Paper Information

Journal:   IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH (IJPR)   October 2004 , Volume 3 , Number Supplement 2 ; Page(s) 0 To 0.
Author(s):  HAGGAG M.Y.*
* Egypt
Traditional medicine has been used since the dawn of history for treating human illness. Herbal medicine constituted the main type of traditional medicine. This type of treatment prevailed during different times of history in different countries, may be until the beginning of the 19th century. By that time a scientific revolution, in nearly all fields started. Much progress was made in the field of organic chemistry. This progress resulted in the synthesis of numerous organic compounds. Many of these compounds were found pharmacologically active and were used for treatments of many diseases replacing the traditional herbal medicine. The use of these organic compounds in treatment was encouraged by the ease of their preparation by synthesis and in quantities according to needs. Besides, the propaganda of the producing companies played a role in their spread use.
The use of such chemical compounds for treatment in conventional medicine was not far from risk. Serious side effects arose from the use of many such drugs, this led WHO to warn member states from using many such drugs.
The motto back to nature arose for seeking more safe drugs among member states.
As a matter of fact, not all natural compounds are free of toxicity or hazardous effects. Some of the drugs used in traditional medicine proved to be carcinogenic or acting badly on some vital organs of the body as, e.g. the liver.
Therefore the call for using herbal drugs for treatment was conditioned by necessity of such drugs being safe beside being effective of course.
A thorough scientific study should be carried out, especially on new drugs, to confirm their safety and efficacy. Such studies usually include:
a-Identification of the botanical origin of the drug including description of its main botanical features that facilitate its recognition, both in the entire and powdered forms.
b-A complete chemical analysis for identification of its different constituents, especially those responsible for its pharmacological action. A reliable method for estimating its main constituents is essential.
c-Pharmacological study, especially toxicity studies both acute and chronic to assure its safety.
d-Clinical studies are required, especially for new drugs to confirm their efficacy. For old drugs, their use for a very long time and in different countries for treatment of same diseases is a good parameter for their efficacy.
It is noteworthy that herbal drugs included in different Pharmacopoeas can be considered reliable drugs as most of them have passed all the necessary steps as aforementioned and such drugs are considered effective and safe when taken in the prescribed manner and reported doses.
Concerning the use of herbal drugs in Egypt, lets go back in history. Egypt has a very old and glorious history in using herbal medicine. May be Egypt was amongst the first countries in the world to use herbal medicine on a rather scientific bases. Description and formulating precriptions was carried out by a herbalist who was a specialized priest. He had the knowledge of formulating herbal drugs.
Preparation of herbs as medicaments was carried out in a special room in the temple. This room was used as drug store. In this room, drugs were arranged according to their organs, e.g. roots, leaves, flowers, seeds, fruits. Special shelves were made for minerals, waxes, vegetable oils, volatile oils.
Drugs were formulated in different pharmaceutical forms such as teas, linaments, creams, lotions, pessaries, drops, etc according to type of disease and manner of application.
The herbalist was aided by a small boy who was taught and prepared to be the future herbalist.
Many of the prescriptions written on temple walls and, or in papyri scrolls revealed that ancient Egyptians were aware of the usefulness of many herbal drugs and used many of them in same purposes as they are used to-day and almost in the same manner.
It is just sufficient to mention the amazing mysterious miracle of embalming. Nowadays, and in spite of the enormous progress in all fields of science, the secret of embalming is still undiscovered.
The use of herbal medicine in Egypt, continued to flourish through different era from Ancient Egyptians through Roman time and first Arab islamic times.
In spite, however, of this glorious old history of using herbal medicine for treatment in Egypt, recent time witnessed a significant decline in this respect. Most treatments are carried out by conventional medicine. Treatment with herbal medicine is carried out as a folk medicine, by Attareens. Attareens usually sell spices and crude herbal drugs in their shops. They are not qualified persons but they have acquired their knowledge from old Arabian books as those of Ibn -Sina and Dawood El-Antaki. Most patients that seek remedy from Attareens belong to the poor class, mainly illeterated people.
A very important reason, in my opinion that lead to decline in use of herbal drugs in treatment, as supportive to chemical ones used in conventional medicine, lies in the ignorance of describing herbal medicines by physicians. Physicians, especially newly graduated ones, have no belief in herbal medicine, simply because they havent studied their value in their faculties. Actually the syllabi of nearly all faculties of medicine in Egypt lack course dealing with herbal drugs. Therefore physicians do not realize the importance of such drugs and regard them as nothing but a folk type of treatment without scientific basis.
To encourage incorporating herbal medicine in conventional medicine, WHO held many symposia among member states. Each member state was advised to establish a committee including different specialists for planning health policy and choosing a list of herbal drugs that are most active, safe and common to be incorporated in primary health care services.
Unfortunately, until now, no such committee has been established. Ministry of health is considered the only organization responsible for planning and controlling all health services. Ministry of health established a committee responsible for registration of drugs. The rules governing registration of herbal drugs are nearly the same as those for chemical conventional drugs. Processes of registration are tedious and lengthy and therefore many herbal drugs producers prefer registering their roducts as food supplements rather than drugs.
Now in Egypt, there is a trend, as in allover the world, to make use of herbal drugs. People every where are getting more and more convinced by their efficacy, beside their safety and comparatively lower price. This trend is potentiated by the fear of the impact of adopting the GATT and Trips agreement in 2005 on conventional drug price.
Much efforts are now done to re-evaluate the Egyptian resources from medicinal plants and discover new ones. Much scientific work is being done to find out most appropriate herbs regarding their efficacy, safety and availability. The studies include the most suitable pharmaceutical forms for their incorporation. This task is taken to find drugs to be supportive to conventional medicine (not alternating to them). The philosophy now is to find a herbal drug that can go side by side with the conventional medicine and make available effective, safe and affordable drugs.