HERBAL MEDICINE

Herbal medicine, also known as herbalism or botanical medicine, is a medical system

based on the use of plants or plant extracts that may be eaten or applied to the skin. Since
ancient times, herbal medicine has been used by many different cultures throughout the
world to treat illness and to assist bodily functions. While herbal medicine is not a licensed
profession, herbal remedies in the form of extracts, tinctures, capsules and tablets as well
as teas may be recommended by healthcare practitioners of many different disciplines as
practical way to address a wide variety of medical conditions. Scientific study shows that
plants posses a vast complex arsenal of phytochemicals that not only calm, restore, and
heal the skin but also stand up to the scrutiny of clinical trial and pharmacology.

HERBAL MEDICINE THEN AND NOW

HISTORY OF HERBAL MEDICINE

Plants have played a significant role in maintaining the health and improving the quality of
human life for thousand of years. The ancient European, Indian (or Ayurvedic) and the
Chinese medicinal systems, although vastly different, all believed that imbalance in the
human body is the cause of all illness. Therefore, all these systems essentially work to
restore balance after which good health will follow. Plants were the only medicines used
before 500 B.C. During this time, it was believed that plants had both ritual magic powers
and medicinal qualities. After 500 B.C., starting with the age of Hippocrates, illness was
gradually seen as a natural human condition and started to shed its supernatural qualities.
During the explosion of world trade in the fourteenth century, herbal remedies and herbs
were exchanged between the Chinese, the Muslims, the Indians and the Europeans. New
herbs like ginger, cardamon and cinnamon began appearing in Europe. While European
herbs like sage were traded in the Far East. Between the twelfth and eighteenth century,
various epidemics and plagues ravaged Europe. European medicine proved unable to
combat these fatal diseases. When the Spanish and the Portugese landed in central and
South America, potent herbal remedies were discovered and exported to Europe. These
herbs were used to treat smallpox, malaria and syphilis. Homeopathy and herbal medicine
became very popular for this reason. Records in ancient clay tablets made more than 5000
years ago by the Sumerians of southern Mesopotamia – a modern day Iraq- refer to a
person known as an asu, who supplied medicine from plant extract resins and spices.
During the past decade, many more Americans have turned to herbal remedies for the
treatment of a variety of medical conditions including coughs, colds, insomnia, digestive
problems, headaches, premenstrual syndrome, prostate problem, anxiety and depression.

The use of plants as a source of drugs and therapies continues to be a feature of traditional
medicine in Western nations. Some medicinal uses of plants began millennia ago endured
unchanged to the modern day. Chewing Willow bark to treat fever and inflammation, for
example, was described by the famed Greek physician Hippocrates- considered the father of
western medicine around 400 BC. Pharmaceutical medicine was heavily influenced by the
nineteenth and twentieth century.

TIMELINE
No one knows when humans began using herbs for medicinal purposes. The first written
record of herbal medicine use showed up in 28000 B.C in China. Since then the use of herbs
has gained and fallen out of favour many times in the medical field.

The timeline that follows shows some of the key dates and major points in the history of
herbal medicine:

 2800 B.C – The first written record of herbal medicine use showed up. (Titled the
Pen Ts’ao by Shen Nung)
 400 B.C – The Greeks joined the herbal medicine game. Hippocrates stressed the
ideas that diet, exercise and overall happiness formed the foundation of wellness.
 50 A.D – The Roman Empire spread herbal medicine around the empire, and with it
the commerce of cultivating herbs.
 200 A.D – The first classification system that paired common illnesses with their
herbal remedy appeared. This was prepared by the herbal practitioner Galen.
 800 A.D – Monks took over the herbal field with herbal gardens at most monasteries
and infirmaries for the sick and injured.
 1100 A.D – The Arab world became a centre of medicinal influence. Physician
Avicenna wrote the Canon of Medicine, which gave mention to herbal medicines.
 1200 A.D – Black Death spread across Europe and herbal medicines were used along
side ‘modern’ methods such as bleeding, purging, arsenic, and mercury with equal or
better results.
 1500 A.D – Herbal Medicine and herbalists were promoted and supported by Henry
VII and the Parliament due to the large number of untrained apothecaries giving
substandard care.
 1600 A.D – Herbs were used in treating the poor, while extracts of plants, minerals,
and animals were used for the rich. The English Physician, an herbal explaining the
practice of herbal medicine, was written during this time.
 1700 A.D – Herbal medicine got another high profile endorsement from Preacher
Charles Wesley. He advocated for sensible eating, good hygiene and herbal
treatments for healthy living.
 1800 A.D – Pharmaceuticals began to hit the scene and herbal treatments took a
back seat. As side effects from the drugs began to be documented, herbal remedies
came into favour again. The National Association of Medical Herbalist was formed,
and later renamed the National Institute of Medical Herbalist (NIMH)
 1900 A.D – lack of availability of drugs during the World Was I increased the use of
herbal medicines again. After the war pharmaceutical production increased and
penicillin was discovered. Herbal practitioners had their rights to dispense their
medications taken away and then reinstated. The British Herbal Medicine Association
was founded and produced the British Herbal Pharmacopoeia. People began to
express the concern over the large number of side effects and environmental impact
of the drugs of the 1950’s
 2000 A.D – EU took action on regulation and testing of herbal medicines similar to
those used for pharmaceuticals.

Herbal medicine have been documented for almost 4000 years. These medicines
have survived real world testing and thousand of years of human testing. Some
 medicines have been discontinued due to their toxicity, while others have been
modified and combined with additional herbs to offset side effects.

Here are some herbal medicines used for common illnesses such as cough, colds,
menstrual discomforts, fever, cancer, injuries, and headache

For cough and colds

 Camphor Laurel - Camphor used to be made by distilling the bark and wood of the
camphor tree. Today, camphor is chemically manufactured from turpentine oil. It is
used in products such as Vicks VapoRub.Camphor products can be rubbed on
the skin (topical application) or inhaled. Be sure to read the label to find out how the
product should be administered.People use camphor topically to relieve pain and
reduce itching. It has also been used to treat fungal infections of the toenail,
warts, cold sores, hemorrhoids, and osteoarthritis. Camphor is used topically to
increase local blood flow and as a “counterirritant,” which reduces pain and swelling
by causing irritation. It is important not to apply camphor to broken skin, because it
can enter the body quickly and reach concentrations that are high enough to cause
poisoning. Some people use camphor topically to treat respiratory tract diseases and
to treat heart disease symptoms. Camphor is also used topically as an eardrop, and
for treating minor burns. Some people inhale camphor to reduce the urge to cough.
Although it is an UNSAFE practice, some people take camphor by mouth to help
them cough up phlegm, for treating respiratory tract infections, and for intestinal gas
(flatulence). Experts warn against doing this because, when ingested, camphor can
cause serious side effects, even death. Camphor is a well-established folk remedy,
and is commonly used. Camphorated oil (20% camphor in cottonseed oil) was
removed from the U.S. market in the 1980s because of safety concerns. It continues
to be available without a prescription in Canada. Camphor seems to stimulate nerve
endings that relieve symptoms such as pain and itching when applied to the skin.
Camphor is also active against fungi that cause infections in the toenails
 Eucalyptus – Eucalyptus is a tree. The dried leaves and oil are used to make
medicine. People use eucalyptus for many conditions including asthma, bronchitis,
plaque and gingivitis, head lice, toe nail fungus, and many others, but there is no
good scientific evidence to support these uses. Eucalyptus leaf contains chemicals
that might help control blood sugar. It also contains chemicals that might have
activity against bacteria and fungi. Eucalyptus oil contains chemicals that might help
pain and inflammation. It might also block chemicals that cause asthma.
 Peppermint – Peppermint is a plant. The leaf and oil are used as medicine. Peppermint
is used for the common cold, cough, inflammation of the mouth and
throat, sinus infections, and respiratory infections. It is also used for digestive problems
including heartburn, nausea, vomiting, morning sickness, irritable bowel
syndrome (IBS), crampsof the upper gastrointestinal (GI) tract and bile ducts,
upset stomach, diarrhea, bacterial overgrowth of the small intestine, and gas.
Some people also use peppermint for menstrual
problems, liver and gallbladder complaints, preventing spasms during endoscopy
procedures, and as a stimulant. Peppermint oil is applied to the skin for
headache, muscle pain, nerve pain, toothache, inflammation of the mouth, joint
conditions, itchiness, allergic rash, bacterial and viral infections, relaxing
the colon during barium enemas, and for repelling mosquitoes. Some people inhale
peppermint oil for treating symptoms of cough and colds, and as a painkiller. In foods
and beverages, peppermint is a common flavoring agent. In manufacturing, peppermint
oil is used as a fragrance in soaps and cosmetics, and as a flavoring agent in
 pharmaceuticals. In 1990, the FDA banned the sale of peppermint oil as an over-the-
counter drug for use as a digestive aid because its effectiveness had not been proven.
Today, peppermint is sold as a dietary supplement. Unlike over-the-
counter medications, dietary supplements do not have to be proven effective to the
satisfaction of the FDA in order to be marketed. Also, unlike over-the-counter
medications, dietary supplements are not allowed to claim that they prevent or treat
illness. Peppermint oil seems to reduce spasms in the digestive tract. When applied to
the skin, it can cause surface warmth, which relieves pain beneath the skin.
 Flax –
 Echinacea – Echinacea is a popular herb to shorten the common cold and flu, as well
as reduce sore throat, cough, and fever. Science backs up the power of echinacea to
treat upper respiratory tract infections and much more. Here are just 8 proven
health benefits of echinacea of potentially 100+ signaled in the peer-reviewed,
published research. Echinacea is a little plant with big healing power. Its name
comes from the Greek word for hedgehog (echinos) because its prickly seed head
resembles the spines of angry hedgehog. Native Americans have used echinacea for
more than 400 years to treat infections and wounds. Before the introduction of
antibiotics it was used for scarlet fever, syphilis, malaria, blood poisoning, and
diphtheria. Use by the medical community in the U.S. has fallen off but it has
become increasingly popular in Europe and especially Germany. Herbalists
recommend echinacea to shorten the duration of the common cold and flu, and
reduce sore throat, cough, and fever. Science backs up the power of echinacea to treat
upper respiratory tract infections and much more.
 Khella –
 Ephdra


For fever and dengue

 Cinchona - Cinchona is a tree. People use the bark to make medicine.

Cinchona is used for increasing appetite; promoting the release of digestive juices;
and treating bloating, fullness, and other stomach problems. It is also used for blood
vessel disorders including hemorrhoids, varicose veins, and leg cramps. Some people
use cinchona for mild influenza, swine flu, the common cold, malaria, and fever.
Other uses are for cancer, mouth and throat diseases, enlarged spleen, and muscle
cramps. Cinchona is used in eye lotions to numb pain, kill germs, and as an
astringent. Cinchona extract is also applied to the skin for hemorrhoids, ulcers,
stimulating hair growth, and managing varicose veins. In foods, cinchona is used as
a bitter flavoring in tonic water and alcoholic beverages. Cinchona bark contains
quinine, which is a medicine used to treat malaria. It also contains quinidine which is
a medicine used to treat heart palpitations (arrhythmias).
 Moreton Bay Chestnut-
 Kudzu
For cancer

 Olive –
 Pea –
 Broccoli –
 Garlic –
 Castor Bean –
 European Mistletoe –
 Cotton –
 Green Tea -

For headaches

 Willow

 Peppermint - Peppermint is a plant. The leaf and oil are used as medicine. Peppermint
is used for the common cold, cough, inflammation of the mouth and
throat, sinus infections, and respiratory infections. It is also used for digestive problems
including heartburn, nausea, vomiting, morning sickness, irritable bowel
syndrome (IBS), crampsof the upper gastrointestinal (GI) tract and bile ducts,
upset stomach, diarrhea, bacterial overgrowth of the small intestine, and gas.
Some people also use peppermint for menstrual
problems, liver and gallbladder complaints, preventing spasms during endoscopy
procedures, and as a stimulant. Peppermint oil is applied to the skin for
headache, muscle pain, nerve pain, toothache, inflammation of the mouth, joint
conditions, itchiness, allergic rash, bacterial and viral infections, relaxing
the colon during barium enemas, and for repelling mosquitoes. Some people inhale
peppermint oil for treating symptoms of cough and colds, and as a painkiller. In foods
and beverages, peppermint is a common flavoring agent. In manufacturing, peppermint
oil is used as a fragrance in soaps and cosmetics, and as a flavoring agent in
pharmaceuticals. In 1990, the FDA banned the sale of peppermint oil as an over-the-
counter drug for use as a digestive aid because its effectiveness had not been proven.
Today, peppermint is sold as a dietary supplement. Unlike over-the-
counter medications, dietary supplements do not have to be proven effective to the
satisfaction of the FDA in order to be marketed. Also, unlike over-the-counter
medications, dietary supplements are not allowed to claim that they prevent or treat
illness. Peppermint oil seems to reduce spasms in the digestive tract. When applied to
the skin, it can cause surface warmth, which relieves pain beneath the skin.
 Feverfew
 ButterBur
 Kudzu

For menstrual cramps/digestive problems

 Pineapple –
 Red Clover –
For injuries

 Sphagnum Moss –
 Aloe Vera –
 Witch Hazel -

References

https://www.drweil.com/health-wellness/balanced-living/wellness-therapies/herbal-
medicine/
https://www.health24.com/Natural/Herbs/A-short-history-of-plants-as-medicine-20150806

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206236/

Herbal medicine today

Abstract
Herbs are natural products and their chemical composition varies depending on several
factors and therefore varying from people to people, from energetic decoctions to the use of
herbal extracts following Western methodologies of mainstream medicine. Traditional
medicines has a very long history: it is the sum total of the practices based on the theories,
beliefs and experiences of different cultures and times, often inexplicable, used in the
maintenance of health, as like in the prevention, diagnosis, improvement and treatment of
illnesses.
In every country traditional medicines find foundation in magical or religious beliefs, or
popular experience and the World Health Organization is engaged to establish definitive
guidelines for methodology of clinical research and the appraisal of effectiveness of
traditional medicine.

European Traditional Herbalism

For centuries traditional medical systems (TMS) were the primary medical system in the
countries of origin, and now nevertheless the present dominance of the Western scientific
medical model, citizens and health-caregivers are starting to rely and trust TMS substituting
conventional scientifically proved therapies with unconventional ones. Generally cultural
rootedness enduring and widespread use of TMS may indicate safety, but not the efficacy of
the treatments especially in herbal medicines where tradition is almost completely based on
remedies containing active principles at very low and ultra low concentrations, or relying on
magical-energetic properties of sun, moon, etc.
In European traditional herbalism categories similar to Asiatic medicines, referring to
‘humoral-energetic doctrines’ that has qualities (like heat, cold, dry, humid), and elements
(fire, air, water, earth, etc.) are used. European popular medicine still counsel the so-called
depurative plants for treatment of dermatological illnesses, like psoriasis or eczemas, like it
were due to intoxications, as well as diuretic plants for arthritis, or a decoction of Stachys
(called ‘herb of fear’) used as bath to wash out fears, or hay baths as treatment of cancer.
A discussion on methodologies for research and evaluation of traditional medicine should be
divided in two parts: herbal medicines and traditional procedure-based therapies.
Herbal medicine has become a popular form of healthcare; even though several differences
exist between herbal and conventional pharmacological treatments, herbal medicine needs
to be tested for efficacy using conventional trial methodology and several specific herbal
extracts have been demonstrated to be efficacious for specific conditions. Nevertheless the
public is often misleded to believe that all natural treatments are inherently safe, herbal
medicines do carry risks, so research in this area must be intensified. The main question
that has not been often answered satisfactorily deal with the triad
absorption/metabolism/efficacy of herbs and their extracts and is actually an important
unsolved problem in judging their many alleged health effects (1).
Mind–body medicine can be considered as a complementary or an alternative mode to
traditional Western medicine, and a variety of other modes of interventions that are
presently used in a CAM paradigm may act in large part via the mind–body connection (2);
and in this sense trusting in the traditional principles of a medicine that is deeply rooted in a
culture can represent a type of mind-body connection having a real pharmacological activity
through a placebo like effect. So a successful treatment is often the consequence of both
types of treatments acting synergistically, nevertheless efficacy assessment of traditional
medicines cannot be different from that of conventional medicine.
Long-term use of medicinal herbs enables a process of selection but limited and only partial,
of short and medium-term safe remedies, that however does not match with modern issues
relatives to the interferences with synthetic drugs. Treatment selection is often limited
because of the multiple meaning of efficacy in relation to pathology and diseases in different
cultures. The transfer of a medical concept to a new country may be really misleading and
lead to deep modifications of its medical-therapeutic and cultural essence, especially if a
remedy is part of a TMS, and modifications follow adaptation to local conditions and cultural
habits. These modifications may deeply vary in extension, but probably years or just moths
after migration a TMS can have absorbed cultural influences form the host country (3).

Efficacy and Effectiveness of a Traditional Herbal Remedy

Several factors are important in determining the outcome of any traditional treatment, both
in experimental and clinical settings including forma mentis, beliefs, knowledge and practical
abilities of the provider, as well as the positive or negative prejudices of the patient with
respect to the provider of the therapy, cultural differences in the acceptability of the
treatment and adherence to it, the patient–doctor encounter, and differences in access to
other treatments (4). In the age of globalization and of the so-called ‘plate world’, assessing
the ‘transferability’ of treatments in herbal medicines is not a relevant goal for clinical
research, while efficacy and safety should be based on the normal patterns of mainstream
clinical medicine. The CONSORT statement for trials of herbal medicines (5) can be a very
important paradigm to follow; and in fact it elaborated 9 of the 22 CONSORT checklist items
to enhance their relevance to trials of herbal interventions, including minor
recommendations for eight items. Besides, Nahin and Straus from the National Center of
Complementary and Alternative Medicine (NCCAM) proposed a pragmatic schema for
allocation of resources in the USA. The authors recommend five criteria: quantity and
quality of available preliminary data to help determine the most appropriate type of
research; extent of use by the public; public health importance of the disease being treated;
feasibility of conducting the research; cost of the research (6).It is very important to keep in
mind the differences between explanatory and pragmatic studies, and the concepts of
efficacy and effectiveness (7); efficacy is the benefit a treatment produces under ideal
conditions, often using carefully defined subjects, while effectiveness defines the benefit the
treatment produces in routine clinical practice (8). Explanatory trials evaluate the efficacy of
a treatment under controlled conditions that optimize isolation of the treatment effect
through design features, such as a control or placebo, randomization, standardized
protocols, homogeneous samples, blindness; these type of studies often represent the
treatment of a particular patient, that is not the usual patient that enter a medical office.
Pragmatic studies do not provide conclusive information on the specificity of the treatment
effect but they have some interesting characteristics.

Pragmatic studies in Traditional Medicine

Pragmatic trials (PT) are designed to find out about how effective a treatment actually is in
everyday practice; while explanatory trials are designed to find out whether a treatment has
any efficacy, almost always compared with placebo under ideal conditions. PT answers
questions about the overall effectiveness of an intervention, and cannot study the
contributions of its different components. The participant to these studies will need to be
representative of the wider population because results need to be generalized; so wide
criteria of inclusion are needed, so that patients having more medical diseases or taking
different medications are included. It would be more satisfactory and sensible to choose
conditions where conventional treatment is often unsatisfactory like irritable bowel
syndrome or panic crises. In PT it is not usually mandatory to use a placebo, while it is
needed with both arms of the trial on normal practice, since the aim is to produce an
evidence to facilitate a real practical choice. The treatment protocol is more complex
because patients with wider criteria are included, so is necessary a larger sample of
patients, and may need a handbook that defines parameters for treatment (9). The main
advantage of PT is that they can deliver evidence of effectiveness directly in clinical practice
(10). Nevertheless they have important methodological limits: most of all the lack of
placebo and blindness, increased costs, the need of several therapists, more complexity and
lack of clarification about the mechanism of action; but PT should be seen not as an
alternative to explanatory studies, but as a mandatory complement that define and improve
evidence primarily coming from explanatory trials, the only one that can reliably confirm
efficacy.

The Chemical Constituents of Herbal Remedies

The other black box of herbal-based treatments is the lack of information about the
composition of the remedy. Herbs are natural products and their chemical composition
varies depending on several factors, such as botanical species, used chemotypes, the
anatomical part of the plant used (seed, flower, root, leaf, and so on) and also storage, sun,
humidity, type of ground, time of harvest, geographic area; and merchandized products
containing on the label the same product varying in their content and concentrations of
chemical constituents from batch to batch; and even the same manufacturer can
merchandize in different periods products containing different substances although
standardized to achieve a high pharmaceutical quality. This variability can result in
significant differences in pharmacological activity: involving both pharmacodynamic and
pharmacokinetic issues.

Adverse and side effects is another open problem, because in citizens still prevail the
respect for everything that is natural tout court, more as a cultural-fashion-based choice
than thinking that the patient is introducing in his/her body chemical substances of vegetal
origin; not knowing that salicylic glucosides and lactonic sesquiterpenes of many
Compositae are often responsible of allergic reactions; that some constituents of plants are
cancerogenic like safrole, bergapten and pyrrolizidines alkaloids. Not of minor importance
especially for the old patient using contemporary more synthetic drugs is the problem of
drug interferences; some plants reduce or improve the bioavailability of some drugs due to
induction or inhibition of cytochromes (St. John's Wort extracts, grapefruit juice, and so on).
Moreover the use of herbal extracts during pregnancy or lactaction should undergo strict
medical supervision because many herbs have not been studied neither in pregnant mice.
Advances in high-throughput experimentations have resulted in massive databases of
genomic, proteomic and chemical data which in combination with efficient separation
methods and powerful spectrometric methods for identification and structure elucidation can
be used for identification of active compounds (11). A powerful and deep biological
approach that integrates such large and diverse sources of information together actually
needs to fully understand the pharmacological effects of natural products; and DNA
microarrays may provide a suitable high-throughput platform for research and development
of drugs from natural products (11). There are three main applications of DNA microarrays:
in pharmacodynamics for discovery of new drugs; in pharmacogenomics for prediction of
side-effects; in pharmacognosy for correct botanical identification and authentication of
crude plant materials as part of standardization and quality control (11).