Contribution to a global proposal supporting the use of medicinal plants by developing countries: The case of Guatemala

ARMANDO CACERES

San Carlos University of Guatemala, Guatemala

Introduction

The genetic and cultural wealth of Guatemala expresses itself on a traditional medicine based on the use of medicinal plants. The experiences of the last decade indicate that the issue of the medicinal plants is of interest from all points of view and it might contribute to the development of the people by means of its systematic study in a multidisciplinary approach. The present paper summarises the Guatemalan experiences in recognising, organizing, coordinating and implementing institutional and national projects in order to fully validate the use of medicinal plants and to support its application by the national health systems.

Research and development strategy

The fact that Guatemala is placed in the junction of the North and the South, the Atlantic and the Pacific, brings about the result that the country has an outstanding biological diversity, in spite of the threatening decay seen in its national heritage. The cultural legacy of the Mayas' forefathers is rich in the wise use of the resources produced by nature, out of which a deeply rooted traditional medicine has been formed. However, it lacks systematization and has not achieved full acceptance as part of the national legal medical system. The social decadence and the financial "bankruptcy" generalized in many countries, to the health problems, the growing incapacity to purchase of imported drugs and the lack of supplies of pharmaceutical products in the the local markets, create the need to look into a therapeutic system which is part of the national heritage. In an effort to contribute to the reconstruction of Guatemala after the earthquake of 1976, Meso-American Centre for Studies on Appropriate Technology (CEMAT) was created as a non-governmental organization, projecting itself towards the adaptation and integration of appropriate technologies for development within the framework of the organization of rural micro-enterpreneurial groups. The areas covered have been: energy (timber, biogas, gasification); sanitation (latrines, digestors, water purification); agriculture and primary health care (phytotherapy, acupuncture promoters); building materials (puzzalana, fibercreto covers), mini-animal husbandry (bees, rabbits, fishes, swine) and information (information center with 250,000 specialized documents, bulletin in two languages sent to 76 countries, translations, organization of national and international events). With the experience attained by means of the joint research with the groups, a methodology of workshops was developed to train and up-grade the rural personnel in construction, monitoring use of the appropriate technology introduced, as well as in the micro-enterprise organization of these community groups.

An area which received particular attention was the project under the title: "Rural Enterprise of Medicinal Plants" which carried out activities during 1979-89 in six fields, namely: ethnobotany, agronomy, pharmacology, industrialization, training and information. The findings have been published in national and international bulletins. At present the Programme of Medicinal Plants of CEMAT is financing four research projects namely: a Producers' Commodity network, Industrialization, Commercialization, and Information and Training.

The ever growing demands to work on medicinal plants on a comprehensive way led to the formation of a multi-disciplinary and inter-institutional group to coordinate the activities for the optimal use of the natural and ethnomedical resources, especially the use of medicinal plants. In 1984 a Committee, CONAPLAMED, was formed, which in 1988, was transformed into a Commission which is now awaiting legalization. CONAPLAMED is made up of 12 public and private institutions. Its organizational structure is based on three national groups: Ethnobotany-Agronomy, which deals with projects related to botanical and agronomical studies; Phytochemistry- Pharmacology whose objective is to conduct scientific studies lending to the validation of the use of medicinal plants, and Industrialization-Commercialization, which deals with industrialization and commercialization of medicinal plants and by- products. The Commission organizes annual National Seminars on Traditional Medicine in which the research information from the national groups is disseminated. In this way the research findings have been disseminated at national level, but coordination at an international level is underway to achieve some international exchange of information. Since 1982 there is an active participation in the TRAMIL workshops for the creation of a Caribbean Pharmacopoeia under the coordination of ENDA-Caribbean in the Dominican Republic which will take place in Guatemala in November, 1990. In 1987 the First Meso-American Seminar of Ethno- Pharmacology was organized with 150 participants from 10 countries. 20 scientific papers were presented and published. The Second Meso-American Seminar of Ethno-Pharmacology took place in San Jose, Costa Rica, in December 1989.

Objectives

General

To scientifically validate the use of traditional medicine as an integral part of the national systems of health care; to strengthen the acceptance of traditional medicine by the people as part of their cultural heritage.

Specific

· To compile existing ethnobotanical information according to practising ethnic groups.

· To encourage the cultivation of medicinal plants as part of the conservation strategy.

· To develop non-sophisticated technology for the utilization of indigenous and exotic medicinal plants.

· To conduct chemical and pharmacological studies in order to validate the efficacy of popularly used medicinal plants.

· To disseminate important scientific information on medicinal plants.

· To compile national and regional pharmacopoeia of medicinal plants.

· To promote the production of plant - derived pharmaceuticals based on the available indigenous medical flora.

· To create an awareness at all decision making levels, on the importance of traditional medicine as a priority in formulating health policies.

· To provide financial support to all initiatives working towards promoting the utilization of medicinal plants and phytopharmaceutical products.

Methodology

In order to achieve these objectives, there is a need to form a multidisciplinary and inter-institutional research team representing various research institutions to effect the following:

· Carrying out countrywide ethnobotanical surveys to assess the medicinal potential of the indigenous flora. The collected voucher plant specimens should enrich our national herbaria for retrieval and exchange purposes.

· To encourage planting of the most commonly used medicinal plants by the farmers and family communities. Further the work of preserving native species would be promoted through the integration of these plants in silviculture and agroforestry programmes.

· To establish medicinal plant farms for those plants with known chemical composition and efficacy. However, experimentation to determine the agronomical parameters of indigenous medicinal plants should be conducted prior to large scale cultivation.

· To establish adequate research infrastructure, including expertise and well equipped laboratories, to conduct chemical and pharmacological studies including in-vitro, in-vivo studies and clinical evaluation of our medicinal plants and pharmaceutical products.

· To exchange research information by means of networks so as to have access to the information in research centers from other countries. Although specialized information networks on medicinal plants do exist, the researchers have a limited access to the information due to either financial or technological reasons.

· To compile a national pharmacopoeia. The proceedings of the TRAMIL workshop illustrates the way to attain this important objective. It is based on information obtained from regional field ethnobotanical surveys and recommendations emanating from scientific workshops.

· To produce laboratory or pilot-plant scale extracts of active principles or phytotherapeutical products at a sustainable level, with the agricultural production capacity. The goal would be to substitute a percentage of the imported drugs and to subsidize these operations until they become competitive with the market of the multinationals.

· To promote and consolidate the use and transmission of the concepts and practices of traditional medicine, as well as to convince the modern medical system on the qualities of these traditional therapeutic practices.

· To establish an international network of institutions working on the validation of traditional medicine. Perhaps the identification work of the institutions and the working plan might require some time but once consolidated it could favour all the member states. The role of the modern medical system is very important but we have to acknowledge the need for a change in the mentality and policies of the entire health systems. The financial support of both the government and donor agencies should put emphasis in strengthening the local research capability to implement the required projects. Where such research capability is not sufficient, joint projects could be implemented by specialized centers in developing countries.

Remarks

Given the political will in the developing countries, the financial backing from friendly countries, the technical cooperation of international agencies, and the commitment on the part of the national groups, then it would be possible to create working teams to achieve the following:

· The creation of resource teams, technically skilled, which, given the proper material and financial resources, would significantly contribute to the multidisciplinary validation of traditional medicine and to its use in legal health systems, in particular, medicinal plants.

· The cooperation among centres from developing and developed countries to carry out joint projects which will facilitate the proper documentation of what has been done on the validation of medicinal plants, of interest to countries which might benefit from it.

· The production of national or regional pharmacopoeia that will facilitate the utilization of medicinal plants as safe therapeutical alternatives to modern drugs.

· The development of phytopharmaceutical products, which might partially substitute some of the conventional medications demanding imported raw materials, and which could be produced by pharmaceutical industries based in developing countries through joint projects.

· The institutionalization of traditional medicine in all those countries having the necessary conditions to incorporate these beliefs and practices to their national health systems. It is encouraging that in China, India and other countries, traditional medicine has been integrated in primary health care and at present it is in the hands of the population.

· The regaining of self-confidence in combating diseases, promoting the strengthening of national identity, providing alternative choices to the country regarding importation of medications, and comprehensively improving the doctor-patient relationship which lacks in the modern medical system.

References

CEMAT (1980). Report from the First Workshop on Medicinal Botany from Guatemala. CEMAT and Mexican Institute of Research in Medicinal Plants, Guatemala: 51 p.

Caceres, A., L. M. Giron, and M. E. Juarez. (1983). Cooperation studies and technical transference on medicinal plants between USAC/CEMAT. Perspective 2: 160-165.

Caceres. A. and I.M. Giron. (1984). A system for revalidating, researching and commercialization of medicinal plants in Guatemala. In: E.M. Villatoro (Ed.) Ethnomedicine in Guatemala. Centre for Folkloric Studies, Guatemala: 283-316.

Caceres, A., L. M. Giron, and S R Alvarado. (1986). Antibacterial action of Plants with a Medicinal Use in Guatemala. Memoire. Ill Nat. Congress of Microbiology, Guatemala: 89-96.

Fletes, L., L. Aguilar, N. Ayala, B. Lopez, and A. Caceres. (1987). Activity against entero-bacteria by maceration of some vegetables. Memoires. I Meso-American Seminr of Ethnopharmacology and III National Congress on Traditional Medicine, Guatemala: 151-152.

Caceres, A., L. M, Giron, A. M. Martine. (1988). Screening of the diuretic activity of plants used in Guatamala against urinary maladies. Revista Anuario Associacion Guatemalteca de Cardiologia 4: 45-49.

Caceres, A., H. Logemann, M. A. Giron, and B. R. Lopez. (1989). Anti-fungi activity of plants used in Guatemala for the treatment of dermatophytosis. Memorires. Ill Scientific Week of the Faculty CCQQ and Pharmacy, Guatemala: B4-B7.

Caceres, A. and D. Sapper. (1977). Diuretic activity of plants used for the treatment of urinary ailments in Guatemala. Journal of Ethnopharmacology 19: 233-245.

Caceres, A. I.L. M. Giron, Sr. Alvarado, and M. F. Torres. (1987). Screening of antimicrobial activity for plants popularly used in Guatemala for the treatment of dermato-mucosal diseases. Journal of Ethnopharmacology 20: 223-237.

Giron, L. M. (1988). Guatemala's medicinal plants project. Woman of Power 11: 33.

Giron, L. M., G. A. Aguilar, A. Caceres and G. L. Arroyo. (1988). Anticandidal activity of plants used for the treatment of vaginitis in Guatemala and clinical trial of a Solanum digrescenss preparation. Journal of Ethnopharmacology 22: 307-313

Giron, L. M., V. Freire, A. Caceres and A. Alonzo. (1988). Ethnobotanical study of the Caribbean area in Guatemala. Presented at TRAMIL 3 Workshop, Havana: 25

Womiger, L. and L. Robineau. (1988). Elements for a Caribbean Pharmacopoeia, Santo Domingo, ENDA-Caribbean: 318pp.

Memoires. I Meso-American Seminar on Ethnopharmacology and III National Congress on Traditional Medicine, Guatemala, 1.

History and reality of medicinal plants from Ecuador

EDUARDO ESTRELLA

Faculty of Medicine
Museum of the History of Medicine
Quito, Ecuador

ABSTRACT

In this paper the author gives a historical background on the documentation, and traditional medicinal uses of the vascular plants of Ecuador. The paper describes the use of medicinal plants in South America, long before the advent of colonial rule, which came with Spanish invaders into the country. Amongst the many traditional medicinal plants documented and discussed are species of Cinchona, locally known as Quinah, a plant which was subsequently developed as a source of quinine, used for the treatment of malaria. The paper calls for the need to establish national reference herbaria for medicinal plants; the need for incorporating traditional medicinal plant use in modern day national health programmes; the need for promoting the conservation of national forests. lest we lose useful species of medicinal plants; the development of documentation centres for medicinal plants and traditional medicine, etc.

Introduction

The survival and superior development of Man is due, to a great extent, to the benefits obtained in his progressive control of the plant Kingdom. Pre-history Man required several thousand years, and of great efforts, to discover the nourishing qualities of plants; to properly collect them and, later on, to freely cultivate them once agriculture was created. Alongside the acknowledgement of the nutritional value of the plants, experience permitted him to identify the plants, and to discover other qualities related to improving the health for the sick. Subsequently, it was possible to identify, in some plants, the advantages of using them for the treatment of a given disease, and, on the other hand the hazardous, and even the mortal effects, or the psychoactive ones.

The American indigenous medical knowledge is a collection of magical-religious empirical knowledge on the health/disease phenomena, and therapeutics is based on the use of plants to which preventive-curative effects have been historically attached. The Shama, the witch-priest-doctor of the primitive society, is the character who collects and transmits, through generations, the medical traditions of the community. He is the depository of the knowledge on herbal therapeutic uses, and is the selected one for using hallucinogenic drugs, which will change his appearance, and will allow him to know details about the disease, and the fate of the patients.

Pre-Spanic medicinal plants

The Andean Region is one of the most important domestication, adaptation, and diffusion centres of plants from the American continent. The Inca civilization emerged in this surrounding, and, by availing themselves from the ancient traditions of other aboriginal populations, shaped an empire whose life supported itself in land economy. During the Pre-Columbus time, several plants were domesticated, and it was possible to attain a good knowledge on several useful plants, for either feeding purposes, timber extraction, or for the making of dyes and medicines.

In ancient Ecuador, the Cacicazgos, or primitive lords, by following a long tradition, had, at their disposal local products which resulted from wild collection, or planting, in the Amazon region. Added to this knowledge, we see the influence of the Incas, which by the end of the 15 Century, started to go into the North. This mixture was what both the Conquistadors and the historians found. Some of them referred to the presence of these plants. According to their information, during the pre-Spanish era, at least 40 different species of medicinal plants were known. We need to say that almost all the plants used as food, had their use in the aboriginal pharmacopoeia.

Three medicinal plants had a peculiar importance in medical matters in ancient Ecuador, and they were soon incorporated into the European pharmacopoeia: the Zarzaparrilla (Smilax zarzaparilla L.); the Palo Santo or Guayaco (Guayacum officinalis) and the Cascarilla or Quinah (Cinchona sp.). The first two were applied in the treatment of buboes, the French disease, or syphilis, creating great expectations during the 16th and 17 Centuries, thus achieving great commercialization in Europe. It was later seen that their effects were either limited or nil, for the efficient treatment of this infection. At present they are still used by traditional healers, but with a different purpose. The Quinah or Cascarilla, was incorporated into the European pharmacopoeia at the beginning of the 17th Century, creating a real revolution, since it was found to be the first medicine of plant origin, having real curative effects against tercianas, malaria or paludism. The Quinah is the biggest contribution America has done to universal pharmacopoeia, thus saving millions of lives.

Starting with the Spanish conquest, a group of alien plants were added to the native ones, which soon got their naturalization documents, and which were included in the national folklore. Under the influence of Spanish popular medicine, primitive medicine reorganized its knowledge, transforming itself into a practice aimed at the treatment of health problems of the aboriginal population, as well as of the lowest urban strata. Scientific medicine, which came together with the Spaniards, had a slow progress, alongside the three centuries of colonial domination, which based its therapeutics in plant applications. This situation did not change until mid-19th Century, already the Republican Period of the history of Ecuador.

Tradition in the study of medicinal plants

The concern over the study of medicinal plants from different perspectives, has a long tradition in our country. The historical and geographical documents, written by the Spanish authorities, have a vast information on the use of the plants by our native population. Regrettably, there is no systematic work of the ethnic-historical knowledge, which is to be fundamental to the assessment of the evolution of the application of each plant that is useful for medicine. Also, as we have noted, during the 16th Century, new species of plants were introduced, which needed to be differentiated from the native ones, and which had to be studied also, taking into consideration their impact on the therapeutics, and their incorporation into traditional medicine. We must stress that in this century, two native plants have rapidly been incorporated into European pharmacopoeia, by virtue of their curative potency for the treatment of syphilis, rheumatism, and fever in general. Here we are referring to "guayacan" or "palo santo" (Guyacum officinialis) and "zarzaparrilla" (Smilax sp.). In the 17th Century, Quinah (Cinchona sp.) was introduced into the therapeutics, of paludism, this being a major contribution to universal pharmacopoeia. During this time, several historians and some colonial officials, wrote valuable reports on common plants used for food and medicinal practices by the aborigines. Alongside, 18th century scientific studies were started on the American plants. In Ecuador, the arrival of a French geodesy mission, was witnessed in 1735. The historian, Juan de Velasco, wrote a book at the end of that century, titled "The History of the Quito Kingdom". The document contained the first list of medicinal plants.

The arrival of the French geodesy mission, whose task was to measure a section of the Earth meridian, set, as of 1736, an important landmark on the development of knowledge on the botany of Ecuador. La Condomine, and the botanist Jussieau, wrote the first scientific memoirs on Cascarilla, or Quinah de Loja, which later on were used by Linnaeus to establish the genus Cinchona in 1742. All along the 18th Century, the Spanish Crown was very much concerned with the extraction, the transportation, and commercialization of this plant.

At the end of the 18th Century, the historian, Juan de Velasco, in his work, the "History of the Kingdom of Quito", presented a list of 60 medicinal plants from the country, giving their uses and modes of application. Also at that time, the natural sciences flourished in America, with the sending, from Spain, of three botanical expeditions: one to Peru (1777-1788), the second one to Nueva Granada (1783-1816), and the third to Nueva Espana (Mexico), from 1737 to 1803. These expeditions introduced the Linnaean system of naming the medicinal plants. Regarding Ecuador, the botanists Juan Tafalla and Juan Augstin Manzanilla, members of the botanical expedition to Peru, studied, for nine years the tropical and Andean flora, and carried out (in Loja) the most important research work on Quinas, describing 32 different species. These works were incorporated in one book, "Flora Huayaquilensis", which remained unpublished until 1989. Several medicinal plants are part of this "Flora". Francisco Jose de Caldas, a member of the botanical expedition to Nueva Granada, visited the country between 1801 and 1805, and also discovered several species of medicinal plants. Humboldt and Bonpland, who arrived in the country in 1802, also carried out outstanding studies on the natural history of Eduardor. Finally, the native botanist, Jose Mejia Laquerica, between 1802 and 1806, wrote the first Ecuadorian botanical study, "Plantas Quitenas", in which he listed several species used in biomedicine.

During the 19th Century, botanists Jameson and Sodiro, developed their botanical research work to such a significant level that this period is known in history as, "the golden age of Ecuadorian botany".

Jameson, a German national, lived in Ecuador from 1822 until 1873, and published his book, "Synopsis Plantarum Aequatoriensium", in which he cited medicinal applications of plants. Sodiro, an Italian botanist, arrived in the country in 1870, and carried out several valuable taxonomic studies on the plants of the country, and also initiated the development of the first national herbarium. He published several books.

Luis Cordero, a distinguished researcher in botany, sent in 1889, a collection of medicinal plants to the Universal Exhibit in Paris, obtaining a silver medal for that. In 1890, this study was published, and in it, indications are given on the uses and effects of the plants. Later on he published his great work, "Enumeracion Botanica", a reference book, which is a must for those working on Ecuadorian plants. Also around those same years, a physician from Quito, Jose Maria Troya, published his work "Vocabulario de Medicina Domestica", which is the first book giving medical information, published in the country, with a scientific perspective. In it, formulae and techniques in the handling of the remedies which are of plant origin are presented.

At the First Medical Congress held in Guayaquil in 1915, Dr. Marco Tulio Varea pre sented a paper under the title "Botanica Medica Nacional, published in 1922 as a book, which later on, became the most valuable piece of work done in this field. During the last decades, valuable botanical, anthropological, phytochemical, and pharmacological research was carried out. Miguel Acosta Solis, Alfredo Paredes, and Plutarco Naranjo merit to be named in these areas due to their valuable contributions.

Medicinal plants and the present medical practice in Ecuador

At present Ecuadorian medical practice might be classified into two big categories: (a) official or scientific practice, and (b) traditional practice. Regarding the latter, some research has been done lately, which Justifies its recognition as "knowledge", widely used by the population. Traditional medicine represents an ideological and empirical answer on the part of the population to its own health needs. It has been preserved, thanks to tradition, and it is used by the vast majority of the population in the rural areas (50 per cent of the 10,000,000 inhabitants), especially by indigenous peasants. It is also used in the urban-marginal neighborhoods of the cities. The concepts and practices used by this medicine, are rational, and are in accordance with the definitions of nature, Man and the society of which the peasant population is a part. These definitions are determined by the functions implemented by this social group in the production process of the country, thus explaining the degree of acquisition of a dominant ideology, especially of the schemes of the catholic religion, and of the survival of ancient ideas and beliefs. There are theoretical as well as empirical elements of great importance regarding traditional medicine we could name: the broad concept of health and disease; the systematization or classification of diseases and their treatment according to the concept of chance, the therapeutic use of the values of the community, the successful application of several psychological resources, the empirical treatment based on the knowledge of medicinal properties of the different plants, animal and mineral products, learning through practice, and the acceptance of tradition. The healers of the aboriginal medical practices are classified as follows: (a) the witchdoctor, (b) the healer by horror, (c) the herbalist, (d) the masseur and (e) the midwife.

Traditional medicine is a lively element in the Ecuadorian medical practice. It is true that in recent years the rendering of medical care by the state medical services, has increased outstandingly, both in the urban as well as in the rural areas. Nevertheless, due to the communication problems derived from the unavoidable cultural problems and the high price of the drugs, a large part of the population still use exclusively or perhaps in combination with the drugs from the Western medicine, medicinal plants. On the other hand, the mobility structures felt by the population, basically composed of temporary small ailments, always offers possibilities to simplify the therapies.

Lately, the historical continuity of the use of plants has come to being part and parcel of the self-identity of the Ecuadorean citizen, thus requiring a study, recuperation and diffusion process of the value of medicinal plants, so as to prevent its disappearance in the hard struggle witnessed in our countries, between what is modern and tradition.

Justification for the development of studies on medicinal plants

As we have been stating, there have been, in the country, an important concern for the study of medicinal plants. But these works have not been systematized and most of them are not known at all. Any research work which will allow the systematization of ethnobotanical, and historical information, and which places in time and space the importance of each plant, would undoubtedly represent a contribution to the knowledge of the important field of medicine. On the other hand, if these investigations would concentrate themselves in the phytochemical and pharmacological studies developed in recent decades, they would provide for objective and scientific backing to the popular knowledge, regarding the beneficial effects of the plants. Finally, if these research scientists were able to collect, by means of epidemiological and anthropological methods, data on the prevalence of the present use of medicinal plants, we would obtain extraordinarily useful information.

Given the situation of national medical practice and the need for training health professionals, it is necessary to start implementing the useful national information on medicinal plants. The professionals graduating from the Faculties of medicine, and who have to complete a year learning about rural medicine, face a serious problem of communication with the population in the countryside, and they are not able to handle situations related to traditional medicinal practice. A technically drafted manual, giving an elaboration on herbal medicine, will be of tremendous help in solving these problems. Also, by doing so, we will start a real process of integrating medical practice.

The population needs to have at its disposal a serious scientific information on the value of medicinal plants, because if, it does not, the people will continue to base their beliefs on information permeated with magic and witchcraft. It is also possible that a more scientifically based application of the plants, might help in solving the health problems of the population.

The Amazon Region is one of the few regions in the world which still holds an extraordinarily rich botanical heritage, which has not been fully studied. The phenomena derived from the impact of modern agro-industry are fostering a speedy deforestation of the virgin vegetation of the Amazon, and it is necessary to take proper measures to ensure its protection; and the country's researchers should undertake botanical, anthropological, clinical, and phytochemical studies, in order to determine the nutritional and medicinal values of the plants in this region.

The conservation of the culture of Third World countries can be effected in several fields. One of these is the recognition and evaluation of all that the population has been able to accumulate as knowledge on the use of the elements of nature, in order to satisfy their needs, and for the solution of their problems. This necessitates that we involve politicians and administrators in the execution of research and the dissemination of information regarding medicinal plants.

Summary and conclusion

The information presented above indicates the following areas of priority with respect to the medicinal plants of Ecuador:

· Ethnohistorical studies on medicinal plants which will allow one to systematize and objectively place, in time and space, information compiled by scientists to date.

· Epidemiological studies on the use of medicinal plants in different ecological and socio-cultural strata.

· Botanical, anthropological, and biochemical research on the plants from the Amazon Region.

· Systematization of the information on the biochemical, pharmacological, and clinical studies undertaken in the country.

· Diffusion of the results of whatever is known, up until now.

· Drafting of manuals, catalogues, brochures, videos, etc.

· Promotion of conservationist policies.

· Incorporation of traditional medicine and medicinal plants in the National Health Programme.

· Development of herbaria of medicinal plants.

· Development of a Documentation Center on Traditional Medicine and Medicine Plants.

· Development of joint regional programmes amongst the countries from the Andean Region.

· Exchange of information and documentation.

References

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Arcos, G. (1933). Evolucion de la Medicina en el Ecuador. (Evolution of Medicine in Ecuador). Imprenta Fernandez, Quito.

Caldas, F.J. (1968). Cartas. (Letters) Imprenta Nac. Bogota.

Cordero, L. (1980). "Plantas Medicinales" (Medicinal Plants) Revista Cientifico-Literaria de la Corporacion Universitaria del Azuay 1(1): 19-25.

Cordero, L. (1950). Enumeracion Botanica. (Botanical Enumeration) Afrodisio Aguado, Madrid, (II Edic.)

Engel, Frederic. (1966). Geografia Humana Prehistorica y Agricultura Pre-Colombina en la Quebrada de Chilca. (Pre-history Human Geography and Pre-Columbus Agriculture in Quebrada de Chilca) Ed.Universidad Agraria, Lima.

Estrella, Eduardo. (1977). Medicina Aborigen. (Aborigine Medicine) Ed. Epoca, Quito.

Estrella, Eduardo. (1980). Medicina y Estructura Socio-Economica. (Medicine and Socio-Economic Structure). Ed. Belen, Quito.

Estrella, Eduardo. (1986). El Pan de America. (Bread from America) CSIC, Madrid.

Estrella, Eduardo. (1989). "Introduccion". En: Flora Huayaquilensis. (Introduction in Flora Huayaquilensis) ICONA, Madrid.

Gonzalez Suares, Federico. (1905). Memoria historica sobre Mutis y la Expedicion Botanica de Bogota. (Historic Memory on Mutis and the Bogota Botanical Expedition). Imprenta del Clero, Quite, (II Ed.)

Gonzalez Suares, Federico. (1968). Historia General del Ecuador. (General History of Ecuador). Ed. Casa de la Cultura, Quito. T. III.

Humboldt, Alexander. (1978) Sitios de las Cordilleras. (Places in the Mountain Flange). Imprenta y Libreria Gaspar. Madrid.

Jameson, Julielmo. (1965). Synopsis Plantarum Aequatoriensium. Typis Joannis Pauli Sanz, Quito. 2 Vols.

Jimenez de la Espada, Marcos. (1965). Relaciones Geograficas de India. Peru. (Indies Geographical Relations. Peru) Ed. Atlas, Madrid. 3 Vols.

Juan, Jorge y Ulloa, Antonio. (1978). Relacion Historica del Viaje a la America Meridional. (Historical Relation of the Trip to Southern America). Ed. Fundacion Univ. Espanola, Madrid.

Munoz, Jose E. (1952). Apuntes para la Historia de la Farmacia en el Ecuador (Notes for the History of Pharmacy in Ecuador) Ed. Ruminahui, Quito.

Naranjo, Plutarco. (1979). Bibliografia. (Bibliography) Revista Ecuatoriana de Medicina y Ciencias Biologicas (Quito), 15 (2): 469-486.

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Paredes, Alfredo. (1970). Propseccion fitoquimica de las plantas economicas del Ecuador. (Phytochemical prospection of plants with an economic value in Ecuador). Politecnica (Quito), 2(1): 4557-499.

Paredes Borja, Virgilio. (1947). La contribucion del Ecuador a la Materia Medica: La Quinah. (Ecuador's contribution to Medicine: Quina). Ed. Casa de la Cultura Ecuatoriana, Quito.

Sodiro, Luis: Most of his works are published in the history of Central University. Anales de la Univ. Central Quito) from 1995 to 1910.

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Varea, Marco Tulio. (1922). Botanica Medica Nacional. (National Medical Botany) Tipografia Vicente Leon, Latacunga.

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African indigenous medicine: Its standardization and evaluation within the policy of primary health care

M. KOUMARE

WHO Africa Office
Brazaville, Republic of Congo

ABSTRACT

The indigenous African remedy obeys some rules of preparation which respect and allow the obtention of acceptably standardized products, qualitatively and quantitatively.

The study of therapeutic dosages used by traditional health practitioners shows that these dosages are also acceptable.

The effectiveness of therapy studied by clinical tests as well as the importance of the accomplishment of indigenous remedy, both constitute the elements for their evaluation.

The rules of this evaluation are expected to take account of the concept of African indigenty.

Introduction

There is no doubt today that Primary Health Care (PHC) offers one of the most viable approaches for attaining accessibility to health for all. In fact, this approach takes into account all appropriate resources available, including the practices and remedies in the indigenous system of care. The pharmaceutical component of this policy of Primary Health Care, requires the provision of appropriate medicines to the populations, taking into account both geographical and economical factors.

In spite of the popularity of the African indigenous medicine, its acceptability is still viewed with certain distrust. Hence the necessity of its evaluation and its standardization in order to enable it to be confirmed and to be registered on the list of essential medicines.

Although everybody is unanimous on the necessity of an evaluation, not everybody is in favour of the conditions which are currently applied in putting new medicines on the market. Our purpose is not really to bid acceptance of whatever medicine for Primary Health Care, nor again to match the African indigenous medicine with the European medicine; but rather to present an experience, whose aim is to dispel the distrust that has been caused by negative prejudices and to assist in solving the problem of public health, which is the regular destination of sanitary training programmes in medicine.

Although there is an apparent analogy in the medicinal conceptions of the two systems of health care, namely, the African indigenous and the European exotic system, it is also true that the philosophy that underlies them is different. One is a result of an analytical method of reasoning and of experimentation; and the other is a result of a systematic method of intuition and empiricism.

At first, one could think that the medicines of the European exotic system treat the causes of illness and that those of the African indigenous system deal with the symptoms. We would like to state that it is not just to say that the African indigenous medicines are only used to treat the symptoms.

As we have already stated orally and in writing, each of these systems of treatment has "etiological medicines" as well as "symptomatic medicines" whose application depends on given rules. It has become both necessary and urgent that we should discuss these rules, so as to know the degree to which they are reliable and to allow better standardization of the African indigenous treatment. As such, we have tried to follow the procedures of its elaboration and its administration.

The elaboration of the African indigenous medicine

The distrust, leave alone fear, that we have described above still persists within the African indigenous medicine, in spite of the great involvement of the populations. One cannot deny the fact that this distrust is justified; but, unfortunately, too often and even improperly, we tend to accuse the therapeutical quality and doses of the indigenous medicines. "The false healers" are, unfortunately, too many and it is not possible to guarantee their skills and competence. In fact, we are not denying the insufficiency of the African traditional pharmaceutical art; but it appears to us unjust not to recognize that there exist rules for the preparation and the administration of indigenous medicines well adapted to the system.

In order to be truly convinced, it is sufficient to note that in certain countries, it has been possible to codify the rules of the indigenous medicine in general and that of the indigenous treatment in particular.

Raw materials

We shall limit ourselves, in this study, to medicinal plants which form the major part of the raw materials and whose techniques for collection seem to be well respected, if not standardized.

The strict respect of the rules for collection, arises from the fear that the phytotherapeutist derives his experience from the transgression of these rules. Each gesture is taken into account. We do not share the view of those who always see in its implementation nothing but superstition. Moreover, even if there was an element of superstition, it would be desirable not to be opposed to it before knowing its origin or making its complete evaluation. In the same way, it is important to preserve all the necessary conditions during the collection phase and to obtain average samples of the raw materials that would be easy to test and to confirm. In our opinion, the presentation under the form of bundles easily draws one's attention. We have tried to find out the approximate weight by vegetable species. This homologation, from our modest experience, is more convenient for the phytotherapists than for the herbalists who are much worried about the sales of their products, even when there is an apparent homogeneity of all the bundles.

The identification of plants is not only morphological; it is a real diagnosis which is practised by the phytotherapist from the organoleptic characteristics. Moreover, he knows the period and the place of collection, and the part of the plant which will ensure constant results. Unfortunately, many researchers do not involve themselves with the terrain and do not ask questions sufficiently. It is rare that the phytotherapist will preserve raw materials for a whole year. While for herbalists this is a usual practice.

In our opinion, with the identification made by the phytotherapists, the knowledge of the useful part of the plant, the techniques, period and the favourable place for the collection - all this makes it possible to establish the basis for an acceptable homologation from the average samples.

It is certain that, it is necessary for the institutions which are responsible for the study of medicinal plants, to gradually improve this knowledge by supplementing it with other elements which are normally not part of the traditional health practitioners. It is the method of approach which make us determine the best period for collection, the major chemical groups, the water content, ashes and essential oils, etc. If the traditional medical ethics require the phytotherapist to observe strict respect of some definite rules of collection, it would be advisable to make an adaptation of the preparation and of the treatment of the patient. This practice makes it very difficult to have standardization in any industrial manufacturing of the medicine.

Composition of the medicine

The qualitative and quantitative standardization of the composition of the African indigenous medicine, will prove necessary when it starts being manufactured industrially or even semi-industrially, for, the rules of individual preparations advocated by the traditional therapists might be difficult to apply. It is, however, important that one should not make too many modifications without making a prior indepth analysis as it was recommended when we discussed the techniques for collection.

With regard to the qualitative aspect, it would not be wrong to say that some African indigenous medicines contain more than ten ingredients. Only medicines in the group "excipient" which are normally registered in a special inventory, such as, the "vidal", would contain as many ingredients. This is why it is important, as we have already stated, that we should never consider anything as useless. It is, however, possible, after discussions with the traditional therapist and conducting some chemical, pharmacological and/or clinical tests, to eliminate certain drugs which would not change the acceptability, the harmlessness or the effectiveness of the medicine. This is the essence of our approach.

As far as quantity is concerned, it is sufficient to be guided by the traditional therapist in taking the right measures of each ingredient. These measures, could easily be reproduced later from average quantities which could be established after several measurements.

In order to facilitate the methods of preparation, we started by adopting kitchenware methods which are used by the traditional therapist. Then, gradually as we established the specific values of certain elements, we replaced the kitchenware, with the appropriate pharmacotechnical apparatus. Thus, we ended up by establishing a certain equivalence between the two devices and to facilitate communication and dialogue between health care systems.

States caused by medicine and how these happen

Although it was relatively simple to compare the tenuity of the powder obtained from local kitchen sieves and the powder obtained from our Forplex grinder, it was not the same thing for the other forms of galena. We can, however, state that the strict observance of the methods of operation guarantees, to a certain extent, the reproduceability of the characteristics of preparations and as a result, that of the doses. That is why in the case of a decoction, for example, the traditional therapist will normally put into account the following:

From the qualitative aspect:

· the colour of the decoction
· if no special colour, its viscosity, and
· how it tastes (astringency).

From the quantitative aspect:

· the number of bundles found in the plant, and
· water volume at the beginning and at the end of the operation, often determined by the immersion or non-immersion of the bundles of plants, and state the time taken for boiling up.

The monitoring of this reproduceability could be done by the extraction of dry decocta by denning, both qualitatively and quantitatively, certain properties and characteristics.

With regard to one of the most frequent criticisms, namely, that concerning the hygienic conditions, again we think that it is not just to say that the traditional therapist is not concerned about it. The methods of nitration or decantation, the use of new containers which have never been used, the taking into account of the pharmaceutical forms (especially orally or externally) explain in part the situation.

We are going to provide one of the fundamental principles of the African indigenous medicines for your consideration:

· The human organism needs a symbiotic equilibrium and cannot subsist in an absolute sterility.
· The administration of the African indigenous medicine: the posology

The existence of doses in the African traditional medication has often been questioned. In our opinion, we have sometimes wrongly attributed to medication accidents caused by the imprudence of the victims themselves. The purpose of our discussion here is more to affirm the existence of acceptable therapeutical doses, rather than to deny the insufficiency of precision of the measurement units.

One of our objectives is to have a better knowledge of the rules which determine the dosage so as to improve such rules.

As we have already said, the strict observance of the methods of preparation makes it possible to obtain relatively good quality medicines that are highly appreciated by the traditional therapist and which, in spite of such a moderately equipped institution, are determined with reasonable precision. Thus, without involving ourselves in the active principle, we shall study both qualitatively and quantitatively, certain ingredients (at least two) and certain characteristics (physicochemical and/or organoleptical) in order to prove that the preparations are of good quality.

The existence of non-unitary pharmaceutical forms makes it imperative to know the rules of the measurements used in collecting the medicine as well as the methods used in doing it. It is not sufficient, for example, to use the same spoon and the same product in order to believe that the quantities of the measured powder are the same. In fact, in order to have the same quantity, it is necessary to respect the rule of the base measurement. Moreover, the use of a spoon requires certain precision, such as, whether it is a tea-spoon, a table-spoon or a spoon used for dessert. Also, in traditional practices, it is necessary to know that the pinch by fingers is done vertically and is limited to the first phalanx. It is necessary to indicate the number of fingers to be used or, at least, which of the two fingers will retain the pinch of the medicine.

A well-balanced study of fresh plant material gave us a variation from simple to triple (1:3 to 3:1). The ones of pinches showed a variation of 1 to 2.5 (see Annex).

By way of mouth, the quantity of decocta absorbed by the sick persons, are functional to the capacity of their stomach whose variation limits (1 to 1.5 litres for an adult) enable the traditional therapists to advocate a drink of a certain infusion of herbs.

In taking again the example of the vidal catalogue, we notice that the usual dose for the day for an adult can vary often from 1 to 3 tablets. In other words, the variation is from a single to a triple dose.

A comparison from these various figures, enables us to state, in our opinion, that the variations of the therapeutical doses advocated by the traditional therapist are acceptable.

We think that the decision as to the dose to be administered depends also on the competence of the practitioner; and this is true of both medical systems. It is up to the doctor to adapt this ordinary dose, taken throughout the day, to different cases. It is only his experience which will enable him to avoid the errors of estimation and accident. The attitude of the traditional therapist, as that of a doctor, is determined by the general state of the sick person, as well as other factors such as, sex, age and bodybuild (for the traditional therapist especially), or weight (for the doctor), and the seriousness of the disease.

Evaluation of the African indigenous medicine

Elements of evaluation

The therapeutical efficiency and the importance of the use of the African indigenous medicine constitute, undoubtedly, the elements of its evaluation:

· In fact, there is no need to recall here, the good results of some of the traditional preparations which are based on the discovery of pure crystalline products and the synthesis of similar substances.

· The acquired popularity since decades of use "(estimated pharmacovigilance)" and the high consumption of indigenous medicine, which enable us to establish its importance for pharmaceutical use and to determine whether it should be registered on the list of essential drugs.

The evaluation method, in our opinion, should be to make comparisons (through clinical tests) with an already existing medicine on the market and which enjoys a very good acceptability in all respects, namely, its cost, its effectiveness and its availability.

Prior conditions in the evaluation of the African indigenous medicine

The marketing of any medicine today depends on a number of strict conditions, which, although necessary and indispensable for new molecules, do not seem to us to be justifiable for the indigenous medicine which has successfully undergone the tests of time after its administration on the human species. This means, in fact, that the pharmacovigilance, that is the supervision of the medicinal results in their usual conditions of use, has not been favourable to it. We cannot deny the possibility of teratogenic toxicity of these medicines; but we think also that it is not just to underestimate the fact that they have gone through the test of time after they were administered on people and not on animals in a laboratory. This is why we are advocating that we should adapt administrative and legislative conditions of marketing so as to ensure that they are appropriate and that they facilitate innovation rather than block it. We think that this adaptation should take place by allowing comparative clinical tests to be carried out sooner than it is the case now, at least legally and officially. The issue involved is more ethical than scientific. This is why the solution should be in line with the ethics of our socio-cultural environment.

Conclusion

At the end of this paper, we think that we have succeeded in discussing very clearly our approach, our results and our conclusions, with regard to the standardization and evaluation of the African indigenous medicine. We have shown how it is important to understand the attitudes and concepts, which are the causes of the shortcomings in the practices, in order to find ways of making them reproducible.

We would like to add that this approach is not opposed to any other earlier approach which may have been used in more indepth studies on, for example, the active principle (if this exists at all), its toxicity and its mechanism of action.

Without denying the importance of these studies, our priority was not to look for an active principle or to determine an LD₅₀ value, or a plan of action. But, our priority was rather to ensure that the reproduceability and the stability of the preparations was carried out within certain norms of specifications. For, we are dealing with medicines for which the pharmacovigilance test has not been unfavourable. As such, we think that the establishment of average samples over a given period of collection, and the strict observance of certain rules suffice.

The improved indigenous medicine, as we have called it, can be accepted and produced, at least semi-industrially, so as to respond to the problem of public health which requires the supply of medicines through health education. This can be effected by an adaptation of conditions of marketing that would be in line with the ethics of our socio-cultural environment.

References

Delmas, A. (1970). Anatomic Humaine, Descriptive et Topographique. Masson, Paris.

Kayser, C. (1963). Physiologie: Fonctions de Nutrition. Flammarion, Paris.

Koumare, M. (1978). "Le Remede Traditionnel African et Son Evaluation" in Journal Sante Pour Tous Bamako. Vol. 3: 28-33:

APPENDICES

1. Evaluation of Fresh Plant Bundles (in grams)

No. d'odre	Guiera senegalensis	Diospyros mespiliformis	Saba senegalensis	Opilia celtidifolia	Bridelia ferruginea (saguan)	Parkia biglobosa (nere)
1	110,2	185,5	182	51,5	232,2	181,5
2	140,4	191,8	177,5	130,2	226,1	220,9
3	116,1	224,4	166,4	164	257,2	169,8
4	122,8	149,4	190,9	142,7	194,9	252
5	161,9	184,3	155,1	105,8	206,4	184,2
6	130,7	230,3	138,8	115,8	184	179,2
7	167,6	191,8	177,5	130,4	190,6	136,5
8	113,5	212,5	113,2	140,2	215,7	153,2
9	147,9	212,3	192	136,5	187,6	104,7
10	122	207,9	189,8	94,6	194,1	193,3
11	1333,1	1990,2	1683,2	1211,7	2088,8	1775,3
Average	133,31	199,02	168,32	121,17	208,88	177,53

2. Calculus of the Variations of the Pinch Measurements of Asthmagardenia Powder

Dgnation des ses de mesures	Mesure extra infeure (Mi)	Mesure extreme supeure (Ms)	Report Ms Mi
1	0,2073	0,5278	2,5
2	0,1976	0,3212	1,6
3	0,1966	0,3282	1,6
4	0,2310	0,3443	1,5
5	0,2542	0,3600	1,4

3. Calculus of the Variations of the Fresh Bundle Measurements

Dgnation des plantes	Mesure extreme infeure (mi)	Mesure extreme supeure (me)	Rapport Ms
Guiera senegalensis	110,2	167,6	1,5
Diospyros mespiliformis	149,4	230	31,5
Saba senegalensis	113,2	192	1,6
Opilia celtidifolia	51,5	164	3,1
Bridelia ferruginea	184	257	21,3
Parkia biglobosa	104,7	252	2,4

4. Evaluation of the Pinch of Asthmagardenia Powder

No. d'odre	Tare Tare + Poudre		Poudre (g)
1	5,9558	6,2604	0,3046
2	6,2375	6,5157	0,2782
3	6,4909	6,6982	0,2073
4	5,8706	6,3035	0,4329
5	6,3572	6,7570	0,3998
6	5,7518	6,2796	0,5278
7	6,3614	6,7975	0,4361
8	6,1505	6,5910	0,4405
9	6,1310	6,4805	0,3495
10	6,0659	6,4950	0,4291

My = 0,3805 gm

5. Evaluation of the Pinch of Asthmagardenia Powder

No. d'odre	Tare Tare + Poudre		Poudre (g)
1	6,2980	6,5042	0,2062
2	6,1622	6,4777	0,3155
3	6,7003	6,9084	0,2081
4	6,2670	6,4646	0,1976
5	6,6130	6,9342	0,3212
6	6,1116	6,3390	0,2274
7	6,6522	6,9386	0,2864
8	6,2492	6,5276	0,2784
9	6,2055	6,4426	0,2371
10	5,6594	5,9298	0,2704

My = 0,2548 g

6. Evaluation of the Pinch of Asthmagardenia Powder

No. d'odre	Tare Tare + Poudre		Poudre(g)
1	6,2980	6,5032	0,2052
2	6,1620	6,3862	0,2242
3	6,7005	7,0287	0,3282
4	6,2672	6,5349	0,2677
5	6,6130	6,8559	0,2429
6	6,1113	6,3628	0,2515
7	6,6522	6,8795	0,2273
8	6,2489	6,4455	0,1966
9	6,2058	6,4220	0,2162
10	5,6593	5,8643	0,2050

My = 0,2364 g

7. Evaluation of the Pinch of Asthmagardenia Powder

No. d'ordre	Tare Tare + Poudre		Poudre (g)
1	6,5,9559	6,2130	0,2571
2	6,2381	6,5824	0,3443
3	6,4914	6,7793	0,2879
4	5,8704	6,1430	0,2726
5	6,3573	6,6548	0,2975
6	5,7522	6,0433	0,2911
7	6,3616	6,6746	0,3130
8	6,1508	6,3818	0,2310
9	6,1312	6,4310	0,2998
10	6,0663	6,3322	0,2659

My = 2860 g

8. Evaluation of the Pinch of Asthmagardenia Powder

No. d'odre	Tare Tare + Poudre		Poudre(g)
1	8,8108	9,1197	0,3089
2	6,1620	6,4421	0,2081
3	6,7005	6,9547	0,2542
4	6,2673	6,5570	0,2897
5	6,6130	6,9702	0,3572
6	6,1112	6,4504	0.3392
7	6,6524	6,0124	0,3600
8	6,2493	6,5490	0,2997
9	6,2057	6,5402	0,3345
10	5,6595	5,9712	0,3117

My = 3135 g

Pharmacological value of plants of Rwandese traditional medicine: chemotherapeutic value of some Rwandese plants

PIERRE CLAVER RWANGABO

Institut de Resherche
Scientifique et Technologique
Butare, Rwanda

Introduction

A detailed study of Rwandese plants was done in order to enhance the knowledge of traditional Rwandese therapy and that of biological activity in medical flora. This study, like many others done in Rwanda and elsewhere, aims at discovering new or better medicines from plants. It also justifies the therapeutic use of certain plants by traditional Rwandese healers. This paper summarises the methodology used and describes the major results of the study.

The study involves some plants widely used in traditional Rwandese medicine. These are Rubus rigidus Sm. ("Umukeri") from the Rosaceae family; Lantana trifolia L. ("Mugengeri") of the Verbenaceae family and Vernonia amygdalina Del. (UMUBILIZI) which belongs to the Asteraceae family.

The paper presents in a condensed form the results obtained up to now from a systematic study seeking to show the pharmacological value and/or chemotherapeutic value of these plants. In order to prove the therapeutic use of these plants, we started with the following general hypothesis: in addition to its psycho-socio-cultural value acknowledged by everybody, traditional medicine also uses plants which have a biological effect that can be demonstrated by using scientific models employed in biomedical research. For one plant species studied, results of which indicated the possibility of its clinical use, toxicological aspects were also examined. The results are promising.

While pursuing research on the therapeutic activity of plants, the isolation and identification of chemical molecules make it possible to have a more complete phytochemical knowledge of the plants being studied for the first time and also to obtain toxicological information which is often inaccessible when working with raw extracts,. The isolation of chemical molecules is important in writing pharmacopoeia of these plants and the identification of chemical molecules is very useful not only in the production of medicines, but also allows the researchers to give useful advice to traditional practitioners who use these species.

A description of the general methodology is given, followed by a detailed study of every species. This study focuses on the chemical molecules that have been identified and their biological activity. Since a tentative conclusion is given during the study of each species, a brief discussion is provided to summarise the importance of the plants studied in the development of a national medico-pharmaceutical sector.

General methodology

The plants studied were selected from the whole range of Rwandese medicinal flora, using in particular the information provided by the traditional practitioners on the ethnopharmacological activity of the species.

For each species, research was done using a methodology that can be summarised by the following seven major elements:

(a) a botanical description and the geographical distribution of selected plants;
(b) an inventory of the uses of plants in Rwandese and central African traditional therapy;
(c) preliminary biological screening of the whole extract of the plant;
(d) phytochemical screening and detailed bibliographical study of the whole extract of the plants;
(e) chromatographic fractionation of extracts as well as investigating the previously identified activity;
(f) isolation, purification and identification of the products responsible for the activity;
(g) detailed study of the therapeutic effect and possible toxicity of active products compared with products already known in therapy.

The botanical study was done at CURPHAMETRA where specimens of the plants can be found. The study of the geographical distribution of the plants was done using specimens at CURPHAMETRA and the Herbarium of the National Botanical Garden of Belgium.

The phytochemical methods of extraction, isolation and identification of plant products have been described in many books. Some particular aspects of this research have been presented in detail in the cited references. A summary of some techniques used in the research on biological activity is presented in this paper, giving the specific character of some of them. Dilution and diffusion were used to demonstrate the antibacterial and antifungal chemotherapeutical activity. Each time we tested the microorganisms that represent major groups recognised as the main pathogenic agents. For purified active products, we investigated the minimum inhibitory concentration (MIC) according to the standard method. Whenever possible, the activity of a product was compared to a known control product used in therapy.

The antiviral activity of plant extracts and of pure products was studied using a more complex technique which necessitates culture and maintenance of cellular tissues, growth of virus on those cells and testing of the antiviral activity by observing the absence or persistence of the cytopathogenic effect of virus according to whether the tested product has any antiviral effect or not. We mainly used dilution of virus in plates of microtitration. The selection of the virus was done in such a way as to include representatives of different classes. Thus the Adenovirus was selected to represent the ADV virus without coating, the Poliovirus and the Coxsachievirus represent the ARN virus without coating, while the measles virus at the Semliki Forest represent the ARN with a coating. Cardiovascular activity was demonstrated using the following experiment models: blood platelets of rabbits, the right and left auricles of guinea - pigs, the central artery of the rabbit's ear, and microsomes of the sheep's seminal vesicle. Some of these experiments were done at the University of Anvers (UIA), in Belgium.

Toxicological studies on 3-methoxyquercetine (3-MQ) isolated from Vernonia amygdalina were done at Butare, at the CURPHAMETRA on experimental models described below.

1. Toxicity of 3-MQ in internal usage (9)

Preparation and administration of the product

The 3-MQ was extracted from the flowers of Vernonia amygdalina (omubilizi). An aqueous suspension was prepared by grinding the powder in a mortar; the suspension was added to a concentration of 15 mg to 20 ml of distilled water and was administered to mice in ratios of 30 mg per kg of the animal's body weight. This translates into 0.8 ml of the suspension for a mouse weighing 20 g. The suspension was administered using a plastic syringe with an unoxidable tip and unlikely to cause trauma in the animal.

Handling and observation of mice

Ten white mice (colony OFI) of both sexes, of more or less identical age and of average weight of 22.4 g were divided into two groups of 5. The general condition and temperature of each animal were observed and noted the day before the administration of the product. The following day, one of the two groups was given a suspension of 3-MQ proportional to the weight of the animals while the other group received an equal amount of distilled water. The weight and temperature of the animals were noted everyday at the same hour and focused on:

· the general condition of every animal
· nervousness and any sign of drowsiness
· temperature
· the condition and form of coat/fur
· the body weight of every animal

The animals were kept in groups of 2 in rectangular plastic cages.

The product was administered for 10 consecutive days and the above- mentioned aspects were initially observed for 44 days.

The animals were given food, water, and libitum. On same dates, the 1st, 9th, 11th, 22nd, 29th, 36th and 44th days, every mice was weighed from the 2 groups and the average weight on those dates was calculated. The comparison of these average weights and initial weight allowed us to evaluate the effect of the treatment on weight evolution and consequently on growth of animals in the experiment.

We used the following procedure to investigate the influence of the product on reproduction: a group of 10 female mice of the same colony were given an aqueous suspension for 10 days. Another group of female mice was given distilled water in the same way like in the previous experiment. On the 11th day, the mice from the 2 groups were mated and kept in pairs in groups of different cages for each lot where they were given normal food, drink and libitum.

The number of new-born mice in each lot was counted and compared.

2. Toxic manifestation of V. amygdalina in UE (10)

The experiment involved 10 adult rabbits with weights between 2.8 and 4 kg; they were divided into 2 groups of 5. After weighing them and observing carefully the general condition of the animals, every rabbit was shaved over an area of 4x4 cm on the back. They were kept in individual cages, fed and given libitum. An ointment of 5% of aqueous-methanolic fraction made from the fruits of the plant was applied in the shaved area of the first lot of rabbits. The ointment had a vaseline base.

The second control group was treated with vaseline only. A small amount of ointment or the vaseline were accordingly applied once a day in the same way by rubbing lightly in order to cover uniformly the bare area.

The experiment lasted a month (from 4th December 1987 to 4th January 1988). On the 18th day the administering of the medicine was stopped. The two groups were observed daily and compared on the following aspects: the general condition of the animals, weight, growth of hairs and especially any manifestation of irritation on the treated surface.

Detailed study of the plants and results

1. Rubus rigidus

The species is widely found in Rwanda and neighbouring countries. The Rwandese traditional practitioners use it mainly to treat bacterial and fungal diseases but it is also used in other areas of pathology such as poisoning, snakebites, etc.

A preliminary study showed an antibacterial and antifungal activity in the whole extract of the plant. Phytochemical studies made possible the isolation and identification of pygallic acid, commonly known as pyrogallol.

The antibacterial and antifungal activity of the product already shown in literature was confirmed by this study with a minimum inhibitory concentration (MIC) of nearly 250 micrograms per ml. The microbes most sensitive to this product are Staphylococcus aureus, Pseudomonas aeruginosa, Microsporum canis, Trichophytom mentagrophytes and Candida albicans.

No other activity, antiviral or pharmacological (cardio-vascular), was noted in this plant during our study. However, bibliographical research has shown that pyrogallol has a hepatoprotective activity which is observable when the same amount of doses are used as those showing antibacterial effect. This triphenol shares that action with other phenols of similar structure, catechins and tannins.

To conclude, we established that the chemotherapeutic activity of Rubus rigidus used by Rwandese traditional practitioners is mainly due to the presence of pyrogallol. From the medico - pharmaceutical point of view, pyrogallol already has several uses especially in external usage. References which we consulted mention also antibacterial ointments with doses of 2 to 10%. However, it is known that the plant has some toxic effect when used internally. We therefore advised traditional practitioners to put more emphasis on its external uses.

2. Lantana trifolia L.

It is a verbenaceous plant widely found in Rwanda where it is known as "umuhengeri". This plant had previously shown an antibacterial activity especially in its leaves. Traditional practitioners use it to treat many syndromes.

It is the antibacterial activity that gives promising results while other biological activities investigated do not give any results that can justify further investigation in other areas.

The chemotherapeutic antibacterial study on the active fraction made it possible to isolate and identify a series of products which have promising activities. These products are: two saturated chains aliphatic hydrocarbons (C₃₃H₆₈ and C₃₅H₇₂), saccharose, two pentacyclic triterpenes of the ursane group (alpha-amyrine, urs-12-ene-3-one), a new polymethoxy flavonoid (5-hydroxy-6,7,3',4',5'-pentamethoxynavone) that we named "umuhengerine" following the Kinyarwanda, name and finally diospyrin which is a binaphtoquinone related to juglone. "Umuhengerine" was isolated from these plants for the first time whereas diospyrin had only been identified in the different genera of Diosypros (Ebenaceae).

Among the products isolated, only the last two showed any antibacterial activity worth investigating. Umungerine has a small antibacterial and antifungal spectrum at concentrations of 300 micrograms. Diospyrin has a wide spectrum on gram positive and gram negative bacteria and some fungi, with a predilection against Mycobacteria (for example the causal agents of leprosy and tuberculosis) whose representatives show sensitivity to an MIC of nearly 2.5 micrograms per ml.

As far as this plant is concerned, even if the comparison of MIC is not the only parameter taken into consideration, diospyrin is active in a similar concentration (perhaps even better) compared with many antibacterial products used in therapy; such is the case for its action against M. fortritum (MIC = 2.5 mg ml) compared to the control, Neomycin, which is only active with a MIC of 32 micrograms/ml. Umuhengeri has a weaker antibacterial spectrum but according to its chemical structure, it could be more active at the level of lipophile balance, a factor presently recognised as determining the activity of chemical molecules against gram negative and gram positive bacteria. In addition, its identification clearly contributes to the chemical knowledge of this species.

According to the literature on Lantana camara, another Verbenaceous plants which resembles very much the preceding plant, Lantana camara has toxic products especially against the liver and the skin, such as those which show some photosensitization. An example of these structures is lantadene A.

We did not isolate these products in the active fraction of L. trifolia. However, we cannot conclude that they are absent in all parts of the plant. It is probable that these toxic products can be demonstrated by other chemical methods which do not take the biological activity as a major indicator. Bibliographic research on the genus Lantana advises some caution in the use of this plant.

3. Vernonia amygdalina Del.

It is an Asteraceous plant belonging to the subfamily of Vernonieae, which is very common in tropical and subtropical Africa. It is called "Umubilizi" in Rwanda and in some neighbouring countries like Uganda and Burundi. Its use in traditional medicine ranges from treating hepatitis, cardiac ailments, poisoning, malaria, stomach pains, snakebites and eczema. The authors of the "Communautes Africaines" journal have confirmed recently the use of V. amygdalina as food for humans in Cameroon. We had earlier on stated this use of the plant in East and Southern Africa.

Concerning the biological activity, especially of the antitumour and cytotoxic nature already identified in this plant, this study identified other structures that had never been stated before and demonstrated other therapeutic activities such as antiviral, and the pharmacological effect at the level of platelet aggregation and cardiac ailments.

The study was done on extracts of dried flowers of the plant prepared and fractioned according to procedures. Given its importance in chemotherapy, the antiviral activity guided the separation and purification of active molecules. Some chemical structures were isolated and identified, for example:

· 11 saturated aliphatic C₂₂ to C₃₂ fatty acids;
· 5 esters of fatty acids derived from glycerol;
· a sesquiterpene lactone known as vernolide;
· a series of flavonoids, that is:

quercetine (3,5,7,3',4'-pentahydoxyflovone), 3-methoxyquercetine (3-MQ), 3,3'-dimethoxyquercetine (3,3'-DMQ), rutine, quercetine -3-0-1-beta-D-glucose-6-1-alpha-L-rhamnose) and kaempherol (3,5,7,7,4'-tetrahydroxyflavone (K).

3-MQ was isolated with a yield close to 1% compared with the powder of dried flowers at ambient temperature.

A detailed study of therapeutic activity of isolated products showed that flavonoids and vernolides are the active principles, while the fatty acids and esters are aliphatic products which are associated with these active principles. Four groups of biological activities were studied. These are the cardiovascular activity, antiparasitic activity, antiviral activity as well as the verification of some lexicological aspects of products that can be clinically used.

1. Cardiovascular activity

1. Effect on platelet aggregation. All technical details of the procedure for demonstrating this activity have been described elsewhere especially in "Revue Medicale Rwandaise" in 1986.

The technique used demonstrated that quercetine flavonoids, 3-methylaquercetine and rutine, to a small degree inhibit platelet aggregation, lipoxygenase activity, and cyclooxygenase, at a concentration of 100 micrograms (110 M) per ml. This concentration is 1,000 times higher than that which shows an important antiviral effect.

Vernolide also shows a completely reversible inhibition of platelet aggregation induced by arachidonic acid, but this activity is very small.

2. Other cardiovascular activities.

At doses of 10 micrograms per millilitre, 3-methoxyquertine shows a positive chronotropic effect on the right auricle and an antiarythinic activity on the left auricle of the isolated guinea-pig's heart.

3. Antiparasitic activity

This was indirectly demonstrated, especially by vernolide. In fact during our research, another group working independently isolated the same product from Vernonia colorata and showed that the product has an antiparasitic action especially against Entamoeba histolitica at nearly the same level as antiparasitics used clinically, such as metronidazole. By demonstrating this product in V. amygdalina we were justifying, at the same time, the use of this plant against intestinal parasites.

4. Antiviral activity

3MQ and 3,3'-DMQ have an important antiviral activity which was shown even at concentrations as low as 10 nanograms. These products have a selective effect since they prevent the formation of ARN and viral proteins without interfering with the metabolism of the host cell. They are especially active against the virus of poliomyelitis, the coxcachie virus, the vesicular stomatitis virus (VSV), the Rhino virus, and against other virus of African origin like Bangin and Bunyamwera.

The importance of this plant in antiviral chemotherapy is thus obvious, especially since even in more developed European medicine, there is no medicine in this area. Fortunately, the family of products isolated from this plant allows us to foresee further research with some hope of success in treating other groups of virus, such as retrovirus. Proof exists some of which is very recent. For example in 1979 Mr. Apple and his colleagues demonstrated inhibition of reverse transcriptase of encornavirus by some flavonols of vegetable origin.

In May of the same year the Japanese group ONO Katsuhiko with French researchers reexamined the action of some flavones related to quercetine as inhibitors of reverse trascriptase, enzymes that were associated with human immuno-deficiency syndrome.

Even if further research was to demonstrate the absence of any important activity in this area, the importance of Vernonia amygdalina in semi-purified extracts as well as pure products is obvious given the low level of toxicity in the plant. One can foresee the therapeutic use of this species in future. Before this stage of the study, we explored some toxicological aspects of the main active principle.

5. Preliminary toxicological study of 3-MQ in internal usage

As described above, we tried to establish the importance of toxic manifestations that can occur when using the plant as an ointment in treating dermatological diseases such as eczema. The study shows that the application of an ointment with 5% of a semi- purified extract of V. amygdalina does not produce any detectable irritation among rabbits in the laboratory treated with it. The same applies to rabbits that only get the expient.

General conclusion and discussion

In reporting the results of this research we have underscored, once again, that the value of African medicinal plants in general, and Rwandese plants in particular, in the treatment of all kinds of diseases does not need to be demonstrated any more. The use in traditional therapy of plants that are the focus of this paper is justified by the demonstrated biological activity of their products. There are plants which have activities already known but of which we did not know the presence in the plant under study, for example pyrogallol. There are products which were very well-known in chemistry as being inactive or nearly so. However the research showed us that they had a very useful activity which was sometimes unknown elsewhere in the medico-pharmaceutical sector. An example of this group is 3-methoxyquercetine isolated from V. amygdalina. Finally we found toxic or inactive products in relation to the activity under investigation. The demonstration of these products contributes very much in toxicological or phytochemical knowledge of plants under study.

As expected, the plants under investigation do not have the same importance in developing further the socio-sanitary sector. The activity of R. rigidus is very low. Its main importance is mostly in justifying its use in traditional therapy. Lantana trifolia, however, has activities similar to those of the most active antibiotics but because the plant is very toxic, the products could be purified and then used in new medicines in bacterial chemotherapy. Vernonia amygdalina is hardly toxic and grows spontaneously in many of our regions. Its varied activity, very obvious in antiviral chemotherapy and as an anthelmintic, suggests that we should develop quickly research on its use, even without isolating active molecules. One could use its semi-purified extract.

The experience of Burkina Faso in the area of traditional pharmacopoeia

JEAN-MARIE THIAMBIANO

Ministry of Health and Social Welfare
Directorate of Pharmaceutical Services
Burkina Faso

Introduction

Geographical Information

Situated in the heart of West Africa, Burkina Faso is a country which is completely landlocked . It borders on the Republic of Niger to the East, on Ivory Coast to the West, on Ghana, Togo and Benin to the South, and on Mali to the North-West. The country covers an area of 274,000 square kilometers with an estimated population of 8,600,000 inhabitants in 1988.

Demographic characteristics

The population density is 31 persons per square kilometre. The urban population is low, only 12%. Thus 88% of the Burkinabe live in the rural zone. The population is mainly that of young people. 42.2% of the population is made up of young people of less than 15 years. The birth rate is at 49.9% and the infant mortality rate is high: 134% while the gross mortality rate is 24%. The annual population growth rate is 2.68%.

Administrative structure

The country is divided in 30 provinces, 300 districts and 7,285 villages. This administrative structure is under the Ministry of Territorial Administration.

Overview of the sanitary situation

The sanitary situation is affected by the following:

· problems of drainage and the provision of drinking water;
· the quantitative and qualitative insufficiency of the sanitary services;
· the persistence of epidemo-endemic diseases due to a low socio-economic level of the population. These diseases remain the main cause of the high mortality rate, especially among children (134%).

In order to rectify the situation, the Burkinabe State has carried out a number of vaccination campaigns, some of which are:

· the operation "Commando vaccination" of 1984;
· the operation "Doors Open on Vaccination" of 1988;
· the operation "Daily Vaccination" of 1989.

These operations enabled the vaccination, during a very short time, of an important number of children. The state also carried out other more permanent actions such as the establishment of fixed vaccination stations and the creation of primary Health Stations (PSP) in the villages. All this has helped to improve the sanitary situation.

The National sanitary policy

Objectives

The sanitary policy is based on the primary health care. Its objective is to ensure "Health for All by the year 2000". As such, a sanitary scheme for the decade 1980 - 1990 has been worked out, and this scheme is meant to deal with the major community health problems. In order to achieve this, it is essential that the state should establish actions of curative care promotion and re- adaptation, in the functional infrastructure, with the necessary equipment and personnel.

Given certain realities, namely the fact that this project was not in line with the financial realities of the country, it became necessary to revise it so as to put into account the sanitary priorities at the national level. The main components of the project centered on the following points:

· the implementation and the working out of programmes for the control of endemo-epidemically transmissible diseases;

· the creation of basic sanitary services, especially maternal and infant health care;

· the training and in-service training of the paramedical personnel in the domain of public health and the control of endemo- epidemics. (epidemiology?)

Institutional Device

In order to meet the objectives of the national sanitary policy, a pyramidal system of Health was recommended. Its structure is as follows:

Starting from the base to the top, we have the following structure:

· ESSA: Institute of Health Science;
· MS-AS: Ministry Of Health and Social Welfare;
· H.N: National Hospital;
· CHR: Regional Hospital Centre;
· C.M: Medical Centre;
· CSPs: health and Social Promotion centre; and
· PSP:Primary Health Station.

The national pharmaceutical policy

The inability to cover the whole national territory with medicines is one of the major handicaps in making an effective implementation of primary health care in Burkina Faso. Thus, the national pharmaceutical policy has instituted the following objectives:

General objectives

· To provide the population with essential medicines at a reasonable price and as permanently as possible.

· To improve the management of medicines in all the sanitary structures in order to make a rational use of the resources which are supplied for sanitary use.

· To institute and develop the natural product by integrating into it the medical returns and the traditional pharmacopoeia.

Specific objectives

· To assess and strive to satisfy the needs for public sanitary education in essential medicines and technical materials.

· To select the medicines which are considered essential in Burkina Faso.

· To monitor the effects of medicines on the market with the help of national and international experts.

· To contribute to the fight against the abuse and illegal traffic of drugs.

· To exploit and to avail to the users all information or documentation relative to pharmaceutical products.

· To promote traditional pharmacopoeia and medicine.

Methods

In order to attain these objectives, a number of measures were considered, namely:

· The establishment of a Directorate for Pharmaceutical Services (DSPH) consisting of a department for pharmacopoeia and traditional medicine. This Directorate is expected to monitor the application of the national pharmaceutical policy.

· The establishment of a national corporation responsible for pharmaceutical supplies (SONAPHARM) in 1985, which played the role of a state whosaler and which enabled customers to buy their medicines at a reasonable price.

· The creation of a medical laboratory for the country (MEDIFA) in 1989 whose role was to study soluble materials (salty and sweet serum). A similar institution had been created in 1978.

This is called IRSN (Research Institute of Natural Substances). It is under the Ministry of Higher Education and it contributes, to some extent, to the local production and to the promotion of medicine and traditional pharmacopoeia.

Burkina Faso's policy in the sphere of traditional pharmacopoeia

Justifications

In spite of the establishment of the SONAPHARM in 1985, which helped to lower the prices of certain medicines, the national budget has problems in meeting the demand for primary medicines in sanitary education. Also, the new medicine supply policy is only confined to emergency medicines.

The cost of the other medicines has to be entirely met by the people. And, in spite of the efforts made by the State, the price of medicines remains always high especially given the very low gross national product. Also the majority of the Burkinabe people have a very low income and therefore turn to the traditional medicineman.

Historical account

In Burkina Faso, both medicine and traditional pharmacopoeia have gone through four major historical periods:

· The precolonial period
· The colonial period
· The revolutionary period

The precolonial period

During this period, traditional medicine was totally under the jurisdiction of traditional practitioners who were scattered in all villages. These were both general practitioners as well as specialists (bone setters, gyneoco-obstricians e.t.c.). Their activities were practically secret and entirely private. Their services were based on humanism and were offered free of charge.

The colonial period

During this period, there was a brutal interruption of the medicinal evolution due to the coming of the colonial power which forbade this practice on the ground that the "civilised" medicine from the metropole was much more superior. But this act was futile since, rather than disappear, this traditional medicine started being practiced secretly.

The neo-colonial period

Since the time of independence in 1960, this period has been marked by an attempt of codification. A number of very general and limited texts were worked out with the intention of legally permitting the traditional healers to practice their art. However, at this period, the traditional healers had not been accorded real freedom by the local authorities.

Revolutionary period

After the advent of the revolution in August 1983, Burkinabe traditional medicine came out from its lethargy. The authorities were openly in favour of having the traditional practitioners participate in the resolution of health problems experienced by the people in order to attain the objective "Health for All by Year 2000". But in order to participate effectively in this challenge, traditional medicine has to adapt itself with time and knowledge. Thus, the minister for Health and Social Welfare, at the opening of the 1st National Seminar on Medicine and Traditional Pharmacopoeia on 16th November 1987, declared:

The fight which we have started in order to restore the confidence of our people in matters of public health, should not only be confined to things to do with our past experiences, but also we should work hard in order to render to this medical wealth a confirmed scientific value.

Medicinal plants: Their production, phytotherapeuticity, uses and propagation

ROGERTO TOKARSKI

Intituto de Manipulacoes Farmaceuticas Ltda
SHLS 716-Bloco 5 Conjunto B
Lojas 01 a 04 -Salas 101/102
Centro Medico de Brasilia
Brasilia -DF

Introduction

In Brazil phytotherapy is a non-conventional therapy that has received great attention from the Government in the past five years, having proved to be useful for the treatment of many ailments. A large part of the population has access to it, not only due to its low cost, but also because of our Brazilian habit resulting in 90% of the population using tea as a medicine.

We are heading towards a stage in which a medicinal plant is seen as medicine deserving all care and attention. The latter has been shown in the fact that several universities and research centres have acknowledged medicinal plants as auxiliaries in the treatment of, and curing several diseases, and as a solution to many other ailments afflicting the Brazillian community. We see medicinal plants as resources able to produce medicated principles.

It is worthwhile to mention the great transformation seen in the panorama of the infectious diseases after Alexander Flemming discovered a substance produced by a fungus Penicillum notatum which is able to kill bacteria. This substance, known as Penicillin, represented a real progress in therapeutics.

Superior plants which, due to their metabolic activity are able to produce antibiotics, and which are found in Brazil include, among others, Capraria bioflora from which biflorine which is a polycyclic orthoquinone, was isolated. The compound shows an anti-Canadida albicans activity.

Considering that the plant synthesizes its active principles starting from the nutrients in the soil and basic elements, such as carbon dioxide, solar energy and water, we then went into the cultivation of plants which we considered as being important phytotherapeutics and which did not exhibit the required qualities which are necessary for medicines.

In the course of cultivation, the plants were provided with all favourable conditions for their development, thus obtaining as a result, a population of uniform plants regarding the external characters as well as their chemical composition which would guarantee a production of active pharmaceutics.

The following plants have been investigated for their phytotherapeutic properties.

Stevia (Steviare rebaudiance)

The leaves of this plant contain the deterpenic glycosides, stevioside and rebaudioside -A as the main components. These glycosides have found their importance as sweeteners. Thus stevioside and rebaudioside - A are 300 and 400 times as sweet as sucrose, respectively. Presently, the two compounds are widely used in Brazil as non-calorific sweeteners in foodstuffs and medicines. The compounds also posses non-cryogenic activities and are known to be harmless to humans.

Stevia reaudiance

The leaves of this plant contain stevioside and rebaudoside - A, which are diterpenic glycosides as main components. The importance of these glycines were given by the fact that they were sweeteners. Stevioside has up to 300 times the sweetening power of saccharose, and Rebaudoside-A has 400 times the sweetening power of saccharose.

At present there is a great interest in Brazil in the use of these glycines as non-calorific sweeteners, both in foodstuffs and medicine. They also present non-caryogenic activities and are harmless to health.

By using almost 10 kg of good quality dry leaves, we can extract 1 kg of stevioside. This sweetener is recommended to people suffering from diabetes, obesity and those under a hypocalorific regime.

We cultivated this plant in our farms. It can also be found under cultivation in Mato Grosso do Sul, Parana, Santa Catarina and Sao Paulo states.

Besides this sweetener being recommended for hypocalorific regimes we also have in our pharmacies a compound tea in which Stevia is the main plant ingredient and this is also recommended for the same purpose.

Other components of this tea include:

(a) Carqueja Amarga (Baccharis trimera Less), with bitter properties and thus favouring and stimulating digestion.

(b) Chapeu de Cauro (Echinodorus macrophyllus Kunt), from which alkaloids, and other substances have been detected. The plant shows diuretic properties.

(c) Jurubeba (Solanum paniculatum L.), whose active principles are found in the whole plant. It is used for the treatment of jaundice and in maintaining a good functioning of the liver.

Another group of plants are those which are rich in essential oils. One of the representatives of this group is Camomila (Matricaria chamomilla), which is also known as matricaria, margaca das boticas and camomila dos alemaes. Its extract is a blueish liquid which, when exposed to light, first turn green and later on brownish. The essential oil content of the extract varies from 0.15 to 1.35%. Azulene constitutes 0.062 to 0.16% of the crude extract occurring as procamazulene-A (matricina), which during the distillation process successively transforms itself into camazulenogen, and ultimately into camazulene. The amount of azulene in the essential oil fluctuates between 1 and 15%.

The pharmacological activity of Camomila is attributed to remarkable anticongestion properties of the extract, which are due to the camazulene and alpha-bisabolol present in it.

The Camomila extract also contains a bicyclic acetylenic ether which causes some toxicity as a result of its spasmolitic properties. Its anticongestion action is superior to that of guaiazulene.

Camomila is used as an internal medicine in the form of an infusion, as a digestive bitter tonic and also as an antispasmodic agent. Externally it is used as an anticongestion drug in erythemas created by sunlight, locally applied as a mask.

In cosmetics the extract is used to increase the flaxen, golden, light auburn, or pale yellowish brown colour of hair.

Barbatimao (Straphnodendron barbatimam Martius)

This is a leguminous Brazilian plant which is rich in tannins. Its thick bark contains 18 to 27%, sometimes up to 40% tannin. The high tannin content gives this plant a pharmacological astringent, energetic, healing, hemostatic and antiseptic action, due to the phenolic nature of the tannin.

Barbatimao tea is prepared under a boiling process, and it is used for cleansing and in baths when treating leucorrea, ulcers, wounds and uterine hemorrhage. Manoel da Silva et al., used it at the Assistencial-Brasilia-DF-Brazil teaching hospital to cure proctitis actinic. This non-comparative work was done on 16 patients with 11 of them having an unspecified proctosigmoiditis and 5 patients with actinic proctosigmoiditcs. Those patients, who were diagnosed by means of a biopsy were given a retention enema with Barbatimao tea, without any other additional oral medication. All patients showed a full recovery. Nine of them had lesions limited only to the rectum and seven to the rectum-sigmoide flexure. The patients selected in this study were those who did not respond to the topical treatment with 5-ASB corticoid or those who could not afford to purchase the conventional medicines. The minimum time for the use of the medicine was one month and the maximum 30 months. Two of the patients had to suspend the medication because they developed abdominal colics. There was clinical and endoscopic recision in 50% of the cases; in 6% there was clinical recision and endoscopic improvement and in 19% there was clinical and endoscopic improvement. The unaltered patients consisted of 25% of all those studied.

Given the initial clinical data, there is the possibility to use this new medicine for the treatment of these ailments, the medicine being easy to purchase and it is cheap.

Conditioning of the soil

We should stress the fact that during the conditioning of the soil when cultivating medicinal plants, several measures were taken that increased the productivity of the crop. Thus the following factors have now been established:

· Calcium favours the growing of Alfazema and Aleerim.

· An acidic soil is ideal for the development of Camomila.

· Nitrogenous compounds guarantee the production of alkaloids in the plant.

Collection

We have some basic procedures for the collection of different parts of the plant:

· Roots, stems and tubercle: collected during the autumn, when the plant is adult.

· Bark: collected from the branches during spring, before blossoming.

· Leaves: when the plant is developing the reproduction organs; preference is given to fully developed leaves.

· Flowers: when the floral buds are opening.

Drying

Regarding drying, we were able to verify that the amount of water present in the plants varied according to the tissue and organs, but in general it reached high volumes, as shown below:

Roots - 70 to 75%
Leaves - 60 to 90%
Flowers - over 90%

We were able to reduce these volumes to a percentage close to 5%, thus avoiding undesirable enzymatic reactions and the proliferation of fungi and bacteria, which endanger the stability of the active principles produced by the plant.

Phytotherapeutic forms

In our pharmacies, the pharmaceutical forms we indicate and prepare for the use of medicinal plants ranges from the simple one, a tea, to the one in which we use a fluid extract and dry plant, microcrushed in capsules. We attach importance to the information given to our clients on the fact that when plants are used as medicine, besides containing a large amount of active principles, they should be prepared in the right way, so as not to alter the composition and damage the medicinal fractions. When used as a tea, we stress on the way to prepare it, either by infusion or by boiling, and how to use it.

In obtaining fluid extracts and dyes for pharmaceutical preparations for topical and oral therapy we use suitable extracting solvents which dissolve and carry in them the active principles of the plants. At present consumers prefer the phytotherapeutic which are in the form of capsules. We either put the whole plant or part of it to a microcrushing process, thus obtaining a product which liberates easily its active principles to be absorbed by the body. Capsules are then made from this material.

Plants also used in Brazilian traditional medicine

1. Guarana (Paullinia cupana Kunts)

A native plant from the Amazon region that sometimes might reach ten meters high. Its principal constituent is caffeine and the average content in its seeds is 3 to 5%. This phytotherapeutic plant has several pharmacological actions:

· It stimulates the central nervous system.
· It stimulates the cardiac muscle.
· It relaxes the lean muscle, in particular the bronchial muscles.
· It acts on the kidneys, determining diuresis.

It is indicated to maintain the person awake, to restore mental lucidity in exhausted patients and to increase the respiratory capacity.

2. Espinheria Santa (Maytenus ilicifolia)

The plant is used for patients with high dyspepsia or peptic ulcers.

Trial uses for the protecting effect of the lyophilized extract of the Maytenus licifolia tea against gastric ulcer on mice, which was induced by indometnacine or by the stress obtained when immobilizing mice at a low temperature were carried out. The protecting effect was found to be dose-dependent and the results revealed an antigastric ulcer action.

Doses up to 360 times larger than the ones commonly used by human beings did not bring about any alteration in either biochemical serum or hematologic parameters.

Mice which were treated for as long as two months did not show a reduction in the reproduction capacity and the offsprings developed normally. The reproducing capacity and the offsprings born from females which received the treatment during pregnancy did not show any alteration when compared to the control group.

The clinical toxicology in healthy volunteers that drank Espinheira Santa during 14 days of a double dose of the posology was negative, indicating that the plant is non-toxic to humans. 23 patients who showed a diagnosis of a non-ulcer high dyspepsia, received during 28 days, two capsules of 200 mg each of lyophilized Espinheria Santa tea, equivalent to 2.4 g of dry pulverized plant material per day. As a result the group which took Espinheira santa showed significant improvement in relation to the placebo group, regarding the symptomatology of global dyspepsia and, in particular, of the burning symptoms and pain.

There were no complaints of side-effects produced by Espinhearia Santa.

3. Mentrasto (Ageratum conyzoides L.)

The plant is used for the treatment of arthritis.

In the research programme on medicinal plants, the authors studied the analgesic action of Mentrasto tea in fifty patients with clinical and radiological arthrosis of the knee, the femur, the hands and cervix. A study was undertaken on the daily and nightly spontaneous pain for a whole week.

Regarding pain, there was an improvement in 66% of the patients after the second week. The mobility of the joints improved only in 12% and probably it was a secondary effect in the absence of pain.

The absence of collateral effects, as well as from my personal impression led to the recommendation of Mentrasto as an alternative treatment for pain in arthritis, mainly for people who are financially unable to buy common anti-inflammatory medicines.

4. Quebra Pedra

To show the interest and depth of the study on medicinal plants as phytopharmaceutics, we tested, by means of this work, a new alkaloid obtained from Phylanthus sellowianus, commonly known as Quebra Pedra, used in the treatment of kidney stones.

Alkaloid fractions extracted from the leaves and branches of this plant presented anti-spasmodic effects in different pharmacological models and one of the alkaloid component was found to have formula C₁₅H₂₀N₂O₂.

5. Ricinus communis

The crude seed extract of this plant showed antineoplastic action. The non-oily fraction of the acetone extract of the seeds of R. comunis showed activity on the Walker carcinoma 256 in mice, with a daily dose of 0.3 mg/Kg for 8 days. A significant tumoral inhibition of 65% was seen in relation to the control group.

6. Alipina nutans

The aqueous alcoholic extract of this plant has shown a prolonged hypertensive effect in dogs.

This plant, commonly known as "colonia", is widely used in popular medicines both in the North and North-Eastern parts of Brazil to control hypertension in a form of tea.

With the objectives of verifying the possible hypotensive effect of these concoctions, male does put under anaesthesia by using Sodium pentobarbital (30 mg/kg) were injected with the extract from the leaves of the plant, to which alcohol had been previously eliminated. A decrease in the mean blood pressure was observed, thus showing that the preparation is less powerful than the aqueous alcoholic extract.

With these data we reached the conclusion that scientific experiments cannot only prove the popular use of a plant, but can also identify the more active forms from it, to be used as a phytotherapeutic. Due to the fact that the interest shown by research centres on medicinal plants is recent, we find that most of the medicinal plants have not been scientifically studied, even though they have been widely used by the people for a long period.

Table 1: Examples of medicinal plants available in pharmacies in Brazil

Botanical name	Common name	medicinal use
Cynra scolymus L.	Alcachofra	Hepatic diseases
Caiaponia tayuya	Caiapo	Rheumatism
Lippia alba HBK	Erva Cidreira	Analgesic
Chenopodium ambrosioides L.	Erva de Santa Maria	Vermifuge
Mikania sp.	Guaco	bronchal dilator
Mentha sp.	Hortela	Vermifuge and carminative
Bauhinia fortificata	Pata de Vaca	Diabetes
Bidens pilosu L.	Picao	Jaundice
Mentha pulegium L.	Poejo	Bronchal dilator & caominative
Sambucus nigra L.	Sabugueiro	Measles
Boudichia major Mart	Sucupira	Throat infections

Acknowledgements

I am grateful to FARMACOTECNICA and my country for making it possible to attend this conference. To the organizers of the conference, I express my gratitude for the successful meeting.