Plants in Complementary Medicine

The past twenty years have seen a dramatic increase in the popularity and use of various complementary or alternative therapies. These can be referred to by many different names such as unorthodox, natural, fringe, complementary or alternative. In 1993 the British Medical Association in its report on Complementary Medicine used the term non-conventional therapies which it defined as those forms of treatment which are not widely used by the orthodox health-care professions and the skills of which are not taupfht as part of the underptraduate curriculum of orthodox medical and paramedical healthcare courses . 

Some of the therapies mentioned in the BMA Report are complementary in that they can be used in conjunction with orthodox treatments. For example, chiropractic, osteopathy, reflexology, Shiatsu and the Alexander technique all involve manipulation of muscle and bones and could be used to complement NSAID-based treatment. Others are genuinely alternatives which attempt to replace orthodox medicines, e.g. herbalism and homoeopathy, while some, e.g. acupuncture, are being assimilated into conventional medical practice. This chapter concentrates on those therapies which rely heavily on the use of plant materials and attempts to explain the basis of the therapy and provide examples of the plants used. In particular, the interrelationship between herbalism, herbal medicines and the phytotherapeutic use of plants, described in Chapter VI, is explored. 

There are three main therapies which rely on plant-based medicines, namely Aromatherapy, Homoeopathy and Herbalism. All three, because they are plant based, exemplify the green, natural image of alternative/ complementary medicine which has helped in making these techniques so popular and so acceptable. Equally the holistic approach of practitioners of these therapies, which embraces the whole person rather than seeing them as a set of symptoms or receptor-sites, has struck a sympathetic chord with patients disenchanted with the impersonal nature of high-tech modern medicine. Allied to this is a sometimes naive view that natural medicines are somehow free from the toxicities and side-effects of synthetic drugs. Chapter VIII shows just how erroneous such a view can be. 

Clinical aromatherapy which is mainly practised by French medical doctors who use essential oils internally as alternatives to conventional medicines. Sometimes the oils are taken orally, sometimes as pessaries or as suppositories. The use of oils in this way is more likely to cause adverse reactions than when the oil is massaged into the skin. This is because massage oils are invariably diluted in a carrier or base oil such as the fixed oil from almonds, avocado, soya or peach. 

There has been little scientific evaluation of aromatherapy oils but it is known that the terpenoid and phenylpropane compounds found in essential oils do possess biological activities ranging from antibacterial, antiinflammatory, sedative etc. There is evidence that molecules such as terpenoid hydrocarbons, esters etc. can be absorbed transdermally into the blood-stream. In addition, the massage element involving physical manipulation of strained tissues as well as the psychological effects of touch and of the smell of the oil, is of significance. Some trials of aromatherapy have shown benefits in intensive-care patients, in epilepsy and in endometriosis. The most popular oils are listed below with their claimed uses. 

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In many developing countries of the world, there is still a major reliance on crude drug preparation of plants used in traditional medicines for their primary health care. Pharmacognosists employed in the different institutions are aware of the changing trends of herbal medications and a number of useful texts on the analysis, uses, and potential toxicities of herbal remedies have appeared recently, which serves as useful guides in pharmacy practice. The history of medicine includes many ludicrous therapies. Nevertheless, ancient wisdom has been the basis of modem medicine and will remain as one important source of future medicine and therapeutics. The future of natural products drug discovery will be more holistic, personahzed and involve the wise use of ancient and modem therapeutic skills in a complementary manner so that maximum benefits can be accmed to the patients and the community. 

Two general principles that the student should remember are (1) that all substances can under certain circumstances be toxic, and the chemicals in botanicals (herbs and plant extracts) are no different from chemicals in manufactured drugs except for the proportion of impurities and, (2) that all dietary supplements and all therapies promoted as health-enhancing should meet the same standards of efficacy and safety as conventional drugs and medical therapies. That is, there should be no artificial separation between scientific medicine and "alternative" or "complementary" medicine. 

Aromatherapy is a highly popular form of complementary medicine usually entailing the application of essential plant oils to the skin by gentle massage. It has been shown to have relaxing effects but other claims have not been substantiated by reliable trial evidence (121). Allergic airborne contact dermatitis occurred in a patient who had previously used several essential oils for aromatherapy (122). The toxicity of essential oils has been reviewed (123). 

With the increasing popularity of phytomedicines (i.e. medicines based on plants) both in conventional and complementary medicine, there has been increasing concern over the health impact of environmental contamination of vegetable drugs. Such contamination can take a number of forms ... 

Phondani, P.C., Maikhuri, R.K. and Kala, C.P. (2010). Ethnoveterinary uses of medicinal plants among traditional herbal healers in Alaknanda catchment of Uttarakhand, India. African Journal of Traditional, Complementary and Alternative Medicim, 1 (3) 195-206. 

An explosion of interest in and information about wellness— not just illness—surrounds us. How to achieve and sustain a healthy lifestyle, how to enhance successful aging, and how to benefit from "natural" remedies saturate the media. Ironically, although this seems to be a new phenomenon, the principles of complementary or alternative medicine are ancient. Some of our oldest and most widely used medications are derived from plants and herbs, and Eastern medicine has for centuries relied on concepts of harmony, relaxation, and meditation. Again, as the world shrinks, we are obligated to be open to ideas that may be new to us but not to others and to carefully evaluate their utility. Muskin and colleagues present a careful analysis of the most familiar and important components of complementary and alternative medicine, presenting a substantial database of information, along with tutorials on non-Western (hence nontraditional to us) concepts and beliefs. 

Herbal medicine is the art of restoring or preserving the health of humans physically, mentally, socially, spiritually and otherwise through the use of plant remedies. The term is often used interchangeably with traditional medicine or traditional remedies because it has evolved through the ages from the traditional and cultural practices of the indigenous people. In the industrialised countries of the West where biomedicine is conventional, herbal medicine is usually referred to as complementary or alternative medicine. Some people in the industrialised nations will even term elements of herbal remedies as health supplements. 

At the same time, one would think that the U.S. government should take up the slack and become more involved in plant remedies, say, via the National Institutes of Health and the National Cancer Institute. (An Office of Alternative Medicine, later called the National Center for Complementary and Alternative Medicine, was founded within the National Institutes of Health, but all seems quiet at the front lines.) Furthermore, as already indicated, musical chairs are being played by government and industry (and academia as weU, which depends on research grants). Call it collusion if you will. It is the downside of capitalism in action. The human element always will out. 

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