have a strong influence, as do the depictions of certain bodily humors (qi, blood, moisture, and essence), and the internal organ systems (zangfu). In Ayurvedic medicine, although the total system is quite complex, there is a dominance of the three dosha (tridosha) system: kapha, pitta, vata (also called vayu). These three function within a body that is described primarily in terms of stages of transformation (following the path of ingested food as it is converted into essential substances that comprise the body) rather than by physical structures and functional organs. ₇

The reliance on a triad of influences on health and disease sometimes forces Ayurvedic medicine into a relatively simplistic system, which has had the effect of strangling its development compared to Chinese medicine. Several books on Ayurvedic medicine that have been presented to the West expend most of their pages on classifying individuals and their symptoms into these three groupings, and then present foods, herbs, physical therapies that are classified primarily by their effects on the three doshas.

Conclusion

Herbal medicine is often thought of as a phenomenon of the so-called New Age; in reality, much of it is older than human history. Every society has herbal cures and remedies, many of which have been incorporated into orthodox medicine. In fact, it is estimated that at least half of our modern drugs originated with natural plant sources. One attractive characteristic of these herbal sources for possible future use is their apparent wide safety margin in terms of toxicity compared with synthetic pharmaceuticals. Most natural herbals have been used for some time, yet there are few reports of adverse side effects in users. If natural drugs are safe for common use, future treatment protocols might involve the combination of herbal and synthetic pharmaceuticals, which would allow usage of far-reduced doses of the medicines.

Correspondence to

Mr.Sonal Sekhar M Faculty of pharmacy practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham University, AIMS Healthcare Campus, Elamakkara (P.O), Kochi, Kerala, India: 682026, E-mail: ask4sonal@yahoo.co.in Fax: +91484-2802141, Phone: +91484-2802140, 2802141, +91484-2801234-8275.