Medicinal plants in tropical countries : traditional use - experience - facts : 22 tables

177 Pages·2005·6.476 MB·English

by  Mechler, Ernst, Mueller, Markus S

Mueller_Plants_138341 29.09.2004 9:59 Uhr Seite 1
Medicinal Plants
MM in Tropical Countries
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rr Complementary Traditional Use—Experience—Facts
Practical medical recommendations for use of Medicine
medicinal plants, based on a scientific approach!
According to estimates of the World Health Organization, M Markus S. Mueller, M.D.
80% of the world population is primarily reliant on traditio- e
d Ernst Mechler, Ph.D.
nal methods of healing, which uses empirical knowledge based on the use of i
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medicinal plants. In many rural areas of developing countries there are no in
alternatives to traditional methods of healing, as neither the financial means a
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nor the necessary infrastructure are in place to allow the use of imported P
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pharmaceuticals. a
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There are, however, insufficient data available regarding the efficacy and side-
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effects of the treatment of diseases with medicinal plants. The plants described

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in this book were chosen from a list of 4776 medicinal plants predominantly r
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used in Africa. 54 of these plants were described in ethno-pharmacological p
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reports from five or more African countries, and from this list 25 of the most c
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frequently reported plants were chosen for this collection. l

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Pharmacists, practitioners, nurses, and other people in health care who work in u
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African or other developing countries must often know about both the positive
t
r
and the toxic characteristics of medicinal plants. These monographs present a i
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helpful summary of the often contradictory information on the use of medicinal s
plants. An assessment of each individual plant is provided in each monograph.
The Americas ISBN 3-13-138341-0 (GTV) Rest of World
ISBN 1-58890-253-6 ISBN 1-58890-253-6 (TNY) ISBN 3-13-138341-0
,!7IB5I8-jacfdf! ,!7ID1D1-didebj!
www.thieme.com
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Medicinal Plants
in Tropical Countries
Traditional Use—Experience—Facts
Markus S. Mueller, M.D.
German Institute for Medical Mission
Tuebingen
Germany
Ernst Mechler, Ph.D.
University of Tuebingen
Pharmaceutical Institute
Tuebingen
Germany
28 illustrations
22 tables
Thieme
Stuttgart · New York
I_VIII_Titelei.fm Seite IV Mittwoch, 25. Mai 2011 9:26 09
Library of Congress Cataloging-in-Publication Data Important note: Medicine is an ever-changing sci-
is available from the publisher ence undergoing continual development. Research
and clinical experience are continually expanding our
knowledge, in particular our knowledge of proper
treatment and drug therapy. Insofar as this book men-
tions any dosage or application, readers may rest as-
sured that the authors, editors, and publishers have
made every effort to ensure that such references are in
Picture Credits: accordance with the state of knowledge at the time
Anamed e.V.: pp. 28, 32, 51, 58, 63, 67, 73, 84, 90, of production of the book.
114, 122, 144, 152, 156, 164 Nevertheless, this does not involve, imply, or express
Elke Mueller: pp. 104, 114, 131 any guarantee or responsibility on the part of the pub-
Markus Mueller M.D.: pp. 21, 39, 45, 98, 110, 137 lishers in respect to any dosage instructions and forms
of applications stated in the book. Every user is re-
quested to examine carefully the manufacturers’
leaflets accompanying each drug and to check, if nec-
essary in consultation with a physician or specialist,
whether the dosage schedules mentioned therein or
the contraindications stated by the manufacturers dif-
fer from the statements made in the present book.
Such examination is particularly important with drugs
that are either rarely used or have been newly released
on the market. Every dosage schedule or every form of
application used is entirely at the user’s own risk and
responsibility. The authors and publishers request
every user to report to the publishers any discrepan-
cies or inaccuracies noticed. If errors in this work are
found after publication, errata will be posted at
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Some of the product names, patents, and registered
designs referred to in this book are in fact registered
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reference to this fact is not always made in the text.
Therefore, the appearance of a name without designa-
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sentation by the publisher that it is in the public
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© 2005 Georg Thieme Verlag,
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Printed in Germany by Gulde Druck, Tübingen
ISBN 3-13-138341-0 (GTV)
ISBN 1-58890-253-6 (TNY) 1 2 3 4 5
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V
Introduction
According to estimates of the World Health Organization, 80% of the world popula-
tion is primarily reliant on traditional methods of healing which use empirical
knowledge based on the use of medicinal plants. In many rural areas in developing
countries there are no alternatives to traditional methods of healing, as neither the
financial means nor the infrastructure is in place to allow the use of imported phar-
maceuticals.
Pharmaceutical and pharmacological studies of many of the commonly used plants
have already been undertaken. However, insufficient data fulfilling the criteria of ev-
idence-based medicine are available regarding the efficacy and side effects of the
treatment of disease with medicinal plants. The result is that medical practitioners
trained in modern Western medicine mistrust their widespread use in rural areas.
These monographs aim to overcome this contradiction – of common usage on the
one hand and lack of knowledge on the other – by presenting the necessary informa-
tion and a critical analysis of 25 important medicinal plants.
The plants described here were chosen from a list of 4776 medicinal plants which
are predominantly used in Africa. Fifty-four of these plants have been described in
ethnopharmacological reports from five or more African countries, and from this list
25 of the most frequently reported plants were chosen for this collection.
An assessment of the state of knowledge regarding the individual plants in each
monograph is indicated with between no and four asterisks, as follows:
* Experimental investigations or studies of the plant chemistry recorded in eth-
nopharmacological reports indicate the efficacy of the described application.
** In addition, there is evidence indicating that a risk of extreme toxicity is ab-
sent.
*** In addition, clinical studies already exist confirming the efficacy of the appli-
cation.
**** In addition, the application has already been recorded in medical books or of-
ficial monographs such as pharmacopeias.
The purpose of these monographs is to present a helpful summary of the often con-
tradictory information on the use of medicinal plants in traditional medicine, in a
way that is useful in the first instance to doctors, pharmacists, and other health prac-
titioners in developing countries. In the first two introductory chapters we also hope
to enable the reader to develop a better understanding of the significance of scientific
investigations of traditional medicine in African countries.
Medicinal plants are often not taken seriously enough in the tropics. We sincerely
hope that this publication will contribute to a more thoroughgoing debate on their
usefulness. It should be seen as a report, not as a handbook of instruction for the use
of the plants.
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VI
Acknowledgements
The compilation of this collection of monographs was made possible through the
support of the German Institute for Medical Mission, Tübingen (DIFÄM) and Chris-
tian Services International, Stuttgart (Christliche Fachkräfte International, CFI). We
would like particularly to thank Dr. R. Bastian (DIFÄM) and Pastor W. Scheffbuch
(CFI).
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VII
Contents
1 Traditional Medicine and Modern Medicine: The Need to Collaborate . . . . . 1
Folk Medicine (Home Remedies) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
The Medicine of the Traditional Healers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Conceptual Traditional Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Integration of Medicinal Plants into Primary Health Care . . . . . . . . . . . . . . . . . . . . . . 2

2 The Example of Malaria: How Helpful Are Medicinal Plants? . . . . . . . . . . . . . . . 5
Traditional Medicine Is Widespread . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Western Medicine and Traditional Medicine: Is Cooperation Possible? . . . . . . . . . 6
Necessity of Multidisciplinary Investigations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Lack of Clinical Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Medicinal Plants and Primary Health Care: The Authors’ Own Observations . . . . . 8
Concluding Remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
3 Monographs on Medicinal Plants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Adansonia digitata (Bombacaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Allium sativum (Liliaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Aloe barbadensis (Liliaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Balanites aegyptiaca (Zygophyllaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Cajanus cajan (Fabaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Capsicum frutescens (Solanaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Carica papaya (Caricaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Cassia alata (Caesalpiniaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Cassia senna (Caesalpiniaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Curcuma longa (Zingiberaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Eucalyptus globulus (Myrtaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Euphorbia hirta (Euphorbiaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Indigofera arrecta (Fabaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Jatropha curcas (Euphorbiaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Mangifera indica (Anacardiaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Maytenus senegalensis (Celastraceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Passiflora incarnata (Passifloraceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Psidium guajava (Myrtaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Punica granatum (Punicaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Rauwolfia vomitoria (Apocynaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Rauwolfia serpentina (Apocynaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Ricinus communis (Euphorbiaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Sida cordifolia (Malvaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Vernonia amygdalina (Asteraceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
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VIII Contents
Zea mays (Poaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Zingiber officinale (Zingiberaceae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163
Inhalt_ok.fm Seite 1 Mittwoch, 25. Mai 2011 9:15 09
1
1 Traditional Medicine and Modern
Medicine: The Need to Collaborate
When we opened a seminar about traditional medicine in Asmara, Eritrea, with the
question “Which of you already has some experience with traditional medicine,”
there was absolute, even hostile silence in the room. Finally, some delegates said:
“We are Christians; we have nothing to do with it.” We then presented a Datura stra-
monium plant, which we had picked just in front of the training center, and explained
how we use it in hospitals in the Democratic Republic of Congo (formerly Zaïre). Sud-
denly life returned to the audience. Everybody knew this plant! It was used in the
delegates’ families for many ailments ranging from toothache to abscesses and ab-
dominal cramps. In the end we talked about this one plant for more than an hour.
This sharp contrast in the reactions of people towards traditional medicine is fre-
quently found in many places in the world. A patient in Uganda told me, “We all use
it but we don’t like to talk about it—at least not in front of a white missionary doctor.”
Part of the problem is the complexity of the subject. Traditional medicine cannot be
clearly defined, as it encompasses a broad spectrum of methods to treat diseases
based on personal observation or on experience transmitted from community mem-
bers orally across several generations. Although there may be some good evidence
for its efficacy from standardized experimental observations presented by university
scientists, people use traditional methods mainly because of empirical experience
derived from observations they have made in certain places at certain times. This is,
in fact, the only common feature of all the different ways of treating diseases that we
call “traditional medicine.”
Traditional medicine can, broadly speaking, be divided into three groups: (1) pop-
ular medicine (domestic remedies), (2) the medicine of the traditional healers, and
(3) conceptual traditional medicine.
■
Folk Medicine (Home Remedies)
From childhood onward, people use medicinal plants to treat ailments and diseases,
often with astonishing effectiveness. In the area of the Bashi people of the eastern DR
Congo, for example, mothers give two or three drops of the squeezed leaves of Tet-
rademia riparia for their babies to drink when they have abdominal cramps. For fe-
ver, people collect leaves of the Vernonia amygdalina tree (“bitter leaf”), and for
intestinal worms the leaves of the small herb Celosia trigyna are used.
These treatments have two characteristics in common:
–They are applied by the patients or their family members themselves, and therefore
they are free of charge.
–Observations about the use of these plants are exchanged freely between families
and there are no secrets about their applications.
Some medicinal plants are used only as medicines, others as medicine and food.