CRC - Harmal: The Genus Peganum

Organization: CRC
Publication Date: 6 October 2017
Page Count: 278


Global warming and global travel are contributing factors in the spread of infectious diseases such as malaria, tuberculosis, hepatitis B, and HIV. These are not well controlled by the present drug regimes. Antibiotics are also failing because of bacterial resistance. Formerly less well-known tropical diseases are reaching new shores.

A whole range of illnesses, such as cancer, occur worldwide. Advances in molecular biology, including methods of in vitro testing for a required medical activity, give new opportunities to draw judiciously on the use and research of traditional herbal remedies from around the world. The reexamining of the herbal medicines must be done in a multidisciplinary manner.

There have been 51 volumes published since the start of the book series Medicinal and Aromatic Plants-Industrial Profiles in 1997. The series continues

 The same series editor, Dr. Roland Hardman, is also covering a second series entitled Traditional Herbal Medicines for Modern Times. Each volume of this series reports on the latest developments and discusses key topics relevant to interdisciplinary health sciences, research by ethnobiologists, taxonomists, conservationists, agronomists, chemists, pharmacologists, clinicians, and toxicologists. The series is relevant to all these scientists and will enable them to guide business, government agencies, and commerce in the complexities of these matters. The background to the subject is outlined next.

Over many centuries, the safety and limitations of herbal medicines have been established by their empirical use by the "healers" who also took a holistic approach. The healers are aware of the infrequent adverse effects and often know how to correct contraindications when they occur. Consequently, and ideally, the preclinical and clinical studies of an herbal medicine need to be carried out with the full cooperation of the traditional healer. The plant composition of the medicine, the stage of the development of the plant material, when it is to be collected from the wild or from its cultivation, its postharvest treatment, the preparation of the medicine, the dosage and frequency, and much other essential information is required. A consideration of the intellectual property rights and appropriate models of benefit sharing may also be necessary.

Wherever the medicine is being prepared, the first requirement is a well-documented reference collection of dried plant material. Such collections are encouraged by organizations including the World Health Organization and the United Nations Industrial Development Organization. The Royal Botanic Gardens at Kew (United Kingdom) is now increasing its collection of traditional Chinese dried plant material relevant to its purchase and use by those who sell or prescribe traditional Chinese medicine in the United Kingdom.

In any country, the control of the quality of plant raw material, of its efficacy, and of its safety in use is essential. The work requires sophisticated laboratory equipment and highly trained personnel. This kind of "control" cannot be applied to the locally produced herbal medicines in the rural areas of many countries, on which millions of people depend. Local traditional knowledge of the healers has to suffice.

Conservation and protection of plant habitats are required, and breeding for biological diversity is important. Gene systems are being studied for medicinal exploitation. There can never be too many seed conservation "banks" to conserve genetic diversity. Unfortunately, such banks are usually dominated by agricultural and horticultural crops, with little space for medicinal plants. Developments, such as random amplified polymorphic DNA, enable the genetic variability of a species to be checked. This can be helpful in deciding whether specimens of close genetic similarity warrant storage.

From ancient times, a great deal of information concerning diagnosis and the use of traditional herbal medicines has been documented in the scripts of China, India, and elsewhere. Today, modern formulations of these medicines exist in the form of powders, granules, capsules, and tablets. They are prepared in various institutions, such as government hospitals in China and Korea and by companies such as the Tsumura Company of Japan, with good quality control. Similarly, products are produced by many other companies in India, the United States, and elsewhere with a varying degree of quality control. In the United States, the Dietary Supplement and Health Education Act of 1994 recognized the class of physiotherapeutic agents derived from medicinal and aromatic plants. Furthermore, under public pressure, the U.S. Congress set up an Office of Alternative Medicine. In 1994, this office assisted in the filing of several investigational new drug (IND) applications required for clinical trials of some Chinese herbal preparations. The significance of these applications was that each Chinese preparation involved several plants and yet was handled with a single IND. A demonstration of the contribution to efficacy, of each ingredient of each plant, was not required. This was a major step forward toward more sensible regulations with regard to phytomedicines.

The subject of Western herbal medicines is now being taught again to medical students in Germany and Canada. Throughout Europe, the United States, Australia, and other countries, pharmacy and health-related schools are increasingly offering training in phytotherapy. Traditional Chinese medicine clinics are now common outside of China. An Ayurvedic hospital now exists in London, with a BSc Honors degree course in Ayurvedic medicine being available: Professor Shrikala Warrier, Registrar/Dean, MAYUR, Ayurvedic University of Europe, 81 Wimpole Street, London, WIG 9RF, email This is a joint venture with a university in Manipal, India.

The term integrated medicine, which selectively combines traditional herbal medicine with "modern medicine," is now being used. In Germany, there is now a hospital in which traditional Chinese medicine is integrated with Western medicine. Such co-medication has become common in China, Japan, India, and North America by those educated in both systems. Benefits claimed include improved efficacy, reduction in toxicity and the period of medication, as well as a reduction in the cost of the treatment. New terms, such as adjunct therapy, supportive therapy, and supplementary medicine now appear as a consequence of such comedication. Either medicine may be described as an adjunct to the other, depending on the communicator's view. Great caution is necessary when traditional herbal medicines are used by doctors not trained in their use and likewise when modern medicines are used by traditional herbal doctors. Possible dangers from drug interactions need to be stressed.

Authors: Ephraim Shmaya Lansky, Shifra Lansky, Helena Maaria Paavilainen