Drug mediated induction of emesis and purgation has been in vogue in all systems of medicine, as in case of food or other poisoning. Coffee enemas are a modern practice to remove toxins and dead cells from the colon in certain types of cancer.

       In Naturopathy, emesis and purgation are measures to cleanse the body. Fifty years ago, every one in our family was compelled to take an ounce of castor oil (an irritant-oil purgative), with ginger and honey to make it less disagreeable, regularly once in three to four months.

       Emetic and purgation therapy is very important in the practice of Panchakarma in Ayurveda, aimed at the correction of the imbalance of doshas. The therapy is also an important tool in the rejuvenation protocols.

       Many stimulant laxatives were found to trigger the synthesis of prostaglandins, which control blood pressure, vasodilation, smooth muscle response, gastric secretions, body temperature, inflammation, platelet aggregation, neural transmission, etc. Charaka referred to 52 species of plants used as emetics, 32 of purgatives and six with both the effects.

       Anti-emetic drugs are also needed to control nausea associated with other conditions, such as the morning sickness in pregnant women or nausea caused by chemo- or radiation-therapy in cancer. Similarly, antipurgative drugs are needed in cases of colon cancer.

       Several species of plants indicated in gastro-intestinal disorders also have anti-emetic or anti-purgative effects, with the result that a number of species are common to these three categories.

       Since emetic, anti-emetic, purgative and antipurgative effects have their own independent applications, 138 species have been separated from the database of plants used in gastro-intestinal disorders and presented in Appendix 9. Emetics and purgatives are more abundant in the Cucurbitaceae, Euphorbiaceae and Fabaceae, than other plant families. A detailed study is needed to evaluate the potential of the species in Appendix 9, in different contexts. The species used as emetics and purgatives and their anti-states, should be evaluated along with the species with effects on the nervous system (see Appendix 17) and the species used in medical toxicology (Appendix 20).

       An interesting correlation is that many species with emetic activity also function effectively as anti-amoebics, the best example is the alkaloid emetin from Cephaelis ipecacuanha (Rubiaceae), as mentioned earlier.

DATABASE OF PLANTS USED IN DENTAL CARE IN INDIA

       Dental care has occupied the minds of people since time immemorial and became an acute concern in modern times as evidenced by the phenomenal amplification of the dental profession throughout the world. South America (Lewis and Lewis, 1995), Africa (Oliver-Bever, 1986), China (Wang, 1983) and India (Shubharani, 1995) have paid a considerable attention to dental problems in traditional medicine, and developed therapies and even surgical procedures. Charaka and Sushrutha have recorded 52 species of plants for use in dental care. Shushratha devised instruments for dental surgery (Shubharani, 1995). Nevertheless, even in courses on traditional medicine, traditional dental care is not a part of the curriculum, except in a few African countries such as Benin, Nigeria, Ravanda, Senegal and Tanzania. Though a number of herbal tooth powders and medications are still available across the counter, the use of plants in dental care has, however, largely fallen into disuse in recent times, in most parts of even the rural world.

       Shubharani (1995) has identified 197 species of plants used in dental care in India (Appendix 10) and compiled a database. For each species, the information on botanical aspects, vernacular names, dental uses, other uses (mostly medicinal), chemistry and pharmacology are given. Appendix 11 shows the specimens of the profiles of two species, Adhatoda zeylanica and Barleria prionitis, from this database.

       The database contains discussion on human civilisation with reference to dental health, cultural aspects of dental health, antiquity of dental diseases, traditional dental care practices in Africa, China, Egypt and India, the morphology and anatomy of teeth, evolution off teeth in Primates, physical, chemical and biological components of dental and oral environment, microbiology of the mouth and current dental practices.

       The distribution and role of lectins and saponins in plants used in dental care, effects of plant extracts on oral pathogens, and the quantification of fluorides in some common plants, which are a part of this database, are discussed separately in the later pages of this volume.

PLANTS USED IN GERIATRIC CARE

       The physical and mental well being of the aged is an important part of national health care programnmes throughout the civilised world. This concern is now far greater than ever before, due to an increase of adult population, on account of an enhanced life expectancy and more efficient health care. It is also that population control measures throughout the world altered the ratio between young and the old.

       Even in the times of Charaka and Sushrutha, several species of plants have been indicated for use in the management of the old age problems. Scientific investigations of some of these plants have shown that they contain several diverse therapeutically active compounds with effects on the nervous system, cardiovascular system, immune system, etc., (Sathnarayana Bhat et al., 1990). The species of plants indicated for use in geriatric care in both ancient and recent Indian medical literature have been reviewed (Sathnarayana Bhat and Kameswara Rao, 1993a). A list of the 61 species discussed in the two publications cited is given in Appendix 12.