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Medicinal Plants for Holistic Health and Well-Being
Edited by Namrita Lall
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.
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1. Traditional Medicine: The Ancient Roots of Modern Practice
Anna-Mari Reid, Carel B. Oosthuizen, Bianca D. Fibrich, Danielle Twilley, Isa Anina Lambrechts, Marco Nuno de Canha, Sunelle Rademan and Namrita Lall
1.1
2.
6.4
6.5
6.6 Plant Products Produced
6.6.2
6.6.3
Rinses and Herbal Mouthwash
6.7 Reported Antibacterial and Antifungal Activity of Medicinal Plants and Phytochemical Compounds
6.7.1 Heteropyxis dehniae Suess.
6.7.2 Syzygium aromaticum (L.) Merr. & L.M. Perry
6.7.3 Vaccinium vitis-idaea L.
6.7.4 Cinnamomum verum J. Presl
6.7.5 Melaleuca alternifolia Cheel
6.7.6 Azadirachta indica A. Juss.
6.7.7 Euclea natalensis A.DC
6.7.8 Diospyros lycioides Desf.
6.7.9 Mentha longifolia L.
6.7.10 Zantedeschia aethiopica (L.) Spreng.
7. Can Medicinal Plants Provide an Adjuvant for Tuberculosis Patients?
Carel B. Oosthuizen, Anna-Mari Reid and Namrita Lall
7.1
7.2
7.3
7.1.1
7.1.3
7.1.4
7.3.4
7.4
7.5
8. Medicinal Plants Used in the Treatment of Superficial Skin Infections: From Traditional Medicine to Herbal Soap Formulations
Murunwa Madzinga, Quenton Kritzinger and Namrita Lall
8.1 Superficial Skin Infections 256
8.1.1 Common Superficial Fungal Infections (Mycoses)
8.1.2 Common Bacterial Skin Infections
8.1.3 Prevalence of Skin Infections Worldwide
8.1.4 Prevalence of Skin Infections in Africa
8.1.5 Current Treatments of Skin Infections
8.2 South African Plants Used in the Treatment of Bacterial and Fungal Skin Infections
8.2.1 Elephantorrhiza elephantina (Burch.) Skeels (Eland’s Bean)
8.2.2 Melianthus comosus Vahl (Honey Flower)
8.2.3 Dicoma anomala Sond. (Fever Bush)
8.2.4 Kigelia africana (Lam.) Benth. (Sausage Tree)
8.2.5 Ekebergia capensis Sparrm. (Cape Ash)
8.2.6 Diospyros mespiliformis Hochst. ex A.DC. (African Ebony, Jackleberry)
8.2.7 Aloe ferox Mill. (Bitter Aloe)
8.2.8 Warburgia salutaris (G. Bertol.) Chiov. (Pepper-Bark, Fever Tree)
8.2.9 Senecio serratuloides DC. (Two-Day Plant)
8.3 Herbal Soaps Infused With Plants Extracts
8.4 Conclusion
9. Garlic (Allium sativum) and Its Associated Molecules, as Medicine
Carel B. Oosthuizen, Anna-Mari Reid and Namrita Lall
9.1 Introduction: Allium sativum and Its Historical Relevance
9.2 Product Development
9.3 Research Findings of Garlic Extracts
9.3.1 Biological Properties
9.3.2 Nutritional Value
9.3.3 Antibacterial
9.3.4 Cardiovascular
9.3.5 Immune Stimulatory Effect
9.3.6 Cancer Treatment
9.3.7 Clinical Significance
9.4
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various sources. Although the work is in the first instance aimed at an academic audience, informed members of the public keen to learn more about the discovery and testing of new medicines should also find it a highly informative read. I would like to congratulate Prof. Lall and her team on a book I believe makes a significant contribution to the field of modern drug discovery.
Abraham E. van Wyk University of Pretoria
May 2017
medicinal plant into many additional rituals and traditional medicine practices. The popularity of mandrake and the legends surrounding its use extend beyond medicine into the world of film, where it was interestingly incorporated into the popular film, Harry Potter and the chamber of secrets
Although difficult, the World Health Organization (WHO) has harnessed the characteristics and elements of traditional medicine, drawing from descriptions as far back as the evidence allows even to modern traditional medicinal practices, to formulate a definition, which describes traditional medicine as “a holistic term encompassing diverse health practices, approaches, knowledge and beliefs incorporating plant, animal and/or mineral based medicines, spiritual therapies, manual techniques and exercises applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness.” Ultimately and more simplistically, traditional medicine refers to any form of indigenous healthcare system with ancient roots, cultural bonds, trained healers, and a theoretical construct. Examples include Ayurveda, Unani, Kampo, Shamanism, and traditional Chinese medicine (Fabricant & Farnsworth, 2001). The use of plants in medicine by specific ethnic groups is termed ethnobotanical medicine (Farnsworth, 1994a,b). A medicinal plant is thus any plant with alleged medicinal value that is used by Western standards or which contains components that are used as drugs (Laird & Kate, 2002). In industrialized countries, adaptations of traditional or ethnobotanical medicine are termed “Complementary” or “Alternative” medicines where complementary medicine refers to the use of medicinal plants in conjunction with a Western medicinal treatment, and alternative medicine refers to the use of a medicinal plant or plant-based medicine in place of Western medicine (WHO, 2003). Western medicine is distinguished from traditional medicine by the fact that it considers only ailments of the physical body, based on the principles of technology, science, knowledge, and clinical analysis developed in Northern America and Western Europe (Richter, 2003).
Medicinal plants and plant-derived medicines are used globally to treat various ailments. In modern society, these medicines are not only used by traditional cultures but are also gaining popularity under Western civilization. Currently there is a trend in natural alternatives as a source of new commercial products to synthetic chemicals. Although the use of plants as medicine is often underestimated, awareness of the active components of plants, which enable them to perform healing functions, needs to be increased. These active components, called phytochemicals, exist as they are required by the plant itself for specific functions. Generally, these phytochemicals are classified as secondary metabolites as they are not crucial for the survival of the plant but rather render a secondary beneficial function that provides the plant with a selective advantage. More than 100,000 such secondary metabolites have been isolated and characterized, many of which have been implemented as active ingredients in common medicines or have provided a basis for the development of synthetic actives that are incorporated into medicines (Rates, 2001).
More than 50% of drugs that are clinically used in the world are derived from natural products and their derivatives, with 25% being from higher plants.
When considering ∼250,000 higher plant species globally, only 10,000 have documented medicinal uses, of which only 150–200 are actually incorporated into Western medicine (McChesney, Venkataraman, & Henri, 2007), it becomes increasingly evident that plants possess a great potential avenue for exploration.
The WHO considers 252 drugs “basic” 11% of these (∼28) originate exclusively from plants, with a significant amount of the remaining synthetic drugs being derived from natural precursors (WHO, 2003). This further exemplifies the importance of plants in healing, across both pharmaceutical and cosmeceutical industries. The vast amount of plants that have yet to be explored outlines the importance of research in medicinal plants, and when considering what has been accomplished with what knowledge we do possess, it becomes very clear that the possibilities are endless and much to be sought after (Verpoorte, 1998).
Natural and herbal medicines have shown their potential over synthetic drugs by mostly having fewer side effects and lower levels of toxicity. Pharmacologically natural medicines have also shown their importance in their use as starting material for drug synthesis or directly as therapeutics. Natural medicines can also function as models for pharmacologically active compounds that may possess higher activity and less toxicity than their synthetic counterparts (Verma & Singh, 2008).
Not only do plants serve as potentially great alternatives to synthetic drugs and therapies, but natural plant-based therapies have also become increasingly popular, setting the benchmark for a more natural and safe platform. Reasons for this increased popularity include inefficiencies or hazards posed by conventional synthetic therapies, adverse side effects, affordability, and accessibility. Folk medicine and increased ecological awareness recently have also encouraged the idea that natural products may be less harmless (Rates, 2001).
1.2 TRADITIONAL MEDICINE IS A CRUCIAL PART OF AFRICAN HERITAGE
Traditional medicine, on the African continent, dates back ∼4000 years. It was once the sole medicinal system; however, even in recent times for some, it remains the dominant system with an estimated 80% of the African Member States population use traditional medicine as a primary source of health care. Africans have used traditional medicine for hundreds of years as a form of health care. In South Africa it is estimated that there are ∼27 million individuals who use traditional medicine. It has been calculated that from these individuals who use traditional medicine, they use it ∼4.8 times/year, which equates to an average of about 157 g of plant material for each treatment and 750 g/ year. In South Africa, indigenous plants are mainly used and this equates to ∼20,000 tons being used each year from at least 771 plant species that have been recorded. There are a range of plant parts used, which are collected from forests, grasslands, woodlands, and thickets (Fig. 1.1; HST, 2015).
The WHO estimates that of the plants harvested for medicinal use, about 86% of the plant parts harvested results in death of the plant, which has a huge
4 Medicinal Plants for Holistic Health and Well-Being
impact on sustainability. The decrease in availability of plants increases the time taken to find these plants and increases cost of the material. Common plants such as Scilla natalensis (Fig. 1.2) cost about R53/kg and scarce plants such as Salacia kraussii can reach up to R4,800/kg. There is also a big trade in plants from South Africa with neighboring countries such as Zimbabwe and Mozambique (HST, 2015).
Bark
Roots
Bulb
Whole plant
Leaves and stems
Tubers
Combina on of parts
FIGURE 1.1 Percentage of plant parts used in traditional medicine in South Africa (HST, 2015).
FIGURE 1.2 Scilla natalensis, a commonly used medicinal plant traded at approximately R50/kg (Shebs, 2007a,b).
various sets of legislation, the history of South Africa and the encroachment of Western medicinal practices have blurred the lines separating the roles between these two (Richter, 2003).
The history of investigating the phytochemical potential of plants in South Africa can be attributed to the importance of stock farming, the risk that many diseases posed toward the stock farming industry, and the catastrophic effects this could have on the economy. Diseases such as “slangkop” poisoning, “stywe siekte,” “vermeersiekte,” and “gifblaar” poisoning resulted in the deaths of livestock due to their grazing on poisonous plants (Marais, 1944; Rindl, 1924; Theiler, 1911; Vahrmeyer, 1982). For that reason, halfway through the 20th century, extensive research was done to understand the nature of these deaths. However, it was only in the 1990’s that a noticeable shift occurred in the field of research that wished to explore the use of traditional medicine and plants in the development of many products from pharmaceuticals to cosmeceuticals (Mulholland, 2005).
Several collaborative efforts between research organizations and traditional healers have found hundreds of plant species with the potential for drug development. Medicinal plants have played a major role in the traditions and lives of many people all over the world and from all walks of life. Plants that were used medicinally by various people and tribes had initiated the development of traditional healthcare systems such as Ayurveda and Unani, which have formed a key part of mankind for thousands of years (Gurib-Fakim, 2006). Today the medicinal importance of higher plants is still recognized with natural products and their derivatives having a 50% share of all drugs in clinical use (Gurib-Fakim, 2006).
1.4 DEVELOPMENT OF MODERN HERBAL PREPARATIONS
The development of modern herbal preparations involves many steps, namely identification of the plant material, authentication, collection, testing, standardization, processing, and finally, marketing. Each step has been developed in response to questions and concerns surrounding the use of herbal products.
The identification of medicinal plants may be through traditional knowledge systems (ethnopharmacology), on the basis of their plant family or through random selection. While random selection is somewhat inefficient in terms of time and resources, selecting a plant based on the traditional knowledge or plant family is more effective. Selection based on the plant family would be based on literature revealing other members of the plant family showing some medicinal value. The ethnomedicinal approach provides the greatest advantage above the aforementioned methods in that, it gives specific information about a specific species. Utilizing such methods, however, may lead to problems when moving forward into the second step of herbal production, authentication. This is because misidentification of the plant material may occur, especially in instances where closely related species exist. In such instances, a trained taxonomist is employed to correctly identify the plant species. The implications