Ayurveda the Science of Life

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Some Traditional Herbal Medicines41

History of use of traditional herbal medicines 1.1 The role of herbal medicines in traditional healing 43 1.2 Introduction of traditional herbal medicines into Europe, the USA and other developed countries 2. Use of traditional herbal medicines in developed countries 46 3.1 WHO guidelines for herbal

Traditional herbal medicines

Traditional herbal medicines encompass an extremely diverse group of preparations, and originate from many different cultures. Many herbal medicines have emerged from healing traditions around the world. Digitalis (from the dried leaf of Digitalis purpurea L.) and quinine (from the bark of the cinchona tree, Cinchonapubescens Vahl) are well-known examples of valuable therapeutic products of botanical origin. Some herbal products in current use in many parts of the world, such as ginseng (e.g., from Panax ginseng C.A. Mey) and valerian (e.g., from Valeriana officinalis L.), have long standing for their modest efficacy and few side-effects. Some, however, such as ephedra (e.g., from Ephedra sinica Stapf) have been imported from traditional healing systems and then used for indications (weight loss, athletic performance enhancement) never contemplated in the traditions from which they emerged. It is clear from these examples that some natural products derived from plants are...

History of Use of Traditional Herbal Medicines

By definition, 'traditional' use of herbal medicines implies substantial historical use, and this is certainly true for many products that are available as 'traditional herbal medicines'. In many developing countries, a large proportion of the population relies on traditional practitioners and their armamentarium of medicinal plants in order to meet health care needs. Although modern medicine may exist side-by-side with such traditional practice, herbal medicines have often maintained their popularity for historical and cultural reasons. Such products have become more widely available commercially, especially in developed countries. In this modern setting, ingredients are sometimes marketed for uses that were never contemplated in the traditional healing systems from which they emerged. An example is the use of ephedra ( Ma huang) for weight loss or athletic performance enhancement (Shaw, 1998). While in some countries, herbal medicines are subject to rigorous manufacturing standards,...

Introduction of traditional herbal medicines into Europe the USA and other developed countries

The desire to capture the wisdom of traditional healing systems has led to a resurgence of interest in herbal medicines (Tyler, 2000), particularly in Europe and North America, where herbal products have been incorporated into so-called 'alternative', 'complementary', 'holistic' or 'integrative' medical systems. During the latter part of the twentieth century, increasing interest in self-care resulted in an enormous growth in popularity of traditional healing modalities, including the use of herbal remedies this has been particularly true in the USA. Consumers have reported positive attitudes towards these products, in large part because they believe them to be of 'natural' rather than 'synthetic' origin, they believe that such products are more likely to be safe than are drugs, they are considered part of a healthy lifestyle, and they can help to avoid unnecessary contact with conventional 'western' medicine.

WHO guidelines for herbal medicines

The document covered such topics as developing protocols for clinical trials using herbal medicines, evaluating herbal medicine research, guidelines for quality specifications of plant materials and preparations, and guidelines for pharmacodynamic and general pharmacological studies of herbal medicines and for toxicity investigations of herbal medicines. WHO has also issued Guidelines for the Assessment of Herbal Medicines (WHO, 1996). These guidelines defined the basic criteria for the evaluation of quality, safety and efficacy of herbal medicines with the goal of assisting national regulatory authorities, scientific organizations and manufacturers in assessing documentation, submissions and dossiers in respect of such products. It was recommended that such assessments take into account long-term use in the country (over at least several decades), any description in the medical and pharmaceutical literature or similar sources or documentation of knowledge on the application of a...

The role of herbal medicines in traditional healing

Many herbal remedies found their way from China into the Japanese systems of traditional healing. Herbs native to Japan were classified in the first pharmacopoeia of Japanese traditional medicine in the ninth century (Saito, 2000). Ayurveda is a medical system primarily practised in India that has been known for nearly 5000 years. It includes diet and herbal remedies, while emphasizing the body, mind and spirit in disease prevention and treatment (Morgan, 2002).

Cancer And Ayurveda An Overview

Humans have traditionally been dependent on nature for the healing and prevention of afflictions and revitalizing body systems for longevity. Natural supplements have been offering relief for nearly every known illness since the dawn of mankind, long before today's conventional medical practices. Swabhavoparana, Sanskrit for remission by nature, was clearly illustrated through the use of herbs and other natural secrets in Ayurveda, the oldest healing science known in India.3 Ayurveda is considered a branch of Atharva Veda, one of the four main texts of Hindu spirituality known as Vedas. Fairly comprehensive information about herbs has been recorded in Charaka Samhita and Shustruta Samhita, the two most important Vedic books. The description of cancer can be dated to earlier than 2000 B.C. by its description given in Atharva Veda under the name apachi. Sushruta, one of the reorganizers of Ayurveda (400 B.C.), described the superficial tumors under the name arbuda. The malignancies of...

IARC Library Cataloguing in Publication Data

Some traditional herbal medicines, some mycotoxins, naphthalene and styrene IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2002 Lyon, France) 1. Traditional herbal medicines - congresses 2. Mycotoxins - congresses 3. Naphthalene - congresses 4. Styrene - congresses I. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans II. Series

General Remarks On The Substances Considered

This volume of the IARC Monographs considers some traditional herbal medicines, including extracts from certain plants of the genera Aristolochia, Rubia, Morinda and Senecio some mycotoxins, specifically aflatoxins and fumonisin Bj and two industrial chemicals, naphthalene and styrene. Of these, the Monographs have previously evaluated several of the pyrrolizidine alkaloids that occur in certain species of Senecio, Crotalaria and other plant genera, including riddelliine (IARC, 1976, 1987) various mycotoxins, including the aflatoxins (IARC, 1993 a) and the family of mycotoxins to which fumonisin B1 belongs (IARC, 1993b) and styrene (IARC, 1994). These previous evaluations are summarized in Table 1.

Origin type and botanical data

Use of herbal medicines in developed countries has expanded sharply in the latter half of the twentieth century. Monographs on selected herbs are available from a number of sources, including the European Scientific Cooperative on Phytotherapy (ESCOP, 1999), German Commission E (Blumenthal et al., 1998) and the World Health Organization (WHO, 1999). The WHO monographs, for example, describe the herb itself by a number of criteria (including synonyms and vernacular names) and the herb part commonly used, its geographical distribution, tests used to identify and characterize the herb (including macroscopic and microscopic examination and purity testing), the active principles (when known), dosage forms and dosing, medicinal uses, pharmacology, contra-indications and adverse reactions. Other resources that provide detailed information about herbal products in current use include the Natural Medicines Comprehensive Database (Jellin, 2002) and NAPRALERT (NAtural PRoducts ALERT) (2001)....

Awareness Control Regulation and Legislation on

In 1992, the WHO Regional Office for the Western Pacific invited a group of experts to develop criteria and general principles to guide research work on evaluating herbal medicines (WHO, 1993). This group recognized the importance of herbal medicines to the health of many people throughout the world, stating 'A few herbal medicines have withstood scientific testing, but others are used simply for traditional reasons to protect, restore, or improve health. Most herbal medicines still need to be studied scientifically, although the experience obtained from their traditional use over the years should not be ignored. As there is not enough evidence produced by common scientific approaches to answer questions of safety and efficacy about most of the herbal medicines now in use, the rational use and further development of herbal medicines will be supported by further appropriate scientific studies of these products, and thus the development of criteria for such studies'.

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Alternatively, they may wish to incorporate herbal medicines into a patient's treatment regimen whenever appropriate. Toward this end, this book details the chemical constituents, mechanisms, and physiological effects of psychoactive plant drugs. Further, information is given on any controlled clinical trials that address the safety and efficacy of psychoactive herbal medicines. Researchers in this field will also benefit from the broad summary of data collected here, incorporating biochemistry, pharmacology, physiology, cognition, and behavior. From this perspective, future avenues for research often become apparent. Ultimately, this book is intended to further the cause of herbal medicines. If they are properly researched and the public is properly educated about their effects and uses, herbal medicines will be an asset to us, rather than a liability. Acknowledgments

Botanical PharmacognosyA Phoenix Rising from the Ashes

In name, this identity crisis remains daunting to modern pharmacognosists. However, as long as people utilize plant-based medicines, the need for the classical tools of botanical pharmacognosy, including botanical microscopy, will remain. As prophesied by Professor Farnsworth (2004) (Figure 1.17), it is unlikely that botanical phar-macognosy will regain its stature in modern pharmacy. However, the day may come when herbal medicines become so integrated into the fabric of modern health care that pharmacists will once again be called upon to do custom compounding and manufacturing of salves, syrups, tinctures, and suppositories. Such practices have reemerged in some pharmacies. Whether this causes pharmacists to pick up the microscope once again is unknown. Surely, modern physicians, who were once the primary teachers of materia medica, will not pick up the botanical skills of pharmacognosy. At the same time, as noted by Professor Wagner (2004), herbal medicine potentially represents...

The Medical Community and Supplements

Many health care professionals find they are just as confused about supplements as the general public. Because of the many uncertainties surrounding the effectiveness and safety of supplements, most physicians err on the side of caution. A few studies about physician health and treatment practices shed some insight on how physicians handle the topic of dietary supplements with their patients. As a group, physicians generally have a healthier lifestyle and lower mortality rate than the general public. Physicians with healthy habits are more likely to discuss preventive health behaviors with their patients, than those who do not, which in turn appears to influence counseling practices.31

Epidemiology Summary and Conclusions

There are only few clearly established and strong risk factors for prostate cancer which are consistently observed in epidemiologic studies (1) African-American descent, (2) a Western life style, in particular Western dietary habits, and (3) a family history of prostate cancer. Less consistently found and weaker risk factors are a history of venereal disease, and employment in farming, the armed services, and the nuclear industry. The strongest single risk factor appears to be a Western life style, particularly Western dietary habits, including a high fat intake. It is conceivable that dietary risk factors exert their enhancing effects mediated by a hormonal mechanism that involves androgens. However, it is unlikely that life style is the sole factor that explains the differences in prostate cancer risk between Asian and American populations 10,135 . The single most important combination of risk factors is to be of sub-Saharan African descent and to reside in the US - African...

Major Taxonomic Groups Algae Fungi and Plants

Traditionally, botany included the study of almost any living organism that was not an animal or a bacterium, including algae and fungi. Similarly, herbal medicines are prepared from virtually every type of plant material not just those that would be botanically described as herbaceous plants. Modern biology recognizes a far more complex classification for the major groups of living things that reflects, as much as possible given incomplete knowledge and practical needs, the evolutionary history of life on Earth.

Lipids and fatty acids

Terminus and contain up to six double bonds. Sea lettuces are particularly rich in o3 fatty acids (Ortiz et al., 2006). Eicosapentanoic acid (EPA 20 5) and docosahexanoic acid (DHA 22 6) are the two important fatty acids of sea lettuces, along with the precursor a-linolenic acid (ALA 18 3). Both EPA and DHA are basically derived from ALA through elongation and desaturation (Alamsjah et al., 2008 Ortiz et al., 2006 Ratana-arporn and Chirapart, 2006). The o3 fatty acids have been demonstrated to play significant role in human body. In human body, the beneficial effect of o3 fatty acids can be classified into two main areas. First, these fatty acids sustain normal healthy life through the reduction of blood pressure, plasma triglycerides, and cholesterol, together with increased blood coagulation time. Both EPA and DHA are important for maintenance of normal blood flow as they lower fibrinogen levels and also prevent platelet from sticking each other. Second, they alleviate certain...

Summary and Conclusion

There are no known exogenous hormonal or non-hormonal exposures that are associated with prostate cancer risk, with the exception of exposure to a western life style (including a high fat diet), to an African American environment, and, perhaps, to venereal disease, unknown factors related to farming, and employment in armed services and the nuclear industry. None of these associations point to specific chemicals, hormones, or other factors. In view of the high frequency of this malignancy in Western countries, this lack of known specific risk factors is remarkable and may indicate that there are many exogenous risk factors for prostate cancer which are too ubiquitous and overlapping to be detectable by epidemiologists. It is also possible that there are strong endogenous determinants of prostate cancer risk which are overwhelming most exogenous risk factors in epidemiological analyses. Androgenic hormones and androgen receptor mechanisms are prime candidates to be such important...

Historical background

Toxic extracts from the seeds (castor beans) of Ricinus communis have been used since ancient times for both medical and criminal purposes (Morton, 1977). The castor bean plant originated in Asia but is now found in Europe and America as well (Olsnes and Pihl, 1976). Castor beans are known to have been used medically by the Greeks, and extracts from R. communis are described as having medical uses in the Sanskrit work Susruta Ayurveda from the sixth century (Olsnes and Pihl, 1976).

Use of HPLC for the determination of chan su danshen and ginsengs

An extract of Radix Salvia miltiorrhiza is used in the Chinese herbal product danshen and related medicines used as heart tonics. Shi et al. successfully separated components of danshen (tanshinones including cryptotanshinone, tanshinone I and tanshinone IIA) using a Ci8 column (150 x 4.6 mm i.d., particle size 5 mm). The mobile phase was methanol-tetrahydrofuran-water-glacial acetic acid (20 35 44 1 v v v v), employing isocratic elution at a flow-rate of 1.0 mL min-1. The analytes were detected by measuring their UV absorption at 254 nm. The method was successfully applied to the analysis of five kinds of Chinese herbal medicines containing danshen.41 Hu et al. used LC-MS for the quantitative determination of dihydrotanshinone I, cryptotanshinone, tanshinone I and tanshinone IIA. These components were separated using a reversed-phase Ci8 column and quantification was based on the M + H + fragments produced under collision activation conditions and the selected reaction monitoring...

Chamaelirium luteum L A Gray

False unicorn is one of the primary botanicals used in Western herbal medicine for its putative ability to promote female fertility and as a uterine tonic. It is reported by some to be relatively scarce and has been known to be subject to adulteration with a different species of plant known as aletris (aka true unicorn or stargrass, Aletris farinosa). Aletris is much less expensive and different in its action than false unicorn. The two species are readily distinguished from one another and care should be taken to differentiate between them (see Aletris).

Crataegus laevigata Poir Dc

Hawthorn is one of the most widely used of all cardiotonics throughout Europe and the United States. It possesses myriad beneficial actions on the cardiovascular system, including documented effects as an antioxidant, an ability to increase coronary output and mildly lower blood pressure and cholesterol, and the promotion of a slow and steady heartbeat, among other uses. The two most widely used species are C. laevigata and C. monogyna. These are considered to be interchangeable. Additional species of Crataegus that share a similar chemical profile may also be used interchangeably. However, most research has been done with the aforementioned species. Traditionally, the berry was used more than the leaf and flowers. However, modern research has focused on the leaf and flower, which have become two of the most extensively studied herbal medicine ingredients. The European pharmacopoeia considers many different species of Crataegus leaf and flower to be acceptable, including C. laevigata,...

Understanding the scope of CAM

We can broadly separate all of CAM into three main classifications world medicine systems, other comprehensive systems of medicine that are not culturally based, and individual therapies (Figure 23.1). Unlike individual therapies, a system of medicine provides treatment for a whole spectrum of symptoms, illnesses, or diseases. It is generally a complete system of medicine with its own philosophy or science of health and disease, and its own diagnostic approach. A world medicine system evolves from the belief system and cultural practices of a society. Examples of world medicine are traditional Chinese medicine and Ayurvedic medicine, which originates from India. Other systems of medicine, such as homeopathy, may evolve from a philosophical construct of health and disease, but is not part of a world cultural tradition. Homeopathy Osteopathy Herbal medicine Acupuncture Herbal medicine Qi Gong Ayurvedic medicine These are shown in Table 23.1 with examples in each category. Mindful...

Acupuncture And Traditional Chinese Medicine

Herbal medicine bodily systems, and a vital energy called qi that flows through the channels. Acupuncture points lie along the channels. Good health and well-being occur when the flow of energy is balanced. Illness occurs when the energy flow is out of balance. It may be depleted from a channel or it may accumulate within a channel at a point of obstruction. By needling acupuncture points, the flow of qi can be restored to its proper balance.

Brief history of acupuncture

As western medicine was introduced in China in the eighteenth century, acupuncture began to lose official favor. It was banned from the imperial court in 1822, but was still practiced widely and its use spread in Europe and other countries even as western medicine was making its way into China. In the 1940s, Mao Tse Tung revived the status of acupuncture practice as he found it a useful, inexpensive, and expedient alternative to western medicine, which was expensive and difficult to access during his quest for power against Chang Kai Shek. Chairman Mao encouraged the development of acupuncture and fostered simplification of acupuncture practice so that large numbers of nonphysicians (barefoot doctors) could use it in their communities together with herbal remedies.

Environment Contextual Adaptations for Management of Pain

Reaches, adjusting the height of a computer workstation for upper extremity neck back comfort, or encouraging social activity choices such as smoke-free environments that enhance rather than discourage a healthy lifestyle. Contextual adaptations include such recommendations as balancing activity or exercise with rest throughout the day to promote endurance and limit painful participation, limiting face-to-face meeting or travel in lieu of phone or e-mail interaction, or using assertive social communication to avoid painful greetings via handshake. Often, the client's use of cognitive behavioral strategies and assertive communication are paramount to promoting a better quality of life. At other times the environment can be changed to promote a more comfortable and effective routine. For some clients, more specialized environmental adaptation approaches can be found through the process of home evaluations, ergonomic evaluations, and worksite job analyses conducted by occupational...

Problems Associated with Dependence on One Antioxidant

Supplementation of diets with any single molecule showing in vitro antioxidant capacity does not necessarily promote health improvement. Recent studies of p-carotene have revealed that there may be risks associated with antioxidant supplementation. In the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (1994) and the CARET study (Omenn et al., 1996) the risk ratio for lung cancer in smokers receiving p-carotene increased. Protective effects of a diet rich in fruit and vegetable have recently been shown to reduce lung cancer independently of the effects of single-vitamin supplements (Yong et al., 1997).

Echinacea pallida Nutt Nutt

Echinacea pallida is one of the three primary species of Echinacea used in Western herbal medicine for stimulating immune function. It is not widely used but can be confused with other species of Echinacea. The roots of E. angusti-folia, E. atrorubens, and E. pallida are most commonly mixed up and are difficult to differentiate microscopically. E. pallida root is very similar to E. angustifolia root, but due to the doubled chromosome number in E. pallida, the size of epidermal cells, sclereids, and secretory cavities is, on average, larger than is found in E. angustifolia.

Pharmacological Properties

Many of today's synthetic drugs originated from the plant kingdom, and only 200 years ago, our pharmacopeia was dominated by herbal medicines. Medical herbalism (i.e., the medicinal use of preparations that contain exclusively plant material) went into rapid decline when pharmacology established itself as a leading branch of therapeutics. In much of the English-speaking world, herb-alism virtually vanished from the therapeutic map during the last part of the 19th century and early part of the 20th century. In contrast, many developing countries never abandoned medical herbalism (e.g., Ayurvedic medicine in India, Kampo medicine in Japan, and Chinese herbalism in China), and in other countries (e.g., Germany and France), medical herbalism continued to co-exist with modern pharmacology, albeit on an increasingly lower key. In recent years, this situation has started to change again. Herbal medicine is most commonly employed for allergies, insomnia, respiratory problems, and digestive...

Pharmacodynamic Input

If blood and or urine is selected as the best choice to evaluate the biomarker, the next question is whether the analytical methods will be sensitive and precise enough to accomplish the job. Unless the site of the disease process is the blood or urine, it is likely that biomarker concentrations will be diluted relative to those at the site of disease drug action before reaching these sampling sites. If the method is sensitive enough, the next issue is how reproducible are the biomarker concentrations from hour to hour, day to day, month to month, and year to year during good health and in the disease state Is there a circadian rhythm or are biomarker concentrations reasonably constant during a 24-h period following placebo, and are biomarker concentrations reproducible between two placebo control periods How much of a change will take place in the biomarker between health and disease state and between untreated disease and disease following therapeutic intervention Is the analytical...

Ligusticum porteri J M Coult Rose

Osha, also known as bear root, is native to the American Southwest and the Rocky Mountains. It and other closely related species are considered sacred among many Native American tribes and are used medicinally and ritualisti-cally. Osha is primarily used in herbal medicine for upper respiratory infections. It has a very limited growing range, preferring growth above 8,000-feet elevation. Thus, it is an environmentally sensitive botanical and this should be taken into consideration before use.

Microalgae As Potential Antiasthmatic Agents

Blue-green algae known as cyanobacteria have shown antioxidant, neu-roprotective, cytoprotective, antiviral, antifungal, antibacterial, and anti-inflammatory activities. Edible blue-green algae, such as Spirulina and Aphanizomenon flos-aquae, are currently marketed as dietary supplements with various health claims for immune function, inflammation, heart disease, and general well-being. Nostoc commune, a blue-green edible microalga, has been used as a food delicacy or herbal medicine in Asian, African, and South American countries for centuries (Cao, 1998).

Treatment of specific fractures

Even isolated rib fractures can be the cause of morbidity and mortality. The impairment of respiratory function that is the almost inevitable consequence of the pain associated with a rib fracture can be enough to induce respiratory failure in those with pre-existent respiratory disease. When these fractures are multiple, even those with previous good health can be pushed into respiratory failure. When major trauma is involved, rib fractures may be associated with lung contusion and injury which increases the risk of complications.

Box 156 Pain treatment options dysmenorrhea [6973

If no pelvic pathology is identified, then surgical neuroablative treatment may be considered. Other potential options with varying degrees of supportive evidence include long-acting hormonal therapies and nontraditional remedies such as vitamin E and B1 supplementation, magnesium supplementation, various other dietary and herbal remedies, acupuncture, and transcutaneous electrical nerve stimulation (TENS). A Cochrane review of high-frequency TENS for the treatment of dysmenorrhea found it to be more effective than placebo in relieving menstrual-related pain. However, the TENS group did experience a higher rate of muscle vibration, skin tightness, headache, and skin irritation 70-73 .

Human amino acid and protein requirements

According to WHO (2002), protein requirement could be defined as ''the lowest level of dietary protein intake that will balance the losses of nitrogen from the body and thus maintain the body protein mass, in persons at energy balance with modest levels of physical activity, plus, in children or in pregnant or lactating women, the needs associated with the deposition of tissues or the secretion of milk at rates consistent with good health.'' Protein and amino acid requirements are differentiated into the safe individual intake and safe population intake (this value is greater than the safe individual intake in most cases). The requirements are suggested for health and disease condition of all age groups (eventually sexes) and women during pregnancy and lactation as well (Tables 24.1 and 24.2). The recommendations for developing countries are also stated. They were based as a sum of the total protein content of the diet (total

Modern Biopharmaceuticals A Primer Stem Cell Research and Very Recent Breakthroughs

Taken together, this will allow for a much better and more rational employment of preventive medicine than today. Of course, this can be regarded as utopia, probably also wishful thinking, but there is no doubt that in certain areas and under certain circumstances this will become reality provided that the ways in which we educate and inform patients and potential patients properly change adequately.

Role Of Natural Products In Cancer Cure

Quickly responding to swiftly spreading overt infectious diseases. The use of plants in the treatment of cancer has not been widely embraced by traditional medicine, has not been supported by documented cures, and has been limited mostly to treatment of easily detectable skin cancers. However, the popularity of herbal medicine as a natural supplement, particularly for the cure and prevention of cancer, has gained momentum since the beginning of the 20th century. were challenged by the medical establishment, which vigorously condemned them as ineffectual and unproven quackery. Some of the therapies, like Hoxsey and essiac (see Sections 20.3.2 and 20.3.4), ignited national movements, with supporters of herbal medicine on one side, demanding the right to choose in health care decisions, and agencies of organized medicine on the other side preventing unconventional medicine for lack of documented evidence for their efficacy. The U.S. bans the use of some of these therapies as cancer...

Drug And Other Interactions

The list of drugs and other factors that may affect the action of oral anticoagulants is prodigious. Any substance or condition is potentially dangerous if it alters (1) the uptake or metabolism of the oral anticoagulant or vitamin K (2) the synthesis, function, or clearance of any factor or cell involved in hemostasis or fibrinolysis or (3) the integrity of any epithelial surface. Patients must be educated to report the addition or deletion of any medication, including nonprescription drugs, herbal remedies and food supplements. Some of the more commonly described factors that cause a decreased effect of oral anticoagulants include reduced absorption of drug caused by binding to cholestyramine in the GI tract increased volume of distribution and a short t 2 secondary to hypoproteinemia, as in nephrotic syndrome increased metabolic clearance of drug secondary to induction of hepatic enzymes, especially CYP2C9, by barbiturates, carbamazepine, or rifampin ingestion of large amounts of...

Measurement of costs and benefits

Quantifying health effects may also create difficulties. Outcome measures from clinical trials and systematic reviews are widely used in cost-effectiveness analysis, but to assess whether resources would generate additional benefits if used elsewhere, a form of common currency needs to be used. For example, would it be more efficient to use more effective, but more expensive, epidural patient-controlled analgesia after caesarean section rather than intrathecal morphine,22 or use the same resources to help finance an acute pain service 23 Specific measures are not helpful in this context. Attention has been focused on measures to assess the impact of interventions on health related quality of life, as well as life expectancy. There are several approaches, which combine these two attributes into a single measure of health status. One of the most common is that of the quality adjusted life year (QALY), which assigns a score corresponding to the health related quality of life during a...

Cancer Prevention And Diet

However, in epidemiological studies, all three cancers show associations with a more or less clearly defined 'Western life-style'. While several aspects of this lifestyle have come under scrutiny, the most convincing arguments point to diet as a major factor. This is not to say that the Western diet is thought to contain a high level of contaminating carcinogens. Rather, diet appears to modulate the risk for these three cancers by affecting endogenous carcinogenic processes. The potential for prevention by changes in the diet is illustrated by the order of magnitude difference in the incidence of prostate cancer between East Asia and North-West Europe ( > 19.1), and even more impressively, by the same difference emerging in successive generations of Asian immigrants into the USA. The incidences of the three cancers in Southern Europe and in the Near East are typically intermediate, so a 'Mediterranean life-style effect' has been postulated. Of note, diet may be only one of several...

Possible Causes for Concern

In adults, a few areas may require further study. For example, there is a report of soya consumption causing an increased incidence of hyperplastic epithelial cells in the nipple aspirate fluid of pre- and postmenopausal women.i2i This could constitute a risk factor for breast cancer. Also, the use in herbal medicine of particular plants emphasises that these species have the potential to cause physiological changes. Consequently, the increasing public interest in the use of herbal medicines could lead to unintended (adverse) effects, particularly as most herbal medicines have received little toxicological assessment.122 However, these potential problems should be balanced against the extensive experimental evidence suggesting a preventive (beneficial) role for phytoestrogens.

Therapeutic options

Treatment includes pharmacologic and non-pharmacologic therapies and is initiated with patient and family education, removal of possible triggers, and if appropriate, changes in a disrupted lifestyle (school attendance, physical activity, sleep, dietary habits). Overuse of particularly symptomatic and centrally acting analgesics is prevalent in children with chronic daily headache. Attempts to discontinue the overused medications may cause rebound. If prophylactic medication is prescribed, it should be given every day, whether or not a headache is present. Attention to the following good health habits remains the primary therapy.

Consumers are Taking Control of Their Health

People identify with the concept of 'wellness being healthy and want to choose health solutions for themselves' (L. Dangar, personal communication). Over 80 of non-prescription medicines sold are through self-selection approximately three-quarters of consumers worldwide opt to self medicate. Consumers want greater autonomy increased control and a healthier lifestyle. They want relevant, current, user-friendly information, which contributes to a quality self and addresses their needs and expectations. Research shows that North Americans are shying away from the medical establishment and are taking responsibility for their own health (ADA, 1997). Single-vitamin usage is skyrocketing, as they believe that to achieve health benefits there is a need to take high doses of one vitamin rather than taking multivitamin supplements. The trend for people to take control of their own health coincides with increased visits to alternative health practitioners. Consumers' understanding and beliefs...

Estimate of the Selfmedication Market Natural Remedies Vitamins

Herbal medicines the growing acceptance of botanicals by mainstream consumers. Sales of herbal remedies are growing by 15 annually, with 1995 year-end sales at about US 2.0 billion (Sloan, 1996). More than one-third of consumers surveyed by HealthFocus want to learn more about herbal remedies and how they relate to disease, while 29 want information about how to use or act on what they learn about them (Gilbert, 1995).

Bacopa monnieri L Pennell syn Bacopa monnieria L Wettstein

Bacopa is one of the most highly esteemed herbs of ayurvedic medicine of India it is also recognized in the Chinese materia medica. Its most prominent use in the West is based on its putative effects in enhancing cognitive functions this function is supported by numerous clinical and preclinical studies. Bacopa shares the common Sanskrit name of brahmi with another commonly used Indian herb known in the West as gotu kola (Centella asiatica). Thus, the two may be traded interchangeably or mistakenly but can be readily differentiated microscopically. The differentiation between the two species is provided.

Caulophyllum thalictroides L Michx

Blue cohosh is one of the primary uterine tonics, uterine antispasmodics, and smooth muscle relaxants used in Western herbalism. It is commonly used as a partus pre-parator, a substance used in the last 6 weeks of pregnancy to help prepare for birth. It is also used to promote efficient uterine contractions during birth. In recent years, concern regarding its use for these purposes has been raised. There are no reported adulterants of blue cohosh.

Side Effects Of Hexaethyltetraphosphate

805-806, 806 Heptane antihistamines, 740t Herbal medicines, as anti-infective agent, 179 Herbs. See Medicinal herbs Herceptin. See Trastuzumab Heroin, 783 , 784 Herplex. See Idoxuridine Heteroarylacetic acids, 799-800, 799 Heteroarylpropanoic acids, 800-801, 801 Heterotopic ossification, 705 HETP. See Hexaethyltetraphosphate Hetrazan. See Diethylcarbamazepine citrate HEV. See Hepatitis E vaccines Hexabrix. See Ioxaglate Hexachlorophene, 184 Hexaethyltetraphosphate (HETP), 578 Hexahydropyrazine, 225 Hexahydrosiladifenidol (HHSiD), 567, 568 Hexalen. See Altretamine Hexamethonium, 559-560, 581, 596, 598 Hexamethonium bromide, 598 Hexamethonium chloride, 598 Hexamethylenetetramine mandelate, 214 Hexamethylmelamine. See Altretamine Hexamethylpropyleneamine oxime, 424 Hexobarbital, metabolism of, 55, 58, 71-72, 86, 88 Hexylresorcinol, 185 HHSiD. See Hexahydrosiladifenidol Hibiclens. See Chlorhexidine gluconate High-density lipoprotein, 647-648 High-osmolar contrast medium (HOCM), 432...

Withania somnfera L Dunal

Ashwagandha Root Ashwagandha is among the most highly regarded herbal tonifiers in ayurvedic herbalism. It is considered a tonic, nervine, and adaptogen. In modern research, it has been compared to Panax ginseng for its endurance-enhancing properties. Three primary chemotypes of ashwagandha are traded. Because only one chemotype was used for this characterization, the other chemotypes may differ microscopically from the sample used.

5 Methoxyhydnocarpin D

Throughout human history, the use of herbal medicines has always been central to all healing systems. Prior to our relatively recent reliance on the isolated, purified, oftentimes synthetic chemical entities dominant in modern medicine today, plants were the primary source of medicines for the majority of the world's population (Figures 1-4). This is still true today. Plants also provide the source material for a large percentage of modern drugs. Some of these medicines include well-known items such as aspirin, of which the precursor, salicin, was originally derived from the bark and leaves of willow (Salix spp.). Aspirin was subsequently named after the first commercial source from which salicin was derived, the botanical meadowsweet (Filipendula ulmaria, formerly named Spiraea), from which the spir in aspirin comes (Figure 2). Digitalis glycosides, another botanically derived category of medicines, originating from the beautiful purple foxglove (Digitalis purpurea), have been...

About the Editors Authors and Associates

Roy Upton, herbalist, has been working and practicing professionally as an herbalist since 1981. Trained in ayurvedic, Chinese, Caribbean, and Western herbal medicine traditions, Roy is the founder, executive director, and editor of the American Herbal Pharmacopoeia is cofounder, past president, and current vice president of the American Herbalists Guild (AHG) and serves on the General Chapters Committee of the United States Pharmacopeia (USP) and botanical expert advisory committees of AOAC International, the American Botanical Council, and NSF International. Roy is visiting faculty for Tai Sophia (Laurel, Maryland) and lecturer for the Complementary and Alternative Medicine Program at the University of California School of Pharmacy (Los Angeles, California). Roy is also the staff herbalist for the California-based herbal supplements company Planetary Herbals and is a member of the Standards Committee of the American Herbal Products Association. Diana Eve Swisher, MA, received her BA...

Physical Management of Pain

Work hardening and work conditioning are interventions often implemented with injured workers who are preparing to return to work. While often used interchangeably, there are significant differences. Work hardening is interdisciplinary and composed of a combination of job tasks the client would perform within his her job capacity with consideration for strength, endurance, pacing, range of motion, and differential movements specific to the client's job (Keegan and Kahlert 2006, King and Olson 2009). Ideally, a job analysis (during which the occupational therapist evaluates physical, mental, and psychological demands of the job) would be completed prior to the development of the client's work conditioning treatment plan. This would allow the occupational therapist to tailor the work hardening treatment plan to the client's work-related needs. Additionally, work hardening is unique as it includes intervention targeting the client's psychosocial factors such as self-esteem, confidence,...

Terminalia chebula Retz

Chebulic myrobalan, more commonly referred to in the herb trade by the names harada or haritaki, is an ingredient in the most widely used formula of ayurvedic medicine the three-fruit combination triphala, which consists of harada with amla (Phyllanthus emblica) and behada (Terminalia bellerica). The three fruits are often sold combined. Although the quality of the fruits can vary substantially, the identity is typically correct. Fruits are traded in whole form and with the seed removed. This characterization describes both the fruit and the seed.

Terminalia bellerica Gaertn Roxb

Belleric myrobalan, more commonly referred to in the herb trade by the names behada or bibhitaki, is an ingredient in the most widely used formula of ayurvedic medicine the three-fruit combination triphala, which consists of behada with amla (Phyllanthus emblica) and harada (Terminalia chebula). The three fruits are often sold combined. Although the quality of the fruits can vary substantially, the identity is typically correct. Fruits are traded in whole form and with the seed removed. This characterization describes both the fruit and the seed.

Characteristics Of Phytomedicines

Phytotherapeutic agents or phytomedicines are standardized herbal preparations consisting of complex mixtures of one or more plants, which are used in most countries for the management of various diseases. According to the WHO definition, herbal drugs contain as active ingredients plant parts or plant materials in the crude or processed state plus certain excipients, that is, solvents, diluents, or preservatives. Usually, the active principles responsible for their pharmacological action are unknown. One basic characteristic of phytotherapeutic agents is the fact that they normally do not possess an immediate or strong pharmacological action. For this reason, phytotherapeutic agents are not used for emergency treatment. Other characteristics of herbal medicines are their wide therapeutic use and great acceptance by the population. In contrast to modern medicines, herbal medicines are frequently used to treat chronic diseases. Combinations with chemically defined active substances or...

The Marshfield Personalized Medicine Research Project

The project is directed toward delineating the predictability of the genetic markers of drug response, outcomes analysis of genetically based prescriptive practices, preventive medicine based on the genetic basis of disease, and answering important questions in population genetics. The hope of this project is that it will allow physicians to use genetic information to be proactive rather than reactive in freeing patients of disease.

Use of Authoritative Microscopic Characterizations

Over the more than 170 years since Schleiden declared that the cell was the fundamental unit in plants, microscopy has been applied to plant materials and thousands of microscopic characterizations have been developed for the botanicals used in ayurvedic, Chinese, Egyptian, and Western herbal medicine. This is good news for quality control personnel because they do not need to reinvent the microscopic wheel in developing their own microscopic characterizations.

Differentiation of Crataegus laevigata and Crataegus monogyna

Hawthorn is one of the most widely used of all cardiotonics throughout Europe and the United States. It possesses myriad beneficial actions on the cardiovascular system, including documented effects as an antioxidant, an ability to increase coronary output and mildly lower blood pressure and cholesterol, and the promotion of a slow and steady heartbeat, among other uses. The two most widely used species are C. laevigata and C. monogyna. These are considered to be interchangeable. Additional species of Crataegus that share a similar chemical profile may also be used interchangeably. However, most research has been done with these two species. Traditionally, the berry was used more than the leaf and flowers. However, modern research has focused on the leaf and flower, which have become two of the most extensively studied herbal medicine ingredients. The European pharmacopoeia considers many different species of Crataegus leaf and flower to be acceptable, including C. laevigata, C....

Ganoderma lucidum curtis Fr P Karst

Ganoderma lucidum, more commonly known by its Japanese name of reishi, is one of the most highly regarded botanicals of traditional Chinese herbalism. It possesses a broad range of beneficial actions on the cardiovascular, hepatic, and immune systems. Reishi mushroom is commonly found in immune supportive formulas for general health purposes and for those undergoing conventional therapies for cancer. The many different varieties and forms of Ganoderma may not be well differentiated on the market. Mycelium biomass is also used. This microscopic characterization was developed on the mature fruiting body of red Ganoderma lucidum.

Atractylodes macrocephala Koidz

Bai-zhu atractylodes is predominantly used in traditional Chinese herbalism specifically, as a tonifier for the digestive system to improve digestion and assimilation. There are various species and forms of atractylodes. Some can easily be distinguished microscopically from each other, but others cannot be. Complete microscopic differentiation of the species in the English language is lacking.

Drug discovery and design a historical outline

Since ancient times the peoples of the world have had a wide range of natural products that they use for medicinal purposes. These products, obtained from animal, vegetable and mineral sources, were sometimes very effective. However, many of the products were very toxic and it is interesting to note that the Greeks used the same word pharmakon for both poisons and medicinal products. Information about these ancient remedies was not readily available to users until the invention of the printing press in the fifteenth century. This led to the widespread publication and circulation of Herbals and Pharmacopoeias, which resulted in a rapid increase in the use, and misuse, of herbal and other remedies. Misuse of tartar emetic (antimony potassium tartrate) was the reason for its use being banned by the Paris parliament in 1566, probably the first recorded ban of its type. The usage of such remedies reached its height in the seventeenth century. However, improved communications between...

Common Side Effects Associated with Antipsychotic Induced Hyperprolactinaemia

Menstrual dysfunction associated with psychoses was recognised well before the introduction of antipsychotics 34 . These early observations supported the view that illness and possibly life style factors also played a role in menstrual abnormalities, separate from the effects of antipsychotics on low oestrogen via hypogonad-ism. The rates of amenorrhoea vary widely between studies, ranging from very low figures to as high 78 as reported by Smith et al. 22 , and averaging around the 30 level. This wide variation in rates may be a consequence of the definition of amenorrhoea. It has been defined as the temporary or permanent absence of menstruation for more than 6 months. Wong and Seeman 35 defined amenorrhoea as 3 consecutive missed periods. Hence, many pharmacological studies in schizophrenia designed for 12 weeks or less would miss clinical signs of adverse events of the menstrual cycle. Wong and Seeman 35 highlighted that 90 of the women linked normal menstruation with good health...

Anti Cancer Effect Of Tulasi Leaves In Lung Cancer

Tulsi (Ocimum sanctum) is the most revered of all sacred medicinal plants in India. In traditional medicine, it is cherished for its holistic healing properties to restore healthy living by warding off imbalances in the body and mind. In Indian herbal medicine, it is used as a remedy for bronchitis, gastric disorders, hepatic disorders, and skin diseases. Tulsi is also considered to be a diaphoretic, an antiperiodic, an anthelmintic, a cardiotonic, and an antipyretic as well as a blood purifier and an anti-inflammatory.166

Zingiber officinale Roscoe

Ginger is ubiquitously used in almost all systems of herbal medicine, including ayurvedic, Chinese, Western, and Hispanic folk traditions. There are many different cuts, shapes, and forms of ginger. However, the microscopic characteristics of ginger are the same regardless of cut, with one exception In some samples, the outer peel (periderm) may be present or absent (peeled).

About the American Herbal Pharmacopoeia

The American Herbal Pharmacopoeia (AHP) is very much a work for the common good. AHP was founded in 1995 as a nonprofit 501(c)(3) educational foundation dedicated to the advancement of knowledge and quality of medicinal herbal products and herbal dietary supplements. The purpose for doing this is to break down the many barriers and fears that prevent the complete integration of herbal medicines into our health care system and our lives. Humans and plants have coevolved for many millennia, and we believe that plant-based medicines are the most appropriate therapeutic agents for human use. Environmentally, plant-based medicines represent the only sustainable pharmacologically based form of medicine on the planet. The societal acceptance of herbal medicine can justify preservation of wild and natural habitats for medicinal plant production and generation of local economies, can provide an alternative to the chemical degradation and pollution that occur from the manufacture of...

Role of Intestinal Immune System in Modulating the Activity of Botanical Polysaccharides

It has been hypothesised that botanical polysaccharides can interact with both epithelial cells and immunocompetent cells in Peyer's patches, resulting in potentiation of distal mucosal and systemic immune systems 265 . In support of this idea, botanical polysaccharides have also been shown to modulate Peyer's patch cells in the intestinal immune system. For example, the crude polysaccharide fraction isolated from Hachimi-jio-gan, a Japanese and Chinese herbal medicine, was found to augment IgA production in Peyer's patch cells, whereas the low-molecular-weight fraction from this medicine was not active 266 . Likewise, oral administration of polysaccharide complexes isolated from the Japanese herbal medicine Juzen-Taiho-To induced activation of Peyer's patch T cells and secretion of haematopoietic growth factors 267, 268 . Similarly, Yu and co-workers 269 reported that high-molecular-weight polysaccharides from Atractylodes lancea contributed to the immunomodulating activity in...

Echinacea angustifolia Dc

Echinacea angustifolia is one of the three primary forms of Echinacea used in Western herbalism to stimulate immune function. Of the species, E. angustifolia is preferred by modern herbalists. It can be adulterated with the botanical Parthenium integrifolium (see separate entry for Parthenium) and other species of Echinacea.

Taraxacum officinale Weber ex F H Wigg

Dandelion leaf is used in Western herbalism for its effects as a diuretic. In this regard, some studies have shown it to be as effective as some conventional diuretics. Dandelion leaf and root, individually, and the combination of leaf and root are widely used and can be considered as separate or combination medicines. This characterization is of the leaf alone. Taraxacum officinale shows a considerable amount of intraspecies morphological variation due to the occurrence of numerous lines reproducing asexually (via apomixis). Such variation appears at the microscopic level as a wide range in the density of the leaf indumentum (trichome cover).

Phyllanthus emblica L

Amla fruit, also known as amalaki in Sanskrit and Indian gooseberry in English, is one of the most popularly used and widely consumed of all herbal foods and medicines in India. It is a component of the legendary ayurvedic herbal compound triphala, which is used by ayurvedic practitioners as a digestive aid, detoxifier, and longevity tonic. There are varying qualities of amla in international trade. The fruits should be picked directly from the tree, deseeded, and properly dried. Material on the market ranges from fruits with seeds that have fallen to the ground and are harvested after prolonged periods of time, resulting in degradation of the fruit, to relatively high-quality material with or without seeds. The characterization provided is of the entire fruit with seed.

Panax quinquefolius L

American ginseng has been a staple of North American herbalism for several hundred years. It was traditionally used by Native American tribes throughout the very broad growing range of the plant. Among the Cherokee, it was among the most highly regarded of medicinal plants. Economically, it has been an internationally traded commodity since the days of Daniel Boone. The majority of wild-harvested and cultivated American ginseng is exported to Asia, where it is as highly regarded as, and sometimes more highly regarded than, Asian Panax ginseng. There are three primary forms wild, grown in woods, and cultivated. Microscopically, the tissues of these forms are identical. For a comparison of the microscopy of American ginseng, tienchi ginseng (Panax pseudo ginseng), and Asian ginseng (P. ginseng), see the entry for Asian ginseng.

Scutellaria lateriflora L

Skullcap is one of the primary nerve tonics used in Western herbal medicine. A number of different species native to North America were used for various purposes by a large variety of tribes. In addition to its nervine properties, skullcap has also been used for colds, rabies, and as an antispasmodic. Different species of Scutellaria can be traded and sold as skullcap. A complete microscopic examination of these species is lacking. A different plant germander (Teucrium spp.), which is a potential hepato-toxin, is more readily found as an adulterant of skullcap. For a differentiation between Scutellaria lateriflora and Teucrium, see the table at the end of this section.

Petasites frigidus L Frigs

Arctic butterbur, more commonly known as petasites or Western coltsfoot, is primarily used in Western herbal medicine for the treatment of migraine headaches, allergies, and urinary incontinence. Petasites contains potentially toxic pyrollizidine alkaloids (PAs). Plants that contain PAs are prohibited from internal use in the European Union. Petasites is being cultivated to be low in or free of PAs. Petasites may also be mistakenly traded as American coltsfoot (Tussilago farfara). For the differentiation of these two species, see entry for Tussilago.

Family History

By this time Sol had regained good health. Indeed I remember him as big, strong, cigar smoking, whiskey drinking, and boisterous. Grandfather decided to return to the fur trade so he sold the farm and used the proceeds to move the entire family back to the city and back to producing fur garments. I recall their factory as a loft in Manhattan with racks of 4 x 8 ft sheets of wood on which dampened furs were nailed to stretch them. There were several sewing machines and lots of naked incandescent bulbs hanging from the ceiling. All unused surfaces were covered with a thick layer of adherent hairs from the furs being unbaled, stretched, trimmed, and sewed.

Subjects and Methods

Subjects were initially screened by written questionnaire and telephone interview by physicians. Potentially acceptable subjects were then screened in person. Subjects underwent complete history, full physical examination, laboratory testing, psychological testing, and interviews by several staff members. Selected subjects were in good health, were nonsmokers, used no medications or supplements, and did not use alcohol or illicit drugs.

The Economic Problem

Automatically generate an improvement in the health of the population. It is far too simplistic to argue that in order to improve the health of the nation and reduce inequalities, additional resources need to be channeled into healthcare services. The USA spends over 2.5 times the average health expenditure of the other 29 OECD countries (Organisation for Economic Cooperation and Development) and yet is one of the least healthy of these nations.21 The issue of whether health care and the availability of healthcare facilities are the most important determinants in securing good health for society has been

Outlook

AD is a complicated disease that is impending on our aging population increasingly exposed to a number of risk factors. Our improved understanding of the disease and its pathologies has generated a myriad of potential therapeutic approaches. Some of these are being investigated in clinical trials while others are being tested in preclinical studies. Both symptomatic and disease modifying approaches will be important in improving the overall well being of AD patients. It should be noted that symptomatic treatments for AD should not be limited to cognitive enhancement but should also include therapies for behavioral changes (e.g. agitation, hallucination, depression and delusion) that could be very difficult for families caring for these patients. Different disease modifying treatments with different mechanisms of action may be combined in controlling the progression of AD. Prevention is always better than cure. Reducing risk factors (e.g. hypercholesterolemia, hypertension, diabetes...

Chapter Overview

Around 1881 and continuing to 1900, microbiologist Paul Ehrlich, a disciple of Robert Koch, began work with a set of antibacterial dyes and antiparasitic organic arsenicals. His goal was to develop compounds that retained antimicrobial activity at the expense of toxicity to the human host he called the agents that he sought magic bullets. At the time that Ehrlich began his experiments, there were only a few compounds that could be used in treating infectious diseases, and none was very useful in the treatment of severe Gram-positive and Gram-negative infections. Ehrlich discovered that the dyes and arsenicals could stain target cells selectively and that the antimicrobial properties of the dyes paralleled the staining activity. This discovery was the first demonstration of selective toxicity, the property of certain chemicals to kill one type of organism while not harming another. Selective toxicity is the main tenet of modern antimicrobial chemotherapy, and Ehrlich's seminal...

Sample Softening

After an appropriate sample of plant material has been chosen for analysis, the first step in preparing the test material for microscopic analysis is to soften it for clearing, sectioning, and subsequent viewing. Both fresh and dried materials can be examined microscopically. Most often, in commercial trade and for regulatory purposes, dried materials are analyzed. There are a few practical reasons for this. First, most plant materials traded for use in herbal medicines and supplements are dry. There are a few exceptions in that many homeopathic mother tinctures and their subsequent homeopathic dilutions are prepared from fresh materials and some product manufacturers prefer using fresh material. The second reason is that fresh material is traded in its relatively whole form, thus making macroscopic evaluation the prominent testing methodology for identity determination, though microcopy can be applied as well.

Summary

The growing use of alternative medicines such as minerals, vitamins, and herbals in the world warrants a more comprehensive understanding of these agents by the medical community. It is important for the pain practitioner to recognize certain facts regarding these supplements. For example, there are about 1,300 g of calcium in a 70-kg adult and the mineral magnesium activates approximately 300 enzyme systems in the human body most of these systems involved in energy metabolism (Kaye and Grogono 2000). Aside from these, the pain practitioner must appreciate the effect of these supplements on such functions on a regular basis as well as during various operative procedures. As demonstrated in this chapter, the use of these compounds may prove beneficial for some patients, but result in alterations in normal physiologic functions in others, thus potentially resulting in deleterious consequences. Moreover, in our own survey, in patients undergoing operative surgery, including...

Images

Gotu kola is predominantly used in traditional ayurvedic herbal traditions to support the nervous system and to treat diseases of the skin and connective tissue (e.g., leprosy). It is also widely used in Western herbal medicine for a putative ability to enhance memory. Traditionally, flowering aerial parts with some fruit are included in gotu kola aerial parts, so fragments of reproductive parts may be found in commercial material. Gotu kola, most commonly known by the common Sanskrit name mandukaparni, also shares the common Sanskrit name of brahmi with Bacopa monnieri. Therefore, the two have the potential to be mixed up in trade. This is primarily due to regional nomenclature in that Indian communities in southern regions, as well as the ayurvedic pharmacopoeia, consider Bacopa as the true brahmi, while those in the northern regions consider Centella as the true brahmi. These can be clearly identified microscopically and care should be taken to distinguish between these two...

Conclusions

Despite many reported toxic effects and drug interactions resulting from the use of alternative medicines, they remain popular and most users consider them safe. Labeling of herbal products may not accurately reflect their content, and adverse events or interactions attributed to a specific herb may be due to misidentification of the plant or contamination of the plant with pharmaceuticals or heavy metals. The addition of pharmaceuticals to Chinese herbal products is a serious problem. Of 2069 samples of traditional Chinese medicines collected from eight hospitals in Taiwan, 23.7 contained pharmaceuticals, including caffeine, acetaminophen, indomethecin, hydrochlorothiazide and prednisolone.108,109 A fatal case of hepatic failure due to contamination of a herbal supplement with nitrosofen-fluramine has been reported. Analysis of the herbal supplement also revealed the presence of fenfluramine.110 Cole and Fetrow reported the presence of colchicine in gingko biloba and echinacea...

Definitions

The terminology used to describe the broad scope of practices that are considered complementary or alternative to mainstream medical practice is diverse and often confusing. Alternative medicine, complementary medicine, holistic medicine, integrative therapies, natural medicine and traditional medicine are all terms that have been used nearly synonymously to represent an approach to health that is different from the biomedical system that is so entrenched in the western industrialized world. Each of the adjectives, alternative, holistic, complementary integrative, etc., have slightly different connotations which define a relationship with mainstream medicine. The term alternative implies instead of'' or apart from'' conventional medicine, whereas complementary connotes in addition to'' as a way of completing an approach to healing. Integrative medicine suggests multiple approaches that are applied together or in concert'' with one another. Holistic is an older term which was used to...

Botanical Therapies

Botanical or herbal medicine is an important part of many broader systems of medicine, such as traditional Chinese medicine, Ayurvedic medicine, and other folk medicines. Of all the CAM practices, the use of botanicals is the oldest and most prevalent. Even allopathic pharmacological therapies can be considered as a highly evolved refinement of botanical medicine. Digitalis was originally isolated from the foxglove plant. Vinca alkaloids come from the Madagascar periwinkle (Catharathus roseus). Taxol is derived from the yew plant. Opioids are derived from the poppy. Many healthy individuals exploit plant products for their physiologic effects. For example, ginger and coffee are used worldwide as stimulants. In a strict sense, herbs are derived from soft-stemmed plants, but botanical therapies include an array of other products derived from fruits, berries, roots, bark, and other components of plants. The spectrum of herbal therapies'' often includes nonplant materials such as horn,...

Case

This case challenges the physician to analyze the pain problem comprehensively using a biopsychosocial model, and then to diplomatically steer the patient away from his misguided path toward a healthier approach that will more likely make a sustainable difference in his life. Although acupuncture can be helpful in the management of low back pain, offering one more passive modality in this case would reinforce this patient's passive maladaptation. Instead, a closely supervised exercise and educational program is needed. Classes in a movement-based therapy like tai chi chuan or yoga would have a self-actualizing effect. A heated pool would provide a tolerable transition toward activity. Frequent counseling and supervision would lead the patient away from self-defeating behaviors. One could negotiate with this patient by offering acupuncture if he would discontinue the other treatments, which have only provided brief symptom relief, and participate in the more comprehensive program...

Conclusion

Seaweeds have recently received a great deal of attention from scientific researchers. A number of investigators have found that these traditional sources of food not only provide nutritional benefits but also help to fight against diseases and contribute to the maintenance of good health. Certain types of seaweeds contain significant amounts of essential protein, vitamins, and minerals. Moreover, various polysaccharides from seaweeds have diverse biological activities, including effects on the immune system and cancer. Although C. fulvescens, a green alga, is consumed for its purported health-enhancing properties, particularly as a treatment for stomach disorders and hangovers, the health effects of dietary C. fulvescens remain unclear. There are also a few studies on the C. fulvescens.

Colorectal Cancer

Natural products have yielded numerous effective anticancer drugs. In particular, many studies over the past few decades have focused on the benefits of algae. Algae are mainly composed of carbohydrates, proteins, and other minor components. They are used as food especially in Asian culture. This traditional food source appears to maintain good health by providing nutritional benefits and thus helping to combat diseases. Further, many compound extracted from seaweeds exhibit diverse biological activities, including effects on colorectal cancer.

Turmeric

Turmeric (Curcuma longa) is a famous herb known in Ayurveda and Chinese medicine for thousands of years for its amazing healing properties. The fleshy underground rhizomes are the medicinally important part of this plant, since these contain curcuminoids, which are biologically active yellow pigments. Turmeric is a regular condiment in food items like curries in Indian and other Asian cuisine. The yellow powder made from the root has great spiritual significance in Hindu culture, and the dry roots are exchanged as a gesture of goodwill, particularly during marriage ceremonies.

Prostate Cancer

> The incidence of clinically significant prostate cancer is vastly different between North-Western Europe and South-East Asia. This difference can be partly ascribed to the aging of the population in industrialized countries and improved detection by PSA assays. A difference remains after adjustments for age and detection rate, and points to factors in the 'Western life-style' fostering prostate cancer. One candidate is a diet rich in saturated fat and relatively low in vitamins and micronutrients from fruit and vegetables.

Trifolium pratense L

The blossoms of red clover are commonly used in Western herbalism as a blood purifier, an action thought to promote endogenous eliminative processes. For the past 130 years, it has been a primary ingredient in various herbal compounds for the treatment of cancer. In more recent years, it has been studied and sold for its putative ability to relieve menopausal symptoms, presumably due to its content of phytoestrogens. Ideally, blossoms (with attached sepals) should be traded alone however, in commercial trade, the leaf and stem are often included.

Human skin

The surface, undergoing apoptosis en route. Apoptosis is the process by which cells undergo programmed cell death in order to maintain a healthy body. The outermost layers of the epidermis, the stratum corneum, consist of these dead cells laid down in a keratin matrix. This results in a strong structure with no gaps between the dead cells. It protects the body by preventing excess water loss and the entry of infectious organisms. However, both sweat glands and hair follicles penetrate the stratum corneum. The dermis underlying the epidermis consists of connective tissue in which are found various glands, hair roots and blood vessels. Beneath this lies a subcutaneous fatty layer.

Regulatory Status

The legal process of regulation and legislation of herbal medicines changes from country to countr (Table 1). The reason for this involves mainly cultural aspects and also the fact that herbal medicines are rarely studied scientifically. Thus, few herbal preparations have been tested for safety and efficacy. The WHO has published guidelines in order to define basic criteria for evaluating the quality, safety, and efficacy of herbal medicines aimed at assisting national regulatory authorities, scientific organizations, and manufacturers in this particular area. Furthermore, the WHO has prepared Pharmacopeia monographs on herbal medicines and the basis of guidelines for the assessment of herbal drugs.

Efficacy And Safety

Although clinical trials with herbal drugs are feasible, few well-controlled doubleblind (placebo-controlled) trials have been carried out with herbal medicines. Several factors might contribute to the explanation of such discrepancies, for example use of different dosages of herbal medicines wide variations in the duration of treatments using herbal medicines

Synopsis

In conclusion, an adequate nutritional supply of vitamin E seems of crucial importance throughout life to guarantee normal function of physiologic processes in the body as well as adequate defense against oxidants generated by endogenous sources or from exposure to environmental stress. In particular, vitamin E plays a unique role in the prevention of chronic and degenerative diseases, and thus in healthy aging. A well-balanced diet rich in vitamin E as part of a healthy lifestyle seems a basic requirement for human health. Moreover, intake of supplementary vitamin E may be advisable for individuals who are unable to sustain adequate levels, or who are at high risk for, or are already suffering from chronic and degenerative diseases.

Article On Amalpitta

Abt AB, Oh JY, Huntington RA, Burkhart KK. Chinese herbal medicine induced acute renal failure. Arch Intern Med 1995 155 211-212. Akerele O. Summary of WHO guidelines for the assessment of herbal medicines. HerbalGram 1993 28 13-19. Bagheri H, Broue P, Lacroix I, et al. Fulminant hepatic failure after herbal medicine ingestion in children. Terapie 1998 53 77-83. Bedi KL, Zutshi U, Chopra CL, Amla V. Picrorhiza kurroa, an Ayurvedic herb, may potentiate photochemotherapy in vitiligo. J Ethnopharmacol 1989 27 347-352. Bensky D, Gamble A. Chinese Herbal Medicine Materia Medica (revised edition). Seattle Eastland Press Inc., 1993. Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Treatment of irritable bowel syndrome with Chinese herbal medicine a randomized controlled trial. JAMA 1998 280 1585-1589. Blumenthal M, Brusse WR, Goldberg A, et al. The Complete German Commission E Monographs. Therapeutic Guide to Herbal Medicines. Austin, TX, USA The American Botanical Council, 1998....

About the Editors

Gupta is a professor of psychology at Banaras Hindu University, Vara-nasi, India. He received his M.A. and Ph.D. degrees from the Department of Psychology at Panjab University, Chandigarh, India. Before coming to Banaras Hindu University, he taught at Meerut University in Meerut and Guru Nanak Dev University in Amritsar, India. He has published numerous research articles and book chapters on behavioral effects of drugs and Ayurvedic herbs, drug abuse, verbal conditioning, personality, perceptual judgment, cognition and environment, talent search and development, and adjustment and coping. He has served as consulting editor on a number of journals, including the International Journal of Psychology. He is now coeditor of Pharmacopsycho-ecologia and is president of the Pharmacopsychoecological Association. He is a member of the Advisory Council of the International Biographical Centre, Cambridge, as well as the Research Board of Advisors of the American Biographical Institute, North...

Tussilago farfara L

Coltsfoot has been commonly used in Western herbal medicine for upper respiratory congestion. There is a potential for it to be mixed with Western coltsfoot, Petasites spp. Both species contain pyrollizidine alkaloids (PAs). The two species can be differentiated microscopically.

Aspirin

Aspirin and other NSAIDs are all effective to some extent, though analgesics without antiprostaglandin activities, such as acetaminophen, are ineffective. As might be anticipated, activity of NSAIDs seems to be related to the dose, frequency, and duration of administration. However, there have been suggestions that aspirin, particularly in high doses, may incite rectal bleeding earlier due to its antiplatelet effects. However, Ahnen found no evidence for this in his review of the literature in 1998,36 and he concluded that there were no confounding variables such as positive fecal occult blood tests (FOBs) or healthier lifestyles in the aspirin studies.

Prevalence

In the United States, the high rates of CAM use crosses socioeconomic, racial, and geographic boundaries but those who used CAM in 2002 were more likely to be white, female, college-educated, with age less than 65, living in the western US, with a higher annual household income.12 The types of therapies that patients use will depend on many factors besides patient preference, such as availability and cost. As reported in a 2002 survey by Tindle et al.,12 the most common therapies were herbal medicine (18.6 percent) and relaxation techniques (14.2 percent), chiropractic care (7.4 percent), and yoga (5 percent), while acupuncture was used by 1 percent of the population. The number of visits to a CAM practitioner varies depending on the nature of the therapy. Thus, chiropractic, acupuncture, and massage therapy will require more visits to a practitioner in a given time period than herbal medicine or homeopathy.

Opioids

Impulsivity is a characteristic of normal everyday behavior, but excessive impulsiv-ity may take on a pathological nature that is exhibited in a diversity of psychiatric disorders including aggression, attention deficit hyperactivity disorder (ADHD), drug abuse, and eating disorders (Hollander and Rosen 2000 Moeller et al. 2001). Impulsivity is not a unitary construct and encompasses a variety of different types of behavior, which may well be independent of each other (Evenden 1999). Two forms of impulsivity have been especially well studied in animal models. Impulsive action, which refers to the tendency to make premature responses in anticipation of an expected event, reflects a loss of inhibitory control over behavior. Impulsive choice is a description of the situation in which individuals prefer a small reward that is available immediately to a larger reward that is available after a delay. Operationally, this is studied in animals tests by allowing subjects to choose between one...