The New Nation - Internet Edition

Development of herbal medicine

Hakim Mohammed Said

Making healthcare and medical facilities available to the people is now a major concern of a large number of countries. The creation of modern healthcare facilities and their dispersal to all classes of population needs resources in terms of manpower, supplies and supervision that would be difficult to provide for many states, And that is why what is cost-effective, what is affordable assumes much greater importance in matters of health. This is the alternative approach relevant in improving the fulfilment of our present and future health needs. Yet the question of contribution that Herbal Medicines currently could make to the health care of the people has largely remained a question in terms of technological and organisational advancements and acceptance on mass scale. However. where on the one hand. modern medicine has raised life expectancy, on the other hand the traditional systems of medicine are contributing effectively towards primary health care. But to employ traditional medicine at the official level. research and development are as vital as they are in modern medicine. Taking a very general view with rnaximum potential for research and development in various traditional systems in vogue, it seems logical to state that all of these systems concentrate upon medicinal plants as primary source, for natural products and for the organo-synthetic and biodynamic compounds of immense pharmacological importance.

The medicinal plants contribute a great deal to the health care programmes of nations. In many countries they haw been a source of therapeutic agents for years and before the beginning of modern pharmaceutical industry. were the most important agents in curing illness. Today, after a relative decline in importance, they are regaining their lost glory. Their importance, especially in curing diseases of an estimated 1.5 billion of the world's population, according to WHO estimates, who can not reach modern pharmaceuticals for disease curing. is evident. However, at the outset, it must be mentioned that it is not only sophistication and costly technology of production of pharmaceutical chemicals which is helping medicinal plants make a comeback. The increasing reliance on medicinal plants is not confined to the poorest developing countries. The developed countries with the sophisticated pharmaceutical industry are also rediscovering the usefulness of medicinal plants.

Propagation : Given the undisputed role of medicinal plants in today's health care needs, it is of utmost importance that these have to be cultivated and propagated. Conservation of plant species is crucial. So is the need to prevent indiscriminate exploitation of flora. It has been necessary to emphasise a genetic improvement of plant species so that most important productive material can be chosen. Generation of propagation materials, improvement in plant breeding methods and continuous research on the bio-synthetic ways of phytochemicals and plants will be important to improve the plant material.

The emphasis on propagation and conservation highlights the need for utilisation of the plant material in the country of origin. The newly independent countries in the initial years of independence were mostly exporting their medicinal plants in crude form. This was as a result of scarcity of funds and lack of production facilities. This export of menicinal plants in the crude form has to gradually stop and their utilisation has no take place in the country of origin.

Safety, efficacy and quality control : Ensuring safety of herbal medicines is of utmost importance. While it is true that references to toxicity in medicinal plant drugs in isolated studies must not lead to generalisation, traditionally used preparations should be assessed for efficacy or toxicity. Regulatory requirements must be developed for medicinal plant preparations such as standard specification for products and protocol for clinical trial. With increasing use of plant material in drugs, countries are developing regulatory requirements. For example, keeping in view of the physico-chemical parameters, standardisation of single and compound Unani formulations and spectroscopic studies have substantiated the surety of provision of authenticated raw material and medicines upto considerable extent.

Plants as sources of biodynamic Compounds : At no time in the development of mankind, however, has there been more rapid and more deeply meaningful progress in our understanding of plants and their chemical constituents than during the past quarter century.

And this is curious, especially in view of the somewhat earlier deprecation in pharmaceutical chemistry of any emphasis on plants. The gradual sophistication of phytochemistry in the last half of the nineteenth century and the exaggeration of hope for specific remedies from vegetal sources for any and all ills set up a counter-current, a tendency to disparage any data concerning the potential value of physiologically active plants. The importance and exclusiveness of synthetic chemistry was exalted and its potentialities were held to be so great that the Plant Kingdom could be sloughed off without ceremony. The "Coal Tar Age" was assured in therapeutics. wherefore there would be no need of harking back to remnants or even hints from earlier ages that counted on natural sources for their medicinal and other products.

Then, as we can recall, the discovery, almost within a decade, of a series of so-called "Wonder Drugs", nearly all from vegetal sources, sparked a revolution. It crystallised the realisation that the Plant Kingdom represents a virtually untapped reservoir of new chemical compounds many extraordinarily biodynamic. some providing novel bases on which the synthetic chemist may build even more interesting structures. The startlingly effective drugs that have come from this decade or two of discovery are scattered throughout the Plan! Kingdom. They range from muscle relaxants from South American arrow poisons, Antibiotics from moulds. actinomycetes. bacteria, lichens and other plants; rutin from a number of species: cortisone precursors from sapogenins of several plants, especially from Strophanthus and Dioscorea; hypertensive agents from Veratrum: cytotoxic principles from Podophyllum, Vinca and other sources; Khellin from Ammi Visnaga; reserpine from Rauwolfia; hesperidin from the citrus groups: bishydroxycoumarin from Melilotus; and sundry others - not to mention the numerous psychoactive structures of potential value in experimental psychiatry, some new, some old, from many cryptogamic and phanerogamic sources.

Not only have new drugs from vegetal sources been discovered, but new methods of testing and refined techniques have led to the finding of novel uses for older drugs.

Comparative Phytochemistry in Medical Botany : Comparative phytochemistry, chemotaxonomy, chemical plant taxonomy, or biochemical systematics" is the study of the distribution in plants of chemical compounds and the biochemical operations involved in their biosynthesis and metabolism. In spite of its highsounding title, it is an ancillary science. But, depending on one's viewpoints, it can help to throw light into the classification and evolution of plants, the biosynthetic relationships between naturally occurring organic compounds of diverse structure, or help to pinpoint those plant families, genera or species which are likely to yield compounds of medicinal interest.

Biologically active substances from traditional drugs developmental strategy : Today, the broad research strategy of any pharmaceutical industry is determined by its appraisal of medical and market needs. The critical issue is the selection of ideas for research projects. Basic research on defined receptors or enzyme targets of relevance can be exploited to design planned programmes for the synthesis of analogues of natural products. One of the successful strategies for investigation of medicinal agents from higher plants includes the pharmacological screening of plant extracts followed by a bioassay-guided fractionation of active plants and leading to the isolation of the pure contituents. Such a strategy can only be effectively carried out by a multidisciplinary team consisting. of at least. a pharmacognosist or medicinal chemist and a pharmacognosist or microbiologist. The leader of the group may he the pharmacognosist acting thereby as a natural intermediary between the other members of the team.

Some Important Medicinal Plants : There are about thirty-eight medicinal plants whose therapeutic activities have been fully established, and which serve as raw meterial for the production of plant-derived medicinals. These medicinal plants can be divided into two groups, the first group comprising those medicinal plants which are employed for the isolation of a particular therapeutically active constituent and the second group comprising those medicinal plants which are the source of compounds as precursors of a number of medicinals. A study of the above groups of medicinal plants reveals that the species of Dioscorea, Agave, Solanum, Costus and Digitalis are the source of corticosteroids, sex hormones and cardiac glycosides, which occupy a leading position among plant derived medicinals. It is interesting to note that such works are being conducted in Pakistan at the PCSIR Laboratories, Peshawar University, at the H.E.J. Research Institute of Chemistry, Karachi University. and from cultivation to clinical pharmacology at the Hamdard University, Madinat al-Hikmah.

Uses other than as Drugs for Plant-Derived Products : Natural drug products, many of which have been derived from higher plants, play an important role as useful investigative tools in pharmacological studies. Some such compounds include for example, morphine, codeine (alkaloids) as analgesic, colchicine (alkaloid) as antigout, camphor and picrotoxin (mono and sesquiterpene) as CNS stimulant, cocaine (alkaloid) as local anesthetic, digitoxin (cardiac glycoside) as cardiotonic, reserpine (alkaloid) as antihypertensive, etc_

Others are mescaline and LSD-derivatives in the study of psychiatric disorders; various toxins, e.g. tetrodotoxin. in the study of nerve transmission: cyclopamine in the study of teratogenesis: phalloidin for induction of hepatotoxicity: and phorbol myristate acetate as a standard cocarcinogen in the investigation of potential carcinogens and cocarcinogens.

It has also been felt that the major purpose for finding in plants new structures with biological activity is to provide templates for the synthesis of analogues and/or derivatives which will have equivalent or better activity than the parent molecule. This may indeed be an admirable purpose and, from a practical point of view, it may be advantageous with regard to patent protection. However, history shows that it is an exceptionally rare instance when a naturally occurring chemical compound that has found utility as a drug in man, will yield a derivative on structure modification that exceeds the value of the parent compound in drug efficacy. Here the significance of traditional or herbal medicines seems comparatively more apparent.

Advancements in the Field of botanies : For me if is a cause of satisfaction and pleasure that the Department of Drug Administration, Ministry of Health, Government of Bangladesh and the Hamdard Foundation, Bangladesh not only feel their common responsibilities but their scientifically oriented eyes also recognise and value the advancements in the field of botanies.

On a previous occasion here, I had taken the opportunity to say that countless plants in the country had not yet been identified and they demand pharmacognosy. In addition, there were many herbs which had not been chemically examined and no attention had been paid to their pharmacognosy. I had said that this extensive wealth was being wasted away when it could be well employed in building a dam over ill-health and bringing happiness to the people of the country.

This Seminar on the "Development of Herbal Medicine" is certainly a significant one. It clearly reflects the fact that countless herbs found in Bangladesh should be used for the promotion of health and for fighting disease. It also stresses the fact that no error must be committed to ignore and waste this limitless resource.

We ought not to commit the mistake of being oblivious of our history and we must endeavour to join together the broken links of our history. When we accomplish this task we shall know· and tell the world that the period between the 9th and the 15th century had witnessed a bonanza of research on herbs. This period marks the high-noon of the Islamic era. We Muslims, never looked back at this academic bonanza nor did we ever try to introduce the great doctors to the world around. although this was the store of knoowledge of which we could be legitimately proud. The treasure of knowledge which survived fires and floods lies 'preserved' in the form of some three million manuscripts scattered in different libraries or the world. Petro-dollars and all the wealth of rich Muslim countries have not been able to bring this treasure into the limelight.

Looking deeply into the history of Muslim science we will note that Muslim scientists were inspired by the Holy Qur'an and by the Sunnah. Both of these sources of wisdom point the way to natural cure and herbs are the basis of it. This explains the fact that Muslim scientists paid the greatest attention to herbs and their curative quality. Great many books have been published on that glorious epoch of Islam and a great many books lie unborn. hidden in the three million manuscripts. We do not even know what they contain.

When the Muslims lost sight of their glorious traditions of learning. the candle of learning passed into the hands of the West, and the West became the cradle of learning. In the field of medicine, the greatest mistake committed by the West was to consider the human body as a mere bag of flesh and bones. It clearly denied the existence of soul. This indeed, is the point of departure between the Western and the Eastern approaches to medicine. The West concentrated its attention on germs whilst the East insisted on the existence of the soul and on a natural attitude to treatment.

This follows a long sequence of history which cannot be discussed in this space, but centuries of apathy have led to a situation where germs, bacteria and viruses have reappeared with greater strength again>t antibiotics, turning the body defenceless against these antibiotics. As a result, today's West is restlessly waiting to return to the fold of nature. America, Canada and Europe are searching for succour in nature.

Whether it is Bangladesh or Pakistan, Western dominance has prevented them from paying any attention to herbs. Herbs were considered worthless and the future possibilities of herbs were little appreciated. As a result, no research work was directed towards herbs. On the other hand, Western laboratories are now giving all importance to herbs and it can be well imagined that in this field too, the West may leave us far behind. [ feel that this Seminar is not unaware of western intentions. and that it is keen to) make efforts to make the best curative use of our herbs. This is a very happy augury and. looking at it scientifically, I find it a very credible effort.

The World Health Organisation's attitude is that herbs should be subjected to chemistry. pharmalcognosy and pharmacology and that herbs should be used as a whole for the preparation of medicines. I with this opinion of the WHO and I consider such a wholesome use of herbs :is natural. Pharmacology is certainly a delicate matter and calls for great responsibility. This science has many demands of the time to meet. and it is essential to meet the demands of the time. I am of the opinion that in Bangladesh attention must be paid. on the one hand. to scientific research on herbs and, on the other hand, pharmacology should receive high attention as well. This is an urgent work.

[n the Western hemisphere. natural cure is gaining more and more popularity day and night. medical practitioners there are already prescribing botanical and natural preparations. Tomorrow, medical practitioners in the East will also be forced to follow the new Western trend. Today is therefore the time to think of tomorrow. We must end our apathy towards herbs and start thinking seriously about them now.

In Orlando (USA) an International Conference on Islamic Medicine was held from 14th to 18th April 1995. It was attended by five hundred doctors from East and West. Herbs received due significance and it is to be hoped that important steps will be taken in this direction.

Such a meeting in the heart of the United States of America, and the attendance of 500 participants, is a rather significant event. It should be taken note of in Bangladesh and this Seminar will be well advised to follow this lead.

Before concluding this paper, I feel it a duty to inform the scientists and medical practioners assembled here that at the WHO/ EMRO meeting last year, Arab, French, Pakistani and British experts recorded their opinion in a scientific session that herbs should be included in the curriculum of medical colleges. Steps are being taken in this connection and I am performing my duty to edit the textbook. I am of the opinion, however, that the curricula of medical colleges should in addition include such subjects as Psychology and the Elements together with Medical Ethics. Medical education cannot be complete without these subjects.

Herbal pharmacy should also be included in the curricula in order to meet the medical requirements of the country.

When I talk about Elementology, I have the Arabi Islamic Medicine in my mind. The four elemcnts theory are an important factor of Arabi Islamic Medicine and their balance is considered vilal for the well-being of the body. On this subject. at least seven conferenccs has been held under the aegis of Hamdard. In the world of medicine. this have been an exemplary advancement and an aspect of Tibb has been widely recognised. Now the inclusion of the Elements in the study of herbs is a new subject of research on which work is being conducted worldwide.

Sunflower leaves cure Malaria

Jamayet Ali

Sunflower is a tall annual erect herb bearing large ovate leaves and showy yellow circular flower heads. It is mainly planted as an ornamental garden plant, occasionally cultivated as an oil seed plant in most parts of Bangladesh. This plant is said to be a native of Mexico and Peru, and to have been introduced into Europe about the end of the sixteenth century. It may be of interest to note that sunflower is mentioned in the Ain-I-Akbari as a flower cultivated for ornamental purposes during the reign of Akbar. Though cultivated mainly as a garden plant, sunflower owes its economic value to its utility as an oil seed or fodder crop. It was tried long ago as an oil seed crop in Caucasus and Ukraine and has now become well established in Russia and Balkans, It has also gained importance as an oil seed plant in Argentina, U.S.A and Canada. Other countries where it is grown to some extent for oil are China, India, Turkey, Italy, France, Chile and Uruguay. It is also raised on a small scale in England eastern and southern Africa and parts of Asia and Australia. As a fodder or forage crop, sunflower is fed green or converted into silage. It is mentioned that sunflower silage is popular to U.S.A., Rhodesia, Canada and a few other countries.

Sunflower thrives at medium and high elevations in the tropics. It requires a warm climate with moderate rainfall and shows a somewhat wide range tolerance to wet and dry conditions. It is drought-resistant and can withstand several degrees of frost. It is adapted to a variety of soils and does well on light, rich, calcareous or alluvial soils and does not require any manuring. It does not thrive on acid soils, water-logged lands or steep slopes. The crop comes to maturity in 4-5 months after sowing. It is left in the field until the colour of the back of the head changes from green to yellow and the seeds become loose. When thoroughly dry, the heads are threshed. The seeds are used mainly for the extraction of oil. They are also consumed raw, roasted or salted. In U.S.A., roasted kernels are sold in packets like peanuts; only selected large seeds are husked for this purpose. Shelled seeds are ground and the resulting flour used for bread. A coffee substitute is prepared from roasted seeds. Sunflower seeds form a nutritious food for cattle, poultry, hogs and cage birds.

Sunflower seed has a hard woody pericarp, the carnel constituting 50-65% of the whole seed. Analyses of the seeds from foreign sources gave the following range of values: moisture, 3.3-12.8; protein, 13.5-21.3; fibre, 23.5-32.3, and ash, 2.6-4.1. The seeds contain very less cholesterol, 0.15%. So its oil is suitable for the people suffering from heart ailments. Moreover, the seeds also contain: lecithin, 0.23% ; nuclein, 0.51 % ; organic acids (including citric, taliaric and chlorogenic acids) 0.56%. The oil is used as a cooking and salad, for the manufacture of margarine, shortening and other edible products, in bakery goods, and as a base in certain pharmaceuticals. It is one of the few oils that contain little or no linoleic acid and can be used with advantage in the manufacture of shortenings of any desired consistency.

It is considered equal to olive oil in nutritive value and is sometimes used as an adulterant. Botanical name of sunflower is Helianthus annuus Linn.

Medicinal Properties: The flower is pungent and hot, anthelmintic, cures "kapha" skin diseases, itching, ulcers, leprosy, hysteria, fever with rigor, biliousness, "vata", asthma, bronchitis, urinary discharges, anaemia, good for burning sensation in the vagina, scorpion-sting Ayurveda). A decoction of the root strengthens the teeth and cures toothache, the leaves are emetic; applied in lumber pain. The flowers have a bitter bad taste; emmenagogue, aphrodisiac; lessen inflammation: given in insanity; applied in complaints of the chest, liver, lungs; used in piles, ophthalmia, ascites, cures diseases of the kidney (Yunani).

The seeds are diuretic and expectorant. This drug has successfully been used in bronchial, laryngeal, and pulmonary affections, coughs and colds. The sunflower is prescribed in snake-bite and scorpion-sting. In the latter case the juice of the flower is warmed and poured into the nostrils. The sunflower is useless in the treatment of both snake-bite and scorpion-sting (Indian Medicinal Plants. K.R. Kirtikar & B.D. Basu. 13 70)

Medicine: Sunflower seeds are diuretic and expectorant. They have been used in bronchial, latyngeal and pulmonary affections, coughs and cold. In Russia, medicinal properties similar to those of the oil are attributed to them. In China, the seeds are administered in dysentery. A tincture of the flowers and leaves is recommended, in combination with balsams, for bronchiechtasia. Leaves are reported to be employed in the treatment of malarial fevers in Caucasus (Wealth of India, Raw Materials. Vol. V. 18-25)

Properties and Uses: Seeds are given in scorpion sting. They are also used as expectorant and diuretic, and in the treatment of colds, coughs and other laryngeal and bronchial affections, seeds are also effective in the treatment of pulmonary affections and dysentery. Seed lecithin has been found to prevent hyperlipindemia in rats. Leaves are used in the treatment of malarial fever. The triterpene alcohols of the flowers showed marked anti inflammatory effect in mice (Medicinal Plants of Bangladesh, Second Edition, Abdul Ghani, 250).

Fighting Mycobacterium tuberculosis

Easir Abedin

Mycobacteria are Gram-positive (no outer cell membrane), non-motile, pleomorphic rods, related to the Actinomyces. Most Mycobacteria are found in habitats such as water or soil. However, a few are intracellular pathogens of animals and humans. Mycobacterium tuberculosis, along with M. bovis, M. africanum, and M. microti all cause the disease known as tuberculosis (TB) and are members of the tuberculosis species complex. Each member of the TB complex is pathogenic, but M. tuberculosis is pathogenic for humans while M. bovis is usually pathogenic for animals.

M. bovis was causing TB in the animal kingdom long before invading humans. However, after the domestication of cattle between 8000-4000 BC, there is archaeological evidence of human infection by M. bovis probably through milk consumption. M. tuberculosis is probably a human-specialized form of M. bovis developed among milk-drinking Indo-Europeans who then spread the disease during their migration into Western Europe and Eurasia. By 1000 BC, M. tuberculosis and pulmonary TB had spread throughout the known world.

Tuberculosis complex organisms are:

Obligate aerobes growing most successfully in tissues with a high oxygen content, such as the lungs.

Facultative intracellular pathogens usually infecting mononuclear phagocytes (e.g. macrophages).

Slow-growing with a generation time of 12 to 18 hours (c.f. 20-30 minutes for Escherichia coli).

Hydrophobic with a high lipid content in the cell wall. Because the cells are hydrophobic and tend to clump together, they are impermeable to the usual stains, e.g. Gram's stain.

Known as "acid-fast bacilli" because of their lipid-rich cell walls, which are relatively impermeable to various basic dyes unless the dyes are combined with phenol. Once stained, the cells resist decolorization with acidified organic solvents and are therefore called "acid-fast". (Other bacteria which also contain mycolic acids, such as Nocardia, can also exhibit this feature.)

Symptoms of tuberculosis include:

Fever

Night-time sweating

Loss of weight

Persistent cough

Constant tiredness

Loss of appetite

Diagnosis of tuberculosis is made by a positive tuberculin skin test, an immune reaction to a small quantity of tuberculosis antigens. It can be confirmed by X rays of the chest and microscopic examination of sputum. Detection of significant numbers of acid-fast bacilli (using the Ziehl-Neelsen stain) in sputum or tissue samples is considered a positive diagnosis, although disease may confirmed by laboratory culture of the bacterium (difficult, dangerous and slow - takes at least 4 weeks).

Ziehl-Neelsen acid-fast staining procedure:

Heat fix cells on glass microscope slide.

Flood the slide with carbol fuchsin stain.

Heat the slide gently until it steams (5 min).

Pour off the carbol fuchsin.

Wash slide thoroughly with water.

Decolourize with acid-alcohol (5 min).

Wash slide thoroughly with water.

Flood slide with methylene blue counterstain for 1 min.

Wash with water.

Blot excess water and dry in hand over bunsen flame.

Tuberculosis kills 3,000,000 people in the world every year, more than AIDS, malaria, and other tropical disease combined. One third of the world's population is infected with tuberculosis. Tuberculosis is the leading infectious disease cause of death and represents more than a quarter of the world's preventable deaths.

Transmission of TB occurs primarily by the aerosol route but can also occur through the gastrointestinal tract. Coughing by people with active TB produces droplet nuclei containing infectious organisms which can remain suspended in the air for several hours. Infection occurs if inhalation of these droplets results in the organism reaching the alveoli of the lungs. Only 10% of immunocompetent people infected with M. tuberculosis develop active disease in their lifetime - the other 90% do not become ill and cannot transmit the organism. However, in some groups such as infants or the immunodeficient (e.g. those with AIDS or malnutrition), the proportion who develop clinical TB is much higher.

In the lung, the organism is taken up by alveolar macrophages and carried to lymph nodes, from where it may spread to multiple organs. Two to eight weeks after infection, cell mediated immunity (CMI) and hypersensitivity (DTH) develop leading to the characteristic reaction to the tuberculin test and, in immunocompetent individuals, containment of infection. Inflammatory immune responses eventually result in lung damage.

In many countries, vaccination against TB is routinely practised. The Bacillus Calmette-Guerin (BCG) vaccine is a live, attenuated strain of Mycobacterium bovis which was introduced in 1922. However, the true efficacy of BCG is unknown. Early clinical trials in Europe showed up to 80% protection, but more recent trials in India and Africa showed little value.

The first effective treatment for TB was developed in the 1940s - streptomycin.

TB is currently treated by means of combination therapy, using cocktails of 3-4 drugs with different properties:

Antibacterial activity: e.g. isoniazid, rifampin, streptomycin

Inhibiting the development of resistance: e.g. isoniazid, rifampin, ethambutol

If you or a member of your family are concerned about tuberculosis, consult your doctor.