This may involve the identification, documentation, conservation, and utilization of medicinal plants. Much of the ethnomedicinal information is largely not validated.

In Nigeria, a number of authors have published a lot of data on plants with their curative values [ 16 , 20 , 21 ]. These provide a vast array of information for scientific research and validation.

Preliminary scientific knowledge is drawn from studies on in vitro and in vivo bioassays on crude extracts of various plants. Using plants as medicine provides significant advantages for treating many chronic conditions. For example, information from folklore medicine in Nigeria has it that Rauvolfia vomitoria is used for treating hypertension and other nervous conditions while Ocimum gratissimum is used for treating diarrheal diseases.

Others include Citrus paradise seeds for resistant urinary tract infections, pure honey for chronic wound treatment, Carica papaya seeds for intestinal parasites, Garcinia kola seeds for pain and inflammation, and Aloe vera for skin diseases.

The same is also true for plants from other African countries [ 22 ]. Knowledge of most of these curative properties was accumulated over time from evidence-based observations. A few examples of some Nigerian plants and their uses are shown in Table 1.

Some selected Nigerian medicinal plants and their uses. Source: Abd El-Ghani [ 51 ]. Table 1 shows some selected Nigerian medicinal plants and their uses. The curative properties of herbal medicine are validated through scientific investigations, which seek to understand the active chemistry of the plants [ 23 ].

The therapeutic activity of a plant is due to its complex chemical nature with different parts of the plant providing certain therapeutic effects.

Chemical components or phytochemicals found in plants that are responsible for the various therapeutic effects include alkaloids, glycosides, tannins, acids, coumarins, sterols, phenols, etc. Many modern pharmaceuticals have been modeled on or were originally derived from these chemicals, for example, aspirin is synthesized from salicylic acid derived from the bark of Salix alba and the meadowsweet plant, Filipendula ulmaria.

Quinine from Cinchona pubescens bark and artemisinin from Artemisia annua plant are antimalarial drugs. Vincristine and vinblastine are anticancer drugs derived from Madagascar periwinkle Catharanthus roseus , used for treating leukemia. Morphine and codeine, derived from the opium poppy Papaver somniferum , are used in the treatment of diarrhea and pain relief, while digitoxin is a cardiac glycoside derived from foxglove plant Digitalis purpurea [ 22 , 24 ].

Medicinal plants are also important materials for the cosmetic industries. The use of herbal drugs dwindled toward the end of the 19th century due to the advent of synthetic chemistry. However, there was a resurgence of interest in plant medicines in more recent years, as synthetic drugs became less effective due to high levels of resistance and also due to higher toxicity and cost.

It is estimated that more than half of all synthetic drugs in use are derived from plants [ 25 ]. In African traditional medicine, the curative, training, promotive, and rehabilitative services are referred to as clinical practices Clinical practice can also be viewed as the process of evaluating conditions of ill-health of an individual and its management.

These traditional health care services are provided through tradition and culture prescribed under a particular philosophy, in which the norms and taboos therein are strictly adhered to and form the basis for the acceptability of traditional health practitioners in the community they serve [ 26 ].

The recognition of disease and illnesses in traditional Africa meant that every society needed to devise means of containing its problem.

Worldwide, different societies have different herbal traditions that have evolved over a long period of time. Similar to modern day Western treatment patterns, African traditional societies also involved herbalism, surgery, dietary therapy, and psychotherapy, in addition to traditional exorcism, rituals, and sacrifice [ 28 ].

Successful treatments became formalized, sometimes with prescriptions of correct methods of preparation and dosage. In addition, the ingredients and the manner of preparation varied with the ailment but were also dependent on various factors such as geographical, sociological, and economic, but the significant point was that in many cases, patients were cured of their physical or psychological ailments [ 29 ].

In African traditional medicine, traditional health practitioners THP assess patients in order to diagnose, treat, and prevent disease using their expertise by the following methods:. Divination means consulting the spirit world.

It is a method by which information concerning an individual or circumstance of illness is obtained through the use of randomly arranged symbols in order to gain healing knowledge. It is also viewed as a way to access information that is normally beyond the reach of the rational mind.

It is a transpersonal technique in which diviners base their knowledge on communication with the spiritual forces, such as the ancestors, spirits, and deities [ 30 ]. It is, therefore, an integral part of an African traditional way of diagnosing diseases.

This is established through the use of cowry shells, throwing of bones, shells, money, seeds, dice, domino-like objects, or even dominos themselves, and other objects that have been appointed by the diviner and the spirit to represent certain polarities on strips of leather or flat pieces of wood.

The divining bones that form the large majority of the objects include bones from various animals such as lions, hyenas, ant-eaters, baboons, crocodiles, wild pigs, goats, antelopes, etc. The bones represent all the forces that affect any human being anywhere, whatever their culture [ 31 ]. Because of the revealing powers of divination, it is usually the first step in African traditional treatment and medicine [ 32 ].

Oral interviews are sometimes used by some traditional healers to find out the history behind the sickness, where they have been for treatment and how long the person has been in that condition.

This approach enables them to know how to handle the matter at hand. In modern times, after the healing process, they also advise their clients or patients to go for medical diagnoses to confirm that they are healed, and the medical reports sometimes serve for record keeping for future reference and are a way of assuring other clients of their ability and credibility.

Due to the holistic approach of the healing process, the healers do not separate the natural from the spiritual or the physical from the supernatural [ 33 ].

Thus, health issues are addressed from two major perspectives—spiritual and physical. Spiritual-based cases are handled in the following manner: Spiritual protection : If the cause of the disease is perceived to be an attack from evil spirits, the person would be protected by the use of a talisman, charm, amulets, specially designed body marks, and a spiritual bath to drive the evil spirits away.

These are rites aimed at driving off evil and dangerous powers, spirits, or elements to eliminate the evils or dangers that may have befallen a family or community [ 34 ]. Sacrifices : Sacrifices are sometimes offered at the request of the spirits, gods, and ancestors.

Sometimes, animals such as dogs and cats are slaughtered or buried alive at midnight to save the soul of the one at the point of death, with the belief that their spirits are strong enough to replace life [ 30 ]. There is also the view that because they are domestic animals and are very close to people, sometimes when they see that someone very close to them is about to die, they offer their lives for that person to live.

This is true especially where the animal dies mysteriously; thus, it is believed that it had offered its life in place of the life of its owner.

Rituals are sometimes performed in order to consecrate some herbs without which the medicine is meaningless. Divine and ancestral sanctions are considered necessary before and during the preparation and application of medicine [ 35 ]. Spiritual cleansing : Spiritual cleansing may be required of the sick person to bathe at specific times for a prescribed number of days either with water or animal blood poured from head to toe.

This practice is common among some communities in Ghana [ 34 ]. Appeasing the gods : If a disease is perceived to be caused by an invocation of a curse or violation of taboos, the diviner appeases the ancestors, spirits, or the gods according to the severity of the case.

These items are usually specified by the gods. The used items may be thrown into the river, left to rot, or placed at strategic places, usually at cross roads at the outskirts of the community, depending on the nature and severity of the case [ 36 ]. Exorcism : This is a practice of expelling demons or evil spirits from people or places that are possessed or are in danger of being possessed by them.

Many of the traditional communities believe that illness, especially mental illness, is mostly caused by evil spirits. Exorcism can only be performed by a religious leader or a priest who has the authorities and powers to do so.

Sometimes, an effigy made of clay or wax would be used to represent the demon and would ultimately be destroyed. The possessed individual would be somewhat agitated but would only calm down as soon as the spirit is removed from the body.

Exorcism is practiced, not only in Africa but also in ancient Babylonian, Greek, and other ancient cultures of the Middle East. This practice is also performed for those who are mentally challenged. In their view, until the possessed person is delivered from the power of that evil spirit, the person will not have his or her freedom.

Hence, the practice of exorcism is considered necessary [ 37 ]. Libation : Libation involves pouring of some liquid, mostly local gin on the ground or sometimes on objects followed by the chanting or reciting of words.

It is usually regarded as a form of prayer. The liquid could also be water or in modern times, wine, whisky, schnapps, or gin. Some cultures also use palm wine, palm oil, and coconut water, while some others use corn flour mixed with water [ 38 ].

Libation pouring as is practiced in some communities has three main parts, namely invocation, supplication, and conclusion. Invocation: They first invoke the presence of the almighty God, mother earth, and the ancestors.

According to the practitioners of libation pouring, offering the ancestors and spirits drink is a way of welcoming them. Supplication: After invocation, requests are made to the invoked spirits, gods, or ancestors to intercede on their behalf for mercy and forgiveness of offenses such as taboo violations and to seek for spiritual consecration cleansing of either the community or individual s.

The content of the prayer is usually case specific [ 38 ]. Conclusion: At the end of the libation pouring, they thank the invoked ancestors and spirits.

Therefore, those who wish evil i. In this process, the person pouring the libation would be pouring the drink or liquid on the ground as he is reciting the prayers, followed by responses to each prayer point by observers. If the illness is of a physical nature, the following approaches are exploited: Prescription of herbs : Herbs are prescribed to the sick person according to the nature of the illness.

Each prescription has its own specific instructions on how to prepare the herb, the dose, dosing regimen, and timeframe.

Clay and herbs application: Application of a mixture of white clay with herbs may be relevant in some of the healing processes. The mixture is applied to the entire body for a number of days, especially in the case of skin diseases. The view is that the human body is made out of the dust or ground; therefore, if the body has any problem, you would have to go to where it came from to fix it.

The use of clay with some special herbs is also sometimes used for preventive rituals to ward off the evil spirits responsible for illness.

This is mostly done when it is an issue of a violation of a taboo [ 39 ]. The THPs use experience, added to the accumulated knowledge handed down by their ancestors in order to provide effective and affordable remedies for treating the main ailments such as malaria, stomach infections, respiratory problems, rheumatism, mental problems, bone fracture, infertility, complications of childbirth, etc.

As there is an African way of understanding God, in the same way, there is an African way of understanding the visible world around us—the cattle, trees, people, and cities, as well as the unseen world, the supernatural world of spirits, powers, and diseases [ 40 , 41 ].

People developed unique indigenous healing traditions adapted and defined by their culture, beliefs, and environment, which satisfied the health needs of their communities over centuries [ 15 ]. Different ethnic groups and cultures recognize different illnesses, symptoms, and causes and have developed different health-care systems and treatment strategies.

In spite of these, profound similarities exist in the practice of traditional medicine in different African countries. The increasing widespread use of traditional medicine has prompted the WHO to promote the integration of traditional medicine and complementary and alternative medicine into the national health care systems of some countries and to encourage the development of national policy and regulations as essential indicators of the level of integration of such medicine within a national health care system.

The peculiar practices of some countries are described below:. In Ghana, herbal medicine is usually the first approach to treat any illness, especially in the rural areas.

Besides, ratio of medical doctors to the patients is about , while for traditional healers, the ratio is This plays a major role in health care decision making. Other influencing factors, such as financial situation, education, and advice from friends and family, contribute to choice of type of health care [ 42 ].

Traditional medicine has a long history in Ghana. This knowledge is typically in the hands of spiritual healers, but the vast majority of families have some knowledge of traditional medicine, which is often inherited and passed down through the generations via folklore.

Most people in Ghana fully accept modern science-based medicine, but traditional medicine is still held in high regard. They believe in the physical and spiritual aspects of healing. In some Ghanaian communities, especially in the Akan communities, traditional healers and practitioners are of the opinion that disobeying taboos is one of the ways that could lead to severe illness to the person s or community involved [ 43 ].

Taboos form an important part of African traditional religion. They are things, or a way of life, that are forbidden by a community or a group of people. One could also become sick through invocation of curses in the name of the river deity, Antoa , upon the unknown offender.

Establishing centers for integrating scientific research into plant medicines and incorporating traditional medicine into university curricular are now the current status in Ghana [ 44 ].

Also, degree-awarding traditional medical schools now train and graduate traditional medical doctors. The first principle is diagnosis followed by complex treatment procedures using plants from the bush, followed by many rituals, the ultimate aim being to cure disease.

This involves killing a lizard and burning the heart with roots of certain trees and grinding with charcoal. Tiny cuts are made on the ailing area and left breast and the mixture rubbed into the cuts.

Plants may be used singly or in combination with other plants. The plant parts are harvested fresh, pulverized, and left to dry first, then soaked in water or other solvents like local gin. Some plant materials are burnt as charcoal and used as powder.

Six major types of treatment common to the 72 or more ethnic groups in Zambia include drinking, eating, drinking as porridge, making small cut on skin and applying, bathing with herbs, dancing to exorcize spirits, and steaming with boiling herbs. The Zambian traditional healer is called Nga:nga [ 45 ].

In Tanzania, traditional medicine has been practiced separately from allopathic medicine since colonial period but is threatened by lack of documentation, coupled with the decline of biodiversity in certain localities due to the discovery of natural resources and excessive mining, climate change, urbanization, and modernization of agriculture.

Traditional medicine in Tanzania is used by people of all ages in both urban and rural areas for both simple and chronic diseases. The traditional healers are of four different types: diviners, herbalists, traditional birth attendants, and bone setters.

Erosion of indigenous medical knowledge occurred as most of the traditional health practitioners were aging and dying, and the expected youths who would inherit the practice were shying away from it and those in the rural areas dying of AIDS.

Another constraint to the development of traditional medicine in Tanzania was lack of data on seriously threatened or endangered medicinal plant species [ 46 ]. As it stands today, the traditional medical practice is under the Ministry of health. Efforts are being made to scale up traditional medical practice by creating awareness of the importance of traditional medicine and medicinal plants in health care and training of traditional health practitioners on good practice, conservation, and sustainable harvesting [ 47 ].

Traditional medicine features in the lives of thousands of people in South Africa every day. Muti is a word derived from medicinal plant and refers to traditionally sourced plant, mineral, and animal-based medicines. In addition to herbs, traditional medicine may use animal parts and minerals.

However, only plant muti is considered a sustainable source of medicines. South African traditional plant medicines are fascinating with so many colors, forms, and effects. It is an art to know these and to use them correctly to bring about health and harmony, which is the aim of all true traditional healers.

The plant muti is commonly sold in specific sections of the open markets in South Africa, as shown in Figure 3.

Muti market in Johannesburg Source—Ancient Origins. Figure 3 shows a muti market in Johannesburg. The traditional healers known as the Sangoma or Inyanga are holders of healing power in the southern Bantu society.

In a typical practice with a female traditional practitioner, the methods used depended on the nature of the complaint. For example, headaches are cured by snuffing or inhaling burning medicines, bitter tonics are used to increase appetite, sedative medicines for depression, vomiting medicines to clean the digestive system, and antibiotic or immune boosting medicines for weakness or infection.

She often counseled patients before administering appropriate healing herbal medicines [ 48 ]. As in many countries in Sub-Saharan Africa, Kenya is experiencing a health worker shortage, particularly in rural areas.

In Kenya, very little quantitative evidence or literature exists on indigenous medicine and the health practices of alternative healers or the demand for traditional medical practitioners or on the role that they play in providing particular health services for the rural poor.

As a result, TMPs currently do not have sufficient formal government recognition and are often sidelined in Human Resources in Health HRH planning activities; further, their activities remain unregulated. Community-derived data show that hospitals are preferred if affordable and within reach.

There is also significant self-care and use of pharmacies, although THMPs are preferred for worms, respiratory problems, and other conditions that are not as life threatening as infant diarrhea and tuberculosis [ 49 ]. Their practices are no different from other African countries.

The various ethnic groups in Nigeria have different health care practitioners aside their western counterparts, whose mode of practice is not unlike in other tribes. Apart from the lack of adequate access and the fear of expired or fake drugs, the prohibitive cost of western medicine makes traditional medicine attractive.

Various training schools exist for both herbal medicine and homeopathy, and as such, most modern traditional health practitioners have great knowledge of pharmaceutical properties of herbs and the shared cultural views of diseases in the society and they combine their knowledge with modern skills and techniques in processing and preserving herbal medicines, as well as in the management of diseases.

In oral interviews with two modern traditional medicine practitioners, Dr. Knowledge was however improved by further training, interaction, and discussion with colleagues, consultation of books on herbal medicine, and the Internet.

They claimed that the practice was very lucrative, especially since some ailments that defied orthodox medicine such as epilepsy and madness could be completely treated by traditional medicine. The two men divulged that the old concept of secrecy and divination is gradually fading away and being taken over by improved skills, understanding, and use of modern equipment where necessary.

Another prominent member of the association, Professor J. Okafor, who is a renowned silviculturist and plant taxonomist, is helping members to identify and classify plants.

The group also shares and documents evidence-based therapeutic knowledge. Such groups and training schools exist all over Nigeria.

ASICUMPON has published a checklist of medicinal plants of Nigeria and their curative values [ 19 ]. Other books have likewise produced useful information [ 16 , 21 ].

The greatest problem still facing herbal medicine in Nigeria is lack of adequate standardization and safety regulations [ 52 ]. However, the interest and involvement of educated and scientific-minded people in herbal medicine practice have to a great extent demystified and increased the acceptability of these medicines by a greater percentage of would-be skeptical populace.

A photograph of Dr. Anselm Okonkwo is shown here in Figure 4 , who is a veterinary doctor and a typical educated and knowledgeable herbal practitioner with the writer after interviewing him.

The writer with Dr. As with synthetic drugs, the quality, efficacy, and safety of medicinal plants must also be assured. Despite the widespread use of herbal medicines globally and their reported benefits, they are not completely harmless.

In as much as medicinal herbs have established therapeutic effects, they may also have the potential to induce adverse effects if used incorrectly or in overdose. The likelihood of adverse effects becomes more apparent due to indiscriminate, irresponsible, or nonregulated use and lack of proper standardization.

These concerns have been the focus of many international forums on medicinal plants research and publications [ 53 ]. The rich flora of Africa contains numerous toxic plants, though with interesting medicinal uses. The toxic constituents e.

In a survey in Lagos metropolis, Nigeria, among herbal medicine users, it was found that herbal medicine was popular among the respondents but they appeared to be ignorant of its potential toxicities [ 22 ]. Several herbal medicines have been reported to have toxic effects.

Current mechanisms to track adverse effects of herbal medicines are inadequate [ 15 , 54 , 55 ]. Consumers generally consider herbal medicines as being natural and therefore safe and view them as alternatives to conventional medications.

Only very few people who use herbal medicines informed their primary care physicians. It is therefore likely that many adverse drugs reactions go unrecorded with either patients failing to divulge information to health services, and no pharmacovigilance analyses are being carried out, or the observations are not being reported to appropriate quarters such as health regulatory bodies.

Establishing a diagnosis of herbal toxicity can be difficult. Even when herbal-related toxicity is suspected, a definitive diagnosis is difficult to establish without proper analysis of the product or plant material. Very few adverse reactions have been reported for herbal medicines, especially when used concurrently with conventional or orthodox medicines [ 15 ].

The results of many literature reviews suggest that the reported adverse drug reactions of herbal remedies are often due to a lack of understanding of their preparation and appropriate use. In a research of liver and kidney functions in medicinal plant users in South-East Nigeria, it was found that liver problems were the most prominent indices of toxicity as a result of chronic use [ 56 ].

Figures 5 and 6 refer to the effect of consumption of herbal medicines and length of usage respectively, on serum enzymes, as an index of liver function.

Toxic components in these herbs such as alkaloids, tannins, oxalates, etc. Serum enzyme levels in herbal medicine users test group and nonusers control. Effect of length of use of herbal medicine on serum enzyme levels.

As such, some supplements may list ingredients improperly or even contain compounds not stated on the label. Thus, you should opt for brands that have been tested for quality by a third-party organization, such as U. Pharmacopeia or NSF International. Herbal medicines carry many possible side effects, so you should consult your healthcare provider prior to taking them.

When shopping, choose brands that have been certified for purity and quality. Many people around the world rely on herbal medicines to treat health conditions. Countless varieties exist, but some of the most popular include gingko, ginseng, ginger , turmeric, and chamomile.

Though their applications tend to be very broad, many of their supposed benefits lack strong scientific evidence. Keep in mind that, like conventional drugs, herbal remedies may interact negatively with other medicines.

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Here's what you should know about this herbal remedy. A Quiz for Teens Are You a Workaholic? How Well Do You Sleep? Health Conditions Discover Plan Connect. Medically reviewed by Kathy W.

Warwick, R. How we vet brands and products Healthline only shows you brands and products that we stand behind. Our team thoroughly researches and evaluates the recommendations we make on our site.

To establish that the product manufacturers addressed safety and efficacy standards, we: Evaluate ingredients and composition: Do they have the potential to cause harm? Fact-check all health claims: Do they align with the current body of scientific evidence? Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness. Read more about our vetting process. Was this helpful? Share on Pinterest. Ginkgo biloba. Precautions for using herbal medicines.

Plants as Medicine. The bottom line. How we reviewed this article: History. Feb 3, Written By Ansley Hill. Share this article. Read this next. Medically reviewed by Debra Rose Wilson, Ph. This means the medicine complies with quality standards relating to safety and manufacturing, and it provides information about how and when to use it.

You can find THR-registered products in your local health shop, pharmacy or supermarket. The risks of obtaining fake, substandard, unlicensed or contaminated medicines are increased by buying medicines online or by mail order.

Unlicensed herbal medicines manufactured outside the UK may not be subject to regulation. They may be copies of licensed medicines, but made in unlicensed factories with no quality control. Some websites may appear to be legitimate, but are fronted by people pretending to be doctors or pharmacists.

Herbal products sold online may also contain banned ingredients and toxic substances. You can find a list of banned and restricted herbal ingredients on the GOV. UK website. Herbal slimming products and products that claim to improve sexual performance, for example, are best avoided.

This is because they have been found to contain dangerous ingredients, including pharmaceutical ingredients, that aren't stated on the label. You can report any side effect or adverse reaction to a herbal medicine using the Yellow Card Scheme run by the Medicines and Healthcare products Regulatory Agency MHRA.

This can help the MHRA identify new side effects or risks associated with medicines, including herbal remedies. It's important to include as much detail as possible, particularly any brand name or manufacturer's details relating to the herbal medicine. In the past, Yellow Card reports have been used to identify interactions between St John's wort and other medicines, and to highlight the use of dangerous substances like mercury, lead and arsenic in unlicensed Ayurvedic and traditional Chinese medicines.