TRADITIONAL AND ALTERNATIVE MEDICINE 2.pptx

TRADITIONAL AND
ALTERNATIVE MEDICINE
BY
JOSEPH SHAHADU ISSIFU (MPHIL., BSC., DIP.)

TRADITIONAL AND ALTERNATIVE
MEDICINE
•Why study T&AM ?

COURSE OBJECTIVES
• Describe the framework on traditional medicine practice
globally and in Ghana
• Explain the place of traditional and alternative medicine in
health seeking behavior.
• Describe the basics in herbal medicine pharmacology
• Counsel clients on making informed choices from available
treatment alternatives

Traditional & Alternative Medicine
Defined
• The World Health Organization (WHO) defines traditional
medicine as "the sum total of the knowledge, skills, and
practices based on the theories, beliefs, and experiences
indigenous to different cultures, whether explicable or not, used
in the maintenance of health as well as in the prevention,
diagnosis, improvement or treatment of physical and mental
illness".
• Alternative medicine is a term that describes medical
treatments that are used instead of traditional
(mainstream) therapies.

ORIGINS OF TRADITIONAL AND
• Traditional Medicine ( 3 most popular)
African Tradition Medicine
Indian Traditional Medicine (Ayurvedic Medicine)
Chinese Traditional Medicine

ORIGINS OF TRADITIONAL AND
• Other Alternative Medicine
Massage
Rolfing
Acupuncture
Acupressure
Qigong/Taiichi

Ayurveda
• Developed in India about 5,000 years
ago
• Holistic approach to health mind, body
and soul
• Person space + air + fire + water +
earth = doshas

Ayurveda
• Doshas imbalance illness

Ayurveda Treatment
• Herbs
• Oils
• Alcohol
• Metals
• Diet
• Exercise
• Yoga
• Meditation

Ayurveda treatment (Back pain)

Traditional Chinese Medicine
• Based on more than 2500
years of Chinese medical
practice
Involve the use of;
Herbs
Dietary therapy
Acupuncture
 Massage
Exercise (qigong)

Traditional Chinese Medicine (Yin and Yang)

Traditional Chinese Medicine
• Lack or abundance of Yin and Yang characterizes
symptoms of disease
• Treatment/drugs identified to reinforce Yin and Yang

Traditional Chinese Medicine Diagnostics
• Inspection
• Auscultation
• Olfaction
• Palpation
• enquiry

Medicinal Raw Material used in TCM

Medicinal Raw Materials used in TCM

Homeopathy
• Created in 1796 by Samuel Hahnemann
• Based on like cure like doctrine
• Underlying cause of disease termed as
miasms
• Homeopathic preparations used to address
disease conditions
• Preparations diluted

Homeopathic Diagnostics
• Homeopath will ask a number of questions about,
 mental,
 emotional, and
 physical health
• Physical Examination

What Conditions Does Homeopathy
Treat?
It’s used for a wide variety of health issues, including some chronic
illnesses:
• Allergies
• Migraines
• Depression
• Chronic fatigue syndrome
• Rheumatoid arthritis
• Irritable bowel syndrome
• Premenstrual syndrome
• It can also be used for minor issues like bruises, scrapes, toothaches,
headaches, nausea, coughs, and colds.

Naturopathy
• Roots in 19 century natural
cure movement in Europe
• Believes in natural healing
• No drug use
• No Surgery
• No Immunization

Naturopathy Diagnostics
• Interview
 Life style
 Medical History
 Emotion tone
• Physical Examination

Naturopathy Treatment Modalities
• Hygiene
• Diet/Nutrition
• Lifestyle changes
• Exercise
• Massage
• Hydrotherapy
• Herbalism
• Homeopathy
• Acupuncture
• Enema

Chiropractic Medicine
• Founded in the 1895 by Daniel David
Palmer.
• Origin lies on folk medicine of bone
setting.
• Well established in USA, Canada and
Australia.
• Overlaps other manual therapies

Philosophical Perspective
• Holism
• Reductionism (Vertebral subluxation)
• Innate Intelligence (Homeostasis)

Disease Diagnosis
 History
 Physical assessment
Observational and tactile assessment
Orthopedic and neurological evaluation
 Skeletal imaging

Management Modalities
• Spinal Manipulation
• Manual therapies (joints and soft tissues)
• Rehabilitative exercises
• Health promotion
• Life style advise
• Electrical modalities (TENS)
• Complementary procedures

Osteopathic Medicine
• .
• A branch of medicine
• Founded in 1800s by Andrew Taylor
Still
• Holistic approach to health
• Practiced in United States and other
countries in Europe and Asia
• Use conventional methods in the
treatment and diagnosis of diseases

Philosophy/Principles
• The body is a unit of mind, body and spirit.
• The body is capable of self-regulation, self healing, and health
maintenance.
• Structure and Function are reciprocally interrelated.

Diagnosis & Treatment
• Conventional methods
 Available technology in diagnosis and treatment
• Osteopathic Manipulative Treatment
• Health promotion and disease prevention

Acupuncture
• Acupuncture is a form of
treatment that involves
inserting very thin needles
through a person's skin at
specific points on the body, to
various depths.

Acupuncture
How Does it Work?
• Traditional Chinese medicine explains that health is the result of a
harmonious balance of the complementary extremes of "yin" and
"yang" of the life force known as "qi,“. Illness is said to be the
consequence of an imbalance of the forces.
• Qi is said to flow through meridians, or pathways, in the human
body.
• These meridiens and energy flows are accessible through 350
acupuncture points in the body.
• Inserting needles into these points with appropriate combinations is
said to bring the energy flow back into proper balance.

Acupuncture
Uses
Acupuncture has been proven to help in cases of:
• low back pain
• neck pain
• osteoarthritis
• knee pain
• headache and migraine

Acupuncture
Uses
In 2003, the World Health Organization (WHO) listed a
number of conditions in which they say acupuncture has
been proven effective. These include:
• high and low blood pressure
• chemotherapy-induced nausea and vomiting
• some gastric conditions, including peptic ulcer
• painful periods

Other uses proven according to WHO (2003) are:
• dysentery
• allergic rhinitis
• facial pain
• morning sickness
• rheumatoid arthritis
• sprains
• tennis elbow
• sciatica
• dental pain
• reducing the risk of
stroke
• inducing labor

Other conditions for which the WHO say that acupuncture
may help but more evidence is needed include:
• fibromyalgia
• neuralgia
• post-operative
convalescence
• substance, tobacco and
alcohol dependence
• spine pain
• stiff neck
• vascular dementia
• whooping cough, or
pertussis
• Tourette syndrome

Acupuncture
Benefits
• Performed correctly, it is safe.
• There are very few side effects.
• It can be effectively combined with other treatments.
• It can control some types of pain.
• It may help patients for whom pain medications are not
suitable.

Acupuncture
Risks
• It is dangerous if a patient has a bleeding disorder or takes blood
thinners.
• Bleeding, bruising, and soreness may occur at the insertion sites.
• Unsterilized needles may infect the patient.
• In rare cases, a needle may break and damage an internal organ.
• When inserted deeply into the chest or upper back, there is a risk
of collapsed lung, but this is very rare.

Acupressure
• Acupressure is one of a number of
Asian bodywork therapies (ABT)
with roots in traditional Chinese
medicine (TCM).
• Used for thousands of years in
China, acupressure applies the
same principles as acupuncture but
without needles to promote
relaxation and wellness and to treat
disease.

Acupressure
Uses
• Pain (Headache, Arthritis etc)
• Nausea and Vomiting (chemotherapy,
surgery/spinal anesthesia)
• Reduces stress(depression and anxiety)
• Fatigue
• Lessen symptoms of cancer (unconfirmed by
research)

Acupressure
Risk
• Treatment is in the area of a cancerous tumor or if the
cancer has spread to bones
• Patients with rheumatoid arthritis, a spinal injury, or a bone
disease that could be made worse by physical
manipulation
• Varicose veins
• During pregnancy (because certain points may induce
contractions)

Qigong
• Qigong (Chi-Kung) is the study and practice of
cultivating vital life-force through various techniques,
including:
• Breathing techniques
• Postures
• Meditations
• Guided imagery

Types of Qigong
There are many forms and styles of Qigong, but they
all fit into one of three main categories:
• Medical Qigong to heal self and others
• Martial Qigong for physical prowess
• Spiritual Qigong for enlightenment

Medical Qigong
Qigong practitioners believe that those who have the ability
to control Qi can emit Qi to heal others. This can be done in
many ways depending on the healer:
• Qigong massage
• Tool manipulation
• Item empowerment
• Qi emission
• Distance healing

Benefits of Qigong
• Loosens/strengthens
muscles
• Prevent muscle spasms
• Improve posture
• Improve flexibility
• Increases balance
• Builds bone density
• Prevent joint injury
• Strengthens ligaments
• Strengthen organs
• Strengthen nerves
• Destroys free radicals
• Increase injury recovery
• Improve Circulation
• Prevent muscle spasms
• Reduce pain
• Lower hear rate
• Normalizes EKG

Benefits of Qigong cont’d
• Lower BP
• Decrease Stroke risk
• Regulate respiration
• Improves Asthma
• Relieves bronchitis
• Build immune system
• Relieve Migraine
• Improve skin
• Improves memory
• Aides digestion
• Improves Kidney Function
• Decreases stress
• Balance emotions

African Traditional Medicine
• Indigenous herbalism and African Spirituality
• Diagnosis usually through spiritual means (divination)
• Treatment involves herbs, dieting, massage, surgery,
spirituality/magic etc.
• Practitioners (diviners, midwives, herbalist etc)

Traditional African Religion as Bases
for African Traditional Medicine
• What is Traditional African Religion?
• Why is the religion of Africa described as “Traditional”?

Salient Features of African Traditional
Religion
• A supreme Being(God)or creator, sometimes above the
other gods, sometimes first among equals
• The chief divinities, generally non-human spirits, often
associated with natural forces.
• The cult of human but divinized ancestors of the clan.
• The charms and amulets, which some have called
‘fetishes’ or ‘juju’

RELIGION AND HEALTH
• The theory of gods
• The Supreme Being and punishment
• Offences against ancestors and deities
• Disturbance of forces of nature
• Religious leaders, divination and exorcisms

Theory of gods: African religious
ontology
Three important ontological views shaped African
belief on the existence of God, they include.
• Reflections on the universe.
• Realization of human limitations.
• Observation the forces of nature.

ontology
Attributes of God (Supreme Being) in Africa:
• God is real to Africans
• God is unique in African religious ontology
• God is Transcendent and Immanent
• In Africa God is Eternal and Immortal.

ontology
Divinities in African Religious Ontology
• The African religions partly recognize a group of
being popularly known as divinities.
• These beings have been given various names by
various writers such as ‘gods’, ‘demigods’, ‘nature
spirits’, divinities, and the like.
• The term “covers personification of God’s activities
and manifestations, the so-called ‘nature spirits’,
deified heroes, and mythological figures”

ontology
Divinities have been grouped into two major groups
namely:
• Principal Divinities
• Minor Divinities.

ontology
Nature of Divinities
There are two major schools of thought as regards the
origin of divinities in African religious ontology.
• Divinities created by the Supreme Being led by John
S. Mbiti.
• Divinities brought into being not created led by E.
Bolaji Idowu

ontology
Relationship between Divinities and Supreme
Being.
• They are created “beings”. As created beings, they
are subordinate to the Supreme Being.
• They are derivations from Deity. The divinities do not
have independent existence or absolute existence,
but derive their being from the Supreme Being.

ontology
• They are given functions to perform. Divinities do not
perform duties against the will of the Supreme Being
rather they are obedient to the command of the
Supreme Being.
• Another important relationship between the divinities
and Supreme Being in Africa is that the divinities serve
as “functionaries in the theocratic government of the
universe”(Idowu, p 170).

ontology
• Divinities are Intermediaries between man and the
Supreme Being. They have therefore become
channels through which sacrifices, prayers and
offerings are presented to the Supreme Being.

The Supreme Being and Punishment
In Africa illness is believed to have spiritual bases. That is
when one misbehaves in a certain way and therefore is
being punished by the supreme being. Such punishment
may range from;
Physical illness
Mental illness
Infertility
Thunder strike
Poverty

Offenses Against Ancestors and
Deities
• Some mishaps and diseases are believed to be as a
result of offenses against ancestors and Deities.

Disturbance of forces of nature
• Certain calamities and disasters are believed to be
as result of disturbances of forces of nature

Religious leaders, Divination and
Exorcism
• What role do religious leaders play in health
care delivery?
• Divination
• Exorcism

Divination
• Divination is the attempt to gain insight into a question
or situation by way of an occultic, standardized
process or ritual.
• Used in various forms throughout history, diviners
ascertain their interpretations of how a querent should
proceed by reading signs, events, or omens, or
through alleged contact with a supernatural agency.

Methods of Divination
• Tarot Cards and Readings
• The Celtic Ogham
• The Norse Runes

Methods of Divination
• Reading Tea Leaves
• Pendulum Divination
• Osteomancy - Reading the Bones

Methods of divination
• Lithomancy: Divination with Stones
• Full Moon Water Scrying
• Numerology
• Automatic Writing

Exorcism
• Exorcism is the religious or spiritual
practice of evicting demons or other
spiritual entities from a person, or an area,
that are believed to be possessed.
• Depending on the spiritual beliefs of the
exorcist, this may be done by causing the
entity to swear an oath, performing an
elaborate ritual or simply by commanding
it to depart in the name of a higher power.

Exorcism in Christianity
• In Christianity, exorcism is the practice of casting out
demons.
• In Christian practice the person performing the
exorcism, known as an exorcist, is often a member of
the Christian Church, or an individual thought to be
graced with special powers or skills.
• The exorcist may use prayers and religious material,
such as set formulas, gestures, symbols, icons,
amulets, etc.

• The exorcist often invokes God, Jesus and/or several
different angels and archangels to intervene with the
exorcism.
• Protestant Christian exorcists most commonly
believe the authority given to them by the Father,
Son, and Holy Spirit (the Trinity) is the source of their
ability to cast out demons.

In Catholic Christianity, exorcisms are performed in the
name of Jesus Christ.
• Formal exorcism: only conducted by a priest during
a baptism or with the permission of a bishop.
• Prayers of deliverance: which can be said by
anyone.

Exorcism In Hinduism
• Beliefs and practices pertaining to the
practice of exorcism are prominently
connected with Hindus.
• Of the four Vedas (holy books of the
Hindus), the Atharva Veda is said to
contain the secrets related to
exorcism, magic and alchemy.

The basic means of exorcism used in Vedic and Tantric
traditions are:
• mantra (sacred utterance)
• yajna (offering).

• Vaishnava traditions also employ a
recitation of names of
Narasimha and
reading scriptures, notably the Bhagavata
Purana aloud.

Exorcism in Islam
• Islamic exorcisms consist of the treated person lying
down, while a sheikh places a hand on a patient’s head
while reciting verses from the Quran, but this is not
mandatory.
• The drinking or sprinkling of holy water (water from the
Zamzam Well) may also take place along with applying of
clean non-alcohol-based perfumes, called as ittar.
• Specific verses from the Quran are recited, which glorify
God e.g. The Throne Verse (Ayatul Kursi), and invoke
God's help.

Exorcism in Islam
• In some cases, the adhan (call for daily prayers) is
also read, as this has the effect of repelling non-
angelic unseen beings or the jinn.
• The Islamic prophet Muhammad taught his followers
to read the last three suras from the Quran,
Surat al-Ikhlas (The Fidelity),
Surat al-Falaq (The Dawn) and
Surat an-Nas (Mankind)

Exorcism in Judaism
• Josephus reports exorcisms performed by administering
poisonous root extracts and others by making sacrifices.
• The Jewish exorcism ritual is performed by a rabbi who
has mastered practical Kabbalah.
• Also present is a minyan (a group of ten adult males),
who gather in a circle around the possessed person.
• The group recites Psalm 91 three times, and then the
rabbi blows a shofar (a ram's horn).

Exorcism in Taoism
• In Taoism, exorcisms are performed because an
individual has been possessed by an evil spirit for one
of two reasons.
• The individual has disturbed a ghost, regardless of
intent, and the ghost now seeks revenge.

Exorcism in Taoism
• An alive person could also be jealous and uses black
magic as revenge thereby conjuring a ghost to possess
someone.
• Members of the fashi, both Chinese ritual officers and
priests ordained by a celestial master, perform Chinese
rituals (exorcisms).
• Taoist exorcisms include chanting, physical movements,
and praying as a way to drive away the spirit.

Exorcism in Taoism
• The ritual of the Exorcising-Ghost day is part of
Tibetan tradition.
• The Tibetan religious ceremony 'Gutor', literally
offering of the 29th, is held on the 29th of the 12th
Tibetan month, with its focus on driving out all
negativity, including evil spirits and misfortunes of the
past year, and starting the new year in a peaceful and
auspicious way.

TRADITIONAL CONCEPTS
OF HEALTH AND ILL
HEALTH
 The germ theory
 Physical
 Social
 Spiritual
 Psychological
 Esoteric (Reincarnation)
 Asteroid (Heaven bodies)

TRADITIONAL CONCEPTS OF
HEALTH AND ILL HEALTH

The Germ Theory
 Diseases caused by specific micro-organisms. This concept is
contrary to the African tradition concept of ill health.
The germ theory was proposed by Girolamo Fracastoro in
1546, and expanded upon by Marcus von Plenciz in 1762.

The Germ Theory
Contributors
 Ignaz Semmelweis (1818 -1865):
 Joseph Lister (1883 -1897)
 Louis Pasteur (1822-1895)

The Germ Theory
 Robert Koch (1843-1910)
 John Snow (1813-1858)
 Paul Ehrlich (1854-1915)

The Germ Theory
• It is important to note that, the germ theory is
traditional biomedical concept of health and ill-health
which is to a very large extent contrary to the African
Traditional concept of health and ill-health

Physical
• Age
• Sex
• Constitutional factors
• Environmental pollutants and toxins

Psychological
• Severe psychological trauma suffered as a child, such as
emotional, physical, or sexual abuse
• An important early loss, such as the loss of a parent
• Neglect
• Poor ability to relate to others

Spiritual
• Existence of a supreme being and supernatural forces.
• Such spiritual entities are associated with health and ill-health in
African traditional societies and for that matter African traditional
medicine.

Reincarnation
• Reincarnation is the philosophical or religious concept that
an aspect of a living being starts a new life in a different
physical body or form after each biological death.
• It is believed in African tradition that one health is associated
with ones reincarnation.

Asteroids/Meteorites/Heaven Bodies
• Falling stars and falling rocks believed to be associated with a
person omen/prognosis of illness

CONCEPT OF THE CAUSES
OF ILL-HEALTH
 Natural imbalance and homeostasis
 Witchcraft
 Spiritual afflictions
 Curses
 Taboo breaking

Natural Imbalances and Homeostasis
Homeostasis is the tendency to resist change in order to
maintain a stable, relatively constant internal environment.

This dynamic state of equilibrium is the condition of
optimal functioning for the organism and includes many
variables;
• Body temperature: Thermoregulation
• Fluid and electrolyte balance: Osmoregulation
• Blood pressure
• PH of extracellular fluid
• Respiration/Blood gases
• Blood sugar

All homeostatic control mechanisms have at least
three interdependent components for the variable
being regulated:
• a receptor
• a control center
• an effector

• Homeostasis typically involves negative feedback loops

Natural Imbalance and Homeostasis
System Interactions
• Each body system contributes to the homeostasis of other
systems and of the entire organism.
• No system of the body works in isolation and the well-being
of the person depends upon the well-being of all the
interacting body systems.
• A disruption within one system generally has consequences
for several additional body systems.
• Most of these organ systems are controlled by hormones
secreted by the endocrine system.

Disruption of Homeostasis
• Many homeostatic mechanisms keep the internal
environment within certain limits (or set points).
• When the cells in your body do not work correctly,
homeostatic balance is disrupted.
• Homeostatic imbalance may lead to a state of disease.
• Disease and cellular malfunction can be caused in two basic
ways:
 deficiency (cells not getting all they need)
 toxicity (cells being poisoned by things they do not need).

Disruption of Homeostasis
When homeostasis is interrupted, your body can correct or
worsen the problem, based on certain influences. They
include:
• Inherited (genetic) influences
• External influences
 Nutrition
 Physical activity
 Environmental exposure
 Mental health/distress

Disruption of feedback, disrupts homeostasis = Disease.
 Diabetes
 Hypertension
 Hypotension
 Hyperthermia/fever
 Dehydration
 Fluid overload
 Electrolyte imbalance

Natural Imbalance and Homeostasis
• Homeostasis is a biomedical concept of the cause of ill-
health
• In African traditional medicine, an imbalance occur when
the is disunity between the a persons spiritual aspect
and his social life.

Witchcraft
• Witchcraft involves the use of magic, the engagement in
activities closely tied with the practice of sorcery and the use
of supernatural powers to affect an event, situation or even a
person against his or her wish.

Witchcraft
• The term ‘magic’ is often used interchangeably with sorcery.
• Words like enchantment, divination and necromancy are
synonyms for ‘magic’.

Witchcraft
• Belief in witchcraft is universal
• Before the coming of the colonial masters, witchcraft had
been part of the culture and beliefs of the people of Africa.
• Accounts of spiritual afflictions can be found in religious
texts and among cultures.

Witchcraft
• Witchcraft is considered a spiritual, complex and secret
society that cannot be monitored or evaluated by scientific
methods
• Witchcraft has made many people live in fear and evil
suspicions.

Witchcraft
• Fear and ignorance is implicated in the belief of the
existence of witchcraft.
• Witchcraft beliefs and practices in disease causation is a
widespread notion in Africa.

Witch Familiars
• A familiar (or familiar spirit or familiar animal) is an animal-
shaped spirit or minor demon believed to serve a witch or
magician as domestic servant, spy and companion, in
addition to helping to bewitch enemies or to divine
information.
• The animal was often believed to be possessed of magic
powers, such as the ability to change its shape.

Witch Familiars
• The traditional vessels for such spirits were the cat, mouse,
ferret, hare, bat, snake, dog or bird (particularly the raven or
owl), by far the most common form being a black cat or a
black dog.
• A familiar could also be a person.

Witch Familiars
• A familiar supposedly aided the witch in her magic in
exchange for nourishment (blood) from sacrificial animals or
from the witch's teat.
• A variation of the familiar is the Medieval conception of the
incubus and the succubus.
• Both types of demon draw energy from their hosts to sustain
themselves, often until the point of exhaustion or death of
the victim.

The activities of witches
• It is held that witches are organized into covens on local,
national, and international levels.
• In the covens are kings, queens, messengers and
executioners.
• At night, when witches sleep, it is believed that their souls fly
out of their physical bodies to meetings.
(Onyinah, 2015)

• Formerly, the Akan believed that witches met
on big trees.
• It was also believed that the covens’ pots,
which were thought to contain human blood,
were usually kept under the trees on which
they met.
• It is currently believed that the meeting places
of witches include the sea, rivers, lakes,
market places, and church buildings.

• It is believed that witches feed on flesh and blood of human
beings, which they take turns in providing.
• From the perspective of the Akan, the witch can mainly
provide a relative.

• Most mishaps and diseases like bareness, still
births, mental illness, hypertension, diabetes,
leprosy and serial infant mortality are attributed to
witchcraft.
• Witches are said to provoke illness using spirits,
objects, substances, working with the victim’s
photo, name, sweaty clothes, hair, nails, or dolls.
• The local witchcraft discourse is undoubtedly
culturally biased and socially constructed by
diverse social actors.

Witchcraft
• Whenever there is a mishap, failure or disease there is a call
for consultation with powerful spirit-persons for supernatural
knowledge of the causes of the problems.
• These are primarily traditional healers, in particular witch-
finders who figure significantly in the process of witchcraft
accusation.

Witchcraft
• A patient influenced by the opinion of other family members
as well as by public opinion in the form of gossip may have a
certain suspicion about a witch in her/his surroundings.
• This assumption can be, however, affirmed or invalidated by
the healer in the process of diagnosis when he/she
designates the cause of a patient’s illness.

Witchcraft
• The main task of a witch-finder is thus to arrange and
interconnect the patient’s separate experiences such as
nightmares, social problems, actual health complications,
fears and worries into a “comprehensible whole”.

Witchcraft
• When a prognosis includes naming a family member, which
it often does, it creates conflicts in the family.
• Witchcraft issues usually become the source of family
tension.

Spiritual Afflictions
• Spiritual afflictions and witchcraft/sorcery
are closely related to the spirits
• Many ailments and problems among
Africans are considered to have spiritual
origin.

Spiritual Afflictions
The circumstances that can result
in spiritual afflictions include;
• Coming into contact with a bad spirit
(dwarfs, marine spirits and jinn, etc.)
• Breaking rules of a supernatural
spirit from which help is sought.

Taboo breaking
• In any given society, a taboo is an implicit prohibition
on something (usually against an utterance or
behavior) based on a cultural sense that it is
excessively repulsive or, perhaps, too sacred for
ordinary people.

Taboo breaking
Some examples of taboos include
• Incest
• Patricide
• Cannibalism
• Incest
• Murder
• Certain diet/food
• Whistling in the night
etc

Curses
• Cursing is traditionally understood as inflicting harm or
horror on someone by invoking the aid of a supernatural
power (Wajnryb 2005; Hughes 2006).

TRADITIONAL APPROACHES TO
DISEASE PREVENTION AND TREATMENT
• OUTLINE
• Disease prevention
Herbs, Diet, Rest/Exercise and Sacrifices
• Assessment of patients
History taking
Physical examination
• Treatment approaches
Herbal treatment, Spiritual approaches, Bone setting
Bloodletting, Horning, Fasting, Homeopathy;

TRADITIONAL APPROACHES TO DISEASE
PREVENTION AND TREATMENT
Introduction
• The oldest form of healthcare in the world
• Used in the treatment and prevention of physical and
mental illnesses.
• Different societies historically developed various useful
healing methods to combat a variety of health- and life-
threatening diseases.
• TM is also variously known as complementary and
alternative, or ethnic medicine,

Disease Preventions
Herbs
• Medicinal herbs have been used by humans since
the beginning of time as "nutritional supplements"
with special properties and power.
• Many plants contain, in addition to nutrients, active
ingredients that enhance the function of specific
organs or certain metabolic processes in the body.
• E.g. the use of Ginkgo biloba (Maiden Hair tree)
products for memory enhancement.

Disease prevention
Diet
• Many preventable diseases associated with poor diet
• Diet is employed as a traditional approach in promoting
health and prevention of diseases

Disease prevention
Rest/Exercise
• Regular exercises is associated with good health and
physical wellbeing
• Resting a body part that is diseased can also promote
healing

Disease prevention
Sacrifices
• Offering of sacrifices to deities and ancestors believe
to prevent diseases and ill health

Assessment of patients
History taking
• Family history
• Past health history
• Present history
• History obtained from family members

Assessment of
patients
Physical examination
• Inspection
• Auscultation
• Percussion
• Palpation

Traditional Treatment Approaches
(Herbal treatment)
• An herb can be any form of a plant or plant product,
including leaves, stems, flowers, roots, and seeds.
• These plants can either be sold raw or as extracts,
where the plant is macerated with water, alcohol, or
other solvents to extract some of the chemicals.
• The resulting products contain dozens of chemicals,
including fatty acids, sterols, alkaloids, flavonoids,
glycosides, saponins , and others

Traditional Treatment
Approaches (Herbal treatment)
Herbal medicines are also referred to as;
• herbal remedies
• herbal products
• herbal medicinal products
• phytomedicines,
• Phytotherapeutic agents and
• phytopharmaceuticals.

• The use of herbal medicines in an evidence- or
science-based approach for the treatment and
prevention of disease is known as phytotherapy.
• This approach to the use of herbal medicines
contrasts with traditional medical herbalism which
uses herbal medicines in a holistic manner and
mainly on the basis of their empirical and traditional
uses.

• Plants have been used medicinally for thousands of
years by cultures all over the world.
• According to the World Health Organization, 80% of
the world's population uses plant-based remedies as
their primary form of healthcare

• In some countries, herbal medicines are still a central
part of the medical system, such as Ayurvedic
medicine in India and traditional Chinese medicine in
China.
• Herbal medicine has a long history and tradition in
Europe.

• The use of medicinal plants in treating diseases is
widespread in Ghana.
• Herbal medicines continue to be a popular
healthcare choice with the general public for health
maintenance and wellbeing.

Traditional Treatment Approaches
(Herbal treatment)
Use for the management of;
minor ailments (e.g. malaria, coughs and colds)
 chronic conditions (e.g. back pain)
 serious chronic diseases (e.g. asthma, cancer,
depression, diabetes)

• This often involves a wide variety of species.
• The medicinal plants belong to different growth forms
and include
• trees
• Herbs
• climbers

Terms Relating to Herbal Medicine
• Herbal medicines include herbs and/or herbal
materials and/or herbal preparations and/or finished
herbal products in a form suitable for administration
to patients.
• Note: In some countries, herbal medicines may
contain, by tradition, natural organic or inorganic
active ingredients that are not of plant origin (for
example, animal and mineral materials, fungi, algae
or lichens, among others).

• Herbs: Herbs include crude plant materials such as
leaves, flowers, fruits, seed, stem wood, bark, roots,
rhizomes or other plant parts, which may be entire,
fragmented or powdered.
• Herbal materials: Herbal materials include, in
addition to herbs, fresh juices, gums, fixed oils,
essential oils, resins and dry powders of herbs.

• Herbal preparations: Herbal preparations are the basis
for finished herbal products and may include comminuted
or powdered herbal materials, or extracts, tinctures and
fatty oils of herbal materials.
• They are produced by extraction, fractionation,
purification, concentration or other physical or biological
processes.

• Finished herbal products: Finished herbal products
consist of one or more herbal preparations made from
one or more herbs (i.e. from different herbal
preparations made of the same plant as well as herbal
preparations from different plants.
• Products containing different plant materials are called
“mixture herbal products”)

• Herbal dosage forms: Herbal dosage forms are the
physical form (liquid, solid, semi-solid) of herbal
products produced from herbs, with or without
excipients, in a particular formulation (such as
decoctions, tablets and ointments).
• They are produced either from herbal materials (such
as dried roots or fresh juices) or herbal preparations
(such as extracts).

• Medicinal plants are plants (wild or cultivated) used
for medicinal purposes.

Chemical constituents of plants
used as herbal medicine
• All living organisms produce numerous chemical
substances that are termed natural products.
• Those natural products that are common to all life
forms are known collectively as primary metabolites
example;
 carbohydrates
 proteins and
 fats

• Thus, many of the chemical building blocks of primary
metabolism are found in all medicinal plants (e.g.
amino acids, common sugars, such as glucose, and
fatty acids).
• In addition to primary metabolites, plants also produce
other compounds with a more restricted distribution
and these are referred to collectively secondary
metabolites.

• Plants are a rich source of
secondary metabolites.
• some of these secondary
metabolites are of such limited
distribution that they are found
only in a particular genus (e.g.
Papaver), or even in only a single
species (e.g. Papaver somniferum
or Opium Poppy).

• Some secondary metabolites are widely distributed
throughout many of the plant families.
• Some secondary metabolites may be are toxic or
attractive.
• Many of them have pharmacological actions and this has
been exploited to provide medicinal drugs such as
Codeine
Morphine
digoxin and
quinine.

• Among the most prevalent of secondary metabolites
are
alkaloids
glycosides and
phenols.
• Examples of these types of secondary metabolite can
be found in many of the medicinal plants.

Alkaloids
• Alkaloids may be classified by their chemical
structure into the following major types:
pyrrolidine (e.g. betonicine from white horehound)
 pyridine (e.g. gentianine from gentian)

Alkaloids
piperidine (e.g. lobeline from lobelia)
pyrrolizidine (e.g. symphytine from comfrey)
quinolizidine (e.g. sparteine from broom)

Alkaloids
• quinoline (e.g. quinine from cinchona)
• isoquinoline (e.g. boldine from boldo)
• indole (e.g. harman from passionflower)

Alkaloids
tropane (e.g. hyoscine from belladonna)
 imidazole (e.g. pilocarpine from jaborandi)
xanthine (e.g. caffeine from maté).

• phenylalkylamines (e.g. ephedrine from ephedra)
• colchicine from colchicum

Glycosides
• Some Glycosides include:
coumarin (e.g. scopolin from horse-chestnut)
flavonoid (e.g. rutin from buchu)
 hydroxyanthracene (e.g. cascaroside A from cascara)

Phenolics
• Many of the aromatic constituents of
plants are phenolics
• There is a wide variety of phenolics in
medicinal plants and they range in
chemical structure from simple phenolic
acids e.g. caffeic acid from artichoke, to
complex tannins

Phenolics
• Some of the commonly encountered natural products
of phenolics include:
Terpenes
Flavonoids
Tannins

Parts of Medicinal plants used
• Leaves
• Flowers
• Stem
• Bark
• Seed
• Fruit
• Roots

Traditional Processing of
Herbal/Medicinal plants
• Herbal processing refers to the overall treatment in
the course of production of herbal materials, herbal
preparations and herbal dosage forms. These
include:
• Post harvest processing
• Primary processing
• Final/secondary processing

Post-harvest processing procedures
• Sorting (garbling): Removing dirt,
unwanted/poisonous parts and foreign substances

Primary Processing
• Washing
• Leaching
• Primary cutting
• Ageing
• Sweating
• Parboiling/blanching
• Boiling/Steaming
• Baking/roasting
• Stir frying
• Drying (sun-drying, Shade
drying, drying by artificial
heat)

Final processing
• Extraction (Separation
technique and
concentration)
• distillation
• fractionation
• Concentration
• Fermentation
• Powdering

Mode of Application of Herbs
• Orally
• Topical application
• Sniffing
• Intranasal
• Instillation
• Steaming

Traditional treatment
approaches (spiritual)
• Divination
• Incantations
• Rituals
• Sacrifices

Traditional treatment approaches
(Bone setting)
• Ancient practice
• Practitioner known as traditional bone setter (TBS); a
practitioner of joint/bone manipulation
• The functions of TBS include the management of;
Bones
Dislocations
Congenital abnormalities along with associated
complications

(Bone setting)
TBS basic treatment includes
• bandaging techniques
• management of inflammation, sprains,
strains, dislocations
• methods of early healing of fractures
• strengthening of bones using medicinal
products such as oils

(Bloodletting)
• Bloodletting is the withdrawal of blood from a patient to
prevent or cure illness and disease.
• Bloodletting is based on an ancient system of medicine in
which blood and other bodily fluids were regarded as
"humors" that had to remain in proper balance to maintain
health.
• It is claimed to have been the most common medical
practice performed by surgeons from antiquity until the
late 19th century, a span of almost 2,000 years.

(Bloodletting)
Methods and Practice
• Phlebotomy/Venesection
• Arteriotomy
• Scarification
• Leech bloodletting

Other traditional treatment
approaches
• Horning
• Fasting
• Homeopathy

BASES AND SCOPE OF
TRADITIONAL MEDICINE IN GHANA
• Organization of traditional medical practice
• Types and mode of operation of traditional medicine
• The role of the traditional medicine in the health care
delivery system
• Interaction between traditional medicine and
orthodox medicine

Organization of Traditional Medical
Practice
The traditional medicine system includes not only
herbal remedies for specific diseases, but also;
 folk knowledge
traditions and values
health behavior rules and patterns, and
identified personnel and structures for delivery and
restorative therapy

Practice
There are many types of practitioners available in
Ghana, each with a distinctive approach to diagnosis
and therapy. They include;
• secular healers often referred to as ‘traditional
pharmacists
• plant drug peddlers

Practice
The most common type of healer in the traditional
medical system include:
• Priest and priestess of deities
• Sacred healers.

Practice
Among these different types of healers are differences
in specialization.
• Generalist
• Specialist (bone setting, child care, delivery,
psychotherapy).

Types and Mode of Operation of
Traditional Medicine
• Diviners
• Herbalist
• Traditional Birth Attendants (TBAs)
• Bone Setters
• Psychotherapist

The Role of Traditional Medicine in
Healthcare Delivery System
• Plays a very important complementary role in
healthcare delivery systems.
• First line of treatment for many diseases in Africa

The Role of Traditional Medicine in
Healthcare Delivery System
• The WHO estimates conservatively that between 60%
and 90% of the populations of low-income countries rely
on plant medicine to meet their healthcare needs.
• The populations generally patronize the services of
TMPs because TM is affordable, accessible and
available.

Interaction Between Traditional
Medicine and Orthodox Medicine
• TM is the oldest form of health care in the world and
is used in the prevention, and treatment of physical
and mental illnesses.
• The medicaments used in TM are mostly derived
from natural products.

Various forms of traditional medicine that make use of
natural products include:
• African Traditional Medicine
• Traditional Chinese medicine (TCM)
• Ayurveda
• Kampo (Japan Traditional Medicine)
• traditional Korean medicine (TKM), and
• Unani (Greek Traditional Medicine)

• TM is too valuable to be ignored in the research and
development of modern drugs.
• In TM, a single herb or formula may contain many
phytochemical constituents, such as alkaloids,
terpenoids, flavonoids, etc.

• It is notable that a lot of plant-originated drugs in
clinical medicine today were derived from TM.
• In addition, it has been demonstrated that the many
valuable drugs derived from plants were discovered
through their application in TM.

• At the beginning of the nineteenth century, the era of
“modern” drugs began.
• Natural products has been exploited in the
development of modern drugs
• Natural products have exerted a far-reaching impact
on chemicobiology.

Various pharmacologically active compounds isolated from
natural products and used in orthodox medicine include:
• Morphine from Opium plant
• Artemisinin and its analogs.
• The Vinca alkaloids from Catharanthus roseus, and the
terpene paclitaxel from Taxus baccata, are among
successful anticancer drugs originally derived from
plants.

REGULATING TRADITIONAL
MEDICINE IN GHANA
The major stakeholders in the traditional health care
delivery system of Ghana include:
• Traditional and Alternate Medicine Directorate of the
Ministry of Health (TAMD)
• Ghana Federation of Traditional Medicine
Practitioners Associations (GHAFTRAM)
• Traditional Medical Practice Council and the Centre
for Scientific Research into Plant Medicine
• The Food and Drugs Law of 1992 (PNDC Law 305B)

Traditional and Alternate Medicine
Directorate (TAMD) of the Ministry of Health
• Attained full directorate in 1999
• TAMD with a mission of “making available to the
people of Ghana, a well defined, recognizable,
complementary system of health based on
excellence in traditional and alternative medicine
knowledge”

Mandate of the TAMD
• Initiates the formulation of policies on Traditional and Alternative
Medicine.
• Organizes and monitors Traditional and Alternative Medicine
Practices within the public sector
• Facilitate collaboration and co-operation between Traditional
and Alternative and allopathic medicine practitioners within the
context of health care delivery system
• Develop policy guidelines for the training of Traditional and
Alternative Medicine practitioners.

Mandate of the TAMD Cont.
• Collaborate with appropriate agencies to determine which
Traditional and Alternative Medicine practices are safe and
efficacious.
• Support Traditional and Alternative Medicine practices through
mobilization of resources
• Liaise with the statutory bodies for the regulation and control of
Traditional and Alternative Medicine products and practices
and to support in the performance of their functions

Mandate of the TAMD Cont.
• To protect and sustainably prospect medicinal plant
resources.
• Liaise with relevant agencies to ensure that mechanisms
exist for the patenting of formulations in Traditional and
Alternative Medicine.
• Maintain a database for Traditional and Alternative Medicine
practices and services.
• Organizes public education in support of Traditional and
Alternative Medicine practice services.

Centre for Scientific Research into
Plant Medicine (CSRPM)
The Centre for Scientific Research into Plant Medicine
was established in 1975 by N.R.C. Decree 344. Its
functions are to:
• Conduct and promote scientific research relating to
the improvement of plant medicine;
• Ensure the purity of drugs extracted from plants

• Cooperate and liaise with the Ghana Psychic and
Traditional Healers’ Association, research institutions
and commercial organizations in any part of the world
in matters of plant medicine
• Undertake, or collaborate in the collation, publication
and the dissemination of the results of research and
other useful technical information

• Establish, where necessary, botanical gardens for
medicinal plants
• Perform such other functions as the Government
may assign to it from time to time.

Practice
• The Ministry of Health facilitated the formation of the
Ghana Federation of Traditional Medicine
Practitioners Associations (GHAFTRAM).
• Inaugurated in 1999

This Federation, formed in the late nineteen nineties, is
believed to be the umbrella body for all associations of
TMPs.

The objectives of GHAFTRAM are to:
• Serve as a body which brings all TMPs associations in
Ghana under one umbrella organization
• Serve as a mouthpiece for all TMPs associations in Ghana
• Protect the interest and well being of all its members
• Improve the mode of practice of traditional medicine by
adoption of appropriate codes of conduct and practice and
help in the promulgation of regulations;

• Liaise, collaborate, cooperate and establish good terms
with the scientific community, Ministry of Health and
related institutions
• Conduct research, document traditional medicine
knowledge and practices an promote good relationship
among TMPs
• Encourage and promote the commercialization of safe,
effective and proven herbal preparations

• Set up a system for monitoring and evaluating
traditional medicine practice in the country
• Mobilize financial and material resources for the
development of traditional medicine practice in Ghana
• Establish or help establish a sustainable program for a
pre-service and in-service training of TMPs in the
country

• Promote the establishment of large-scale arboreta and
herbaria
• Initiate a sustainable environmental protection program
to prevent the depletion of medicinal plats and other
natural resources
• Collaborate with the government, non-governmental
agencies and private institutions in the development of
health services in Ghana.

Ghana Traditional Medicine Practice
Council
• Act 575 of the Parliament of the Republic of Ghana,
the Traditional Medicine Practice Act, 2000
established “a Council to regulate the practice of
traditional medicine, to register practitioners and
license practices, to regulate the preparation and
sale of herbal medicines and to provide for related
purposes”.

Council
• The Traditional Medical Practice Council provides a
legal framework for the practice of traditional
medicine in the country.
• The Council is charged with setting standards as well
as determining and enforcing a code of ethics for the
practice of traditional medicine in the country.

Council
• The Council is also to advise the Food and Drugs Board
on the rules for
 preparation, labeling packaging
Sale
Supply
Registration
Advertisement
importation and exportation of all traditional
medicinal products.

Council
According to the Act, the object of the Council is to
promote, control and regulate traditional medicine
practice and it is to achieve this through the following:
• Set standards for the practice of traditional medicine
• Issue certificate of registration to a qualified
practitioner and license premises for a practice

Council
• Determine and enforce a code of ethics for traditional
medicine practice in conjunction with an association of
TMPs recognized by the Minister of Health referred to in
the Act as “the Association”
• Promote and support training in traditional medicine

Council
• Approve, in consultation with such educational
institutions as it may determine, the curriculum for
training in traditional medicine in the institutions
• Collaborate with the Ministry of Health to establish
centers for the provision of traditional medical care
within the national health care delivery system

Council
• Advise the Minister of Health on matters relating to
and affecting the practice of traditional medicine
• Collaborate with the appropriate agencies for large-
scale cultivation of medicinal plants and for the
preservation of biodiversity
• Advise the Food and Drugs Board, in writing, on rules
for registration, advertisement, manufacture,
packaging, preparation, labeling, sale, supply,
exportation and importation of any herbal medicine

Council
• Advise the Ghana Standards Board, in writing, on
standards for safe and hygienic preparation of herbal
medicine
• Monitor fees payable by clients for services provided by
TMPs; and,
• Perform such other functions as are ancillary to the object
of the Council

Challenges of Regulating
Traditional Medicine
1.Regulatory status, on control of the drugs.
2.Assessment of safety and efficacy, of drugs.
3.Quality control, on drug production and distribution.
4.Safety monitoring of the drugs.
5.Lack of knowledge about TM/CAM within national drug
regulatory authorities.

REFERENCES
• Twumasi, P.A., (2005). Policy guidelines on medical systems in Ghana.
Accra: Ghana Publishing Corporation
• Franz, S. C. (2008). Common sense pediatrics: Combining alternative and
traditional medicine in everyday practice. Bloomington, IN; Authourhouse.
• GoG (2005). Traditional and alternative medicines handbook. Accra, MoH,
Ghana.
• Willcox, M. & Bodeker, G. (2004). Traditional medicinal plants and malaria.
London: CRC Press.
• O’Matuna, D., Larimore, W. (2006). Alternative medicine: The Christian
handbook updated and expanded. Grand rapids, Michigan; Zondervan.
• Wikepipedia
• Barimah, K.B., (2018). Traditional Medicine in Ghana. OKAB Publishing.

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