RF_DR.A_10_A_SUDHA.pdf
Media
- extracted text
-
1 111111LUIICO.
RF_DR.A_10_A_SUDHA
US s ranglehold over Neem t
and iurmenc continues
Govt yet to counter foreign onslaught
on Indian natural curatives.
By Naved Zahir
Have Turmeric and Neem real
ly been freed from the clutches of
the US and European companies?
The answer is affirmative, though
partly.
W’ ’'e the Patent rights of
Neu
was acquired by a US
based company, W R Grace and
the United States Department of
Agriculture (USDA), it was can
celled after a protracted legal bat
tle on May 10 this year. Similarly
Turmeric was released from the
bonds of Patent Bill in 1997.
But this is not the end of the
story. Though the Patent rights of
the two prime natural curatives
found in India have been
quashed, they are yet to be com
pletely free.
The truth is that hundreds and
thousands of Patents have been
acquired and simultaneously reg-
1* .
istered for Neem and Turmeric
according to their quality. All the
registered patents are 'Procedure
Patents.’
panics by the Research Foundation for Science Technology and
Ecology, an NGO, which fought
a solo battle on the neem patent
issue. Till date, other than raising
a hullabaloo over the issue, the
BIOTECH
Union Government is yet to come
It took a long time to break the up with a strategy to contest the
stranglehold of the foreigni com- remaining Patent rights of both
Neem and Turmeric or other nat
ural herbs that have been
acquired by foreign companies
under the Patent Bill.
Speaking to Explocity, officials
of the Research Foundation said
it is a herculean task to get the
rest of the patents on neem cancelled due to the apathy of the
government.
Foundation officials said that
United States, Europe and Japan
have acquired more than 100
patents on Neem so far. Few of
the toughest nuts to crack are the
patents
numbering
WO
9902533A1 and EP 874550A1.
Interestingly, the Council for Sci-
Jl<"£
entific and Industrial Research
(CSIR) has also acquired a patent
on Neem in US bearing number
5602261. "Till recently there
were only 67 patents registered
for Turmeric but now it has shot
up to more than a hundred,"
Foundation officials claimed.
"And it is very unfortunate that
till date,, we Indians, have be< *
able to shoot down only two
patent rights, while a hundred
each for all the goodies still
remains," they said.
While the patent on Neem was
cancelled following representa
tions from a non-government
organisation, the patent on
Turmeric was brought down due
to the efforts pf the CSIR.
Considering the fact that large
numbers of patents are ’Procedure Patents’, ample preparations
are needed to get them cancelled.
It may be noted here that the
US company, W R Grace has
claimed in its patent that the shelf
life of the juice extracted from
the leaves of the Neem can be
increased to more than a year,
(Otherwise, the life of the juice is
to a maximum of five to six
hours.) Sources in the CSIR
reveal that it is "practically
impossible" to get this kind of a
patent cancelled.
With more and more foreign
companies getting in, exploita
tion of natural wealth of India
seems imminent even as the
Union government continues to
look the other way.
r
1
j a postgraduate in Linguistics, a
| stroke of luck took her to the Corj don Bleu School in France for a
course in Continental cuisine.
Bangalore knows her as chef
extraordinaire, running the wellknown Florentine Catering service. She also does interior designing for Rocklines, acts as a food
consultant for 5 star hotels, leach
es Continental, Mexican, French
to■
ART
There appears a white knight to
see us through KEB power cuts.
Bahmani convinced me other
wise.
For example, to make a dahlia,
the hot wax is poured onto a slab
and each petal is shaped and cut
by hand. The petal is then stuck
onto a base with hot wax. Defi
nitely not for the delicate fin- c
gered. With no formal training in 1
candle making, Bahmani works .
with constant experimentation
and observation. Right now she is
Arresting Jamini Roy
paintings at Sakshi
■<
'
I
By our art correspondent
Sakshi Gallery has put together
- the works of J am ini Roy from
private collections ( for viewing
only) and a few pen and ink
sketches that are for sale.
Jamini Roy was born in Bengal
in 1887 and belonged to the Calcutia School of art. He spent most
of his life living and working in
Calcutta and died in 1972. But
his art lives on in the homes of art
collectors and the memories of
art enthusiasts.
His early works on display
reflect the influence of the
impressionists, Cezanne and
t
Monet. But he soon created his
own style drawing inspiration
from the sanlhal folk dance, trib
al art and his own traditional surroundings. Red, ochre, vermilion,
grey, blue and white were the
predominant colours used. The
most striking aspect of Roy's
paintings are line and definition
and bold figures, that capture the
simplicity of Indian rustic life,
The response to the exhibition
has been excellent and has
drawn newer patrons of art to
Sakshi.
The 'exhibition in on till Jun 4.
....
FT?
AID KIT
HERBAL FIRST
MEDICINES AND THEIR USAGES
No.
Mama of medicines
Indication•
Palkayam (Asafectida) .Stemache
Dosage♦
Methord of Administration»
S m.g.
Grind and mixed with hot water and drxnK*
a drope
Apply in the hole of the tooth in a cotton.
for Worm
Infection.
Euchalyptus Oil.
2
3.
JathiKKa (Nutmeg) •
Tooth ache
and head ache.
For head ache apply i*. jan the forehead.
Vomiting,
5 m.g.
Grind and mix with hot water and drinK
a pinch
Apply to the wond and bandage. For stomach pain
Diarrha.
4<
5.
Turmeric powder»
Lemongrass oil+
Cuts&Wonds,
Stomach paxn.
eat mix with honey.
Indigestion, 4 pepper
Eat 4 pepper kept early in the lemon grass oil.
gas trouble,
stomach pain.
6.
Ay amodakas a th
Stomach trouble. 5. m.g.
Mix with hot water and drink.
(Ajxvam essance)
7.
Ve luthulli, E latexai.
Stomach trouble.2 pice.
Chew it and drinK the Juice.
8.
Marmanx Thai lam.
Burning,cuts, few drops,
Massage tne affected part after applying the oil
banges,disloc
ation, joint
pains etc.
y.
VayuguliKa.
(Ayurvxdic pills)
Vomiting sen- 3 pxlls.
Chew xt and swallow.
sation, gas
c
trouble.
10.
Vxlluadx gulxxa.
(Ayurvxdxc pills)
/i
Poisoness
case.
15
1 gulika.
Grind and drink, apply a little on the injury
p~
/?
(bite or cut)
v
11/25/03
'I
' io-
Prior, t fif t
Main identity
From:
T/%1 w.
sent:
Attach:
Subject:
“bala" <ba!a(a)haiaD.ora
<s!aas@itmin.com>
Tuesday, November 25, 2003 12:25 PM
cover page.doc, intellectual! Property Rights and Herbal Medicines.doc I + 3^ P r*
Intellectual Property Rights and Herbal Medicines.SLAAS Annual Sessions. Dec 2003
X—x
I
ATTN . Ms. Manel - Administrative Officer.
Genera! Secretaries
Dear Madam.
i have pleasure in attaching my presentation for the seminar.
’ sha!! appreciate if you can let me know whether you have received all 24 pages clearly.
Thanks and Regards,
U/i . iv. uoiaouk>i ai i iai hoi h
Dr K Baiasubramaniam
Advisor and Co-ordinator
Health Action International Asia - Pacific
5, Level 2, Frankfurt Place
Colombo 4
Tei: +(94 11)2554353
Far + (94 11) 2554570
E-mail: bala@haiap.org
I
1
1
Page 2 of 2
Page 1 of3
> Sarojini
p|2-71 - IO.
CMC
From:
To:
Cc:
Sent:
Subject:
"IndianSocietyFor SustainableAgriculture" <indiansocietyag@yahoo.co.in >
<nodice@.globalnet.co.uk>: <s.prasad@cgiar.org >: <s_kavula@yahoo.com >;
<anthra@hd2.dot.net.in>; <sakshi_ap@satyam.net.in>; <sambavna@sancharnet.in>;
<sandeepc@.actionaidindia.org>: <sandhya@.bom3.vsnl.net.in>;
<sandhyas@actionaidindia.org>: <Sara.Cottingham@vso.org.uk>; <Sarah.Hall@vso.org.uk>:
<satyavalleti@yahoo.com >: <secretariat@phmovement.org>: <sgkabra@sanchamet.in>:
<shashi@tehelka.com>: <sheelu1@vsnl.com >: <shivasundar35@rediffmail.com>;
<shu@.bbc.co.uk>; <sidur@tatanova.com>: <samata@satyam.net.in>;
<smitashu@vsnl.com>: <smitu@usa.net>: <sochara@.vsni.com>: <speql@rediffmail.com>
<sputnik_k@hotmail.com >: <spwd_hyd@satyam.net.in>: <sreedhara@vsnl.net >:
<srinivask99@yahoo.com>: <stephane.parmentier@mdmoxfam.be>:
<goDaraiusudha@yahoo.com>: <sumitra_m_gautama@surfeu.fi>:
<sunanda_vik@.yahoo.com>: <surrender@eth.net >; <kavitha_kuruganti@yahoo.com>;
<tukarams@uclink.berkeley.edu>
Tuesdav. Seotember 28. 2004 4:24 PM
ORGANIC FARMING & HERBAL MEDICINES
Here Are TWO News Items
L UK Firms To Sell Herbal Medicines (from Incas) Tn India
2 Rice-Wheat Consortium/CTMMYT Calls For ORGANIC FARMING
T nndon Firm Set To Market Herbal Products Tn India
http://www.financialexprcss com/fc full story,php?content id=69^2 5
ASHOK B SHARMA & INDU BHAN
Posted online- Monday, September 27, 2004 at 0000 hours 1ST
Q>
NEW DELHI, SEPT 26: Medicines and cosmetics prepared from the herbs grown in the land of
ancient Inca civilisation arc soon to be made available to India consumers through a new British
company set up a naturopath of Indian origin
The new I zOndon-based company, The Natural Health GB_Ltd, set up by Dr Sashi Mohan
Sharma is set to market a range of its branded herbal products in India. Mr Rakesh Arora has been
appointed as marketing director for South Asia.
“The product, Vigamax, an innovative blend of herbs and vitamins, is a natural, nutritional food
supplement for increasing vigour, energy, vitality and stamina levels,” said Dr Sharma.
Vigamx contains ingredients of the root powder of the Peruvian herb, akka Maca (I xpidium
Mcycnii Walp), Guarana and vitamins C and E of natural origin.
“Our products contain ingredients from natural and vegetarian sources and has no side effects
The company adopts transparent policy for marketing and distribution,” asserted Dr Sharma.
He said that Maca was used by Peruvian natives over 3000 years. This resilient plant is grown
approximately 4000 meters above sea level, in an extreme and diverse climate.
The hardiness of the Inca people who lived in severe cold at high altitudes is due to the
consumption of this ‘miracle’ plant. The Inca warriors used to cat Maca before preparing for the
9/30/04
9/30/04
Page 2 of 3
battle
The other ingredient of Vigamax is Guarana. well known for its qualities to combat fatigue and
reduce susncctibility to weather conditions. Guarana helps to alleviate diarrhoea and reduce the
incidence of urinary’ tract infections.
Dr Sharma said that Vigamax was analysed by a public analyst in Germany and in UK, both of
which have given certification of analysis and safety’. “We will also be suggesting to hospitals to
study’ the effects of our food supplements on patients,” he said.
Other products in the range include Slim-n-Shapc capsules made out of green tea extracts, TNH
Shampoo, TNH Hair Growth Shampoo, TNH Hair Tonic, TNH Skin, Nail and Hair capsules,
TNH Hair Oil, TNH Smile-n-Shinc and TNH Face & Skin Beauty Cream.
The next product in the pipeline is Minchol, a vegetarian capsule for controlling and maintaining
cholesterol levels, said Dr Sharma
He said that all the products of the company arc manufactured in France or Germany, following
strict environmental and health safety standards. As these products arc categorised as food
supplements and arc drug-free, no approval of either the drugs controller or FD A is necessary’.
The company’s director for international marketing, Paul F Brown said that the products arc
marketed to Sweden, Denmark, Holland and Austria from Germany. It is sold in retail stores in
UK, I ns Angeles, New York and Kanasas. “We arc considering India as a gateway to South East
Asia, Australia and South Africa,” he said
Mr Brown said that the UK Trade and Investment body’ under its scheme 'Passport to Export’ has
supported the exports of these products through matching funding, export advises, training and
subsidising the vist to the
first market
Back To Basics, Exhorts Rice-Wheat Consortium Seminar
http://www.financia1cxprcss.com/fc_fii11_story.nhp7contcntjd=69824
ASHOK B SHARMA
Posted online : Monday, September 27, 2004 at 0000 hours 1ST
NEW DELHI, Sept 25 : 'Go Back to the Basics’ by inching towards organic farming and
conservation of water was the message the participants carried after the conclusion of regional
seminar of the Rice-Wheat Consortium in Delhi, last week.
The week-long seminar orgainised jointly’ by the Mexico-based global research body on wheat and
maize, CTMMYT and the Rice-Wheat Consortium had a component for visits to 59 farm sitics
across the country About 40 participants including farmers, manufacturers of agri implements and
scientists from Bangaladcsh, Nepal and Pakistan participated in the seminar.
The Pakistan delegation included the parliamentarian, Dr Rozina Tulfail of the Muslim T eague
The foreign delegates by and large expressed that they have learnt a lot about the practice of zero
tillage and conservation of water. Some suggested that India can also try some farm practices in
vogue in their country’
9/30/04
Page 3 of 3
Md Akhtcr Hossain Khan, principal scientific officer in Bangladesh Rice Research Institute
(BRRT) was pleased to sec the use of power tillers on small farm lands in India and said that the
power tillers arc mosted suited for Bangladesh were landholdings arc small. He said that there is a
need to reduce production costs through innovative technologies like conservation of w’atcr and
minimum tillage of soil The chief executive officer of the Dhaka-based Janata Auto Engineering,
Mohammad Kader Nawaz said that he found Indian industry’ was open for discussions w’hcn he
visited the manufacturing sites He said that bed planters and seeders are manufactured in
Bangladesh. There is need to manufacture suitable power tillers.
Dr Altaf Hussain, director of the Agriculture Research Institute in Sariah in Quetta in Baluchistan
appreciated the the system of paddy transplanting through raised beds in India He said that the
practice of rice transplantation through raised beds involves conservation of the scarce rcsoursc,
water Haji Abdul Rasool Khosa said that in Baluchistan province of Pakistan paddy is cultivated in
only two out of 26 districts The rice area is fed by water from a canal of Sakkur barrage. Due to
scarcity’ of water farmers in the region arc thinking of switching over to cotton. He said that he
appreciated very’ much the practice of roof water conservation in Almorah district in Uttaranchal
which can be replicated in Baluchistan and used in cultivation of paddy and horticulture crops.
Dr Nazir Ahmed, director, Rice Research Institute, Dckari, Sindh said that farmers in Jacobabad
district can adopt zero tillage practice in cultivation of paddy’ Dr Anjum Ali, director, Agriculture
Institute for Adpativc Research said that in Punjab province of Pakistan there is problems of soil
degradation due to excessive use of chemical fertilisers and pesticides and depiction of ground
water table. Also land holdings have become fragmented. Hence indegenous technology’ suited for
small landholdings should be adopted coupled with measures like zero tillage and water
conservation
Dr Raghawcndra Mishra, regional director, Agriculture Research Centre, Bara in Nepal said that
the farm practices in Almorah district in Uttaranchal is best suited for a hilly country’ like Nepal
Yahoo! India Matrimony: Find your life partner online.
9/30/04
Intellectual Property Rights and Herbal Medicines.
Dr. K. Balasubramaniam
Advisor and Co-ordinator
Health Action International Asia Pacific
Level 2, #5 Frankfurt Place
Colombo 04, Sri Lanka.
Tel: ++(941) 2554353
Fax: ++(941) 2554570
E-mail: bala@haiap.org
Sri Lanka Association for the Advancement of Science
Annual Scientific Sessions, December 2003.
Theme Seminar “Herbal Medicines for the People
Sri Lanka Foundation Institute
Itf1' December 2003.
Contents
Executive Summary
A. Introduction
B The TRIPS Agreement, patent laws and herbal medicines
C.
D.
Biopiracy: The misappropriation of traditional knowledge
Conservation of biodiversity, genetic resources and medicinal plants
E. Who is coming to pirate your plants?
Pharmacogenetics of Bethesda
Maxus Petroleum of Dallas
Knowledge Recovery Foundation International of New 'i 01 k
Floating Bio-Pirates
F.
Conservation of genetic resources and biodiversity: International
Initiatives.
The Chiang Mai Declaration
Convention on International Trade of Endangered Species (
First World Congress on Medicinal and Aromatic Plants lor Human
Welfare
The Convention on Biological Diversity (CBD)
The Arusha Declaration 1990
African Ministerial Conference on the Environment
Declaration of Belem, Brazil-July 1988
The 7th Asian Symposium on Medicinal Plants , Spices and othei
Natural Products (ASOMPS) 1992, Philippines
Intergovernmental Committee on Intellectual Property and Genetic
Resources, Traditional Knowledge and Folklore (The WIPO
Committee)
G. Conclusions and Recommendations.
Bibliography
Annex 1 : A sui generis regime on traditional medicines : Thailand
Annex 2 : Conflicting views.
1
Executive Summary
An imeUectnal property ts a creation of the tnintL Wswtll
aXtefor^eTe'paTenS'V^^
importing, distributing or offering for sale the patented product.
For an invention to be patentable it has to meet the following criteria.
•
•
•
Novelty or
Inventiveness / Inventive step
Industrial Applicability
New pharmaceutical products introduced by research based pharmaceutical
companies are good
good examples
examples of
of inventions
inventions for which patent rights are given
limited periods of time.
Let us pose the question “Can herbal medicines be patented.
Herbal medicines have been used for centuries. Knowledge about their preparation is
well known and documented. The lack of novelty of the product and the process o
manufacturing will, therefore prevent patent protection for well known hetbal
medicines.
There are other important practical hurdles related to the process of acquiring a
patent.
. A patent application should be written in scientific legal language. This will
require obtaining the services of a patent lawyer. This in combination with
high costs of filing a patent, may make patents for herbal medicines
prohibitively expensive for owners of herbal medicines.
•
Another practical problem facing prospective patent holders of herbal
medicines is related to the protection of their patents against infringement, in
the first place a patent owner may not be aware of infringements; even if they
are, legal action to defend the patent in court is usually very expensive and
may be well beyond their means. And if a case would go to courts, an
infringing company with more financial resources and bettei access to
eminent patent lawyers may well succeed in convincing the court that its
product, or process or use are sufficiently different from the original
to constitute an invention of its own or at least not to constitute an
infringement.
•
And last but not least, patent protection of herbal medicines under the I RIPS
Agreement will lead to an increase of their costs and restriction on their use or
2
diffusion. This will reduce access to the poor who are most dependent on
herbal medicine.
The ongoing nahonal and international debates and discussions on
property rights and herbal medicines are, therefore not to explore posstb,hires lor
providing patent protection to herbal medicines but to
1. Conserve medicinal plants, genetic resources and biodiveisities, and
2. Prevent misappropriation of traditional knowledge (TI ) oi no pnacy.
Sections C D and E of this paper deal with misappropriation of TK or biopiracy and
conservation of medicinal plants, genetic resources and biodivers.ty. It needs to b
emphasized that traditional knowledge has played and still plays an important icle
vital areas such as food sovereignty, the development of agriciiltuie and medicim
treatment. However, this paper will focus only on herbal medicines.
Bio-piracy has been defined as the process by which the rights of indigenous cultures
and communities to their knowledge and genetic resources are “erased and ieplaced
for those who have exploited indigenous knowledge and biodiversity .
The paper lists examples of a number of patents that have been granted on genetic
resources and traditional knowledge obtained from developing countnes without the
consent of the possessors of the resources and knowledge. Ihese include the high
profile” cases of neem & basmati rice. Many of these patents have been revoked by
the competent national authorities. The sources of references are provided lor those
interested in more details.
The lack of novelty is a factor that will prevent patent protection for well known
herbal medicines such as the neem. How was it possible lor the US to giant these
patents? The reason is a notorious problem relating to the standards ol novelty in the
US. Under the US Law, novelty is destroyed if an invention has been disclosed:
1. Through publication or
2. Through use in the US
Use outside the US does not destroy novelty. This is why patents have been granted
in the US for traditional knowledge and genetic material used in developing countries
for centuries.
The neem patent was revoked after the Indian Council of Scientific and Industrial
Research was able to provide relevant scientific literature including an ancient
Sanskrit text and a paper published in 1953 in the journal of the Indian Medical
Association.
The justification for granting these patents in the US is as follows:
'■‘Informal systems of knowledge often depend upon face-to-lace communication,
thereby limiting access to the information only to persons in direct contact with one
another. The public at large does not benefit from the knowledge nor can the
knowledge be built upon. In addition, if information is not written down, that
3
inaccessible to patent examiners everywhere as prior art
information is completely inaccessible io p
bl therefore for a patent to
&
“ b-y -
re-
examination.
TRIPS requires countries to allow patenting of micro-organism and micro biolog
process'2 T' e^two factors together with the loose mterpretat.on of “inventiveness
national patent offices allow bio-piracy - patenting of genetic resources and
appropriation of developing country biological assets by research based companies in
developed countries. It has been estimated that if a two percent royalty were levied on
geneSresources, the North would owe the South more than US 5 b.llion m royalt.es
for medicinal plants alone.
Uncontrolled and unregulated commercial collection, harvesting and processing of
medicinal plants have led to the near extinction of some very valuable medicinal
plants.
Section E lists four institutions that are known to engage in biopiracy.
sustainable
Section F describes nine international initiatives for promoting
resources
and
consumption and conservation of medicinal plants, genetic
biodoiversity.
The final section gives conclusions and some recommendations.
The objectives of protecting TK include the following:
•
•
•
•
•
Conservation of medicinal plants, genetic resources and biodiversities,
Prevent misappropriation of TK (bio-piracy);
Preservation of traditional practices and cultures,
Promotion of TK and its importance in R&D of traditional medicines, and
Fair and equitable distribution of the benefits derived from technologies and
innovations based on TK.
At present there is no consensus on what would be the most appropriate way of
protecting TK to achieve the above objectives. TK can be protected within and
outside the IPR’s system. IPR’s are seen as one possible mean to protect TK. There
4
are strong supporters and severe enttes of
gives the eontf,eting views.
are or could be protected by Ute ewttng ^^y^ ^
'’Xn.,/..1 of TK Ural
-pests of
'TTnd onnclpl s namely the essent.al ineompat.bility between concepts ol
□cm X i the pr’acoces and cultures oflocal and indigenous oonrntuntttes.
in view of the lack of consensus, it may be premature to inmare dtscussu.ns rewards
development ^^°^2"riorityftl>ul7beWSe development of global
ofTK^d use these
these as
bidclines to
to deve.op
as Bguidelines
develop
national laws to prevent biopiracy.
The following are some of the activities proposed for protection of TK. genetic
resources and medicinal plants.
. Promote the development, at the national level, of an holistic approach toward
the protection ofTK, Genetic resources and biodiversity;
. Develop workable models for the preservation and promotion ol the use ol
.
include as appropriate, legal mechanisms for the protection of TK against
misappropriation;
• Collect and analyze existing national customary laws and practices relating to
protection of TK.
.
• Work towards co-ordinating the various activities ol all the international
initiatives listed in section F.
• Consider the protection of TK iin the context of the recognition and
implementation of human rights.
-----3 of
role--of TK in fostering national innovation, researcher
• Improve awareness
c.the
-------and development of Traditional Medicine.
• Propose amendments to the TRIPS Agreement requiring patent applicants to.
i. disclose the origin of the resources or knowledge they are using.
ii Obtain prior informed consent of the original knowledge holdeis and shaic
benefits with them.
• Provide a specific and tight definition of “inventiveness” and novelty in national
patent laws. This will exclude applications where the subject matter is not a
real invention, or where the knowledge is already in the public domain.
. At the national level, a country should develop guidelines for the
implementation of article 8 (j) of CBD. This article is reproduced below.
“Subject to its national legislation, respect, preserve and maintain knowledge,
innovations and practices of indigenous and local communities embodying
traditional lifestyles relevant for the conservation and sustainable use ol
biological diversity and promote their wider application with the approval and
involvement of the holders of such knowledge, innovations and practices and
encourage the equitable sharing of the benefits arising from the utilization of
such knowledge, innovations and practices”
5
Intellectual Property Rights and Herbal Medicines,
A. Introduction
HaW seines
.radii—
provision of healthcare in Sri
an
sovereignty and
XXel" The i™ —a
X
number of 'high profile’ cases of ™saPP^^
the u ncy of
associated knowledge Have
Xledg . M Zn.s.ns „«d Io be
consent of their holders, and ways have to be foun > ens
rty
Xhtfg^Xtr “vZTr ayiiamrt”od of time. It gives the owner exclusive
rights°to make, import, distribute and sell the patented product.
For an invention to be patentable it has to meet the following criteria.
i.
ii.
iii.
Novelty;
Inventiveness; and
Industrial Applicability
In addition most patent laws require that the inventor (s) should be identified.
New pharmaceutical products introduced by research based drug companies are good
examples of inventions. But herbal medicines have been used loi centuries,
knowledge about their preparation is well known^ and documented. C an l tey
patented? The turmeric patent illustrates this clearly .
In March 1995, a United States patent on “Use of Turmeric in Wound Healing was
granted to the University of Mississippi Medical Center. 1 he claim covered a
method of promoting healing of a wound by administering turmeric to a patient
afflicted with the wound”. However, in India, the wound-healing propeities ol
turmeric powder are well-known, and have been applied to the scrapes and cuts ol
generations of children.
In 1996 the Council of Scientific and Industrial Research of India (C SIR) requested
that the’patent for turmeric be revoked, on the basis that turmeric powder is widely
known and used in India for its wound healing properties, and that a great deal ol
research has been carried out by Indian Scientists that confirms the existence ol these
'TRIPS CBD and Traditional Medicines concepts and questions.
n ir
Report of ASEAN Workshop on the TRIPS Agreement and Traditional Medicines. Jakarta 13-15
February 2001
National Agency for Drugs and Food Control, Indonesia, WHO
6
properties. Eventually, the patent was revoked on the basis of lack of novelty. CS1R
succeeded in challenging the patent, because it was able to provide relevant scientific
literature, including an ancient Sanskrit text and a paper published in 1953 in the
Journal of the Indian Medical Association. In view of the criteria for patentability, we
need to answer the following questions,
How can Intellectual Property Rights (IPRs) be used to protect herbal medicines and
traditional knowledge?
Can exclusive rights over herbal medicines and traditional knowledge be sought
under the TRIPS Agreement?
B. The TRIPS Agreement, Patent Laws and herbal medicines.
TRIPS is the acronym for Trade - Related Intellectual Property Rights, an
international trade agreement. Sri Lanka is a signatory to this agreement. An
intellectual property is a creation of the mind. This will include, among others, artistic
and literary works, inventions and trade marks. For protecting herbal medicines and
TK we need to focus on inventions. An invention is a product or a process which is
new, useful and capable of manufacture. A patent is an intellectual property right
(I PR) given for an invention by a government for a limited period of time.
The lack of novelty is a factor that will prevent patent protection for well known
herbal medicines; while this is true in all countries, a notorious problem relates to the
standards of novelty in the US. Under the US Law, novelty is destroyed if an
invention has been disclosed.
(1) Through publications, or
(2) Through use in US.
Use outside the US does not destroy novelty; this is why patents have been
granted in the US for traditional knowledge and genetic material used for
centuries in developing countries.2
There are other important practical hurdles related to the process of acquiring a patent
for herbal medicines in order to provide protection. A patent application should be
written in scientific legal language. This will require obtaining the services of a patent
lawyer. This, in combination with the high costs of filing for a patent, may make
patents for herbal medicines prohibitively expensive.
Another problem facing prospective patent holders of herbal medicines is related to
the protection of their patents against infringement. A patent holder may not be aware
of infringements; even if they are, legal action to defend the patent in court is usually
very expensive and may well be beyond their means. And if a case would go to court,
an infringing company, with more financial resources and a better access to eminent
patent lawyers may well succeed in convincing the court that it’s product or process
2 TRIPS , CBD and Traditional Medicines. Concepts and questions opcit
7
or use, are sufficiently different from the original to constitute an invention of it’s
own or at least not to constitute an infringement.
And last but not least, patent protection of herbal medicines under the TRIPS
Agreement will lead to an increase of their costs and restriction on their use and
diffusion. This will reduce access to the poor who are most dependent on herbal
medicines.
The ongoing national and international debates and discussions on I PR and
herbal medicines and TK are therefore, not to explore possibilities providing
patent protection to herbal medicines but to
Prevent biopiracy; and
ii.
Conserve genetic resources, medicinal plants and
iii.
biodiversity.
C. Biopiracy: the misappropriation of traditional knowledge
Bio-piracy has been defined as the process through which the rights of
indigenous communities and cultures to their genetic resources and knowledge
are “erased and replaced for those who have exploited indigenous knowledge
and biodiversity” 3
In fact, a large number of patents have been granted on genetic resources and
traditional knowledge obtained from developing countries without the consent of the
possessors of the resources and knowledge. There has been extensive documentation
of IPR being sought over resources “as they are”, without further improvement (e.g.,
US patent No. 5,304,718 on quinoa granted to researchers of the Colorado State
University; US Plant patent No. 5,751 on ayahuasca, a sacred and medicinal plant of
the Amazonia) and on products based on plant materials and knowledge developed
and used by local/indigenous communities, such as the cases of the neem tree, kava,
barbasco, endod and turmeric, among others.4
Many of these patents have been revoked by the competent national authorities. The
revocation of the patent on turmeric has been referred to earlier. In early 2000 the
patent granted to WR Grace Company and US Department of Agriculture on neem
(EPO patent No. 436257) was also revoked by the European Patent Office on the
grounds of its use having been known in India. A re -examination request for the
patent on Basmati rice lines and grains (US Patent No. 5,663,484) granted by the
USPTO was also made by the CSIR 5
3 Vandana Shiva, Afsar Jafri, Gitanjali Bedi and Radha Holla-Bhar, “The Enclosure and Recovery of the
Commons”, Research Foundation for Science, Technology and Ecology, New Delhi 1997
4 Pat Roy Mooney, “The Parts of Life. Agricultural Biodiversity, Indigenous Knowledge, and the Role of
the Third System’” Development Dialogue, Special Issue, Uppsala, 1998
5 R A Mashelkar, “The role of Intellectual Property in Building Capacity for Innovation for Development:
A Developing World Perspective”, WIPO, WHO Panel Discussion, New York, 2000
8
The US government has justified the problems posed by these patents as follows:
“Informal systems of knowledge often depend upon face-lo-face communication,
thereby limiting access to the information to persons in direct contact with one
another. The public at large does not benefit from the knowledge nor can the
knowledge be built upon. In addition, if information is not written down, that
information is completely inaccessible to patent examiners everywhere as prior art
when they are examining patent applications. It is possible, therefore, for a patent to
be issued claiming as an invention technology that is known to a particular
indigenous community. The fault lies not with the patent system, however, but with
the inaccessibility of the knowledge involved beyond the indigenous community. The
US patent granted for a method of using turmeric to heal wounds, referred to is an
example of a patent issued because prior art references were not available to the
examiners. In that instance, however the patent system worked as it should. The
patent claim was cancelled based on prior art presented by a party that requested re
examination. 6
And paradoxically the TRIPS Agreement which is designed to protect IPRs is silent
about the bio-piracy of traditional knowledge and medicinal plants. Firstly TRIPS
does not find out from where the patent applicant obtained his knowledge for the
invention nor the owners of the resources or originators of the knowledge. Secondly
TRIPS requires countries to allow patenting of micro-organism and micro biological
processes. These two factors together with the loose interpretation of “inventiveness”
in national patent offices allow bio-piracy - patenting of genetic resources and
appropriation of developing country biological assets by research based companies in
developed countries. It has been estimated that if a two percent royalty were levied on
genetic resources, the North would owe the South more than US 5 billion in royalties
for medicinal plants alone. 6b
D. Conservation of bio-diversity, genetic resources and medicinal plants.
High degrees of natural forest cover are extremely important for the preservation of
diverse species of medicinal plants. There is evidence from studies reported by the
World Health Organization (WHO), The International Union for Conservation
(IUCN) and the World Wide Fund for Nature (WWF) that rain forests are being
depleted due to deforestation and habitat fragmentation declining at an alarming
rate of 16.8 hectares per annum7. Tropical forests contain the largest number of
known medicinal plants. In addition, they are also the largest resources of cultural
knowledge and experience in the use of these plants as medicines. In the United
States over 2,400 acres of native habitat are lost everyday. Many of the most
6 US General Declaration to the First Meeting of the WIPO Committee 01s1 May 2001
6b Fatal Side Effects : Medicine Patents Under the Microscope, Oxfam. This publication is available from Oxfam
website (www.oxfam.org.UK/outthecase)
7 The World Health Organization (WHO). The International Union for Conservation of Nature (IUCN)
and World Wide Fund for Nature (WWF), 1993, Guidelines on Conservation of Medicinal Plants,
CASTLE Gray Press, UK.
9
important native medicinal plants, used by the first humans to inhabit North America.
are threatened with extinction 8 .
The velocity of global genetic resource degradation and depletion is both
extraordinary and accelerating threatening species depletion of immense proportions.1
If the present trends of depletion continues, the WHO, IUCN and WWF, based on
studies in 1988 and 1994 estimated that by the end of the 20th century about 20,000
plants used in traditional medicines as healing agents would become extinct and by
the middle of the 21st century, some 60,000 higher plant species may become extinct
or near extinct. 10 11 Two recent World Bank reports on medicinal plants have also
drawn attention to the same issues, namely the loss of medicinal plants. 12 l ?
The negative impacts of commercial collection, harvesting and processing of
medicinal plants causing tremendous short and long term damage to both
communities and eco systems have been well documented. One well known example
is a UNESCO report on the African plant Primus Africana 1 . Another example
comes from South America. Cats Claw is a jungle plant whose bark contains
substances which boost the human immunological system and which have been found
to be effective against certain types of cancer. Cats Claw is one of the best known
medicinal plants in the indigenous pharmacopoera in Peru. It is almost extinct due to
massive extraction by foreign pharmaceutical companies. In July 1999 Peru passed a
law which prevents non value - added export of some botanical species, including
Cats Claw uu.
Many species of medicinal plants in the Himalayan forests are now in danger of
extinction. In the late 1950’s soon after reserpine was introduced as a therapeutic
agent, Rauwolfia serpentina became almost extinct from the Himalayas. Now it is
Taxus baccata which grows at 1600 meters above sea level. The leaves of this plant
yield taxol, an anticancer drug. Commercial collectors rape the forests and sell
through middlemen at USS 3.50 per kg to city based exporting firms. This species has
disappeared from large parts of India and Nepal. I ?
8 Liebmann R. “Strategies for the Preservation of Commercially at Risk Native Medicinal Plants of North
America: The Transition to Sustainable Cultivation” in International Symposium in Herbal Medicines.
Honalulu, Hawaii, 1-4 June 1997 organized by the University of San Diego in California in collaboration
with the United Nations Industrial Development Organization.
9 Falk D.A., Millar C.l. and Olwell M (Eds) (1996) Restoring Diversity: Strategies for Reintroduction of
Endangered Species. Island Press, Washington DC.
10 “Saving Lives by Saving Plants" International Declaration adopted at Chiang Mai World Health
Organization, Press Release WHO 14-15th April 1988.
'1 Worldwatch Institute (1994) A Worldwatch Institute Report on “Progress Towards a Sustainable
Society”, Norton, New York.
12 Lambert J., Srivastava J and Vietmeyer N. “Medicinal Plants: rescuing a Global Heritage'”. World
BANK Technical Paper No. 355, the World Bank, Washington DC, 1997.
13 Srivastava J., Lambert J & Virtmeyer N. “Medicinal Plants: An Expanding Role in Development”.
World Bank Technical Paper No. 320, The World Bank, Washington DC, 1997.
'4 Cuunigham, A.B. & Mbenkum F.T. 1993, “Sustainability of Harvesting Prunus Africana bark in
Cameroon: A Medicinal Plant in International Trade “ People & Plants Working Paper #2, Paris .
UNESCO
i4B - TRIPS, CBD and Traditional Medicines opcit
15 Uniyal M. “Medicinal Plants Need a Cure”. Bangkok Post, 14 October 1993, Bangkok.
10
Trade in medicinal plants is known as one of the least monitored, least regulated and
most secretive in the world. Medicinal plants are traded in the absence of tariff
restrictions since most medicinal plants and crude drugs are exempt from duty. 16
Over-exploitation of medicinal plants growing in the wild are major environmental
protection concerns according to WHO, IUCN and WWF 1/. Non sustainable harvest
practices and rates can lead to losses of large numbers of individual plants within
populations, to extermination of a species .
A number of organizations in the US are actively engaged in supplying biological
specimens from the tropical forests of Latin America to the pharmaceutical industry
for further exploitation. This has been described under the title “Bio-prospectors Hall
of Shame... or Guess Who is coming to Pirate your Plants”? IQ.
E. Who is coming to pirate your Plants?
•
Pharmacogenetics of Bethesda , Maryland supplies biological specimens
from the tropical forests of Latin America to pharmaceutical, chemical, agricultural
and cosmetic companies. Pharmacogenetics is partly owned by the Pan-American
Development Foundation (PADF) a private voluntary organization which has
provided technical assistance to indigenous and rural groups throughout Latin
America for over 30 years. Pharmacogenetics, will use its link to PADF to organize
plant identification and establish contacts with indigenous groups. Will these
indigenous communities be fully informed that the non-profit PADF is also part
owner of a for profit commercial business that will collect thousands of biological
specimens each year, screen them for special biological activity, and then isolate and
obtain patents for the active compounds?
•
Maxus Petroleum of Dallas, Texas is in the business of extracting not just
petroleum, but also tropical plants from Ecuador’s primary tropical forest. The
company is building 120 km road for oil exploration, and has contracted with the
Missouri Botanical Garden to collect and catalogue plants it encounters along the
way. Conveniently, the road traverses the Yasuni National Park and Waorani Ethnic
Reserve. According to Maxus, 1,200 plant species have already been gathered, 18 of
which are new to the scientific world, and 20 new species in Ecuador.
•
Knowledge Recovery Foundation International of New York city proposed
to develop a medicinal plant extractive ‘library’. The foundation’s long term goal is to
develop a well documented, well-preserved library of plant extracts (including
detailed information on local ethno medical uses) that can be “rented” to
pharmaceutical companies for screening. According to the Knowledge Recovery
,o Lewington A. A review of importation of medicinal plants and plant extracts into Europe Traffic,
Cambridge, England, 1993
17 WHO, IUCN and WWF 1993 Guidelines on the Conservation of Medicinal Plants . Gland,
Switzerland: IUCN
18 Given D.R. 1994. Principles & Practices of Plant Conservation, London, UK.
19 Bioprospecting / Biopirary and Indigenous Peoples, RAFI, Communique International, 1994
11
Foundation, entries could be screened from a fee of $25 to $50 per extract, and the
Foundation will guarantee the re-collection of any sample which the company wants
to investigate in more detail. The Foundation proudly asserts that, “what the
pharmaceutical companies are getting when they rent the extract to be screened
is intellectual property, not material property.” Companies will be required to sign
an agreement that, if a drug should be developed based on one of the collections
furnished from the library, they will return a small royally (0.1 to 0.2%) to the
indigenous peoples of the country where the collection was made.
•
Floating Bio-Pirates: The Knowledge Recovery Foundation International
also proposes to purchase a river going vessel with a “mobile collection” laboratory.
As the Foundation puts it, “This is preferable from a logistical point of view, in that it
would enable collections to be made from any part of the Amazon that was accessible
by river, and would not restrict us to working within a single extractive reserve”
The problems of loss of useful plant species arise only when a successful product has
been developed and it cannot be synthesized. Enormous amounts of plant materials
will then be necessary for commercial production of the product. The amounts of
dried plant material required for the various stages of drug development beginning at
initial screening and leading to the commercial production of a drug has been
estimated 2". These estimates are based on the assumption that the concentration of
the active material is extremely low.
• Initial screening and isolation of a new chemical entity 5kg
• Confirmatory screens and initial development - 50 kg
• Additional research and development through clinical testing 200 tons
• Commercial production of the drug - 200,000 tons per year.
F.
Conservation of Genetic Resources and Biodiversity - International
Initiatives.
According to the WHO the vast majority of the world’s population (estimates about
80 per cent) depend on herbal medicines for their primary health care. There is
therefore a need to ensure:
Availability of safe and effective herbal medicines of good quality for all who
need them; and
Continuous supply of medicinal plants.
While scientists in universities and research institutes have focused their attention on
screening medical plants for biologically active compounds and evaluating herbal
remedies, little attention was given to conservation of biodiversity. This has resulted
in serious genetic erosion, loss of biodiversity, extinction of several useful medicinal
plant species threatening the continuous and regular availability of herbal medicines.
20 McChesney J. “Biological diversity, chemical diversity and the search for new pharmaceuticals",
paper presented to the Rainforest Alliance Symposium onTropical Forest Medical Resources and the
Conservation of Biodiversity, 24-25 January 1992, New York.
12
The health care needs of more than four billion people, who depend on traditional
systems of medicines, are in danger.
In response to this crisis, a large number of inter governmental and international
agencies have set in motion a series of initiatives to promote sustainable consumption
and conservation of bio-diversity. Biological diversity plays a pivotal role in the
sustenance of life on earth.
Sustainable consumption means the use of components of biological diversity in a
way and at a rate that does not leads to long term decline in biological diversity
thereby maintaining its potential to meet the needs and aspirations of the present and
future generations. (The United Nations Convention on Biological Diversity, Article
2, 1992)
International Initiatives
Fhe Chiang Mai Declaration
1.
“Saving Lives by Saving Plants”, 1988
i.
n.
A major International Consultation on Conservation of Medical Plants
organized jointly by the WHO, the International Union for the
Conservation of Nature (IUCN) and The World Wildlife Fund (WWF)
met in Chiang Mai, Thailand from 21-26 MARCH 1988.
The Consultation issued the Chiang Mai Declaration, “Saving Lives by
Saving Plants”, stating that participants:
recognize that medicinal plants are essential in primary health care,
both in self-medication and in national health services;
are alarmed at the consequences of loss of plant diversity around the
world;
view with grave concern the fact that many of the plants that provide
traditional and modem drugs are threatened;
draw the attention of the United Nations, its agencies and Member
States, other international agencies and their members and non
governmental organizations to:
a.
the vital importance of medicinal plants in health care;
b.
the increasing and unacceptable loss of these medicinal plants
due to habitat destruction and unsustainable harvesting
practices;
c.
the fact that plant resources in one country are often of critical
importance to other countries;
d.
the significant economic value of the medicinal plants used
today and the great potential of the plant kingdom to provide
new drugs;
13
4. procedures be developed to compensate native peoples for the utilization of
their knowledge and their biological resource;
5. educational programmes be implemented to alert the global community to the
value of ethnobiological knowledge for human well being;
6. all medical programmes include the recognition of the respect for traditional
healers and incorporation of traditional health practices that enhance the
health status of these populations;
7. ethnobiologists make available the results of their research to the native
peoples with whom they have worked, especially the dissemination of these in
the native language;
8. exchange of information be promoted among indigenous and peasant peoples
regarding conservation, management, and sustained utilization of resources.”
8.
The 7th
tn Asian Symposium on Medicinal Plants, Spices and Other Natural
Products (ASOMPS), February 2-7, 1992, Manila, Philippines.
Nearly 300 scientists participated in the above symposium organized under the
auspices of UNESCO in collaboration with the International Foundation for Science
(ITS), the Asian Co-ordinating Group for Chemistry (ACGC) and other bodies in the
University of Philippines. 27
The Scientists expressed concerns that:
•
•
•
9.
Plant samples from tropics where most Third World countries are located are
collected in an “uncontrolled manner” and taken to Europe, Japan or North
America for their drug value. The discoveries are then covered by patent laws
granting exclusive rights and subsequent profits to the one who applies for it.
The local botanists and foresters collect the plants without fully realizing the
potential value of the resource. Moreover the folk herbalists rarely get credit for
the important scientific findings they often foster.
The participants unanimously agreed that collection and export of all biological
resources must be controlled.
Intergovernmental Committee on Intellectual Property and Genetic
Resources, Traditional Knowledge and Folklore. (The WIPO Committee)
This Intergovernmental Committee was established by the World Intellectual
Property Organization (WIPO) in 2000. -The objective of this committee is to address
the needs of traditional healers identified by the WIPO.
27 Cecelia Quiambo. “Good medicine, Bitter Pill” - Scientist at Manila Symposium call for bigger Third World
Share of medicinal plant wealth" - UNESCO, sources no.35 March 1992.
17
The needs identified include.
The prevention of the acquisition of intellectual property rights> over
traditional medicine by its documenting and publication as searchable prior
art.
ii. A reassessment of what constitutes prior art for purposes ol patent
examinations;
iii. The testing of options for the collective management of IPR by traditional
healers associations;
iv. A study of customary laws which protect traditional medicine in local and
traditional communities;
v. Testing the applicability of the present intellectual property system for
protection of traditional medicine;
vi.
vi. Facility access to intellectual property system for traditional medicine
practitioners;
vii. Legal and technical assistance with the documentation of traditional
medicines; and
viii Awareness raising as to the role of intellectual property protection in relation
to traditional medicine.
i.
This Committee, now known as the WIPO Committee met for the first time on
30th April 02nd May 2001. Several delegates reported on the initiatives taken at
national levels for the protection of TK. They were supportive of the idea of
exploring the possibilities of legal protection of TK under IPRs. The US
delegation had a different view and made the following statement. “ Is it possible
or even desirable to establish a comprehensive uniform set of rules at the
international level to govern the use of genetic resources, TK and folklore before
individual countries have, in conjunction, with the communities within their
borders, established their own regimes for protection within their own territories
and have gained experiences in the application of that protection and its effect on
the communities involved?
The newer generation of intellectual property laws share certain characteristics
with the older generation of intellectual property laws of copyrights, inventions
and trade marks namely:
• An incentive mechanism for innovation;
• Date of creation;
• Known identity of creator (s);
• Defined parameters of the relevant products; and
• Limited duration of patent protection knowledge.
A regime to protect TK, cannot by definition adhere to these principles.
Many of the goals of indigenous and local communities in “protecting” their TK,
medicine, folklore etc stem from their concern for self-determination, health.
18
justice, cultural heritage and land issues. These are serious interests that must be
examined fully within the appropriate national contexts "s.
G. Conclusions and Recommendations.
The objectives of protecting TK include the following:
Conservation of medicinal plants, genetic resources and biodiversity;
Prevent misappropriation of TK (bio-piracy);
Preservation of traditional practices and cultures;
Promotion of TK and its importance in R&D of traditional medicines; and
Fair and equitable distribution of the benefits derived from technologies and
innovations based on TK.
At present there is no consensus on what would be the most appropriate way of
protecting TK to achieve the above objectives.
Whatever the regime is eventually developed, the most effective way to protect TK
should take into consideration the following:
1 .Policy issues:
Objectives and modalities of such protection; and
Impact and implications on its intended beneficiaries
2. Technical issues;
Problems of collective ownership;
Modes of enforcement of rights.
3. Ethical, environmental and socio economic concerns.
In this context, Thailand has enacted a sui generic regime on traditional medicines
(Annex 1)
TK can be protected within and outside the IPRs system. IP Rs are seen as our
possible means to protect TK. There are strong supporters and severe critics of
extending IPRs to protect TK. Annex 2 gives the conflicting views.
Supporters argue that there are many examples of TK that are or could be protected
by the existing IP system or by modifying certain aspects of the current form of I PR
protection 29. Critics base their arguments on both practical reasons and principles,
namely the essential incompatibility between concepts of modern IPRs and the
practices and cultures of local and indigenous communities
28 General Declaration of the USA to the First Session of the WIPO Committee 30,h April - 02nd May 2001.
29 WIPO - Intellectual Property needs and expectations of traditional knowledge holders, Geneva, 2001
30 The Crucible 11 Group. Sending Solutions; Policy Options for genetic resources. Peoples Plants and Patents
revisited, Vol 1.
IDRC - IPGRI. Rome 2000. Available at http//www.idrc.ca/books/926/05part 2_01.html
19
In view of the lack of consensus, it may be premature to initiate discussions towards
development of international standards in the framework of the World Trade
Organization, (WTO)
The immediate priority should be the development of global rules to prevent the
misappropriation of TK and use these as guidelines to develop national laws to
prevent biopiracy.
The following are some of the activities proposed for protection of TK
• Promote the development, at the national level, of a holistic approach toward
the protection of TK, genetic resources and biodiversity;
• Develop workable models for the preservation and promotion of the use of TK.
including, as appropriate, legal mechanisms for the protection of TK against
misappropriation;
• Collect and analyze existing national customary laws and practices relating to
protection of TK.
• Work towards co-ordinating the various activities of ail the international
initiatives listed in section F.
• Consider the protection of TK in the context of the recognition and
implementation of human rights.
• Improve awareness of the role of TK in fostering national innovation, researcher
and development of Traditional Medicine.
• Propose amendments to the TRIPS Agreement requiring patent applicants to:
i. disclose the origin of the resources or knowledge they are using.
ii Obtain prior informed consent of the original knowledge holders and share
benefits with them.
• Provide a specific and tight definition of “inventiveness'’ and novelty in national
patent laws. This will exclude applications where the subject matter is not a
real invention, or where the knowledge is already in the public domain.
• At the national level, a country should develop guidelines for the
implementation of article 8 (j) of CBD. This article is reproduced below.
“Subject to its national legislation, respect, preserve and maintain knowledge,
innovations and practices of indigenous and local communities embodying
traditional lifestyles relevant for the conservation and sustainable use of
biological diversity and promote their wider application with the approval and
involvement of the holders of such knowledge, innovations and practices and
encourage the equitable sharing of the benefits arising from the utilization of
such knowledge, innovations and practices”
31 Carlos M.Coorea, “Traditional Knowledge and Intellectual Property”. A Discussion Paper. Issues and options
surrounding the protection of traditional knowledge. Commissioned by the Quaker United Nations Office (QUINO)
Geneva with financial assistance from the Rockefeller Foundation. (Available in downloadable electronic format
from http//www.QUINO.org. click on Geneva paper.
20
Bibliography
1.
Report of the Inter-Regional workshop on Intellectual Property Rights in the
Context of Traditional medicine.
Bangkok, Thailand 6-8 December 2000, World Health Organization
2.
TRIPS, CBD and Traditional Medicines. Concepts and Questions.
Report on an ASEAN Workshop on the TRIPS Agreement and Traditional
Medicine.
Jakarta 13-15 February 2001, National Agency for Drug and Food Control,
World Health Organization.
3.
Traditional Knowledge and Intellectual Property Issues
surrounding the protection of traditional knowledge.
A Discussion paper by Carlos M. Correa,
Quaker United Nations Office, Geneva, November 2001.
and
Options
21
Annex 1
A siii generis regime on traditional medicine : Thailand
Thailand has developed a comprehensive sui generis regime for TM.
The “Thai Traditional Thai Medicinal Intelligence Act" distinguishes three different
categories of “Traditional Formulations"
National Formulae are formulations given to the Nation which are crucial for human
health.
The Act stipulates that the ministry of Public Health has authority to announce a
certain formula of traditional Thai medicine as a national formula. In this case, the
traditional formula should be of significant benefit or have special medical value.
After the announcement, the rights of such a formula belong to the State. The
commercial use of a national formula for the production of drugs or for research and
development, is subject to permission from the government (criminal sanctions are
provided for under the act for infringement).
Private Formulae can be freely used by the owner. The request for the registration of
a private formula can be submitted by an inventor or developer of the formula; or an
inheritor of the inventor or developer of such a formula. The act grants exclusive
rights by allowing the owner of the registered personal formula for research and to
sell and distribute any product developed or manufactured by using the formula.
However, there are certain limitations to the exclusive rights. The rights over a
registered personal formula subsist throughout the life of the owner and for a further
50 years form the date the applicant dies. One of the main objectives of the sui
generis protection is that the exclusive monopoly granted by the State should enable
the owners of traditional knowledge to be adequately compensated for their
contributions. Third parties must obtain permission from the owner to use the
formula.
General Formulae, finally, are well known traditional formulae that remain free to
use by anybody.
One important feature of this law is that all three types of formula can continue to be
used free domestically by traditional healers or Thai communities in a limited
quantity. The law also provided for measures aimed at the conservation and
sustainable use of the medicinal plants, specially those at high risk of extinction. In
addition, The Institute of Traditional Thai Medicine was formally established (after
having being in operation for seven years). The Institute is governed by a committee
composed of equal numbers of NGO’s and governmental officials. Registrations and
other activities are distributed among 75 provincial offices throughout Thailand. A
“Thai Traditional Knowledge Developing Fund" was also created. The Thai
regulations have permitted the registration of over 700 licensed local manufacturers
producing traditional medicine. In 1998, there were already 4.300 formulations
registered with Thai FDA and still increasing. The total value of production in 1999-
22
2000 was around 320 million baths, without including traditional medicines
individually produced by healers.
Sources Jakkrit Kuanpoth, “Legal Protection of Traditional Knowledge: The case of Thai
♦ra/tihAnai
traditional rnAdirmp
medicine””. Panp.r
Paper nresented
presented at
at the
the at
at the
the ASEAN
ASEAN Workshop
Workshop on the TRIPS
Agreement and Traditional Medicine, WHO, Jakarta, 15 Feb 2001
Pennapa Subcharoen, Omboon Luanratana, Jugkrit Kuanpoj and Suradeth
Assawintrangura, “Indigenous Knowledge and Intellectual Piopeity lights in the
context of traditional medicines. BANGKOK, 8-10 Dec 2000
Annex 2
Conflicting Views. (Carlos Correa opcit)
(i) “There are many examples of TK that are or could be protected by the existing IP
system. In addition, while many informants believe that the present IP system does
not adequately recognize TK holders’ rights, they are interested in undertaking further
work on how the IP laws and system can be modified to curb those aspects of IP laws
and systems “which allow piracy or seen to condone it”. Several informants also
suggested certain modifications to IP law to improve its functionality in TK
protection, and, others, new IP tools”.
WIPO Intellectual property needs and expectations of traditional knowledge holders.
Geneva 2001
(ii) “ Patent and copyright not only presume that the act of innovation is largely
individual rather than social, but that innovators are motivated by financial gain, and
that it is the role of the state, rather than innovators to, to ensure that new knowledge
is used responsibly. In my experience, custodians of local knowledge believe that
knowledge is socially created, through interaction amongst humans and non-humans;
that individuals are obliged to put their knowledge to use unselfishly; and that
teachers of knowledge possess an inalienable responsibility to ensure its proper use”
Russell Baosh. ” Who steals indigenous knowledge? (mimio) New York University
and First Peoples World Wide, New York 2001
(iii) “In order to protect and encourage (TK), the necessary conditions may be in
place, namely, security of tenure over traditional terrestrial and marine estates;
control over and use of traditional natural resources; and respect for the heritage,
languages and cultures of indigenous and local communities, best evidenced by
appropriate legislative protection (which includes protection of intellectual property,
sacred places, and so on”
Executive Secretary of the Biodiversity Convention in Traditional Knowledge and
Biological Diversity. UNEP/CBD/TKBD/1/2 October 18,1997.
23
(iv) Many participants, particularly representatives from indigenous organizations,
felt that most existing legal framework didn’t reflect their concerns adequately. They
argued that the premise of intellectual property is based on terms and conceptual
foundations that remain outside their worldview. As an alternative, some advocated
an integrated approach to the protection of traditional knowledge as illustrated by the
ANDES initiative called “elparque de la papa” which aims to create a protected area
of agro-biodiversity, genetic resources and traditional knowledge. Often discussions
over specific mechanisms to increase the equality of resource transactions overlook
the fundamental inequalities that exist between actors. Therefore, the expanded
participation of indigenous groups and local communities at the design, development
and implementation stage are essential to processes of building socially responsible
regimes for the regulation of resources. Furthermore, issues such as equitable benefit
sharing maybe secondary to the more basic issue of defining ownership rights”.
Report of the Multistakeholder Dialogue on Trade. Intellectual Property and
Biological and Genetic Resources in LATIN America, Cusaco. Peru. 22-24. February
2001 (http://www.ictsd.org/dialogiieweb/texts/report2.htin)
24
Herbal Medicines: A Holistic Approach
Dr. K Balasubramaniam
Pharmaceutical Adviser
Consumers International Regional Office for Asia and the Pacific
PO Box 1045
10830 Penang
Malaysia
Tel: (60-4) 229 1396
Fax: (60-4) 228 6506.
Email: ardaroap@tni.net.my
2nd International Workshop on Herbal Medicines in the Caribbean
St. Croix, US Virgin Islands,
June 14-16, 1999
Contents
Herbal Medicines: A Holistic Approach
Executive Summary
1. Introduction
2. Herbal medicines
3. Source of medicinal plants; source of knowledge about medicinal plants
4. Loss of biodiversity: threat to medicinal plants
5. Saving Lives by Saving Plants; Conservation of Biodiversity;
International initiatives:
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
ix.
p
6.
The Chiang Mai Declaration (WHO/IUCN/WWF) 1988
Convention on Internatonal Trade of Endangered Species (CITES), 1975
First World Congress on Medicinal and Aromatic Plants for Human Welfare,
1992
The Convention on Biological Diversity (CBD), 1992
The Arusha Declaration 1990
African Ministerial Conference on the Environment, 1994
International Symposium on Herbal Medicines, 1997
The Declaraton of Belem, July 1988
The 7th Asian Symposium on Medicinal Plants, Spices and other Natural
Products (ASOMPS), February 1992
Peoples’ Guide to Herbal Medicines & Medicinal Plants
Executive Summary
Herbal medicine is as old as human kind and as contemporary as the latest discovery
in biomedical science. A wide spectrum of sectors, issues and activities are
encompassed within herbal medicine together with a number of stakeholders
including several intergovernmental and international agencies.
A holistic approach to herbal medicine needs to take into consideration and examine
the various sectors, issues and activities and the needs and concerns of the different
stakeholders. Quite often each stakeholder group examines its particular sector in
isolation ignoring the ultimate objectives. Consumers, on the other hand, are
concerned with each and every sector, issue and activity in this long and complex
chain.
I
The ultimate objectives of the consumer include the following:
G>
•
ensuring the availability, accessibility and affordability of safe and effective
herbal medicines of good quality to all those who need them now and in the
long term future;
•
regulating the manufacture, promotion, sales and use of herbal medicines
to ensure the safety of consumers;
•
defining the place of herbal medicine in primary health care;
•
searching for new medicines among the many medicinal plants that are yet
untapped;
•
looking for, protecting and preserving endangered plant species;
• conserving biological diversity; and
f
searching, protecting and preserving indigenous cultures which are the
repositories of the knowledge of medicinal plants.
It is indeed a paradox that in an era of molecular biology, genetic engineering,
biotechnology, computerised drug design and an annual global pharmaceutical
market of over $300 billion, herbal medicines serve the health care needs of 80
per cent of the world’s population, or over four billion people.
There is evidence that consumers in developed countries are becoming
disillusioned with modern health care and are seeking alternatives. Consumer
demand for herbal medicines is, therefore, increasing in these developed
countries.
i
The multinational drug industry in the North is showing renewed and
heightened interest in the South’s medicinal plants. Over 200 firms are
screening plants for medicinal properties.
However, in both developing and developed countries, there are no integrated
national policies on herbal medicines to facilitate drug administrators to
regulate the manufacture, trade, promotion, sales and use of herbal medicines.
There is an urgent need for national policies on herbal medicines with
regulatory control to regulate the herbal medicine market.
The lethal combination of increased consumer demand, the renewed industry
interest in bioprospecting and the lack of national legislation or effective
international agreements on conservation of biodiversity has resulted in
‘slaughter harvesting’ of medicinal plants and massive depletion of biodiversity.
Tropical rain forests are the home to 70 per cent of the million or so species of
higher plants that are believed to inhabit the earth. Fewer than one per cent of
the tropical rain forest species has been examined. Of the total plant material
utilised in the preparation of traditional medicine, about 90 per cent are
collected from the tropical forest.
-
Indigenous cultures living close to these plants, use thousands of them in their
medical practice. Many of these have not even been named, let alone studied.
Indigenous people know much more about the properties of these plants than
modern scientists. This knowledge is community owned intellectual property
but there is evidence that this knowledge is pirated by the multinational drug
industry and patented as private intellectual property.
High degrees of forest cover are extremely important for the preservation of
diverse species of medicinal plants. Tropical rain forests are declining at an
alarming rate of 16.8 hectares per year. Since 1970 tropical forests have
declined from 4.4 sq. mile per 1000 people to 2.8. In the US 2400 acres of
native habitat is lost everyday.
The conflagration of tropical rain forest threaten not only countless species of
valuable medicinal plants but also the indigenous cultures and individuals who
know their properties and use them in their daily lives. What we are
witnessing today makes the burning of the library in Alexandria look
insignificant by comparison. It is as if the greatest medical library in the world
is burning faster than we can read its contents, which we have just begun to
catalogue.
>
Several intergovernmental and international agencies have been sounding
alarm bells during the last two decades to raise global awareness on the
ii
~
I
j
a
enormous extent of loss of biological diversity and threatened extinction of tens
of thousands of valuable medicinal plants. Health professionals have raised
serious concerns on the lack of regulatory control of herbal medicines,
nutraceuticals and dietary supplements that are promoted as drugs and abuse
of herbal remedies.
The alarms, concerns and fears were based on critical analysis of enormous
empirical data. Remedial measures were carefully considered and rationally
presented in the form of comprehensive conclusions and recommendations.
The commitments made at the international summits have turned up to mere
lip service. There is no evidence that any of the recommendations have been
implemented.
The dramatic pleas and recommendations were made to
appreciative but docile audiences - scientists, research workers and
international civil servants. These people are no match for the vested interests
who are depleting genetic resources, threatening several plant species and
heavily
promoting thousands of ineffective
phyto-pharmaceuticals,
nutraceuticals and dietary supplements directly to the consumer. Sales of
these '‘natural products” are skyrocketing.
The paper argues that the inability of the international initiatives to bring
about appropriate changes in public policies and national legislation is due to
their failure to inform and educate the voting public and thereby mobilising
their support for campaigning and lobbying for changes in public policies.
The history of humankind clearly illustrates that changes in public policy are
possible only through mass movements when the entire general (voting) public
is sincerely convinced of the urgent need to bring about appropriate changes.
The paper concludes with a "People’s Guide to Herbal Medicines and Medicinal
Plants”.
This guide attempts to present the relevant conclusions and
recommendations arrived at various international summits in a way people will
understand and rally round to support a campaign to implement the various
resolutions reached by global consensus.
iii
|
Introduction
1.
A holistic approach to
contemporary
as examine
consideration and
a wide spectrum of sectors, issues and activities inclu
g
following:
sources of medicinal plants,
•
trade °f medictad
:
plants;
conservation of biodiversity;
research and development;
•
•
production professes"1-conversion to traditional and modern dosage forms;
safety, efficacy, quality, marketing and sales of herbal medicines,
the rational and economic use of herbal medicines;
the place of herbal medicines in health care; and
training and registration of traditional healers.
.
•
•
.
In view of the wide spectrum of sectors and issues. *
=T
S f„XS ,“d
diffS^t1"^ntries
iLes listea above. These
include the following:
'
Latin America and the small
indigenous people living in remote areas in Africa Asia,
“
'2^.
Herbal
medicines are the only
island states in the Caribbean and South Pacific. I,r are the repositories of the knowledge of
available health care for these people; they
medicinal plants. Their lands are also
ul— the
-1- homes of medicinal plants;
.
•
in the developing non-industrial countries who have, for
people living in rural areas m
medicines for their health care,
centuries, relied herbal
on 1------
•
practitioners of traditional medicine;
.
people living in developed countries and urban areas in developing countries who have
begun to use herbal medicines;
.
scientists involved in R & D related to traditional medicines;
.
' > are responsible to ensure the safety, efficacy
regulators in national governments who
and quality of herbal medicines in the
t-- market;
.
ministries of health which decide the place of herbal medicines and traditional
practitioners in the national health service;
• 5X~rieT
and food supplements;
1
Herbal Medicines: A Holistic Approach
-J
-■ ' • r international norms and
orp involved in establishing
of the
attributes of herbal
intematlonal^enae, wh.eh^
m
. different
...
agreements
iciiico.- These are.
medicines
.
>
>
>
>
>
>
>
>
>
>
,unido’
World Bank (WB)
nuwTn*
World Wide Fund for Nature (WWF)
n (UNESCO)
“ned Nations Environment
(UNEP)
Food & Agricultural Organization (FAO)
International Foundation for Science: (IF )
Nongovernmental organisations (NGO )
A holistic approach to herbal
tnd address^ the needs of each of the
Quite often each stakeholder e-mines a pabular
Consumers see this
inwived,
in isolation ignoring the
each and
V di°seus°s md “ZSend wa^d me“ s to reflate and
forum for all the stakeholders to discuss an
of hi.rbal „edlcmes. The
"A 0- view include, amo„g others, the
.
ensuring the availability, accessibility andflttr^particularly to the
meSs of good quality “ * “™“VoX O““‘ o' U"Se ,“‘iiCtaal P18ntS
.
regulating the manufacture, hade, promotion, safes and use of herbaf medicines o
.
ensure the safety of consumers;
defining the place of herbal medicines in primary health care;
.
searching for new medicines among th. many medieinaf plants that are yet lappe ;
.
.
conserving biological diversity; and
.
senrcbmg, protecting and preset indigenous cultures which are the repositories
the knowledge of these plants.
1
.The World WMlfe Fund (WWF>,
““
to World Wide Fund
for Nature. The acronym remains the same
2
i
i
Herbal Medicines: A Holistic Approach
Herbal medicines
2.
2 ‘ ► as “Finished
The World Health Organization (WHO) has defined herbal_ medicines
ingredients aerial or underground
combinations thereof, whether
in ,he
the
”heth"
crude state or as plant preparations.”(l)
“^“h^X'oe.a^T S“985X
““:^Xre X
X the
pharmaceuticals used m the US.(4)
Herbal medicines, as defined by the WHO, can
be classified into three categories:
sold as over the counter (OTC) products
Phytomedicinesj or phytopharmaceuticals
tablets, capsules and liquids for oral use;
in modern dosage forms such as 1—
called nutraceuticals
Dietary supplements containing herbal products, also
available in modern dosage forms.
i.
ii.
Xs
~
== SS
occupying increasing shelve space in modem pharmacies.
iii.
“=5:s:xs='"- iss—-
long tradition of using plants for medicinal
between humans and their environment. It 1
confirmed by the WHO that
cent Qf the worid»s
of over $300 billion per annum (10), herbal medicines serve
per cent of the world s population.
In addition to meeting the health care
resource base for over half of our
1 therapeutically useful drugs, have been
products, though they have nottools
become
to evaluate physiological and pathophysiologic
instrumental as pharmacological too.s to
■ j how plant based products have helped
processes. The following examples
illustrate
understanding in key areas of physiology and
scientists to elucidate our i-------pharmacology:
I
Herbal Medicines: A Holistic Approach
■
•
•
•
•
•
•
the cholinergic system: - atropine, muscarine, physostigmine, pilocarpine
the adrenergic system: - ephedrine, reserpine, ergot alkaloids;
the ganglionic junction: - nicotine, lobeline
the neuromuscular junction: - tubocurarine
the cardiovascular system: - cardiac glycosides, veratrum alkaloids; and
the smooth muscle: - papaverine, xanthines.
i
Life-saving and essential drugs from medicinal plants such as morphine, digoxin, aspirin,
emetine, and ephedrine were introduced into modem therapeutics several decades ago.
However, herbal medicines, as defined by the WHO, and used for over a millenium in
several countries, now refered to as the Third World, attracted scientific attention in the
second half of the 20th century when previous colonies in Africa and Asia became
independent and focused attention on their centuries’ old traditional systems of medicine.
It was only in 1978 that the WHO first recognised the role of herbal medicines and the
traditional medical systems in providing basic health care for the majority of the world s
population. (5)
Qince then there has been a renewed interest in herbal medicines and traditional medical
/stems leading to an increased requirement of herbal medicines in developing countries
with a change in the pattern of utilization. Traditional health systems and herbal
medicines have been used mostly by the rural population. This is now changing
particularly in Africa where due to macro-economic factors such as devaluation of
currencies, and structural adjustment programmes, there is a substantial shift from
modern to traditional medicine in the urban population.(11)
While the demand for herbal medicines is growing in developing countries, there is
evidence that consumers in developed countries are becoming disillusioned with modern
healthcare and are seeking alternatives: Between a third and half of the population m
some of these countries use some form of complementary medicine, paying for it from
their own pockets.(12, 13) There is, therefore, an increasing consumer demand for herbal
medicines in developed countries. Annual sales growth rates of over 100 per cent for
popular herbs such as ginseng, St. John’s Wort, garlic, aloe vera, evening primrose oil
and echinacea have been recorded on both sides of the Atlantic. In certain countries they
are more popular than their prescription alternatives. For example, in Germany the value
of prescriptions written for the anti-depressant St. John’s Wort is twice that for Prozac, a
p selling antidepressant. In 1994 the prescriptions for St. John’s Wort were worth
DM61 compared to Prozac which was worth DM30.(14)
However in both developed and developing countries, there are no integrated national
policies on herbal medicines which will facilitate drug regulators, health administrators,
health professionals including traditional and modem practitioners to regulate the market:
and ensure consumer safety and protection. A national policy on herbal medicine
should be designed to serve as an instrument to ensure that all herbal medicines in
the market are safe, effective, of good quality, reasonably priced and are prescribed
and utilised rationally. There is, therefore, an urgent need for the preparation of model
guidelines for developing national policies on herbal medicines. The major elements that
should go into the proposed guidelines have been described and presented in a recent
document by Consumers International.(14b)
With advances in biotechnology, plant molecular biology, cell culture and the availability
of new, precise diagnostic tools for screening, the multinational drug industry in the
North is showing renewed and heightened interest in South’s plants. For example, in
1980, none of the US pharmaceutical industry research budget was spent on research
Herbal Medicines: A Holistic Approach
4
©.
I
into higher plants. It has been estimated in the mid-1990s that over 200 companies and •
research organisations worldwide are screening plant and animal compounds for
medicinal properties. It is conservatively estimated that the market for natural product
research specimens within the pharmaceutical industry alone is $30-60 million per
annum.(15) Medicinal plants and microbials from the South contribute at least $3 billion
a year to the North’s pharmaceutical industry.(16)
This lethal combination of increasing demands for herbal medicines by consumers
in both developing and developed countries, renewed interest by the multinational
pharmaceutical industry in bioprospecting and the lack of national legislation or
effective international agreements on conservation of biodiversity, has resulted in
“slaughter harvesting” of medicinal plants and massive depletion of biodiversity.
3.
I
Source of medicinal plants: source of knowledge about medicinal plants
Plants have been used as medicine for millenia.(17) Traditional medicine is a summation
of several thousands of years of human experience in the selection of plants and other
natural products for preventive and curative purposes in health care. Among the earlies
records available was the use of Dichroa febrifuga for the treatment of malaria by the
Chinese emperor Shen Nung about 3000 B.C. The plant has been shown to contain an
antimalarial alkaloid, febrifugine.
The ancient Egyptian scripture, Ebers papyrus
mentioned in 1500 B.C. the use of squill (Drimia maritina), as a cardiac tonic, a precursor
of digitalis therapy. (18)
Out of an estimated 250,000-350,000 plant species identified so far, about 35,000 (some
estimate up to 70,000) are used worldwide for medicinal purposes. About two-thirds of
the total plant species grow in the tropics.(19, 20, 21)
The world’s tropical rain forests, covering only six per cent of the earth’s surface are home,
for at least half of all the world’s plants. Fewer than one per cent of the tropical rain
forest species have been examined for their possible use to humankind. But at least 1400
plant species of tropical forests are believed to offer potential cures for cancer. (22)
Another estimate is that the tropical rain forests are the home to approximately 70 per
cent of the million or so species of higher plants that are believed to inhabit the earth.(23)
A World Bank study showed that four out of five medicinal plants utilised by humans are
collected from the wild. (24) Yet another estimate suggests that of the total plant materia,
utilised in the preparation of traditional medicine, about 90 per cent is collected from the
forest. (25)
Tropical rain forest plants have been likened to “complex chemical
storehouses”. In these rain forests, the number of plant species per unit area is far
greater than in other biomes; the plants in the rain forests are immobile compared to
domesticated and cultivated plants. These plants in the forests have, therefore, to
constantly compete with each other for their survival - the Darwinian theory of survival of
the fittest. In response to this competition, these plant species are adapted to specialised
environment often in the form of unique biocompounds in tissues for their defence.(26)
This explanation underscores the critical importance of in-situ conservation (conservation
in the natural habitat) as a source of continuous supply of planting material for
propagation, re-introduction, agronomical and genetic improvement, domestication and
for research and development.
Only about a third of the million or so species of higher plants have been identified and
named by scientists. Of those named, only a tiny fraction has been studied. It is
estimated that one in 125 plant species contains a useful pharmaceutical.(27) In Brazil
Herbal Medicines: A Holistic Approach
5-
less than 10 per cent of even biologically active extracts have been investigated by modem
scientists.(28) WHO published an inventory of medicinal plants in 1983 containing
21,000 plants. This includes species mentioned in official documents and publications
from 91 countries.(29) A 1997 survey showed that up to date only about 10,000 species
of medicinal plants have been investigated. (30)
Several important drugs used in modern medicine have come out of medicinal plants
studies. Indigenious cultures, living close to these plants, use thousands of them in their
medical practices. Many of these have not even been botanically named, let alone
studied. Indigenous people know much more about the properties of these plants than
modern scientists.(31) And researchers have now realised the truth of this. Between
1956 and 1976 the US National Cancer Institute screened over 35,000 plants and
animals for anticancer compounds. The programme was terminated in 1981 because of
its failure to identify a greater number of anticancer agents. A retrospective study
conducted on the project concluded that the success rate in finding valuable species
could have been doubled if medicinal folk knowledge had been the only information used
to target species. (32)
It is generally accepted that about one in 10,000 chemicals derived from mass screening
of plants, microbes and animals eventually results in a potentially profitable drug. By
contrast, Shaman Pharmaceuticals Inc, the US based company that collects plants by
talking to indigenous healers and watching them work, claims a success rate of .50. per
cent. Shaman targets only those plants which are used by three different communities
for medicinal purposes. With this formula, Shaman’s researchers get positive results in
50 per cent of the plants brought in by their collectors. (33) The linking of the
indigenous knowledge of medicinal plants to modern research activities, therefore,
makes them 5,000 times more effective than with random collection.
Research scientists have found that 86 per cent of plants used by Samoan healers
displayed significant biological activity when tested in the laboratory.(34) Crude extracts
of plants used by one traditional healer in Belize gave rise to four times as many positive
results in lab tests for anti-HIV activity than did specimens collected randomly.(35)
4.
Loss of biodiversity: threat to medicinal plants
<f :
High degrees of natural forest cover are extremely important for the preservation of
diverse species of medicinal plants. There is evidence from studies reported by WHO,
IUCN and WWF that rain forests are being depleted due to deforestation and habitat
fragmentation - declining at ah alarming rate of 16.8 hectares per annum.(36)
Tropical forests contain the largest number of known medicinal plants. In addition,
they are also the largest resource of cultural knowledge and experience in the use of
these plants as medicines. A recent UNDP Human Development Report has pointed
out that since 1970, the world’s forests have declined from 4.4 sq. miles per 1000
people to 2.8! In the United States over 2,400 acres of native habitat is lost
everyday. Many of the most important native medicinal plants, used by the first
humans to inhabit North America, are threatened with extinction.(37)
The velocity of global genetic resource degradation and depletion is both extra
ordinary and accelerating threatening species depletion of immense proportions.(38)
If the present trends of depletion continues, the World Health Organization, the
International Union for Conservation of Nature and the Worldwide Fund for Nature
,estimate that by the turn of the century about 20,000 plants used in traditional
'Herbal Medicines: A Holistic Approach
6
©
A
JS.
medicine as healing agents may have become extinct and by the middle of the next
century, some 60,000 higher plant species may become extinct or near extinct (39,
40). Two recent World Bank reports on medicinal plants have also drawn attention
to the same issues, namely the loss of medicinal plants. (41,42)
The negative impacts of commercial collection, harvesting and processing of medicinal
plants causing tremendous short and long-term damage to both communities and eco
systems have been well documented. One well known example is a UNESCO report on
the African plant Prunus africana.(43)
Many species of medicinal plants in the Himalayan forests are now in danger of
extinction. In the late 1950s soon after reserpine was introduced as a therapeutic agent,
Rauwolfia serpentina became almost extinct from the Himalayas. Now it is Taxus baccata
which grows at 1600 meters above sea-level. The leaves of this plant yield taxol, an
anticancer drug. Commercial collectors rape the forests and sell through middlemen at
US$3.50 per kg to city based exporting firms. This species has disappeared from large
parts of India and Nepal. (44)
©
Trade in medicinal plants is known as one of the least monitored, least reguh
1
and most secretive in the world. Medicinal plants are traded in the absence of tariff
restrictions since most medicinal plants and crude drugs are exempt from duty. (45)
Over-exploitation of medicinal plants growing in the wild are major environmental
protection concerns according to WHO, IUCN and WWF.(46) Non-sustainable harvest
practices and rates can lead to losses of large numbers of individual plants within
populations, to extermination of populations and eventually extermination of a
species. (47)
A number of organisations in the US are actively engaged in supplying biological
specimens from the tropical forests of Latin America to the pharmaceutical industry Tor
further exploitation. This has been described under the title “Bio-prospectors Hall of
Shame... or Guess Who is Coming to Pirate your Plants.”(47b)
Pharmacogenetics of Bethesda, Maryland supplies biological specimens from
the tropical forests of Latin America to pharmaceutical, chemical, agricultural and
cosmetic companies. Ph arm aco-genetics is partly owned by the Pan-AmenVon
Development Foundation (PADF) a private voluntary organisation which
.s
provided technical assistance to indigenous and rural groups throughout Latin
America for over 30 years. The company will use its link to PADF to organise
plant identification and establish contacts with indigenous groups. Will these
indigenous communities be fully informed that the non-profit PADF is also part
owner of a for-profit commercial business that will collect thousands of biological
specimens each year, screen them for special biological activity, and then isolate
and obtain patents for the active compounds?
Maxus Petroleum of Dallas, Texas is in the business of extracting not just
petroleum, but also tropical plants from Ecuador’s primary tropical forest. The
company is building a 120-km road for oil exploration, and has contracted with
the Missouri Botanical Garden to collect and catalogue plants it encounters along
the way. Conveniently, the road traverses the Yasuni National Park and Waorani
Ethnic Reserve. According to Maxus, 1,200 plant species have already been
gathered, 18 of which are new to the scientific world, and 20 new species in
Ecuador.
Herbal Medicines: A Holistic Approach
7
-
•
•
Knowledge Recovery Foundation International of New York City proposes to
develop a medicinal plant extractive ‘library’. The foundation’s long-term goal is
to develop a well-documented, well-preserved library of plant extracts (including
detailed information on local ethnomedical uses) that can be ‘rented to
pharmaceutical companies for screening. According to the Knowledge Recoveiy
Foundation, entries could be screened for a nominal fee of $25 to $50 per extract,
and the Foundation will guarantee the re-collection of any sample which the
company wants to investigate in more detail. The Foundation proudly asserts
that, “what the pharmaceutical companies are getting when they rent the
extracts to screen is intellectual property, not material Property.
Companies will be required to sign an agreement that, if a drug should be
developed based on one of the collections furnished from the library, they will
return a small royalty (0.1 to 0.2%) to the indigenous peoples of the country
where the collection was made.
•
< .. ,
Floating Bio-Pirates: The Knowledge Recovery Foundation International also
proposes to purchase a rivergoing vessel with a ‘mobile collection’ laboratory.
s
the Foundation puts it, “This is preferable from a logistical pomt of view, m that it
would enable collections to be made from any part of _the Amazon that was
accessible by river, and would not restrict us to working within a smgle extractive
I
I
t
I
reserve.”
The problems of loss of useful plant species arise only when a successful product
been developed and it cannot be synthesized. Enormous amounts of plant materials will
then be necessary for commercial production of the product. The amounts of dned plant
material required for the various stages of drug development beginning at imti^ screening
and leading to the commercial production of a drug has been estimated.) )
estimates
based on the assumption that the concentration of the active material is
extremely low.
t.
•
•
•
•
5.
V
Initial screening and isolation of a new chemical entity 5 kg
Confirmatory screens and initial development - 50 kg
Additional research and development through clinical testing - 200 tons
Commercial production of the drug - 200,000 tons per year.
Saving Lives by Saving Plants: Conservation of Biodiversity:
International Initiatives
In 1978 the World Health Organization (WHO) and the United Nations,Chil,d^^FXe
health care to 80 per cent of the world’s population.(50)
In 1987, the 40th World Health Assembly adopted a resolution reaffirming the Alma Ata
Declaration and gave two further mandates to the WHO.
i.
Initiate comprehensive programmes for the identification,
cultivation and conservation of medicinal plants used m traditional medicme.
8
Herbal Medicines: A Holistic Approach
ii.
Ensure quality control of drugs derived from traditional plant remedies by using
modern techniques and applying suitable standards and good manufacturing
practices.
As stated earlier, the vast majority of the world’s population (estimates about 80 per cent)
depend on herbal medicines for their primary health care. There is therefore an urgent
need to ensure:
Availability of safe and effective herbal medicines of good quality for all who need
them; and
Continuous supply of medicinal plants.
•
•
While scientists in universities and research institutes have focused their attention
on screening medicinal plants for biologically active compounds and evaluating
herbal remedies, little attention was given to conservation of biodiversity. This has
resulted in serious genetic erosion, loss of biodiversity, extinction of several ^sefu*
medicinal plant species threatening the continuous and regular availability of
herbal medicines. The health care needs of more than four billion people, who
depend on traditional systems of medicine, are in danger.
In response to this crisis, a large number of inter-governmental and international
agencies have set in motion a senes of initiatives to promote sustainable consumption
and conservation of bio-diversity. Biological diversity plays a pivotal role m the
sustenance of life on earth as we know it.
Sustainable consumption means the use of components of biological diversity m a way
and at a rate that does not lead to long-term decline in biological diversity thereby
maintaining its potential to meet the needs and aspirations of the present and future
generations. [The United Nations Convention on Biological Diversity, Article 2, 1992]
International Initiatives
I.
o
The Chiang Mai Declaration
^Saving Lives by Saving Plants", 1988
1.
A major International Consultation on Conservation of Medicinal Plants org^ed
jointly by the WHO, the International Union for the Conservation of Nature (IUCN)
and the World Wildlife Fund (WWF) met in Chiang Mai, Thailand from 21-26 March
1988
The Consultation issued the Chiang Mai Declaration, “Saving Lives by Sharing
Plants”, stating that the participants:
■
■
■
■
recognise that medicinal plants are essential in primary health care, both in
self-medication and in national health services,
are alarmed at the consequences of loss of plant diversity around the world;
view with grave concern the fact that many of the plants that provide traditional
and modern drugs are threatened;
draw the attention of the United Nations, its agencies and member State, other
imtAmational agencies
aeencies and their members and non-governmental organisations
international
to:
a.
the vital importance of medicinal plants in health care,
9
Herbal Medicines: A Holistic Approach
b.
c.
the increasing and unacceptable loss of these medicinal plants due to
habitat destruction and unsustainable harvesting Pr^c®J
critical
the fact that plant resources in one country are ofte
e.
importance to other countries,
the significant economic value of the medicinal plants used today and the
great potential of the plant kingdom to provide new drugs,
the continuing disruption and loss of indigenous cultures which often
hold the key to finding new medicinal plants that may benefit the g o
. f.
Sargent need for international cooperation and coordination to
establish programmes for conservation of medicinal plants to ensure tha
d.
adequate quantities are available for future generations.
Convention on International Trade of Endangered Species (CITES)
II.
The principal tool for monitoring or rest”cting
0°ff Endaimer^Species ^CtTES
exploitation is the Convenhon on n ^national
which entered into force m 1975J51) In
representatives from 91 countries
on
^r^tional
"
SltLLhtag'a “emit system to regulate trade
XtSes 7:^u^e=
JT _e„t
authorities to issue permits and certificates.(5 lb)
III.
First World Congress on Medicinal and Aromatic Plants for Human
Welfare
conclusions and recommendations:
Al the same dm. as SO per cent at the^oATs
medicine systems, chiefly herbal me c
,
ations has caused overexploitation of
"E “4 Tn g»"ti" erosion’ and threat of extinction ot many source
.
plants harvested in the wild.
We recognise that the problems and solutions revolving around Medicinal & Aromatic
.
Plants (MAP) genetic resources and conservation are complex.
■ ?“Eo44i.>4ba:“t6h srs
suppliers, researchers, manufacturers and end users.
.
Th. initiatives on genetic resources and
S'2'“S^‘XySd™»tifloOOdisoourse and discussion to implementation ot
meaningful solutions.
’
conservation as a
priority.
10
Herbal Medicines: A Holistic Approach
‘
a
jaA
A
w
Bi
The Convention on Biological Diversity (CBD)
IV.
The direct causes of loss of biodiversity are habitat loss and over-exploitation. Equally
important are the complex social and economic development problems such as poverty,
inequitable distributions of land, wealth and other benefits and illiteracy. These problems
influence the ability of societies to use medicinal plants and other biological resources.
The need to find solutions to the threats to biological diversity in the context of these
problems led to the drafting of the UN Convention on Biological Diversity and Intellectual
Property Rights signed by over 150 countries in Rio de Janeiro during the First Earth
Summit in 1992. This Convention reflects a fundamental change in how the international
scientific community perceives the environment and issues in human ecology. This
international agreement entered into force in 1993.(52)
I
i
1
The CBD is the first international legal instrument to address biological diversity
conservation and the sustainable use of its components comprehensively. Unfortunately,
individual countries are still left with the task of developing viable policies that effectively
promote bio-prospecting and sustainable development while protecting the rights and t e
cultures of local communities.(53)
The Arusha Declaration 1990
V.
The South Commission organised an International Consultation of Experts from
Developing Countries on Traditional Medicinal Plants in 1990.(54) The participants
adopted the Arusha Declaration of 1990. This Declaration called for:
■
■
■
■
■
A South-South Cooperation on Medicinal Plants;
Exchange on medicinal plant methodology, herbal medicine production technology,
medicinal plant conservation strategies and horticulture for commercial production of
medicinal plants;
t
Giving priority to the optimal utilisation of these plants in standardised form by the
people of developing countries;
t
Adequate intellectual property rights frameworks to protect community, national an
regional knowledge on the use of medicinal plants against the unchecked profit
making interests of the major pharmaceutical companies of the North;
An emphasis on a promotional approach to the development of traditional health
systems and the use of medicinal plants in health care.
VI.
African Ministerial Conference on the Environment
Representatives from African nations gathered in Nairobi October 24-26, 1994 at the
African Ministerial Conference on the Environment. Among other recommendations, the
Conference proposed a temporary ban on access to African biological resources until
there are effective mechanisms in place to ensure fair and equitable sharing of
benefits through the Convention on Biological Diversity.(55)
VII.
International Symposium on Herbal Medicine
There is growing concern about the abuse of herbal medicine, the need to protect
consumers as well as to protect the indigenous people’s right as custodians of knowledge
and medicinal plants. There is also an urgent need to create greater awareness of the
Herbal Medicines: A Holistic Approach
Il-
?
i
potential and relative benefits and risks of herbal medicine,
further research and development.
There is equal need for
For this purpose, the International Institute for Human Resources Development at San
Diego State University in co-sponsorship with the United Nations Industrial Development
Organization (UNIDO) and in collaboration with a number of institutions convened an
International Symposium on Herbal Medicine in Honolulu, Hawaii, June 1-4, 1997.
The Symposium came out with:
■ Eight policy recommendations
■ Fifteen recommendations for action; and
■ Ten recommendations for research addressed to the various stake-holders.(56)
VIIL
The Declaration of Belem, Brazil, July 1988
The International Society of Ethnobiology was established in July 1988 in Belem, Brazil.
The society is devoted to promoting the study of how "... indigenous populations uniquely
perceive, utilise and manage their natural resources as well as to the development of
pr Tammes that will guarantee the preservation of vital biological and cultural diversity.”
The society adopted the following Declaration:
Declaration of Belem
22 July 1988
I
“As ethnobiologists, we are concerned that
SINCE
— tropical forests and other fragile ecosystems are disappearing, — many species,
both plant and animal, are threatened with extinction, — indigenous cultures around the
world are being disrupted and destroyed;
and GIVEN
— that economic, agricultural, and health conditions of people are dependent on
these resources, - that native peoples have been stewards of 99% of the world’s genetic
resources, and - that there is an inextricable link between cultural and biological
diversity. We, members of the International Society of Ethnobiology, strongly urge action
as follows:
4ir
j-.
~
■■
■
.11-
r
IK
HENCEFORTH!
substantial proportion of development aid be devoted to efforts aimed at
ethnobiological inventory, conservation, and management programs;
2) mechanisms be established by which indigenous specialists are recognised as proper
authorities and are consulted in all programs affecting them, their resources, and
their environments;
3) all other inalienable human rights be recognised and guaranteed, including cultural
and linguistic differences;
4) procedures be developed to compensate native peoples for the utilisation of their
knowledge and their biological resources;
5) educational programs be implemented to alert the global community to the value of
ethnobiological knowledge for human well being;
6) all medical programs include the recognition of the respect for traditional healers and
incorporation of traditional health practices that enhance the health status of these
populations;
7) ethnobiologists make available the results of their research to the native peoples with
whom they have worked, especially the dissemination of these in the native language;
1)
Herbal Medicines: A Holistic Approach
12
I
oil
I
■
a Jgaik
i
81 exchange of information be promoted among indigenous and peasant peoples
regarding conservation, management, and sustained utilisation of resource .
IX.
The 7tfl Asian Symposium on Medicinal Plants, ^P^ces^in^P^er,
Natural Products (ASOMPS), February 2-7, 1992, Manila, Philippi
Nearly 300 scientists participated in the above s^pos“™
of UNESCO in collaborationuvith the In^honal Found
Co-ordinating Group for Chemistry (ACGC) and otner
Philippines. (57)
S
tJ u^ity of
fThrrd World »untries -^dar. collect
H.'
sr
Tru?vXXLX"X then “ve’rrd bypltenl laws granting exciusive rights
and subsequent profits to the one who applies for it.
scientific findings they often foster.
of all biological
The participants unanimously agreed that collection and export
resources must be controlled.
•
7.
Peoples’ Guide to Herbal Medicines and Medicinal Plants
S^ral ^rgove—a. and
X—
promoted as drugs and abuse
of herbal remedies.
The alarms, concerns and fears were based on ^^^^^reifeveT'from published
SXS1 SedrX“
considered and rationally presented in the
form of comprehensive conclusions and recommendations.
. j _ “declarations” A good example is the Chiang Ma
Some of these ^re pr^ented as ^ecl^F in 1988 I «Saving Lives by Saving Plants’
to copse™ =tS
Trade of Endangered Species (CITES).
AU the dramatic pleas and declarations ime made to a^reciative but^
'
converted
scientists, research workers and mteenattonal emljemmts ^a
The audiences have been me ec v
ieg
enactea into appropriate nationa
declarations into scientifically sound p
P
interests who are depleting geneti.
XX ^^iXTp^XSXXbng and marketing; dmusands o.
1.
Herbal Medicines: A Holistic Approach
1
■
J.
J
•i
'
ineffective phyto-pharmaceuticals, nutraceuticals and dietary supplements,
these “natural products” are skyrocketing.
Sales of
The commitments made at international summits have turned out to be mere lip service
and there is no evidence that any of the recommendations have been implemented.
The almost total inability of these international initiatives to bring about appropriate
changes in public policies and national legislation is due to their failure to inform and
educate the voting public thereby mobilising their support for campaigning and lobbying
for changes in public policies. Information and education are the best weapons against
ignorance which forces the general public into situations, which make them docile and
accept whatever is given or told.
The history of humankind clearly illustrates that major changes in public policy are
possible only through mass movements when the entire general (voting) public is
sincerely convinced of the urgent need to bring in appropriate changes.
A series of international and regional initiatives in the form of conferences, seminars, etc,
during the last two decades assembled an enormous wealth of empirical data. Based on a
critical analysis of this data comprehensive sets of conclusions and recommendation,
reached by consensus were presented. Unfortunately none of these were passed on to the
general public to inform, educate and include them as one of the group of stakeholders.
When the information including the conclusions and recommendations arrived at the
various international summits and conferences are presented m a way they will
understand, people will certainly rally round and support a campaign to implement the
various resolutions reached by global consensus. This could be presented as a Peoples
Guide to Health Medicines and Medicinal Plants.
14
Herbal Medicines: A Holistic Approach
je.
Peoples’ Guide to Herbal Medicines and Medicinal Plants
A.
•
Health is a basic arid fundamental human right. It is not a commodity in the market
.
since 1978 his repeatedly stated that 80 per cent of the worlds population or over
four billion people depend on traditional systems of healthcare.
Medicinal plant lore or herbal medicine is a major component of traditional systems of
•
•
.
healthcare.
Medicinal plants are of vital importance in health care.
Medicinal plants are essential in primary health care both in self-medication and in
IherNeatirScreaslngSeII1nCsumer demand for herbal medicines in developing and
.
MeVdidn2 p^tTme a valuable global resource increasingly ^eatened by loss of
.
habitat and over-exploitation. Increasing consumer demand aggravates the threa .
Tropical rain forests are home to 70 per cent of the million or so species of highe.
.
plants that are believed to inhabit the earth.
.
Less than one per cent of the plant species in the tropical forests have been
.
OHhe total plant material utilised in the preparation of traditional medicme, about 90
•
•
•
o
i
Situation Analysis
per cent are collected from the forest.
Indigenous cultures living close to these plants use thousands of them in their
medical practice. Many of these have not beeni even named, let alone studied.
the medicinal properties of these plants thanIndigenous people know more about C
modern scientists do.
There is evidence that this community owned
This knowledge is intellectual property.
knowledge V pirated by multinational pharmaceutical indushy and patented as
.
T^piXg^unmoXrS ’ unregulated and expanding trade in medicinal
.
Tr^ical forests are located in the developing countries where the 80 per cent of the
world’s population, who depend on herbal medicines for their primary health care
lives. It would, therefore, appear that these people would have a regular access
.
medicinal plants. But, unfortunately this is not so.
Tropical rain forests are being depleted due to deforestation and habitat fragmentation
.
- declining at an alarming rate of 16.8 hectares per year.
Since 1970, the world’s forests have declined from 4.4 sq. miles per 1000 people to
• In the United States 2400 acres of native habitat are lost everyday.
. There is a loss of biological diversity around the world. Many of the
that
provide traditional and modern drugs are threatened with extinction. This will have a
maior negative impact on the health of over four billion people.
.
XS Sdhi:XXXl™Td^
!
than weP can read its contents
which we have just begun to catalogue.(58)
15
Herbal Medicines: A Holistic Approach
=3
Conservation of medicinal plants currently lacks priority in public policies and
national legislation.
There are three aspects which are of critical importance to ensure the success of
herbal medicines now and in the future:
❖ Safety, efficacy and quality of herbal medicines.
❖ Knowledge of medicinal plants;
❖ Continued availability of medicinal plants;
•
•
i
!
B.
Guidelines to Policy & Action
National governments should encourage discussions among traditional healers, health
professionals and the general public to formulate and deydoppublic policies' “c uding
regulations, which address the utilisation of traditional medicine in primary health
.
.
.
Semational organisations, governments, NGOs, manufacturers and traditional
healers need to develop ethical criteria for the promotion of traditional medicine and
herbal remedies.
,
International organisations, governments, traditional healers should examine the
concept of a selection of a limited list of useful medicinal plants and a formulary of
over the counter (OTC) phyto-pharmaceuticals for primary health care.
Appropriate methods for the clinical evaluation of traditional and herbal remed1®®
should be developed. These methods and criteria should not be limited to methods
i
J
I
and concepts of modern biomedical science.
Academic and research institutions, traditional healers, NGOs and commum y
organisations should be supported by national governments to raise public awareness
of the benefits and risks of traditional medicine and herbal remedies.
.• Academic and research institutes, traditional healers, NGOs and communi y
organisations should develop criteria for the establishment of priority list of existing
.
herbal medicines for research and development.
/ Academic and research institutes and traditional healers should consider the
development of national pharmacopeial monographs on selected medicinal plants.
. There is an urgent need for international co-operation and coordination to provide
assistance to developing countries establish programmes for the cc^cryation of
biodiversity so that adequate quantities of medicinal plants are available for future
Cohlctitn of non-cultivated medicinal plants from the wild should be encouraged only
.
.
.
if the supply can be maintained and ecosystem damage does not result.
International organisations, national governments, traditional heaters^ ™^f^ers
and traders should develop international norms and agreements to monitor, regu
and control international trade in medicinal plants.
Countries importing medicinal plants should have adequate facilities to ensure that
supplies originate from sources that are biologically and socially sustainable.
This
Knowledge of medicinal plants resides in communities rather th^di
knowledge is intellectual property. There is no provision in the TRIPs Agreement to
Snfer rights and ownership of intellectual property to communities by awarding
patents. An alternative suggested that in these instances lnte11^
could be awarded as Traditional Resource Rights and recognised as such in nat10
laws and international agreements. This will help developing countries to Prevent the
indigenous and community knowledge of medicinal plants from being pirated by the
uncontrolled profit making interests of multinational drug companies.
16
Herbal Medicines: A Holistic Approach
;•
J
..
F-
.
.
contained in various international agreements such as ther Convention »"
■
Diversity, Convention on International Trade of Endangered Species, the Declaration
of Chiang Mai, Declaration of Belem etc.
The International agreements provide the mandate for nation^
to enac
appropriate policies and regulations for conservation, cultivat on
marketing of medicinal plants and to monitor the implementation of mtemation
TheTnahonal instrunrenls should he designed as a possible bridge linking. togeUiri,
sustainable economic development, affordable health care and conservation of vital
biological diversity.
Q
!
■
I
4
i
17
Herbal Medicines: A Holistic Approach
References
1.
World Health Organization, WHO Technical Report Series, No. 863, 1996. Annex II,
“Guidelines for the Assessment of Herbal Medicines”, pp. 178-183.
2.
De Silva T., “Production of Herbal Medicines in Developing Countries”, paper
presented at the International Symposium on Herbal Medicine, Honolulu, Hawaii,
June 1-4, 1997 organised by the University of San Diego in California in
collaboration with the United Nations Industrial Development Organization.
3.
Principe, Peter J., “The Economic Significance of Plants and their Constituents as
Drugs”, Economic & Medicinal Plant Research, vol. 3, 1989, p. 9.
4.
’ 1 rain forests: potential source of
Soejarto D.D. & N.R. Farnsworth (1989), Tropical
new drugs”, Perspectives in Biology & Medicine, 32:
32. 244-256.
5.
“The Promotion 8s Development of Traditional Medicine”, WHO Technical Report
Series, 622, Geneva, 1978.
6.
Traditional Medicine: Progress, Problems and Future Direction. Report by the Regional
Director, Regional Office for Western Pacific, Thirty-eight session of the Regional
Committee, WPR/RC38/14, 24 June 1987.
7.
Report of the Second Meeting of Directors of WHO Collaborating Centres for
Traditional Medicine, Beijing, PRC, November 1987, WHO/TRM/88. 1.
8.
Traditional Medicine
Medicine and
and Modern
Modem Health
Health Care.
Traditional
Care. Progress Report by the Director
-General, Forty-fourth World Health Assembly, A44/19, March 1991.
9.
a
WHO Policies and Activities in the Field of Traditional Medicine, WHO, Traditional
Medicine Programme, February 1996, WHO/TRM/96.2.
10. Anon. “World pharma market $302 billion and growing”; SCRIP No. 2424, March 31,
1999, p. 13.
11. AFDB/UNICEF, “Les strategies d’adaptaton sociales des populations vulnerables
.[’Abidjan face a la devaluation et a ses effects”, African Development Bank, 1995.
ei <
-
'■
12. Eisenberg DM, Kesler R.C. Foster C, Norlock FE, Calkins DR, Delbanco TL.
“Unconventional Medicine in the United States. Prevalence, costs and patterns ot
use”. New Engl. J. Med. 1993: 328(4): 24-52.
13. Machennan AH, Wilson DW, Taylore Aw. “Prevalence and cost of alternative medicine
in Australia”. Lancet, 1996; 347: 569-572.
14. Jacky Law, “Making sense of herbal medicines” in SCRIP Magazine, May 1999, pp.
37-39.
14b. Balasubramaniam, K. Herbal Remedies: Consumer Protection Concerns.
Consumers International, Regional Office for Asia and the Pacific, Penang,
Malaysia, 1997.
18
Herbal Medicines: A Holistic Approach
I
'"'I
■
15. Bioprospecting/Biopiracy and Indigenous Peoples:
Advancement Foundation International], Nov 1994.
RAFI
Communique
(Rural
16. “Conserving Indigenous Knowledge: Integrating Two Systems of Innovation”, UNDP,
New York, September 1994.
17. “Saving Lives by Saving Plants” International Declaration adopted at Chiang Mai.
17.
World Health Organization, Press Release WHO 14-15th April 1988.
18. Taylor J.B. and Kennewell, P.D. 1981, Introductory Medicinal Chemistry.
Horwood Limited , Chichester, England.
Ellis
19.
19. Comer,
Comer, M.
M. &
& Debry
Debry E.
E. 1996.
1996. “A partnership: Biotechnology, Biopharmaceuticals and
Biodiversity”, 488-499 in Biodiversity, Science & Development, F. di Castn & T.
Younnes (Eds) CAB International, Oxford.
20. Cecilia Quiambo, Good Medicine, Bitter Pill. “Scientists at Manila Symposium call
for a bigger Third World share of medicinal plant wealth”, UNESCO, Sources No. 35,
©
March 1992.
a review of their importation
21. Lewington, A. 1993. Medicinal plants and plant extracts:
into Europe. Cambridge, UK, Traffic International.
22. Myers, N, The Primary Source, 1984, p.213 quoted in
i RAFI Communique, Nov 1994,
op. Cit.
23. Maybury - Lewis, D. 1992.
York: Viking.
Millennium: Tribal Wisdom and the Modem World, New
n
isiavei J.
O Lambert, J. and vietmyer
J- -24. Srivastava,
N. 1995 “Medicinal Plants: Growing role
Development Agriculture and Natural Resources Department”, World Bank, USA.
25.
Chomchalow, N. “Production of Medicmal Plants in Asia”, International Symposium
on Herbal Medicines, June 1997, op. cit.
©
26. Myers N. 1992: The Primary Source: Tropical forest and our future. New York, Norton.
27. Callahan, JR., “Vanishing biodiversity”. Environ Health Reports 104, 368-388, 1996.
28. Sonza Brito Arm & Souza Brito AA„ “Medicinal plants research in Brazil”. In: MJ
Balick, E. Elisabetsky & SA. Laird (Eds) Medicinal Resources of the Tropical Forest,
Columbia University Press, New York, 1996, pp. 386-401.
29. Penso G. Index. “Plantarum Medicinalium Totus Monde Eorumque Synonymorum ,
OEMF, Milan, 1983, p. 1026.
“Literature published during the past two decades on medicinal,
30. Bhat KKS.
Somatics, and other related group of plants”. IDMA Bull, 1997, 28, 450-54.
31. Maybury - Lewis D. 1992, op. cit.
32
Congressional Research Service for Congress, “Biotechnology, Indigenous Peoples,
and Intellectual Property Rights”, April 16, 1993, p. 11.
Herbal Medicines: A Holistic Approach
*
<
II ■"j
—I
*
33. Bioprospecting/Biopiracy and Indigenous Peoples, op. cit.
34. Cox, P.A. and Balik, M.J., “The Ethnobotanical Approach to Drug Discovery”;
Scientific American, June 1994, p. 84.
35. Ibid.
36. The World Health Organization (WHO). The International Union for Conservation of
Nature (IUCN) and World Wide Fund for Nature (WWF), 1993.
Guidelines on
Conservation of Medicinal Plants, Castle Gray Press, UK.
37. Liebmann R. “Strategies for the Preservation of Commercially at Risk Native
Medicinal Plants of North America: The Transition to Sustainable Cultivation” in
International Symposium on Herbal Medicines, June 1997, op. cit.
38. Falk D.A., Millar C.I. & Olwell M (Eds) (1996) Restoring Diversity: Strategies for
Reintroduction of Endangered Species. Island Press, Washington DC
39. Saving Lives by Saving Plants, op. cit.
40. Worldwatch Institute (1994) A Worldwatch Institute Report on “Progress Towards a
Sustainable Society”, Norton, New York.
41. Lambert J., Srivastava J & Vietmeyer N. “Medicinal Plants: rescuing a Global
Heritage”. World Bank Technical Paper No. 355, The World Bank, Washington DC,
1997.
A
42. Srivastava J., Lambert J 8s Vietmeyer N. “Medicinal Plants: An Expanding Role in
Development”. World Bank Technical Paper No. 320, The World Bank, Washington
DC, 1997.
43. Cunningham, A.B. & Mbenkum F.T. 1993, “Sustainability of Harvesting Prunus
Africana bark in Cameroon: A Medicinal Plant in International Trade”. People &
Plants Working Paper #2, Paris: UNESCO.
44. Uniyal M. “Medicinal Plants Need a Cure”.
Bangkok.
Bangkok Post, 14 October 1993,
1
45. Lewington A. A review of importation of medicinal plants and plant extracts into
Europe, Traffic, Cambridge, England, 1993.
46. WHO, IUCN and WWF 1993 Guidelines on the Conservation of Medicinal Plants.
Gland, Switzerland: IUCN.
47. Given D.R. 1994. Principles & Practices of Plant Conservation, London, UK.
i
48. Bioprospecting/Biopirary and Indigenous Peoples, op. cit.
49. McChesney J. “Biological diversity, chemical diversity and the search for new
pharmaceuticals”, paper presented to the Rainforest Alliance Symposium on Tropical
Forest Medical Resources and the Conservation of Biodiversity, 24-25 January 1992,
New York.
50. World Health Organization: Traditional Medicine, WHO, Geneva, 1978.
i Herbal Medicines: A Holistic Approach
20
4
■
|
A
51. Shippmann U. & Rosser A. 1997. CITES News. Medicinal Plant Conservation.
(Newsletter of the IUCN Special Survival Commission Medicinal Plant Specialist
Group(3 (28 Feb 1997) p. 17-18.
51b. Liebmann R. op. cit.
52. Glowka, L. F. Burhenne - Guihuin & H. Synge, 1994. “A Guide to the Convention on
Biological Diversity”. Environmental Policy & Law Paper No. 30, Gland, Switzerland:
IUCN.
53. Iwu M. 1996. “Implementing the Biodiversity Treaty: How to make international co
operative agreements work”. Trends in Biotechnology 14: 3(146): 67-107.
54. Msheneui KE, Nkunya MHN, Fupi V., Mahunnah RLA, and Mshiu EN. Proceedings
of an International Conference of Experts from Developing Countries on Traditional
Medicinal Plants. Dar Es Salaam University Press, 1991.
55. “African common Perspectives & Position on the Convention on Biological Diversity”
In Proceedings of the African Ministerial Conference on the Environment, Nairobi,
October 24-26, 1996.
1
56. International Symposium on Herbal Medicines.
Documents, Proceedings and
Recommendations of the International Symposium on Herbal Medicines, 1-4 June
1997. Honolulu, Hawaii (Eds) Wozniak D.A., Sylvia Yuen, Mario Garret and Tarek M.
Shuman International Institute for Human Resources Development, College of Health
& Human Services, San diego State University.
1
-
57. Cecilia Qumbayo, op. cit.
A
58. Maybury-Lewis D. 1992, op. cit.
SR
r
i
!
S''
I
1
"I
Herbal Medicines: A Holistic Approach
21
■>
Herbal
Remedies:
Consumer Protection Concerns
Dr K Balasubramaniam
Consumers International
Regional Office for Asia and the Pacific
Dr Kumariah Balasubramaniam graduated in medicine from
University of Sri
Lanka. He completed his PhD in Clinical Pharmacology in 197G the University of
Manchester, United Kingdom. He held the post of Professor and Head, Department of
Pharmacology at the University of Sri Lanka until 1978.
For the period 1978-1983, Dr Balasubramaniam was the Senior Pharmaceutical
Adviser in the Technology Division, of the United Nations Conference on Trade and
Development (UNCTAD) in Geneva.
In 1983 he was transferred to the Caribbean Community Secretariat (CARICOM) in
Guyana where he was the Pharmaceutical Adviser for three years. While in
CARICOM Dr Balasubramaniam worked with Ministries of Health in the 13 Member
States in formulating and implementing a Caribbean Regional Pharmaceutical Policy.
In 1987 Dr Balasubramaniam joined Consumers International, Regional Office for
Asia and the Pacific in Penang as the Pharmaceutical Adviser.
Contents
Summary, conclusions and recommendations
1.
Introduction
1
2.
Regulation, patterns of utilisation and consumers’ perceptions
of herbal remedies and traditional medicines in selected countries.
4
2.A.
This paper was presented at the International Symposium on Herbal Medicines held
from June 1-4, 1997 in Honolulu, Hawaii, USA, co-sponsored by United Nations
Industrial Development Organisation and the University of San Diego in California.
Published by Consumers International (CI)
Regional Office for Asia and the Pacific
PO Box 1045, 10830 Penang, Malaysia.
ISBN No: 967-9973-74-3
Copyright @ 1997 by CI
Printed by WONDERprint Trading, Penang, Malaysia
June 1997
i
2.B.
3.
Developed countries
2.A.i. The United States
- Dietary supplements
- Phytomedicine
ii. The UK
iii. Germany
iv. Japan
v. Australia
- Registrable medicines
- Listable medicines
- Exempt medicines
vi. Adverse reactions to herbal remedies reported in
developed countries
Developing countries
2.B.i. WHO, developing countries and traditional medicine
ii. Consumers perception of traditional medicine
iii. Malaysia and Pakistan
iv.
Vietnam
v. Thailand
vi. Republic of Korea
vii. India
Evaluation of traditional medicines
References
6
6
10
11
12
14
14
15
15
16
16
17
18
19
20
21
21
22
23
25
27
Summary, Conclusions and Recommendations
Tables
1. Worldwide phytomedicines market, 1994.
“Maintains Healthy Cholesterol: Reduces Total Cholesterol, Reduces LDL ‘Bad’
Cholesterol, Reduces Triglycerides and Increases HDL ‘Good’ Cholesterol.”
5
“Suitable for migraine, weak heart, hernia, menstrual pain, kidney stones, rheumatism,
sexual stress, impotence, frost-bite, internal and external cancer and infection.”
Projected phytomedicine annual growth rate expressed in percentage,
1993-1998.
5
3.
Percentage sales of phytomedicine categories in Europe, 1994.
5
4.
Prevalence of selected dietary practices in the US, 1994.
6
The first claim appears on the label of Cholestin, a recently launched cholesterol
lowering natural ‘dietary supplement’ in the US. The second is an advertisement for
‘Tea of Longevity’, a herbal tea, which appeared in a daily newspaper in Malaysia in
1995. A 150 mg pack of this herbal tea costs between 160-240 Malaysian Ringgits.
This is equivalent to about 10 days wages of an unskilled worker in Malaysia.
5.
Patterns of utilisation expressed in defined daily doses (DDD) of
modem and traditional herbal remedies of three commonly used
therapeutic classes of drugs in Germany in 1995.
13
Pattern of utilisation of health care services in Thailand, 1970, 1979
and 1985 expressed in percentage.
22
2.
6.
These health claims have not been approved by the drug regulatory agencies in either
country. They are addressed directly to the consumer and reflect the major concerns
consumers have on the way herbal remedies are marketed. The extent of consumer
concern is also evident from the fact that since 1990 the US Congress has received
more mail on the regulation of herbal remedies than any other issues including Bosnia,
the Gulf War, Somalia, gun control, tax reform and health care reform!
This paper describes the legal control, patterns of utilisation, and consumers
perceptions of herbal remedies in selected countries. Based on the analysis of the
empirical data obtained, some recommendations for assuring the safety, efficacy and
quality of herbal remedies are suggested.
There is now documented evidence that people in both developed and developing
countries are purchasing and consuming herbal remedies in increasing amounts. There
is also evidence that some of the herbal remedies in the market are not safe, effective
and of good quality.
To examine, study and analyse the utilisation of herbal remedies in developed and
developing countries, it will be useful to classify herbal remedies into the following
three categories:
i. Phytomedicines sold as over-the-counter (OTC) products in modem dosage forms;
ii. Dietary supplements, containing herbal products, in modem dosage forms;
iii. Traditional medicine, consisting of either crude, semi-processed or processed
medicinal plants and herbs.
Phytomedicines and dietary supplements are used by consumers in developed
countries and those in the urban areas of developing countries.
4.
Herbs, which are in fact drugs, are regulated and sold as foods in several
countries. Consumers are concerned that herbal products regulated as dietary
supplements will not provide an adequate level of safety. Consumers ask for a
pre-market safety review for plant derived products marketed as food
supplements and compulsory post-marketing surveillance.
5.
At present FDA can intervene only if there is evidence of injury to consumers by
dietary supplements. Consumers demand legislation that can proactively
regulate for safety but will never accept a legislation that provides for reactive
safety regulation after evidence of injury has been proved.
6.
There is no monitoring and control over advertising and promotion of herbal
remedies in almost ail countries. In some countries the regulation applies to
media advertising and health claims on packages but no control over the
promotional practices of medical representatives when they visit health
professionals. Consumers ask for the development of an Ethical Criteria for
Promotion of Herbal Remedies. This should also include promotional practices
of medical detailmen and direct selling of health products to consumers.
7.
Modem pharmacies stock herbal remedies and pharmacists are expected to make
appropriate product selection to consumers. But at present there are no
authoritative sources from where pharmacists can obtain relevant information on
herbal remedies to advise consumers and other health professionals. Consumers
request this symposium to examine how best to provide this information to
pharmacists.
8.
There is uncontrolled cross-practice. This means that practitioners not trained in
a particular system prescribe and dispense drugs belonging to that system
indiscriminately. This should be prevented by appropriate legislation.
9.
Consumers propose that there should be self-regulation by appropriate
professional bodies as well as state legislative control on the training,
certification and registration of traditional healers and practitioners.
10.
There is insufficient data on the per capita consumption of traditional medicines
in developing countries. Estimates are available for Malaysia and the Republic
of Korea. In Malaysia the per capita consumption of traditional medicines is
more than double that of modem pharmaceuticals although traditional healers are
not recognised in Malaysia and there is no formal system of traditional health
care. In the Republic of Korea, the per capita consumption of traditional
medicines is about 36 per cent more than that of modem drugs.
Traditional medicine, according to the World Health Organization (WHO) is believed
to serve the health needs of about 80 per cent of the world’s population. It is relevant
to note that in the US because of the difficulty of approving herbs as OTC drugs and
the limitations placed on health claims for dietary supplements, particularly for herbs
there is a suggestion to create a third category - traditional medicines.
In both developed and developing countries, there are no comprehensive integrated
national policies on herbal remedies which will facilitate drug regulators and health
administrators to regulate the market and ensure that all herbal remedies in the market
are safe, effective, of good quality, of reasonable cost and are used rationally. A
major recommendation follows from this conclusion - the need to recommend
guidelines for developing national policies on herbal remedies. These guidelines can
serve as a model to enable individual countries to develop their own national policies
on traditional medicines and herbal remedies including appropriate legislation to
provide legal support for the national policy to regulate the market.
The proposed guidelines should take into consideration the
the various
various consumer
consumer
protection concerns identified in this paper so that appropriate components can be
formulated to take care of these concerns.
1.
2.
3.
A model legislation on traditional medicines needs to be developed. At present
there seems to be as many approaches to regulating herbal remedies as there are
countries.
Some countries such as Australia and Germany have useful
components in their legislations which may be incorporated into the proposed
recommendations. The Japan Chinese -Medicine Manufacturers have developed
voluntarily “Regulations for Manufacturing Control & Quality Control of Ethical
Extract Products inKampomedicine (Oriental Medicine) Formulations”, a useful
model for developing Good Manufacturing Practices (GMP) for traditional
medicines.
It will be useful to have universally acceptable definitions for the various terms
used such as herbs, botanicals, medicinal plants, herbal remedies,
phytomedicines, dietary supplements, traditional medicines. In this context it is
relevant to note the definition of a ‘therapeutic good’ in the Australian law which
states Any product that is likely to be.thought to be a therapeutic good for any
reason, most often because of advertising, dosage form or appearance.”
Consumers are confused over tens of thousands of herbal remedies in the market.
It will not be possible to formulate a national policy to regulate these tens of
thousands of herbal remedies. Consumers want this symposium to debate the
concept of a limited number of useful herbal remedies and traditional medicines.
This could be at two levels:
• Limited number of useful medicinal plants and herbs for use at the
household level.
• Limited number of phytomedicines and traditional medicines and
• Development of a formulary of phytomedicines.
ii
Consumers consider that it will be important to carry out a cost/benefit analysis
of herbal remedies and traditional medicine in a selected number of countries
and make it available to consumers and health administrators.
iii
11.
Consumers in both developed and developing countries use both modem and
traditional medicines simultaneously. But they do not provide this information
to the prescnber or dispenser. There is a potential risk of adverse drug
mterachons. Increasing public awareness of the benefits and risks associated
with the use of traditional medicines should be built into the components of a
national policy on traditional medicines and herbal remedies.
12.
There should be a structure and mechanism in place for an international alert
system for rapid sharing of information on toxicity and adverse reactions to
herbal products among ding regulators.
13.
The paper concludes with an appeal for a new approach to the evaluation of
traditional medicines.
Consumers International Regional Office for Asia and the Pacific will be pleased
to collaborate with UNIDO in following up on the recommendations that will be
adopted by this international symposium.
I.
Introduction
There are more effective, safe and good quality modem pharmaceuticals available
today than ever before. However, it is paradoxical that consumers, particularly in the
developed countries, are purchasing and using more and more herbal remedies/
There is now ample documented evidence that people in both developed and
developing countries are purchasing and consuming herbal remedies and traditional
medicines in increasing amounts. There is also evidence that some of the herbal
remedies in the market are not safe, effective and of good quality. This raises the
issue of consumer safety.
Consumers International (CI), a global federation of 214 organisations from 92
countries, representing consumers worldwide has consumer safety high on its agenda
CI is pleased to participate in this symposium, which will, among other issues examine
consumer protection concerns.
What herbal remedies are the people in advanced industrialised countries such as the
US and Western Europe and those in poor developing countries in sub-Saharan Africa
and South Asia, consuming? The morbidity patterns are different and so is the pattern
of utilisation of modem pharmaceuticals between developed and developing countries.
What then is, the pattern ot utilisation of herbal remedies and what are the consumer
concerns in these countries?
To answer these questions and understand the issues it will be useful to classify herbal
remedies into the following three categories:
I.
Phytomedicines or P
P'hyiopharmaceufreals
____ ’
sold as over-the-counter (OTC)
products in modem dosage fo;inns such as capsules, tablets and liquids for oral use.
2-
PietarV supplements containing herbal products, also called nutraceuticals,
available in modem dosage forms.
These two types of herbal remedies are used by consumers in developed countries and
those in urban areas of developing countries. These herbal remedies are gradually
occupying increasing shelve space in modem pharmacies.
Herbal—remedies consisting of either crude, semi-processed or processed
medicinal plants and herbs. These remedies are available at two levels:
i) Traditional beliefs, norms and practices based on centuries old experiences of
trials and errors, successes and failures at the household level. These are
passed through oral tradition and may be called, “people’s health culture”,
home icmedies or folk remedies. These have a vital place in primary health
care in developing countries. A very good example was the universal
availability of home made, cereal based oral rehydrating fluids in all cultures
in developing countries till they were displaced by the commercial varieties of
iv
1
oral rehydrating solutions which have been skillfully and aggressively marketed
by the drug industry.
ii) A codified system of traditional medicine at the level of the traditional healer.
In the context of developing countries, consumer protection concerns cannot be
realistically studied by examining herbal remedies in isolation. They should be
taken together with traditional medicine. Traditional medicine includes the
indigenous knowledge available in the community, the traditional healers and the
means by which they provide health care, namely herbal remedies. Consumer
protection and safety are closely related to herbal remedies, the prescribing
practices of traditional healers and the health care systems in which they operate.
Having stated that the prescribing practices of traditional healers are also cause for
consumer concern, it is also understood that this symposium cannot examine issues
related to the training, certification and registration of traditional healers. However it
will be necessary to reflect these concerns in the conclusions of the symposium. This
will inform policy makers in developing countries to examine and develop appropriate
policy measures to train, certify and register traditional healers and to regulate and
control their professional practice.
In this paper the terms “traditional medicine” and ‘herbal remedies’ will be used
interchangeably to describe the third group of herbal remedies used in developing
countries.
It is also the term used by the World Health Organization (WHO), health
administrators and policy makers in all developing countries. According to WHO,
traditional medicine is believed to serve the health care needs of about 80 per cent of
the world’s population. The goal of Health for All by the Year 2000 cannot be
achieved without traditional medicine. (1, 2, 3, 4, 5)
While there is a distinct difference between the patterns of utilisation of
traditional medicine/herbal remedies in the developed and developing countries,
consumer concerns are the same the world over. These include:
• Safety;
• Efficacy;
• Quality;
•
Costs
• Unethical promotion; and
• Irrational use
of traditional medicine and herbal remedies.
Inspite of the fact that consumer concerns are the same in both developed and
developing countries, international conferences that have been convened to study
traditional medicines, herbal remedies and consumer protection concerns fall into two
distinct categories.
For example, the July 1996 Open Conference on Botanicals for Medical and Dietary
Uses: Standards and Information Issues, convened in Washington DC, July 7-9, 1996
looked exclusively at problems and prospects facing consumers in developed
countries.
On the other hand, all international, regional and national conferences organised by
the WHO and its Traditional Medicines Programme were confined mainly to the use
of traditional medicine in developing countries. (1,2,3,4,5)
Consumers believe that sharing of information on consumer protection measures
between developed and developing countries would be advantageous to both for the
following reasons:
i) Developed countries have effective and efficient regulatory control over modem
pharmaceuticals.
These may serve as useful models to enact appropriate
legislation to regulate herbal remedies;
ii) Developing countries have had several centuries of experience with the use of
traditional medicine in health care. Developed countries may find this experience
useful;
iii) Neither developed nor developing countlies have an effective regulatory
mechanism to ensure the safety, efficacy and quality of herbal remedies;
iv) Almost all herbal remedies marketed in developed and developing countries are
OTC products, although some of these are known to be toxic;
v) hi both developed and developing countries a herbal medicine, if marketed as food,
is not regulated; but if the same product is marketed as a traditional medicine, it is
regulated;
vi) In all developed and most developing countries, there are no systems, selfregulatory or otherwise, for the training, certification and registration of traditional
healers or herbalists. Consumers have no guarantee that the traditional healers or
the herbalists whom they visit to obtain health care have the necessary
qualifications.
CI is pleased that this International Symposium will among other things examine
consumer protection, and the use and abuse of herbal remedies in both developed and
developing countries.
One of the objectives of this symposium will be to strengthen consumer protection
and consumer safety in a well regulated market where safe and effective herbal
remedies of good quality are available at affordable prices and are used rationally.
To achieve this objective, this symposium will have to recommend guidelines for
developing national policies on herbal remedies which can serve as a model to
enable countries to develop their own national policies on traditional medicine and
3
herbal remedies including appropriate legislation to provide legal support for the
national policy to regulate the market.
Policy recommendations have to be based on a critical analysis of empirical data on
traditional medicine and herbal remedies in developed and developing countries. This
data will include:
i) Patterns of utilisation and consumers’ perceptions of traditional medicines and
herbal remedies;
ii) Existing legislation to control and regulate the herbal remedies market;
iii) Problems faced by countries in regulating the market;
iv) The marketing and promotional practices of the herbal drug industry;
v) The training, certification and registration of traditional healers and herbalists; and
Table 1: Worldwide phytomedicine market, 1994.
Worldwide Phytomedicine Market, 1994
per Dr Grunwald, PhytoPharm, Phytotherapeutlcs market
Country
European Union
Rest of Europe
Asia
Japan
North America
Total
Million USS @ retail
6,000
500
2,300
2.100
1,500
12,400
Source: Brevoort. P. ‘The current Medical & Dietary Uses of Botanicals: A market perspective’ in
July 1996 USP Open Conference on Botanicals (or Medical & Dietary Uses: Standards &
Information Issues. Proceedings of the Conference. United States Pharmacopeial
Convention Inc.
vi) The role that traditional medicines and herbal remedies play in the overall health
care services of a country in providing health care to its people.
The projected phytomedicine annual growth for 1993-1998 is given in Table 2. Table
3 gives the percentage sales of phytomedicine categories in Europe, 1994.
This paper attempts to review the available data by describing the experiences of
selected countries. And based on analysis of the data it suggests appropriate
recommendations.
Table 2: Projected phytomedicine annual growth rate expressed in percentage
1993-1998.
2.
Regulation, patterns of utilisation and consumers’ perceptions of herbal
remedies and traditional medicines in selected countries
In the developed countries, consumers are making a deliberate choice in opting for
herbal remedies. Their popularity is widespread in North America, Western Europe
Japan and Australia.
In the developing countries, on the other hand, a vast majority of the people use
traditional medicines because modem health care services are not accessible, available
or affordable to them.( 1,2,3,4,5)
___________ Region
North America
European Union
Rest of Europe
Japan
South East Asia
India/Pakistan
Source: Brevoort P. op. cit.
Table 3: Percentage sales of phytomedicine categories in Europe, 1994
Therapeutic Category
The worldwide market for phytomedicines was USS 12.4 billion in 1994. (Table I)
Cardiovascular
Respiratory
Digestive
Tonics
Hypnotic/sedative
Topicals
Other
Source: Brevoort P. op. cit.
4
Projected phytomedicine annual growth
rate in percentage 1993-98_________________
12++
8++
12
15
12
15
Percentage of Sales
27.2
15.3
14.4
14.4
9.3
7.4
12.0
International market prices of top-selling herbs have been pushed. Some of the
more popular herbs such as echinacea and goldenseal sell for quite a high wholesale
pnee of about $30-$50 per pound for their roots. There is at present ^shortage of
supply of these herbs. The 1996 echinacea crop had been sold before they were
harvested. The 1997 crop was being negotiated in 1996. Some may want to try for
utures on the 1998 crop. The most expensive herb in the world is wild Chinese
gmseng. It sells for $ 1000 a gram and is traded in the market place.(6)
There is very little published data on retail prices of herbal remedies and how much
consumers pay out of pocket for them particularly in developing countries. This
information will be essential for health planners and consumer development workers.
Table 1 refers to the phytomedicine market only,
As described earlier, herbal
remedies could be divided into phytomedicines, r..
nutraceuticals and traditional
medicines. The American market for nutraceuticals is ab<
-bout one billion dollars. (7)
A study conducted by the US Food & E.
Drug Administration (FDA) in 1994 showed
that, of approximately 1600 respondents to
J a telephone survey, eight per cent said that
within the past year they had used a herbal dietary supplement (Table 4).
Consumer concerns regarding the regulation of herbal remedies in the US has been
very well described by Loren D Israelsen.(lO) The US FDA has not drafted specific
policy statements or regulations to guide industry on safety or approval of herbs,
good manufacturing practices or the use of scientific evidence to support proposed
claims for herbal products. Over the past several years, the FDA has expressed
concerns that herbs are in fact drugs and yet are sold as foods.
Dietary snppiemenls
From a scientific standpoint, the claimed benefits of many of the dietary
supplements are better evaluated in pharmacological rather than nutritional
terms. Many of the herbal products are being sold as dietary supplements. While
some of these consist of herbs traditionally used as food, many are made from
plants that have no traditional food use.
Consumers are concerned that herbal products regulated as dietary supplements
will not provide an adequate level of safety. Consumers ask for a pre-market
safety review for plant derived products marketed as food supplements and
compulsory post-marketing surveillance.
Table 4: Prevalence of selected dietary practices in the US, 1994
Supplement use
Percentage not using/using
None
Any supplement
Vitamin/minerai supplement
Amino-acid supplement
Herbal supplement
47
53
42
06
08
I
Herbal remedies are regulated by two Acts in the US. The more recent one is the
Dietary Supplement Health and Education Act of 1994 (DSHEA). This legislation has
been the focus of intense debate and consumer concern since the regulation for “health
claims’’ for dietary supplements including herbs under the Nutrition Labelling and
Education Act of 1990 (NLEA) became an issue several years ago. How much
concern was felt by the consumers can be gauged by the fact that since 1990, the US
Congress has received more mail on the regulation of herbal remedies than any
other issue including Bosnia, the Gulf war, Somalia, gun control, tax reform and
health care reform’(ll)
Source: Brevoort P. op. cit
2.A.
Developed Countries
Consumers are very much concerned with the new legal definition of dietary
supplements given in DSHEA.(12)
2.A.i.
Regulation of herbal remedies in the United States
Dietary supplements include:
A 1993 study }(8)} revealed
Americans were becoming disillusioned with modem
health
\ that
3t Americans
health care and were seeking alternatives. About 30 per cent of the adults in the US
42P5°m'n USln®
eaS' °nj
°f unconventional ^rapy in 1990 and made about
Sts7o modem
of uncon''entional therapy contrasting with 388 million
Visits to modem primary health care physicians.
The same study showed that about three per cent of Americans
were using herbal
medtcmes. The consumption of herbal medicines is increasim
ig. A more recent poll of
a little more than 1000 adults found that 63 pc.
per cent of them said that herbal products
would be the answer to many common ailments
—.3 or part of their daily routine or regime
within five years.(9)
6
•
a vitamin
•
•
•
•
•
•
a mineral
a herbal or other botanical
an amino acid
other dietary substance to supplement the diet by increasing total dietary intake
concentrate, metabolite, constituent extract or
combination of the above ingredients
Consumers believe that this definition is not any better than no definition since an
infinite number of permutations and combinations are possible considering the
fact that there are several thousands of herbs and botanicals in the market. This
is a pro-industry and anti-people definition of a dietary supplement which has
opened the flood-gates!
7
One provision in the Act prohibits FDA from regulating herbs and dietary
supplements as food additives. This brings into focus the FDA concern mentioned
earlier namely herbs are drugs but sold as food and the consumer
<
that
----- • concerns
herbal products regulated as dietary supplements will not provide an adequate
level of safety.
The FDA had tried to argue that some dietary ingredients are food additives and
therefore require pre-market approval. The industry has opposed this and
considers its dietary supplements as foods and therefore regulated as foods.
Unfortunately for consumers, several federal courts have agreed with the industry
and apparently the Congress agrees.(13)
Consumers view another provision in DSHEA with great concern. A new safety
standard has been developed for dietary supplements. A dietary supplement will
oe deemed unsafe only if it presents a significant or unreasonable risk of injury or
illness under the conditions of use on the label. And the burden of proof that a
dietary supplement is unsafe rests on the FDA.(14) Consumers cannot understand
how FDA can prove a product is unsafe and protect consumers if the agency is not
allowed to evaluate the product but must wait until it has evidence that patients are
injured by the product. How many consumers have to be injured before FDA can
intervene? These are not hypothetical questions as revealed in a news item in the
pharmaceutical journal, SCRIP.(15). The US FDA has been taken to courts.
Pharmanex, a US marketer of plant based substances recently launched Cholestin as a
dietary supplement in compliance with the Federal Food, Drug & Cosmetics Act. The
claim on the Cholestin package states, “Maintains Healthy Cholesterol; Reduces
Total Cholesterol, Reduces LDL “Bad” Cholesterol, Reduces Triclycerides, and
Increases “Good Cholesterol”. Pharmanex argues that these health claims fail
within the acceptable structure/function claim in accordance with the Nutrition
Labelling & Education Act and there is no claim for the treatment of a disease.
Pharmanex is suing FDA to obtain a declaration
declaration that
that Cholestin
Cholestin is
is a ‘dietary
supplement’ and not a drug. The FDA’s Centre for Drug Evaluation & Research
wants to regulate Cholestin as a drug based on the labelling claim “reducing
cholesterol” and its formulation (it contains HMG CoA reductase inhibitors,
including a small quantity of a molecule, identical to that in Merck & Co’s
lovastin product, Mevacor).
In its law suit Pharmanex maintains that Cholestin should be classified as a natural
dietary supplement under DSHEA because it contains food ingredients - Monascus
purpureus Went yeast fermented on rice.
Under the DSHEA, as it stands now, FDA has no power to regulate dietary
supplements. The agency must prove that patients have been injured by a product
before it can intervene/16)
8
Consumers will be watching this case with great interest to find out whether
DSHEA is going to be pro-industry or whether it can be made to be more
consumer-friendly.
Consumers demand legislation that can proactively regulate for safety but never
accept an Act that provides for reactive safety regulation after evidence of injury
has been proved.
Consumers are very much concerned about the potential dangers of herbal
remedies that are being sold as dietary supplements and are often wrongly touted
as being free of adverse effects. Since December 1993, dietary supplements
containing ephedrine and related compounds have been implicated in
approximately 800 reports of adverse effects, including at least eight deaths in the
State of Texas alone.(17) That herbal remedies were not necessarily safe simply
because they were natural was shown several years ago.(18)
The DSHEA has devised a statutory commission. One of the tasks of this commission
is to prepare a report that evaluates how best to provide truthful, scientifically valid
and non-misleading information to consumers so that they can make informed and
appropriate health care choices for themselves and their families.
Consumers are concerned with the health claims made for dietary supplements.
Health claims for dietary supplements - a statement of the relationship of a nutrient to
a disease - are regulated by the Nutrition Labelling and Education Act of 1990 which
was established in response to a wild proliferation of health claims that was occurring
in the 1980s. It was estimated that in the first half of 1990, 40 per cent of new
products that were released bore some type of health claim and many of them were not
substantiated by science.(19)
But has NLEA helped the consumers to make informed choices by reading the labels
on dietary supplements? For example, a structure-function claim for a feverfew
product states, “Helps to maintain normal blood vessel tone” and talks about the active
ingredient parthenolide which helps to normalise the fraction of platelets in the blood
etc.(20) How many consumers can understand this complicated label and make
informed and appropriate health care choices for themselves and their families?
It is the elderly who use herbal remedies and dietary supplements most. Studies done
at a Senior Health Centre in New Mexico and at the University of New Mexico
showed that herbal remedy use is prevalent among the elderly.(21) According to the
American Association of Retired Persons Pharmacy Service, from Retired Persons
Services, Incorporated (RPS), there has been a tremendous interest among the elderly
on the use of natural products as dietary supplements. Consumers have been
bombarded with product reports in all types of publications and advertisements, often
with conflicting or confusing infonnation. The RPS strongly believes that
consumers should not be “guinea-pigs” for unknown product components.
Outrageous health claims certainly go too far when they are attached to the
following disclaimer. “This statement has not been evaluated by Food and Drugs
9
Administration. This product is not intended to diagnose, treat, cure, or prevent
any disease.”(22)
If this is the situation in the US with probably one of the best drug regulatory
systems in the world - one that prevented thalidomide from getting registered what is the plight of developing countries with very weak regulatory systems?
This international symposium, will hopefully, provide answers.
herbal remedies do not tel! their primary care physicians that they are taking
them; presumably they do not tell their pharmacists either.(26)
Critical
information essential for prescribers and dispensers to be forewarned about
possible drug interactions are withheld.
Consumers may not be telling their physicians either because the latter do not ask
them or because consumers are under the mistaken belief that herbal products are not
medicinal products but dietary supplements.
Phytomedicines
Several herbal remedies are used by millions of consumers in America for a number of
purposes, some of which are therapeutic. The annual market value of phytomedicines
in 1994 was $1.5 billion.
However there is no special Act under which
phytomedicines can be registered.
Herbal remedies, for minor self-limiting
conditions, are registered under the OTC drug review process that began in 1972.
Many industrialised nations have developed regulatory models that provide for safetv
approval and proof of efficacy for many
any of their
their herbal products either based
based on:
• Evidence of traditional use; or
• Modem scientific information.
In 1991 a group of leading US and European phytomedicine companies formed the
European American Phytomedicine Coalition (EAPC) and petitioned the US FDA for
European marketing histories for botanical ingredients to be eligible for inclusion in
the OTC drug review process that began in 1972.(23)
The European regulatory models accept histories of traditional use of herbal remedies
as evidence of safety. These are called old drugs and are subject to a more lenient
approval process. There is, thus, an enormous legal difference between new and
old drugs in Europe. This is not the case in the US.
European phytomedicine companies have been unable to sell in US as drugs, herbal
r,egulated as medicines in their countries. It was to overcome this barrier that
i
had Petl*,oned the us FDA
accept European marketing approval. Upto
1996, the FDA has not responded.
H
The constraints to registering herbal remedies as OTC drags and the limitations placed
on healtli claims for dietary supplements, have led many to suggest that the US should
develop appropriate legislation to review and approve herbal remedies as legitimate
OTC drugs. The American Herbal Council, the Herb Research Foundation and
t e Americal Herbal Products Association support a separate traditional
medicines category in addition to dietary supplements in order to arrive at a more
rational framework for the regulation of herbal remedies (24, 25).
American consumers’ concerns are not limited to the safety, efficacy and quality
of herbal remedies. Equally distressing is the communication and information
vacuum that surrounds herbal remedies. Seven out of 10 consumers who use
10
Consumers do ask their pharmacists. In fact, 74 per cent of pharmacists are
asked about herbal remedies. This was revealed in a recent survey by Texas
Pharmaceutical Association. Often their answer was very simple - “I do not
knowl”(27)
From a consumer point of view the pharmacist’s role in providing objective
information is vital. They stock herbal products and are expected to make
appropriate product selection for consumers. Pharmacists therefore need to be
adequately knowledgeable on the safety, efficacy and quality of herbal products.
They also have to provide information to other health care professionals. At
present there are no authoritative sources from where pharmacists can obtain the
relevant information. Consumers look forward to this symposium to find
appropriate solutions to this concern of consumers.
The United Kingdom
As in the US, many people in the UK use herbal remedies for minor self-limiting
conditions. The failure of modem medicine to cure and anxiety about their potentially
serious unwanted effects have led some to turn to herbal remedies for the treatment of
more chronic and disabling conditions as well often in the (mistaken) belief that timehonoured natural medicines must be safe.(28)
The Medicines Act of 1968 initially exempted herbal remedies from licensing
requirements and did not restrict their supply. Subsequent legislation recognised that
certain plants and herbs had powerful pharmacological effects and restricted their sale
and supply to pharmacies while still permitting prescribing herbalists to use some of
them within specific dosages.(29)
In the 1980s about 5,500 herbal products were available either as pharmacy medicines
or on the general sales list. Of these about 1000 products derived from 550 herbs
were estimated to be on the market with product licences of right. The Committee on
the Review of Medicine (CRM) were examining them. Assessment of their safety,
efficacy and quality was difficult. Few herbal remedies have been evaluated by
clinical trials. CRM had decided to accept bibliographic evidence of efficacy even
where this is only an appropriate reference in a herbal pharmacopoeia.(30)
Medical herbalists choose and prepare medicines and accept responsibility for their
recommendations. Herbalists can practise without a formal qualification but a few are
also medically qualified.(31) However, relatively few people consult a medical
11
herbalist. Some go to pharmacies but health food shops and department stores are the
mam sources from which consumers buy their herbal remedies often selecting them
with no qualified advice.(32) Supply of herbai remedies by mail order fs also
increasing and this accentuates the problems of unsupervised self-medication.
2.A.iii.
TableS:
Patterns of Utilisation r ,
• ;
expressed in DDD of modern and traditional
J used therapeutic classes of drugs in
herbal remedies of three commonly
Germany in 1995
Germany
Therapeutic category
DDD in
millions
1995
Percentage
change in
1995 over
DDD in 1994
>
scientific data - chemical, toxicolog.cal, pharmacological, clinical, epidemiological or
hevb,t - Th7c
,S reqUhave
n 10what
ru™
‘he SafSty
Cfficacy of
of reasonable
the !ong-term
Tv, Germans
has been
calledand
a “doctrine
certaintyof
”
]
whrch is the criterion they use for determining the efficacy of a herb, but they go by a
nenof'w °f abS°£te Certamty” Wlth resPect t0 safety. So while safety is not a
ne0otiable issue, efficacy ls reviewed using a more relaxed standard.(33)
966.3
192.8
Marks per
DDD
1.5
Total cost In
Marks
(Millions)
+ 6.8
1.0
0.23
0.67
1413.8
167.9
157.7
129.0
+ 5.5
1.29
64.4
+23
1.44
83.8
12.0)
)
)
38.0)
Herbal immune therapy drugs
^0^QnnUmbr.°f reglStered med,cinal druss in Germany is about 50,490. Of these
somP 608 °’i- 2 per^nt are herbai Phytopharmaka. Majority are OTC productsabout ^OO6 reoT5^ y
In addidon to phyttopharmaka, there are
The^
rcgl tered homeopathic drugs which may include herbal ingredients
Ube s Tet anoth
b""1’
Sta'e indications for
on the
and In bYi
8roup °f d™8S are a combination of modem chemical substances
and herbal ingred.ents. In addition to these herbal remedies which are registered
drugs, ^ere are herbal products which do not make any health claims and are used as
mode and Tt, :3' lhesekare not controlled by the Medicines Act. Practitioners of
m medicine prescribe herbal medicines which are paid for by the social health
insurance.
I’
-However,
they do not have any specialised training in prescribing
phy
topharm
aka.
A
. . .
------- .. recent rev.ew showed that in 1970, 52 per cent of all Germans
used phytopharmaka; a survey done in 1997 revealed that 70 per cent use
phytopharmaka now.(34)
676.8
+ 2.5
+33.0
- 5.3
167.9
Modem immune therapy
drugs: liposaccharides &
oligosaccharides of bacterial
origin
Homeopathic immune
therapy drugs: mostly herbal
Herbal remedies, called phytopharmaka, are registered under the medicines ActArznemntelgesetzs - and are allowed to make health claims and indications for use on
cann« Y
e>.ar 1 i." ? d"'°n’ Other
products’ not registered as drugs- they
cannot make any health claims.
°
Table 5 gives the pattern of utilisation
Germanv for thr.
'i------ 7TV‘‘ of modern a,ld traditional herbal dmgs in
7-™ Z’/ ™^COTmon,y used therapeutic categories of drugs in 1995. Defined
daily doses (DDD) of the modem
and traditional medicines of each therapeutic
category are given.
Modem psychotropics
Herbal psychotropics
Modem cardiac glycosides
Herbal cardiac glycosides
Cost in
58.2
Source: Monika Schemer, BukoPharma Kampagne, Bielefeld.
Germany, Ref. 33.
Psychotropic and cardiac glycocides are essential, prescription only drugs- cardiac
of rh
llfe;sav,n.8 d™gs: an advanced industrial country and the home of one
e biggest multinational drug company, Hoechst is going back to trndv
i
s"r
"d
~
utilisation of herbal psychotropics was 33 per cent compared to three per cent for
Odem psychotiopics. Herbal cardiac glycocides are three times more expensive than
cardiac g ycoc.des. Yet the utilisation of herbal glycocides has increased
inh bitn^ a h
m 8lyC°CldeS has decreased. It is relevant to note that ACE
ablb tors are being increasingly used in the management of heart failure Inspite of
this, the use of herbal cardiac glycosides has increased.
P
Immune therapy dings are non-essential.
)
Their efficacv has nnt
j
BSE
A single plant medicine marketed to i.._
increasev cerebral circulation achieved a turnover
of 120 million pounds (about DM280 million) in
1989. Germany has been described
as the Garden of Eden for herbal remedies.(35)
12
13
2.A.iv.
Traditional medicines in Japan are based on traditional Chinese medicines introduced
into Japan more than a 1000 years ago. The Pharmaceutical Affairs Division of the
Ministry of Health & Welfare issued new regulations in 1985 setting quality control
standards for ready to use traditional drugs. Traditional drugs of standard quality
became available on the market a year later. They are used by more than 40 per cent
of the physicians in their routine practice.(36) More than 100 kinds of traditional
medicines (Kampo drugs) have been placed in the national health insurance scheme.
The government is increasingly recognising traditional medicine. There has been
multisectoral research on herbal medicine and acupuncture funded by the Japan
Science and Technology Agency.(3 7)
Quality assurance requires specifications and test methods employed in the major
phases of production: raw materials, the extract, and the final dosage form, e.g. tablet,
capsule, granules, etc. In assessing the safety and efficacy of traditional medicines,
two broad approaches are used. For medicines that have been used over a long time in
Japan, safety and efficacy are accepted because of the long history of uneventful use.
Therefore for this category, no data demonstrating safety and efficacy need be
submitted. On the other hand, other products that have been recently introduced, e.g.
new formulations, should be treated as any new pharmaceutical product. For these,
data are required to demonstrate safety and efficacy, including data on clinical trials.
The Good Manufacturing Practices (GMP) for traditional medicines were developed
voluntarily by the Japan Chinese - Medicine Manufacturers Association. It is known
as “Regulations for Manufacturing Control & Quality Control of Ethical Extract
Products in Kampomedicine (Oriental Medicine) Formulations.(38)
2.A.v.
standards, finished product liability, tablet disintegration.
Japan
All products are assessed for basic safety and quality. Further evaluation to consider
the safety in more
risk to the consumer
Y
ProdUC' “
*there could be some
Herbal and traditional medicines are evaluated by the Traditional Medicines
Evaluanon Commtttee (TMEC). Where herbal medicines are eaten or made into teas
y for nutrition or flavour, these would be considered to be foods, not medicines
Where herbal products are made
solely to
moisturise or cleanse the skin, these would
made solely
to moisturise
be considered to be cosmetics, not medicines.
Medicines made by herbalists (and other practitioners) for individual patients
following a consultation are texempted from controls in the Act, but these medicines
should meet acceptable standards.
i, JiSSESfi -
by
Medicines in Australia fall into one of the following three groups:
• Registrable medicines;
• Listable medicines; and
• Exempt medicines
Registrable medicines
Australia (39)
Prior to 1991, there were no Commonwealth Controls exercised over herbal products
which were, at that time, often treated as foods. In 1989 a new Therapeutic Goods
Act (TGA) was passed by parliament (replacing the old 1966 Act).
In the case of herbal medicines, full evaluation (Registration) is required if:
• the product contains a substance that is a scheduled poison, e.g. certain toxic
1 IV I V
•
Requirements for herbal medicines
Herbal products are recognised as medicines where they meet the definition of a
‘therapeutic good’. This includes:
• Anything used for the prevention, treatment or diagnosis of diseases and other
bodily conditions in humans or animals; and
• Any product that is likely to be thought to be a therapeutic good for any
reason, most often because of the advertising, dosage form or appearance
(emphasis mine).
All medicines supplied in or exported from Australia must:
- first be approved by the TGA
- be made by a manufacturer with an acceptable standard of good manufacturing
practice (GMP)
- comply with relevant standards, for example: labels, advertising, raw material
14
y
the product contains an active ingredient from an animal or mineral source where
this ingredient is not permitted in the “Listed” products;
^^OdlICt iS
be Urd for a Seri0US condition which should be monitored by a
practitioner or the product needs to be sterile e g. eye drops and injections.
TMEG will at its discretion, accept evidence of established tr aditional use as proof of
dShreauT/6
’ 'Ong Peri°d °f
US6’ °n'y Iimited ^icological
Listable medicines
Low nsk methanes - mostly herbal medicines, vitamin and mineral products
sunscreens and some homeopathic products - go through the “Listing” process before
PPro-'ah Tl>ese products are assessed for quality and safety. To ensure safety only
ertam ingredients are allowed in these products. For some ingredients, only^ safe
15
dose or a particular route of administration is allowed,
manufacturer must be established as acceptable.
The standard of the
Proof of efficacy is not usually requested, although the product sponsor is required to
hold this information as a condition of Listing. Where a product is approved for
“Listing”, a Certificate of Listing is issued. Information about registrable and listable
medicines is stored in the Australian Register of Therapeutic Goods (ARTG) database.
There are over 1, 500 different herb species in the medicines being supplied in
Australia. Most herbs are permitted to be included in “Listed” products. It is
estimated that two-thirds of “Listed” products in the Australian Market contain one or
more herbal ingredients. There are approximately 400 “Listed” products imported
from China.
France.
.as lead was not followed in Canada, where the first two cases of hepatitis
were reported recently.(45)
Four cases of acute hepatitis attributable to single plants
or mixtures were reported in
British patients taking vallerian and scutellaria.(46) Valerian is
one of the top selling
herbs in the US.(47)
In Belgium 70 cases -°S
( ' re2ali r ainnent alt,ibutable t0 preparations based on Chinese
plants were recently reported.(48)
^98n8ef4n9?1Theat1' XhCr: a
drinkin8 herbal
reported in
1988.(49) The mother had regularly taken an infusion based on 10 different plants
cX’for cauti^T7'
Wi‘h herba* tea iS difficult t0 establish but d,is
cans tor caution during pregnancy.
About 27,000 Registered and Listed medicines are supplied in Australia. A quarter of
them are manufactured overseas.
One research field that has been neglected and poorly studied is the potential
ARTG - Exempt medicines
to thdr'nh
TedieS 3nd m0<iern drUgS i08ether and d° not reveal thil
to their physicians or pharmacists.
Minimal risk medicines do not need to be evaluated or assessed prior to marketing.
Suppliers of raw materials do not need to apply for approval to sell the material to
practitioners and other manufacturers who use the material to make a finished product.
Medicines made by herbalists (and other alternative medicine practitioners) for
individual patients following a consultation do not need a TGA approval before being
sold to the patient. Most homeopathics are exempt. Details of raw materials,
practitioner dispensed products and most homeopathic products are not stored in the
Australian Register of Therapeutic Goods.
Advertising to the public
In most cases, medicines cannot be advertised to the public for serious conditions that
require supervision by a trained practitioner. The Therapeutic Goods Advertising
Code sets out conditions that may not be mentioned in advertisements to the public.
These restrictions do not apply to communication between a practitioner and patient
and also do not apply to information in books and journals.
Hundreds of tonnes of illegal herbal products are seized each year in Australia. But
compared with the total trade in herbal medicines, the authorities are confident that
high standards are maintained in Australia.
2.A.vi.
Adverse reactions to herbal remedies reported in developed countries
There is a long list of medicinal plants that are toxic to the liver.(40-43) Gennander
has been used with apparent safety for centuries. It was in the early 1990s, that
gennander was first identified as a hepatotoxic drug.(44) In May 1992, all
preparations containing gennander were withdrawn from the market and banned in
16
2.B.
Developing Countries
Trad ttonal systems of health care and herbal remedies were freely ava.lable in
le fntem8tC0U1
CentUries' The WH0 ca™e into existence in 1948 as
the mtemational agency mandated to ensure a healthy world. Several programmes
were inrtrated. However, >t was in 1976 that WHO decided that traditional healers and
TraditVeS’|PMVa0US y Soen 35 an obstacle 10 progress, must play their part.(51) The
Traditional Medtcmes Programme under a Director was set up in 1978 Consumers
were told, among other things thatconsumers
’ ^di®031 °f Hea’th f°r A1' by ‘he Year 2000 Cannot be achiewd w“h™' traditional
lllVrUlvlUC*
• Without traditional medicine most Third World people would have no medicines at
an,
’ I"diti°nal ’^tems of health care provide primaty health care to about 80 per cent
to about 80 per cent
of the population who have no regular access to modem health care services.
These statements bring into focus a major consumer concern. What is WHO’s
meX0L‘7d;l.‘'0"al n,edic‘ne? Does t,le WI[0 consider traditional medicine as
Xailahlenr
" mediCi"e When ‘he latter is either n°‘ accessible,
av
I he^th^ t
6
• P°Or in ,he ™rd W°rld7 Or is 'rational medicine
a valid health technology in itself?
work ’
n 1 K 4
W3S eSt'ma
7 the WH°’ that ab0ut 80 Per cent °f
world s people had no access to modem health care. As recently as 1993 it was
reported by the Director of the WHO Traditional Medicine Programme that 80 per
17
cent of the world’s inhabitants rely chiefly on traditional medicines, mainly plant
based, for their primary health care needs.(52) It is difficult to understand how this
precise numerical value was arrived at and the particular research methodology used
to determine it. However it must be taken as authoritative since it was given by the
Director of WHO Traditional Medicine Programme. It is relevant to note that this
figure fits very well with the other side of the coin. More than 80 per cent of health
budgets in developing countries are directed to services that reach approximately 20
per cent of the population.(53) This figure refers to modem health services. It would
therefore appear that whether in the seventies, eighties or nineties, according to
the WHO, 80 per cent of the world population depended on traditional medicine
because modern health care was not accessible, available or affordable to them.
Consumers want an explanation why there was no improvement inspite of the
enormous resources WHO had put into its several programmes. But this
Symposium is not the forum to bring up this issue.
WHO, developins countries and traditional medicines
In 1978 the Traditional Medicine Programme was set up. A WHO Report (54)
proposed that traditional medicine should be integrated with primary health care. This
integration, the report stated, “offered the best means of achieving the goal of Health
for All by the Year 2000”. In September 1987, the Regional Director of the Western
Pacific Region stated that while the WHO programme on traditional medicine made
considerable progress in acupuncture, not much has been achieved in herbal
medicine.(55) In November 1987 the Director-General of WHO deplored the fact that
recognition of traditional medicine in the Member States was still low. He added that
the safety and efficacy of traditional medicine have not been fully validated; its
rational use had still to be defined.(56)
In 1993 the second evaluation of the implementation of the global strategy for Health
for All by the Year 2000 was published for the South East Asian Region. In this
report there was a brief mention of traditional medicine in only two countries,
Mongolia and Myanmar, out of a total of 11 countries in the region.(57) In 1995, the
WHO Report “Bridging the gap” was published. The report had 118 pages. But only
a small fraction of one page out of the 118 pages was devoted to the topic of
traditional medicine. However, the report stated that traditional medicine continued to
be an important part of health care in many developing countries; but admitted that
traditional medicine had not been integrated into most national health care systems.
This scaling down of the Traditional Medicine Programme is a cause for serious
consumer concern as it means that the recognition of traditional medicine as a
health technology which needs to be promoted and strengthened in developing
countries is given a low priority by WHO. This is all the more disturbing since
the Director General of WHO had stated that the safety and efficacy of traditional
medicine have not yet been fully validated. Providing technical assistance to
developing countries so that they can ensure the safety and efficacy of herbal
remedies which consumers use is the sole responsibility of the WHO.
Consumers, therefore, look to UNIDO and this symposium
expectations.
with
great
Consun1ers, perception of traditional medicine
While there is a fair amount of published evidence that (consumers in developed
countries are turning more towards using traditional medicine, there
, —3 are no recent
reports that have studied consumer perception of traditional medicine in developing
countries.
Prof. D. Banerji, formerly of the Jawaharlal Nehru University of New Deihi, in one of
his early studies in the 1950s, reported on the perceptions of traditional medicine in
the rural population in North India. One of the items in the questionnaire he used was,
J_Z0U ha,VC en°u,gh money and easy a«ess to both the traditional and modern
systems of medicine, which one will you choose?” The vast majority of the
respondents opted in favour of the modern system.(59)
Both modem and traditional medicine are equally accessible and available in China.
A study reported m 1978 described the incorporation of traditional medical practice
into the organised health care system taking as an example the health care services in
Toushan, a community with a total population of 57,934.(60)
It was left to the people in Toushan to choose between modern and traditional
. .
were freejy avajlab!e In I9?7 the ratio was 7:3
favour Qf
systems both of which
the modern system.
It was also estimated that nearly 70 per cent of the medicinal materials consumed
by the commune health clinic were modern pharmaceuticals.
What the WHO had failed to do in the Member States - inability to integrate
traditional medicine with the modem health care systems - it has succeeded in its
headquarters in Geneva. The Traditional Medicine Programme has been integrated
with the Essential Drugs Programme. The post of Director, Traditional Medicine has
been reduced to that of Medical Officer who works in the Essential Drugs Programme.
The cunent budget for traditional medicine is in the region of $180,000 per annum.
This sum includes the salaries of the medical officer and the secretary, travel and
grants for traditional medicine activities.(58)
It appears that people m China and India prefer modem medicine to traditional
medicines^ Very rough estimates for the utilisation of traditional medicines in the
Asia Pacific region vary from about 35 per cent in Sri Lanka to over 75 per cent in
Nepal. However, it is important to remember that there is no exclusive use of
traditional medmine, by one section of the population and modem medicine by
another. A vast majority of consumers in developing countries use both, modern
and traditional medicine; they may also take them simultaneously but do not tell
this to their physicians.
18
19
They may be self-medicating with an OTC herbal remedy, a herbal dietary supplement
or taking traditional medicine prescribed by a traditional healer. As in the developed
countries, there is a perception in developing countries that, because they are “natural”
and have been used with apparent safety for several centuries, herbal remedies are
always safe.
2.B.iii.
{elnam
The use of traditional medicines in Vietnam is regulated and controlled in two distinct
ways.(69):
Malaysia and Pakistan
Regulatory systems for the control of traditional medicine vary widely among
developing countries. Malaysia, for example, introduced the Drugs & Cosmetic
Control Act (1984) to regulate and control traditional medicine.(61) Only those
preparations that are processed and presented in modem dosage forms such as tablets,
capsules and oral liquids will be subjected to evaluation, approval and registration.
Raw materials such as seeds, or any parts of plants will not be registered.(62) These
will include herbs sold as food or drinks such as herbal teas which are not regulated.
For example, the advertisement for “Tea of Longevity” states, “suitable and beneficial
to many ailments including migraine, weak heart, hernia, menstrual pain, kidney
stones, rheumatism, arthritis, sexual stress, impotence, frostbite, internal and external
cancer and infections”. A retail pack of 150 mg costs between 160-240 Malaysian
Ringgits (US$62-96).(63) This is equivalent to 10 days wages of an unskilled worker
in Malaysia.
The mandatory registration of tr aditional medicines is not intended to give recognition
to traditional healers, who are not recognised in Malaysia.(64)
Consumers’ safety in Malaysia, therefore depends on the control of traditional
medicines in the market through a system of evaluation, approval and registration.
Traditional healers are not recognised and are not held responsible for the safety of the
medicines they prescribe and dispense.
A problem faced by the drug regulatory authority in Malaysia is the enormous work
involved. Several thousands of traditional medicines have been submitted for
approval. It will not be possible with the available resources to evaluate all of them
for safety and quality and to continue to monitor them in the market.(65)
The annual market for traditional medicines in Malaysia is approximately
US$800.(66) This is more than double that of the market for modem pharmaceuticals
which is about US$350.(67)
In Pakistan, on the other hand, all traditional healers are registered by the Ministry of
Health. They are responsible for the safety, efficacy and quality of the medicines they
prescribe and dispense. There is no regulatory control of traditional medicines.(68)
Not all the traditional medicines consumers use are purchased from the traditional
healers. Regulating the traditional healers and not the traditional medicines will
therefore, not ensure consumer safety.
20
responsible for the safety and quality of the products they prescribe.
ii. A small number of herbal remedies of proven safety and efficacy are pennitted to
be manufactured on an industrial scale. All manufactured products must be
registered by the Ministry of Health. Provisional registration is accorded in the
iirst instance and remains valid for one year.
In 1976, the Ministry of Health promulgated
,
a pharmacopoeia which included
monographs on imedicinal plants. A formulary which promotes the rational use of
essential
for •primary
. ,drugs
.
' health1 care an^ ’n which both modem essential drugs and
medicinal plants are mentioned, has been compiled and published with WHO support.
LTS WO.rkshoP.inNovember 1986 reported on the successful application of
trad Uonal medicine m the fields of internal medicine, surgery, gynaecology and
ophthalmology.C;0) Vietnam is perhaps the only country where modern and
healATe'rtke (717' merS m mediCa' ednCation’ are j°in"y Practiced within a single
2.B.v.
Thailand
Lhealth
hae1^*care
naiSt7(PHC).
P°f^eaThis
',.h PrisTbased
0,eo on
'he the
USEscientific
°f 66 traditi0nal
medicinal Piants in P^a^
evidence of efficacy of these plants
as well as on traditional patterns of utilisation. The Ministry of Health also promotes
? >5 J “ medlclne ln state-run hospitals and health service centres The
Fourth Public Health Development Plan (1977-81) stated the country’s general policy
nooaToo^6 USe °f trad"10nally used medicinal plants in PHC. The Seventh Plan
(1992-1996) promotes the integration of traditional Thai medicine into community
nealth care and gives priority to research into medicinal plants.(72)
f
The most effective use of traditional herbal medicines in PHC in Thailand is their role
m self-medication. Most Thais in rural areas treat themselves first before seeking help
from either modem or traditional medical practitioners; herbal medicines offer a low
cost inten.enhon in the early treatment of disease. What is important to recognise is
at this practice of self-medication with herbs provides a much safer alternative
to the senous problem of self-medication with inappropriate doses and various
combinations of harmful drugs which are freely available.(73)
Table 6 gives the pattern of health care service utilisation in Thailand in 1970, 1979
and 1985.
21
There is a definite shift away from traditional practitioners to modem health facilities
inspite of the government’s policy of promoting the use of traditionally-utilised
medicinal plants.
There is also a fall in the percentage of the population resorting to self-medication.
Table 6: Pattern of utilisation of health care services in Thailand, 1970,1979 and
1985 expressed in percentage.
Source of Health Care
enter the traditional market. The Government held an examination to license these
pharmacists to practice traditional medicine. The traditional healers demanded that
the examination be declared null and void alleging that the examination was too easy
and threatened to close all their shops if their demands were not met.(76)
It would appear that the Republic of Korea is perhaps the only country where a
pharmacist has to be licensed in traditional medicine before he can stock and sell
traditional medicine. The per capita consumption of modem pharmaceuticals is
33.9.(77) This is lower than that of the per capita consumption of traditional
medicine.
1970
Percentages
1979
1985
Take no medicine
2.7
4.2
6.3
Traditional practitioners
7.7
6.2
2.4
Self-treatment and self-medication
(medicines bought at drugstores)
51.4
42.4
24.4
Government health centres
4.4
16.8
13.3
Traditional medicine in India is regulated by the Drugs & Cosmetic Act 1940 (Act No.
23 of 1940). This Act regulates the import, manufacture, distribution and sale of
drugs. A separate section deals with traditional drugs. There are three well known
and widely used systems of medicine in India, namely Ayurvedic, Unani -Tibb &
Siddha. Each system uses its own variety of herbal remedies. For the purpose of this
Act, all herbal remedies belonging to these three systems are collectively known as
Ayurvedic drugs.
Government hospitals
11.1
10.0
32.8
Drugs & Cosmetics (Amendment) Act 1982 defines Ayurvedic drugs as follows:
Private clinics and hospitals
22.7
20.4
20.8
Source:
Ministry of Public Health (1978: 45 and 1982: 78) United Nations (1986) Institute for
Population and Social Research (1987) quoted in The Triumph of Practicality. Ed.
Stella R. Quah Published by Institute of South East Asian Studies. Singapore, 1989.
Whether consumers use traditional or modem medicines to self-medicate is not
known. However, herbs are available in the market in various forms of commercial
products, including cosmetic lotions, creams and soaps as well as a vast
pharmacopoeia of herbal preparations in modem dosage forms. Food and dietary
supplements with medicinal properties are also available. About 100,000 traditional
healers were involved in the preparation of herbal medicines in 1987 but few of them
were practising healing full time.(74)
2.B.vi.
Republic ofKorea
The Republic of Korea is unique in that traditional medicine is favoured equally by all
levels of society. Health insurance coverage is available for traditional medicine and
traditional medical practitioners typically earn more than modem medical practitioners
due to the popularity of the traditional approach to health care. However, only 15 to
20 per cent of the national health budget is allocated for traditional medical
service.(75)
The traditional medicine market is estimated at about $2 billion a year or per capita
consumption of $46 per year. Pharmacists trained in Western medicine wantedI to
22
2.B.vii.
India (78)
Ayurvedic drugs include all medicines intended for internal or external use for or
in the diagnosis, treatment, mitigation or prevention of disease or disorder in
human beings or animals and manufactured exclusively in accordance with the
formulae described in the authoritative texts of Ayurvedic, Unani-Tibb & Siddha
systems of medicine specified in the First Schedule”.
There are 54 Ayurvedic texts mentioned in the first schedule, Administratively, the
traditional and modem systems
are separate.
There
is a central
.
----------------- or federal department
for the Indian System of Medicine (ISM) at the Centre in New Delhi, and each state
has a directorate for ISM.
A recent Amendment to Section J of Drugs & Cosmetics Act has triggered a debate
between a section of the national Ayurvedic industry and consumers.
Under an amendment introduced in January 1996, drugs for liver disorders, memory
enhancement and several other ailments for which Ayurvedic remedies exist, can no
longer be advertised as cures for these disorders.
A spokesperson for a national Ayurvedic drug company described the amendment as
the deathknell for the Indian herbal drug industry which may be wiped out by the year
2005. On the other hand, the Indian Council for Medical Research (ICMR) and
consumer organisations have welcomed the amendment, saying that some sort of
regulation is necessary to ensure the safety, efficacy, quality and manufacturing
practices of medicines sold over-the-counter as Ayurvedic drugs.
23
However, this amendment does not prevent medical representatives from
recommending their products to physicians. This, say spokepersons for the small
scale industry, will be discriminatory. The larger companies will recruit an army of
medical representatives to promote their products to physicians in their clinics. Small
firms will not be able to do this.(79)
Research & Development
Research & Development ( R & D) on indigenous medicinal plants have been going
on since Col. Chopra initiated R & D in the School of Tropical Medicine, Calcutta
about 50 years ago.
Several research institutes and university departments are actively engaged in R & D
on the Indian systems of medicine. Many of these have been funded by the Indian
Council for Medical Research. The Central Drug Research Institute (CDRI),
Lucknow was established in the late fifties.
their clam.
at these are traditional medicines the manufacturers have
substituted the chemical names of the ingredients with Sanskrit or older English
names For example, the camphor in Vicks Herbal is Karpoora; citric acid in
Eno s fruit salt is Nimbasaar; methyl salicylate in lodex is Oil of Wintergreen.
In India practitioners trained in modem medicine though not trained in
in other systems
or medicines can freely prescribe medicines belonging to other systems Evan
. Examples are
the Ayurvedic drugs such as Essentiale, Ginsec (Dupher Interfran), and
1 Liv 52
(Himalaya Drug Company).
However practitioners trained in other systems cannot prescribe modem medicines In
^ly 1992 a homeopathic practitioner treated a patient with paracetamol and an
antibiotic. The patient later died of complications of typhoid fever. The homeopath
was taken to court and the Supreme Court found him guilty of negligence perse
ecause the Indian Medical Act prohibits any person without the requisite
qualification in allopathic system of medicine to practice in that system. The judges
CDRI and other research institutes are focussing their R & D efforts to isolate new
active ingredients from medicinal plants to develop new drugs and obtain patents on
them.
“A person who does not have knowledge of a particular system of medicine, but
practices in that system is a quack and a mere pretender to medical knowledge or
skill or to put it differently a charlatan.”(82)
Consumers are disappointed that these research institutes have not addressed
consumers’ concerns about the safety, efficacy, quality, costs and manufacturing
standards of the tens of thousands of Ayurvedic drugs and particularly those that
are skillfully and aggressively promoted. Consumers pay enormous amounts to
purchase them.
Based on this judgement, can practitioners of modern medicine who prescribe
Ayurvedic drugs be called quacks or charlatans? Consumers are concerned that
there is uncontrolled cross-practice - practitioners not trained in a particular
system using drugs belonging to that system indiscriminately.
A good example is the German Ayurvedic drug Essentiale. Messrs Rhone-Poulenc
markets this drug as a “Membrane-therapeutic agent for liver diseases” and sold
943,140 units valued at 41.1 million rupees in 1994.
3.
It was left to a consumer organisation, the Foundation for Health Action, Calcutta, to
get the manufacturing licences for this drug, given by FDA in the States of
Maharashtra and Gujerat, cancelled effective on 25-6-95 and 15-3-96 respectively on
the grounds that there was no evidence of its efficacy and that it was not an Ayurvedic
drug according to the Drugs & Cosmetic Act.(80, 81)
However, this drug is imported and available in the market in India and is prescribed
exclusively by practitioners of modem medicine.
Multinationals and traditional medicines
The Drugs and Cosmetics Act does not recognise herbal remedies; it only recognises
Ayurvedic drugs manufactured in accordance with 54 ancient texts. Notwithstanding
this a few multinational companies have changed their manufacturing licences for well
known allopathic OTCs to Ayurvedic drugs. For example. Smith Kline Beecham now
markets lodex as an Ayurvedic drug. Proctor & Gamble markets Vicks Herbal. It is
relevant to note that traditional drugs have no excise duty. In order to legitimise
24
Evaluation of traditional medicines
Clinical pharmacologists and other scientists workingJ on medicinal plants focus all
their attention on isolating
i ' ’ and- identifying
-biologically active ingredients in medicinal
plants and herbs.
Traditional pharmacologists argue that the efficacy of herbal remedies is due to the
synergistic activity among the several ingredients of herbal mixtures. Complex
mixtmes of plants or herbs form the basis of traditional medicines. The mixtures are
usually subject to crushing, heating, boiling, etc. It is possible that this process may
change the chemical structure of the active ingredient in the plants.
Traditional healers do not accept that the efficacy is necessarily due to the active
ingredients in the plant. According to them, modern clinical pharmacologists by
their “active ingredient” approach, take the knowledge from the plant but throw
away the wisdom of centuries.
If there is acceptable historical evidence that traditional herbal remedies have
been effective in the treatment of certain diseases, but neither their active
ingredients nor the mechanisms are known, will it be ethical or moral not to
25
References
accept and use that treatment? Some examples of successful treatment by
traditional medicines will be useful to answer these questions.
In the late 1980s children attending the Dermatology Department, Hospital for Sick
Children, Great Ormond Street, London showed marked improvements in their eczema
symptoms. These improvements were due to oral treatment with aqueous decoctions
of a mixture of 10 Chinese medicinal herbs.(83) Clinical experimentation and
pharmacological testing revealed that a mixture of the 10 herbs were necessary and
that the efficacy could not be attributed to any single active ingredient from any one of
the 10 Chinese herbs. A placebo controlled double-blind clinical trial using the 10
Chinese herbs was carried out on 47 selected children with non-exudative eczema.(84)
The conclusions of the trial were to validate to the standard of current conventional
clinical trials utilised in the UK that the traditional Chinese therapy was efficacious.
If these children had to wait till the clinical pharmacologists had screened the 10
Chinese plants for active ingredients and tested them for biological activity, they
would never have been given the chance of getting effective treatment with a
mixture of 10 Chinese herbs.
Potential cytotoxic drugs are tested for their activity against experimental or human
cancer cells. Efficacy depends on the ability to kill specific cancer cell types without
affecting normal body cells. Studies on the effects of certain Ayurvedic herbal
preparations for possible cytotoxic activity revealed that these herbal preparations did
not kill the cancer cells but transformed them into normal healthy cells.(85) These
drugs, therefore, have a different mechanism of action. Classical testing methods
would have missed this important anti-cancer activity.
I wish to conclude this section with a philosophical question. Is medical science
one universal and uniquely expressed (western) paradigm - a biomedical
paradigm? If it is possible to conceive of alternative methodologies, theories and
practices in other domains such as music, logic, linguistics, art and politics, is it
not possible to consider possibilities of alternative methodologies in medical
science, knowing that doctors practice medicine within a biopsychosocial
paradigm?
The guiding principles by which knowledge is built up in the biomedical paradigm are
those of the scientific method where hypotheses are clearly stated, then tested and
accepted or rejected as truth “until further notice” or “within the stated confidence
limits” using only experimental or quasi-experimental designs - a deductive approach
to problem solving.
1.
ReZ Iehn\sro622O,tiGnenl°7;7O8Prae,’t °f
2.
Traditional Medicine: Progress, Problems and Future Direction. Report by the
Regional Director, Regional Office for Western Pacific, Thirty-eight session of
the Regional Committee, WPR/RC38/14, 24 June 1987.
S
3.
W? °f. w neCOnd Meeting Of Directors of WH0 Collaborating Centres for
Traditional Medicine, Beijing, P.R.C; November 1987, WHO/TRM/88.1.
4.
r Cint n,d ^°dem Hea,,h Care' Pr°8ress ReP°rt
the DirectorGeneral, Forty-fourth World Health Assembly, A44/19, March 1991.
5.
POl1iCxi,eSJ and ACtivitieS in the Field of Traditional Medicine WHO
Traditional Medicine Programme, February 1996, WHO/TRM/96.2.
6.
PeZ0°f P’-'-ThTeTCment Medicinal and Dietary Uses of Botanicals: A Market
Perspective in July 1996 USP Open Conference on Botanicals for Medicinal and
t).le.‘a7 Use: Standards & Information issues. Proceedings of the Conference
United States Pharmacopoeial Convention Inc, pp. 58-77.
7.
Hasler, C.M. “Botanicals and Health Claims”
in July 1996 USP Open
Conference, op. cit, pp. 78-81
8.
cisenberg, D^M., Kessler, R.C., Foster, C., Norlock, F.E., Calkins D.R. and
CostsTd Patterns
' PreValenCe’
9.
Hasler, C.M. Botanicals and Health Claims, op.cit.
Medici"e- W!O Technical
10. Israelsen L.IT (1994), Harmonising North American Herbal Regulation- A US
Perspective. Herbal Gram #32: 20-22.
11. Blumenthal, M. (1994) Congress Passes Dietary Supplement Health and
Education Act of 1994. Herbs to be protected
I as Supplements. Herbal Gram
#32:18-20.
12. Ibid.
13. Ibid.
Is it possible for research scientists to examine other methodologies, for example,
using experiential methods - an inductive approach, to evaluate traditional herbal
remedies?
14. Ibid
15. Anon "Is OTC hypolipaemic a “drug”? SCRIP No. 2225, April 22, 1997, p. 18.
27
'■'x
*—
34
16. Blumenthol, M. (1994), op.cit.
17. Skolnick, A.A. (1996) China is Eager to Export its Traditional Medicine but
Some Chinese Scientists Urge More Skepticism, JAMA, Vol. 276, 21:1707-1709.
<E“>:
(2) Medtkament & Meinung, Zeitung fur Arzneimittel-und, Gesundheitswesen
ed^Bundesverband der Pharmazentischen Industrie, 21, Jahrang, Nr. 3, March
18. Hiscoe, H.B. New Engl. J. Med. 1983, 308:1474.
19. Hasler C.M. Botanicals and Health Claims, op.cit.
35. New Scientist, Vol. 139: No. 1882, July 1993, pp. 44-45.
20. Ibid.
36. ”Jrac-tifi°nal Medicine: Pr°gr«s, Problems & Future Directions, WPR/RC38/14,
21. Zailman, C.A. “The Utilisation of Herbal Remedies by Hispanic & Non-Hispanic
White Elderly in New Mexico”, July 1996, USP Open Conference, op. cit.
37.
22. Grote S. “Presentation of Retired Persons Services Inc”, in July 1996, US Open
Conference, op. cit.
M.1tS .“'S'”
“f WH0
38. Ibid.
23. Israelsen L.D. (1994), op. cit
39'
“Re,^'ation of Herba! Medicines in Australia”. Paper presented at the
24. Ibid.
G“sa»"=
25. Blunmenthal M. “A new Regulatory Category for Herbs as Traditional
Medicines: A Review of the American Botanical Councils Traditional Medicine
Research Project in July 1996, USP Open Conference, op. cit., pp. 4-5.
26. Eisenberg D.M. et al, op. cit.
41. Huxtable RJ ‘The myth of beneficient
nature: the risk of herbal preparations”.
Ann Intern Med. 1992;\\’l(2y. 165-166.
27. Grauds C.E. ‘Importance of Standards & Information to Practising Pharmacists”
in July 1996, USP Open Conference, op. cit., pp.37-38.
42.
28. Anon “Herbal Medicines - Safe & Effective?” Drugs & Therapeutic Bulletin,
Vol. 24, No. 25:97-100.
43' 27O3ff(6^502erbaI hepatOtOxicity’ Revisi,i"8 a da"gerous alternative” JAMA 1995;
29. The Medicines (Retail Sale or Supply of Herbal Remedies), Order 1977, SI No.
2130, London HMSO.
44. “Withdrawl of Germander-based preparations” Prescr. Intern
30. Phillipson J.D. 1981, Pharm. J, 227:387-392.
45. Laliberte L and Villeneuve JP “Hepatitis after the
use of germander, a herbal
remedy” Can Med Assoc J 1996; 154.
31. Fulder S., Monro R. Report on the Status of Complementary Medicine in the UK.
Threshold Foundation, London 1981.
46. 299:?ir5M15F7B
32. Anderson L.A., Phillipson, J.D. 1986, PharmJ., 236:303-311.
1993; 2(6):75,3.
a’’ “Hepa,Ot0xity of herbal remedies” Br Med. J 1989;
47. Brevoort P, The Current Medicinal & Dietary Uses of Botanicals, op. cit.
33. Blumenthal M *"
“A ”
New Regulatory Category for Herbs as Traditional
Medicines”, op. cit.
28
An
M°S;efa;Kara N “Hepatotoxicite des piantes medicinales et des
preparations a base de plantes’ Gastroenterol Clin. Bial 1993; 17:79-85
48. Vanherweghem JL et al ‘T
* “ progressive interstitial renal fibrosis in yoi
Rapidly
I
29
49. Roulet M et al. “Hepatic veno-occlusive disease in newborn infant of ia woman
drinking herbal tea” J Pediatr 1988; 112(3):433-436.
rf S Si!*™”'’
Mtalm
Coml
50. D’Arcy PF “Adverse reactions and interactions with herbal medicines,
Drug interactions” Adverse Drug React Toxicol Rev. 1993; 12 (3): 147-162.
- ---
51. “Traditional Medicine & Health Care Coverage - a reader for health
administrators & Practitioners”, eds. Bannerman RH, Binton J. and Ch’en Wenchieh, WHO, Geneva, 1983.
Emerging Issues and Concerns”, Penang, April ‘1997.
nC'n8 'n
52. Akerele 0. Nature’s Medicinal bounty: don’t throw it away. World Health
Forum, 1993, 14:390-395.
67. Estimates by Ministry of Health, Malaysia.
53. Bannerman R., et al 1983, Traditional Medicines, WHO, Geneva.
68. Dr Zafar Mirza, The Network, Pakistan, personal communicarion
54. Anon. The Promotion & Development of Traditional Medicine, op. cit.
55. WHO Regional Committee for the Western Pacific 38th Session Summary
Record of the Sixth Meeting, WPR/RC38/SR/6.
56. Report of the Second Meeting of Directors of WHO Collaborating Centres op
cit.
57. Anon. Implementation of Global Strategy for Health for All by the Year 2000
Second Evaluation, Eighth Repon on the World Health Situation, Vol. 4, South
East Asia Region. WHO Regional Office for South East Asia, New Delhi 1993.
70. Traditional Medicine: Progress, Problems &
Future Directions, WPR/RC38/14.
op.cit.
-
’■
12
Medicinal Plants in Thailand”, WHO Symposium
ants. Moms Arboretum, Philadelphia, PA, 19-21, April 1993.
58. Boedeker, G. & Bicham, H.M. 1996, Gifts - an overview of Health. J. Alternative
& Complementary Medicine, 2:387-395.
73.
59. Prof P.K. Sarkar, Foundation for ITJA
Health Action and Department of
Pharmacology, School of Tropical Medicine,, Calcutta, India, Personal
Communication.
60. Lee R.P.C. 1982. “Chinese & Western Medical Care in China’s rural
communities”, World Health Forum 3 (3):301-306.
61. New Straits Times, Malaysia, January 26, 1988.
62. New Straits Times, Malaysia, July 12, 1990.
,XM'dW" S H""h
74. Ekachais. “Traditional Medicine
in Thailand at a Critical Stage”. Bangkok Post,
May 7, 1987.
75. Choe Won Sok, 1993, Country Report,
WHO Symposium on Utilisation of
Medicinal Plants, op. cit.
76. New Straits Times, Malaysia, September 6, 1996.
77. UNIDO - The World's Pharmaceutical Industries: An International Persoective
63. The Star, Malaysia, July 7, 1995.
64. The Sunday Star, Malaysia, February 3, 1991.
78.
30
H'‘"h Aaio"- “»“■ ■"d wp™.™
31
80. Anon, "Essentiale” - The Story of
a “European Ayurvedic Drug”, Bodhi 6, JuneAugust 1995.
81.
C'aimS Essentiale “restores damaged liver cell
, MaL.4M International News, January/February 1997, Vol. 15, No
82. XppPSmC°Urt & Penalty”’ Edit°riaI B°dhi’ 13 November-December
83. Harper, J. I. et al 1990, “Chinese herbs for eczema”, The Lancet, 335:795.
84. Sheehan, M. P, and Atherton, D.J. 1992.
Chinese Medicina! Piants m WideJr^Non^S^^S
Jburnal ofDermatology, 126:179-184.
85. Bodeker, G. 1994. “Traditional Health Knowledge & Public Policy”, op. cit
f
I
32
plM 'io.
People Initiatives
Best Practices of A Herbal Village : A Case Study in Bangladesh
■ July 2005
*
i
gJ
■*
a ' >
S■
A
Contents
According to the World Health Organization (WHO), 4 billion
people, 80% of the world population currently uses herbal
medicine for some aspects ofprimary health care.
As major component in all indigenous
peoples' traditional medicine and a
common element in Ayurvedic,
homeopathic,
naturopathic,
and
traditional oriental and Native medicine,
herbal medicine has a significant
importance on sound health of human
body. WHO states that of 119 plantderived pharmaceutical medicines,
about 74% are used in modem medicine
in ways that correlated directly with
their traditional uses as plant medicines
by
native
cultures.
Major
pharmaceutical companies are at
present, conducting extensive research
on plant materials gathered from the
rain forests and other places for their
potential medicinal value. Very recently
it is found that different cosmetic
companies like Square Company,
Aromatic Cosmetic Company, Keya
Cosmetic Co. and Uniliver Co. of
Bangladesh have started to use herbal
materials for increasing the medicinal
qualities of their products suitable to
human body. Herbal plants are also
being used as row materials of
medicinal plants and are directly being
used as medicine at local and national
levels. Thus herbal plants are playing an
important role in creating a good effect
for preventing diseases.
Once upon a time people of
Bangladesh were depended on quake,
mysticism, hymns and herbal medicinal
treatments for healing from diseases.
With the advance of modern science,
allopathic and homeopathic medicines
are occupying those places. In spite of
prevalence of these modern medical
treatments, herbal medicinal treatment
still is not so less. In Bangladesh, herb
and herbal products of millions of
money are imported from other
countries like India, Pakistan, China,
Nepal, Bhutan and Malaysia every year.
Most of the imported herbal materials
are brought from India. Markets of
these imported materials are located in
Chalkbazar of Dhaka and Moulivibazar.
Different Ayurvedic and Unani
companies purchase herb from these
markets. Though some of such
companies have own herb gardens.
During last two decades, popularity of
this area has increased in the country.
Nowadays herbs are sold in the hat
bazaars at the levels of district, upazila
and village. In rural areas poor peoples
are also cultivating herbal plants in their
own lands. Herbal villages of Natore in
the country can be sited in this regard.
At least 45 species of herbs are being
cultivated in these villages. Cultural
practices of these plants are increasing
day by day.
How do many people
involve in herbal plantation?.. 2
Challenges................................. 2
History of herbal
2
Practices in the villages
2
Location of the Villages
■ ’
■ ’^'7^ 7.
' M 1 ri ’
n i i L > i '■
i Wi
111
IW aIK ;!■
Why do people call
harbal village ?........................
Story of Afaz Pagla................
Livelihood of villagers on
harbal & case study................
Name of harbal plant of
harbal villages.........................
How to cultivate......................
Recomendations......................
Conclusion...............................
I
I®
2
3
3
4
4
4
4
How Do Many People Involve in Herbal Plantation?
Nowadays, at least 255 farmers, 100 hawkers and
300 herbal healers are found to be very active in the
10 villages of Natore in respect to herbal cultural
practices. At present, 8-9 retail shops, 01 wholesale
shop and 03 groups have been established based on
those herbal areas. Dry plant powder, roots, barks
and seeds are sold at those shops. In the holesale
shop herbal plants are collected according to the
demand of the buyers and arrangement is done for
selling those at reasonable price. Each bundle of
Ghritakanchan weighs 55 kilograms .For each
bundle 04 Taka is to be paid to the market committee
as fee. In case of other herbal plants, money is taken
in other rates. The group members get opportunity of
selling their own herbal products through the
wholesale shop. At present, number of members of
Kholabarhia Adarsha Chashi Kallyan Samity is 127.
Each member deposits 50 Taka as savings every
month. Each alternate 05 years, that money is
divided for the welfare of group and members.
IT
. '..J
0^ r
Ik
Ghritakanchan (Indian Aloe)
Challenges:
■ Though currently, rural poor people can easily cultivate any kind of herbal medicinal
plants in their own land applying indigenous knowledge, if such cultivation is extended
in larger area there will be probability of enacting patent rules resulting in creating
barrier of extension of herbal medicinal crop cultivation.
■ At present poor people can obtain maximum benefit from marketing their herbal product as
the existing marketing system is managed by the poor producer. But in future, if the
production and marketing system will become large, production and market controlling will
go under rich businessmen which will deprive the poor people to get maximum benefit.
■ In case of extensive and intensive culture of herbal crops, farmers may used to apply
chemical fertilizer and pesticide in the expectation of more production and profit, which
will create public health hazards.
History of Herbal Practices in the Villages:
The villages where herbal cultural
practices are continuing are known as
herbal villages. The main actor
behind the history of herbal practice
is a simple illiterate poor person
named Afaz Pagla. Though the
profession of Afaz Pagla was
suddenly changed, the scenario of the
villages has changed slowly for about
25 years. Once, an herbal healer
named Jalil Pagla was selling herbal
medicine in a Tebarhia hat of Natore.
In the mean time, Afaz Pagla arrived
at that place while showing monkey's
play. Having been motivated by Jalil
Pagla, he returned to his native village
Kholabaria Khamar. Leaving showing
monkey's playing he started to collect
herbal medicinal seedlings and
saplings and transplant those in his
own land. Thus he started for herbal
medicinal treatment for healing
people from diseases. Once, his late
elder brother Riach Uddin Maker (Bi
cycle maker) brought 3-4 seedlings of
Ghritakanchan (Indian Aloe) for
planting. Coming to learn high
medicinal qualities and market
demand of this plant, the neighbors
also started to cultivate the
Ghritakanchan.
Thus such cultural
practices have increased day by day in
that area and gradually in other
adjacent villages.
Location of the
villages:
A total of 10 villages of Lakshmipur
Kholabaria Union situated at 5
kilometers west from Hoybatpur
which is also located in the east of
Natore town have been covered with
herbal cultural practices. The villages
are: 1 .Lakshmipur, 2.Hajigange, 3.
Amirgange, 4.1brahimpur, 5. Taltalia,
6. Kalitala, 7. Kholabaria Khamar, 8.
Nutan Bazar, 9. Kathalbari, and 10.
Barhabarhia.
Why Do People Call
Herbal Village?
People of the said villages are
mostly depended on herbal
cultivation,
processing
and
marketing. Most of the fallow lands
of the villages have gone under
herbal crop production. Even, many
field croplands have also being
utilized
for herbal cultural
practices.
Livelihoods of major portion of the
farm families in these villages are
deeply
correlated
with
the
cultivation of herbal medicinal
crops. So, people started to call
those villages as herbal villages.
Even, Government has also
recognized those as herbal villages.
In 5-6 January 2005 the issue was
discussed
in
the
National
Parliament of Bangladesh where
proposal on recognizing the said
villages as herbal villages was
passed.
Page - 2
Story of Afaz Pagla
i
I 1
*
f
I
■-a*.
i
■■
Every invention has as an inventor, there is so a
pioneer in every adventure. Similarly, in this herbal
village there is also an initiator whose life leading is
g,of different polarity. He is no other than Afaz Pagla
fwho lives at Kholabarhia Khamar of Natore and used
to show monkey's play. Being a philosopher's stone of
change, a person named Jalil Pagla who lives in
another village showed Afaz Pagla the way of
different life. Afaz Pagla left showing monkey's play
when he was around 35 years of age. It was started to
make collection in his nomadic life. This is not
collection of money or luxurious resources. He
collects plants moving across deep forest and
I transplants those plants in his homestead area.
Collecting plants from different places he hears the
medicinal values and informs these values to other
people. Thus the villagers started to love herbal
medicinal plants gradually. Afaz Pagla told all people
to plant Ghritakanchan (Indian Aloe) as it is easy to
cultivate and very profitable. In influence of him,
currently, Ghritakanchan is being cultivated in 30 acre
land in the herbal village. There is no as light under
|I lamp, there happens not so exceptional in the life of
I Afaz Pagla too. Though his vision is that there will be
f developed herbal villages in whole over the country
I and these herbal plants will also spread over whole
I world. But, being concrete houses belonging to those
f who have been involved in this cultivation, Afaz
Pagla he lives in tin shed house. Though he is now
about 65 years old, still he is very enthusiastic for
doing his restless job with the hope of realizing his
vision.
Livelihood of Villagers on Herbal & Case Study:
There will be found only herbal crops
whole over some villages. In fallow
land of homesteads of these villages,
one or more species of herbal crops
are found to cultivate. Many of the
farmers have started to cultivate
herbal crops in their cultivated lands.
The main reason is, according to their
opinions, that profit obtained from
cultivation of herbal crops is more
than that from rice and jute
cultivation as a result of low
production cost. Husband lost Helena
Begum together with her daughter
has cultivated herbal crops in her own
land of 50 decimal. She leads her life
through cultivating different species
of herbal crops in her land. Once, she
could earn at best TK. 2,200.00
during five months cultivating crops
on 10 decimal lands. One herbal
businessman named Salam cultivated
cotton crop (Shimul) in her one acre
of land. After six months of seed
sowing, Shimul roots were harvested
for sale. During one year, total cost of
production for one-acre land is TK
15,000.000 whereas income from
same land and for same duration is
TK. 100,000.00.But before that, it
could be obtained TK 18,000.00
profit from the same land and period.
Many people are involved in this
work in different ways. In those
villages, different works have been
developed based on herbal plantation.
Some cultivate, some take care of
crops, some cut twig of Indian Aloe,
some make packets for marketing the
herbal products, some sell at hat
bazaars moving from one place to
other places and some bring these to
the market of Dhaka.
There lives Abdur Rahim in
Kholabaria Khamar. His right foot
had to be cut for gangrene. To meet
treatment cost he had to sell two
bighas (66 decimals) of land.Now, 10
decimal land is his only the resource
where he is cultivating herbal crops.
Simultaneously, he supplies herbal
materials to Dhaka Wednesday to
Friday every week. Thus, he has
made his one daughter got married
and is continuing education of his
one son. At present, his family is
doing well.
Through different ways, it has been
known that number of farmers and
businessmen
is
continuously
increasing. Similarly, number of
healers like Kabiraj and Hakim who
know medicinal values of herbal
plants and can prescribe medicine is
also increasing. But whatever they
know about the application of
medicinal values of herbal plants,
people are being benefited. So,
people go to them for their needs.
These healers easily tell people about
the name of herbal medicine in case
of ordinary diseases. Thus people
also become self- confidant. It has
been learnt through traveling across
the villages that women of these
areas are now capable of resisting
general diseases using the herbal
plants planted surrounding their
houses. They often use the solution of
Indian Aloe for hospitability of their
guests.
Page - 3
Name of Herbal Plant of Herbal Villages:
In most of the homesteads of the villages the main cultivated plant is Indian Aloe.
Though there is exceptional of it. Some are making garden on asparagus; some are
doing it on cotton root (Shimul) in large scale. Generally there are found 45 species
to be cultivated in these areas such as: 1 .Ghritakanchan (Indian Aloe) 2. Shatamul
(Asparagus) 3. Ashwagangha (Withania) 4.Tal Mui (Curculigo orchicides) 5. Bhui
Kumra (Impoema peniculata) 6. Shimul (Cotton root) 7. Shwet Lazzabati (Sensitive
Plant- white) 8. Lal Lazzabati (Sensitive Plant -Red) 9. Nerha Lazzabati (Sensitive
Plant) 10. Raj Kantha 11. Rani Kantha 12. Neel Kantha 13. Hasti Kampalash
(Downp Branch Butea)14. Rahu Chandal 15. Rakta Chandal 16. Guru Chandal 17.
Turup Chandal 18.Brahma Chandal 19. Bhui Chandal 20. Bone Chandal 21. Pathar
Kuchi (Irisspa) 22. Masinda 23. Lal Tulsee (Holy Basil -Red) 24.Krishna Tulsee
(Holy Basil- Black) 25. Shwet Tulsee (Holy Basil -White) 26. Ram Tulsee (Holy
Basil -Ram) 27. Durga Tulsee (Holy Basil- Goddess) 28. Gandaraj Tulsee (Holy
Basil -Essence) 29. Kalo Dutura (Datura metal) 30. Sada Dutara (Dutura metel) 31.
Tajbal (Velvet leaf) 32. Olat kambal (Devil's Cotton) 33. White Kuch (Bear Tree white) 34.Lal Kuch (Bear Tree - Red) 35. Bhui Alma (Phylanthus) 36. Ishwar Mui
(Indian Birthwort) 37. Ananta Mui (Indian Sarsaparilla) 38.Shankha Mui 39.
Sarpagandha (Snake Root) 40. Akangee (Zedoary) 41. Basak (Vasaka) 42. Thankuni
(Asiatic Penny Wort) 43. Akanda (Gigantic Swallon) 44.Kalo Megh (Great)
45.Michhri Dana (Gold Thread).
m
J
. 'SC;
u-
Ashwagangha (Withania)
How to Cultivate the Harbal Plant
Cultivation of Ghritakanchan (Indian Aloe)
Though
there
are
different
production technologies for different
plants. But in consideration of soil and
climatic conditions of Bangladesh,
cultivation technology of herbal plant
is very easy. For exampleGhritakanchan is to be cultivated in
line planting where line spacing is 1.5
feet and seedling-to-seedling spacing
is 6-8 inches. For Shimul cultivation,
land is needed to plough two times
and weeding out is done three times a
year. Roots of Shimul are become
suitable for harvest and sale after six brokers. Amount of these seedlings
months of sowing. Shatamul grows selling is not considerably less. In
of only
Ghritakanchan
well in loam soil. Shatamul takes 2-3 case
years to be matured well for sale. cultivation, artificial fertilizers and
Market price of Shatamul is Taka 25- pesticides are used. In case of other
30 per kilogram. But price of dry herbal crops, it does well to apply
powder of Shatamul is Taka 300.00- ordinary cultural practices.
400.00 per kilogram. Seeds of Gold
Thread are also sown almost like
turmeric and cultural practice of this Recommendations:
herbal crop is same as turmeric. It is ■ Making people aware of beneficial
sold in the market at Taka 40.00-50.00
qualities of herbal medicinal plants
per kilogram in raw form whereas its
through media advocacy, drama
market price in dry condition is
and documentation filtyi show etc,
Taka 100.00-1200.00 per kg. Besides,
people's interest can be grown for
in these villages Anantamul and Hasti
more production and utilization of
Kama Palash are cultivated as
herbal crops.
perennial crops that take 4-5 years to ■ Through establishing demonstrative
be matured. Alongside, as short period
organic herbal garden at different
crops Ashwagandha and Shimul are
places, herbal cultural practices
cultivated. Seed of Ashwagandha is
can be widely extended.
broadcasted like amaranth. Its market ■ To protect unexpected patent rules
price is Taka 120.00 per kilogram.
people's voice needs to be raised
Alongside of this selling, all types of
for influencing policy makers.
herbal seedlings are sold in different
places in the country through the local
Conclusion:
Herbal medicinal plants available in our country are well adapted with our climatic and soil conditions. People of
rural areas are more or less faithful with the medicinal values of herbs. People's interest in herbs has been proved at
the herbal villages in Natore. Initiative of Afaz Pagla has got popularity in his village as a result of which, farmers of
own village have gradually adopted his herbal cultural practice and this herbal cultural practice has also disseminated
into adjacent villages. In the aggression era of modern allopathic treatment it is really a good notion. With spreading
this model, herbs could be possible to be exported in other countries meeting the domestic demands. Rural poor
farmers will also get opportunity to improve their family economic condition through proper utilizing their land.
People will increasingly use herbal plants for their primary health care, which will ensure people to keep themselves
safe from chemical residual effects of medicine of modern allopathic treatments. So, if it is upheld properly, the model
of herbal villages initiated by Afaz Pagla will spread over the whole country quickly.
Edittor : Naresh Madhu, Executive Director : Satsanga Palli Kallayan Samity (SPS), House No. - 282, Road No - I, Baitul Aman Housing Society, Adabor, Dhaka.
E-mail: s_ps25@hotmail.com, Supported by : Action-Aid Bangladesh. E-mail: arif@actionaid-bd.org & Peoples Health Movement (PHM) Bangladesh.
1I07/A, Baitul Aman Housing Society (1st Floor), Ring Raod, Shyamoli, Dhaka. E-mail: phmbc@dhaka.net
Design & Printing : PURABI OFFSET PRESS, Phone : 9127746 / 0152325788
Page - 4
-10
DR. BACH FLOWER REMEDIES OF ENGLAND
Call it Money workshop, Personality Development, Business
improvement or even problem solving & increase of life-style.
The complete answer to all difficulties faced by men—call it
unemployment, insufficient income, not getting your daughter
married to a good boy, unable to realise your dues from others
etc., Bach Flower Remedies help you. Get things done in govt,
offices without paying bribes. Excellent in terminal illness.
In Chronic Headache/Migraine, Allergy, Addictions,
Asthma, Cervical Spondylitis, Sinusitis, Backache,
after taking x-ray/scan if doctors say you are 'clinically alright,’
CHINESE ACUPRESSURE (No Needles & No Drugs) can give you total relief
by just 3-MINUTE TREATMENT given once only. Treatment by Dr. Krishnamurthy
Treatment on: September 14 to 16Z 23 to 25
Learn CrttfiltSfe ACt[j?n£SStmfe
3-Day Personal Course
I
14th, 6 pm : Chennamma Memorial School,?
*•
68 Mission Road,
$
Near Fly Over
z
<■
15th, 6 pm : SOMBO, 1064, 36th Cross,4th T Block, Jayanagar
16th, 6 pm : Gandhi Sahitya Sangha, Malleswaram 8th Cross
Fee: Rs.4200 |
Our Next Course: Sept. 23 to 25
FeeJM200/-
| FREE INTRODUCTORY LECTURE |
I 9448537584
ph: 23117112
| 57622699,
JIINIIIUIWI
..........
exactly & accurately in our
2-Day Personal Course: Sept. 17 -18.
Fees: Rs.1500 for each complaint
FOR DETAILS CONTACT DR. MANIAN AT THE ABOVE PHONE
I
THE HEALTH SERVICE SOCIETY
Raman House
Old No.21, Kuppaiah Street
West Mambalam, Chennai-33
Phone: 5539 3214, 2489 0370
Dr. Krishnamurthy
Camp at Bangalore: 14th to 18th and
23rd to 25 Sept. 2005 (Hotel Chalukya, Race Course Rd.,
Phone: 22266866, 22256576
DR.
BACH
FLOWER REMEDIES OF ENGLAND
The medicinal effects of 38 wild flowers were discovered and introduced by the
late Dr. Edward Bach, M.B.B.S., M.R.C.S. of London way back in the year 1936.
Thus, this system was introduced not by a stranger to medicine, but by one of the
leading
allopathic
Hollywood
Before
of
practitioners of
medical
Harley
Street in
London,
well
know
which
is the
doctors.
learning
any
you
subject
would
do
to
the
scope
and
limitations of the subject as well as the scope and limitations of the teacher from
whom you are learning it. The one single word to describe both is ‘grace’. Grace
means much more than what you deserve or what you would have expected or even
imagined.
Yes,
in the system of
Bach
Flower Remedies
everything
concerning
our
accurately.
’Precision’
is the action of these remedies.
life
on
earth
is
answered
we find a world
completely,
where
exactly
and
A new-comer to the subject may think that these remedies are for 'pains’ and
’aches.’ But it is much more than that. To enable you to understand the scope of
the subject I would first of all put a question before you:
"What is the use of
encyclopaedias?" You may reply that it is for ’reference’ etc. But it is not so. You
need text-books for study to get a degree in your hands. After this when you enter
your profession, be it psychology, medical practice or any other field, to go up the
ladder, you work in various organizations, gain experience, than work under so-called
1
%
SLP1 D:\DRKRISH_1 \JBAS_SPE.PM5
seniors and experts, attend seminars and workshops etc. May be, after 15-30 years,
you too may or may not go to the top:
But there is a sure short-cut to go up the ladder in just 1-2 years time. It is
the study of encyclopaedia. If any one has written an encyclopaedia in your subject
and if you study it as a text-book, you too can go to the top and no one can excel
you in your line.
Text-book is for passing
Examination to get a
degree or diploma.
Encyclopaedia is the
text-book for professionals
to become No. 1 in their field.
You may ask me as to how I came to know about the correct use of
encyclopaedias? Here comes in BACH FLOWER REMEDIES. Your knowledge
becomes complete, exact and accurate with the aid of Bach Remedies study. Call
it
addiction,
unemployment
problem,
hijacking,
naxalites,
extremists —Bach
Remedies give the right solution and nowhere else, we get the right answers as
to why men suffer, be it disease or problem in life like poverty etc.
Let us examine one of the social evils viz., 'addiction' as to how Bach Remedies
approach it:
1. Walnut is the name of one of the thirty-eight Bach Remedies discovered &
introduced by Dr. Edward Bach. (Each one is prepared from the trace quantity
of a particular non-toxic wild flower and all these thirty-eight remedies are found
in one place in a thick forest in England. The place is called Mount Vernon, a
small village. A few of these flowers are found here and there in some parts
of the World but not all are found that too in one place!) Walnut is given to
cure all types of addictions and also all bad habits etc. i.e., where the patient
is doing one and the same thing repeatedly over and over again with his fingers/
hands-be it chain smoking, drinking alcohol in excess daily, tobacco-chewing,
taking several cups of coffee/tea, thumb-chewing in children or nail-biting in
elders.
After taking Walnut for a certain period of time, though they got cured we
continued to give the remedy Walnut to them, because we have to find out as
to why he became addicts. In due course, these persons started learning
instrumental music or painting and soon started performing in stages earning Rs.
500 to 1000 for each two-hour performance as compared to his earlier income
of mere 5-7 thousand rupees working as an office clerk for 8 hours x 30 days.
The question now before us is, "What has 'playing instrumental music/painting'
to do with addiction?"
In both cases the person does one and the same thing with slow and repeated
movement his fingers/hands
We call
Smoking cigarettes or nail-biting or taking
ganja as NEGATIVE aspect of the
remedy Walnut
2
SLP1 D:\DRKRISH_1 \JBAS_SPE.PM5
Playing instrumental music or painting as
POSITIVE aspect of Walnut
From the above we infer that mighty Nature (or God) tells all addicts: "I sent
you on earth to learn and play instrumental music (or painting) and earn 1-2
thousands daily. But you did the mistake of studying science or accountancy
to earn a mere few thousand rupees once a month only. TO REMIND YOUR JOB
ON EARTH I made you an addict. At least now, realise your mistake, start
learning instrumental music and earn a few thousand rupees every 2-3 days."
Addiction is not a punishment given by Nature but a chiding only.
Thus, Bach Remedies DO NOT 'TREAT' OR 'CURE* human beings but change us
from 'negative' to 'positive' types. On the one hand Walnut enables addicts to
completely give up the bad habit; on the other, it enables them to automatically
learn and master instrumental music/painting, irrespective of their age.
We, therefore, call Sitar Ravishanker of North India and Veena Gayathri of Tamil
Nadu as
"POSITIVE Walnut-type persons." Had the parents of these
instrumentalists done the mistake of discouraging them to learn instrumental
music and insisted on their first becoming at least a graduate, they would have
ended up as a diploma/degree holder and working in an office for a mere 5-10
thousand rupees per month but soon becoming addicts to alcohol, drugs etc.
From the above, we get the lesson (by the study of Bach Remedies) that in de
addiction centers we must employ teachers of instrumental music/painting and
this alone is the only and correct solution to cure addictions.
2. Let us now go to another Bach remedy Cherry Plum. This is prescribed for the
following
(a)
symptoms:
where the affected person weeps/cries with
(whatever may be the name of his disease)
'unbearable'
pain in
body
and/or
(b)
wherever a patient prefers death to put an end to his sufferings. ('Man
commits suicide by swallowing poison after trying the best doctors in vain
for his chronic abdominal pain.' We occasionally read these in the local
dailies. Or 'entire family commits suicide due to poverty.')
Cherry Plum not merely reduces pain but cures the underlying pathology and so
the pain stops. Again in the case of suicidal disposition due to poverty, when
Cherry Plum is prescribed it enables the victim to automatically find ways and
means of earnings money and so the suicidal disposition disappears.
The best place to illustrate the use of Cherry Plum is the labor ward in any
maternity
hospital.
Bach Remedies are 38 in all. Every person would be of one remedy-type only at
any given time. Thus, roughly three out of every hundred persons would be
Cherry Plum type. Go and stand in the verandah of any labor ward at midnight
and you would be hearing the shouting, crying or weeping of three out of every
one hundred expectant mothers. The child wants to come out of the uterus but
the mouth of the uterus (os uteri) does not dilate (expand.) Thus, it causes
"unbearable" pain making the mother cry. This happens in the case of three per
cent of expectant mothers at delivery time. We gave Cherry Plum at this time
3
SLP1 D:\DRKRISH_1 \JBAS_SPE.PM5
to these ladies (say, 1-3 doses every 5-15 minutes.) Soon they were safe and
normal delivery. At this point please do not take down notes that the Bach
Remedy Cherry Plum is for "easy delivery." Not only painful delivery but in all
diseases or problems in life where the concerned person cries/weeps with
'unbearable' pain (or resort to suicide) Cherry Plum is to be prescribed and it
cures them. In the case of life problems making them to commit to suicide, the
remedy enables them to find ways and means to solve their problems
automatically.
I call aside all the above ladies to whom Cherry Plum was prescribed for
'unbearable pain' and advise them to take daily one dose of the same remedy.
They say, "Sir, we have delivered the baby. Why more medicine?" I advise them
that this remedy would enable them to know as to why they got such
'unbearable' labor pain for hours together and also prevent all sufferings (be it
bodily diseases or problems in life) making them weep or cry. All of them started
taking the remedy. After a few weeks it was noticed that all of them started
learning vocal music (irrespective of their age) and after a year were performing
in music clubs and stages and their income multiplied several-fold.
Mighty Nature indirectly tells the above ladies: "I sent you on earth to learn vocal
music and earn several thousand rupees. But you did the mistake of choosing
an unsuitable profession to earn a few thousand rupees once a month. To remid
your work on earth, I gave you that unbearable labor pain. At least now realise
your mistake, start taking the Bach remedy Cherry Plum which not only cures
your prolonged labor pain, but also, simultaneously enables you learn vocal
music and earn several-fold of your previous monthly income.
The question now before us is, 'What is the connection between ’vocal'■' music
and 'crying with pain or problem in life?' In
I.. both
—-------instance
--------- 'voice' is used
continuously in
high
pitch.
We call
‘Weeping with pain or
problem in life,1 as
‘NEGATIVE ASPECT’ of Cherry Plum
‘Singing1 as
‘POSITIVE ASPECT’
of the remedy__________
M. S. Subbulakshmi of Tamil Nadu and Latha Mangeshkar of North India are
Remedies
Practitioners) as
’Positive’ Cherry Plum-type
called by (Bach
■
i
a
routine
monthly income job, they
personalities. Suppose they had chosen
would have ended up with disease or problems in life making them weep.
14-year old girl studying in 9th Std. would weep/shed tears for every minor
setbacks/disappointments. I gave her Cherry Plum. After a few weeks of taking
it, the girl asked her mother to allow her to join evening classes for learning
music. The lady came to me asking whether she can permit her, because this
would affect her studies as she was getting low marks in most of the subjects.
I told here that if and when correctly prescribed Bach Remedies, would enable
everyone to earn several-fold of their counterparts.
After learning vocal music for five months the girl started performing in local
music troupes and next year she got a job as musician in a five star hotel in
4
SLP1 D:\DRKRISH_1 \JBAS_SPE.PM5
Dubai on a salary of one iakh rupees.
Let us now turn our attention to the learning of Bach Remedies.
This system of medical treatment has no 'theory' or 'concept' introduced by
human beings like Kant, Sigmund Freud etc. Here, everything is practical and
practical only. Again, in this system no one has 'classified' so-called
psychological patients as 'schizophrenic' or 'deviant behaviour'
'juvenile
delinquency' etc. etc. To learn this subject you do not do any ’systemic5 study
of the subject for months and years in any institution doing a course of study.
On the other hand, a classification of human suffering do exist and all of you
know of it, but all these years you have been ignoring them. Let me explain this:
1. After coming back from radium treatment my neighbour was explaining what
all happened in the hospital and ended up saying (in reference to his
sufferings with cancer pain and horrors of side-effects of radiation
treatment): "No one should get this type of suffering." Please make a note
of his words "No one should get this type of suffering."
2. A patient with chronic abdominal pain that resisted treatment by specialists,
used to say quite often that he was paying for his past sins and that is why
doctors are not able to diagnose his case.
3. In another case of chronic headache, since no treatment was of any help,
he would say, "All doctors are useless. They only know how to extract money
from patients."
First person. "No one should get this type of suffering."
Second says that he is paying for his sins. (Blames himself and not doctors)
On the other hand, the headache patient "blames” doctors for grabbing money
from patients without giving any relief.
From time immemorial, all of us have been listening to the above words.
a. Whatever may be the name of disease or problem in life, if a person says
that no one should get the type of suffering which he has, the Bach remedy
to be prescribed for his is ROCK ROSE.
b. For self-contempt or sinful feeling, the Bach Remedy is PINE.
c. If a person is blaming others or God for his sufferings he indirectly says that
he is to be prescribed the Bach Remedy WILLOW.
Thus, we say that in Bach Remedies system the PATIENT IS (indirectly) TELLING
OR INDICATING THE REMEDY THAT WE HAVE TO PRESCRIBE FOR HIM.
For all of you, as well as for doctors of all systems of medicines, the above
words or statements has no significance. But all of us since our childhood are
listening to the above statements. Thus, there does already exist a classification
of patients by the words used by them in reference to their diseases or life
problems.
Now, in BACH REMEDIES SYSTEM we make use of these statements only, for
selecting the remedy.
5
SLP1 D:\DRKRISH_1 \JBAS_SPE.PM5
Dr. Edward Bach discovered 38 wild flowers. When we examine the method of
using these remedies (be it bodily diseases or psychological complaints or
problems in life) we are surprised to find that every one of us would fall within
the description of one remedy only.
Thus, on the one hand we find 38 different types of personality or individuals
On the other hand, mighty Nature has provided 38 corresponding flowers in
Nature.
What you have to learn in this system is just and only the names of 38 different
remedies along with their corresponding mental states or behaviour or attitude
or words used by them. You are not required to do psycho-analysis etc. •
No sooner you complete our 4-day personal course, you are able to identify
patients with their remedies (may be your neighbor/relative or friends.)
We are yet to come across any type-person who does not fall under the
classification of one of the 38 Bach Remedies.
Let me now describe, by way of example, what we mean by remedy-type or
personality. as it already exists in humanity.
Name of
Bach Remedy
Remedy description. (Picture of persons for whom the remedy is
prescribed and with type you would have met quite often)
CRAB APPLE
Sensitive to dirt, filth, contamination, contagion, infection, sepsis,
ugliness etc. They avoid using toilet in school/cinema theatre and
in their friends'
houses. There are extreme types of CRAB APPLEtype persons who would wash their hands after shaking hands
with others. These are called Crab Apple-type persons. These
persons also do not use others' soaps, towels, kerchiefs etc.
Another classification of this remedy is "Sensitive to his
appearance." Pimples in the face of teenage college girls, grey
hair, baldness etc. etc. Those who use wig or use hair-dye we call
them Crab Apple type persons. When this remedy is prescribed
most of their diseases are cured and problems in life get
automatically solved. Also either their baldness is cured or the
remedy enables them to accept it.
CHERRY
PLUM
'Mind giving way' 'fear of loss of reason' 'Uncontrollable' anger,
unbearable thirst, insatiable appetite, cannot wait for food when
hungry. Irresistible temptation. (A diabetic patient of Cherry Plumtype cannot avoid sweets on seeing it when served in dinner
parties.)
Suicidal
disposition:
Wherever a person prefers death to put an end to his sufferings
(be it bodily pain or harassment from debtors) this remedy comes
in. Occasionally we read in local dailies that a person commits
suicide because of unbearable chronic abdominal pain that resists
the treatment by best doctors in the city. Cherry Plum, when
6
SLP1 D:\DRKRISH_1\JBAS_SPE.PM5
prescribed, not merely stops the pain. It cures the underlying
pathology and so the pain is cured completely & permanently.
"Man commits suicide due to extreme poverty." This also we read
occasionally in the dailies. Cherry Plum does not merely remove
suicidal disposition but the remedy enables him to find ways and
means to earn sufficient money and thus suicidal mentality is
cured.
I repeat, that I am not introducing any new classification of 'concepts' about
human sufferings but a type of classifications as mentioned above do exist which
all of you know.
In other words, we say that in BACH REMEDIES SYSTEM the patient himself
indicates the remedy to be prescribed for him. This is either
(i) by way of words/phrases told him; and/or
(ii) his attitude towards his disease/problem or his attitude towards the doctor
and/or
(iii) the words used by those around the patient
and/or
(iv) in the case of kids which have not learnt to speak, report of the mother/
nurse (such as "desire to be carried always' 'fear of strangers' 'timidity' etc. etc.)
Let me finish with an in-depth study of one more Bach Remedy called ROCK
WATER
Dr. Edward Bach abandoned his lucrative medical practice in Harley Street and
wandered in forests in search of a better method of treatment. Fortunately, he came
across 37 wild flowers, all found only in one area in a thick forest in England, the
place called Mount Vernon, a small village.
He found that the water of natural springs found
medicinal properties. This he called ROCK WATER.
37 flowers
+
among
rocks also had
1 spring water (called ROCK WATER) = 38 remedies
He took five out of the 37 flower remedies, mixed them and called the mixture
of RESCUE REMEDY. Thus the total comes to 39 in all (to 37 + Rock Water +
RESCUE
REMEDY)
Just because these are imported into India from England you need not think
that these must be costly. These are the cheapest of all medical systems. These
are available in all homoeopathic drug stores. These have no toxic effects
whatsoever and there are no diet restrictions.
Let us now learn the use of Rock Water.
Those extremists and Naxalites who take law into their hands are called
negative Rock Water-type persons. In other words, those who follow a 'cult' are
Rock Water negative types.
7
SLP1 D:\DRKRISH_1 \JBAS_SPE.PM5
Hijackers too are negative Rock Water-type persons. You are travelling in an
aircraft and in the mid-air it is being hijacked. If you have the remedy Rock Water
in your packet, take two pills and chew them. The hijacker would release you alone.
Of course, all those who take Rock Water would be released by the hijacker.
What does happen if you take Rock Water? The remedy makes us so humane
that the inhumane nature of the hijacker dilutes away. Rock Water is recommended
for SPECIAL TASK FORCE police personnel dealing with extremists, naxalites and
commandos surrounding a hijacked plane on the ground. If they take Rock Water,
these extremists who take law in their hands would automatically surrender to them.
USES OF ROCK WATER IN OUR DAY-TO-DAY LIFE. A child is kidnapped and
the kidnapper demands a ransom of a few lakh rupees. At this moment all members
in the family of the kidnapped kid may start taking (say every 2-3 hours) all the
following Bach remedies:
ROCK WATER to remove the inhuman attitude of the kidnapper;
RED CHESTNUT (Because the relatives become anxious for the welfare of the
kidnapped child)
ROCK ROSE (Terror/Panic situation. The kidnapper may kill the child)
GORSE (Hopeless situation). Without paying ransom amount, which you don't
have, you cannot get back the child alive.
SWEET CHESTNUT (During the scene of kidnapping every member of the family
starts praying to God. (A dose of Sweet Chestnut if taken before prayer,
enables you to automatically pray correctly and thus your prayer is answered)
Within 24-48 hours of taking the above remedies by the family, the child comes
back safely without being hurt and without your need to pay any ransom.
By taking Rock Water you cannot make every one bow their head before you.
But if any one misbehaves with you or threatens, Rock Water protects from unruly
and anti-social elements, rowdies etc.
In Police stations and R.T.O. offices as well as in Registrar's office you cannot
get things done without paying bribe. Before going to these places take a dose of
Rock Water and another Bach Remedy called Gorse and you get things done without
paying bribe. By your taking Rock Water inhumane mentality disappears in the
atmosphere.
If an M.L.A. or local rowdy is harassing you take Rock Water and he stops his
nuisance.
Goondahs, dadhas, hard core criminals etc. would automatically surrender if the
concerned Police personnel take the Bach remedy Rock Water.
For postal course in Dr. Bach Flower Remedies of England,
Krishnamurthy, Raman House, 21, Kuppaiah Street, Chennai-33.
8
SLP1 D:\DRKRISH_1 \JBAS_SPE.PM5
write to
Dr.
- * o ■
Ir
SEMINAR
ON
HERBS IN HEALTH
/
DECEMBER 11, 1993
NUTRITION SOCIETY OF INDIA
BANGALORE CHAPTER
HOME SCIENCE ASSOCIATION OF INDIA
KARNATAKA BRANCH
.1
*
INSTITUTION OF AGRICULTURAL
TECHNOLOGISTS,
BANGALORE
INTRODUCTION
The
December
succes s
of the Seminar
on "HERBS IN
HEALTH"
11/ 1993 was manifested in abundance when
participant
at the Seminar made a spontaneous demand
held
on
almost
every
for
print-
outs of the subjects covered in the Scientific Sessions. While the
N.S.I.(Bangalore
grateful
to
Chapter)
the
and H.Sc.A.I.
participants
for
(Karnataka
their
stout
Branch)
are
support
and
encouragement, we have the pleasure of presenting in the following
pages a collection of Lectures delivered by eminent speakers.
We
are sure, this will be of immense practical use to the readers.
USHA V. RAO
Convenor /Secretary
N.S.I. (Bangalore)
<
Mailing
Addres s : Mount Carmel College,
58,Palace Road,
Bangalore - 560 052.
Dr.ELIZABETH S.THOMAS
Secretary
H.Sc.A.I.(Karnataka)
1
Keynote Address
HERBS IN HEALTH
INDIRA BALACHANDRAN*
*
To
be
frank with you, I was a bit nervous when
got
the
invitation to deliver the key-note address at this seminar on
the
of
role
herbs in health because. to borrow a term
parlance, I know my
all
I
from
'credit worthiness’ to this honour is not
at
that good. But at the same time, I was thrilled at this
chance
to address
I
have
rare
a galaxy of enlightened people. Though I
from a family of great repute in Ayurveda, I myself am a
and
banking
been working on the Botany
of
Ayurvedic
come
botanist
medicinal
plants.
But I did not have much time to understand the system
of
Ayurveda
deeply. So, I have come here with the selfish motive
of
enriching
myself
than
enlightening
on various aspects of herbs and
health
you on them. I thank the organisers
for
rather
this
great honour and pass on to the text of my lecture entitled "Herbs
in Health" .
In
fact,
the
subject
dealt
with
is
so
vast
and
the
applications of herbs as food, medicine and cosmetics are so
wide
that
these
and
hence
only
some stray thoughts on plants and their importance in
human
points cannot be detailed in a brief talk
health are presented here.
* Dr.Indira Balachandran, Research
Officer,Arya Vaidya Sala,
Herbal Garden, Kottakal - 676 503, Kerala.
2
By far, health is the most important attribute that any human
being would desire and pray for. Healthy individuals are essential
and
of a healthy society. This explains, why medicine
components
health care. have acquired so great an importance in the agenda of
human culture, civilization and polity.
But,
affects
all
health ? No doubt, it is
is
what
all
endeavors and behaviour. But,
human
and
pervasive
doubt
I
yet,
whether we have definition for health, covering all aspects of it.
sually,
it is defined as the general condition of body and
as to their vigour and soundness. Our ancient system of
puts it more succinctly. Based on the philosophy of
mind
Ayurveda,
'pancabhutas'
and ’tridosas'; it defines health as :
Samadosah samagnisa samadhatu malakriyah
Prasannatmedriyamanah svastha ityabhidhiyate
i . e.
.Health is a state where individuals have a balance
elements,
their hormonious functioning, an enlightened
of
body
state
of
we
will
consciousness, sense organs and mind.
Learning
these
philosophical disquisitions aside,
here
some
of the pragmatic
discuss
Health-care
has
two
distinct
aspects
of
human
health,
One
is
the
adequate
aspects.
nourishment required for the growth and development of human body,
and
the other is to keep on fighting the causative factors,
♦inherent and external,
causing
diseases
both
which would derail normal state of health,
and debilities. This is
where
medicine,
both
4
the
memory
power.
Acrid cures diseases
affecting
oedema
etc.. Pepper, long
pepper.
red
acrid in taste.
Astringent
purifies
the
The excessive use
of
It
is
way
or
preparing
our
indigestion,
etc. ,
%safoetida
are
blood, heals ulcers and reduces excess fat.
any
of
these
tastes will affect the
to
interesting
of
chillies,.
adversely.
note that our traditional food has
other included all these tastes
Many
health
throat t
the
some
in a balanced way.
the items we use in our kitchen for
daily
food
such as cumin, mustard seeds.
black
gram,
pepper, turmeric etc., are not only
fengreek,
asafoetida,
but
nutritious
also having high medicinal values.
Plants
have provided cure for ailments since ancient
times.
Yet, we do not know, when and how man first discovered the healing
properties of herbs. Probably, man learnt his early lessons
herbs,
the animals. Gradually, he learnt
from
identify
plant species to be used in various conditions
different
health.
to
Another
probability
is
that
plant
using
medicine
the
of
ill
had
its
oeginnings in ancient faiths and beliefs, got involved with occult
practices
and
rise
to
It
is
insist
on
developed into herbalism. Later, it gave
traditional
systems
interesting
to
recognising
medicinal plants with the help of
of
note
treatments
that
the
as
such
Ayurvedic
Ayurveda.
classics
hermits,
sheperds
and
the tribal men. While examining the Indian scenario, we
find
that herbs have been a source of solace for human
from
time
immemorial.
In Rigveda and
Atharva Veda,
will
ailments,
there
is
5
3
mention
about
natural
environment, who carried physical, mental
development
Even
the miracles of herbs. Persons brought, up
to its climax, used to depend on natural
of
the
vegetation.
beings, who got benefits from
Mythologies
Ramayana,
give
Hanuman
'Mritasanj ivini'
great
existing,
among
science of herbs existed
the
spiritual
when the scripts or means of publication were not
fundamentals
in
and
in
human
the
it.
to
medicinal
herbs.In
Gandhamadana
mountain
with
the
plant to give life to Lakshmana, who falls
dead
brings
the battlefield. ’Soma’
importance
the
is considered to be the divine
plant
created
by Brahma for the longevity of gods. There are many
such
stories
about
the
influence,
the
medicinal
plants
herbs
on
had
which
human
indeed
establish
civilization,
time
from
immemorial. Apart from these myths, in Hindu culture, we find many
herbs being used in rituals like Tulasi (the sacred basil), Darbha
(the sacrificial grass)and Durva.
Besides
the
institutional
system
of
treatments
such
Ayurveda, other local systems of medicine were in vogue in
all
almost
traditional societies, which were called 'home remedies'
most of them
and
are plant based. Our grandmothers used to cure
many
diseases of the family members, by giving juices or decoctions
of herbs. that grew at the
pastes
made
houses.
A
few examples which were in very
quoted
to
show, how plants were involved in the
care.
out
or
of
their
practice
are
premises
c ommo n
as
routine
health
6
speaking about the medicinal herbs, Tulasi,
the
holy
of Hindus, deserves to be mentioned first. Apart
from
its
medicine
in
While
•plant
it is famous as an effective
importance,
spiritual
cough,
chest
seen
among
children, Tulasi is used as an antidote. Decoction made of
Tulasi
many
kinds
congestion,
illness. For diseases
of
cold,
like
fever, digestive problems etc., commonly
leaves
and
cough
and
fever
for persons of all ages. It is also useful in various
skin
pepper, is an effective remedy for
cold,
ailments and insect bites.
The
traditional
symbol
use of Turmeric, not only as a
of
prosperity and fortune, but as an inevitable ingredient in several
our
preparations, establishes its importance in
food
day-to-day
life. Turmeric is a well known antiseptic and it helps to
the poisonous substances
helps
to
purify
destroy
which might include in the food. Lt also
blood and is widely used in
the
treatment
of
several skin ailments. Curcumin, a substance found in turmeric, is
found
to be effective and cream of milk, is used to
improve
the
■complexion of the skin.
Ginger, a
from
common article, is being used as medicine in India
Vedic period. The ancient Indian and Greek
physicians
Ginger as an antiflatulent and rectifier of the defective
of
the body. Ginger is a valuable drug for
digestive
used
humours
disorders.
Dried ginger boiled in water with jaggery, is a very old treatment
for cough, cold
and fevers resulting from cold.
7
Several medicinal properties have been attributed to Garlic a
wonder
heart,
used in many diseases. It is good for the
drug
feed for the hair, a stimulant to
a
appetite, a strengthening food,
>
useful
in catarrhal disorders, piles, worms.
asthma
cough.
and
Garlic is regarded as an effective remedy to lower blood
pressure
and the cholesterol level in blood. It helps to avoid formation of
gas in the digestive tract.
kitchen,
the
burning
boiled
as a wonderful
a very popular name in
in
drug
ailments.
various
for
to Ayurveda, it subsides pitta in body and is good
According
the
acts
Coriander,
in the palms and
sensation
water
with
is given to
children
feet.
Dried
coriander
to
improve
digestive
power. It is also used an eyewash in conjunctivitis.
is
Neem
the
and
a tree which has been popular in the past
as well, and it belongs to every facet of Indian life
present
house
keeping, religion and ceremony, agriculture
There
is
mention about this tree in Atharva
medicine.
and
ancient
The
Veda.
physicians
used
eczema
and
jaundice,
among other diseases. Ayurvedic Samhitas refer to
neem
neem
diabetes,
to treat leprosy.
The
modern
scientific
research establish the findings of the ancient
Indian
scholars.
Everything about this tree is under scrutiny
as
the
an
effective
remedy
against
dental
diseases.
Western laboratories especially in Germany and
today
U.S.A.
in
Neem,
with its myriad bitter principles, is making news as the source of
a
possible
biopesticide,
an
excellent
efficient
nitrogen
cure for AIDS. It is also found to be
herbal
contraceptive,
an
regulator in the soil and an effective remedy for tooth decay
and
8
gum
inflammations.
The American scientists call it
a
'miracle
tree
growing in the backyards of developing countries for solving
global problems.
The drum stick tree (Moringa olefera) is very common in most
parts of India, but seldom do we know that this tree is
a store
house of nutrition and medicine. The
leaves of Moringa have
abundant stock of vitamin A & C.
Moreover, it is rich with iron
and calcium. The soup made of Moringa leaves
is an excellent
remedy
for anaemia, malnutrition,
cold asthma and
general
debility, besides being a well known
galactagogue and aphrodisiac.
The drumstick fruits and flowers also
are highly nutritive.
Moringa is widely used in the
treatment of night blindness,
hypertension, urinary problems and some kinds of rheumatism.
Herbs
play
a vital role in the health care systems of the
different tribes of India, though sometimes it is
associated with
occu«lt practices. But many of the practices
are worth subj ecting
to scientific analysis. Normally, the tribals
are reluctant to
reveal the identity of medicinal
plants used by them. But the
recent study made by the scientists of
Botanical garden of
Palode,
Kerala,
at Agasthyar hills in the Western
ghats,
established the necessity of such studies.
They have found out a
plant called
’Arogyappacha’ (Trichopus Zeylancius) used
by the
Kani tribals which revealed the
secret of their
’evergreen'
health. This plant has today
entered the modern pharmacopoea as a
safe antistress, antifatigue.
appetite promoting and restorative
herbal tonic for people in all age groups.
9
quite
But,
unfortunately, our knowledge of
in
plants
our
immediate surroundings has suffered badly, consequent to change in
social
life. With the present mode of imparting
traditional
systems,
themselves
from
men
of
medicine
instructions
also
have
plants -- the resource base. As
a
distanced
consequence,
there is widespread adulteration in plant medicine, which in
erodes
the efficacy of the system itself. Probably, this
a
alleviated
little,
if
men
of
traditional
in
turn
can
medicine
be
could
actively collaborate with Botanists.
The discovery of many of the so-called modern drugs,
of
them
some
ancient
tribal
practices and traditional systems. Thus we have got aspirin
(from
a
life-saving,
can
be
traced
to
back
European plant commonly called 'meadow sweet') which is
used
an analgesic and antipyretic, reserpin
as
serpentina)
quinine
(from
vincristin
cancer
in
used
and
treating
treatment;
and
hypertension
psychotherapy;
dreaded
malaria;
(from Catharanthus
roseus)
used
(from
Digitalis
digitalin
and
digitoxin
used against cardiac problems -- all from the
purpurea)
Rauvolfia
the
Cinchona sp.) used against
vinblastin
(from
widely
in
treasure
house of traditional knowledge of the various ancient societies.
In
fact,
us in two
different
ways
in
drug
Firstly, plants and plant parts themselves serve
development.
medicines
help
plants
directly,
as
in most cases
of
traditional
as
systems.
Secondly, the 'active principle' out of several hundreds of
plant
concentrated
form,
compounds,
is
isolated and administered
in
10
which
yields
the
desired results much faster,
as
followed
modern medicine. With the advances in science and technology.
know
that, at present, we are relying mostly on
in
synthesised
on the basis of the models that we obtain from
our factories. But these
compounds. At
the most,
for
surer
better,
penicillin
versions
that
of
we
drugs
are
we
drugsk
synthetic
manufactured
invariably
plant
what we can do is to improve upon
results.
Thus ,
the
have in the market
innumerable
now,
are
the original penicillin, isolated
them
kinds
of
improved
the
from
in
the
fungal
plant Pencillium.
Even
now.
a
good majority of the
prescription
drugs
are
either direct plant products or their synthetic counterparts. Yet,
we
have not been able to exploit the full potential of plants
t,his
sphere.
Only 5-10% of the plant species have
so
far
in
been
s'tudied for their medicinal prowess, which means that majority
of
them
are
we
have
around
yet to be analysed and understood. In India,
15,000 species of flowering plants,
not
4,000 species are now used in medicine. Considering the
.taxim
where
than
more
Ayurvedic
"Jagathaivamanoushadham" (i.e. there is nothing which
not medicinal in this world), we have miles to go. because
is
higher
plants, still seem to be the "sleeping giant" in drug development.
The
distinction
between medicinal and
plants
is
highly lop-sided, because all of them are medicinal in one way
or
other.
be
non-medicinal
Our limited knowledge about their potential should not
an alibi for this sort of highly arbitrary classification.
11
a time, v/hen cure for diseases like cancer
At
elusive,
are
and new scourges like AIDs are casting shadows on the survival
species t
human
medicinal
there
is a great need for us
to
pharmacognostic,
with
preserve
plant studies in all its various aspects --
of
botanical,
pharmacological, clinical etc., and to
preserve
the plurality of approach to human health care.
Unnerved
by the predominantly antibiotic mode
treatment
of
and the disastrous side effects of modern medicine, people, by and
large,
have now realised that 'natural is better'.
there
is a palpable shift in public preference in favour
traditional
the
of
the
call
it
witnessing
the
herbal medicine, throughout the world. They
'green
spectacle
Consequently,
wave'.
of
In our own country,
we
are
mushrooming of Ayurvedic pharmacies in
the
recent
times. Systems like Siddha, Unani and even Homeopathy have
caught
up
very well with people. Eventhough the philosophy and
of
many
of
these
systems,
like
the
'Tridosa
concepts
of
Siddhanta'
Ayurveda, are still out of bounds for modern scientific
analysis,
no
provided
body can wish away the fact that these systems
have
and continue to provide a healing tough to the suffering millions.
in
various
efforts,
medicines'
parts of the world.
afoot
to
resuscitate
Naturally,
and
promote
which we hope will enable us
there
are
these
to provide
serious
'natural
health
for
all by 2000 A.D.
But
road
this is a destination which be at the farthest end of
which is full of pot holes. Some of the hurdles are of-
a
very
12
fundamental
nature. For example,
sustainance of herbal
medicine
depends very much on the available medicinal plant resource
base.
pow
their
of it is available now ? What do we
much
potential ? Are they available
we
are
in
know
about
adequate measure ? If not. how
going to sustain the system ? These are
all
fundamental
questions that should disturb us, because plant resources are
the
foundation on which the whole superstructure of these systems
are
age
of
we
are
living
in
an
constructed.
Unfortunately,
environmental
crisis, brought about mainly by forest and
destruction.
This has resulted in the depletion of our
habitat
medicinal
plant stocks. Many valuable medicinal species have already
endangered.
Several
others
On
are extremely rare.
become
broader
a
scale, out of the 15,000 species of plants, we have here in India,
- 4,000 species are now threatened, which is a pointer
3,000
ttie
future
plants
are
for
scenario. The tragedy is that most of
the
medicinal
them
are
averse
forest
dwellers
and many
of
to
cultivation.
The most important point to be noted is that, as we progress.
we
are
going to be more and more dependent on
other
organisms,
including plants, not only for our food and medicine. but also for
other day-to-day requirements. That is why, it is being
said
that the future quality of human life here would depend very
much
all
qn the existing biodiversity. Unfortunately, we have been on a way
path
with nature all along, with the intention of conquering
By now, it is amply clear that it is going to be a losing
it.
battle.
13
The course of
progress and development that we pursue now, is not
sustainable in the long run, because, metaphorically speaking.
have
been eating up the capital, instead of being contended
feeding on the interest. Sustainable development requires that
develop
ways
resources.
So,
and means of very prudent exploitation
unless we retrace from this
perilous
of
we
with
we
natural
course
of
destruction and mayhem and strike a compromise with nature. we are
going
to be the vanquished. The writings on the wall is, by
very clear. In this war of attrition.
now.
nature is going to have the
last laugh and as all of us know, he laughs best who laughs last.
THANK YOU.
14
.scientists
from
a
me narrate the experience of
let
Incidentally z
who
Trivandrum
went
on
a
collection
plant
Kani
expedition to Agasthyar hills at the Western ghats, with the
scientists
tribals as their guides. In spite of the good food the
had
consumed
of the Kani tribals fascinated
stamina
offered
tribals
whereas
the
In
fact,
the
few
a
a
fruits rom
botanists.
the
plant
to
The
exhausted
the
and the effect was sudden. They felt
an
exhilaration
fruits
gave their tired bodies a flash
of
energy
and
tribals
were reluctant to reveal the
identity
of
the
scientists
and
tired,
looked fresh and even without taking any food.
tribals
the
on their way. they were much
of
team
vitality.
The
fruit,
pleading
that
it
was a
time
honoured
secret.
tribal
After a great deal of persuation. the Kanis led the scientists
a
to
place called Arogyappacha.
Back
at
labs , the plant was
the
(Trichopodaceae ).
zeylanicus
jharmacopoea
as
a safe,
identified
modern
restorative
anti-fatigue,
tonic. The scientists are confident that it
herbal
the
This plant has entered
antistress,
Trichopus
as
will
replace
the Korean ginseng. as the health food of the 21st century and
it
will soon be available in tablet. liquid or powder form.
The
Ayurvedas
searched
the
Ayurvedic
texts
for
some
information on this plant. They have come across descriptions of a
plant
which match with Trichopus zeylanicus. It could
indeed
be
15
divine
the
Varahi which was considered as
the
ultimate
he.-alth
grow
tonic by Sushrutha, the father of Ayurveda. Many plants that
around us are highly medicinal, but unfortunately unknown to many.
few such plants for information.
I shall introduce a
Punarnava (Boerhaavia diffusa - Nyctaginaceae), a very common
annual weed seen during monsoon, is an important rejuvenative drug
in Ayurveda.
Naturopathists
the Sanskrit word 'Punarnava'. Much recommended by
diuretic,
stimulant of heart, kidney and liver. Being a good
roots boiled with milk, is an effective remedy for oedema.
clinical
as
intake, this herb is widely used by Ayurvedists
daily
for
of
'That which revives again' is the literal meaning
studies
hypotensive
and
attribute
anti-inflammatory,
cardiovascular
activities
to
a
the
Recent
anti-arthritic,
the
roots
of
Punarnava.
important
Brahmi (Bacopa monnieri - Scrophjulariaceae) is an
drug
used in Ayurveda for improvement of intelligence and
and
revitalisation of sense organs. It clears voice and
improves
it
is
customary in Kerala to give the juice of this plant to
the
digestion.
still
memory
It
could be because of these properties, that
new born babies. Many preparations made of Brahmi are available in
todays'
market.
It
is
also
indicated
against
bronchitis,
dyspepsia, anxiety neurosis and insanity.
used
Mandukaparni (Centella asiatica - Apiaceae) is the herb
by
the Physicians of North India in the place of
Brahmi.
Almost
all the qualities of Brahmi are attributed to this plant also.
It
16
improves
rhe recepture and retentive capacity of mind. The
is
plant
studies
reported
have
to be a
proved
nervine
and
cardiotonic.
its efficacy in improving
the
whole
Clinical
faculty
of
memory in mentally retarded children.
Amrta
(Tinospora
cordifolia - Menispermaceae)
is
a
Hindu
mythological term which refers to the heavenly 'elixir’which saved
the
celestial
young.
This
ecognition
longevity
people
term
from senescence and
is attributed to this
kept
them
in
drug
eternally
Ayurveda,
in
of its capacity to impart youthfulness, vitality
and
to
antipyretic,
the
consumer.
and
an
The
mature
stem
effective
remedy
for
is
restorative,
fever,
jaundice,
diabetes, skin ailment and neurological disorders. Recent
made by
studies
some voluntary women movement establish that this drug is
effective in various uterine complaints.
Charngeri (Oxalis corniculata - Oxalidaceae) is a small
herb
that gave solace to the house-wives in olden days. The whole plant
boiled
nd
with buttermilk is a reputed home
diarrhoea
remedy for
in children. It is a digestive
indigestion
stimulant
and
so
beneficial in loss of appetite, dysentery and bileousness.
Karpooravalli
(Coleus ambonicus - Lamiaceae)
This
aromatic
plant is a common home remedy for infantile cough. cold and fever.
Leaf juice mixed with little honey relieves cough. bronchitis
fever seen in children.
*
and
17
Aswagandha
(Withania
somnifera
Solanaceae)
highly
is
esteemed as a rejuvenative drug which is capable of imparting long
life.
youthful vigour and intelligence. It is widely used
as
an
aphrodisiac and in cases of anxiety neurosis. It improves physical
strength
and
Because
of
is
prescribed in all cases
of
general
debility.
the high medicinal values of this plant, it
is
even
considered as ’Indian ginseng'. Common name : Winter cherry.
Amalaki
important
(Emblica
officinalis
of
Vitamin C and a
source
Euphorbiaceae)
major
ingredient
renowned health tonic Chyavanaprashz Amalaki has become a
of
very
A
in
synonym
total health. It is found to be effective in the treatment
peptic
ulcer and dyspepsia. Juice of goosberry mixed with
******
of
little
honey and turmeric powder, has been found to be very effective
controlling diabetes.
the
in
1
CONCEPTS
FOOD,
OF
Dr.K.T.ACHAYA,
NUTRITION
CSIR
AND HEALTH
IN
ANCIENT
Emeritus Scientist (Retired)t
INDIA
282,
by
Hundred “
feet road, Indiranagar, Bangalore - 560 038.
I
feel
speakers
it
a previlage to join the
list
of
distinguished
who have preceded me in giving the Kamla Puri
Memorial Lecture at Lady Irwin College.
I would like to express my
gratitude
to those v.’ho have asked me to do so. For the
years,
have
I
India,
University
would be
our
been an avid student of the history
and indeed my
Sabharwal
of
last
f evz
food
in
book on the subject will be issued by Oxford
Press. What would strike anyone traversing
this
the remarkable analytical insights that were evinced
ancestors
in
these
finding
experimental
in
matters,
to
recent
times ,
the
wh ether
protein
of
complementation, or of dieuary fibre. or of linkages between
and
through
mind
traditionally
understood
and
seem
implemented.
this lecture the concepts that
m
illustrate
neurotransmitters ,
have
to
by
many
that
extent
path
body
been
would
like
to
prevailed
in
the
I
three related areas of food, nutrition and health.
SOURCES
Of the three chief sources,
Samhita
knowledge
may
the Charaka Samhita
both represent periodical redactions to
that
and Sushruta
a
body
of
was perhaps first put together about 400
BC
and
added to over eight centuries.
The former is primarily a
medical
2
text z
the latter a surgical one. The Charaka Samhita
into
eight
devoted
major sections and 120 chapters. of
to
fundamentals
(Chikitsa).
It
congenital
conditions,
(Sutra
Sthana)
describes 200 diseases and
is
which
and
150
divided
half
are
therapeutics
pathological
and their treatment using
341
or
medicinal
plants.
177
ministrations.
The
Susrutha
Samhita is in six sections, all relating to surgery,
it
animal
drugs
and
64
mineral
describes 101 blunt instruments (like forceps, catheters, rods and
probes)
and 21 sharp instruments (knives, scalpels,
hooks),
and has excellent procedures for several operations,
eg.
for
the reconstruction of a nose using a skin-flap let down
from
the
forehead, for kidney-stone removal, and for couching
of
the
eye
(the
floating
in
surgeon is advised to practice on
saws ,
grapes
axes,
water). There are specific diets for various bodily disorders such
as diabetes, jaundice. tuberculosis and asthma that can hardly
be
faulted
even
today.
of
Science)
of
Vaghbhata,
ayurvedic
text
The
Asthangahrdayasamhita
written
about 750
which is particularly good
AD,
on
(Compendium
is
a
food
Buddhist
injunctions
related to season. Many other Sanskrit writers were polymaths. and
even unexpected works, even the Bhagavad Gita of the
or
Mahabharata,
Kautilya’s Arthashastra, carry materials related to
food
and
health.
In
South
India, ayurvedic concepts came
with
Aryanisation
after
about 500 BC. The Sth century Rural of Thiruvalluvar
with
the three chief concerns of man, which are
love,
deals
knowledge
3
and health; it draws heavily on ayurvedic principles of moderation
in
eating, the patient-doctor relationship, and so on. A
’contribution
to
ayurveda came from Nagarjuna of the 7th
•century
who
pioneered
special
or
Sth
therapy,
and
invented black sulphide of mercury and several arsenicals for
the
AD
the use of
metals
in
purpose.
FOOD
Concept of food : In the Aryan ethos, food had a very exalted
position.
"From
food are all creatures produced and by
food
they grow. Man thus consists of the essence of food". Life
do
itself
was visualised as a tripod connecting body, mind and sprit, and an
equilibrium
"Without
use;
of
the body was the object of the science
of
lif e.
a proper diet, medications by themselves are
of
little
with
a proper diet, medicines are largely
unnecessary".
A
balanced diet is essential to help maintain the equilibrium of the
elements and appropriate physical excercise was part of the health
package.
Food
in the Aryan belief was
not simply a means
of
bodily
'ustenance, or even of good health ; it was part of a cosmic moral
cycle,
and
ii
the self consists of food. of breath,
understanding" . In the
of
cosmic cycle, the eater, the food
the universe must all be in harmony. It was
eats
and
gave
rise after consumption to products as dissimilar
-mind
and
connected
waste (excreta). Disharmony between
with
cosmic
factors, and good
<
balance between various forces.
body
health
of
mind,
that he
food
that
as
flesh,
humours
was
represented
a
4
which
The humoral theory : Five states of matter were postulated,
in
combined
when
body
engendered
translated
These
dhatus.
pitta,
guna
sattvik,
intelligence,
sobriety
as bile. is expressed in
is manifested in qualities such as
which
three
themselves in the body in three gunas.The dhatu
expressed
loosely
the
the
the
and balanced judgement. Kapha, or phlegm, expresses itself in
guna tamas, compounded of courage and valour, but also in rash and
mechanical action. The third dhatu. termed vatha or enthusiasm and
also with excited action born of uncertain
energy,but
One
the best accounts of these correlation is
of
judgement.
in
found
the
advice given by Krishna to Arjuna in the Bhagavad Gita. Foods also
in
the
body. Since each of the six tastes is also believed to consist
of
combination of two of the five states of matter. the taste
or
possess
a
rasa
of
food,
a
them
same gunas and when eaten, engender
these
no less than
its
inherent
(heaviness,
guna
lightness, unctuousness etc) influence its behaviour in the
body.
hot
water,
of its guna of warmth, is not. Sattvika foods are
tasty,
Thus
cold
because
nutritive
water when imbibed is kapha-inducing, but
agreeable,
and
conducing to
serenity
and
spiritual
qualities; they are exemplified by milk and its products, jaggery.
honey,
and
fruits
wine.Tamasic
foods
goat
and
sheep
meats,
are stale or ’•cold” foods,
chicken,
or
eggs
and
highly-spiced
and
strong
liquor. Rajasic foods consist of bitter, salty, pungent and
sweet
items
consisting
materials,
for
of pork, beef and non-scaly
fish,
example scaly fish, many spices like
garlic
ginger, pickles, the amla fruit (nellikai) and mustard oil.
and
5
Natural temperaments or prakruthi are likewise of a
sattvik,
tamasic or rajasic cast, and the foods used must coutneract
these
•traits. People with a sattvika temperament could use tamasic foods
-with
advantage
in winter,
and rajasic types are assisted
to
a
better
harmony through sattvika foods. Rajasic and tamasic
enhance
restlessness and eroticisn, and are therefore banned
for
use
widows,
of
by
students and the celibate in
various
foods
rules
conduct laid down in the Sutras and Smrithis.
An
important concept was that of agni, the
f ire.
digestive
gni brings about digestion which releases the rasas of food. Agni
is
different
in each individual, and must be
preserved
It
kindled by the use of ghee and
light
at
its
gruels,
and
sweating z
and
The choice of food is strongly influenced by the season,
and
these
injunctions not surprisingly were developed in North
India
where
the
peak.
weakned
is
during summer, in certain diseases, after
when food habits are irregular.
seasons,
seasons
both
vary markedly round the
In
year.
agni, and the three bodily gunas,
different
In
alter.
inter season, the digestive fire is believed to be at its
there
eaten
are hardly any food restrictions and more
height
can
be
mutton t
or
food
without ill-effect. Sour, salty dishes of goat
the
roasts of watery or marshy animals like the iguana. or of birds or
beasts of prey, new rice, sweet preparations, hot drinking
water,
In
other
and
strong
liquor were all recommended winter
foods.
Reasons, levels of both agni and body doshas influenced the choice
of
food.
Thus in spring, when kapha increases.
sour,
oily
and
6
sweet foods were to be avoided, and barley, wheat, venison.
hare,
quail, porcupine and certain liquors were the foods of choice.
summer,
foods that were a strain on digestion, like
In
salty,
sour
and pungent materials, were best avoided. and cold, oily or
fluid
foods were the ones of preference, like barley with milk, or
milk
deer
itself,
rice,
dilution.
was
ghee
meat,
1iquor
taken
after
During the rainy season vatha increases :
strong
meat
and
with
undesirable, and the choice was venison with a boiled
barley,
sauce,
wheat, old rice, and medicated types of liquors in
smal 1
amounts with honey or wine. Finally in autumn, when pittha
begins
to
rise,
other
fats ,
and
indeed even fried foods, were to be left alone; light,
"cold"
and
and
agni is only moderate, ghee and
bitter foods were to be consumed in moderation so as not to stifle
the agni, and liquor was a normal component of the meal. Vaghbhata
sensibly
advises :
"Together with friends, drink undiluted
asava
and arishta liquor, rum, wine and meat mixed with mango juice, but
abstain
in summer”. While the "hot" and "cold" food
perhaps
carried
concept
was
a
good
to fanciful extremes on paper, there is
deal of practical commonsense in the seasonal food injunctions
of
the Aryan life style.
In
foods
a
modern
scientific experiment,
human
subjects
given
drawn only from a "cold" list were compared with others
on
"hot" foods, both diets being identical in nutritional terms. Less
was retained on the "cold" diet, excretion
of
sulphur
less, and the urine was alkaline, in contrast to
the
acidic
nitrogene
f
was
reaction shown by the urine of those of "hot" foods.
1
Vegeratianism
The
sacrifice,
by inference for eating.
and
Rigveda
mentions 50
animals
This
as
fit
for
horses,
included
bulls, buffaloes, rams and goats. After the sacrifice. each carved.
portion
had a specified recipient. For example, the
right
went to the brahmin who chanted the mantras, and the two
thigh
jawbones
and tongue to the prastota priest. For a special guest, a large ox
or goat was expected to be
sacrificed. The great sage Agasthya is
praised
for his sacrifice4 of a hundred bulls in
the
Taittiriya
Brahmana.
Use of meat at a shraddha ceremony to
one ’ s
ancestors
izas considered very meritorious.
Yet right from the start of the thoughtful Aryan had begun to
question the taking of life for food with particular reference
the
gentle
specified
Rigveda
and
to
bounteous
COV7.
be a barren one, and the very
the
cow
earliest
was
always
text,
the
of about 1500 BC itself, carries two verses in praise
"Adithi, the cow, the sinless".
BC,
The sacrificial
eating
of
In the Shatapatha Brahmana -
of beef is declared a sin.
but
this
to
is
800
under
protest from the imposing sage Yagnavalkya who, after listening to
11
the
arguments, declares :
'That may be so, but I
shall
eat
beef if the flesh is tender" . The Dharma Sutras begin to lay
down
penances
for killing an ordinary cow,
and stricter ones
milch cow or draugt ox. so the vision is economic and
for
a
utilitarian
rather than humanitarian. By the time of the Manu Smrithi the list
•of
forbidden meats is a very large one. and ahimsa or
has entered the picture.
non-injury
8
The
battle
of the Vedic sacrifice. it has
been
said,
was
really won by the Buddhists and Jains. Buddha was strongly opposed
to
ritual
occasion
was
sacrifice,
did permit
his
followers
if the killing had been unintentional. and if
received
powerfully
had
but
in the form of alms. The
Buddhist
flesh
on
the
meat
emperor
Ashoka
propagated non-killing in his far-flung edicts,
which
a salutary effect. The other new religion. Jainism,
extraordinary
lengths to avoid injury even to living
went
forms
to
that
cannot be seen. like germs. let alone to large animals. From being
simply one virtue of a priest, vegetarianism had come to form part
of
common
Shankara,
consciousness.
Madhva
The
three
later
Vedic
schools
and Ramanuja each got over the problem
of
animal sacrifice by simply prescribing substitutes for the
of
the
animal
head, like round pumpkins, or coconuts smeared with vermilion.
or
animal shapes made of flour.
By 1000 BC therefore the vegetarian concept had become firmly
established.
But
one should not forget
that
vegetarianism
was
possible in India because of the sheer abundance and wide range of
food stuffs even then available. In fact, except for a few
fruits
and vegetables that came to India following Columbus and Vasco
da
Gama after 1500 AD, practically all the cereals (about a dozen
of
them), pulses (another dozen), vegetables, green leafy
fruits
and
milk,
along with
numerous
materials,
condiments
and
agents, were available even three thousand years
ago,
to fashion into vegetarian meals of high nutritional quality.
and
of
was
sweetening
gustatory
and aesthetic appeal.
spices,
It is doubtful if
true anywhere else in the world till very recent times.
this-
9
NUTRITION
Even
the Rigveda has ahymn to nutrition, and terms
for
the
in
such
Sanskrit v.ords as aharatattva, ooshana, purshi and palan. To
this
concept
was
CL
nutrition,
as distinct from food,
existed
linked an important concept in the Aryan food
ethos,
namely
its taxonomv of cooking. Cooking did not necessarily mean the
use
of fire or heat. In fact cooking without fire constituted a
major
division
are
in the taxonomy of Vedic cooking, in which key
fire,
grains,
ghee,
cultivated grains
collectively
called
phala.
or
anna,
Both
and
milk
concepts
uncultivated
and
ghee
were
considered to have already been cooked, and their presence ensured
ritual
purity in the food. Washing and peeling of fruits,
or
of
vegetables
to give a pacchadi, or pickling in the sun, would
all
fall
the category of cooking without fire
into
products .
there
of
to
give
Cooking with fire is of course a familiar concept,
is a fine ritual distinction in the Aryan ethos in
ghee.
would
This is of course the only fat that
countenance,
cooking
the
but
respect
Vedic
Aryans
the
lowly.
and ghee and sugar
added
with oil being left
if rice is added to boiling milk,
^j^igain,
edible
to
only later, what one gets is a dish called ’Doodhbhat'; but if the
rice is first lightly fried in ghee, before boiling with milk
sugar, what results is a food which tastes similar, called
and
kshira
or kheer. The latter is a naturally superior pucca food.
distinct
from
do
a
restrictive kaccha food like doodhbath.
.terms connote ?
What
these
10
pakka
foods : Literally,
kaccha
Kaccha
and
cooked
and pucca fully cooked, but both are
edible
foods.
basically
means
imperfectly
really
fully-cooked
foods
are
those cooked using water. like rice, kihchdi, roti
and
The difference is a ritual one. Kaccha
dhal. These items are both pure and exclusive, and the cook cannot
leave the kitchen till they have been cooked and served. Left over
food must not be eaten later, being
kaccha
polluted,
considered
or jootha. Pucca foods are those cooked with ghee, and
ba si
they
can be carried outside the domestic cooking area; they suffer less
restrictions, are less liable to pollution. and can even be shared
across caste boundaries.
The
are
microbiological implications of many
readily apparent.
injunctions
Vedic
more
Boiled food is liable to much
rapid
spoilage in a tropical climate than is fried food, and restricting
it
the kitchen ensure freshness and freedom
to
pathogens.
from
orthodox
Fried foods on the other hand can travel, and even today
families, travelling say on piligrimage, carry tins of fried
a
religious
end.
Washing
them. The injunctions on cleanliness, to which
with
sanction
was imparted, were also conducive to this
hands, feet and mouth before entering the kitchen for a meal.
the
meal,
so
impressed
early
through
washing
Buddhist
travellers to India that they exhorted their
to
likewise.
do
banana,
¥
after
or
Leaves, either used whole
like
stitched together into a plate called
and
Chinese
countrymen
of
the
patravali,
or
those
materials,
into
leaf cups,were the ancestor of modern disposable
and
less polluting than the latter on the environment. Clay
r
food
cups
11
used
for
- plates.
drinking,
and in the old days.
all
clay
dishes
and
into
the
were destroyed after one use. Water was poured
“ mouth to be drunk, and not sipped, as part of the saliva-pollution
concept.
Of course all drinking water was boiled
perfumed
before
use
(churnadivasin), as
was
and
frequently
also
milk.
The
natural practices cannot be faulted in terms of hygiene.
Nutritional strengths : Many Vedic food practices are perceived as
strikingly nutritious in the light of modern knowledge. The use of
cereals
and pulses in combination, either as rice-dhal
or
roti-
dhal.
or as composite dishes like idli, dosai, khichri or
holige
(poll), are now known to bring into effect protein-complementation
that
raises the biological value of the entire protein
. that
of milk at a fraction of the cost, and in forms that
"the
palate. Extensive use from the very start of the
ethic.
close
please
Aryan
of green leafy vegetables, those store-houses of
our
raw
chutnies, pacchadis and
kocchumbers
food
vitamins
and minerals. is exactly what modern nutritionists urge. And
are
to
but
what
ways
of
ensuring no loss of vitamin-C through cooking. the salads of India
?
Even pickling without the use. of heat is generally
Vitamin-C
rich
fruits
like
the
lime,
green
applied
to
mango
and
amla(nellikai); it has been shown that retention of the
in
a
morabba
exceptionally
or salt pickle even over
high.
Sprouted
six
grains, used
months
since
vitamin-C
storage
early
develop tenfold levels of vitamin-C, and their B-vitamin
are
is
times,
contents
doubled : further, they are frequently eaten raw in the
form
12
a kosumalli or kosambri. Fermentation is another technique
of
in
which natural enzymes enhance food value. The prime example in the
Indian diet is the daily use of curds, today as a healthy food. In
making the idli, kadabu, dhokla and khaman, the fermentation
step
at the start after grinding not only enhances vitamin levels,
but
carbohydrates and proteins to more
easily
digested
breaks
down
forms
and releases ionisable-iron, while the final steaming
step
Puffing
and
parching of grains like rice and pulses have been shown to led
to
fluffly texture and organoleptic appeal.
a
ensures
carbohydrate breakdown into forms that are more easily absorbed
and these are very old Aryan practices indeed. Parboiling of paddy
to
give the pulungal arisi of old
Tamil literature seems to have
been a contribution of the south, a practice of great
nutritional
import
to rice eaters. Thanks to the wisdom of our ancestors
who
enjoyed
the
rice,
and
of
plenty
of
vegetables, problems of dietary fibre simply
did
not
use
of whole wheat, of hand-pounded
exist.
Balanced diets : We have already noted that moderation in food was
day
was
the
norm prescribed. The stomach was visualised as consisting
of
four
parts
enjoined
liquid,
Two
I
lists
by the fathers of Indian medicine. Two meals a
: two could be filled with solid food, and
one
with
for the movement
of
cas.
always leaving one part empty
examples
will show how modern were the
concepts.
the articles of food (which he termed pathyam)
for everyday eating because they were Igiht (laghu) and
Sushrutha
recommended
generally
wholesome. These were aged winter or shall rice, barley, mung dhal
13
(we
know that this is the least flatulent of our common
pulses),
deer
meat (this flesh always had a very high place.
for
reasons
that
we do
salt /
honey‘
and
rainwater (doubtless for its purity). We could hardly
better
the list today. Incidentally, apathyam foods included the
radish,
not yet understand), butter, amla, rock
jackfruit, beef, seasalt and sheep ghee, and intake of these foods
needed to be carefully regulated. In the Arthashastra of Kautilya,
a
manual
statecraft
of
about
written in 300 BC
of
time
the
is laid down as
the Great, a ’’Genmtlemen’s daily diet"
one-sixth of
one prastha of rice, one-fourth of a prastha of dhal,
a prastha of salt. The
a prastha of oil and one-sixtyfourth of
is uncertain in modern terms, but the relative
weight of a prastha
Alexander
proportions accord well with current thinking.
The
person,
kinds
food
prakruthi or temperament, the agni
of
each
the taste of each item of food influenced
both
the
individual
and
In the event,
of food recommended as well as its quantity.
connotations,
in the Indian ethos, apart from its spiritual
excellence.
was of both nutritional and gustatory
HEALTH
The
of
practice
equilibrium
of
Medicine
agni
with
happiness of mind, soul and
thoroughly
f
Sushrutha
the doshas
defined
and
health
dhatus,
along
as
an
with
sense organs. Ayurveda had therefore a
holistic view of health, but nevertheless a
practical
totally devoid of
In fact the Sanskrit medical writings are
Repeatedly
ritual.
reference to holy writ or to socio-magical
one.
14
the experimental method of direct observation is stressed, such as
careful
be
palpation of the body by the physician.Everything had
supported
by
reason and observation.
discussion with people of
way
The
knowledge
is
by
practice
of
medicine
noticed,
was
given pride of place. However the
disease
( germs were called krmi ) was
of
surgery, diet.
and
to
to
increase
experience.
In
as
already
we
have
germ
the
theory
of
well recognised in
terms
infection. Even the red blood corpuscle is described as
being
club-like
in
remarkable
insight
preferred
to
surprisingly
one dimension and disc-like in
another,
truly
a
medication
was
breast
milk
is
modern. Prescriptions for administering of drugs
on
in pre-microscopy days. Mild
dosage.
strong
on
The emphasis
an empty stomach, or pre - or post prandial, or along with a
meal
in many different ways, are well in line with modern practice. Two
practical
tests
are of great interest. One is
meant
poison
food
by antimony compounds, or green
for
in
boron.
In
a
patient
is
using a drop of oil gently placed on its
surfaces
an
diagnosis. Sushrutha was well aware of the
sweetness
of
swarm
he
another.
the
determined
aid
to
specific
urine,
diabetic
which
gravity
of
urine
from
was noted ants
it
would
to:
that affluent diabetics walk twenty yojanas (about
recommended
km)
a day or practice wrestling or horse - riding, while
the
thin
dietary
detect
to
diabetic
not to exert himself
too
much.
injunctions for various ailments can hardly
even
today.
For biliousness. it was coconut
thirst
and
indigestion, barley water, and for
r
warning
Indeed
be
8
the
bettered
for
fever,
dysentery,
milk.
water;
15
night with sugar and
a
warm
at
honey for insomnia. Tuberculosis called
for
also recommended for hyperacidity, and
was
Milk
taken
rich meat diet,and asthma for meat soups with plenty
ghee
and
acid juices.Dyspepsia meant fruits, cooked
of
salt,
roots,
and
tasty beverages. Sugar was toboo in diabetes for which a series of
herbal extracts were prescribed.
Yet another concept cardinal to ayurvedic practice is that of
fasting.
was the ultimate in therapy or medicine
This
both reduces
since
it
and purifies the dhatus. Fasting did not mean
total
abstinence from food; usually it implied restrictive eating.
such
as only of fruits.
Of
the
341 medicinal plants described as
have
any
stood
the test of modern pharmacology and medicine ? Perhaps
the
most
striking has been the development of the
drug
resprpine
tubers
from
hypertensive
the sarpagandha, Rauwolfia serpentina.
of several
versatile
drugs,
From
the
Dioscorea species can be extracted sapogin,
precursor
for
several
drugs
including
an
a
oral
contraceptive pill. The root of the common wild plant Vinca rosea.
now
termed
yields
Catharanthus
roseus (with pink
or
purple
two alkaloids, vinblastine and vincristine, which in
yield drugs used in treatment of Hodgkins disease, acute
of
i
flowers)
turn
leukemia
children, and cancer. From Commiphora mukul exudate have
been
obtained both sallaki, for use in arthiritis, and guggulipid.
now
widely used in coronary arterial disease. The asmagguptha of Vedic
terminology
is
Mucuna
prurita which
contains
natural
L-Dopa,
16
useful
in Parkinson’s disease. Forskolin is the active
principle
of Coleus forskohlii and is a hypertensive and sedative. Composite
ayurvedic
medication in commercial use include Liv-52
and Plus-30 and Chyavanpras as
protection,
1 iver
for
restoratives
general
and tonics.
Of
diabetes,
against
modern science has so far vindicated fenugreek
(methi)
non-
insulin
traditionally
and
effective both in insulin dependent
as
seeds
used
many natural materials
the
dependent diabetics. Other naturally occurring compounds that have
been
household remedies are isabgol (Plantago
husk
from
the grain of which induces persistalis and acts
mild
mechanical laxative, and in dysentery and
the
though
Coconut
are
well
by its very low sodium and high potassium content,
and
fluids.
The
has ayurvedic status in kidney conditions, which
that it is isotonic
fact
a
acathartic
alkaloidal principle which is now a commercial commodity.
supported
as
diarrhoea
its water absorptive power. Sennapods and leaves carry
water
the
ovata)z
long
body
with serum and
of rapid wound-healing called vrana-ropana by
Sushrutha,
is being revived at the Institute of Indian Medicine in
Varanasi,
concept
and
a
ghee
medicated with jasmine
(jathi)
flowers
has
shown
excellent results in rapid healing of ulcers,burns, abscesses
and
surgical
wounds,and somaraji (Vernonia cinerea) extracts in
skin
wounds.
Garlic
lowering
serum
cholesterol
pills
now common
are
use
for
levels, and turmeric extracts have
anti-inflammatory action in arthritis.
i
F
shown
pronounced
17
being
Various parts of the neem (leaves, fruit, and oil) are
recognised
in
skin
spermicides,
and
above
agricultural
chemicals
diseases,
dental
and
conditions,
all as powerful
and
yet
even
been
accepted
that
have
as
biodegradabie
by
the
body
are
support.
The
Environmental Protection Agency of the U.S.A.
The
cardinal
closely
connected
Ayurvedic
in
principle that mind
receiving
and
substantial
information
neurotransmitters represent molecules that can encode
and
transmit
but
carbohydrates
or
nothing
chemically
to
peptides, they appear
mental states like drowsiness, anger.
distinct
even
it throughout the body. Though
correspond
contentment,
to
and
and can transmit such mental
states
across
receptor sites. Four major biogenic
amines,
namely
schizophrenia ,
w synapses
to
• dopamine,
norepinephrine,
epinephrine
and
serotonin,
affect
normal
emotional
behaviour. Thus eating carbohydrates
has
been
shown
to
the level in the brain of
which
is
raise
associated with
serotonin,
relaxation and sleep. Hot milk and honey have the
same
effect. The nervous system is now found to have
the
immune
system,the
circulatory system and
links
with
all
body
indeed
functions, through monocytes which are white blood cells that move
all
through the body, flooding it with awareness of
the
brain 1s
thoughts. The ayurvedic holistic concept, that the body is totally
integrated and must not be treated piecemeal but in terms of basic
to be receiving vindication. To
quote
:"Life
is
causes,
seems
spoken
of as the union of the body, mind, sense and
spirit.
The
body,
mind and spirit together are, as it were. the
tripod.
The
18
body and the mind are both considered to be the abodes of disease,
well-being.
Mlikewise
of
harmonious
and
or
psychic
concordamt
somatic,
The
cause
of
cause
of
disease,
absent
or
excessive
interaction. The
is either erroneous.
their
is
well-being
interaction. The morbidity of the body is remedied by
medication,
knowledge,
philosophy,
the
of the mind is
morbidity
spiritual
fortitude, remembrance and concentration".
Considering
available
metabolism
ayurveda
the
two
thousand years ago.
human
concepts
the
represent a remarkably cogent attempt to
experimental
and
limited knowledge of physiology
weld
observation, theory and practice into an
of
together
integrated
whole. Modern thinking may differ on the high place given to
ghee
recommended
for
learn
about
* or
to deer meat or to honey (which was actually
diabetics) ,
seasonal
but
there
may still be
something
foods, incompatible foods, prescribed
to
foods,
individual
food idiosyncrasies, fasting, integration of types of cooking with
health, and, in the area of medicine, about drug concepts as
as of
drugs themselves.
THANK YOU
much
]
PRODUCTION AND USE OF HEALTH GIVING HERBS
Dr.Thimmaraju
INTRODUCTION :
The
practice of herbal medicines dates back to the
earliest
periods of roman human history. There is evidence of herbs
been
the
in
used
treatment
of
various
diseases
revitalizing
body
Such
herbal
cures may have a significant role in
They
are
increasingly
alternative
but
in
systems in almost all
being
used in
ancient
system.
medicines. Herbs can be used in many
Once
absorbed
in the blood stream,
and
for
civilisations.
cosmetic
any case, they should interact directly
having
modern
times.
goods,
and
different
vzays
the
human
with
they
as
circulate
to
influence the entire system. Thus the skill of a herbalist lies in
using this effect to balance and strengthen the body's own healing
mechanism instead of suppressing or disturbing it, as many
drugs
do.
modern
The list of herbs that have
medicinal
properties
is
extremely
long.
has
made
here
to
highlight
the medicinal values of a few important herbs. Some
of
However,
an
attempt
been
the most common human disorders have been selected for the purpose
of demonstrating the medicinal usefulness of the herbs.
1.
Digestive
Disorders
Several
herbs
are
known
digestive disorders arising due to various reasons. For
to
instance,
pepper, ginger, cummin, curry, clove and cinnamin are widely
in
this regard. Pepper has a stimulating effect on the
cure
used
digestive
organs and produces an increased flow of saliva and gastic juices.
••
It is an appetiser. A quarter tea spoon of pepper powder mixed
in
thin
in
butter milk can be taken during indigestion or heaviness
stomach.
Ginger
is another known herb known to
dyspepsia r
cure
flatulence, colic, vomiting. spasms etc. Half a tea spoon of fresh
ginger
juice mixed with 1 tea spoon each of fresh lime
and
juices
and
effective
a
table
spoon of
honey
constitutes
an
mint
medicine for dyspepsia, nausea and vomiting. Chronic diarrhoea can
be
cured by the juice or dry powder of turmeric mixed in
milk
butter
or plain water. Garlic aids in elimination of noxious
waste
latter in the body. It stimulates secretion of digestive juices.
Fenugreek
Leaves
for
indigestion
and
flafulence,
seeds
boiled
& fried in
butter,
seeds
for
colic flatulence.
Cumin
a
Seeds
for indigestion,
dyspesia,
diarrhoea,
flafulence, colic. 1 tea spoon of cumin
seeds
boiled in a glass of water and decoction mixed
with 1 tea spoon of fresh coriander leaf juice
and a pinch of salt.
Jurry leaves
Fresh
juice of curry leaves with
lime
juice
and sugar for nausea and vomiting.
Clove
Promotes
enzymatic flow and boosts
digestive
functioning.
Cinnamin
Checks nausea. vomiting and diarrhoea. 1 table
spoon
cinnamin water after
flutulence and indigestion.
meals
relieves
3
COUGH AND COLD
Pepper
20
with
gm of pepper power boiled in milk
a
pinch of turmeric power once daily for 3 days.
Ginger
as sociated
tea for frequent colds and
Ginger
fever. Juice of ginger with honey 3 to 4 times
/ day for cough.
Small
pieces
boiled
in
and taken with. 1/2 tea
strained
of
water t
spoon
sugar
cup
a
for colds.
Turmeric
1/2 tea spoon fresh turmeric power mixed in 30
ml warm milk for cough and throat irritations.
Cumin
Diluted cumin water is an antiseptic beverage.
associated
water with ginger for colds
Jeera
with sore throat.
Clove
salt
eases
expectoration, relieves irritation in
throat z
with
Chewing
stops
cough.
honey
and
a crystal
of
oil
3-5 drops of clove
clove of
garlic
with
alleviate
helps
asthma
and
of
H2°
honey
for
influenza, sore throat, malaria. Cinnamon
oil
cainful
spasmodic
coughs in TB,
bronchitis .
Cinnamon
Powdered
with
cinnamon
boiled in a glass
a pinch of pepper powder and
mixed with honey for colds.
4
Asthma
Jurmeric, garlic and clove).
4
Turmeric
Tea
spoon
of powder in a glass
of
r.i'lk
2-
3 times everyday. Best on an empty stomach.
Garlic
3 cloves of garlic boiled in milk everv night.
Clove
1
tea spoon of decoction by boiling 6
cloves
in
30
taken
thrice
2 tea spoons of powdered seeds mixed in
broth
mis of water and
honey
daily as expectorant.
DIABETES
Fenugreek
or milk taken daily.
Curry
Eating 10 fresh fully grown curry leaves every
morning for 3 months prevents diabetes.
OTHERS
%
1.
Muscular pains
Pepper
2.
Teeth disorder
Pyorrhea
Pepper
3.
Aches & Pains
Ginger
4.
Wheezing cough, blood
disorder, wounds & ulcers,
diptheria, rheumatism,
heart attack
Garlic
5.
Anaemia
Curry leaf,
fenugreek
6.
Measles, sprains,
boils, sore eyes
Turmeric
turmeric and
I
l
I /
■
-I
/
SHODHINI -- HERBS AND WOMEN
BACKGROUND :
/%•.
Most poor women have no access to good health care.
Allopathy
has not much to offer — the whole z_
system is loaded against
women.
For eg ; they do not even mention
n
the problem of painful
periods in their books.
So it was felt
that an alternative had
to be searched.
A lot of health
heal th care iwork is being undertaken by
the voluntary sector but usually we find
------- thatj rwomen are mainly
looked upon as mothers and child birth is considered to be their
main problem. They are not seen as individuals,
We too, quite
often,
are afraid of our own body and are not so kind
towards
i t.
In this context, Shodhini emerged through
a national consultation
of women 's groups working in the field of ----health,
The
consultation, held in Tamil Nadu in October 1987 brought
together
women's health activists both,
rural and urban, from all over
India to discuss the state of the art in women's health. The
discussions revealed that the interests of the
urban and rural
women are totally different.
:The urban women are keen to learn
about the use of traditional remedies
and plants in women s
health from their rural sisters.
The
rural women on
the other
hand wanted to learn about modern developments
in health, they
wanted information that they had no access to.
The
discussions C
further revealed that there <existed
‘
‘ very little
knowledge about
terns other than allopathy for treatingf women s
common problems.
Women 's native knowledge for managing their
own health problems is dying ou t.
On
the other hand, the health
care delivery system fails to reach the vast majority
of Indian
women,
inadequately staffed government health facilities, a
health care system target ted at family
planning and population
control policies, indifferent and sometimes
s even hostile
personnel manning {literally) the primary
health centres,
all
this and more is making programmes for women 's heal th.
.
--a
mockery.
!n the reality
of uhls
this situation,
situation,.
the women
women's
health activists
.,
the
's health
I0jO
feAhD
hat
p
alternatives
need
to
be
created
to
make
quality care
that
18
j
f
i
Or
MO!ien
The
activists
argued
further,
c for women.
that
traditionally,
women have been health care providers.
The
patriarchal forces have succeeded
succeeded in
in reducing
reducing their
their roles and
pushing them into subordinate
t
’
,
r positions
within the heirarchy of
the medical svst^.
Women
system.
Vomen therefore need to reclaim their power
and assume their rightful place
we.
--- * in the he i rar any.
This consultation led to the formation of a small group of women
under the. banner of "Research Action on Alternative Medicine and
Women 's Health"
----------- ..
This group consisted of women from grass root
oiiganisations ('like Deccan Development Society, Action
India,
BRED.,
’
Eklavya
) from support <organisations
_
like CHETNA and from
Women s Research and Documentation
------------------ 1 organisations like
Jagori,
Anveshi, Shakt1.
_ o _
jo sum up, Shodhini
emerged as a collective effort
to create an
alternative for women s health, an alternative which seeks to :
Cl) Increase women 's control over their own
bodies and their own health by training
local women in simple gynaecology.
(2) Empower women by validating their traditional
knowledge and enhancing its status through
the tools of modern scientific knowledge.
{3) To increase women s control over technology
and over resources by growing medicinal plants.
OBJECTIVES
To realise the above goals,
were as follows : --
our specific objectives in Shodhini
(1) To validate (or otherwise) local healers'
traditional remedies for women
^omen ’s common
health problems.
(2) To disseminate the va lid a ted kno rwl edge
widely, so that women can treat their
own symptoms with substances easily
available to them.
Shodhini 's work moved through
three distinct phases,
The firstwas
the collection of
of information on plants commonly used for
women d health problems.
The second was,
training the local
s health workers in gynaecology based on the self-help
women's
approach.
And third
was to test some potential plants in a
systematic way at the community level.
METHODOLOGY :
In nine different f i eld areas from all over India,
local
trad i t i on_aj.___ he a 1 ers_ ^'ere contacted by members of Shodhini.
Through indepth interviews, information was elicited from them on
local treatments for specific women 's problems.
This way of
approaching the tasjr or data collection.
collection, led to a problem,
Nomen
had different ways of referring to their problems. they had their
own terminology.
The group thus decided that the unit
of data
collection needed to be the plant.
|
An information sheet
established. This provided all
t-he
essential information
on .a particular plant
: i ts local name,
part used, method of preparation, symptoms for which it is used.
etc.
r« 3
- J-
¥
a
n
a
a
Z3
3
S3
a
SHODHINI
MEMBERS
a
FIELD
ORGANISATION
STATE
a
a
ej
Bharati
23
Su tra
Mahila Samakhya
Himachal Pradesh
Bandaj U.P
Sarojini
Vika Ip
Saharanpur U.P
Anu Gupta
Ekalvya
Madhya Pradesh
Uma Maheswari
DOS
Andhra Pradesh
Philomena Vincent
Aikya/SHSD
Karnatak a/Tam i 11Vadu a
Smit a Bajpai
SUDF
Gujarat
Renu Khanna
Sart hi
Gujarat
a
■
£3
3
a
23
3
a
sa
Eg
3
a
a
a
a
E3
e
The healers were
also asked to collect specimens of the
particular plants. Herbariums of these were prepared and indexed
systematically.
The data collected in this way was triangulated
through field visits to the forests with the healers.
They were
asked to point cut the specific trees/plants which has medicinal
values.
Complete information, according to the headings on the
information sheets, was then elicited for each such tree.
The information sheets and the classified herbariums were sent to
the botanist and physiologist, who is a part of Shodhini.
She
provided the botanical name for the plants and verified their
medicinal properties and whether
they could be effectively used
for the symptoms specified by the healers.
Shodhini members who had collected the information from their
field areas also did a validating exercise at their own level for
their learning.
By referring to the Indian Materia Medica they
v/ere able to satisfy their own curiosity about
the efficacy of
the plants used in their respective areas.
k
Though the members had come from various organisations., they had
come in a personal capacity. After the initial stages., few members
also dropped out.
... 4
, J- -
I-____________ our primary task was to go to the villages
For us in Shodhini,
and identify the traditional healers who use herbal medicines and
learn from them.
. Thus, we wanted to increase our own indigenous
skills and decrease our dependence on doctors.
^e ffere actually apprehensive in the beginning -"Where and how
it vss Pina who pushed us -Bu t
.
wi11 we find such healers
documenting
the knowledge, collecting
Thus began our effort at
them
to
the• research centre in
the various plants and sending
Indira Balachandran,
There a botanist
Kottaka 1 in Ca1icut.
and
checked on their
them
found the botanical names for
properties.
The completed and verified information sheets were then fed into
the computer.
After 13 months of painstaking field level data
collection and subsequent verification, <4.39 entries were made
into the computer.
These corresponded with about 300 plants.
A ng with the botanical names, the other units of' in formation
wtzre the properties of the plants and the symptoms for which each
could be used.
The information was then checked against the
the
existing literature.
The plants which were mentioned in
In
'■A".
literature for a particular symptom were categorised as
they
did
our sample, were found out 150
"A" remedies. That is^
find a mention in the existing literature.
The remedies which
were not confirmed by the existing literature,
but because• of
th^ir properties, did have a potential for women s problems, were
.
Very few
categorised as "B".
Our sample had 150
152 "B"
"2" remedies.
They were either
items,
14 out of 4*99 were "0" remedies,
dangerous or toxic. ■ Quite a number of remedies in our sample
This factor too
found a mention in more than one field area,
increased the validity of these remedies.
It took us almost 2 to 2 1/2 years to collect this information
and we collected over 300 plants.
Some of the plants were common
in various States all over India and were being used as
Heines.
So, their credibility increased.
This also revealed
tnat these illiterate women had considerable knowledge.
The plants f^ere put under 3 categories.
’
(A)
Plants that were mentioned in the books.
Their validation is ensured because the
establishment accepts something only if
it is listed in the books. We called it
category “A".
b
(F)
Those that were not found in any books
but had been found to be safe in use
after being used for a long duration.
This was categorised as "B".
♦
.
5
(C)
*
Plants that were used for contraception
or abortion.
There were 8-10 such plants.
But we had to be cautious about them
because reproduction is a sensitive area.
r
we were not merely gathering and sharing
Through Shodhini,
taking a
knowledge bu t were trying to understand our bodies,
hoi is tic view of heal th - not viewing women as cases but as
barefoot
to
become
the
healers
enabling
persons
and
gynaecolgists.
The healers also learnt from us -- no one had given them any
importance till now, so when we learnt from them, they were also
ready to be trained in the self-help approach.
SELF-HELP APPROACH
we had
We had decided to be in charge of our own bodies, Hence,
and
healthy
are
beautiful
to begin to accept that our bodies
We did not start from
though this was difficult initially.
the
beginning. we had some
In
disease, but from our own bodies.
all
thanks
to
patriarchy.
fear, some sense of shame
Rural women were quicker to learn and we, the middle class women
We were asked to look at our own vagina in
were more resistant.
speculum
— when we got over our initial
a mirror using a
experience
was
very liberating -- we were asked
inhibition, the
Rina took the initiative and
to undress and ex lore our bodies.
undressed herself and asked others to examine her.
There is no such thing as
We found that many myths had no basis,
Every breast is normal and
an ideal breast or a normal vagina,
There is no standard.
every breast is different.
Even in menstural cycle there is no standard normality.
is normal and 35 days is also normal.
t
25 days
we passed on to phase B of our
With this much of understanding,
We used to
programme which dealt with plants of category "B“.
in which we exchanged our
have one workshop every month
experiences.
she was first
Whenever any woman came with some problem,
observed very carefully -- how she was walking. her posture, how
All this holds a lot of significance.
she sat down etc.
••'G
--
Then, besides her physical complaint, we would talk to her at a
personal level,
her life since childhood,
any problems in her
family, any oppression, any event which affected her emotionally,
any death etc.
A lot of things came out in
this session and
^tlimately we found that most women did not need any treatment at
-all.
They had no disease.
In 9DZ cases, the problem was poor
Nutrition and this we could deal with.
After this.
there was the actual physical examination.
(A) Mirror and Speculum.
(B) Examination of vaginal secretions by using gloves
-- we identify them by their smell, colour etc.
We have found that neem leaves are very effective
infection in case of vaginal infections.
and stop the
Since mal-nutrition was the main culprit in 90 % cases, good food
for women as a matter of right was propagated.
Why eat the left
overs ?
Gradually, we in our own
team also stated trying these herbs.
\One Shodhini team member had suffered bleeding for 15 days in a
^jnonth for almost 15 years,
If she has gone to a doctor,
sfe
wouId have
probably been diagnosed as being afflicted wi th
cancer. Being married and with children, she was under great
pressure of work and iwas not ’ having sufficient nourishment.
She
was asked to eat green vegetables and
-- f a lot of green gram.
And
she bad no excessive bleeding after a month of consuming such
nutritious food.
Thus,
we all developed more faith in this
system.
Sometimes, the healers recommended meditation as a! cure
and it worked well.
SELF-HELP PHILOSOPHY AMD WOMEN'S EMPOWERMENT -•
Within eighteen months of starting the self-help groups, these
groups had to a 1large extent acquired
___ 7
the salient characteristics
underlying the self-help philosophy.
The members
.
were addressing themselves ito not just the physical
health
n problems but were providing support
„:
to each other at
deeper psychological levels.
They were responding genuinely to
each others' needs.
► ' • 7
-7-
The groups used the
resources of every member for training.
There were some in the
group who were excellent at massaging.
They led the session on these.
Some of the WHW'S were eager to
learn and practice in
the^ field ; they moved faster than others
and, .soon assumed the positions of
Within six monhs, the hierarchies r^sou^rce persons in the group.
in the groups
participants moved towards the situation of~greater melted and the
■ equality.
The self-help groups also
choice of alternatives for provided the members with a greater
treatment from traditional medicines,
massages, relaxation and imagery exercises,
meditation, nutrition
a--^Pa^Lic solutions.
Complementarity
of treatments was
^tiessed rather than any one approach being singled
_ f out.
Above all,
the self-help
■ _’7
group was instrumental, in
changing
radically the participants'
I- o 7 o +■ ■;
l
per cep t i on s of t hems e 1 ves
and
their
relationships to their
After
their bodies
bodies,
the
initial
shyness
and
awkwardness of looking at
themselves nad worn
had worn off,
most
Participants allowed their wonder and curiosity
to surface and
finally concluded that their bodies
bodies were
nr tic- m
-i i
?
—c? beautiful and unique
-olDe or
r us middle class women broke myths cf
of a different kind.
We had thought that
sisters would have
J dirty, smelly
gent lais because of lack of
adequate water and privacy in
the
villages to clean themselves fully.
We were surprised and
ashamed at our own sense of
superiorty to find that
— rural
---- J women
had bodies <8s clean (if not cleaner
------- c than ours !)
HAJOR LEARNINGS FROM THE SELF-HFLP APPROACH : -
Shodhmi members
approach : --
t
evaluate their
exp erience ^i th
the self-help
(1. It has broken the myth, that
that illness
11
has
to be treated only by a doctor,j gi ven me
the confidence to know, to feel and to
understand my own body, its rhythm, its
healing powers, and the value of herbs in
neipmg one to be in charge of oneself and not
fully dependent on external expertise only.
(2)
Helped me to learn how to deal with most
of the common woman Es complaints
" '
ranging
from white discharge, <excessive bleeding.
b3pCK'' pain'/stoxach pain to minor infections
In T-HV13'
AlS° 1 "aS surPcised to learn
that'
the
d of our 3 years. action research
tbat 9OZ °f wotaen 's health problems
are l.nKed^to nutrition, seif-acceptance and
personal care and don 't need a gynaec most
'' 8
of the time.
- S5 -
(3)
t
oTthTholistTf
undestanding
one holistic approach and value of
^rking towards better health and well
beme ,„d
jast
tvr
Faiseases.
(4)
The self-help r~approach provided an excellent
opportunity and
- ra system of developing ordinary
non-literate wonen healers
lntto
becoming barefoot
gynaecologists.
This approach
offers
----• an exiting
alternative to the expensive and ineffecti
ve
hea.lth care no^ available through
allopathic systeu and use of drugs primarily
for every complaint and illness
prllnar^y
(5)
Enabled me to understand and work with the
accept Tt I
Y awareness ^3 capacity to
accept it as a resource and a friend and
break out of the patriarchal stereotypes
oTshale "leaffd5
res“ltant attitude
sname, fear and anxiety about one's
reproductive system and sexuality in general.
(B)
firmed ry role in being able to work with
tasTo7^e^^^
^dyouslyin the
ezpowernent and social justice.
VJlSIBhE AtfP SIGflFTCAHT OUTfntfk
Hina Nissim has so .successfully outlined,,
Today these women
healers ’who are spread across India
from
Andhra Pradesh,
Karna,taka,, Uttar Pradesh and Gujarat are
to
a
vaginal discharge due to anaemia,, vaginal infection distinguish
du~e
-----to
excess
of "heat" (acid) in the body.
They can differentiate between
heavy bleeding with or ,wi
_____
_ fibriods.
thout
They are comfortable
giving advice about diet as well
ss
with
simple remedies,
>hey have been able tn
to pass on to
more difficult areas like
bleeding in mid-cycle (Oestrogen
a or Progesterone deficiency),
irr egular eye les 1eading to infertility
and all this without
leaving
aside
the personal
problems.
They have become
trustworthy barefoot gynaecologists with
the
confidence
of the
experience they have gained through their
health problems.
This is the success of the self-help approach o^n
! "
In conclusion,
after 5 years,
now a number of trained
^bare-foot gyn aecologists, some we have now
of
them
are health workers and
Jiave regular practice. They have
very
rightfully
begun to charge
^professional fees in their practice. 7
---In
Karnataka^
we have about
g 6“ workers.
We are trying to document all
the
information
and
publish it in the form of a book,
One
of
the
outcome
--------c
is
that
there is climate and a desire for
the use of herbs.
Herbal
I
- ?-
I
gardens have been set up.
The quality of life of these full time
healers is going up.
They are getting empowered.
And more than anything else, the Shodhini experience has taught
us to be humble.
We have learnt to learn from the resourceful
women in our villages.
4
•’
1
'pg_/9- "IOHerbal Medicine for Human Health
I
hi
United States of America
In the United States of America, herbal remedies are referred to as
homoeopathic remedies. All such remedies, because these are offered for
treatment of a disease, are regarded as drugs. This means that if a herbal
remedy is included in the United States Pharmacopoeia, the official
Homoeopathic Pharmacopoeia or the National Formulary, it will be recognized
officially as a drug. If it does not appear in any of these official compilations,
it will still remain a drug but not an officially recognized drug.
!L
8-
I
The only way that a drug is approved for its intended use in the United
States of America is by approval of a new drug application by the Food and
Drug Administration. Up till now, no homoeopathic drugs have been approved
for administration under a New Drug Application. This however does not
necessarily mean that it is illegal to market these herbal preparations. These
could be marketed without the approval of the Food and Drug Administration
in certain circumstances. All marketed drugs have to be listed with the Food
and Drug Administration.
IJ:
The position in the United States of America is that there are many
homoeopathic preparations in the market which have not gone through the
process of approval by the Food and Drug Agency. Some of these may be
mentioned in the pharmacopoeias concerned or in the national formularies.
If so, these homoeopathic remedies are officially recognized but not officially
approved for marketing. They are however marketed but not illegally. They
are marketed as homoeopathic remedies recognized (if it is in the Formulary
or Pharmacopoeia) but not approved for marketing. It is not illegal for use.
I
i
The United States Government did not, up till now, stringently regulate
the use and marketing of homoeopathic remedies because, in the past, these
have really been marketed only by a very few manufacturers on a very limited
scale. These firms have been serving the need mainly of homoeopathic
practitioners who needed these medicines. Further, these medicines have
little or no labelling for the consumer. The labels were intended for use by
the homoeopathic physician who would make a diagnosis and then either
dispense the homoeopathic medicine himself or give the patient a
homoeopathic prescription. The patient could have that prescription made
out at a homoeopathic pharmacy.
■
I
i
It is difficult to know whether this system is largely used for what is
commonly known as homoeopathic medicines i.e. small dilution of substance
prescribed in the science known as homoeopathy founded by Hanneman,
or whether it is also used for medicinal plant medicines and, if so, to what
1u
I
ill
68
Sovr^-r -
Hex ho./
v\ ex (
vneoL t
0-
fv
■
Regulation
extent. In other countries, herbal remedies are not known as homoeopathic
drugs which, in fact, are not herbal. In the United States of America, the Act
is labelled as Homoeopathy but covers herbal products. It may look confusing
but is in fact quite clear.
I
There has, however, been a change in the use of homoeopathic medicines
in the United States in recent years. The number of firms marketing
homoeopathic drugs has increased. There has also been a great increase in
the promotion of homoeopathic medicines. There has been an increase in
the marketing of homoeopathic medicines as “over the counter” (OTC) drugs
to be sold without prescription. Some of these homoeopathic drugs - whether
strictly homoeopathic drugs or herbal remedies - are being marketed and
promoted for use in serious conditions such as cancer and multiple sclerosis.
In these changed circumstances, it is expected that regulatory control
on the use of herbal remedies in the United States will be changed and made
more stringent in the near future. The change in the use of herbal/homoeopathic
medicines was in fact documented by an inspection survey of homoeopathic
practices in the USA, carried out by the Food and Drug Agency in 1981.
I
To summarize, in the United States, there is at this time minimal control
over marketing of products from medicinal plants. A plant substance, whether
listed in the pharmacopoeia or not, could be marketed in the country without
approval from the Food and Drug Administration. The producer would need
to list the substance, however, with FDA. This system has worked so far
because it was used with care largely by practitioners of Hanneman school
of homoeopaths. The situation has changed with large-scale production of
actual medicinal plants as therapeutic agents, of more widespread use of
Hanneman’s homoeopathic medicines as “over the counter” medicines and
by promotion. In these circumstances, it is inevitable that the regulations
governing the use and marketing of herbal remedies, will, in the near future,
become more stringent.
Australia
Regulations controlling the use of herbal remedies in Australia will be discussed
in two parts. In the first section, the system which is being used in the state
of Victoria (and has been used for the last 50 years) will be presented.
Australia is moving to a central control for the regulation of import, manufacture
and registration of drugs which would include herbal remedies. The new
system will be operating for the whole country by the time this book is
published. The regulations relating to these new regulations will be discussed
69
p
Herbal Medicine for Human Health
i
in the second part of this section. The reason why the present system in
Victoria state is dealt with (even though it is being given up in Australia) is
that it contains much to commend and the Victoria model will be considered
with interest by countries trying to develop regulations of their own, both for
synthetic drugs and for herbal remedies. Only control of use of herbal remedies
will be discussed below.
i
!
In Victoria, all herbal remedies sought to be sold in the state have to be
registered and the person selling that particular medicine has to apply for
registration to the state drug authority. This application is then considered
by an expert advisory committee which evaluates all applications using the
criteria of quality, safety and efficacy.
I
i
F
The general rule appears to be that if a herbal preparation is not thought
to be toxic and there is no clear evidence of efficacy, then registration is
given to the plant substance provided that no claim is made citing the efficacy
of any ingredient in the preparation. If any such claim for efficacy is to be
allowed to be made to the public, then the committee has to be satisfied,
from the clinical and scientific data provided, that the substance or ingredient
has been shown to clearly demonstrate efficacy.
r
The toxicity of a herbal preparation governs the scheduling of it and
hence its labelling and distribution as provided for under the Drugs, Poisons
and Controlled Substances Act rather than being a prime consideration as
a therapeutic substance or medicine in terms of its registration under the
Health Act. Such registration still requires proof of efficacy before it can be
given. This applies to the plant substance or any part of it intended for
therapeutic use.
I
If there is one constituent in a combined herbal preparation which is
known to be active whereas no such evidence has been shown for the others,
then it must, for those other constituents, be clearly stated that those ingredients
form part of a base containing those plant substances. It is clearly implied
that these substances are just there - and that there is no evidence that
these additional substances or plants either add anything or substract anything
from the preparation.
I
The drug registration authority will usually not register any herbal
preparation which does not contain at least one substance known to be
effective and accepted as such by the Victoria Drug Regulatory Authority. A
plant substance or a combination of plants - all of them not known to be
toxic - and none of them having shown to be effective to the satisfaction of
the authorities will not be registered and thereby not allowed to be sold in
it
•s
T
i
70
Regulation
the state of Victoria. This is where the Victoria Drug Regulatory system is
perhaps superior to other existing systems and will not allow unnecessary
harmless but ineffective herbal medicines to flood the market. This may prove
attractive to other countries formulating, at the moment, regulations for the
use of herbal remedies.
I
■
i
The guidelines issued by the Victoria Drug Regulatory Authority for Chinese
and other Asian herbal ingredients may be of interest to such countries and
is therefore reproduced below.
“The identification of the constituents of many herbs used in eastern
medicines has often proved difficult. Applicants will need to furnish
chemical data to assist the Committee as information from local
sources is elusive. Toxicity and efficacy data are expected where a
claim is to be attributed to these ingredients. The Committee observes
that many of the claims made for eastern medicines are exaggerated
and are not acceptable. Foreign languages used on labels and
pamphlets must be an accurate translation of the English language
i
text”.
r
If a herbal remedy is being sought to be used as a prescription medicine
for a specific disease, the New Drug Application will be reviewed for efficacy
and toxicity and quality in the same way as any synthetic drug.
In the United Kingdom, an anomaly exists as regards herbal teas and
foods containing plant substances to be used for medicinal purposes. As
long as the label does not specify the purpose for which these teas and
foods are to be used, no registration is required. Teas and food being sold
for the same purpose do not need to be registered if the labelling does not
indicate the medicinal value of the package. This again is not completely
logical as the teas, for example, would be taken by people for the same
complaints and the toxicity of tea, if any, will be the same, whether the label
indicates the therapeutic indication or not. The indication for use of a medicinal
tea has little to do with the possible side-effects which could be induced by
that particular tea.
The ease with which a herbal remedy is administered in humans in China
and the rapidity of the transition from folklore use or use in a particular region
to clinical evaluation is also not fully understood. A combination of plants,
or single plant, which may be effective, may also induce serious side-effects
and some toxicological studies need to be carried out before administering
the medicine to the human for the first time under controlled conditions.
71
fi
i
y
f’ •
Herbal Medicine for Human Health
i
In the United States of America, there is a legal requirement that all drugs
have to be approved for their intended uses through the approval of a New
Drug Application (NDA) by FDA. Herbal medicines are drugs because these
are used for the treatment of disease conditions. Yet, homoeopathic drugs,
which include medicinal plant products, are legally allowed to be marketed,
and, at this time, are also being promoted for use, without this being frowned
upon. All that is required at this time Is that all such medicines marketed for
use are listed at the Food and Drug Administration “Y”.
I
i1
In Australia, when the new regulations come into effect, it will be possible
only to “list” a new herbal remedy for conditions such as diarrhoea or for
dissolving kidney stones without demonstrating any efficacy provided there
has been no indication of toxicity. This may lead to a plethora of harmless
but useless medicinal plant substances being approved for sale.
yh
k
In spite of a few existing anomalies in the regulations of all countries, the
broad general approach appears to be similar. Generally, countries are not
much interested in regulating herbs and plant substances being prepared
and used by individuals on a small scale. When such substances are packaged
for use as teas or foods, the regulatory agency would like to be kept informed
of what is happening and may or may not have a system of registration for
these. When a herbal remedy has been in general use‘for a long time and^
is being used for a long time In the country, the regulatory authorities do
not want to interfere or regulate the use of such a medicine. If a new substance
is sought to be introduced for use in the modern system of allopathic medicine,
the requirements in this instance will be the same as would be for a new
synthetic substance.
'I
I
I),
i*
It has sometimes been stated that the stringent requirements needed
before clinical evaluation of traditional medicines are a constraint in the search
for new medicines. While this may perhaps be true in a particular country,
there is no evidence that generally the new drug regulations in countries act
as such a constraint.
h11
Past experience, in fact, has shown that national drug regulatory authorities
are willing to discuss early clinical evaluation of possible new herbal remedies
without fulfilling all the statutory requirements as regards prolonged
toxicological studies on different species of animals and associated
pharmacokinetic studies. It is, on the other hand, disappointing that despite
this newer herbal remedies have not emerged In the last decade.
I:l
II
When the new federal regulations come into force, these will be applied
throughout the country and the Victorian system of registration will be replaced
I
72
I
Regulation
by the new system. The new law takes a less rigid approach by allowing
herbal remedies to be listed on the basis of quality and safety. The national
authorities will no longer look to see if there is at least one known effective
substance in the medicine. Evidence for efficacy will not be required provided
(a) the herbal medicine is not a poison on the schedule; (b) it is not in the
attached schedule shown, and (c) no representation is made in relation to
the disorders shown in the schedule put forward. Although the schedule is
fairly exhaustive, it will be possible for herbal remedies to be marketed and
therapeutic claims made for use of the remedies for conditions not in the
schedule. All herbal remedies to be used in Australia are to be registered or
listed in the Australia Register of Therapeutic Goods. In this system, herbal
remedies could either be registered or listed with the federal drug regulatory
agency.
I
I
i
J
i
General Review
It appears from the regulatory approach adopted by the six countries that
demonstration of efficacy before registration and use of herbal remedies is
generally not required. The lack of toxicity is considered more relevant. The
only timfe demonstration of efficacy is required is when a herbal remedy - a
new one - is introduced for use in the modern system of medicine. The
approach to the assessement of safety of traditional herbal medicines
sometimes varies in the different countries. It is not always easy to understand
the logic behind the approaches used. A few apparent inconsistencies will
be discussed.
The Indian authorities do not need any application for the registration of
herbal medicines if these are prepared in exactly the same way as described
in the ancient medical texts. The reasoning here is that if a particular medicinal
plant preparation has been mentioned or described earlier in a treatise, then
that preparation will not be toxic. It is difficult to accept this reasoning. It is
possible that one or more of the medicinal plants used originally have now
been shown to be toxic. To accept that a plant preparation is harmless just
because it has been mentioned in an ancient text is not completely logical.
Some assessment should be carried out before the herbal medicine is released
and registered, and the release should, in fact, be dependent on the results
of the assessment.
H
'i
The Canadian authorities have less stringent requirements for traditional
herbal medicines which would be used to treat minor self-limiting conditions.
The reasoning is that a herbal remedy used for treating a minor self-limiting
73
11
1
j!
i;
1
Herbal Medicine for Human Health
condition is generally not harmful and therefore safe. The actual toxic effects
associated with the use of a particular plant has, in fact, no relationship with
the Indication of use of that plant. A traditional herbal medicine to be used
for treating mild allergy could induce more side-effects than a herbal medicine
used for the treatment of cancer.
Many countries with no regulations at the present time are interested in
developing such regulations controlling the use of herbal remedies and
traditional medicines. These countries range from several countries In Africa
and Asia where herbs have been used for generations for therapeutic purposes,
to countries in the Gulf where there is increasing use of such substances.
People in these countries are importing raw materials, preparing medicines
and distributing these medicines, for example, in the Asian population in the
Gulf countries. There is also a perception of the potential toxicity of chemical
substances in the indigenous Arab population who may be interested in
looking at some of the herbal alternatives available for use. Unless, however,
some regulations for use of these crude substances and brand name plant
medicines are introduced, the situation may well get complicated.
An attempt has been made by the Eastern Mediterranean Regional Office
of the World Health Organization to develop a broad document to be used
by countries when developing their own regulations. Representatives of nine
countries in the Eastern Mediterranean Region of WHO assisted by the WHO
Secretariat from Alexandria, drew up, discussed, formulated and adopted in
their personal capacity broad guidelines for such regulations at an intercountry
meeting held In Kuwait In April 1986.
This document “An Act aimed at ensuring the safety and quality of herbal
remedies” (The Herbal Remedies Act) and Notes for Guidance can be obtained
from the WHO Eastern Mediterranean Regional Office, Alexandria, Egypt
(WHO/EM/Pharm/119-E). It contains an outline of an Act together with explanatory
notes on different articles of the Act. In the second part of the document,
there are notes for the guidance of persons applying for regulations of herbal
remedies. These deal with general guidelines as well as specific guidelines
required for the manufacture of finished products of single herbs or a mixture
of herbs and herbs used as tablets, powders, liquids, tinctures and extracts.
The document deals with quality control requirements: specification of raw
materials, pharmacognostic and chromatographic characteristics. The
document also describes the pharmacological and toxicological information
required and, finally, quality control requirements of the finished product.
Finally, there is in the Annex a Model Application Form which can be used
for application and regulation of a herbal remedy. This is very useful to
|
I
I
74
I
Regulation
s
national drug regulatory agencies interested in developing their own regulations
for the use of herbal medicines.
The Issues which have been discussed earlier in this section about the
need for testing medicinal plants already in widespread use and the extent
of toxicological and clinical evaluation before general use were also naturally
discussed at length. This issue had already been discussed, before the Kuwait
meeting, by the author and a few experts at a consultation held in Alexandria
and the report printed as an EMRO document WHO-EM/Pharm/105 in 1985. The
group prepared a set of “notes to the competent authority on toxicity
requirements”. These notes, which this author agrees with, are reproduced
in the document containing the Act (document WHO-EM/Pharm/119-E), and
which, together with the guidelines, are included in this publication with the
permission of the Regional Director of the Eastern Mediterranean Regional
Office of WHO as Annex.
I
/
■
i
i
li
■
■
I
I
■
75
THE HINDU, Sunday, June 13, 1993.
igs to
'ministered
popular,
ngly and
ius side
among
jil-bejng
iwonicn
le
Money on
jfest as
.[mess and
is do lend
v. In an
a! years
lien with
■ignosed as
ind, some
y be
?•
sion to
•By and
jachiic
rover, as
.disease .
She heart
les,
Jal no
p
The healing powers of garlic
"Garlic then have power to save from death.
Hear with it though it nuiketh unsavoury breath.
And scorn not garlic like some that think.
It only maketh men wink and drink and stink."
ARLIC undoubtedly makes the breath
stink. But as John Harrington, the early
19th century writer, persuasively
points out, it is an odour well worth
suffering to obtain the benefits of the powerful
action of garlic.
So remarkable is its efficacy that Indian
mythology lias a story about its divine origin.
The story goes that when Garuda look away the
pot of nectar amrit, a few drops fell on earth.
Not only did those spots become sacred, but a
plant sprung up from all of them, which had all
the divine nectarine properties. As it turns out.
the plant was called rasona. as it had six out of
fSKe
_.
.'A.
■
. X. -
w
Ji|l
V;
ft
,
\ 'W/'
■
hw-A..-
i
■/
. “I® <
>
Food, beauty aid, curative
and preventive medicine —
the simple garlic pod is all
this and more. Scientists the
world over arc now
working to unlock its
magical secrets.
poisoning and wound Infections of soldiers du
ring the war. The antiseptic properties were
traced to sulphur: 33 sulphur compounds were
discovered in the garlic pod. The most signifi
cant of these are: Allicin (responsible for its
antibacterial/anli inflammatory effect), Alllln (or
Russian Penicillin" — as garlic is otherwise
known — which is what produces its antibiotic
activity). Di-Sulphides (a cholesterol lowering ef
fect in the blood vessels and arteries). Garlic has
been used for anemia, asthma, regulating sugar,
blood clotting, blood pressure, hypertension,
chest and heart conditions.
However garlic is best eaten raw. Cooking de
stroys both the smell and anti-bacterial propert
ies. As an alternative to immediate medication
or first aid, garlic is again the better alternative
as wounds respond and heal faster.
Garlic is also nature's own natural pesticide
and insecticide. A solution of garlic (paste +
Sincelhcgarlicplanthas ahollowstcm.ergo.il water)Jias
1JU>, UVVII
been IUUU1
found to be an effective pest
would be of benefit In afflictions of the windpipe controller. Garlic can be
I grown alongside other
(respiratory disorders, asthma, bronchial prob- vcgclablcs/fruits/plantts — as it uses very little
lcms- ^c). Further, its overall hcartlikc shape space, grows quickly
‘ •• and needs little attention.
would be good for ailments of the heart.
Garlic is perhaps one of the lew herbs that
Though these theories have become a part of has been used for thousands of years without
herbal history, the principal still remains true any toxic after effects. While research as to how
that garlic has many uses. It was only during it generates Its healing magic may continue, the
the First World War that extensive scientific re- evidence, loud and clear, is that it does cure. ®
search was undertaken to investigate the garlic,
Vijay A Venkat
This interest probably sprang from the miracuIons effect of garlic in ease of gangrene, septic
Sanctuary Features
13
f
-10
......................■■
■ .
lhe seven rasas. Uihsun, the name by which
garlic. Allium satvium, is commonly known in
India, is a corrupted form of rnsotia.
While laboratories throughout (he world arc
working Io unlock the secrets within the simple
garlic pod, attempts are being furiously
made to dissolve and dispel its 'anti-social’ prop
erties (its pungent smell and odour). 'Hie garlic
■t
has been around as food and medicine earlier
'mortality.. than records can prove. Whether by accident or
n some
research; instinct or systematic knowledge: folk
;he,
lore or medical fact, the garlic has survived and
Ibido.
enjoys a tremendous reputation.
se women
'I’hcre are innumerable stories about vampires
them as
who shied away from garlic, or devils driven in
'the least. sane by the power of garlic, about fevers and
A’onicn
colds vanishing with garlic necklaces, about the
jploms
slaves who built the pyramids subsisting on a
rouble to
high-garlic diet, about garlic caters who were
t of the
prevented from entering Greek temples and lhe
Yet
Roman Senate, about the aristocracy who stay
but also
ed away from the "garlic breathers."
Is of the
Ancient records from China, Egypt, India.
isicr said
Greece, Rome or even the Garden of Eden, pro
vide substantiation of garlic's naturally anti
at home
biotic temperament. Historical records show
.'f
that for over 5()()() years garlic’s healing powers
■ill esc
have been used to treat a wide spectrum of dis
y, with a
eases. Though it is not known if garlic was first
1 cloaks
used as a food or medicine, it is known that in
'tience.
all cultures where the garlic was used, it was a
his
panacea — a cure for all.
respond
Garlic has several uses today as food, beauty
aid. curative or preventive medicine. An inter
Ise th a*
esting fact from South India highlights the na
•leccssr
help can ture of garlic. In highly orthodox Brahmin
households, underground untouchables like on
Tical
ions and garlic were normally taboo, but the
s.
rule was reversed during pregnancy. Garlic was
ychiatrist
then introduced as a compulsory 40-day treat
j by both
ment, extending even Io (he child, who had to
often suffer an overdose of garlic in his food,
nd up
garlic baths, massages, and infusions. Interch of a
cslingly, a nutritional analysis of garlic (In
live
terms of Recommended Dietary Allowances) rcveals zero value. But medical’research and laand also hour is only now beginning lo gain on the early
ill •
herbalists and healers.
is due.
One of lhe popular theories of the late Middle
's a
Ages was the ‘Doctrine of Signatures'. In effect,
3
lhe physical
,
characteristics
.... of. ,plants were
‘read’, examined, and applied to people. Nature
VVAMY was taken as a greenprint for human health.
.n
VII
©
Page 1 of3
E-HEALTHCAREINDIA.COM - - Ginger & its Medicinal Uses
IO-
□
Login
Membership
Type
Password j
|
(Select Here
Fl
Fl
a
□
What is Ginger
Ginger is a strengthening food that has long been used to maintain health. Ginger has a
long history of both culinary and medicinal use in Chinese, Japanese and Indian
medicines. In ancient China, ginger was regarded as a healing gift from God and was
commonly used to cleanse and warm the body.
Qualities of Ginger
The major active ingredients in ginger are terpenes and oleoresin called ginger oil.
These two, and other active ingredients in ginger, provide antiseptic, lymph-cleansing,
circulation, and constipation relief qualities.
• Ginger is good for the respiratory system
• It is good to fight against colds and flu
• Ginger offers substantial protection from
stroke and heart attack because of its ability to
prevent blood clotting
• Ginger, a multifaceted herb, is crucial in the
battle against cardiovascular disease
• Relieves headaches and pains
• Helps to clear sore throats
• Good for upset stomach and indigestion.
It is very effective as a cleansing agent
through the bowels and kidneys and also
through the skin
Some of the problems cured by Ginger
Colds/Flu
Kills influenza virus by improving immune system's ability to fight infections. Ginger also
relieves headaches.
http://www.e-healthcareindia.com/medyindia/newsletter/ginger.phtml
J
I
8/18/02
E-HEALTHCAREINDIA.COM - - Ginger & its Medicinal Uses
Page 2 of 3
Increases Circulation
Increases the muscular contractions of the heart atria, there by increase in overall
circulation. Ginger has been proven to prevent internal blood clots and lowers blood
pressure. Ginger Root stimulates the central nervous system controlling the heart and
respiratory centers. Ginger helps reduce serum cholesterol, which can slow down
circulation.
Ginger Relieves Motion/Morning Sickness
Ginger is one of the most effective herbal remedies to get rid of Motion/ Morning
Sickness.
Digestive Aid - Indigestion, Stomach Ache
Ginger Root increases production of saliva in the mouth and dramatically increases
digestive enzyme amylase in the saliva to additionally aid digestion. Ginger Root also
contains a very effective digestive enzyme zingibain.
Women's Health
Ginger Root is good for the uterus as well as the intestinal tract and may ease
menstrual cramps
Skin
Very cleansing - reduces pus in infected wounds as well as boils. Clears spots caused
by chicken pox and shingles. Useful for burns, sores, sunburn, ringworm, warts,
herpes, athletes foot and even for dandruff.
Stress Protection
Ginger Root appears to limit the effects of adrenergic stimulation and there by relieves
the stress
Arthritis
As Ginger root is a proven anti-inflammatory agent, some arthritic victims may find it
helpful.
Ginger is sometimes recommended as an alternative to aspirin for people who can not
take aspirin because of its irritating effect on the gastrointestinal tract.
Ginger cures following ailments
Asthma - Adults
Boils/ Blisters
Cold
Glandular Fever
Infections
Mouth Ulcers
Skin Conditions Antiseptic
Athlete's Foot
Cold Sores
Flu
Gum Infections
Insect Bites / Stings
Mumps
Acne
Cuts
Gingivitis
Head Lice
Mosquito Bites
Ringworm (tinea)
Sore Throat
Warts
With all the benefits to the average person, ginger should be included in the diet every
http://www.e-healthcareindia.com/medyindia/newsletter/ginger.phtml
8/18/02
E-HEALTHCAREINDIA.COM - - Ginger & its Medicinal Uses
Page 3 of 3
day. especially tor a person who are suffering from heart problems, cold/tiu, stress
problem, motion sickness a daily dose of ginger combined with other herbs to enhance
their effectiveness is part of a sensible, healthy diet.
□
| Medical Records | Hospitals | Doctors | First Aid | Emergency Services | Diagnostic Services | Blood & Organ Banks | Chemist Shops |
Healthcare Company | Health Insurance | Medication / Drugs | Conference / Camps | Job Offers | Nursing/ Home Services | Membership
Facilities | Suggest Our Site | Disclaimer |
Contact Us | About Us | Privacy Policy |
Copyright © 1999-2002 E-Healthcareindia.com. All rights reserved. No part of the contents of this web site may be reproduced or transmitted in
any form or by any means, without the written permission of the publisher.
http://www.e-healthcareindia.com/medyindia/newsletter/ginger.phtml
8/118/02
pM -io
'aaorreu
”850
1)
fti.,0
«)
») tt>oa,ja surkjart 8*0
adasooao„ suaRidteu-
Cj'fV) Tb VsSuO’ &
1
1
•
-------------
wo, woaa^jaoaaj< adau xooj<joJj
>
a)
a)' r-odo asjF duto^Uu auaku
sonj a«rtfd «?v dodu^a du«*ed
tftaaat!*, erBsnai«6( <But9^arf*oauS'j<
world ciyAoduBoaao^ aw?! s^ajarede^,
SrtcMtfda ooso saoduoou ad «aodo„
ddA sjaadcsu’
j2>j
q?)
ri^sS-S^tS ^i'go .
5c>anz3g*( auratfai*! acod,
dvoy^v wivaj< kocu ae.
ssauad s, ajc>reoo kocie dj®<u atoao,
(ssi w^Fdj^e.u ^^oanjaadrw sjoa
<5vjro<3u (
-ot szraoJjaaj^ gjaadtS'-’’
th.)
■& <K» oio. XVA Bi
<^°
®
| 'US «.X15 JMB ^K'aS ®*£) ..'.^jfii ^£><W 5^
duaikJ^oaj dtOJ, ^dtOu, r5c90ajorfe.oo
qkKj„j>U| »OvJ„*u, woaoaoi, eSVuv'Jv ,
djreSu ,«;3rsvaj< uodu waii s^aj®c®do,
t-OCSxJ
atOrfSjBVrt aro* ®^>0*
(55® odd acre 0 ffuaodoritcj’
a) suod ad t^oda Aa| aaoaoe so
dureKWj.4 adde oatSd dejeoo trooodooJ
2) szsaoH^o
VA<xis
ajvrodu oarw s®c.) suaodud? su-
3) audtOoJvra
'
>
a) tuodo aaua de.aa aS* suaodoaj^
kode djaeu £<o?3o„ oroa mof dcraew
fcto'»ruoadruB sod* aosso s<jadd daou
a^ odd® e.aaaa nj3_»d •
a) juocw *a ju5uGv?j
Jrtuu
suaodsAxsckj •
■j?) oojroj>0^e>) oror\aj„i oJjaonau^aa
aujaoe 5aanvaj< t^oau duae.w
<55d & 5<>o0o^ acjg4 aojsou aaooo
dvev^v aoerooa <5jraAasavae< aua
a jo a rfaa <n gc>& 5uaoJudtaa«
-«<) Svjasa as atf^oOuau^ s>?.oao
asrfoau auttf areerf^so'
r5r^<?>
V
u
■<
a«so
4) tfaujfc
k
2W
SuroSv), iHOrt,
?3cC)<<i SijaoJa Skjciffi soOoojdtS'J*
cj5
3 ^Aastf^ .
*7bw
p
*E~> <w3t>
»
.
------------------------------ 1-------------------------------------------
l
Lr \
' '^ '
’ l’ 1
>41 wM
«0BSJiSjT>OtJJ( tSWj^'Pv, Surosu( BtOrt O0-JF5O^
5uK)u uocsu djae.u SeOcSjcioort s3<8&
dfja <A yaooj<t suaoJudeSj-
(.
Go
’S.o<mu^3 £> nXSky, cyQ db ocuo V>
.
i<i';]■ :®!id
’™KW>
■ ’■.'' /
‘
'■■
"?.,!'■'';
■
i
‘
A IL oh ’ '<•’'
~~
6) iaoofejdna
w) *n»B 3o5*<?rt
1
A'
'
■,.
■■
,
■’V '
..
;•;'
*v.
■'
-■
i
w) ^atsjaRJa a»n oo^Orkj*
^’■'
,
. .O' uSM':''
.*•
» '
.1 e
4 »•* , .
..
JB'ft $
i^SopxK' e
ftS vQ e
o'iJxH 'vo'S nSJp c^ ^rKSO'&<s,'8
■’CH*
1?
w) aod?.t)Aj aaaorinCAj, ktfvt aov*,
sroooj Suva #jastJoo’? asa no aai
woe>saau< aaj3_/djaraoo„ do*
*>to?5dm soo* i5i$aooo aoaa aoasdtso*
tn^ccuaSj-S Aua .
a) AtoAO adoJoao< ac.oao„ »»* eoax
woo «j5oOjao< aooaaa aojaotf
d^a^oan ?5ria( tfaooi, sadoodjarus-jd-
1?) kOQu a^xsasifc) Va5v>< SjsJc) BOJvJOp,
doa ?.(«<& dutsKWj< KJou^oan ejooa
e6jartoJuao< djjaAa ajjaos Srtdo
tfoaoMd dna sJauo^ eaduoojanuajd*
-»?.) «OBOiS>jao«jao< De.SBO„ tfONJ.j
woo o6jartoOjSu< ?3t&*od dria(
G aS ,ie£4c<.<^ caJ e>*io'< OtT'X
o-«o> <3j .xA-^ o x .
SaoOfe sadooOoa rkj3L,d •
W -Aazx-k? .s
Lo^ a
,^o
aai-TTfoO
«-Aaa ft ffufn 'S-^'Fb ~5V!>
—»x.-,a .03 d’ £ki..i .. s. /.-'■k-j . q, mt;
._____________
7) aauFdcrotnnwj:
w) akjWtfaa
w)
<3) «urojort$rt
o)
Caj
ex3du
O)
®aa nao o5aoao< ®ba woo doed
wOBaaao< a5afft3e»<J’
amo aotsoaa^aooa
«a sumodo•
'..o
°
©*l’ «^ e y ro.t> ra^qj. .i^ co^yT^o:
AiSi-.O.-S'k.
,,
tVo/4<xjeso
... ‘J
gAMQnt^ Jg| £]&
d?.as5dja<.3o<ji «OBS( i/us^ao^
«<3do ^dtso.
«) dvov^v oaaao< ®aoa<5^,od<eocSP
} , Au ..-p igo^
'
/
>’
.
a«a
yaoood
a) SoaSuOoC, tsaatfoaa.’jooorao^
8)
?TdO0JA
°
-ti ’&
<2aO
0Dc>5de.^j’
$Lt) 4>XpO
kSSo&aZ’T!?^
,
»o»ai aaSiAEj^ao^ wddo
ora 3rtoo3o3oao( a
Aaodoo„ awou as..
P-t)
do
<S\ t^vSoTTV^
ccr?g^^xs gs 3>
, *'&
-vo
■ot)
053 00 3OdO WCSOO„ 03 3>
33ao>aao4 3?5ooo<fc ooo arooao^
£>S^
5s o X c?
-s ■?<<-> .
*-O oi-i <-4 TV
q>'aJ
r\
OOJdt^O’
<us?rooo£
o
O&> ^4
LiOCJU
"& ,xioL^
WCJO OrSSFSU^ d^OJUO^
riVrtn Odoo Add 053 A O5.8_,O0O?5O<
i r? 0.0 <v^i 'go
DaritSO1
9) a»o3
^\O 03 a o oi)
etSaX 6t
&Aj e.3» c>S3C~<^ Xu Cjg; CEO
75-5-1^ .
& n^)p
a©ojn0odoaj<
a) srarf<5aU(
3rtdo??oaVv«tei5'U’
sa&’adu do3o_,
aaoodOoooao^ a<toooo„ eH)o<5oA
de.sosos.jdoaaS «30A SA*RJd?.®o«
w) 35oro?5asc9ja (
«doo
duciodoo^ '«wou<SoooaJu «do
W> &3_»0 OTOA
Qzj c'iS 1 q-X>“o'1 'C
1 <.
'-In
0saao< rduorto>_,00c,so'
10) ^e.o
«) a6*nsn^i srarfatfluoJuaj< yaocu
arooRS tfljBiirt wdau euaiotfeauss><?.oo adodj o<saav>< aurkj&a
«) K5rao aj8*$rt ‘
* Qr\J cfe g»*S--O
•^r
o
3c5oOo 0j«.«5 ojasritso*
a) toOdo djatu £>e.C>rt kodo dflrf
kodu uaott
6doJodo< oyaa daa^Ci
O/VJ
cits T^vSuJU
»o* dofi*<?rt soaaoAjOrieso-
•s) ywu nbaKati (BOtfrtn wj,j AtBeStSU
«) waauess^jja A aomOrtja'
»'
QA J
cT»
; x
c5c)^o?3
■c)
^->
w)
/
wiou ©u^oOudt^^ •
SoUjOan m&jjatfawodo.t
3ao<3_,ode.Bo<
V
11) (6j'drfu^t^
w) eflvuv^v ^oau ^ooui SjoaOJ
'
iSurcrOu
k*
$4
CO
.• ^ .■
V’
(Cameraoso luooo doatw 85*
*C0'3U4 6'jaoJude.i5O’
’
(r, ?E1 <S^T)
«) uooo djatu aodotStsd cWtf* tuOOo
aatf wso^Crtoa
dtO*
Mfy
1
^Odu tfh3$ CAJE5O?5^< IR> 00 jfl
-<
GrUO ■! rU.’
. ^r ■
50* soaododtffO’
. •$ ••
<H
Q) "Jo( £-j£ StoS
1j
■■■’^
*«) dvov^v, soo®, do»*y), a<Ort,
O %5\ 8>
wwao.t uooo uc aaoaaaxJu
don;tart otfcJo SmSoJo doa® soffiododtso*
cabojj
■cS’
J <J5~
w) dSjO Consort cfija
Qj d>l o\_>"'</'
ae.ort szjaoouaau^ ajafc
oCx-'kL-^v-x ,
caO 'kaoi3o<
aoaBrtoOoo„ or>&
i
I
ft
"'
<
■
’OO tJ5~ ja&jfr)
cab)
J'
300®, «3cj„ 3ond eBoadudoatsj
aa *oJoa no3_»d •
*
M
'.j;, ^*1'
,/ f-
jxj)
G
‘ClMw^X.a
soo®, cao^aJo^ dto* soaad q5tf5
oBoadu^oato a» *ooo» nosGd •
V) *reB 3ow*0rt 88JikJui4jrae.3
(?/v>
C*e
BOd<ad doas^do^ ao8;brtoJoO„ ojba
akw ) aorfrtaojjssu^ efioas^^rt Mj,
^-'\) d5 cx^x^.» <Gr>
,
actfe.t!doJo?3u< o?.5dom tfaooo*
dBurraa « adoJjF3u< cCoa's*1^
doe.asasdtSvJ’ ’
&) «ivrtn a«c5Sj<>t<3 ^OoddOo
12)
^0J «^5j.
’L.V z^lG* 4^ <*&
^•L
*U
wtf «d X*
M0J
on-J3-a-
■^j^(;SvAos1^Aye(S7
3rtoC'0d sjtJaOJodo^ ®t«oJo do<0
Co<WwX)77)^
oraffdtso-
■©4) Suoas, «0»F3a^j< wdda «rfrt ®mu
35> <.^“d«e c£L>e ?
zrai> ijauyd sdiSjao sra Aooua rkj3_»d •
caj)
>-6—7 odnvssu^C^ccj^o) a?.oao„ 5ja<<
o5doJu^u< Srtcutfjc)offer 3d3uae.''5,
<4na ffo ^oJua nu3_,d •
sumo
soAe
1-2
ssoOu
3ucm3
5
5-6
9
10
11
12
13
14
15
16
17
'IS
19
20
21
22
nao na(cwa no) wyaa wsaAodu
sua^na
6jrf
23
OJ»0
24
25
<26
27
28 -30
31
32
33
^34
35
oaCod
08*
(AK8_»crart
«a 0088 ouu
S3<> OdU
OvMbSjjOC? <3ou0 (<9<> O 8 <5u<jV<Jv)
scovu
anta
iSo„8a odu
At a
nJuO^
^o aou8„0
Oua tOO^reOVu
a®u«_»0
eB<o*ff»oJu
08* a auuuu,*
ot^odudd
oo crewaw
36
37
dvTOttf so
38
aancretfCasaa soaa Ouaauj)
39
08 5?SvJ8 Sdjj
40
41
42
43
SOO UtJ^OU
Bdnoa
dj8aaS3t,
duatncifiraovj
iiotJ
dna-tigO :aO^;
aoau at aaua ®ood djaj.^a osa
due id aojaoj so <kjro*a ffsvaj^ auo auea dd* oatf d
aooooo so (,d<?rtni aup«4O5<( so ooooffe o) Jdaotfjeoad
dria—tj.o a» *oju» rk>3_>d •
saoaod aasooosnua ass -et
BU»adttror\j3_»t3'
aqaj bo K0o(t3^srdoojrf):
aoaj at saua s^od
?3ja&<Ja oaa djOrt sujaou so jJucsAa s-dva^ s^a ajea
ad* aad* aujeou ao (dtfdn, au^5<a5<i aaoauoerao)
t<j «“n
o
artoofJuaoad aqaj Bo «o0 a» *oou» nu3_»d •
aa *ooj® rkjaadrt -et
ao®ffldt6T>no3_>d'
■et ereoood •souaen daba cba «w»o aoao., aooya®o
BtreFaarua (od noa. akwenv^ 'Ji®»«o) 4douifu®vvdt5j>
Bo saa^Fdtfoa auao ^ojodj ?-^voOoou (tratfarejo
®o*a5®odj( uod, suouv ■«®<><o)
aujaojja iQ:' j^odj at eaua 3k>od ofsaau^ «4ut
KRjt9Bo -s^atoavraaS dd* oatf* aoau so (d$rtn
saoJuoffat)) irtautfoaVydoj•
-7) ^> ^0
cbtd auoaoj aaorw erao
J5 <=&■>>£>
sM®aao„ duavtf sb* okrotnua^d-
4do<jrfuavuvJ_>oua oanvo„ daaun uao noai
djaaou, ajjaoon ?5jasjUi urw
ifa $ I -Ji®® «o 5uao<kHJ® oou •
(toba troajad:
aaja
Asu<aau usrvoouOu>
A) b.-\>
t>oao at aoua ®uod
aoau at
dd* oa£* oooj uao Jdaurfj8Vvdteo
sod) «n>oaud ■wouaadrv® aft J
Ayss^xdw
ao8ffldtffonu®_»d'
%
< ; f',
■ot ffsooud •sooaaoo aaa3 SD®(pFrivau< aosuaroF
*o„* eadoo-
^>0J r?
v^l
F'Th^-^
_
^aujaj^duatn:
uxju
<t>a suod duai^SuaoOrt a9oud-aou eo
ducsAo jrevoj^ suaaa aut»Brt wdou
as
£toOoo AAouvjas^ dus^n aaAodusnua^d-
*^?0<x5v)^
aaorv sao irtdudu9vvdtsu-•
C voO "S aXXjT^'Sl o> cAa
LX " C
”'■
S^V 0
c^ObJU
t®, a exy
■’S^e r< .5$ 7^2
■«t eraooud nouoaau <m> so«>pFnvou< dtowdtuaoou.X
ei^co
SrMu ajaa rtuatp, era o( du9tvnvau< caeoduBtOAod ^)w-
ga,,, nauj, 33, g0O ^eo:
«Ssja<n 3j9tfou ud*
3uofl(u
lO0u
d>a 3uod dusauKju<
gJ8oo;5^o0rt uooo aa!}
<AE5ou dda 0009009 0009 303^
®9* dsra^n Wdou sa
Zf8|aj ^39^0 houo anma* dsj9<n cajbo
Atn aao dvna otf aAoao„ 15 aau^nv 590 oadtgj.
o* atoao„ *trt suaoouoo 09^0 ooga^dtsu-
& 3030
OOU0H9 *
oouaruaadrt
«.
CF\J •
COG
c-xj jb'c^ o
^OUUO^tn.
t>oou ^ouvMja^n*
TOo0oa BS)0
M
a«.oao„ d^ra^n 8o0A cacoJuatrwdc.su.
ad^uat^: t-oou a>a 4uod ^Jc>wur5u^ Jk/d^CJU
a<^ ou9 a cfirtd Bouuoaooo uou os *ooui nu<»d •
«yr ad
wdou
koou at aoua 3uo«fl
uoou dvuv^y
««w «ao Of0 (
Aoa, oa uo 3O3j»taood wo sooou
auunnuB aa«fl<BU" <fc?_rt ouaauoarf
nowoom jvo ooj3_»d. rouo
oouaruo wanesJoouo„ojjou^
f " 'k' °rlJ ** *
V^aa^O,
oxje :
,u#0^^
t-oou at aaua sued oarf* «4wt wj rftau
»«jsw ao* oatf*
oaau k(ji ®odAdu oa ajaaoua araneJ* aBua39_,
wood Huro soau wouijd*
«ad ooousra^n srt.ad,
«J9 ooodot «ad nou wsoduatn
aanuaocr..
a®* Oo°^^^00„ 5rtort '009 opus 3l1UOO0J9t WfO
‘009 DO<J9 57) OJJd
uoou OU9 ooOdod -at a«3^ cajso^^^
«JOU3_,d •
T^tVo cXaivx^ J1 rt*
<Vy;
<>v A as-uo^-
J
®aB :ts63:
(Xw.
moc5«j
<t>a d<a3 o<5i
mocso
wOfta Sjraoaa
3ooau ( uooo aas? juso^
doc.d '«CS3O< CAJBa ®audc.i5o-
Soso flvrw atf a^ort a53o_» 3&os,
dda^n au8fc 33^3 aoaBdcso*
auja <Hrtt.i5'-»®oJ<jer,
oa aj^artteru’
,' . -
--■
.7
'
,.-5 >
P r'f^
XT
z> r
o
f, • :■ '■ O-’’
dbtrt 3300*
••-»
r I
. ,.
■'
..
»14
<» r
' " >/
efaa aoModo»c.naao0ooo asadci udu,oJo3o4 n33e030„
BOO3dt9O«
OGTdO :
v
otyaoa rutfvnvj «rtaarkja ?sauojjao„(
t^OCJxJ d>®
Mock) soocsu «0&a ^oaotjo, moou ack>a soacOrt
t3e.£>3
asafi aae^n w3ck> aooo<5»A i/uBb asUydtso*
aauu-jja., mociu s5aodS<. os
5ijaoJuao„ KTc)<a O^a«dt®U»
BCf® O0OJ53o< rfoadynoa ^O^38JCt5OC^O•
ns ■x*' d
dbC.rt c3\J\Jd Ou 0c5
,
'T-.
,s rj ?' ■*- --J "
.,-> • ;Al
r> >~l < ■£
vi
•et 3aoodooo„ 6rtort <Joa3_,ouO ae.a33o< 33*0 3t03o<
UTfdn C6c) SuAjOd^Su:
K( a/tK)
xraauaa<
----------
djaaurXiu tu^vooudu*
& shdi)
dcaa rtJ&a>ua e^ooudo,
df.&3 dO0Bu3O< Bo03(
3c.03 «©ooo3o< A<.0«!o»Vvdt.Bo«
CK'<y*T|Wt?^9
aoOOJOOAjOoa
<f>cO<SodVov>aan
3o3o_»
3dodo3o< uodt Mtjjooooo saa aooao0i3dOoo aa adipFaao
c6o» tnoaoo^•
' •■> r?
<'T'
OthJ'iS&a :
» ’ «T:' ys CJ
MOOO OiVBo dWOv
r->; ■ -
■'
>v
yC
f
r. ■ ’■
, r>-
00030 < dead 0300
■.
aa*
oatf.j aujaou troo o5aju«a_» uond «jvsa a aoa oJoaa no®.,^ •
■AEMacjan
kjcw
^oOvji^ua
Soao
CAJOOt-^CSO MtfvOJOCJO>
:
Sjasu1Jnvs>j< o6a* rf?5a^o 5u0&(
^jasucJj aorf
c60^d aoa (3(«Be.oj
ddSMaocu) Sjaeaoja socunefi jS^sa^n suOooijaVv^su-
sjaa^ja
MOfld aoau^uaesJ <Ja^oauanu3_»t5-
.1 v ■ '
<•
r,
'i
> \r ^':
<Hrt
ood:
-- -------
oOxja
aOt, Osro tfort
^^wUtaiJOOoa
'-O0O M
»»« WO «JSl!urt
'o® nuac.c5.
Jjg otjcJrt
saacxxwo
;°®®ooujn>nu<,d.
®C.ScJ rSjg,.’,
OX) irfau
tf^fflsjijcjooo OsJe>4vo’ev <&Jc)bJ
u ®^VsjHV
A"
: aaou4 at aauaaaua
®0B3 5aauad:
<s>
^t®sSu®a_» rfuatod «0»S jasuad rkjrasa rU3_»t3 •
oa
5a ooucS aa aouua rtuaadnua ^353^
^rftauauCjjCio,. itoa o?re ffidJaA^dod 5c»>jo^jc)
1 uV
^>6 w
/
wvicxkj
5tsoa duatJSrwu: uodoou 3uawua
.
auooouujjou,
sjctjUq
t 5rt©F50^
dutf V OO jc> HU4)0j
(AjO
i ortou o
’
iKWtOrWj aaaoci wius_.t3CJc) ASrUOUCSU J
ef^ia (50)
sjvaoUu
kodoau iuauu^
aau^,.* wodd ere A, uoduaj dOoreo
0?33;3u< ass
(6oum duat.'J, aacsu duae.^Ji
L>odj tsaja Suva cWtJjaoOrt
aaou* sOducoAa savj dtoa aure,sd wdou ®ou„ au3u_* aaart
aajuaaooo ®uu„F5ua?.iJ, aaauduat-ij au3u_» aaaao„ os_» uou-xsu
oatfja^au^ 5<>oju<5 aa^oJU9rkWuSdrue -e><
suaa auu„3.J,t3-
auaadt5o<
)
58b:
t,o<3uaocsu aaus 3uva oa( Oodoa au3u_» -otouCv
oaaau< auz>ra aua® oaa ®auo3a_» uoesd 58c nuraoa nuS-.d •
wae.c9F: uoau aaua ae.au suw^duaoort «»5<j?. s^ouara
3uV* oa a^oa suaoJuu^dOoG »e<reF aaaorfouuanu3_»c3 ■
,.
<!->>>
tjaouu duod*:
.
ej®0 ^nou
'ovu—aoMj Outfit oc5nvau< oatfd auvTO ou
twooueflJ® «$♦
rue*fl*
T
I
3uva oaaau< yrran anoduu.aaood duat>u„ »uo
oouuaou 4JUJUL, eijs owu^aou &jj»Oi4oJJonu4_»d'
k-"P
e.o
dauu^( nowuu tfds:
uoou *a
adoJussu^. rtusco
rras^Oiju.j ma suoOoduaoort wJdu uoau issues rft.au rft.oa
oaa* aoosu u»0 dt.Bau3_>Oo0 nowou 503, sSauu^, nuresarU3_,rt•
1
. ' c.
r
®ova owoe„*auA* acenvsj^ «doj a^n
awuaSJaOocJ
rkwaanus^d-
djaad, sdnvu:
u®na Suva odnvsu^ AtOAo„ wdou
auui»$4 «6S<jos_,aoc} duaaS sdnvj ?ia ajjarkjs_,d •
toou asufl suv* cwoo„ dvo^Vv OR>a^u<
S5tO* akivsa.rt ®a A ad akjvs4a nuwjjanu3_,d-
'ij & t?> A
QzA<&^
f
■?
aaujfe w^ao era.»ajc>: a*3^:
■ ii*mi!IMM>>Mi iMKMin i ■«■«». .- ■■aB timimi
■■i.»m—rTw-»T"nn-
i
uocu *a
»iuhi ,-.: ni» wmiikiw
djos<Jaj< ®dodoo„ d<oOv>* oa ^dou, aoa^r-aujaou so
«5>j«K)au^ aua aoaa d^o<^(
<7°
d<?rtn
uocjj
aaua tS?.au aua.j
a»o c6oa«Jur1 uonu a»o sou irtootfjaVv^CBO’
oauufe, ®a3uoojarkj3_»d-
«<i_,aja d^atno cwura^ sazJjoJJ®rkJ3_»d
Seesen urencs «audja<d au3j_» d30a_,o
i
ucjooo
adnvaj< sau
"
3jaj»nae„ ddA sua soaa a<.aoojo3 sou ?5e.nu^dOoa oaj&a
bit<s\p
A
$□004, ^<58 otioJxja nuBjd •
3oOj:•
«^wv
t~>oc3u 23<3v)&5 cfltjrt osoc) ^^5 Oo5 3r5cJo »di*
J >i,V^
-------’
tod^j saua rft«5u sus^ de.OA oaa aoaj aty i^o^jd^va(_so
J>^v
<t>C.rt aoau 3ortv aAi^oduoo sodu as<toojadoa^d • 1
1
- _ -.--- -
a* dvro i3aoouaj< ott>oao„ asoA j8c^3uau dd* Jrtou
tfjovuvijaj fijodu Ckro tftnsrt »joua waso odjao nu3L,d •
ta.,0:
oocj
*a aaudoatd
l,ooj sjobu
ad,
tXJOO 3uoBsJ S«JO0 taffle, 05®* SiJBCXXj 30® 8 OOBO dSJ®3O_»
aoDu aaua dtao aua^ ddrt Koaoouuanooa wotjs® oroaan
uooa tSoOCdn®—tseo) d5j®trkjs_»c5'
snB| •SKJeju
'skjlkj :
wMudoatd anoddoouau^ sfloO «0»3(
rtoatajjas^ d^OA auraort wJcsu a5a>j0<xsooci S8&| ■'■•JaJUU (
ad
khj so® noa^d •
5oaodj®td:
uooo d>a aaodoatd djas^ao^ sua^,
aoao *a siSAs-doou wijiaa «oo odoouao^ dd* aodo aaoo*
° <<■ +•<
do® tw 3<oao„ 55®ooo*6uo^ aoao doatMOOdd u3_>ade_eu.
a^'
•«daj4 ?flo®c^ ddou ooau aaua aotfrt0oduao< dtO<tw<ju
rfuaoau oa® d<?rtA uOe. dkrod^rt aodu aaua soaododcuo^tOoooancjj -da^oo^aaod 'Saoodu SyOjarBoao^ sado aoaa
t)®OCk) •
<i>ert 30330.,—WSSjj oa idoorfoaoBd ®oa0do®td
33® orfoooa no3_»d •
t \.
•
rfm
«2» oususra^a:
w
0»<*
<, ■
j>‘)
,o6^'
oobu
aa<ja
uooj aaua dtauajs^ dd* 3rtck>Sja oad aMSosJa^a
sOiSuodja rkJ3_»d •
tfdavvdt®U‘
Kra^a ’soja ajjaoo oasja Doao< Srtou
oatf* aoaj so 3dojrfjaoad u^voduou*
<’.)
e>y:*
<2
so a j aaoa ewod^atd dua^a o?5#4
d03j C5c5U25
«<?; -etooCv osiaau^ uoao aaoa de?3o3j;;<Jaaj< dd* oa<*
aujaoo djaajj irtoo^oaoad
sosoaraF ^aa ododja rRj3_»d •
<1
<5
^1^0$
ft>e.nopaau< atoao,
55u«_»t3t»u-
.aoau oacs ousaaoDon adduata nut»a®nu«_,d'
avOaou® 3> :
crvoauu^otr:
Stoo ^odu a jack)
®uu„ as*d os®ft txxsu du®t.w auaartouuo,
aooo <7uo auj®3_/ Da®otftocJu®rsu;s_»t3-
a
0?3iJd
jxjau treOoJuo^
auu® ou oa -et. a*^Mouuau< au®H«5e.5u&c8m :
dj®aoao„ noipaau< jJe.au ®0uoijaOoa Bab>)
duaaSrtVu nureo® rtuJSjJi •
-©< c/uatsao auu® ou—a® uu * oa
au®asj3t5u<
Susaa:
&_,e.nop auau_» «OBa ^j®ouunvau< 3e.ou
osaea $ac>uoau< dda
au®asan5?a—
asaoz3<e>j. *<rt kocsu aeo— ivM
---- -------------
ft a tfuatouacJu:
aaO^^Qu ^£u®mu*<4
dO(pd
gj OJ J (\5J
a®ou4—caou Da aja^oua ftart as® sox®iwood da tfjatcJj^dj
aoau e8u® c.rkJ3_»<3«
J
FSaojjtfdjj^:
&ytnop£?3J4 zSt^J^jss^do^ 3<dj
dje_d ^rmn ®t5jtt^dod otojj tSdjj^ a® aojj® rij3_»d •
oa
aft^^ auaarftsu•
!>>tno^aau< 3o„8®oou oaao„ <cou taonu saua
dc.a3j®o0rt j30* ataauijoOoo o®O'« aoau <6u®<riu3_,c3-
10.
03^02^
oaeod *rto^ okssssu^, uo^Ddod u-sno
a-3^<0: OAi.j :
ras4do<5jc>oOA dd<t
-JiOO a$rto3 <<>;5uoJj?5xJ< SuS sjaa sou
tfaCod ;3>jannskJ4 cx3 arao^o^, eeS^ dA^KkxJOOoOOJ®
IptO &CAJ„4L,d'
I
r
■■’■■
',;
Ott, I0C.O:
t
-■
w*
V
au3sj_» anoddnv^^
CJBtfOd ®rtoS
d3a<n wdou duBiartocxjo^ dd* irtajiSjavuv^dOod
^rtoufSdavuvd djaooj e>nuroo idstSosrt
•
„ wcSod<e>j^ \.
<^^-
jjraooj^ -ck.
caOt;
<suVj: (J&tfod A«a^JjorldoJu?3J4
o« JJrtckj dc^u3u;;uao„ dd<t t?jouud ua® awVj k>«u_» Ajso
uouaGd •
«uaas o^c5^u< 3rtau
oeL* &3L,:
rknGd*
uodoou iUBMJy aratfvWOod dec*
(NOau Jd 3j :
aXLOaJO^
uocju
d>A iSv/oau^owO oc«^u< ^oou dj^cw
auO<UkJurfj&Vvdti5^’
taoau cro^od cort^a oe.6iriVKk)<
■C) ftda ci uwi3flu< o< fctOrt dd<<) amdn tfuftoJuu^Udotf avo
(?/O*y> ’7"-
OT ^oOvJo rkj^d •
uodu A® ODtfod ^do0u^u< «dt3j skresoae,
ddx Osia sjaodou^dod nyrts fl6orwoo„ soau ucxja oSj,
AtssJ oa<3uoJUor\j3_,t3>
«Ud< 3orivo„
.Ari’-.
<■;'
r 7
7^
.'^ # *
T . ’•( .
.■-<;-r> p-
(O c f-
f ■
7'
■■'■
■
"
-’"'
■''’
r. fc ? .
>
f
>}< jr>
owsaoo sjaffldc«v>-
■
■.r> .-r-
• r'
P
•. '
’
< J>f
f
Il
oauu^djatrcaA^:
303 ® iQM^Auatfvrits^.
3^SW«>n>0o„
woa o(54o dtoau.i kmwu U
^OOu GCUG
taoou aatf
aua^ooo^ rid*
^ocm a< aooa
H7'8 0* riCrtn ao3<»
. ^oouoerao <rtoj^jc>vvJ5e.»j.
03nv ereo ■»< «a^ ajsarf^Bfj.
i?(5oOD
oauu^ £Td ^oo«_ra rkJ3_,d
dua
:
08,0 OrtW?3a< rfoffla ^td
o<^ i5>J&a I aa*
0S *oa
am^ooa OTOSJ<
Ou <^U0 hJU
G) ^°'
ohM U «•?_, ««uJoari<.5j.
SUjdOu 03
Jc) ^OOU
troOoduoS A^rt 3u®aort 6a rtua <ou5jck>
;
d^&Jc)
^P^>-'^''':K'J'j
^000j ooas
*■*2
"0» ^8,0
suoaj rie.oou< txxk>
<ua;Jrt
^^duo yanoO"
aoad now (joau ooua-.d.
^»doo„ dvra^ij;
,5'
O8,o odnvou< o* ouaa *_»s5
Wrt
ffw<jwi3oOoD vosas rtda^q ^oaadoJvranu<,d^2TtlQj
^vd?. 8k) •
ae-,0 rie.0* a^oouaJj^
»=><tJ nomoousu, Mai,^
2^^
OGd^gro*
M
swaoiScxxj os
^a wort
uoo are ort osa
« >
dbert
J
u
aw
^auaoood duo tn
ouaau^aoa xiUkjoouoo^
^fsua^dnopo^ 0A
^<0^
$ StAjauoa^.-
^aodoricau.
t_oao aa
n dj~d {j,
-.1^
^ort «doo t,oou aoua
wuGodu&oon dd^
" tp
OB 0^50^ kockj
Odud woa^j
^>vi aon ?sanrf a ®^ad<&'u*
b <&J©
®ato Suon d*rtn oouo Ks.a
'*
’ uoou oao
^*^«»oouoa duavff
^ock^reF o&a aMae.ru® d. a*^
a0"
^0%
KSOG-
j CO^)
w WrtOBuQv)-
WOoJjBQd R5
rfe^usus^ dda
*
a%jua oaa 9: dftd^:
cw
bo
logo
*a &u3_»cra(fl duaSjjau^
dutBria Bi^djBoort ajtsort «doj Syfl oa cwasu
<flt.DiCusKJOod a<jja uaa $ q aa &oj«jb rkJ3_»d •
txxju *a owS-jOciifl adockjasj^
rxjmu.j djbo
ajaa kodu
t-odu a^oau suoOoJoaj^ aocuaao
dj®tu X)e.0;3o„ sua
Su® 2JU<) ® ®d 6 f3<©^U^dOO0O0'd tiu ja uae e f sa <^ooja nxj3_>d
uoou sra Ou® tsojc) tit.
ausaritsu-
W3_»crart as.aaaj.i
gou^
c3Uc) & 25^ >5 O^J
ri9rtri—Cc>5_y L,OCkJ RJC9,©
tJvJJc) OS$c)
sajSoockre rk)3_,d •
wAsTao wsjsja atkisoi:
<j>a av3_»cre(fl ^doJj?3u<
<aric)rtn
tfspaodu u5j3&
•Sou^s^d05^2)3^:
BHOti dtAJuSUCSj
JX5C8U AA JUS^OTrt
dertn (&jd
ftnoQuo^ &j<>o(j(3:
ju3_»oi> rt
WddU L/OdU
6u3o0xju^cJOo0
odoou?\j^ ujao ajaa
'rl
^v(<e»oj<jo„ ^e.o^ auja rirt ova suaoooa ftawauo,
6€)O0UOm
oe>_, dua<ou<3ckJ( «a^ado5 ft^wj sro ^oJvTOrkj3f_»d •
cWu5?6a:
cAKGcra« ado-Jo djai a50^dwoJu?5u< ora ft
exJou owjfta arantf* Eda wjsj irtoojjjajckj•
C’/'-’
0527^ V 6^050
Bjsjaa_,j|
L.0O0 AO
ajjoua cSjad^
asoDtitfoooj odoJjSj^ SrtojtSjooosj oofflj SjcoAS ®owj(
^S/ooaj ®v®j dwjv^v ®»* «Sf5o<n wdoj l,oqj djatu ^tOao,
BOASdtBJ*
uooj
®Dutsa 30ocss5u< tfoart erdoJoA -eft
ojEL/rauo^ BOoiflcaoos 2j&o
ao«o axja^cess.’^j^ iSoaoJutStej*
-»< adi^oJuKSu^ ajT>ade.&\j-
du jo cm a?3 tkMoifl a jo and sjouo ^vojjcmao3O0O
<5UJ® OJ
SiOvJbH* jjrkJul
auuijo ua
a JO BtKB JOJ •
aBjo «3u
®jV :
atfoaj aue6wo„(uonj Sorwj) c6j»tda
®jtf wjjaoj soaj wood ®»hcj odoJj os 3rtcso( »-ooj
e/j
aajao^jj^ sjoo ^BjotS^d ®jaxjd<^®j*
oa tst tiM,* ajaod<«j<
oa nujjj os ( ajjo oj
rtjoJj sa^Oodjo 'jjqOoo sotooJj
aa nj3_,d •
saajad:
aoaj saja oranojfaojj oai4
a<.Sj3k)Suaaj< ddA ajao Ajatf^rt 3®ujd
gooj
saja
os SrtajtfjoVv^tso*
13
tn f
1
Q
aujaa, &ocso Suaoad: adS^:
aujas, &oao oaaaad?.
Sjaoodrt aatfcxk) ooaau< «raoao„ cBesaun wsoduatrwusfcjOod
cAW_»auaark><,ditjatfcxkj »rtQa
irtckirfj^oaM
aoosj dw^a do^ffDoju, t-oau JkoOvj 5oo„^k4c5oJu^o< Kate
)
ddA( L-ociuaao® dcausus^aaxj^ ddA jjOoJu cMs>durt aaou*
oa SrtouiJvraoad aedork; ae Aoaja rks^d •
trotfoJu osjoDS ao<*M<j< rittfock) dual
acxkraOA 1*00^ aao>j4 aa Aoad Krajkroae
St5;5'Jc>
<£\J<> (_ft
OQ\j3 fcd *
c6vT9
4
:
watfBc9w;k)< djaaOao„ *ssts
Srtckjtfjaoad su-ja^a akrad^ 3jat£J AoSsj aau3!_»d-
cre>y 5ooufflo:ffl44^:
uocsj
Oss® i3#rtA
saou yanasjUu soon asraoSu^ rttasos®., cfja<dd cre.s_,
sadoockro rk)3_,d •
sooocjj
■jjoo ijjairt osatkre aoao sa^diJ, L>odu M ajrtAt
S<ja S<j(j (
oOvjassdt asvo ®OBreO) asrauortvao^ Stasu^re.,
oBjatod kode. ■Sorwoei rkiro sure reu 3_, d •
asaockj akSta^j
U's/YUM^tfuaoMu
Su® su'd a aKJjfcrt assort oaau ioc kjobu^kJ^ suaoJu^u^ asaft
^rtou^jsvvdcso&
aue^enaad uode. xragu-
■ecu efijad^
akjVvjart ^uotra socjaausuo: ssasaoJj auSoduau^ ^ftoouart odou ®uo 'Wq
crerirf* uWodudoouoo &ioucjdi auaortoOd os# d &\j<3
Ou
dkJ®cr\j<,dtatjsf Bft_»rt:
iAauaaa aoao sjsaodxjo mdcu (fija<vs$vj^
-sau^jjoooa wasao ctrefirenoj sore odusa rkJ3_»d •
uso flBorwou szreodu ®fajo Aso^dOocs nyrsreasren
uowdodvj a6aou3a_>d■$
I
«csd ■«doo„ s^a <ozsau„ •
5SOJU
srecreockJDoa uocu <3?.^ voza wreoJuModsre 'POtwsodo, asrauo
tkrea, djatcauue^,•
4
4-
15
og»^€.0:a»^:
djatu
ms*-
dujaou nskja
Bxkjea ®® 03 dJ® ad a»o dj<>d<3rt artdogja oad
D5_»^e.D 3da orfojoa noa^d •
■ J9^
4krdoad:
.fa
asaodo^ t^odu
aa
dvjcraou os •«< aM,j auo a •
muj„ Sjaed
o»_» dou%jo>ji mou„
’iw&eO SusoadriGrt oae dertin
( ®0vOJj saaojuod aeju„esufc
O'^>-
A>l5od rkjro UTBreused'cj
3d orvO:
d^5j*
5^vOJj zxirt asatfei» <3d0 sdoJu d«j<d
rt ajjo oj—t^jc) U\j 4 rtodrw jjjo nadesj.
ckrt
aj jo o j aa cm * nodriv jao dwu^ skroaod duucickj-^ou*
fid £M®aua<5uao„ ad c/vo saduockra rk)3_»d •
au»a<3:
sCvKscaj
®«od adod
v jo jo rui^d •
t
/’V-
-
“----- - ------------- -----
...
«■*...... . .................................................
w^® aususra^a:
dtoj AJiSoe^ <3uuaud<3
r\a Srtckj&jaofflu de.oCM<t> woo oaaau< Boaade.®j-
c3\J<J3 UO
os) *c.rt aj® and 095 auaujue^a e;ai3xjoo<j®rkj3_»d'
•
'ido0o0rW(
skjja^od suua r>ad d<oav>< adooduo,
da®<n soCM ®aot3d 6t<3 cfi^jaauoau as^reuo au®nu3_,d-
e>i $k.O:
Q,^t
cP"
aj®*0rt wJ^tOodJ®n njaffa^o oSuaart
eOuAad f a<jjauoad
dj®suaj< da®<n wdoj ruaoScOtf*
Ow^i * ®aB ®au
-«< 83®
eBjaort boo Ao
oa
auaaod 5_,du<ra L>vrt ®jc>e.^!3ao3_,d‘
aooa^a
duatiJ:
aviuw^ad auufc adoJuau<
iMOt oa irtou uoau a? aaua oa^A
irtouiSj®oad auuaua
oa
n aeoo*
5ou„»s^d dd<t
<6u® <<3 sad^cxvaruajd-
oarfj® *oo»a-8Fo>Juod au®ad<5j-
a^u®00
coo'y<j
uoau
eORS saause:
a>o<7ss arkxJd irtou
tS3a <0 w5t3»j ovocS
tfjeocsj tjOOJ 3ooa<J «0B3 #jc>ou;5v><
rtjsto rras^cssijj •©?. cwdooj^j^ s^ooj^d
tfauaa
z30rtn uOf. fl6jai3urt
?sauj*—ooj oa
irtdutfjc* oasd
Wv^tS^’
sjd&oojanuaud •
<£cn
c6j's»fluocJuo„ 05jv:
*trt
uobj
‘c
<"\ •
ac. aa<j0a£ij,j asotfrtoooj^u^
uOt aSjanS.jrt Srtojdjooad Aj^>tSu (Buvneoad atvua_»d-
..l> ..^c;;; 31SJ
sa^BaOj® •uoOoo xJardoJ-jE3®rk)3_»c3'
cJJ5 tpo-a^T/
3d—doj-cajO:
sr&^ss sjaadtSvj*
a50^rfaOdoaj< 3d( doj-
{coca odd aotfrta 050^
05fla sdrt Ba^rfoaoao
e-oau Dac oss atdud sd ao c630o^<5 akrotrv3_»c3-
aBvro au awjtjO:
aoc^ <fijO 3<J_
nBvXSaooa <fij»au cakjdO BaajoO'jorvjB-.tS'
CLs v5^ ,x J’t^'Ss
SxjjauKS djBiiu iSjatsr
odoJuau< zraai a<roa
•«ic3q<3
:5u<d
oso^ss sc5oJj?5j< e><^
cst etaJuoJJsrkiaL.d-
os'-’
c*\‘:'^'.,
sujaua oBoc)^^ ?krotart aoca
efeno Sued uuju
rat50v)»c>_.
JT’1 \.<j..rtr) ■© cxmC5c<>
4
>u
odnvau^ aojkjj
tvoau <t>a andouu
P -'a.^
ne.aaau< daa^n ttiate uoou atkja de.au 3usuao„ dda oarf*
n>~r
oouu wao uoau En»o Jdourfuaoad miwa aaaarfouuanuajdantfoou ae.«aau4 «a<a noa ae.03o„
w3au add ®aoad opr adduae,^ nureaa nussou •
os_»$ko ;
t-oau aSvia andoJv* adoou cwrf,, LOCJ
atorf tABxjjj ?3?.6a rfuaw^d O5_*?pt0 as ^oJja riuiacsj ■
05UV8ao :
Oodoa au3Su_» onia rSjaa^a cw
s^ajara
oo„ «to& BuV(saart c6av>t);ya_, wood ®uV5aaooj>j aa»aanua^tj•
ffauo^ <Mt®:
«onaoao„ aa wad &'auau< daa<n iuatfau
and duas^au^ wdou uatf odoJuo„ era3,
d^rtn daade.5J-
-ot o<3 txjou JJonvaooja auaade.eunoau zSvjb^v KiSisaon Sjaood:
(ata) caborfjaoaootf
andouu rie.oau< aodoaoo^ ^e.ou
cABOrfuaoa aanrf* ®atJde,5U'
c.j
K
**
j,
vi
j ki'C.
’k
no®u au5d£rt aaaaon
®jadMnja suO^dtsu-
30
r0t5F~r3U3^U a ’ ad
loOu
<4 *
M rtaO odd 3^0^ (.aai)
no^3?3U4 t3<5<* t/Odu £od
\
0^
cbofc 03 ^rtdu dd3 d3a<n
f!)3d<.5U’’
wdou d$rtft 3c)O0OOtfc>0
saoduos^o d3c)<n
daa^n d<
d<r*>adt<5^
5>A
<t>
' po
£ nva^< (aOiSsaOdoi suou^^aooo 'ssa <o) -et sauoJuao^
•J Aa^jjacickj’
*s ;P
? K
C?
aoas soa^SF
db<rt ^oOvj aao ajas^sa
nureija rkia^d •
c6jae_c!d ssfsussq
w^i-yO-Ju ‘B^DoJ^ zSuairtc. ■©< '850
a^re ujcjaowud o<kj •
CJ
uqou
mC
d>® nmO odi
trOOU
UbdJ
av®j dVoyOv dja# wdOo asovsffia "sio^a iB^riiJ*
d r^c)
dSod du ok;Vj i«Ood -we BijC) (Aesodjatn#*
adoOoa c6jsi!Ju osjvj 'sOotf ;3<Jc>3oj wo#*
5^)00 3030 -ot
ajdaritso*
C\
oO-JSSOCJ^
irtdutfjaosj
)
kooj oao -«t ad#^
d<6j>
«o«f :
tuOt5O oS® rtCdO tddO0r3O2u2S|3 Ord <5rtO\J tuOOO
aa# cajesj^ ecad sdA woar ^oua trentf* d^<A c/\fcjted<su*
L/Odoau 03 -ec
tftt* :
5JciG5dc.5U«
r-ooj M *J»Sulao< t.,O0u duQOM wORS
dudona ^j«>S d?Jc><n «dou r..oau awrf cajsju dd&
arerutoj< dfSa^Pi ^>ja%*ou aaudtd^*
(i/J 1
r5xJC93S r5o3_>0 *
3d CM
wojj
03 obcrt ajd&od
^1
nd
war
ruao Ddrt kodu
db®
a\ttb
^ou«3
C/^
:
w3dJ war
caE5uau<<
OrStiO^
aujKOuKSo <t>trt
5 Jc) OMiSCJOOCJ^CNSF <3J® oJUJTd HJ^tS •
auj»r\a aajao® uodoaa lj9uuw
,,^e
naa
adoou osasu< t>ot3oaj aBuaau., au^d a?.3 j6aotj„ao3
oauSjd•
auvsOa:
L,oau A3 5J&O
naa adoauau^ irtaotfjaouj
;aoau o5Vbj dvuyCv <Sa®^ dfSBwJau ®uv®aa 'vous araniS*
C.P
flMSMli^.8'J•
a«j^>c3'
uoaa aso d<rt avjaauye.. uoad ®ovb®o ae*ooj»
■
5'2
*0*’
du^^vo^ 3J’s duo
£jc>odd: 863^:
^xj&dou|
TRciod, rfJdou^ fouOoJuu^_»dod
ijcJodd ^dod adCdcdu)
odj 3uodjrdod3u< dde. srft 6dti^u^_>a^ce»<J*
suss^vu 5flttou
L/d^Ddod a5aodom 3<da d^ort wjjtfo dxjarl
®dDdc®u*
ddc dde.
Oxjdas^^Ood djauu^ rvuOoJuu^du ^o3uf
4j»doj oMkA
RJ^u^nu^d’
Lock) 3uo0u Dd (d<0j) tfjuju
aao>-tpt&*
ajaterloajo^ <3c_0& ^xJ<)LJud OTo-^-^pcO ^ou^-jCS •
aj<>a(
03$ * □Odxj-d^j'a oj tjsO dvroazSt®^’
33Oo^-^.kv\?
Q) 2
c.) C\)9 <xQ>
GxS-loC?
<r'^“
.
(U>il5D &
C"
rSri J5U<S <U)
c
<-<>
cfei r75v?
3.3
i
®oVaaa : S43.J :
ujaaa s'doo.j A&>ji uxsooa
®uV5aortf
awutj^^ zjodd
is oso®uvu:
sjaaa
aooua rkjaud •
auraort «doo rtaae.0
rtd^d (/vodlnvau^ oai* soau tjao jyauo*—oau os Sta^od
8030 ®OVO DOOo <«Ji>e.no3jj5'
(j.
^QjV
wausotf:
kooj <t>a ajaas anud<5nvso< ejjsoOu
I
3J®a 03$4
p.
ooao aooaoo u»o irtaotf je oa<3
wAsrao:
•O
£R> ^oaoa rto3_»d •
tooo <j>a ajaas ®jc>aso< aocsort «dou t-oao
doatu a?.oao„ soa oarf* auu'eoo so suaud «3OT>a aovjm3_»d-
wwwhihww !■ i»i^wMiiani>fM.—i —-.uni■ iii.i
00 tfcjrkj:
3ork>:
'h<';’
tjo3 dw^o
tw
^oounvF5>j<
.
oaarwa *<rt Ssabujosuau •
db^rl f3(3&bju
30,
5c»OOUOUU^U<
ooau as uodj®ooooi d«rtn sriourfudoad a<> ?3oru fOuau^S
a® <too u® nujjjd •
>;
)
adAjO:
30^tfBO0sJO0u;3U< a5<H asaoao^
-------wJcu stirt osfla#jaocad 3d cac cBjc)c.no3L»d*
sj® oou
^jouou^ou ^ou„a_»dog_,
^o„ff®oouoJuau< da®<n wrfou
dtausos^do,, dd* 5ou„?55*d dda d<«« auaft oa®
kodjdock) rtja^.0 Hci^^CJO,
X
Ls
fcU&xjrf '
-Sood 03.
isTdOJ WuSSOv)
rfjdtacJ 9 a* «^<ond
aa^;35®oo-j
OOOSsJ r-3oi5® OOU
^o^jsroF cBj<>trkj^d*
«o„dt odjassd?.
dOm5<>OOUO0UKkJ< d?.OOU?JtJc)OdJ-
a® »a® rk)S_.d •
*<3-8 a8j®e.ou3_»d'
auscsuoan
dtoouAdd woo aa^nvu
ujaooouom a* so® a tx^du fidua so «cortojj rtcroS
aj>»0<30„ w3du wo dkJdd^rt eofcooudcSv)-
:
tuoou d>a
i /4jBoau tx>dj fidufi ^Distort
dooj ark)ddnvAj< irtcu
<3ja A0r30m cxSdj
7
dujaou aaOoouoi SrtdjiJaVv^tsj’
CH>Aj euOUCSvH
«S<re3
A^ uodu yo^dbju^^
^<»t)u a©n
O^'-O 0
do„ 060 d 2530 <r\ dtO0O<^ $ddO^J0Vvd<6Oaad
uodu ajaou
83M<4 £KJc>®dd a<>^>
ajjauOT
:
O5Or5tj)C5'J Oc5
suoocsu
kOCJU fiSUfi
uodu d>3 aurtn
□(5*d 050 03 djM d30<n wdOU rf<3UsK)2>u dd<t
05eswood ajjDotfMQ djoviS 3R3 cMa(.ru<>d •
cSur^nOOoo.
Aorwout azJa$_»
awaui^-a wo<5 suoej^ ^ou^dOocj nyfrt
tqous^oj
oto>uA rtta^dd
u^vojuou*
Cj)
c\ooJM V
9rt
q
s^auao :ad3,j:
uoou *a So aoua„0 Sua&^rt
ts^5
--------------------y t/oou sooau «0»a ®a& rfaa^A wdou uod aja® rtjaeo
ty- na3_,o -»< cAJoc*nvsu< cw# 4 Sujaou tjao(d0rtn| a^i^a^os^,
e
X
o
saoauoaao) iSou^Javv^<6'J•
oouod
aatu* cwcs ■so®®
(todjb Huawei •
LXX3U d>a 3o 3UJd^0oJo3u< d3c) <0
dja<.w autSfcrtoJuo.
soft tfj&oOudctf'J’
uao aaouA 03 -e<
audade.^*
L»OC5U
OS^ 4 30 Jc) co
as
»c3 •
oj jd nu^Gd •
wae.»f^nu^d‘
gJQ
tfdboojur^ ckJ^e.tfoJudfKXj^d-
05_>
o£ocvanj^_,d •
&<5
cVd<tfoJjc)fiCkJo 05_,
a&ou sc) ooo^
dujarkj l4ou 05^ DDu^dSu jc> </:
dMa crujaosc) nu^d •
<3uud j
rkJ3L>c5 •
autfUaSoS «rk>3^c5’
C)d< dde (riodd 15—20 tfo)
tuOdo ^vTahJxj^
c3\J\ja
i4
3UOCJ<) (AJ0(XMc>n
o<xjd$d£.
irtojiSJc> Vvdt rfvJd^od
&jc>3rt 05^
a5jc>cnou tfa>ooyOTrU3i>d-
®^ve>aa :
^□u ^ackj—dFkj^nvo,
T?di$*
bJUjj d\J9 j
doosu
^oauzjou^cS •
o» dSj9duoJuo^ asuvwu^ickj’
rkjtfvnvu ouoad wonuoaoS 6da&$j<)wov^d-
cJGJq
^CSgj
suotra
iuOiSodj^no^cJatfrfork): ( avusu oflja c nu^jou ) :
'Sdu duebv/ocuoo^
soaj uous d>j0e.ni aso ac tfoadecj©
©oadoco„ oc’^iorkJ aoo<j
^json-j^e.d-
oad O5?oojan ckjatnu-sdua
otfrtorkj
dua<tfoJUe>n fltoe^rkj.-xjj n^sSono^ •
wu atfvTOerijcj u^ro.
D’JSorkj £toafcrtocto «art Avv^
ctoa?.rkj3_,c3.
'scwoo^-
\O^
rfortoum •
k?5
Wu3_,d-
WrpdOro de.^doJuo^ axjaudo<S® wobjudj#^rb
Srau© ^OMrVan <3£0j
zjou^de ^Ou^d*
d^e.^
jOoJuu^O•
oJUciaenojc)
Md
^■1
wsorwj erartA^xjavuv^iJ3u» ton rl j«ioo„ •
wf^o,
d<aa
s usiudja e.n :
o5\J?8 m OOoO305
■paF3u< ouaaoduo„ ajatjOdja
R>at f*jo?> nou3_»c3 •
a^jJ-jtro riovurivu,
douanu, eraou 'nsaaOrWu duatn *®au sonuaa., oBuacn
oonasuJ Tvoh/a nuSjd-
auvraooa «p:
Se> ^ooyno,
axjoudQ^f.«ed^rl rfuotnuOTn
8«SuOdrk)<3aj) OU45J,
auoao„ 06.
fl6u‘a<rkj<3)au avows nu-3_»t3-
«_,Outre auoos^o (ss^xju ousuua aan) oo,
•
tfareMuavuv
'DOU ^.jrl 5JM (tnu^tJ-
(Mr-Ou US 3j dustn:
aj3u_» «jOu3_»t3-
Ojav^oOuaoCu
3uo2ja r^u^a
3_jjC? *
3d
sdt sdt auuajSj ajasdti^^'J<3_»t3 •
saoo„ «B3 ejou3_»t3-
as'* rraoJu 6 jacs aa^oouandt
:AJtfoJuu3_>d •
duatri souu *aoJuu<30u:
oa.s. uoou tjwuoao.
duua a_j SUB® '^KJU.j, t5tfrtn aauo duatauoan wao 3v^aaao„
a^oou ureaO suaoJuoajsouo aorv®a3r>ou3_,d>
«yf »d OjatO:
0u<)tsou3_»d-
3dodu ®odt yanao„ suoua
uiiua^du*, uoau sdoouoa ouJua_,oau
srtrt oaadoouaouSjd-
w3 oou dun tn:
era ou rfvndoouod aau wux®
oM>tn
Kat aaou ' adodu sao* a so® os u W1u3_»d-
noaaort
6uaa -et eraooudrt ®j3a_»rkj3_,d •
*J_»rJ<S
■saw snoujjajowj-
aucbtfoJuo
30
C£jj f A*
J? O A*
aMdimiiiBi Mt-multi f. iflitu ra'ifr rtlf
tr 1 ■pi wiwjJOTM^wr*1 Jl11 ***111,1 ,lf ~‘r‘*‘ |,"^fr|flr
Ofi_»<t><r5^ :
auuajs! a^8Su^oaou3_»dSraUo a3A
3ua taoaH D4a3Jaoaoj3_,t5 •
aaodoouja a«aiuaoaoua^d
rtjoou iSodtij '«tk>o aaot® «ojja ?saa nu3_»d •
.^KidOja SjusJa^Mvjs^tJ.
oCtSiSjaouj Md^oua
cajhuoj
tjcxj;s_,d •
iSu^sJucd oarao ‘avuooi ckja^odu
sous? j ?5t^:
^vrt aOuOuSjd-
an tfuanSj 3jat.i3 wu3_»c5-
«5c> fl de.0
a^o
0?.-9ojj »urauonvj aoanoua cBuaid^jae.^ oouSjrt-
uvdoJv fSoaosja saJuoujanciOod au^djae.i
Bed 'ooacsoua ndo dtfoouu tfa^.
WJBF :
aas^oo^ ^uac.©^1
"siaoo^ 3uo?ja 0<-8 'sfd-
LxxJuaoou woBFoujanuffiuou*
sajO^dja^
?~>z5ua
oOja ^cra ooja t>oou wxsao
ao<£jae.r(00od ( ouawu o>0od( rfuartoujand d^rt d<d z5e<3
saoc»rK?r1 caioMa rkj3_,d •
woaroO ua r\j3_»0 •
Suaort rte.00 auoo Svrt aSuatOrft
aoBFoduood Su^oduoa^ eftooucAj
wa_,ooyaar> rfoau nodouua r\>-.}ou.
CAJObJJ*
odjaa soa^FDoauaaoua
aoapF, aasaoore
SoaOrt naoJu wnu^du
tsou
«nu<»unu>
oouao
ao<oS^ ^rkjn5JOo„i5® e «o®»oOoo
*aau
Juaoudoojodoja onuauOuOOU.JOJ, r_nnooujdt aottr •
r>0(.u6* wyo «x>du„
3/
o
r-odj *a D3i>jro_»o adod^aa^ norp aoso.
aodoao t8a»3rt daa^n wdoo Of. a a
&c.rt aaaaad nasuu^ jja
CSOUFiJO
:
CM 4
0<3
rk)3_,c3 •
oojaa>cJe son aauFaa^^d,
<X-9ckXjo„o3sjf. dtsa sojjao* das^n aoudtsuao^ockjarua 3S5B ®uuu«a
wOjEJu® :
aauajOoou okra a t uos adnvau<
3o$>ao„ u»aa aua aoaa a^a ®au df.ous'a., cM>rtoJuau<
kvnd 3rtou$j®vvik&u*kodt.&u-
aatf* 5tf34 SJBOU* at®OJOr32> «iOCM»
aatud oa Atrt auaaad «KJ_,aMd aauut.
rUro Bc>r»uac,c5'
Fi a® a
•
□3J<>_»0 Of.8 aaoOxJUBj •
8apoouo„
woo :/U5odjaf.n aoaatreooj■‘■? C
o
f M tlS cf/- '-<
^Lt)
Fo -V&')
c£>
-'c.^ o?>~) ~Svj3>
31
tS\M
I
\j^c5 rxJ \») >3>O b •
oj«>a uodu ssoa 8<ort sua
cftvreevu
taodoau iso# avsuj
□uorusan auSoou aaartoJ-j
<?
asa
uo^ou^ja nd<
03
ttft^oouod
053 ft
OT j
(tkuort 'cadtefu-
wo oMaiJ^rt
fta<rie.su’
c5\J<Jc> O*J
t5a (t»oO\jd rixj^._>$ ■
■v
J
_>
.
ckja^Ort cficotf craoouoJo o;o &o& a^>o
cftuahl^rt ftu^od wa^cor cftua^nu^d*
sd caO :
tfdoouoJuao.i waa^CcraA/
J^onuaon udoJu da^na ujoDoauo„ auuaubjuu t3-5rtn
y Irfdjrfuo vva®urjo) «aa tuvnw y»riij^u<
*
J
o^ojjonou^andt
tjatfadoouo„ avouO^ acM Gh3ue?ja vvdc.?yo •
au js Ou—FSa 00 *
nod yao *<rt 5tou ouj^
OOxJ o^s obc.rt
suaBua^jOo^ oJja^dt urtocu
aua oouaa M\j3_>d •
sJvjaadtftu’
ad t/vo, &®_»
■vi
<a5T Wgj5 cS
O0\J <J• 83$•
031
at flSufl Ot^o^jcSd
^uj at tssja a$ -otcMtfv 03
<ooGJu at flaua
rftaoajs.jdjdoOrt 3*0^ **?on3u< 3<du 03#d t3<J\Jc) CH) SJ^F
odxja oOrt
^t^O^dOod 33O0U rfskju^
rfjdd.j C/VjjgjO 8jaw3uu
^op'dOffi soau wouS-ad*
ovu^o:
Q'/O
at^ddoJuo,, wijSF at aauaai5u(4
rf^ra3_>ou0 Dteo s«jaoJu^<Uvju troatjijao aoao rtcoaod {6jafiu
>aiu1)O
3dc8us Msju t
cfj'dduu cAJdudu^du: 0<^oJuddnv3u<
3<x»od (sddd ^UddjjO crfttoJuo
'MdoCluOp.,
aoc* ^drt ®auw^dOoa
flooodvA^du <3u3u.
SJdOCM CAJduOu^dU
16'
aoso d&jdtrk^du*
omu^
OvJO".,y r0c33o
\J$dd
^ccsu nodnv cto
^trtwuftoouocJ JjdtfoOjdts^-
Atd 3BOUd
sjaadtsu’
3ddxjd<^:
ot^oOuddo3u3xj< rfood dutd 03
add ?^2) rfvjdw^d sddudt^
c.^
c6jc>cnu^du-
, \) oCxjpJ’jp
tforlreu®: 6rooo (Jowddd Lodoasu c63 Ot^oOjdd
o»33u< tfrtwd aft’
03tf
OOCJDd^FOJUO^ W0U 3d 0 t>t
«3joau<JdOod rkxo tfoauaou^du*
W ? T> '
R
T>y
td .
auuaojro
• O'S;®^ '•
Srtautfjaoaj, aj^., t)t3MoJ\jo„
sS?3a<r* ftiaB
mdj
skxjvurkja<auu (BSjaa au3dao„ aJ8« dOT<n 8J0«dc®'J•
a ao^o »dskj<
bo4j,dj dsfw
®^5ut)r5 3\Ju)4j
o<>A> auonusan o6dttt5t®^*
?ru su^acJd aujaojJDeQ ruroiXBrk>3_,d•
r&riOCJo S£ido„ !?^^0(aSO^r80)oOu^>J<
WoJjc) </VJUC6ock> •
5
'(,o '35>
o^.<5 -&. J
'feu
■V'
.•< c..^ fj rcCx^cIxJ
II
15C
:
ooau *a
t50 tja»£S«>vo
3U 30^ □oau (bO ®jd dud3rt Bodeau
Z<^'’
Q?
P
ivTatfck) d^sa^n aojjude.5J’
3030 S7)fpt
so^jaOA
^javvuaooj-
ajc)O cMadurt ds?dn
tscsOocs
*03Uc) 3rtckJ
-Of. ad<^odu3u< l,oou de)0 su^Odof «od
o$ dork) rkjrejja rU3_,d •
3d tAJO:
sousj <f>a a$ oaxiaJavn uo3 adoou dua3rt
ooasu ddud duo3« dd^ d3o<0 oudu dV03 wad 3drt 6b3u
.javvd<5Kj-
tJU'J'd Ou
nodnv 3030 craisaavo adoou
dudttfoouod iuBtfou 3rtoJod<tfu-
cbtrt duuaou 03 zk^Ocftj
3cUO nucscte nu^du^rf 5Jc>c5ou truduoudidua duu^aud*
'TVOOuUd j •
t^odoau M ae cR>3ddVcj ?x5oJu3u<
d3®<n &a* 000 du?) <^000304 dbo® Jrtdu OOO djc>3rt
LOOU GJDOU 500^3&' ad(
OOQJU OOufi #Ud 3^O«j0 Z3f.&0 3u0
L>odu dudtu ov3f.ou aft>e>i5<su*
"Of. OxJ^yrod^U^ Od^
30JUdO&NU^ dert n 2Jao rfjad^d suao^udtau-
03 OUDOdd ctvo duua3_y rUroOTrkj^^d •
dbfd OuJdOU
\
dSjao
srao® ^vo:
34
^rinu
yanaaj4f ®ra<J® auofla Etsoa djao saoa dotd
c5ja3vj_» DBd<5u*
*<rt sdc. adt ajaauaa_» uoad 5ca^o0
Aja e.nu3_»d •
SdAO—ajaoou (MlucxjiWJ:
uodoau duat^^oo
Jdau asaA roreo a ua o urw
asvurw?k>< Srtdviijaoaj
ajaa ®oea adoauo„ ass* acid sa^^jsVvri^gjaujaoj riotinv
<t>e.rt
sioso duoa^a soaoouoo
su^aqjo
Sjatfau AtrV.a^aoouoa
dvna Ajaaoou *trt
aujaou aa ajaaod ad iao ajaockjaeri ®jaou>j c/vcucu<jd.j
okjajrjaj a:
5OJ„
kodv> astfj
sJ5ed d<5* a0<
^oa o?5 3rto<j
eoaoJudtsu-
•sason dt>e.rt ajasjaiaooa saduoaja n-j3_,d•
(j:o ^SxVs^'h
■5A 8
y <bJ
Xj
uJ-J .jD A. j <g> rXxi
f
<04^^
^>3< SUiSjj Hon 5e> OQ ( J3^_O>J(
adnvs$u< (koau Ana) rfsra^n
a<OSO„
aaa ?5duu a <5sJd<W
«cwj< koou c5jae.NaziJ<4 a5_,rod<.8j-
csoifl^avj oanv vuv
doo
iAaofjovvtkexj-
Djoaoa x)auoouao„ «*jr>oooi„
<neo3u® tfiAod <A»_»au‘
C’^'^d
cr<>ri| rtua^p
ewraoaOe, M> ts3s3u auaadtHj-
USp ObltoT£:,§2_
3
-
38
rOfolrfa3*
l-ooj
aSvja ffiSuas asaoso^ «5<5A saooud aoci sjruart
-r »ao aBuaidjrt sjvjaflritsj- owuj euasua » «
Z
jj oo j
nvrjj^ Jiss^uaoau-
scra^f
Atrt ?5aoj* oa auaaod srf* ajad
aa r^oaJvja r\j^s_*d *
skJB^v saodud:
aanoatf
Lz»ri<t
'«ioo «6jartoojaj< saooud uoa skj{5*0rt sua^ad rkx»sanu3_,d<
,Tx ©
b <>-)
C2O
bo J-
o
.■X3
C^h
Z
*
*
□uouua a5oahju
uoou *a rfatfSodi^d
uooo osvbu dvuv«v aoao SoinXa b»wji
UOOU ?JUtS (Ajao^j
®aA rfaa^ri wdoj auuwou BacWtfjavovS doaodt rfoad
Soata aa^aoyaanoaart ;$rt<3jtfjawvd^5j.
a<,Oi adSvja ta, So4—‘fj, Soatij:
uodoao *3
L>oao ffivso dVov^vOJo tfoaJ wddu So j—
d^a<n dtaaod
daosnu a o0~3dSja
sJjjj—£,5
e.nu3_,c5 •
I
QO
iortoJta
:
SoOutJuthj
sdoJu tcaoao,,
«00 5rtB;3 3u<.c5 sc3c S«t ■SUJ®®.. uo0<5 iJortoJ0 rUa
a® rvjSjtJ •
-^A © j<
I
c-o
&
orL. ov>^V
’?>'“ '-' - •>>'<r*'
»
f
*
ad /
nd
■■■—............................................................................ __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
w5 ipe.0 : a:
LjOOkJ dbft OSrfjj
Si3o?.3 «8fc siaoj* ekratu
saOoJoou 'sade.gj*
k>y
'A lxxJu ?kra?.u ssfaoOsJdSdrl sj^jA Ovjnrt ri<5c)ac5 s3o„3?5u<
tr
)
&<03j<)o0rt rid^ su&oJuou tfxjdarie.^-
05^^ idoau
/V8
'jqcK)
natxfcuou •
?Fc) UClCKJd „ ^r\jrX)O^-
dtfocRju^d*
63J.JI 30V0,
voo
GTc)
&ud joJuo,
M^Nu^vraoau
lxs/Vj
wuA
^<^0000.
^uooAwuu^J^Vvdc®^*
1
X
cg»4^
yo^vu dg.3:
jsa^:
odu^j^ t/usodja
ocraa:
M®i,ooo„ c6«3sju tkraaa<53,
wood eouvude.^ 5f8^doouc>rk)3_>t3-
owao uod DO0 oarwu doaaa <5
OO\J
a»o rfjadud sua^uaou MfvoJuau.
»dou
®auuijojc> t^vojvao.
0X0 au ja
djaaa
:
idou L-ock; duatu auSartoJuo,,, rid*
s^_y
(
o*
tocJu &&
•'/^atiaOoa drtn uoa^j e5j»tu
tfiJB O0Ui3c3o^ «Ort dd<<
1-^
<flv>ariurt <daudu®Vvrie.9u«
£k)<
O
3u3
L^vojuao’
r
1
..urksR®*4
COM"
.uJOOl
ROLE OF TRADITIONAL MEDICINE IN PRIMARY HEALTH CARE
- ■■—f . ^1 ■■1 ■—Hm n>«l t fl— IW
~ ~I imiiib irn -n
in-
• — ■■■I - - -—JI - IMH »■■■-■■-
n—— -ij-r n - --_-i
Traditional systems of medicine are deeply rooted in the cigilization of Asian
region and India in particular has recognized systems of traditional medicine which
have continued to flourish upto modern times. Practitioners of traditional systems of
medicine in like manner have remained a part of the community they serve. Being
sensitive to the traditions,beliefes and customs of the people they exert considerable
influence within the community in relation to health and health related practices.
Recognizing this health man-powe^ potential in the delivery of primary health care
services the joint UNICEF / WHO study recommended to mobilise and train practitioners of
traditional systems of medicine for primary health care services.
Traditional medicine is the sum total of all the knowledge and practices,whether
explicable or not, used in diagnosis,prevention and elimination of physical,mental or
social imbalance and relying exculsively on practical experience and observation handed
down from generation to generation,whether verbally or in writing.2.
The traditional systems of medicine practiced in our country recognised by the
Government include the Ayurveda, Sidda,Unani,Yoga and naturopathy systems. In our
country today there are 4,50,000^3) traditional practitioners out of which,5,41,408 are
traditionally trained. This includes herbalist,bonesetters,spiritual healers and
traditional birth attendants and/another 1,08,592 institutionally qualified practitioners
in various systems of trdditional medicine.
there are
5
It is unfortunate that a large number of these practitioners are in the field but
largely working outside the National Health Service system. The manpower potential
available may be utilised for primary health care services for achieving the goal of
health for all by the year 2000.
A cornibation of traditional healing and modern medicine appears to be the most
promising and appropriate for the health problems facing the developing countries.
Ayurveda or the ’’Science of Life”contributes much in this direction as majority of the
Ayurvedic preparations are cost-effective non-toxic and can be prepared locally.
It is well known-Ct in many ailments of functional origin like consltipation
dJjjspcpbia, Indigestion and cases that have proved refractory to modern medical treatment
good results have been produced by the Indigenous system. Yoga practice and meditation,
forms the part of the indigenous system. They were once considered only as a subjective
experience. These practices have been objectively assessed and their physiological effects
and possible clinical application in many anxiety disorders are being recognised.
The practitioners of Ayurveda normally prepare the medicines needed for the patients
in their own clinics from simple decoctions to powder. The physician also advises the
patient to prepare them in their own homes, from locally available herbs. For example in
villages combination of Thulasi leaves juice,pepper powder and hone^ for cough is used
which is inexpensive,effective and also easily available in rural areas. However in
urban areas the practitioners give prescriptions for patent drugs which are available
at Chemists and Drug shops. The large scale production of Ayurvedic drugs is now undertaken
by many pharmaceutical companies like Himalaya Drug Company,Baidyanath Company and
Indian Medical Practitioners Co-operative Pharmacy and Stores Limited(IMCOPS) Madras
using modern pharmaceutical technology. Those products include patent,proprietary and
classical preparations. Every state has got its own drug standardisation centre which
supervises and maintains standard of Ayurvedic drugs. There are as many as 4500
pharmacies which produce these drugs in South - Eastern Asia, Statutory controls over
the manufacture of Ayurvedic drugs are also enforced in some countries.
Ayurvedic pharmaccptra contains 8000 recoipcs. Besides these there are large number
of receipts which have not been documented but which are used by the community in every
day practice.
in
c
Ci
ca
o
w
—
—
—
M
«•
Paper Presented by Dr.T.N.Manjunath ,Assistant Medical Officer,(ISM) CHAD Programme?, -rX,Voile:
at the workshop on ’’Towards a People-oriented Drug policy ” at St.Oohn’s Medical College,
Bangalore from 23rd to 25th November,1984.
s 2 :
PropaiaSons(Asav\,flrish^)u^uT
frmonted
(Choorna) ghaaCGhritham) Tablets,pillsCvat^dococtSnuSa)^’ 9-'1Glls(bhas"la> P™**
Departen^orChSstianXdica^Cotr^^
Pr°9rammQ of the immunity Haalth
the traditional prlctT-loners
^-ibility of incorporating
provides sorvicos for th!
!
2?, Primary Health Care. The
The CHAD
CHAD Proorammn
Programme
This st!ri!
! ! lra bloc,< Df Kaniyambadi with
a
population
of 80,ODO.
-y
being conducted in a population of 15,000.
College
is studying the
in thTp^
Availability of Ayurvedic,Allopathic i
roof is a unique feature of the CHAD healthand Accupuncturo treatment under the same
.1 programme and is a definite step towards
integration.
Ihe Qbj8ctive of tho study is to identify the
constraints
effective involvement of practitioners of traditional
mudicin which prevents the
medicine in primary health care
programme and avolve strategies for their greater involvement
---- j in promotion of
Family Planning, Maternal and Child Health(MCH) and
immunization
programmes. It also
includes their orientation,training,monitoring and
supervision and identify areas
iS Possibl°also aims to identify
’ “/Ipossible
Ill- linkage between
the practitioners of traditional systems
'
of~ medicine andX national
----------- health care system,
11 Practitioners have tbeen identified in the 15,000
population. These practitioners
--------------. The
are visited by the Assistant Medical Officer
Systems of medicine
of the CHAD Programme and their activities r~•
are supervised every week, rfuring which ho
tries to establish a (good rapport and get their participation
i in the health programmes.
Initially they iwore reluctant to share their knowledge <
------a- 2nd practices.
After
gaining the confidencec in the
th" P^9
--- rammQ through the repeated uisits of the health team
they slow., ly started sharing their knowledge and techniques. They were also afraid
that their practicesJ rmay be asked to be stopped
J or controlled.
This was overcame by
assuring- them that
- - their
--- •' ppractices which are good
c
and helping the community will be
maintained and strengthened • They were also informed
—---- 1 of the unhealthy practices like
branding,and persuaded to discontinue them.
In the early stages there was over reporting of cases hv the
FcdloZg this^ver XorSng'came'dain3/"0'1
th0 CaSe*-3*
This
It is observed from the preliminary studios that the
traditional practitioners
by virtue of their close association with the
community
plays
a key role as educator
and change agent on matters relating to health
and
family
welfare.
He,as a part of
health team,actively involves himself w5 -.h national health r •--- in
progr
tioner and as a community leader.
They
are being used
the mmes both as a practi^te
Tuberculosis,
ilanasis, RF/rhd,Malaria eradication programmes*
diarrhoeal diseases which causes high
Liy;, morbidity
,.„iLJJ.UJ.Ly and high infant r
• -■
mortality
needs
promotion of oral rehydration therapy,which would make
an impact particularly on the
The traditional practitioners I
———
\j u SQ
j and its practical application
goal of making oral rohydration therapy
in the community.
ORS packets are distributed to them repeatedly and they are
ideal oral rebydration solution in theabscence of readymade packets taught to prepare
in which they have
shown a definite improvement in the managornGBt of diarrhoeas.
x
tr.st.nt
related^rtetem^10!31 practitioners are educated on various health and health
the child"ith ’dia^h^^^asHplsn !99
lan9Ua9B- °ral -hydrXn for
orud. cauteXJt
!! bratete!
*°Oept??
enthus”
preference to the
r branding. This is really a change
brought about by their
I
S 3 5
bducation ,helped changing their attitude regarding some beliefs ishich doos not have
any basis.
The high cost of drugs and inability of many devoloping countries to purchase
such drugs have prompted several countries to look forward for local products in the
form of medicinal plants and herbal medicines that have proved to be effective,safe,
in expensive and culturally acceptable.
in this direction a herbal garden is grown in CHAD Campus as a means of home remedy
for common ailments and also encouraging
traditional practitioners to iden i y
locally available and commonly used medicinal plants and herbs and.make usej of
of them
them in
in
Mahila
their treatment. The community is being educated regarding herbs in the M
^ila Mandal
andal
(Women's Group) as a means of home remedy to make people become more self reliant and
make herbal medicine as people’s medicine.
A few low-cost effoctive remedies taught at Mahala Mandal(Womens Club) meeting
and used by the community.
boiling water helps much reliving cold.
1 • For cold inhalations of eucalyptus oil in
or fumes of turmeric powder.
2. Pomergranate skin dry powder in buttermilk helps in certain cases in reliving
Dysontry.
3. Decoction of oman seeds helps in reliving tummey ache in case of idigestion*
4. For fresh cuts and wounds fresh ginger paste with Jaggery helps much in healing
formation.
and stops •
pus'
5. Scabies paste of margosa leaves mixed with turmeric helps much.
the site of the sting and refer
6. For scorpion stings rubbing a piece of onion on
to hospital.
7. For intestinal worms seeds of papaya works effectively.
8. Clove oil application for tooth ache.
9. For certain diabetic cases in the community bitter gourd has helped much in
bringing down blood sugar level.
Referencess
1.
Primary Health Care? Roport of the International Conforonco of on Primary
Health Cars, WHO Genova Health for all series No.1,1978
2.
Promotion and development of Traditional medicine9WH0 Geneva Technical
reports series 1978,
3.
Gunaratna V.T.H.,Voyage towards health, New Delhi, Me Grawhill,1930.
Gaa.
tar.
p
i
a.
PM -(O
Approach paper on Traditional Medicjne
f
“Traditional Medicine is the sum total of all the knowledge
^0^ and practices, whether explicable or not, used in diagnosis
prevention and elimination of physical, mental or social
imbalance and relying exclusively on practicial experience and
observation handed down from generation to generation whether
verbally or in writing".(WHO TRS-22) .
Traditional*. Medicine might also be considered as a
solid <amalgamation of dynamic medical know-how an<
ancestral experience.
I
While there exists a number of traditional systems of
medicine as well, as-• traditional practices in India and all over
the world, for practical purposes a few of global importance
depending on their long experience, authenticity as also
current applicability and acceptability by masses are identified.
Traditional systems of Medicine and practices that are
h recognised by Government of India are (1) Ayurveda, (2) bidoha,
(3) Unani, (4) Yoga, (5) Homeopathy. The traditional
Apractic s are (1) Acumpuncture, (2) Naturopathy (3) Folk Medicine
and Tribal Medicine (4) Herbal Medicine.
The global importance of traditional medicine and practices
has now been recognised and some of the practices have become
an integral part of the social culture, particularly in
South East Asia. Like China, India and Vietnam.
Promotion of 'Oaditional Medicine is the need of the cay.
Why herruse.of The increasing cost of Modern Medical Care
and growing adverse' effects (toxic effects) of synthetic drxigs,
non-availability to the- masses in remote^ruial areas,
. a.;, oppoocd—to traditional Medicine which is affordable I /
masses and less or no side effects aqd still easily available
to the rural masses in remote areasA promotion can be done
through following approaches by various levels of health
' professionals. Any organization wants to start a
procramme on traditional medicine the first things is to take
a stock of traditional healers, categories and practices in
a specified geographic area. Then after categorisation, the
individual practices can be studied and validated through
logical (sci.^.tific) knowledge. From this (1) we know the
I
I
existing human health resources/pereonnel available in
traditional medicine (2) we also come to know about various
beneficial and harmful traditional health practices if any
(3) based on this information people can be educat’d about
beneficial effects of traditional medicine- after validation.
Q
2
Once the healers are identified they should be suitably
trained to upgrade their existing knowledge and. also of the
community.
The other approach can be to take stock of locally available
medicinal floraz and its use Isxia-H-y with the help of local
healers and documentation (i) Then its validation from the
available scientific knowledge, toxicity and clinical studies
(ii) study of the local market and potential for medicinal plants
(iii) totake up cultivation of such medicinal plants and also
renewal or extinct species which are needed for local cumsumption
with the help of Agronomists, Ethnobotanists and physicians (iv) To
popularise few common medicinal plants as home remedies after
studying the local practices with logical reasoning (v) to popularise
a few kitchen condiments as popular home remedies fox common
ailments.
Cornuunity heal th care institutions
u
i A ui.p i..
k.
,
.
,
1. To take up tra^-ining programme of traditional healers
2. To conduct workshops fox' various levels of health personnel
on traditional medicine
■
3. Demonstration plots on various medicinal plants for
identification and training.
Research Institutions on
1. To take up basic literary research on all the available
literatures and manuscripts on TSM ’J. C
2. To take up pharmacological tests and efficacy stu- ies of
medicincal plants
3. ^Clinical studies of tjq e tested home remedies
4. Clinical trials of medicinal plants
Planners
l.*To take policy decisions on promotion and development of
TSM in general and preservation of medicinal flora and
manuscripts in particular
2. Unoer the social forestry programme inclusion of plants of
food, fodder.and medicinal value in daily use
3. To shorten the deviation of public education and dilution
of resources there is a need for education revolution to
introduce and integrate various aspects of TSM in educational
curricula and specially in school health programmes and training
programmes of various levels of he..1th professionals.
. . .3
i'
3
4. To
j
establish research
lnstitutions for
d<3vanced
research in TSM
fur ther
failed.
where modern
medicines
I
1
^foifflation
■
I!
I
Collection,
collation
and disseminati
an important area.
Hence there is an on is dually
inforrnation
on various institutions urgent need to
col 1ect
national level/
at -rH tarnation a 7 i
regional- level,
voluntary o,m„
1''Velgovernment institutions >
o
rganizstion
'"Orking
of health care
and
traditional
Practices so
°f knowledge
systenis
there
and
can be 3 free
mutual utiiisati
I’his infori
exchanoe
on of
■mation need to be
expertise WiH b&
easy.
Organisati ons
disseminated
working in
to various
1rass roots in
different
Network inc,
caP^citi
» vaaX
y.““Xln9 is equal,y M
levcXT
vej- and wilnf
th «^«ure
lmPOrtant area wnere info
various non
r
wh ere
global,
-government oro^dtionai
government c
Organisatjons workim
Or<^
3^nisatL
anisationa
related issue
' ^k.ng on health
,
health and
and h.
]
—“s (inclusive of
traditional
alth
to be collected
onal
for e±fecti ve network
of knowledge.
®*Pertise and dissemination^0
Dr T N
Manjun<ath
e‘s EduCatiOn f
Of . Vol
Health Action
A Divisi
16-2.1989.
nt’ry Health flssMt,tlo„ of
pOOpl
exc} iai )qe
- IO
BACKGROUND PAPER PREPARED FOR
FEVORD-K ANNUAL GENERAL BODY
MEETING AT «■■■■* BELGAUM
17-18 MAY ‘1990
by
Shirdi Prasad Tekur
Community Health Cell
47/1 St Mark’s Road
Bangalore 560001
r . ...i,T1in—l I !■■■■■
Ill
»»
CONTENTS
r?
WHAT IS TRADITIONAL MEDICINE?
__ „
SALIENT FEATURES
OF health care SYSTEM PREVALENT
IN INDIA (non--allopathic)
...
aQ
b.
c.
d.
Ayurveda
Unani-T ibb
Siddha
Yoga
e. Nature cure
f. Tibetan Medicine
g. Homoeopathy t
h, ficupuncture/Acupressure
WHY TRADITIONAL MEDICINE
a.
b.
c.
d.
e.
Relevance
Cost
Accessibility
Holistic Approach
Under-utilized resource
WHAT CAN WE DO ABOUT IT?
References
'•v ’
TRADITIONAL MEDICINE
WHAT IS TRADITIONAL MEDlCINEs
The history of medicine is as old as t. e history of ™an.
Each culture has catered for its pattern of illness with
There are
from people to
people as their traditions and culture differ.
The World Health Organisation defines Traditional Medicine
as "the sum total of all the knowledge and practices,
whether explicable or not, used in diagnosis, P-T^^ion
and elimination of physical, mental or social ^balance and
relying exclusively on practical experience and observation
handed down from generation to generation, whether verbally
or in writing”o
Traditional Medicine does not define a unified homogenous
practice. Formalised medical systems
as aiso
informal folk practices. The Government of India officially
recognises formalised systems i^e/^rveda, Giddha, Unani,
Yoga, Naturopathy and Homoeopatny m addition
P
Y
Tibetan Medicine is gaining popularity in areas of
country contiguous with Tibet and also m and around.the
Tibetan Refugee settlements here. Accupuncture an
Acupressure are being increasingly
Other
and' are popular in the rural areas of the North-East. Oth
non-formalised systems like Tribal Medical Practices ar
being documented and studied in the tribal areas.
SALIENT FEATURES OF HEALTH CARE SYSTEl^^EVALEN^IjLJNpiA
"
' ~
(Non Allopathic)
a) AyURVEDAs ’Ayurveda’ means, ‘’science of life . This
system traces its origin to ’Rig Vedic times, over 3000
veers ago. It deals elaborately with measures for a healthy
-- 5 to combat
life, and has a wide-range of therapeutic measures
framework evolved
illness. It has an elaborate \theoretical
----Tfom ^ubSt^htial^dbserv^lLional^ data^, The Ayurvedic concept
lo 1what the W.H.O. has evolved as a
of health is similar to
,
definition of health, viz., physical, mental, social and
spiritual well being and notf just the- absence of disease or
infirmity. This system is prevalent all over India.
b) UNANI-TIBB; derives from Greco-Arab
In^th^fourTnd'iA around the eleventh century. It is baseo. on rne j-uu
« “Zy cf Hippocrates, who Is considered the father
Of modern medicine. Avicenna, one of its greatest schol
flpfines Tibb as, "the science with which we leorn of -ne
v!rtoul states of the body in health and when not in health,
meS by which health is likely to be lost and when
by which health is
JSstj'is likely
be restored".
likely to
to be
restored". It is used more m
Northern TnH-ia
is predominant.
India in areas where Islam
II
1'. It has its roots
c) SIDDHAs Siddha means ’’sure and true
originated,
from the
' ■
and is said to have
in ---Tamil- culture
and
diagnostic
methods
are
sage Agasthiar. Its philosophy a...
in therapeutics. It
similar to Ayurveda, with differences
in Tamil and is more prevalent in the
fl B S L) Q S I”1 recorded
1- — —• —
Tamil-speaking areas of our country.
. .2
d) YOGA: Yoga is one of the six orthodox systems of Indian
Philosophy aiming at liberating the soul through perfection.
Yoga strives for full and integrated development of an
individual. It can be utilized as a safe and effective
method for good health, through mastery of the mind, Along
with Ayurveda, it dates back to the Rig Vedic times.
NATURE CURES Naturopathy is based on the art of living
according to the principles of nature.. Disease is
considered as the body’s effort to cleanse itself of
impurities brought about by faulty.living. Nature s cure
utilizes air, water, earth and sun-rays abundantly available
in Nature for cure. It stresses prevention of disease and
proper diet, exercise and rest to maintain health.
Mahatma Gandhi was a great believer in naturopathy.
f) TIBETAN MEDICINE; Tibetan medicine has been in existence
for over 2500 years and is said to have originated from the
teachings of Sakyamuni Buddha. It had interactions with
Ayurveda, Greek medicine, Arab medicine and has incorporated
aspects of all these systems into ito It believes that all
suffering is rooted in ignorance of existence, which gives
rise to poisons of the mind, manifesting as disease.
Tibetan medicine has a well developed diagnostic and
therapeutic system, utilizing herbs, minerals, metals,
salts, precious and semi-precious stones, as well as
astrology.
g) HOMOEOPATHY; Homoeopathy began in the 18th.century with
Samuel Hahnemann, a German doctor who based his therapies
on the "Law of similars’5 and'1’’minimal doses" It considers
a person's mental, physical and environmental situation
as a whole. India has the largest manpower of Hornoeo^pathic physicians in the world.
h) ACUPUNCTURE / ACUPRESSUREs is the traditional Chinese
system of medicine dating back to over 35OC years. It is
based on the concept of energy in the body which circulates
in meridians. Disease manifests when there is imbalance in
this energy and its flow. It is used as complementary and
supplimentary to herbal, dietary, physiotherapy and other
measures. It is well integrated with other systems of
medicine in China, and is shown as an example of
"Integration".
WHY TRADITIONAL MEDICINE?
"If human history were telescoped into a day, modern
medicine would put in an appearance only in the last few
seconds - Diana Melrose in "Bitter Pills".,
Relevance; Allopathic medicine was introduced into our
country by the British rulers, mainly for themselves.
Having state support and with suppression of the indigenous
systems prevalent, it has become the dominant system both
in the Governmental and Non-governmental efforts at health
care. It is Western in origin and with continuing strong
.3
A
3
links with advanced research establish’-'ents in the West.
Consequently/ “western models-’’ tend to be transplanted for
solution of local health problems without.success.
Traditional systems of medicine have survived through
history as a natural curative resource base which is however
largely unutilizedo
India/ which takes major' responsibility for providing of
Allopathic health services finds it difficult to meet these
rising costs. It is becoming inaccessible to the people
who really need it - the poor.
c) Accessibility; According to ’World Drug Situation’, less
than 25% of ‘ the Indian population has access to Allopathic
drugs.
Traditional medicine is used by a significant number of
people as the only health resource available/ or as a
substitute for or a complement to allopathic services.
- 3 are
d) Holistic approach;.Traditional medicine practices
with the totality of
believed?"to be holistic and <concerned
------Illness
is
seen
not only
human functions in society, -----,
^,,4. in
oi <=r>
terms of biochemical and supernatural disharmony/ but ^l
as a breakdown
in the
patient
with
others,
breakdown in
the interaction
-- ---- of
-- the
.
,I
•_, The psychological/
within his social environment.
psychosomatic value of traditional medicne is widely
recognised. The traditional practitioner often depenos more
on his ability to mobilize the patient's hopes, restore his
morale, and gain his re-acceptance by his group, than on
his pharmacoepocia .
’
e) Under-utilized resource/.
The former Birectqp Genernf^o-f W/HrO. Dr..HiMahler•-•’said/
”Fo^ far too long, traditional systems of medicine and
’modern* medicine have gone their separate ways in mutu 1
antipathy. Yet are not their goaSs identical.. to improve
the health of mankind and thereby 'the quality of life
Only the blinkered mind would assume that each has nothing
to learn from the other".
The National Health Policy statement of 1989 clearly states
that, "the country has a large stock of health manpower
comprising of private practitioners in various systems,
for example, Ayurveda, Unani, Siddh^, Homoeopathy, Yoga,
Naturopathy, etc. This resource has not so far been
adequately utilized.
. .4
4
The two tables below give an idea of the Health resources in
our country and State.
TABLE Is INDIA
Naturo
pathy
Allo
pathy
1,183
43
3,30,755
28,711
11,581
108
3,30,755
1,469
101
106
6
10
9,831
15,913
1,267
885 40
190
5,85,889
12,109
871
316
4
43
1,18,806
100
18
2 34
3
12^
Ayurveda
Unani
1,08,085
7,912
2,72,800
3. Nooof Hospitals
4. Total beds
provided
Siddha Yoga
l.NOoOf Institu
tionally
qualified
Practitioners.
2. Total NOoOf
registered
practitioners
5. No.of Dispensa
ries .
6. No.of Colleges/
Institutions
(Sources Health Information India-1988)
TABLE Ils KARNATAKA
1. No,of Colleges
2. No«, of Hospitals
Ayurveda
Unani
Homoeopathy
Naturo
pathy
3
1
1
1
4
2
1
12
7 dist.
level,
3 teaching
Siddha
Yoga
1 wing VJings
in IISM at 3
B’lore Hosp.
B'lore
Mysore
Bella-
ry
3.No.of Dispensa
ries
360
32
10
5
(Source.Status Report 1988-89, Department of Health & Family
Welfare, Karnataka Government)
Traditional medical systems are now widely adopted through
government policy and have been institutionalised at
national and State levels, in universities and other
training centres, and in the utilization of all types of
personnel in health care delivery systems in the rural
areas, and in drug manufacturing units.
. .5
5
Traditional Birth Attendants (TBAs) or Traditional
midwives have been well recognised as a specific group
within the traditional sector, as they deliver a high
proportion of children and focus on maternal and child
health in their activities.
The understanding of and contact with Traditional medical
practices will help us to be constructively critical of the
prevailing health services and may be useful in building
up a more comprehensive approach to health.
WHAT CAN WE DC ABOUT IT?
All healing practices are legitimated by people use them/
by their efforts and capabilities to cure ills and improve
the public’s health.
It does not mean accepting any practice uncritically. But
it does imply a recognition that there are values and be
benefits, as well as shortcomings and dangers, in both
allopathic and traditional practices.
People use all the systems for their various illnesses and
"health problems", using their own mechanisms to determine
choice. They include experience, hearsay evidence, tradition,
peer-group pressure, medical advertising, and sometimes
informed opinion.
For available Traditional Medicine to be useful to people,
we need to know;
1. What human and material resources in Traditional Medicine
are available in our areas of work.
2. How we could critically look at its usefulness in health
care.
3. How could this knowledge be recorded/utilized/disseminated/validated for common good, and
4. How it could be integrated into the prevailing health
care system.
Let us make a beginning towards Health.
REFERENCESsL
1. W.H.O. Technical Report Series No.622
-The Promotion & Development of Traditional Medicine.
2. E.P.C. Publication No.18 - Traditional Medicine and
Primary Health Care.
..6
J
6.
3. Moving Technology - June 1989
of the
4. Proceedings third International Conference on
Traditional Asian Medicine.
5. m.f.c. bulletin Ho.155/156
September/October 1989.
60 Seventh Five Year Plan - Government of India.
□
7. Status Report 1988-89-, Department of Health and
Family Welfare - Government of Karnataka.
-xxxxxxxxxxxxxxxxxx-
I.-. ■
!
h
HOME HERBAL GARDEN
Grow & Use
5^?
Medicinal Plants
for Primary Health Care
r-
-
j
-
4v. ‘
L2.
Pl Ifc
-
-
——
*—
“
X-
I
'*■
' ■
mi:
d
I
—-
Executive
Institution
Parmparagat Vanoushadhi Prashiksliit Vaidh Sangh
Ward No.: 04, Kasturba Nagar, Bilaspur (C.G.)
Mobile No.: 9685441912, 738708414
Email: c.g.thabsp@gmail.com
"Adoption of Medicinal Plants'
"So that when they grow up
..... They will take care of you”
Organization Chhattisgarh State Medicinal Plants Board, Raipur
I
Institution
Medical College Road, Raipur, Phone & Fax : 0771-2522056
Email- cyvaiiuushadhiboard@yahOO co.m, Websiteiwww. cgvanoushadhi.gov.in
Follow Us on : T CG MED. PLANTS BOARD @Herbal36garh / f Chhattisgarh State Medicinal Plants Board
Gudhal
Hibiscus rosa-sinensis
Part Used : Flower
It is a ornamental perineal shrub.
Use:
The traditional primary health care system in India is embodied in a 'people's health
culture'. This culture is based on very effective and sound, region-specific health practices
involving about 8000 species of plants across the country. Whereas most of the medicinal
plants used in these local health cultures were freely available in the vicinity of the
households, some of these were also raised and maintained in the home gardens. This
'people's health culture' provided an easy and cost effective succor to day-to-day primary
health care problems of the local communities over centuries on one hand, also contin^kto
develop and evolve alongside the codified Indian Systems of Medicine like Ayurveda,
Siddha, Unani and Gso-rigpa on the other hand.
Tribal groups and traditional healers of Chhattisgarh state are rich in indigenous
knowledge of medicinal plants. The tribes of Chhattisgarh believe that they acquired the
knowledge of medicinal properties of various plants from their deity, transmitted in
different ways. Some of them claim that they received this knowledge when in a trance
under the visitation of a deity upon them. Since this knowledge is largely gained from divine
sources, they are averse to charging a fee for treatment. They believe that the medicine may
lose its potency, and the treatment may fail if they levy a fee for a god-sent gift. In recent
times though, with changed thinking, they have begun to view it as a means of livelihood,
and so sometimes do charge an affordable fee, paid by the patient in cash or in kind.
Through the ages, medicinal plants have been used for a variety of purposes and
home grown medicinal plants offer a high quality, low cost, easily accessible and safe
primary health care option. Today, urban people are losing touch with nature and this
wealth. In this crucial time, the concept of Home Herbal Garden (HHG) is a ray of hop^br
developing interest of people in herbs or primary health care. As we know that by nSre,
human beings give importance to their belongings. So, if a person is planting a plant in his
own garden than, it will be important for him/her. Moreover the concept itself is very strong
as when the diseases comes, one can get the remedy in his/her own home with no extra cost.
The plants, promoted under the Home Herbal Garden (HHG) scheme, are selected with
great care and, in consultation with Traditional Healers. Those plants are easy to maintain,
require minimum space, have medicinal value, and are safe and effective; besides having
aesthetic value as well. With a view to attract the attention ofnew generation, towards herbal
culture, C.G. State Medicinal plants Board, Raipur is distributing basket of selected
medicinal plants, in the state.
❖ Nourishment of Hair - Grind fresh flowers to
make paste. Apply to the head, 15-20 minutes
before taking head bath on a regular basis.
❖ White discharge : Grind 4 fresh flowers to make
paste. Take the paste on empty stomach in the
morning followed by warm milk for 7 days.
' - J: ■
Brahmi
Bacopa monnieri
Part Used : Whole Plant
-
rfc,
It is a spreading fleshy herb.
Use:
£>3
❖ Hair Care - Brahmi & sesame oil. Boil the
mixture, filter the oil and apply to the hair daily.
❖ Mental Tonics - Prepare milk decoction of the
whole shoots. Take 1 cup of the decoction per
r
Giloe
r
Tinospora cordifolia
Part Used : Stem
It is a large spreading climber leaves are dark
green, heart shaped.
Use:
"I'i
❖ Acidity - Crush fresh shoot to extract juice
take 1 tsp. ofthejuice with honey.
❖ Liver tonics - Prepare Giloe decoction of the
shoots take 1 cup of the decoction per day.
Satawar
Asparagus racemosus
Part Used : Bulb
Adusa
A spiny climbing plant with leaf like rudimentary
branchlets arranged in whorls.
Use:
❖ Acidity - Crush fresh tubers to extract juice take
this juice with sugar in the morning and evening.
❖ Purifying Breast Milk - Take fresh tubers peel the
skin and wash. Crush the tubers and extract the
juice. Warm the juice slightly. Take 1 cup of the
juice with 1 tsp. of sugar in the morning.
Stevia
A branched, evergreen shrub with broad leaves
tapering at both ends.
*-v '
Use:
❖ Excessive menstruation - Crush Adusa leaves
to extract juice take fresh juice with honey.
❖ Dry Cough/Asthama/Cord - Take 2-3
throughly washed tender Adusaa leaves, boil
these in 1 cup of water and reduce it to half.
Take the fresh diction.
Aloevera
Stevia rebaudiana
Part Used: Leaf
Adhatoda vasica
Part Used : Leaf, Root
Aloe barbadensis
Part Used : Leaf
It is a annual herb.
It is a cactus like perineal plant with a stout stem
Use:
Use:
❖ Diabetes - Dry the leaves in shade and pound to
make powder. Take 3 gm of powder with water
after food.
❖ Cuts, Wounds & Bums - Aloevera slit open a
leaf and scoop out its pulp apply this pulp over
wounded port twice daily till the wound heals.
❖ Stevia extract has been in use to reduce weight.
Swelling in the legs and as a tonic to treat
Tulsi
13
❖ Eye burning sensation and redness use
Ocimum sa^tum
Part Used: Leaf
It is an evergreen erect herb having greenish to
purplish appearance.
Use:
❖ Conjunctivitis - Take 5-7 fresh leaves and extract
juice mix the juice with 3 drops of honey. Apply 23 drops ofthis mixture in both the eyes as bed time.
❖ Wet cough Use- extractjuice of 10-20 fresh Tulsi
leaves mix this juice with Itsp. of honey and take
twice daily for 3 days.
Withania somnifera
Ashwagandha Part
Used : Leaf, Root
It is an erect and branched shrub.
Use:
❖ Chronic headache - Use Ashwagandha root to
make powder, take 1 tsp of this powder with
1/2 cup of warm milk.
❖ General immunity - Use Ashwagandha root
decoction, take 1/2 cup of the decoction twice
daily.
sylvestre
Gudmar PartGymnema
Used : Leaf, Roots
Andrographis paniculata
Kalmegh
Part Used : Whole Plant
It is a woody, large, branched, climber with milky latex.
Use:
❖ Fever : Take some fresh Gudmar leaves and wash.
Mix one part of leaves with four parts of water and
boil to reduce. Take 1ml. of decoction twice a day.
❖ Diabtes : Dry the Gudmar leaves in shade and
pound to make powder. Take 3-6 gm of the powder
with warm water after food.
It is a small erect branched annual herb.
Use:
❖ Fever - Boil 30 gm fresh shoots in 1 liter of
water until it is reduced to 120 ml. take this
decoction in 2 equal doses twice a day on
1
Shankhpushpi Convolvulus pluricaulis
Part Used : Whole Plant
It is a creeping herb.
Lawsonia inermis ’
g Mehandi Part Used : Fruit,
Leaf, Bark,
Seed
It is a large shrub with dense angular branches
Use:
❖ Mental tonic - Crush the whole shoots and
prepare decoction take 1/2 cup of decoction at
bedtime.
❖ Hair care - Mix equal quantities of plant juice of
Shankapushpi and sesame oil. Boil the mixture
and apply to the hair daily.
Use:
❖ Burning sensation of feel: Crush fresh leaves
to extract juice, Apply the juice all over the feet
and soles in the morning.
❖ Fungal infections - Grind fresh Mehandi leaves
to make paste, Apply this paste on affected
areas in the morning and evening.
!
T ■
A*
■k. IF
Mandukparni
Centella as^^ca
forskohlii
Patharchur PartColeus
Used: Leaf, Roots
Part Used : Whole Plant
It is a creeping herb with kidney shaped leaves.
Use:
❖ Mental tonics - Crush the whole shoots to extract
juice take 1ml of fresh juice at bed time.
❖ Fever - Make decoction of 30 gm each of
Madukpami and tulsi leaves in 250 ML of water
and reduce it to half. Mix a pinch of black pepper fl
in 1 /2 cup of the decoction and take thrice daily. (
It is an evergreen short shrubby plant.
f•
Ir
Use:
❖ Wet cough - Mix 1 of Patharchur leafjuice and
1 -4 of sugar and take 2-3 time a day for 3 days.
❖ Headache -Mix 1 of Patharchur leafjuice with
Not viewed