Introduction to

PHYTOTHERAPY
 Phytotherapy
⚫ From the Greek “phyton” meaning “plant” and
”therapeuein” meaning “to take care of, to heal”

⚫It is the use of plants or plant extracts for

medicinal purposes (especially medicinal plants)
 Medicinal plants
⚫ Medicinal plant is that plant which contains one or more
constituent in one or more organ and possessing certain
therapeutic activity.
⚫ The production of medicinal plants includes several stages
(other than the cultivation process):

⚫ Collection and treatment after

collection.
⚫ Drying
⚫ Standardization
⚫ Storage
⚫ Re-standardization
⚫ Marketing
Natural products and Traditional
Medicine:
⚫ Traditional medicine (also known
as indigenous or folk medicine) comprises
knowledge, skills, and practices that developed
over generations within various societies before
the era of modern medicine based on the
theories, beliefs, and experiences indigenous to
different cultures. (e.g.: Traditional Chinese
medicine, traditional African medicine, traditional
Indian medicine,…). It is used in the
maintenance of health as well as in the
prevention, diagnosis, improvement or treatment
of physical and mental illness.
⚫ Conventional medicine: A system in which
medical doctors and other healthcare
professionals (such as nurses, pharmacists,
and therapists)
treat symptoms and diseases
using drugs, radiation
or surgery.
⚫ Alternative medicine: Any practice having the
healing effects of medicine but is not based on
scientific method. It is used in place of
conventional medicine. Examples include new
and traditional medicine practices:
homeopathy, naturopathy, energy medicine,
various forms of acupuncture, traditional
Chinese medicine, Ayurvedic medicine, …
⚫ Complementary medicine: is alternative
medicine used together with conventional
medical treatment in a belief, not proven by
using scientific methods, that it
"complements" the treatment. CAM is the
abbreviation for Complementary and
alternative medicine.
⚫ Most people in the world rely predominantly
on medicinal plants as drugs. The WHO has
emphasized the importance of scientific
investigations into indigenous herbal
medicines.
⚫ The use of medicinal plants by the world
during the last 20 years has been paralleled
by a great scientific interest because of their
importance in traditional medicine.
⚫ Although modern organic chemistry has
provided us with an increasing number of
synthetic compounds for use. Many important
drugs of modern medicine are still extracted
from medicinal plants and some of them are
still used in traditional therapy.
Medicinal plants as a basis for
synthetic drugs and pharmacy:

⚫ Medicinal plants are the first drugs used in

treatment of diseases in the past and some of
them were discovered by accident
⚫ Ex.: Salix (salicin) as analgesic, antipyretic
and anti-inflammatory, Strophanthus as
cardiotonic (was used in animal hunting with
arrows), Cocculus (in catching fish), Tobacco
plant in smoking, Belladona herb for
mydriasis.
⚫ Then, people depended on them as drugs for
treatment and began the discovery of the
different herbs as carminatives (e.g., Mentha),
antispasmodics, urinary tract antiseptics,
purgatives (as Colocynth, Rhubarb, Senna, …),
in renal colic (as Half bar, Ammi visnaga), ….

⚫ Then herbal formulas and herbal teas began to

be prepared and prescribed for people.
⚫ Then the pharmacological actions of the
different medicinal plants were studied, and
synthetic drugs or derivatives were
synthetized. Examples include:
⚫ Atropine and its derivatives as anticholinergic
drugs.
⚫ Physostigmine from Calabar beans and its
derivatives as cholinergic drugs.
⚫ Ephedrine as sympathomimetic drug.
⚫ Ergot alkaloids as sympatholytic drug.
⚫ Cocaine and its derivatives as local
anaesthetic.
⚫ Digoxin as cardiotonic.
⚫ Picrotoxin, Lobeline and Strychnine as
respiratory stimulants.
⚫ Vinca alkaloids, podophyllotoxin and taxol as
anticancer drugs.
⚫ Reserpine as hypotensive drug.
⚫ Caffeine as CNS stimulant
⚫ Theobromine as diuretic.
⚫ Anthraquinones as Laxative
⚫ Flavonoids as antioxidants, diuretics,
antispasmodics, diaphoretic, anti-
inflammatory and in treatment of capillary
fragility, while isoflavones have estrogenic
effect.
 Advantages of using medicinal
plants:
1- Medicinal plants can be used in different forms:
a- The whole plants can be used in the form of tea
(crude drug), and this is considered the best form.
b- The total extract
c- The active constituent alone.
d- Semisynthetic compounds.
Ex: Belladonna can be used as tea (crude drug) or
as 70% alcoholic extract or pure atropine or its
derivative (homatropine, ipratropine…)
2- Ease of use or administration of medicinal
plants.
3- Highly effective in treatment of most diseases
due to their richness in pharmacologically active
compounds.
4- Using the crude drug (the best form) gives
usually the highest therapeutic effect and
decreases the side effects (that could take place
if a pure active compound is used).
5- The availability of common medicinal plants
everywhere.
6- Medicinal plants are more affordable than
purchasing expensive modern pharmaceuticals.
Disadvantages or problems of using
medicinal plants:
1- Most people ignore the pharmacological actions and the
side effects, herb-drug interactions, contraindications,
toxicity of different medicinal plants.
2- They could be prescribed by non qualified persons which
may cause dangerous consequences.
3- The difficulty of dose and dosage interval determination
by the user.
4- The common belief of most people that herbs are usually
more safe than synthetic medicines.
5- Danger of incompatibility with other administered
medicines.
Factors Affecting the Active
Constituents in plants
1-Storage:
⚫ Anthraquinone containing plants should be
stored for 1 year before use to prevent griping
effect. This is to allow conversion of anthrones
and anthranols (which cause griping and
irritation) into anthraquinones by oxidation in air.
⚫ Drugs with volatile oil in the external secretory
structures loose part of their volatile oil during
drying and storage (decrease effectiveness, ex:
mentha)
⚫ Moisture during storage activates some
enzymes, causing hydrolysis of active
constituents. (ex: digitalis and ergot).
Furthermore, high percentage of humidity will
cause rancidity of fixed oils.
⚫ Increased temperatures activates enzymes
and helps biochemical reactions, also
affecting drugs containing volatile oils as :
Buchu, Ginger,…
⚫ Oxygen in air produces color and chemical
changes, affecting the therapeutic activity. For
example: lemon oil undergoes resinification,
benzaldehyde in almond oil is oxidized into
benzoic acid.
⚫ Light may also affect some drugs such as:
digitalis which loses its effect in sunlight,
Rhubarb changes in colour into red or orange
in presence of light.
Therefore, medicinal plants should be stored in:
⚫ Tightly closed containers

⚫ Cool / dry places

2- Soil:

It can affect the percentage of active

constituents in plants.

3-The climate:

The climate affects the percentage of active constituents

from region to another. For example:
Cannabis in temperate regions doesn’t contain narcotic
resin.
African Capsicum is the most pungent.
RULES OF HERB USAGE
 RULE 1

• NEVER take herbs in any from at the same time you

take prescription or over the counter medication. The
two will always be incompatible with each other. Keep
them separate and take apart from each by at least 4-5
hours. Examples include:
• Ephedrine as decongestant antagonizes the action of
antihypertensive drugs and gives synergistic effect
with sympathetic drugs.

• Hibiscus if taken with antihypertensive drugs, it will

cause severe hypotension.

• Diuretics as Ambrosia leads to hypokalemia if

administered with cardiotonics as digoxin.

• Liquorice is contraindicated with antihypertensive

drugs due to its mineralo-corticoid like action
(hypernatremia and hypokalemia).

• Rauwolfia is CNS depressant, therefore it should not

be taken with CNS depressants (to avoid synergism).

• Expectorant plants and mucolytics should not be

taken with antitussive drugs in treatment of cough.
• Coffee with sedatives and hypnotics → antagonism.

• If emetine (Ipeca) is given to induce emesis to a person

who previously administered CNS depressant, it will not
cause emesis, but it will be absorbed (leading to toxicity).

• If Ipeca (CNS stimulant) is taken with CNS stimulants,

convulsions may take place.
• Drinking tea directly after meals or iron supplements (for
treatment of anemia), cause precipitation of iron (due to
tannis).

• Solanaceous drug (CNS stimulants) should not be

administered with CNS depressants and sedative drugs.
RULE 2
• If any herb is causing an unpleasant side effect of extreme
proportions, DISCONTINUE IMMEDIATELY until the
problem can be explained. Remember that what may be
used for "healing" could, in fact , be "life threatening"
(when in doubt, do without). Examples include:
• black mustard may cause vomiting.
• Capsicum may increase blood pressure for some
persons.
• Griping may occur with anthraquinone containing
herbs.
• Long term administration of Ginseng may cause
hypertension, headache, nervousness, insomnia,
morning diarrhea, inability to concentrate, estrogen-
like effects after menopause in few cases.
• Colchicine irritates GI mucosa.
 RULE 3

• Learn to educate yourself on herbs before using them.

You need to consult with a professional herbalist,
homeopathic doctor, folk healer, or any similar person
skilled in the medicinal application of herbs. Or refer to
books on medicinal plants that are reliable and
trustworthy to learn more about side effects, drug-
herb interactions, contraindications. Examples include:
-Drinking Hibiscus may induce renal calculi; thus, it should
be contraindicated for renally impaired patients.

-Tea may cause constipation due to the presence of tannins.

-Drug-herb interactions examples: the use of sedative herbs

with CNS depressant drugs, or the use of tea with iron
containing medications, …

-Ipeca should not be used as emetic with pregnant women

(emesis will increase intra-abdominal pressure and thus
inducing abortion). It should not be used also in case of
caustic substances ingestion.

-Juniper may cause abortion as it provokes uterine

convulsions.
RULE 4
• When attempting treatment for any serious health
problem, very important points must be
considered by the individual:
1- Is the problem treatable using alternative medicines
instead of conventional therapy ?

2- Do you thoroughly understand the nature of the

problem at hand?

3- For how long should treatment with herbs continue ?

RULE 5

• Generally Speaking, Herbal medicines are just that

Medicine!. Herbs should only be used when body
health is placed in some Kind of danger. Otherwise,
most medicinal herbs should be left alone. There are
however, some very qualified exceptions to this
fundamental rule:
Exception1.
Plants with definite nutritive value may by used on a
fairly consistent basis, because of their rich blend of
vitamins, minerals, trace elements, amino acids,
enzymes, and hormones afford the body solid
protection against potential illnesses. Such herbs
might include: alfalfa, beet root, chamomile,
dandelion, flaxseed, ginger, onion, parsley and
turmeric.
Exception2.
A lifetime illness that demands the constant use of
certain herbs. Goldenseal (Hydrastis) for diabetes and
garlic for yeast infection are two that come to mind.
However, a chronic condition that leads to using a
particular herb may cause some potential harm to the
body. For example, the prolonged consumption of
juniper berry, for example, for congestive heart failure or
elevated serum cholesterol will irritate the Kidneys.
 RULE 6
• Some herbs are easily contradicted in particular
health situation, making them quite undesirable
e.g.:
* Cayenne pepper, garlic, goldenseal and onion are
strongly hypoglycemic and should NEVER be taken
individually by those suffering from low blood sugar,
otherwise, they may have unexplained fatigue and
mood swings.
* Juniper Berry provokes uterine contractions, and in
women who are pregnant, this could cause an early
abortion of the developing fetus.
 RULE 7
• Know when and how much to take of an individual
herb or herbal formula. Because this such a highly
technical area involving a large number of qualifying
factors. In order to do so, it is better to create four
distinct categories into which all herbs and herbal
formulas could somewhere be placed (Dosages for
children (ages 4-12) are usually one-half the amounts
suggested for adults):
• 1. Energy/Stamina:
Single herbs and herbal formulas especially
designed for this category are best taken on an
empty stomach or in between meals, usually in the
morning or early afternoon .
Dosages: 2-4 capsules/tablets; 10 - 18 drops fluid
extract/tincture beneath the tongue, or 1 cup tea.
2- Vitality/Nutrition:
Single herbs and herbal formulas intended mainly for
nutritional support are best taken with meals any time
of the day or night .
Dosages: 4-6 capsules/ tablets; 10-15 drops fluid
extract/tincture beneath the tongue or in a glass of
water; or 2 cups warm or cool tea
3- Weight Loss/Cleansing:
Single herbs or herbal formulas intended to shed
unwanted pounds and detoxify the system of impurities
are best taken between meals.
Dosages: 3-5 capsules/ tablets; 12 drops fluid
extract/tinctures three times daily with glass of water; 1
cup tea at morning, noon and night. Always take
mineral supplement to ensure replacement of lost
minerals and vitamins.
4- Relief:
Single herbs and herbal formulas designed to relive pain
are best taken in between meals, and periodically
throughout the day (say every 4-6 hours or on and "as
needed" basis)
Dosages: 2 capsules/tablets every 4-6 hours; 15 drops
fluid extract/tincture beneath the tongue or in a glass of
water, every 4 hours; or 1 cup warm or cool tea
(depending on the situation ) every 4 hours.
 RULE 8

• The effectiveness of a herb depends on a wide variety

of factors, some of which are human-related and
others environmentally based. Some include: age, sex,
diet, ethnicity, soil, climate, storage, etc. For example:
 Anise causes diarrhea to infants and babies if used
as antispasmodic so better use caraway and dill.
 Elderly patients and infants should take care of
toxic doses, metabolism, excretion, …
 Capsicum can’t be used in treatment of flatulence
and dyspepsia in young children (use mentha,
fennel, … instead).
• Elderly patients suffering from glaucoma shouldn’t
take any Solanaceous drugs.
• Senna can’t be used as laxative for babies.
RULE 9

• When purchasing herbs, always keep in mind that

the best values are often found in a herb shop,
health food store or nutrition center.
 RULE 10
Fresh herbs and dried herbs have near equal advantages:
• The former contain essential oils which are lost in the
drying process. On the other hand, some herbs would
still retain volatile components that can evoke drastic
side effects if not dried!.
• Fresh herbs grow molds fast once they are picked, but
dried herbs can be kept for several years with proper
storage.