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1. North East Nursing College
South surma , Sylhet
Sub: behavioral science
TRADITIONAL MEDICINES
1

2. OUTLINE
 Definitions
 History
 TraditionalMedicinePractices
 Traditional Healers
 Traditionalmedicinesvs. Orthodoxmedicines
 Casefor &againstTraditional medicines
 summary
 Conclusion
 Acknowledgement andreferences
2

3. DEFINITIONS
⚫T
raditional medicine(also knownasalternative,
complimentary,indigenousorfolkmedicine)comprises
knowledgesystemsthat developedover generations within
varioussocietiesbeforetheeraof modern medicine.
⚫ TheWorldHealthOrganization(WHO)definestraditional
medicineas"thesumtotal of theknowledge,skills, and
practicesbasedonthetheories,beliefs,andexperiences
indigenousto differentcultures, whetherexplicableornot,used
inthemaintenanceof healthaswell asintheprevention,
diagnosis, improvement ortreatment of physical andmental
illness.
3

4. BRIEF HISTORY OF TRADITIONAL
MEDICINES
Emperor ShengNun(2730BC
–3000BC)compiledthefirst
pharmacopoeia.
TheEgyptianPapyrusElber
datedtohavebeenwritten at
about 1500BCmentioned
someveryprominent medicinal
plantsstill usedtoday
.
Hippocrates(460BC);the
father of modern medicine
wrote abookknownas Materia
Medica composed of over 400
simpleremedies.
BC);abiologist andbotanist
knowntohavewrittenthebook
HistoriaPlantarium.
Traditional
medicine
practitioners
worthy of
mention
TheophrastusofAthens(370
4

5. HISTORY cont’d
⚫Otherpractitioners worthyofmentionare;Dioscorides,Galen
Plinytheelder, ScriboniusLargusandAvicenna.
⚫Traditionalmedicinesmaybeclassifiedinto;
1) Medication:
Medicinalplants, MineralmaterialsandAnimalmaterials
2) Non-medication:
Acupuncture,Chiropractic,Osteopathy,Manualtherapies,
Qigong,Taiji,Y
oga,Physical,Mental&Spiritualtherapies
5

6. TRADITIONAL MEDICINE
PRACTICES (TMP)
TM
P
AYURVED
A
ACUPU
NCTURE
TRADITIONA
LAFRICAN
MEDICINE
SIDDHA
MEDICI
NE
ANCIENT
IRANIAN
MEDICIN
E
IRANI
IFA
UNANI
ISLAMIC
MEDICIN
E
TRADITION
AL
CHINESE
MEDICINE
TRADITION
AL
KOREAN
MEDICINE
MUTI
6

7. TMP cont’d
7
⚫T
raditionalAfricanMedicine
(T
AM):Aholisticdiscipline
involvingIndigenousHerbalism
andAfricanspiritualitydelivered
bydiviners, midwivesand
herbalists. Diagnosisisreached
throughspiritual meansanda
treatment (usuallyconsistingof a
herbal remedywithsymbolicand
spiritual significance)is
prescribed.

8. ⚫Acupuncture: Atreatment
derived fromancient
Chinesemedicineinwhich
fineneedlesareinsertedat
certainsitesinthebodyfor
therapeuticor preventative
purposes.
8
TMP cont’d

9. ⚫Ayurveda: Oneof theworld’s
oldest holistichealingsystems
developedover 5,000years
agoinIndia. It isbasedonthe
belief that healthandwellness
dependonadelicatebalance
betweenmind, bodyandspirit.
It isbelievedthat thebody
constitution(prakriti) ismade
upof acombinationof five
universalelements; space, air,
fire, water andearth.
9
TMP cont’d

10. TMP cont’d
⚫TraditionalChineseMedicine(TCM):Asystemof primary
health carethat includesAcupuncture,Chinese herbal medicine,
Remedial massage(anmotuina), Exercise&breathingtherapy
(e.g qigong),DietandLifestyleadvice. It originatedfromChina
datingbackthousandsof years.Theprimary featureof modern
TCMisthepremisethat goodhealthrelies ontherestoration
andmaintenanceof harmony
, balanceandorder tothe
individual.
⚫Coredisciplineswhichstudytraditional medicineinclude;
Herbalism, Ethnomedicine, Ethnobotany
, andMedical
anthropology
10

11. TRADITIONAL HEALERS (TH)
Thefollowing arethecategories ofTH;
Herbalists
Traditional birthattendants
Bone-setters
Traditional medicinal ingredient dealers
Traditional psychiatrists
Practitionersof therapeuticoccultism
11

12. WHY TRADITIONAL MEDICINES?
⚫Traditionalandmodernmedicinehavemuchtooffereach
otherdespitetheir differences.Thetimeis right for therevival
of traditional medicineuse.
⚫Forseveralmillennia,THsaroundtheworld havehealedthe
wounded,ill andsickwithherbaland/oranimal-derived
remedies, handeddownacrossgenerations.
⚫InAfricaandAsia,about80%of thepopulationstill use
traditional remediesrather thanmodernmedicinefor primary
healthcare.
⚫Onlyabout 4%of existingplantshavebeenresearchedon.
12

13. WHY TM cont’d
100
90
80
70
60
50
40
30
20
10
0
Nigeria Tanzania Rwanda India Benin Ethopia
Populationsin developing countriesusingtraditionalmedicinesforprimaryhealthcare(courtesyWHO,2010)
Percentage
13
Percentage

14. WHY TM cont’d
10
0
30
20
40
90
80
70
60
50
USA Australia France Canada Germany
Populationsin developedcountrieswhohaveusedTM/CAMat leastonce(courtesy WHO,2010)
Percentage
14
Percentage

15. WHY TM cont’d
⚫In developednations,TMis rapidly gainingappeal.Estimates
suggestupto80%oftheworldpopulationhavetrieda
traditional therapy suchasAcupunctureor Homeopathy.
⚫Asurveyconductedearlierthis yearfoundthat 74%of US
medicalstudents believe thatwesternmedicine wouldbenefit by
integrating traditional/alternative therapiesandpractices.
⚫Theindustryis alsoworthlots of money.In 2013,traditional
medicinesworthUS$14billionweresoldin China.Andin 2007,
Brazilsawrevenuesof US$160millionfromtraditional therapies
whichformpart of aglobalmarketof morethanUS$60billion.
15

16. WHY TM cont’d
⚫In developingcountries,TMrepresents anaccessible and
affordablemediumofPrimaryHealthCare(PHC)forthe
populace.Across-sectionisshownbelow;
RA
TIOOFPRACTITIONERSTOPOPULA
TION
Traditional Medical
Practitioner Doctor
Swaziland 1:100 1:10,000
Ghana 1:200 1:20,000
Uganda 1:700 1:25,000
Mozambique 1:200 1:50,000
16

17. TM vs. ORTHODOX MEDICINE(OM)
TRADITIONAL MEDICINE ORTHODOX MEDICINE
Traditionalmedicinesmaynothaveall
the answers. But a valid
alternative
Modernmedicineis desperatelyshortof
new treatments
The drugs are readily available
more
research should be carried out on
them
It takes years for a new drug
to pass through research,
development and then
manufacture.
It is more cost effective
since it is readily available
to patients
Economic burden for
manufacture and procurement
The issue of drug resistance may
not be as pronounced although
more research should be
conducted
Drug resistance has rendered
many drugs (especially
antibiotics) less efficacious
17

18. TM vs. OM cont’d
⚫Traditionalmedicinesprovideanalternativeapproachtohealth
carein developedcountries.Thisis necessaryduetoconcerns
aboutorthodoxdrugsafetyandthepotential for greater public
accesstodruginformation.
⚫These facts have led to the collaboration between scientists and
pharmaceutical companies to continuously research on/discover
newdrugsources.
⚫Major triumphshavestokedinterest inTMasasourcefor highly
efficaciousdrugs.Thebestknownof theseis thediscovery of
“Artemisinin” usedtotreat malaria.
18

19. THE CASE FOR TM
⚫Tradition:Beenusedthroughout history
.
⚫Natural: Perceivedasgentlerandsafer.
⚫Cost:Oftenlessexpensivethanprescription medicine.
⚫Access:Patient maintainscontrol &noprescription(s)
necessary.
⚫Synergism:Aviewthatmultipleingredientsworkingtogether
yieldbetter results.
19

20. THE CASE AGAINST TM
⚫LackofFDAregulationandoversightleadingtolackof
standardizeddosagesandpotentialfor adulteration.
⚫Safetyandefficacydataarenotalwayssufficient.
⚫Lackof researchdatais mostlydueto lackof adequateor
acceptedresearchmethodologiesfor evaluatingTM.
⚫Strongreservationsandoften frank disbeliefaboutthebenefits of
TM.
⚫IncreaseduseofTM/CAMhasnotbeenaccompaniedbyan
increaseinthequantity,qualityandaccessibilityof clinical
evidencetosupportclaimsofTM.
20

21. MEDICINAL PLANTS AND THEIR
USES
21
DRUG BIOLOGICAL SOURCE USES
Acacia gum Acacia senegal Emulsifying agent
Aloe Aloe spp Purgative
Belladonna Atropa belladona Antispasmodic mydriatic
Caffeine Thea sinensis CNS stimulant
Caraway fruit Carum carvi Flavoring agent and
calmative
Cascara bark Rhamnus purshiana Laxative
Castor oil Ricinus communis Purgative, vehicle of eye
drop
Cinchona bark Cinchona succirubra Bitter tonic quinidine for
atrial fibrillation
Coca leaf Erythroxylon coca Local anesthetic

22. EXAMPLES OF MEDICINAL PLANTS AND THEIR USES
22
DRUGS BIOLOGICAL SOURCES USES
Digitalis Digitalis purpurea Myocardial stimulant
Ephedra Ephedra sinesis For relief of asthma and
hay
fever
Ergot sclerotium Claviceps purpurea Uterine stimulant
Gentian root Gentiana lutea Bitter used to stimulate
appetite
Ginger Zingiber officinale Calmative and aromatic
Rauwolfia root Rauwolfia serpentina Psychiatric cases
and anti hypertensive
Theophylline Thea sinensis Diuretic mild CNS
stimulant
Tubocurarine Chondodendron
tomentosum
Muscle relaxant

23. SUMMARY
⚫ Traditional medical knowledge is widely prevalent around the world
and a large percentage of the public have integrated them for their
varioushealthneeds.
⚫ Although,continuedcommunityandpublicpatronageissustaining
andfostering growthin developinganddevelopedcountries,there
still exists agapbetweenpublicchoiceaswell asnationaland
institutional efforts forTM integration.
⚫ Hightechnology/external resource orientation andusein the
developmentanddistribution (markets) of medicinescontinuesto
marginalizetraditional medicalcultures in the health-caresystems.
⚫ Thevarious stakeholders(regulators, consumersandpractitioners)
alsoseethe challengesandissuesdifferently.
23

24. SUMMARY Cont’d
⚫It is evident that any model of health-care based on a single
systemof medicinewill find it difficult to copewith the health
caredemandsinthenear future.
⚫It is alsoobviousthat traditional andcultural medicalknowledge
hasacatalyzing effect in meetinghealth sector development
objectivesandwill continuetobeso.
⚫Thereexistsmajordifferences in theusageofTMin the
developedanddevelopingnations.Whilesafetyis theprimary
concernindevelopedcountries,accessandcostseemtobe
critical issuesindevelopingcountries.
24

25. CONCLUSION
⚫ThereisscantdataonutilizationofTMandadearthofresearch
policyandgoodintegrationmodelsinthesector.
⚫It is essentialnotto romanticizeTMusebutseriouslyconsider
issuesof safety,efficacyandquality,accessandrational use.
⚫ Integratetheminto themainstreamhealthsystemwithout
compromisingthediversity anduniqueaspects.
25

26. ACKNOWLEDGEMENTS
26
⚫Pharmacist BashirA.S
⚫Pharmacist Oluleti Lekan
⚫Pharmacist Okhuosami F
.S

27. REFERENCES
27
Bodeker, G., C. K. Ong, C. Grundy, G. Burford, K. Shein, WHO Global Atlas of
Traditional, Complementary and Alternative Medicine, World Health
Organization, Kobe, 2005.
Bodeker, G., and G. Burford, Traditional, Complementary and Alternative Medicine
Policy and Public Health Perspectives, Imperial College Press, London, 2007.
Cohen, M., Bodeker, G., eds., Understanding the Global Spa Industry: Spa
Management, Butterworth-Heinemann, 2008.
Janska, E., What Role Should Traditional Medicine Play in Public Health Policy,
UNU-IAS working paper no.142, UNU-Institute of Advanced Studies, Yokohama,
2005.
JOICFP, Household Medicine Distributors in Rural Japan, JOICFP, Tokyo, 1983.
Patwardhan, B., Traditional Medicine: A Novel Approach for Available, Accessible
and Affordable Health Care, A paper submitted for Regional consultation on
Development of Traditional Medicine in the South-East Asia Region, Korea, World
Health Organization, 2005.
WHO, WHO Traditional Medicine Strategy 2002─2005, World Health
Organization, 2002

28. REFERENCES
28
⚫ Barnes, J., “Pharmacovigilance of Herbal Medicines: A United Kingdom
Perspective,” in G. Bodeker and G. Burford eds., Traditional, Complementary and
Alternative Medicine Policy and Public Health Perspectives, Imperial College
Press, 2007, pp. 101─144.
⚫ Bodeker, G., “Medicinal Plant Biodiversity and Local Health Care: Rural
Development and the Potential to Combat Priority Diseases,” in B. Haverkort, and
S. Rist eds., Endogenous Development and Biodiversity, Compass, Leusden, 2007
(a), pp. 241─255.
⚫ Bodeker, G., Kronenberg, F., and Burford, G., Policy and Public Health Perspectives
on Complementary and Alternative Medicine: An Overview in G. Bodeker and G.
Burford eds., Traditional, Complementary and Alternative Medicine Policy and
Public Health Perspectives, Imperial College Press, 2007 (b), pp. 9─38.
⚫ El-Gendy. A. R., “Regional Overview: Eastern Mediterranean Region,” in G.
Bodeker, C. K. Ong, C. Grundy, G. Burford and K. Shein eds. WHO Global Atlas on
Traditional, Complementary and Alternative Medicine, WHO Centre for Health
and Development, Kobe, 2005, pp. 153─158.
⚫ Farnsworth, N., “Screening Plants for New Medicines,” in Wilson. E. O. ed.,
Biodiversity,. National Academy Press, Washington D. C, 1988, pp. 83─97.
⚫ Gaitonde, B. K., Kurup, P. N. V., “Regional Overview: South-East Asia Region,” in G.
Bodeker, C. K. Ong, C. Grundy, G. Burford and K. Shein eds.,

29. THANK YOU
FOR BEING A
GOOD
AUDIENCE
29