The Role of Traditional Medicine in Fighting Diseases

Traditional medicine in this context should be discussed as

• Practice
• Drugs/medicines

TM as a Practice

• A brief description on TM as a practice should be made and narrowed down to medical herbalism
• TM plays a key role in the treatment/management of chronic conditions, fertility issues, Fractures, etc.
• For newly diagnosed patients: emphasis should be made on how diagnosis is arrived at. History taking and physical examinations to arrive at differential diagnosis, laboratory investigations to confirm diagnosis.
• For Chronically ill patients: Seek knowledge of medical records and current treatment plans. Liaise with Orthodox care provider to space out herbal and orthodox medicines. Constant reviews should be done
• Admitted Patients: Herbal clinic/Hospitals with medical wards may admit chronically ill patients and treat them with freshly prepared herbal medicines
• There should be existence of appropriate referral system in place- for emergencies and cases beyond expertise.
• A potent herbal medicine or product does not necessarily make one a good clinical herbal practitioner or clinician.

TM as a product (Drug/Medicines)  

• Unlike pharmaceuticals where an active ingredient or compound is isolated from plant, animal or mineral sources and made into finished products with a particular strength for a particular disease condition ( e.g Nifedipine 20mg and 30mg for hypertension), herbal medicines makes use of plant parts that contains a lot of compounds in their inactive state. Some of these compounds have been researched on and include: tannins, saponins, flavonoids, glycosides, alkaloids, coumarins, etc. The listed compounds found in plants are very broad and each type encompasses several subtypes whose activities have been confirmed through research. For instance, Reserpine, a type of alkaloid found in the plant Rawoufia vomitoria (known in twi as Kakapenpen) has been demonstrated to have antihypertensive effect and thus support the use of the plant in the management of hypertension.

• Herbal Medicines exist as herbs (e.g whole plant or leaf), Herbal materials (e.g powdered leave), Herbal preparations (e.g Tincture) and finished Herbal products (e.g Herbal mixture, capsules)

• Herbal Medicines are used for treatment in two main forms: as fresh preparations (usually in clinical settings) and finished herbal products

• Some Herbal medicines/products are meant to offer relief to certain symptoms experienced at any point in time whiles others are specific to one or more disease conditions.

• Herbs and herbal materials are well utilized by practitioners in herbal clinical settings alongside herbal preparations and finished herbal products, for the benefits of patients than with peddlers on buses, street, etc, whiles the finished products may be directly made available on the market through the appropriate outlets.

Different dosage types of Herbal medicines exist. These include

• Tonics,
• Decoctions/Mixtures,
• Bitters
• Infusions/Teabag,
• Capsules,
• Ointments
• Creams
• Soaps

• General mechanism of Action: The various phytochemicals in a plant formulation interact with each other in various ways. i.e synergism, potentiation, among others, to bring the body back to its natural state. TONICS are prescribed to provide a general wellbeing by toning the body tissues and improving blood circulation.

• Herbal Medicine Formula

Product formulae comprises of two main components’; active constituents and excipients. Active constituents are responsible for therapeutic actions to alleviate symptoms, and treat/manage disease conditions. Active constituents in pharmaceuticals/orthodox medicines are purified isolated chemicals included singly or combined in different formulas specified for different conditions. Medicinal plants form the ‘active constituent’ component of herbal formularies. These plants have been proven with science to contain several therapeutic constituents, some of which serve as source of drugs for pharmaceutical companies.

Availability of scientific evidence and an evidence of long-time safe use of medicinal plants within a community validates inclusion in a product formulary as directed by the World Health Organization (W.H.O). It is however important to ensure compatibility of plants through the knowledge of possible herb-herb interactions before inclusion so as to obtain full responses from different doses of the resulting herbal product. Information on plant compatibilities can be obtained from licensed indigenous practitioners, plant medicine research centers, Medical herbalists, and herbal pharmacopoeias.

An herbal formula for a product (like herbal mixtures) can be developed to treat more than one disease condition due to the number and nature of the plants included as against most orthodox medicines which are disease/illness specific most times. The Food and Drugs Authority (FDA) however recommends that only up to 3 disease conditions should be stated and this confirmed through product analysis by designated institutions before registration for sale/use. In the case where the product is meant for symptomatic relief only, more than 4 symptoms may be accepted by the FDA as being treated by the Herbal product after analysis.

Medicinal plants used in herbal formularies exist in different classifications depending on the named conditions, according to the Handbook for Medical Herbalists, and this determines their amount in a formula. Class A plants have direct scientific and long-term folklore justification for use in a named condition, where side effects are known and can be managed. Class B plants do not have direct justification for their use in a named condition but their biological properties are adjunct to treatment of that condition. In a few cases the supporting plant part acts to reduce the side effects of Class A plants.

Plants classified as Class A for one disease condition may remain Class A plants for other conditions provided there is scientific and folklore justification, else they become Class B plants to those conditions if they possess certain biological activity significant to the disease condition in question. The stem bark of Alstonia bonei (Nyame dua) although has no data of traditional use in malaria treatment, possesses antimalarial activity and may be classified as Class B in formulas meant for malaria treatment. Medicinal Plants belonging to Class C produce general wellbeing by ameliorating disturbing symptoms important to treatment of a named medical condition by Medical and indigenous herbalists. Examples include Solanum torvum fruits (Nsusuaa; Beduru; Bedru), Zingiber officinale (Ginger), etc. Effects described under C are considered palliative and only offer opportunity for natural healing to take place. These plants are usually included in herbal tonic formulas.

Class D Medicinal plants are used solely for preservation, flavoring and other reason relating to formulation techniques. Plants such as Xylopia aethiopica (Hwentia), Piper guineense (soro wisa), Aframomun melegueta (Famu wisa) and Syzygium aromaticum (P3pr33) are examples of Class D plants commonly used in Ghana.

Excipients also form part of formulas used in the manufacture of different forms of herbal products. These are substances formulated alongside the active ingredients of medications/products, included for the purpose of long-term stabilization, dose compliance, enablement and control of drug bioavailability, etc. Excipients exist in two main forms; Solid dosage and solutions/suspension excipients, and may include sweetening agents, flavouring agents, thickening agents, diluents/fillers, binders, disintegrants, and preservatives. Burnt sugar, glycerol, and honeys are the most used sweetening agents in herbal products like the tonics. Starch may be used as thickening agent in the manufacturing of herbal capsules from decoctions, infusions and concoctions.

• Management of some disease conditions

Management of common diseases like BPH, Diabetes, Hypertension, Male and Female reproductive diseases/conditions, Typhoid and malaria, etc should be discussed in general.

• The pathophysiology of such diseases should be discussed briefly
• The duration of treatment/management of the mentioned conditions should be discussed. This is important as most people think Herbal medicines work like orthodox medicines. Emphasis should be made on the fact that treatment of chronic conditions with herbals may take months with clinical reviews.   

Written by

Emmanuel Bentil

Herbal Consultant and Advocate

Bsc Herbal Medicine, KNUST

Mphil Pharmaceutical Chemistry, KNUST