E-Book, Englisch, 176 Seiten, ePub
Mueller / Mechler Medicinal Plants in Tropical Countries
1. Auflage 2004
ISBN: 978-3-13-258077-0
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Traditional Use - Experience - Facts
E-Book, Englisch, 176 Seiten, ePub
ISBN: 978-3-13-258077-0
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Markus S. Mueller, Ernst Mechler
Zielgruppe
Medizinische Fachberufe
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
1 Traditional Medicine and Modern Medicine: The Need to Collaborate
2 The Example of Malaria: How Helpful Are Medicinal Plants?
3 Monographs on Medicinal Plants
From "Adansonia digitata" to
"Zingiber officinale"
1 Traditional Medicine and Modern Medicine: The Need to Collaborate
When we opened a seminar about traditional medicine in Asmara, Eritrea, with the question “Which of you already has some experience with traditional medicine,” there was absolute, even hostile silence in the room. Finally, some delegates said: “We are Christians; we have nothing to do with it.” We then presented a Datura stramonium plant, which we had picked just in front of the training center, and explained how we use it in hospitals in the Democratic Republic of Congo (formerly Zaïre). Suddenly life returned to the audience. Everybody knew this plant! It was used in the delegates’ families for many ailments ranging from toothache to abscesses and abdominal cramps. In the end we talked about this one plant for more than an hour.
This sharp contrast in the reactions of people towards traditional medicine is frequently found in many places in the world. A patient in Uganda told me, “We all use it but we don't like to talk about it—at least not in front of a white missionary doctor.”
Part of the problem is the complexity of the subject. Traditional medicine cannot be clearly defined, as it encompasses a broad spectrum of methods to treat diseases based on personal observation or on experience transmitted from community members orally across several generations. Although there may be some good evidence for its efficacy from standardized experimental observations presented by university scientists, people use traditional methods mainly because of empirical experience derived from observations they have made in certain places at certain times. This is, in fact, the only common feature of all the different ways of treating diseases that we call “traditional medicine.”
Traditional medicine can, broadly speaking, be divided into three groups: (1) popular medicine (domestic remedies), (2) the medicine of the traditional healers, and (3) conceptual traditional medicine.
Folk Medicine (Home Remedies)
From childhood onward, people use medicinal plants to treat ailments and diseases, often with astonishing effectiveness. In the area of the Bashi people of the eastern DR Congo, for example, mothers give two or three drops of the squeezed leaves of Tetrademia riparia for their babies to drink when they have abdominal cramps. For fever, people collect leaves of the Vernonia amygdalina tree (“bitter leaf”), and for intestinal worms the leaves of the small herb Celosia trigyna are used.
These treatments have two characteristics in common:
– They are applied by the patients or their family members themselves, and therefore they are free of charge.
– Observations about the use of these plants are exchanged freely between families and there are no secrets about their applications.
Some medicinal plants are used only as medicines, others as medicine and food.
The Medicine of the Traditional Healers
For health problems that are difficult to treat, the patients have to ask for the help of specialists in modern or traditional medicine.
Traditional healers are often specialists. Traditional birth attendants can be found in nearly every village. Other traditional healers are bone setters or specialists in mental or chronic diseases. Often the work of the healers is not limited to physical health problems. Social and religious problems such as conflicts between people, or conflicts between men and demons or gods, are often seen as the cause of diseases and so the treatment must involve religious or social procedures.
Unlike folk medicine, the healers’ treatment procedures are secret and cannot be discussed openly. They may only be transferred from generation to generation within the family of the healer, and the healer must be paid for his work. The price of the treatment often depends on the social status of the patient; often goods such as chicken and goats are accepted as payment.
In Christian societies there is a general fear of traditional healers, because they may work with spiritual powers which are in conflict with Christian beliefs, but there are also healers such as traditional birth attendants and herbalists who are well integrated into church activities.
Conceptual Traditional Medicine
The general term “traditional medicine” also includes systems of traditional medicine which offer not only empirical knowledge, but also theories recorded in written documents about the causes of ill health. Ayurveda in India, Unani, which originated in the Arab world, and traditional Chinese medicine are examples of systems of traditional medicine.
Integration of Medicinal Plants into Primary Health Care
In many countries in the tropics, people have very limited access to modern medicine. In north-eastern Congo where we are working, for example, the infrastructure for the transport and provision of imported medicines in remote areas has broken down. And even if they were available, the majority of patients could not afford them.
Against this background, we wondered whether the local production of medicines from medicinal plants could be helpful. We started to use some well-known plants used in folk medicine for which references about dosage, efficacy, and side effects were available. In the end we planted a medicinal garden, and with the permission of the regional health authorities some herbal medicines were produced and applied when imported medicines were not available. Some examples are given in Table 1.1 Most of these drugs were appreciated by the patients, and several medicinal gardens were planted, with widespread participation among the communities. Over the last few years, the DR Congo has endured very hard times. Some health centers were looted completely, and the local production of herbal medicines helped these centers to start their service again.
Table 1.1 Examples of herbal medicines produced in Nebobongo Hospital, DR Congo| Scientific plant name | Plant part and preparation | Indication |
| Aloe ferox | The gel of the leaves | Burns |
| Artemisia annua | Dried leaves for tea | Malaria in semi-immune adults |
| Carica papaya | Seeds (raw or dried) | Nematode worm infection |
| Unripe fruit | Infected wounds |
| Capsicum frutescens | Powdered fruit for ointment | Rheumatic pain |
| Cassia occidentalis | Leaves for tea | Constipation |
| Eucalyptus globulus | Leaves for tincture | Bronchitis |
| Euphorbia hirta | Whole plant for tea | Amebic dysentery |
| Passiflora edulis | Dried leaves for tea | Sleep disorders |
| Zingiber officinale | Fresh rhizome | Nausea |
One plant that we imported into eastern DR Congo was Artemisia annua It is well known that this plant has been used for centuries in Chinese traditional medicine to treat malaria and other fevers. One component of A. annua, artemisinin, a sesquiterpene lactone, has already been extracted and used by modern pharmaceutical companies in the manufacture of antimalarial drugs. In a first study we discovered that A. annua hybrids with a high concentration of artemisinin can be cultivated without too much difficulty in different vegetation zones, that the concentration of artemisinin remains high in these plants, and that a reasonable proportion of artemisinin can be extracted in simple tea preparations. In the South Kivu province of DR Congo, with the permission of the health authorities and the informed consent of the patients, the first case-observation studies were performed, with encouraging results. At present the work is at the level of a clinical trial comparing the tea preparation with the standard treatment. In parallel with these studies, a forum was started in which traditional healers joined medical doctors and nurses, health service administrators, and political authorities to discuss health problems and the possible contributions of traditional medicine and modern medicine.
The perceptions of traditional and modern medicine vary enormously, and some subjects were very difficult to discuss. Medical doctors were skeptical about the efficacy and side effects and complained about poor ethical standards in traditional medicine. On the other hand, after some bad experiences, traditional healers did not want to have their procedures investigated without guarantees for the protection of their intellectual rights. They for their part also complained about poor ethical standards in modern medicine. The research on A. annua, however, was followed with keen interest by all members of this forum, and both groups were interested in the results. In this process of working together we learned a lot from each other. We are convinced that continuing collaboration between traditional and modern medicine, rather than mere coexistence, is the best way to provide good health care in developing...
