The New Nation - Internet Edition

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.