1. Traditional systems of herbal medicine

2. Oriental systems   There is a growing interest in the older oriental systems due to: 1. 1. A dissatisfaction with conventional treatments 2. 2. The recent interest in all things natural, environmentally friendly and biodegradable

3.   These older types of medicine are philosophically based, and are holistic in that they treat the patient as a whole rather than as the ‘owner’ of a disease or malfunctioning organ   Holistic medicine: An approach to medical care that emphasizes the study of all aspects of a person’s health, including physical, psychological, social, and economic influences on health status

4.   It is necessary for pharmacist to know about the basic principles of the older medical systems for two main reasons: 1. 1. to be in a position to advise patients who may wish to consult an alternative practitioner 2. 2. because traditional use is a common starting point in the ongoing search for new drugs   Two types of traditional medicine have been chosen as an illustration: 1. 1. Traditional Chinese Medicine (TCM) 2. 2. Ayurveda

5.   Minor or self-limiting disorders such ailments include aches and pains, diarrhea, wounds or injuries, and facilitating childbirth, for which a common remedy will be usually offered   Chronic or serious disorders These may be fatal, life-threatening or debilitating conditions, or those that cannot be diagnosed by indigenous healers; they are often considered to have a “supernatural” component e.g. forms of cancer and genetic or metabolic disorders The diseases in traditional systems can be classified as minor or self-limiting disorders, or chronic or serious disorders

6. Traditional Chinese Medicine (TCM)

7.   The study of TCM is a mixture of myth and fact, stretching back well over 5000 years   Chinese medicine is philosophically based, and as an holistic therapy the concept of balance and harmony is supremely important

8. Concepts in TCM   Qi, the essential life force Digestion extracts Qi from food, drink and transfers it to the body; and breathing extracts Qi from the air and transfers it to the lungs. These two forms of Qi meet in the blood and form ‘human Qi’, which circulates through the body. Qi is considered the original vital energy. It is important to conserve Qi using diet, kung fu, breathing exercise and herbal medicine

9. Yin and Yang   The theory of yin and yang still permeates all aspects of Chinese thought. Attributes of both are:   Yin: negative/passive/dark /female/water   Yang: positive/active/bright/ male/fire

10. Yin and Yang   Yin is considered to be the stronger: fire is extinguished by water, and water is ‘indestructible’. So yin is always mentioned before yang   Yin and yang are always in balance

11. The vital organs   These do not correspond to our organs exactly   The organs are considered to be yin or yang and are paired.   Coupled organs are connected by meridians, or energy channels, through which qi flows.   Meridians are not associated with the nervous system and cannot be seen physically.   Meridians are stimulated with herbs and by acupuncture and will have a direct effect on a particular organ as well as a toning effect on the system.

12. Causes of disease   Bacteria, viruses and chemicals are not considered to be causes.   If an organ is weak, it may be attacked, and therefore the weakness is the cause and must be rectified.   The disease may be the result of external forces and internal emotional factors.

13. Causes of disease   The external forces are called the six excesses: 1. 1. Wind 2. 2. Cold 3. 3. Summer heat 4. 4. Dampness 5. 5. Dryness 6. 6. Fire   Most people, if healthy, are not affected by the six excesses but, if the body is deficient in qi or weather conditions are abnormal, then this may cause problems.

14. The seven emotions   These are considered to be the major internal causes of disease.   Excessive emotional activity causes: 1. 1. A severe yin/yang imbalance 2. 2. Blockage of qi in the meridians 3. 3. Impairment of vital organ function   Excessive emotional activity will lead to damage of the organs and allow disease to enter from outside, or a minor weakness from inside to develop.

15. The seven emotions   These are considered to be the major internal causes of disease.   The seven emotions are: 1. 1. Joy 2. 2. Anger 3. 3. Anxiety 4. 4. Concentration 5. 5. Grief 6. 6. Fear (A feeling of agitation and anxiety caused by the presence or imminence of danger) 7. 7. Fright (Sudden intense fear)

16.   There are a few other causes of diseases, which are not emotional or external include: 1. 1. Epidemics 2. 2. Insect and animal bites 3. 3. Worm infestation 4. 4. Hereditary diseases

17. Diagnosis   Various methods are used: 1. 1. Examination of the tongue 2. 2. Pulse diagnosis 3. 3. Palpation of internal organs (to determine consistency and tone) 4. 4. Massage (to detect temperature and knotted muscles and nerves) 5. 5. Interviewing (vital, questions are asked about sleep patterns, tastes in food and drink, stool and urine quality, fever, perspiration and sexual activity)

18. Treatment   the purpose is to rectify harmony, restore qi and the yin/yang balance.   For example: ‘cold’ diseases, such as cold in the lungs, coughs, vomiting and nausea are considered to be a deficiency of yang and treatment would be with a warming herb such as a ginger.   Once the prescription has been chosen and written out, the patient takes it to a Chinese herbalist who prepares the remedy.

19. Type of disease Example of disease Nature of disease Nature of remedy Example of remedy Desired effect Cold Nausea, vomiting YinYangGingerWarming Hot Malaria, fever YangYin Sweet wormwood Cooling

21. Ayurveda

22.   Ayurveda is considered to be the most ancient of all medical disciplines.   Ayurveda is a system of sacred Hindu medicine, originating in India.   In Ayurvedic medicine, the patient is viewed as unique, and ‘normality’ as what is appropriate for that particular person and this is in contrast to Western medicine, where populations are generalized and ‘normal’ means what is applicable to the majority.

23. Concepts in Ayurveda

24. Prana, the life energy i i Prana is the vital energy, activating both body and mind it is equivalent of qi in TCM.

25. Tridosha (equivalent to Yin and Yang): vata, pitta & kapha (the three humors) i i The three humors (vata, pitta, kapha) govern all biological, psychological and physiopathological functions of the body and mind. i i The primary requirement to diagnosis and treatment of disease is to understand the relationship between the humors.

26. i i The tridosha Responsible for the elimination of toxins (ama) from the body.   The tridosha can be considered to govern all metabolic activities: catabolism  vata metabolism  pitta anabolism  kapha

27. Agni, the digestive fire  Agni  Agni governs metabolism and is essentially pitta in nature.  Agni  Agni plays a vital role in the creation and maintenance of Dhatus (body tissues).  Agni  Agni also helps in destroying ama (toxins). Malas, the three waste products These are as may be expected the feces, urine and sweat, and production and elimination of these are vital.

28. Diagnosis   The case history involves astrological considerations.   Examination of appearance of the tongue.   properties of the urine, sweat and sputum.

29. Treatment  Treatment may involve: 1. 1. Diets 2. 2. Bloodletting 3. 3. Fasting 4. 4. Skin applications 5. 5. enemas 6. 6. Yogic breathing 7. 7. Herbal treatments 8. 8. minerals

30. Some important herbs of Ayurveda and their uses Botanical name Ayurvedic name Effect on dosha Medical use Nigella sativa KalonjiPacifies vata & kapha Digestive, antiseptic Piper nigrum KalmirchPacifies vata & pitta Digestive, respiratory disorders Terminalia chebula HaritakiBalances tridosha Digestive, blood tonic, antiasthmatic