Introduction

Introduction

All through the human history, there has been a conspicuous concern for health care and the cure of the disease, though the concepts themselves took a very long time to develop into a body of knowledge.

EVOLUTION OF CONSCIOUS USE OF PLANTS IN THE MANAGEMENT OF HEALTH AND DISEASE

In the dawn of human cultural evolution, the art of curing was essentially magical (Pardal 1937; Lain Entralgo, 1982; Naranjo 1984). Few plants, that were usually psychoactive, known as magic or psychedelic plants, were used. Later, empirical medicine arose, using many plants for the treatment of various afflictions. This tendency culminated, in the Old World, in the famous work Materia Medica by Dioscorides, published in the first century CE*, in which the characters and properties of numerous drugs are described, the majority of which are from the plant kingdom.

Some of the oldest pre-literate archaeological records in both the Old and New Worlds concern the medicinal use of plants. A record of several plant species found in Iraq, dated to the pre-Christian Era, contained some of horticultural interest, but most others certainly were used in local medicine.

The ancient possessed an extensive vegetal pharmacopoeia. The Egyptian Pharaohs sent scouts far and wide in search of medicinal plants. Alexander the Great, a student of Theophrastus (the Father of botany), sent back from his campaigns in Asia, medicinal plants for cultivation. Starting long before even Aristotle, till almost the early part of the 19th century, botanical studies were conducted mostly on medicinally useful plants, by the European physicians, and this fund of information is the body and soul of plant taxonomy, that culminated in the Species Plantarum by Linnaeus (1753).

India had an extensive pharmacopoeia thousands of years ago. The rich heritage of herbal medical culture of China is still very much alive, with some of the written records dating from the beginning of the Christian Era. The traditional plant therapeutic knowledge of Africa and South America, along with that of China and India, has given several new drugs to modern medicine. Even though the first British Pharmacopoeia, that of the Royal College of Physicians, was published in 1618, the nineteenth century was the century of pharmacopoeias. Several countries published their own pharmacopoeias, incorporating drugs, the therapeutic effects of which were already ‘proven’, at least according to the procedures and techniques of the period. Until 1930, around 90 per cent of the official medicines were of plant origin (Swain 1972).

Chemistry achieved very significant progress during the nineteenth century, and by the beginning of the twentieth century, the first artificial pharmaceuticals were obtained by synthesis, among these are phenacetin, urea, barbital, and acetylsalicylic acid (aspirin). The fruitful period of chemotherapy began in the 1930s, with the synthesis of the sulphonamides. The era of antibiotics began in the following decade, and when the second World War ended, conditions became more favourable for the development of synthetic chemistry, to the point that in a few decades therapy was radically transformed. Since the 1960s, over 75 per cent of all standard medicines are of synthetic origin or the product of fermentation, lowering medicines of plant origin to a secondary role.

In the biomedical system that predominates the developed world, there is an over-riding emphasis on research for synthetic therapeutic compounds, though a certain amount of interest in medicinal plants always persisted. As previously analyzed by many authors (Farnsworth and Bingel 1977; von Reis Altschul 1973; OTA 1983; Balandran et al. 1985; Duke 1985; Naranjo, 1981, 1995), there are many powerful reasons for conducting broad ethnobotanical, ethnopharmacological, and even clinical therapeutic research, on medicinal plants, as discussed separately.

*Before Common Era (BCE) and Common Era (CE) are the currently popular ‘secular’ terms for BC (Before Christ) and AD (Anno Domini, in the Year of the Lord), respectively.

THE ALMA-ATA DECLARATION

At the meeting at Alma-Ata, in the former USSR, in 1962, the first step towards the recognition of indigenous and traditional medical practices, was taken. This resulted in the establishment of Medicina Alternativa Institute at Colombo, which is affiliated to the Open International University for Complementary Medicines, with branches and affiliate bodies in 120 countries (Jayasuriya, 1997).

THE WORLD HEALTH ORGANISATION

In 1977, the 30th world assembly of the World Health Organisation (WHO), an organ of the United Nations, formed to deal with matters of health, adopted a far reaching resolution urging the governments of the member countries, to give ‘adequate importance to the utilisation of their traditional systems of medicine, with appropriate regulations to suit their national health needs’. Traditional medicine is defined as ‘the therapeutic practices that have been in existence, often for hundreds of years, before the development and spread of modern medicine and are still in use today’ (WHO, 1991).

Immediately following the 1977 resolution of the WHO, a world wide promotional effort of traditional medicine was launched, creating a greater awareness and interest in traditional medicine, though in some countries the efforts came much later, for political and other reasons. For example, South Africa could not act till very recently, when her Parliament approved the formation of Statutory Council to regulate 350,000 traditional healers, who serve about 80 per cent of the population (Lancet, August, 1998).