2. The Relationship between Tradition, Research and Industry

The origins of modern medicine are mainly attributed to the knowledge and long usage of medicinal plants by Man. In this section, we shall look at the importance of traditional medical herbalism in the Maltese Islands and the worldwide development of traditional remedies into modern pharmaceutical products. Therefore, we shall look at three aspects; tradition, research and industry.

Few studies have been carried out on the traditional use of medicinal plants by the Maltese. The three main medical problems related to the Maltese are diabetes, hypertension and heart problems. The Maltese were always keen in trying to cure these three conditions. Cichory and fenugreek for controlling diabetes; snapdragon, onion and garlic for hypertension, while squill and oleander for heart problems. Despite this, a large number of medicinal plants have been used for the treatment of stomach and intestinal problems, considering the fact that most believed that most health problems were related to the gastrointestinal system. The uses of medicinal plants in folk and modern medicine shall be considered individually for the plants in the following sections.

Medicinal plants used to be either administered crudely or processed. The processing of medicinal plants is a science in itself. We shall look at some examples. The most common forms of processed medicinal plants include infusions, macerations, extracts, decoctions, tinctures, herbal oils and poultices.

Infusions are prepared by steeping medicinal plants in hot water for about 5 to 15 minutes, in a closed container. This is usually used for herbal teas. Examples of infusions are chamomile and peppermint teas, both used for their stomachic and antiseptic properties. This is effective for the administration of active ingredients present in essential oils that would otherwise be destroyed by boiling. 1 part of plant material is usually mixed with 30 parts of hot water. These are usually taken internally.

Macerations are prepared by steeping the plant in water, alcohol, or white wine at room temperature. The plant is usually left there for about 2 to 12 hours. This is used for fenugreek and marshmallow. 1 part of plant material is mixed with 20 parts liquid. These are usually administered both internally and externally.

Extracts are similar to macerations but the liquid or solvent is then removed by evaporation. Dry extracts should contain not more than 5 % of solvents. Extracts are prepared for example from blue pimpernel for rheumatic pain and from oats as a nerve tonic. These can be used both internally and externally.

A decoction is prepared by boiling 1 part of plant material in 30 parts of water to extract the constituents. This usually takes 15 to 20 minutes. Examples include the carrot decoction for the treatment of jaundice and liquorice decoction for colic pain. These are usually administered orally.

Tinctures are prepared by steeping 1 part of plant material in 5 parts of 60 % alcohol, usually, for about 3 - 7 days. Tinctures are prepared with chamomile for treating diarrhoea in children and tree of heaven for asthma. These are usually used internally.

Ointments are solid preparations that are fatty in nature. In fact, 1 part of dried plant material is usually simmered in 8 parts of petroleum jelly, for up to 2 hours. Herbal ointments include myrtle for skin erruptions and greater celandine for the treatment of heamorrhoids. These are used externally only.

Herbal oils are usually prepared by steeping the plant material in a fixed oil, such as almond or olive oil. The extraction usually takes several weeks. Examples include garlic for the treatment of sciatica and cotton for the treatment of gouty joints.

In poultices, the medicinal plant herb is prepared as a hot and moist paste that is spread over a towel and applied hot. These include marshmallow poultice for inflammation and squirting cucumber poultice for ear infections. These are usually used externally.

Success in research has been achieved by the application and translation of traditional knowledge to scientific "terms". In fact, compounds derived from traditional remedies are either classified as:

• efficaceous unmodified natural products, such as digoxin used for the treatment of heart failure,
• remotely-used unmodified natural products, such as vincristine for the treatment of cancer, and
• modified natural products or synthetic drugs, such as aspirin for the treatment of colds, headaches and inflammation.

Through research, traditional uses of medicinal plants have been proved or disproved. Scientists have also investigated for the chemical constituents that provoke the effect. For example, the analgesic in the white willow is salicin, while the sedative constituents of opium poppy are mainly morphine and papaverine. In the first case, scientists have produced aspirin as the synthetic derivative of salicin, while in the latter case, morphine is still used as such for the treatment of unbearable pain. Scientific evalutation implies both chemical analysis of the constituent or extract and the pharmacological effects under laboratory conditions and later in human trials.

Once a constituent or extract is proved to be effective against a particular condition, then the commercial production of the constituent is commenced.

Although some of the preparations mentioned have a traditional implication, they are still prepared today by the pharmaceutical industry. The principles of extraction are similar for both industrial and traditional preparations. The difference lies in the standardisation of the medicinal product. Due to strict quality control measures in industry, all pharmaceutical products, whether extracts or pure substances, examination of the final product is essential. The product should have a consistent content of the active compounds, that should fall within certain limits imposed by pharmaceutical authorities.

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Designed and Coordination by Prof. Everaldo Attard. All rights reserved 2010.

Last Update: 11th February 2010