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Introducion 1
1. INTRODUCTION
1.1 MEDICINAL PLANTS
Medicinal plants are the plants which are used in the field of medicine due to having
medicinal properties. Some plants or their phytochemical constituents have been
proven to have medicinal effects by rigorous science or have been approved by
regulatory agencies such as the United States Food and Drug Administration
(USFDA) and European Food Safety Authority (EFSA). India is a country known for
ancient scripts, the number system and invention of zero and Vedas. Medicines in
India are used by about 60 per cent of the world's population. These are not only used
for primary health care not just in rural areas in developing countries, but also in
developed countries as well where modern medicines are predominantly used. While
the traditional medicines are derived from medicinal plants, minerals, and organic
matter, the herbal drugs are prepared from medicinal plants only.1-2
Use of plant parts as a source of medicine has been an ancient practice and is an
important component of the health care system in India. In the Indian systems of
medicine, most practitioners formulate and dispense their own recipes; hence this
requires proper documentation and research. In west also the use of herbal medicines
is growing with approximately 40 per cent of population reporting use of herb to treat
medical diseases within the past year. General Public, academic and government
interest in traditional medicines is growing rapidly due to the increase side effects of
the adverse drug reactions and cost factor of the modern system of medicine.3-5
There are approx 45,000 medicinal plant species in India, with concentrated spots in
the region of Eastern Himalayas, Western Ghats and Andaman & Nicobar Island. The
officially documented plants with medicinal potential are 3000 but traditional
practitioners use more than 6000. India is the largest producer of medicinal herbs and
is called the botanical garden of the world. There are currently about 250,000
registered medical practitioners of the Ayurvedic System, as compared to about
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700,000 of the modern medicine system. In rural India, 70 per cent of the population
depends on the traditional type of medicine like Ayurveda.6-8
In India, many forms of alternative medicines are available for those who do not want
conventional medicine or who cannot be helped by conventional medicine. Ayurveda
and Kabiraji (herbal medicine) are two important forms of alternative medicine that is
widely available in India.
Ayurvedic form of medicine is believed to be existent in India for thousands of years.
It employs various techniques and things to provide healing or relief to the ailing
patients. One of the think is that Ayurveda uses is medications of plant origin.
We have evidence of a traditional use of medicinal plants with the scripts in the
Atharva Veda that is more than 3000 years old. It is estimated that about 80,000
species of plants are utilized in some form or other by the different systems of Indian
medicine. The knowledge about plants and plant products is detailed, sophisticated,
and has evolved into a separate shastra itself, called Dravya Guna Shastra.
Plants have been studied on the basis of clearly defined biological parameters like
rasa (taste), vipaka (metabolic property), guna (quality), prabhava (biological effect)
and virya (potency). The codified traditions have about 25,000 plant drug
formulations that have emerged from such studies. In addition to this, over 50,000
formulations are believed to be existence in the folk and tribal traditions. All these
point to the deep passion and exhaustive knowledge about medicinal plants that have
existed in this land from time immemorial.9-10
1.2 IMPORTANCE11-15
Medicinal herbs are staging a comeback and herbal period is happening all over the
world. The herbal products today have symbol of safety in contrast to the
synthetics that are regarded as unsafe to life and environment. Although herbs had
been priced for their flavouring, medicinal, nutritional and other qualities for
centuries, the synthetic products of the modern age surpassed their importance, for
a while. Thus, now a d a y our blind dependence on synthetics is over and we are
returning to the naturals with hope of safety and security and also for other benefits.
More than one third of the world’s population relies on plants and plant extracts for
health care. Over 30% of the entire plant species is used for medicinal purposes at one
time or other. It is supposed that world market for plant derived drugs may account for
Introducion 3
about Rupees Twenty Thousand Crores. Presently, the contribution of India is less
than Rs.2000 crores. India export of raw drugs has steadily grown from Rs.130
crores in 1991-92 26% to Rs.165 crores in 1994-95. The annual production of
medicinal and aromatic plant’s raw material is worth about Rupees Two Thousands
Crores. This is approx to touch US $1150 up to the year 2000 and US $5 trillion up
to 2050.
This is estimated in developed countries like United States that plant drugs constitute
more than 25% of the total drugs, while in fast developing countries like India and
China, the contribution is more than 80%. However, the economic importance of
medicinal plants is very much to developing countries such as India comparison to
rest of the world. These countries provide more than two third of the plants used in
modern system for medicine and the health care system of rural and urban population
depend on indigenous systems of medicine. From the 245,000 higher plant species on
earth, more than 75,000 have medicinal value. India is one of the world’s Twelfth
biodiversity centres with the presence of over 45000 different plant species. India’s
diversity is unmatched due to the presence of sixteen different agro-climatic zones,
ten vegetation zones, twenty five biotic provinces and four hundred twenty six biomes
(habitats of specific species). From 45,000 plants approx 15000 to 20000 plants have
good medicinal value. Thus, only 7000 to 7500 species are used for their
medicinal values by traditional communities. In India, drugs of herbal origin have
been used in traditional medicine system such as Unani and Ayurveda since ancient
times. The Ayurveda System of medicine uses more than 700 species, Unani System
uses about 700, Siddha System uses about 600, Amchi System uses about 600
species and Modern medicine System around uses about 30 species. The drugs are
found either t he from of whole plant or t he form o f different organs, like stem,
bark, root, leaves, flower, seed, etc. Many drugs are prepared from plant
secretion such as resins, gum and latex. Even now Allopathic system of medicine
has adopted a number of plant-derived drugs which form an important place in the
modern pharmacopoeia. Some modern drugs are also obtained from plants e.g.
diosgenin, solasodine, ionone. Even not only, that plant-derived drug offers a stable
market worldwide, but also plants continue to be an important source for some new
drugs.
From ancient civilisations, India has been known to be rich country of medicinal
Introducion 4
plants. The forest in India is the principal repository in large numbers of
medicinal and aromatic plants, which are collected as raw materials for drugs
manufacturing and perfumery products. About 8,000 herbal remedies have been
codified in Ayurveda. In other Veda’s, The Rigveda (5000 BC) has recorded 67
medicinal plants, Yajurveda recorded 81 species, Atharvaveda (4500-2500 BC) have
290 species, Charak Samhita (700 BC) and Sushrut Samhita (200 BC) had described
properties and uses of 1100 and 1270 species respectively, Almost all have their
uses in compounding of drugs and these are still used in modern medicine with
classical formulations. In the Ayurvedic system of medicine, the ancient knowledge
and many valuable plants are being lost day by day at an alarming rate, Due to the
rapid depletion of forests, impairing the availability of raw drugs. Like other systems
of herbal medicines, Ayurveda has reached a very critical phase. More than 50% of
the tropical forests, the treasure house of plant and animal diversity have already
been destroyed. In India, forest cover is disappearing at an annual rate 1.5mha/yr.
What is left at present is only 8% as against a mandatory 33% of the geographical
area. Many valuable medicinal plants are under the verge of extinction. The Red Data
Book of India has 427 entries of endangered species of which 28 are considered
extinct, 124 endangered, 81 vulnerable, 100 rare and 34 insufficiently known species.
Medicines like Siddha, Unani Folk (tribal) and Ayurveda, are the major systems of
indigenous medicines. Among these systems, Ayurveda has a wide role and is
most developed and widely practised in India. Ayurveda dating back to 1500-800
BC has been an integral part of Indian culture. The term comes from the Sanskrit root
Au (life) and Veda (knowledge). As the name implies it is not only the science of
treatment of the disease but covers the entire range of happy Human life involving the
physical, metaphysical and the spiritual aspects. Ayurveda recognises that besides a
body balance, elements one has to have an enlightened state of consciousness, mind
and sense organs, if one has to be perfectly healthy. Ayurveda by and large is an
experience with nature and unlike in Western medicine, many of the concepts elude
scientific explanation. Ayurveda is beneficial as the natural system of health care all
over the world. Today Ayurveda system of medicine is being practised in countries
like Bhutan, Sri Lanka, Nepal, Bangladesh and Pakistan, while the traditional system
of medicine in the other countries like Mongolia, Tibet and Thailand i s appear to
inspire from Ayurveda. Plant medicines are also being used increasingly in
Introducion 5
Western country like Europe. Recently the US Government has established the
“Office of Alternative Medicine” at the National Institute of Health at Bethesda and
its support to alternative medicine includes basic and applied research in
traditional systems of medicines such as Ayurvedic, Chinese etc. with a view to
assess the possible integration of effective medications with modern medicines.
The development of pharmacopoeias i s dated back to 3000 BC, when the Chinese
were already using more than 350 herbal remedies. Ayurveda, the system of
herbal medicine in India, Sri Lanka and South-East Asia has more than 8000 plant
remedies and using around 45,000-70,000 plant species. China has demonstrated the
best traditional medicine use in providing the health care. China has
pharmacologically validated value and improved many traditional herbal medicines
and eventually integrated them in formal health care system.
The plants synthesise and preserve a variety of biochemical products, many of
which are extractable and a l s o used as raw material o r chemical feed stocks for
various scientific investigations. Many secondary metabolites of plant are important
and find use in a number of pharmaceutical compounds. However, a sustained supply
of a source material often becomes difficult due to the many factors like cultural
practices, diverse geographical distribution, environmental changes, labour cost,
selection of the superior plant stock and over exploitation by pharmaceutical industry.
Those plants which are used in Ayurveda can provide biologically active molecules
and lead structures for the development of modified derivatives with enhanced
activity and may reduced toxicity. The small fractions of flowering plants that have
so far been investigated have yielded approx 120 therapeutic agents of known
structure from about 95 species of plants. Useful plant drugs include vinblastine,
vincristine, podophyllotoxin, camptothecin, taxol, digitoxigenin, gitoxigenin,
digoxigenin, tubocurarine, codeine, aspirin, atropine, pilocarpine, morphine,
capscicine, allicin, curcumin, artemesinin and ephedrine among others. In many cases,
the crude extract of medicinal plants can be used also as medicaments. On the other
way, the isolation and identification of extract for the active principles and
elucidation of the mechanism of action of a drug is of paramount importance. Hence,
works in both mixture of traditional medicine and single active compounds are very
important, and we know the active molecule cannot be synthesised economically,
the product must be obtained from the plant cultivation. The scientific study of
Introducion 6
traditional medicines, derivation of drugs through bio prospecting and systematic
conservation of the concerned medicinal plants are thus having great importance.
1.3 CLASSIFICATION OF MEDICINAL PLANTS16-20
Over the 240,000 higher plant species on earth, about 75,000 species are reported to
have at least some medicinal value and around 5000 species have specific
therapeutic value. Some of these are classified according to the part used, habit,
habitat, therapeutic value etc, besides the usual botanical classification.
Based on part used
• Whole plant: Boerhaavia diffusa, Phyllanthus neruri
• Root: Dasamula
• Stem: Tinospora cordifolia, Acorus calamus
• Bark: Saraca asoca
• Leaf: Indigofera tinctoria, Lawsonia inermis, Aloe vera
• Flower: Biophytum sensityvum, Mimusops elenji
• Fruit: Solanum species
• Seed: Datura stramonium
Based on habit
• Grasses: Cynodon dactylon
• Sedges: Cyperus rotundus
• Herbs: Vernonia cineria
• Shrubs: Solanum species
• Climbers: Asparagus racemosus
• Trees: Azadirachta indica
Based on habitat
• Tropical: Andrographis paniculata
• Sub-tropical: Mentha arvensis
• Temperate: Atropa belladona
Based on therapeutic value
• Antimalarial: Cinchona officinalis, Artemisia annua
• Anticancer: Catharanthus roseus, Taxus baccata
• Antiulcer: Azadirachta indica, Glycyrrhiza glabra
Introducion 7
• Antidiabetic : Catharanthus roseus, Momordica charantia
• Anticholesterol: Allium sativum
• Antiinflammatory: Curcuma domestica, Desmodium gangeticum
• Antiviral: Acacia catechu
• Antibacterial: Plumbago indica
• Antifungal: Allium sativum
• Antiprotozoal: Ailanthus sp., Cephaelis ipecacuanha
• Antidiarrhoeal: Psidium gujava, Curcuma domestica
• Hypotensive: Coleus forskohlii, Alium sativum
• Tranquilizing: Rauvolfia serpentine
• Anaesthetic: Erythroxylum coca
• Spasmolytic : Atropa belladona, Hyoscyamus niger
• Diuretic: Phyllanthus niruri, Centella asiatica
• Astringent: Piper betle, Abrus precatorius
• Anthelmentic: Quisqualis indica, Punica granatum
• Cardiotonic: Digitalis sp., Thevetia sp.
• Antiallergic: Nandina domestica, Scutellaria baicalensis
• Hepatoprotective: Silybum marianum, Andrographis paniculata
1.4 PROCESSING AND UTILIZATION OF MEDICINAL PLANTS21-27
Medicinal compounds can be present in different parts of the plant like root, stem,
bark, heartwood, flower, fruit and leaf or plant exudates. These medicinal compounds
can be separate by different processes. The most common process is extraction. The
process or extraction is the separation of the required constituents from plant
materials by using a solvent. In the case of medicinal plants, the extraction procedure
can be divided into two categories.
a) Where it is sufficient to achieve within set limits equilibrium of concentration
between drug components and the solution. Example is Tea, Tinctures, Decoction etc.
b) Where it is necessary to extract the drug to exhaustion, means until all solvent
extractable are removed by the solvent.
Both the above methods are employed depending on the requirement in industry but
the latter method is mostly used. In all industrial procedures, the raw material is pre-
Introducion 8
treated with solvent outside the extract or before changing the latter. This prevents
sudden bulk volume changes which are the main cause of channelling during
extraction and facilitates the breaking up of the cell walls to release the
extractable. To facilitate the extraction, the solvent should diffuse inside the cell
and the substance must be sufficiently soluble in the solvent. To complete the
extraction ideal solvent is that one who is most selective, has the best capacity for
extraction and is compatible with the properties of the material to be extracted.
These parameters are predetermined experimentally. The availability and cost of the
solvent are also taken into account. Alcohol ( widely used), because of its great
extractive power it is often the least selective, in that it extracts all soluble
constituents. Alcohol in various ratios is used to reduce selectivity. The ideal
alcohol ratio for woody or bark material is 75%. For leafy material, it should often
less than 50% thus avoiding extraction of the chlorophyll which makes purification
difficult.
Some componants such as alkaloids are soluble in acid, their extraction is facilitated
by adjusting the pH in the acidic range. The alkaloids can be extracted easily with
hydrocarbons after they have been released from combination with organic acids by
grinding with alkali. It is first ground with moist calcium oxide and extracted with
chloroform. A large number of alkaloids can be also extracted directly with aqueous
acids, inorganic or organic acids, and the alkalised extracts counter extracted with
hydrocarbons or other nonpolar solvents.
process used for extraction with solvents usually comprise an extraction vessel with
a heating jacket for steam heating or fitted with electrical devices, a condenser in
reflux position, a solvent reservoir, a facility to convert to reboiler position or a
separate reboiler and a short column for solvent recovery. Sometimes, sophisticated
and costly equipment like the Carousel or the Inoxa extractor is employed.
For the manufacture of standardised extracts and phytochemicals, much
technology is available and there are many extracts already in the international market
in the form of drugs. Drug such as an extract of Centella asiatica can be
manufactured as an extract containing a standard quantity of asiaticoside. Similarly
for senna a standardised extract of which, containing a standard quantity of
sennoside-A and sennoside-B could easily produced with equipment that is designed
and constructed in most developing countries.
Introducion 9
The development and promotion of processing of medicinal and aromatic plants have
gained momentum recently in many developing countries. Green consumerism and
resurgence of interest for plant based products, liberalised and free market
economy, by increasing awareness about biodiversity conservation and right use of
natural resources coupled with poor socio-economic conditions of native populations
are ground realities for planning and harnessing the low-cost and purpose oriented
process technologies.
1.5 FORMULATION AND INDUSTRIAL UTILIZATION28-34
Medicinal plants are used as raw materials for extraction of active constituents in pure
form (eg. alkaloids like quinine and quinidine from cinchona bark, emetine from
ipecacuanha root, glycosides from digitalis leaves, sennosides from senna
leaves), as precursors for synthetic vitamins or steroids, and as preparations for
herbal and indigenous medicines. Products such as ginseng, valerian and liquorice
roots are part of the herbal and health food market, as well as the food flavours,
fragrance and cosmetic industries. Certain plant products are industrially exploited
like liquorice in confectionery and tobacco, papaine as meat tenderiser, quinine as
soft drink tonic and cinchona as wine flavour. A large quantity of medicinal plant
material is used in the preparation of herbal and medicinal teas, eg. chamomile.
These herbal and food uses are of great importance, also to the exporters from
developing countries. Hundreds of medicinal plants are items of commerce, however
relatively small countries are used in formulated herbal remedies.
Several formulations like herbal teas, extracts, decoctions, infusions, tinctures, etc are
prepared from medicinal plants.
Herbal teas, Herbal remedies: herbal tea or infusion mixtures are mixture of un
ground or suitably ground medicinal plants to which drug plant extracts,
ethereal oils or medicinal substances can be added. Infusion mixtures should be
as homogenous as possible.
1.6 DRUG EXTRACTS: They are preparations obtained by extracting drugs of a
certain particle size with suitable extraction agents (menstrua). The extract obtained
after separation of the liquid from the drug residue is called miscella. It may already
represent the final liquid doses form called as fluid extract, or be used as an
Introducion 10
intermediary product which is to be further processed as quickly as possible.
1.6.1 Aqueous drug extracts: The following degrees of comminution are used for the
extract depending on the type of plant parts. Leaves, flowers and herbs shredded
(4000mm); woods, barks and roots shredded (2800mm); fruits and seeds
(2000mm). Alkaloid containing drugs powdered (700mm).
Decoctions: The drug in the prescribed comminution is put in to water at a
temperature above 90 C. The container is suspended in a water bath and
maintained at this temperature for 30 minutes, with repeated stirring. The mixture is
then strained while still hot.
Infusions: One part of the comminuted drug is kneaded several times in a mortar with
3-5 parts of water and left to stand for 15 minutes. The rest of the boiling water is then
poured on to the mixture, which is suspended in a container in a water bath and
kept for 5 minutes, with repeated stirring at a temperature above 90 C. The mixture
is covered and left to stand until cool.
Macerates: The comminuted drug is left to stand, with occasional stirring, for 30
minutes after the required quantity of water has been poured on to it at room
temperature. The extract is then strained and made up to the prescribed weight with
rinsings.
Tinctures: Tinctures are extracts from drug plants prepared with ethanol of
varying concentration, ether or mixtures of these, perhaps with certain additives, in
such a way that one part of drug is extracted with more than two parts, but at most
ten parts, of extraction liquid.
1.6.2 Fluid extracts: Like tinctures, they are liquid preparations, the difference being
that they are more concentrated.
1.6.3 Dry extracts: They are usually very hygroscopic and should therefore be
ground and mixed under conditions which exclude moisture as much as possible.
Intermediate and end product must also be stored under dry conditions.
There are also liquid, semisolid, solid and controlled release formulations or
preparations. The other dose forms are injections, implants, ocular preparations,
inhalations and transdermal systems. Liquid formulations may be solutions,
emulsions, colloids or suspensions in the increasing order of particle size. They
may be intended for administration parenterally, orally or topically including
administration into body cavities. Homogeneity for the formulations is very important,
Introducion 11
particularly where the active ingredient is present in lower concentration.
1.7 PHYTOCHEMICALS35-36
Phytochemicals are non-nutritive plant chemicals that have protective or disease
preventive properties. There are more than thousand known phytochemicals. It is
well-known that plant produces these chemicals to protect itself but recent research
demonstrates that they can protect humans against diseases. Some of the well-known
phytochemicals are lycopene in tomatoes, isoflavones in soy and flavonoids in fruits.
They are not essential nutrients and are not required by the human body for sustaining
life.
The different phytochemicals are as follows:-
• Volatile oils
• Alkaloids
• Glycosides
• Flavonoids
• Tannins and Polyphenolic compounds
• Carbohydrates
• Proteins
• Fixed oils and Fats
• Terpenoids
Volatile oils
The essential oil is a concentrated, hydrophobic liquid containing volatile odour
compounds from plants. Volatile oils are also known as essential or ethereal oils, or
simply as the oil of the plant from which they were extracted, such as oil of clove. Oil
is necessary or essential in the sense that it carries a distinctive scent, or essence, of
the plant. These oils do not as a group needs to have any specific chemical properties
in common, beyond conveying characteristic fragrances. They are not to be confused
with essential fatty acids.
Essential oils are generally extracted by distillation. Other processes include
expression, or solvent extraction. They are used in perfumes, cosmetics and bath
products, for flavouring food and drink, and for scenting incense and household
cleaning products
Introducion 12
Various essential oils have been used medicinally at different periods in history.
Medical application proposed by those who sell medicinal oils range from skin
treatments to remedies for cancer, and are often based on historical use of these oils
for these purposes. Such claims are now subject to regulation in most countries, and
have grown vaguer to stay within these regulations.
Interest in essential oils has been recorded in recent decades with the popularity of
aromatherapy, a branch of alternative medicine which claims that the specific odour
carried by essential oils have curative effects. Oils are volatilized or diluted in carrier
oil and used in massage, diffused in the air by a nebulizer or by heating over a candle
flame, or burned as incense.
Alkaloids
Alkaloids are naturally occurring chemical compounds containing basic nitrogen
atoms. The name derives from the word alkaline and was used to describe any
including bacteria, fungi, plants, and animals and is part of the group of natural
products (also called secondary metabolites). Many alkaloids can be purified from
crude extracts by acid-base extraction. Many alkaloids are toxic to other organisms.
They often have pharmacological effects and are used as medications, as recreational
drugs, or in entheogenic rituals. Examples are the local anesthetic and stimulant
cocaine, the stimulant caffeine, nicotine, the analgesic morphine, or the antimalarial
drug quinine. Some alkaloids have a bitter taste.
Saponin Glycosides
Saponins are a class of chemical compounds, one of many secondary metabolites
found in natural sources, with Saponins found in particular abundance in various plant
species. Specifically, they are amphipathic glycosides grouped phenomenological by
the soap-like foaming they produce when shaken in aqueous solutions, and
structurally by their being composed of one or more hydrophilic glycoside moieties
combined with a lipophilic triterpene derivative. A ready and therapeutically relevant
example is the cardio-active agent digoxin, from common foxglove.
In chemistry, glycosides are molecules in which a sugar is bound to a non-
carbohydrate moiety, usually a small organic molecule. Glycosides play numerous
important roles in living organisms. Many plants store chemicals in the form of
inactive glycosides; which can be activated by enzyme hydrolysis. This causes the
sugar part to be broken off, making the chemical available for use. Many such plant
Introducion 13
glycosides are used as medications. In animals (including humans), poisons are often
bound to sugar molecules as part of their elimination from the body.
Formally, a glycoside is any molecule in which a sugar group is bonded through its
anomeric carbon to another group via a glycosidic bond. Glycosides can be linked by
an O- (an O-glycoside), N- (a glycosylamine), S-(a thioglycoside) or C- (a C-glycosyl)
glycosidic bond. The given definition is the one used by IUPAC. Many authors
require in addition that the sugar be bonded to a non-sugar for the molecule to qualify
as a glycoside, thus excluding polysaccharides. The sugar group is then known as the
glycone and the non-sugar group as the aglycone or genin part of the glycoside. The
glycone can consist of a single sugar group (monosaccharide) or several sugar groups
(oligosaccharide).
Anthraquinone Glycosides
Anthraquinone (9, 10-dioxoanthracene) is an aromatic organic compound. It is a
derivative of anthracene. It has the appearance of yellow or light gray to gray-green
solid crystalline powder.6
Its other names are 9, 10-anthracenedione, anthradione, 9, 10-anthrachinon,
anthracene-9, 10-quinone, 9, 10-dihydro-9, 10-dioxoanthracene.
Cyanogenic Glycosides
Introducion 14
In this glycoside, the aglycone contains a cyanide group, and the glycoside can release
the poisonous hydrogen cyanide if acted upon by some enzyme. They are
stored in the vacuole but if the plant is attacked they are released and become
activated by enzymes in the cytoplasm. These remove the sugar part of the
molecule and release toxic hydrogen cyanide. Storing them in inactive forms
in the cytoplasm prevents them from damaging the plant under normal
conditions. An example of these is amygdaline from almonds. They can also
be found in the fruits (and wilting leaves) of the rose family (including
cherries, apples, plums, almonds, peaches, apricots, raspberries, and
crabapples). Cassava, an important food plant in Africa and South America,
contains Cyanogenic glycosides and therefore has to be washed and ground
under running water prior to consumption. Sorghum (Sorghum bicolour)
expresses Cyanogenic glycosides in its roots and thus is resistant to pests
such as rootworms (Diabrotica spp.) that plague its cousin maize (Zea mays
L.). Some Cyanogenic glycosides may have anti-cancer properties. A recent
study may also show that increasing CO2 levels, caused by anthropogenic
emissions, may result in much higher levels of Cyanogenic glycoside
production in Sorghum and Cassava plants, making them highly toxic and
inconsumable. A doubling of CO2 concentration was found to double the
concentration of Cyanogenic glycosides in the leaves.
Flavonoids
Flavonoids (or bioflavonoid), also collectively known as Vitamin P and citrin, are a
class of plant secondary metabolites. According to the IUPAC nomenclature,
they can be classified into:
• Flavonoids, derived from 2-phenylchromen-4-one (2-phenyl-1, 4-
benzopyrone) structure (examples: quercetin, rutin). • Isoflavonoids, derived from 3-phenylchromen-4-one (3-phenyl-1, 4-benzopyrone)
structure • Neoflavonoids, derived from 4-phenylcoumarine (4-phenyl-1, 2-benzopyrone)
structure.
The three flavonoids classes above are all ketone-containing compounds, and as such,
are flavonoids and flavonols. This class was the first to be termed "bioflavonoid." The
terms flavonoids and bioflavonoid have also been more loosely used to describe non-
ketone polyhydroxy polyphenol compounds which are more specifically termed
Introducion 15
flavonoids, flavan-3-ols, or catechins (although catechins are actually a subgroup of
flavonoids). Flavonoids (both flavonols and flavonols) are most commonly known for
their antioxidant activity.
Flavonoids (specifically flavonoids such as the catechins) are "the most common
group of Polyphenolic compounds in the human diet and are found ubiquitously in
plants". Flavonols, the original bioflavonoid such as quercetin, are also found
ubiquitously, but in lesser quantities. Both sets of compounds have evidence of health-
modulating effects in animals which eat them.
Tannins and polyphenolic compounds
Tannins are astringent, bitter plant polyphenol that either bind and precipitate or
shrink proteins. The astringency from the tannins is what causes the dry and puckery
feeling in the mouth following the consumption of unripened fruit or red wine
Likewise, the destruction or modification of tannins with time plays an important role
in the ripening of fruit and the aging of wine.
The term tannin (from tanna, an Old High German word for oak or fir tree) refers to
the use of wood tannins from oak in tanning animal hides into leather; however, the
term is widely applied to any large Polyphenolic compound containing sufficient
hydroxyls and other suitable groups (such as carbonyls) to form strong complexes
with proteins and other macromolecules. The compounds are widely distributed in
many species of plants, where they play a role in protection from predation and
perhaps also in growth regulation.Tannins have molecular weights ranging from 500
to over 9,000. Tannins are incompatible with alkalis, gelatin, heavy metals, iron, lime
water, metallic salts, strong oxidizing agents and zinc sulfate.
Tannins are distributed in species throughout the plant kingdom. They are commonly
found in both gymnosperms as well as angiosperms. Histological tannins are mainly
physically located in the vacuoles or surface wax of plants. These storage sites keep
tannins active against plant predators, but also keep some tannin from affecting plant
metabolism while the plant tissue is alive; it is only after cell breakdown and death
that the tannins are active in metabolic effects.
Tannins are found in leaf, bud, seed, root, and stem tissues. An example of the
location of the tannins in stem tissue is that they are often found in the growth areas of
trees, such as the secondary phloem and xylem and the layer between the cortex and
epidermis. Tannins may help regulate the growth of these tissues. They are also found
Introducion 16
in the heartwood of conifers and may play a role in inhibiting microbial activity, thus
resulting in the natural durability of the wood. There may be a loss in the
bioavailability of still other tannins in plants due to birds, pests, and other pathogens.
The leaching of tannins from the decaying leaves of vegetation adjoining a stream
may produce what is known as a black water river.
Hydrolysable tannins
At the center of a hydrolysable tannin molecule, there is a carbohydrate (usually D-
glucose). The hydroxyl groups of the carbohydrate are partially or totally esterifies
with phenol groups such as gallic acid (in gallotannins) or ellagic acid (in
elligitannins). Hydrolysable tannins are hydrolyzed by weak acids or weak bases to
produce carbohydrate and phenol acids.
Examples of gallotannins are the gallic acid esters of glucose in tannic acid
(C76H52O46), found in the leaves and bark of many plant species.
Condensed tannins
Condensed tannins, also known as Proanthocyanidins, are polymers of 2 to 50 (or
more) flavonoids units that are joined by carbon-carbon bonds, which are not
susceptible to being cleaved by hydrolysis. While hydrolysable tannins and most
condensed tannins are water soluble, some very large condensed tannins are insoluble.
Condensed tannins from Lithocarpus glaber leaves have been analyzed through acid-
catalyzed degradation in the presence of cysteamin and have a potent free radical
scavenging activity.
Carbohydrates
Carbohydrates or saccharine are the most abundant of the four major classes of
bimolecular. They fill numerous roles in living things, such as the storage and
transport of energy (e.g., starch, glycogen) and structural components (e.g., cellulose
in plants and chitin in animals). In addition, carbohydrates and their derivatives play
major roles in the working process of the immune system, fertilization, pathogenesis,
blood clotting, and development.
Carbohydrates are simple organic compounds that are aldehydes or ketone with many
hydroxyl groups added, usually one on each carbon atom that is not part of the
aldehydes or ketone functional group. The basic carbohydrate units are called
monosaccharide; examples are glucose, galactose, and fructose. The general
stoichiometric formula of an unmodified monosaccharide is (C·H2O) n, where n is any
Introducion 17
number of three or greater; however, not all carbohydrates conform to this precise
stoichiometric definition (e.g., uronic acids, deoxy-sugars such as fructose), nor are all
chemicals that do conform to this definition automatically classified as carbohydrates.
Monosaccharide can be linked together into what are called polysaccharides (or
oligosaccharides) in a large variety of ways. Many carbohydrates contain one or more
modified monosaccharide units that have had one or more groups replaced or
removed. For example, deoxyribose, a component of DNA, is a modified version of
ribose; chitin is composed of repeating units of N-acetyl glucosamine, a nitrogen-
containing form of glucose.
While the scientific nomenclature of carbohydrates is complex, the names of
carbohydrates very often end in the suffix -ose. Glycoinformatics is the specialized
field of study that deals with the specific and unique bioinformatics of carbohydrates.
Proteins
Proteins (also known as polypeptides) are organic compounds made of amino acids
arranged in a linear chain and folded into a globular form. The amino acids in a
polymer chain are joined together by the peptide bonds between the carboxyl and
amino groups of adjacent amino acid residues. The sequence of amino acids in a
protein is defined by the sequence of a gene, which is encoded in the genetic code. In
general, the genetic code specifies 20 standard amino acids; however, in certain
organisms the genetic code can include selenocysteine and in certain archaea
pyrrolysine. Shortly after or even during synthesis, the residues in a protein are often
chemically modified by post-translational modification, which alter the physical and
chemical properties, folding, stability, activity, and ultimately, the function of the
proteins. Proteins can also work together to achieve a particular function, and they
often associate to form stable complexes.
Like other biological macromolecules such as polysaccharides and nucleic acids,
proteins are essential parts of organisms and participate in virtually every process
within cells. Many proteins are enzymes that catalyze biochemical reactions and are
vital to metabolism. Proteins also have structural or mechanical functions, such as
actin and myosin in muscle and the proteins in the cytoskeleton, which form a system
of scaffolding that maintains cell shape. Other proteins are important in cell signaling,
immune responses, cell adhesion, and the cell cycle. Proteins are also necessary in
animals' diets, since animals cannot synthesize all the amino acids they need and must
Introducion 18
obtain essential amino acids from food. Through the process of digestion, animals
break down ingested protein into free amino acids that are then used in metabolism.
Proteins were first described and named by the Swedish chemist Jones Jacob
Berzelius in 1838; however, the central role of proteins in living organisms was not
fully appreciated until 1926, when James B. Sumner showed that the enzyme urease
was a protein. The first protein to be sequenced was insulin, by Frederick Sanger, who
won the Nobel Prize for this achievement in 1958. The first protein structures to be
solved were hemoglobin and myoglobin, by Max Perutz and Sir John Cowdery
Kendrew, respectively, in 1958. The three-dimensional structures of both proteins
were first determined by x-ray diffraction analysis; Perutz and Kendrew shared the
1962 Nobel Prize in Chemistry for these discoveries. Proteins may be purified from
other cellular components using a variety of techniques such as ultracentrifugation,
precipitation, electrophoresis, and chromatography; the advent of genetic engineering
has made possible a number of methods to facilitate purification. Methods commonly
used to study protein structure and function includes immunohistochemistry, site-
directed mutagenesis, and mass spectrometry.
Fixed oil and Fats
Fats consist of a wide group of compounds that are generally soluble in organic
solvents and largely insoluble in water. Chemically, fats are generally triesters of
glycerol and fatty acids. Fats may be either solid or liquid at normal room
temperature, depending on their structure and composition. Although the words "oils",
"fats", and "lipids" are all used to refer to fats, "oils" is usually used to refer to fats
that are liquids at normal room temperature, while "fats" is usually used to refer to
fats that are solids at normal room temperature. "Lipids" is used to refer to both liquid
and solid fats, along with other related substances. The word "oil" is used for any
substance that does not mix with water and has a greasy feel, such as petroleum (or
crude oil) and heating oil, regardless of its chemical structure.
Fats form a category of lipid, distinguished from other lipids by their chemical
structure and physical properties. This category of molecules is important for many
forms of life, serving both structural and metabolic functions. They are an important
part of the diet of most heterotrophs (including humans). Fats or lipids are broken
down in the body by enzymes called lipases produced in the pancreas.
Introducion 19
Examples of edible animal fats are lard (pig fat), fish oil, and butter or ghee. They are
obtained from fats in the milk, meat and under the skin of the animal. Examples of
edible plant fats are peanut, soya bean, sunflower, sesame, coconut, olive, and
vegetable oils. Margarine and vegetable shortening, which can be derived from the
above oils, are used mainly for baking. These examples of fats can be categorized into
saturated fats and unsaturated fats.
Table 1.1: Structural features and activities of various phytochemicals from
plants37
Phytochemicals Structural features Example Activities
Phenols and
Polyphenols
C3 side chain, - OH
groups, phenol ring
Catechol,
Epicatechin,
Cinnamic acid
Antimicrobial,
Anthelmintic,
Antidiarrhoeal
Quinones Aromatic rings, two
ketone substitutions
Hypericin Antimicrobial
Flavones
Flavonoids
Flavonols
Phenolic structure, one
carbonyl group
Hydroxylated phenols,
C6-C3 unit linked to an
aromatic ring
Flavones + 3-hydroxyl
Abyssinone,
Chrysin,
Quercetin, Rutin
Totarol
Antimicrobial
Antidiarrhoeal
Tannins Polymeric phenols (Mol.
Wt. 500-3000)
Ellagitannin Antimicrobial,
Anthelmintic,
Coumarins Phenols made of fused
benzene and α- pyrone
rings
Warfarin
Antimicrobial
Terpenoids and
essential oils
Acetate units + fatty
acids,extensive
branching and cyclised
Capsaicin Antimicrobial
Antidiarrhoeal
Alkaloids Heterocyclic nitrogen
compounds
Berberine, Piperine,
Palmatine,
Tetrahydropalmatine
Antimicrobial,
Anthelmintic,
Antidiarrhoea
Introducion 20
Lectins and
Polypeptides
Proteins Mannose-specific
agglutinin, Fabatin
Antimicrobial
Glycosides Sugar + non
carbohydrate moiety
Amygdalin Antidiarrhoeal
Saponins Amphipathic glycosides Vina-ginsenosides-
R5 and -R6
Antidiarrhoeal
1.8 EXTRACTION38-40
The commonly employed technique for separation of active substance from crude
drug is called as ‘Extraction’ which involves the use of different solvents. The plant
material used for extraction should be properly authenticated or identified. The choice
of the plant material for extraction depends upon its nature and the components
required being isolated. The dried powdered plant material is commonly used for
extraction. The solvent used for extraction is called menstrum and the residue is
known as marc.
Methods of extraction
There are various methods of extraction. Some of them are described below:
Maceration
The word maceration means softening. It is the simplest method of crude drug
extraction and was official in I.P.1966. The process consists of keeping the crude drug
in intimate contact with whole menstrum in a closed vessel with occasional shaking
for seven days, straining, pressing the marc, mixing the liquids and finally clarifying
by subsidence or filtration. The process may take up to 14 days in some cases for
complete extraction. The drug: menstrum ratio should be 1: 10.
Infusion
Infusions are usually prepared from vegetable drugs containing water soluble and
easily extractable principles. The process consisted of moistening the drug with water,
macerating it with boiling water, straining and making up the volume.
Digestion
This is a modified maceration process in which extraction is accomplished at a higher
temperature at which the active ingredients are not adversely affected. Use of higher
temperature provides for enhanced solvent action of menstrum and constant
Introducion 21
mechanical agitation of the system accelerates establishment of equilibrium in a short
time.
Decoction
Decoction is also employed for extracting vegetable drugs containing water-soluble
and heat-soluble constitutes. The process consisted of boiling the drug with water,
cooling, expressing, straining liquid and finally make up the volume.
Percolation
Percolation is extraction process in which granulated or powdered drug is deprived of
its constant by the descent of a suitable menstrum through it. In Greek, the word
‘percolate’ means ‘to pass through’. The process implies a slow passage of menstrum
under the influence of gravity through a column of the drug. During this movement,
the menstrum goes on extracting the drug particle layer wise, it being replaced by
other layers above as it moves downwards.
Ultrasonic extraction
The speed of drug extraction is enhanced by application of ultrasonic vibrations. The
mixture of the drug and the menstrum is subjected to ultrasonic waves of 20 to 450
kilocycles/second followed by extraction in a soxhlet extractor. The treatment with
ultrasonic vibrations provides rapid and superior extraction.
Successive solvent extraction
Soxhlet extractor
A Soxhlet extractor is a piece of laboratory apparatus invented in 1879 by Franz von
Soxhlet. It was originally designed for the extraction of a lipid from a solid material.
However, a Soxhlet extractor is not limited to the extraction of lipids. Typically, a
Soxhlet extraction is only required where the desired compound has a limited
solubility in a solvent, and the impurity is insoluble in that solvent. If the desired
compound has a high solubility in a solvent then a simple filtration can be used to
separate the compound from the insoluble substance.
Normally a solid material containing some of the desired compound is placed inside a
thimble made from thick filter paper, which is loaded into the main chamber of the
Soxhlet extractor. The Soxhlet extractor is placed onto a flask containing the
extraction solvent. The Soxhlet is then equipped with a condenser.The solvent is
heated to reflux. The solvent vapour travels up a distillation arm, and floods into the
Introducion 22
chamber housing the thimble of solid. The condenser ensures that any solvent vapour
cools, and drips back down into the chamber housing the solid material.
The chamber containing the solid material slowly fills with warm solvent. Some of
the desired compound will then dissolve in the warm solvent. When the Soxhlet
chamber is almost full, the chamber is automatically emptied by a siphon side arm,
with the solvent running back down to the distillation flask. This cycle may be
allowed to repeat many times, over hours or days.
During each cycle, a portion of the non-volatile compound dissolves in the solvent.
After many cycles the desired compound is concentrated in the distillation flask. The
advantage of this system is that instead of many portions of warm solvent being
passed through the sample, just one batch of solvent is recycled.
After extraction the solvent is removed, typically by means of a rotary evaporator,
yielding the extracted compound. The non-soluble portion of the extracted solid
remains in the thimble, and is usually discarded.
1.9 PRELIMINARY PHYTOCHEMICAL SCREENING41-44
Preliminary Phytochemical Screening is a process of tracing plant constituents. There
are general plant constituents that can be performed with a standard test. The plant is a
biosynthetic laboratory, not only for chemical compounds such as carbohydrates,
proteins and lipids that are food by man, but also for a multitude of compounds like
glycosides, alkaloids, volatile oils, tannins etc. that exert a physiological and
therapeutic effect. The compounds that are responsible for medicinal property of the
drug are secondary metabolites. A systematic study of crude drug embraces, through
consideration of primary and secondary metabolites derived as a result of plant
metabolism. The plant material is subject to dried to preliminary phytochemical
screening for the detection of various plant constituents. Chemical test evaluation is a
method by which we can determine the different constituent present in the drug, so
different chemical test will be performed. Plant-derived substances have recently
become of great interest owing to their versatile applications.
1.9.1 Choice of solvents
Successful determination of biologically active compounds from plant material
is largely dependent on the type of solvent used in the extraction procedure.
Properties of a good solvent in plant extractions includes, low toxicity, ease of
Introducion 23
evaporation at low heat, promotion of rapid physiologic absorption of the extract,
preservative action, inability to cause the extract to complex or dissociate. The
factors affecting the choice of solvent are quantity of phytochemicals to be extracted,
rate of extraction, diversity of different compounds extracted, diversity of
inhibitory compounds extracted, ease of subsequent handling of the extracts, toxicity
of the solvent in the bioassay process, potential health hazard of the extractants. The
choice of solvent is influenced by what is intended with the extract. Since the end
product will contain traces of residual solvent, the solvent should be non- toxic and
should not interfere with the bioassay. The choice will also depend on the targeted
compounds to be extracted.
Table 1.2: Solvents used for active component extraction
Water Ethanol Methanol Chlorofor
m
Ether Acetone
Anthocyanins Tannins Anthocyanins Terpenoids Alkaloids Phenol
Starches Polyphenols Terpenoids Flavonoids Terpenoids Flavonols
Tannins Polyacetylen Saponins Coumarins
Saponins Flavonol Tannins Fatty Acids
Terpenoids Terpenoids Xanthoxyllines
Polypeptides Sterols Totarol
Lectins Alkaloids Quassinoids
Lactones
Flavones
Phenones
Polyphenols
1.9.2 Phytochemical Screening: Phytochemical examinations were carried out for all
the extracts as per the standard methods.
Detection of Alkaloids:
Dragendroff’s reagent: Reddish brown precipitate
Wagner;s reagent: Reddish brown precipitate
Mayer’s reagent: Cream colour precipitate
Hager’s reagent: Yellow precipitate
Detection of Carbohydrates:
Molisch’s Test: Violet ring
Introducion 24
Benedict’s Test: Orange red precipitate
Fehling’s Test: Red precipitate
Detection of Glycosides:
Modified Borntrager’s Test: Rose-Pink colour
Legal’s Test: Pink to Blood red colour
Detection of Fixed oils and Fats
Spot Test: Appearance of oil stain
Soap Formation Test: Formation of soap
Detection of Fenolic compounds and Tannins
FeCl3 Solution Test: Violet colour.
Gelatin Test: White precipitate
Lead Acetate Test: White precipitate
Detection of Proteins and Amino acids
Xanthoproteic Test: Yellow colour
Ninhydrin Test: Blue colour
Detection of Flavonoids
Alkaline Reagent Test: Yellow colour
Lead Acetate Test: Yellow colour
Detection of Steroids and Triterpenoides
Salkowski’s Test: Golden Yellow colour
Libermann Burchard’s Test: Brown ring
Detection of Mucilage and Gums
With Absolute Alcohol: Precipitate and examined for swelling property
Detection of Waxes
Alcoholic Alkali Solution Test: waxes get saponified.
Detection of Phenols
Ferric Chloride Test: Bluish black colour.
1.10 ANALGESIC45-57
The term analgesic is known any member of the group of drugs which is used to
relieve from pain means achieve analgesia. The word analgesic derives from Greek an
maens “without" and algos means "pain". These drugs act in various ways on the
nervous and central peripheral systems. These drugs include many category like
Introducion 25
NSAIDs (non-steroidal anti-inflammatory drugs) such as the Acetic Acid derivatives,
Salicylic Acid derivatives and opioid analgesics drugs such as morphine and opium.
They can be distinct from anaesthetics in the manner of reversibly eliminate
sensation.
Pain is defined as neuralgia, an unpleasant sensory experience associated with tissue
damage. The nerves in our body send a response to the brain which allows the body to
feel pain. Pain can chronic or acute and can come and go in repeated manner. All of us
have suffered from pain in once or many times whether it can be from injury or not.
Sometimes we can ignore pain but many times we may need something to help us
along.
There are many herbs in the world that are very useful and effective for relief of pain.
Many of them are safe and effective for everyone but some should be avoided during
pregnancy or while nursing. Herbal medicines definitely have outstanding analgesic
properties, in addition anti-inflammatory and anti-spasmodic functions also found.
However, even though herbs and pharmaceutical drugs have many overlapping
functions, they are not directly interchangeable or analogs of each other. The
therapeutic effectiveness of herbal formulas is dependent on accurate diagnosis and
careful prescription. When analgesic herbs used properly, it can be powerful
alternatives to drug of choice for pain management.
The use of herbal medicine in the world has increased dramatically in recent years.
These products are not regulated by the Food and Drug Administration with the same
scrutiny as conventional drugs. Patients who use herbal supplements often do so in
conjunction with conventional drugs.
Being a natural pain relief herb, any type of analgesic herb has the advantage of not
producing any side effects as is the case with other chemically produced pain relief
medicine. There are many analgesic herbs that are typically known as joint herbs for
their analgesic properties of giving relief from joint pains like those felt in arthritis,
neck and back pain, or tendonitis. In fact, these therapeutic herbs are anti-
inflammatory herbs and treat the pain conditions that result from inflammation of
joints.
The choice of drug analgesic is also determined by the type of pain means for
neuropathic pain and traditional analgesics are less effective and there is often benefit
Introducion 26
from classes of drugs that are not normally considered analgesics category, such as
antidepressants and antiepileptic.
Treatment
Paracetamol and NSAIDs
The exact mechanism of action of paracetamol/acetaminophen is uncertain, but it
appears to be acting centrally rather than peripherally (in the brain rather than in nerve
endings). Aspirin and the other non-steroidal anti-inflammatory drugs (NSAIDs)
inhibit cyclooxygenases, leading to a decrease in prostaglandin production. This
reduces pain and also inflammation (in contrast to paracetamol and the opioids).
Paracetamol has few side effects and is regarded as safe, although intake above the
recommended dose can lead to liver damage, which can be severe and life-
threatening, and occasionally kidney damage. NSAIDs predispose to peptic ulcers,
renal failure, allergic reactions, and occasionally hearing loss, and they can increase
the risk of hemorrhage by affecting platelet function. The use of aspirin in children
under 16 suffering from viral illness has been linked to Reye's syndrome, a rare but
severe liver disorder.
COX-2 inhibitors
These drugs have been derived from NSAIDs. The cyclooxygenase enzyme inhibited
by NSAIDs was discovered to have at least 2 different versions: COX1 and COX2.
Research suggested that most of the adverse effects of NSAIDs were mediated by
blocking the COX1 (constitutive) enzyme, with the analgesic effects being mediated
by the COX2 (inducible) enzyme. The COX2 inhibitors were thus developed to
inhibit only the COX2 enzyme (traditional NSAIDs block both versions in general).
These drugs (such as rofecoxib and celecoxib) are equally effective analgesics when
compared with NSAIDs, but cause less gastrointestinal hemorrhage in particular.
However, post-launch data indicated increased risk of cardiac and cerebrovascular
events with these drugs; this is probably due to an imbalance in blood coagulation.
Rofecoxib (marketed as Vioxx) was subsequently withdrawn from the market. The
role for the remaining members of this class of drug is debated. The introduction of
the new IV pain medication, Ofirmev (IV acetaminophen) has been shown to improve
pain relief and reduce opioid consumption in the perioperative setting. Ofirmev does
not carry black box warnings for increased bleed risk and renal toxicity, which are
Introducion 27
warnings for some of the commonly prescribed NSAIDs. IV acetaminophen is the
most widely used IV analgesic in hospitals throughout Europe, where it has been
commercially available since 2002. The use of IV acetaminophen for surgical patients
is quickly becoming a standard of care in the United States.
Opiates and morphinomimetics
Morphine, the archetypal opioid, and various other substances (e.g. codeine,
oxycodone, hydrocodone, dihydromorphine, pethidine) all exert a similar influence on
the cerebral opioid receptor system. Buprenorphine is thought to be a partial agonist
of the opioid receptor, and tramadol is an opiate agonist with SNRI properties.
Tramadol is structurally closer to venlafaxine than to codeine and delivers analgesia
by not only delivering "opiate-like" effects (through mild agonism of the mu receptor)
but also by acting as a weak but fast-acting serotonin releasing agent and
norepinephrine reuptake inhibitor. Dosing of all opioids may be limited by opioid
toxicity (confusion, respiratory depression, myoclonic jerks and pinpoint pupils),
seizures (tramadol), but there is no dose ceiling in patients who accumulate tolerance.
Opioids, while very effective analgesics, may have some unpleasant side-effects.
Patients starting morphine may experience nausea and vomiting (generally relieved by
a short course of antiemetics such as phenergan). Pruritus (itching) may require
switching to a different opioid. Constipation occurs in almost all patients on opioids,
and laxatives (lactulose, macrogol-containing or co-danthramer) are typically co-
prescribed. When used appropriately, opioids and similar narcotic analgesics are
otherwise safe and effective, however risks such as addiction and the body becoming
used to the drug (tolerance) can occur. The effect of tolerance means that frequent use
of the drug may result in its diminished effect so, when safe to do so, the dosage may
need to be increased to maintain effectiveness. This may be of particular concern
regarding patients suffering with chronic pain.
Flupirtine
Flupirtine is a centrally acting K+ channel opener with weak NMDA antagonist
properties. It is used in Europe for moderate to strong pain and migraine and its
muscle relaxant properties. It has no anticholinergic properties and is believed be
devoid of any activity on dopamine, serotonin or histamine receptors. It is not
addictive and tolerance usually does not develop. However, tolerance may develop in
single cases.
Introducion 28
Specific agents
In patients with chronic or neuropathic pain, various other substances may have
analgesic properties. Tricyclic antidepressants, especially amitriptyline, have been
shown to improve pain in what appears to be a central manner. Nefopam is used in
Europe for pain relief with concurrent opioids. The exact mechanism of
carbamazepine, gabapentin and pregabalin is similarly unclear, but these
anticonvulsants are used to treat neuropathic pain with differing degrees of success.
Anticonvulsants are most commonly used for neuropathic pain as their mechanism of
action tends to inhibit pain sensation.
Specific forms and uses
Combinations
Analgesics are frequently used in combination, such as the paracetamol and codeine
preparations found in many non-prescription pain relievers. They can also be found in
combination with vasoconstrictor drugs such as pseudoephedrine for sinus-related
preparations, or with antihistamine drugs for allergy sufferers. While the use of
paracetamol, aspirin, ibuprofen, naproxen and other NSAIDS concurrently with weak
to mid-range opiates (up to about the hydrocodone level) has been said to show
beneficial synergistic effects by combating pain at multiple sites of action, several
combination analgesic products have been shown to have few efficacy benefits when
compared to similar doses of their individual components. Moreover, these
combination analgesics can often result in significant adverse events, including
accidental overdoses, most often due to confusion which arises from the multiple (and
often non-acting) components of these combinations.
Topical or systemic
Topical analgesia is generally recommended to avoid systemic side-effects. Painful
joints, for example, may be treated with an ibuprofen- or diclofenac-containing gel;
capsaicin also is used topically. Lidocaine, an anaesthetic, and steroids may be
injected into painful joints for longer-term pain relief. Lidocaine is also used for
painful mouth sores and to numb areas for dental work and minor medical procedures.
Psychotropic agents
Tetrahydrocannabinol (THC) and some other cannabinoids, either from the Cannabis
sativa plant or synthetic, have analgesic properties, although the use of cannabis
derivatives is currently illegal in many countries. A recent study finds that inhaled
Introducion 29
cannabis is effective in alleviating neuropathy and pain resulting from e.g. spinal
injury and multiple sclerosis. Other psychotropic analgesic agents include ketamine
(an NMDA receptor antagonist), clonidine and other α2-adrenoreceptor agonists, and
mexiletine and other local anaesthetic analogues.
Atypical, adjuvant analgesics & potentiators
Drugs which have been introduced for uses other than analgesics are also used in pain
management. Both first-generation (such as amitriptyline) and newer anti-depressants
(such as duloxetine) are used alongside NSAIDs and opioids for pain involving nerve
damage and similar problems. Other agents directly potentiate the effects of
analgesics, such as using hydroxyzine, promethazine, carisoprodol or tripelennamine
to increase the pain-killing ability of a given dose of opioid analgesic.
Adjuvant analgesics, also called atypical analgesics, include nefopam, orphenadrine,
pregabalin, gabapentin, cyclobenzaprine, scopolamine, and other drugs possessing
anticonvulsant, anticholinergic and/or antispasmodic properties, as well as many other
drugs with CNS actions. These drugs are used along with analgesics to modulate
and/or modify the action of opioids when used against pain, especially of neuropathic
origin.
Dextromethorphan has been noted to slow the development of tolerance to opioids
and exert additional analgesia by acting upon the NMDA receptors; some analgesics
such as methadone and ketobemidone and perhaps piritramide have intrinsic NMDA
action.
High-alcohol liquor, two forms of which were in the US Pharmacopoeia up until 1916
and in common use by physicians well into the 1930s, has been used in the past as an
agent for dulling pain, due to the CNS depressant effects of ethyl alcohol, a notable
example being the American Civil War. However, the ability of alcohol to relieve
severe pain is likely inferior to many analgesics used today (e.g. morphine, codeine).
As such, the idea of alcohol for analgesia is generally considered a primitive practice
in virtually all industrialized countries today.
The use of adjuvant analgesics is an important and growing part of the pain-control
field and new discoveries are made practically every year. Many of these drugs
combat the side effects of opioid analgesics, an added bonus. For example,
antihistamines including orphenadrine combat the release of histamine caused by
many opioids. Stimulants such as methylphenidate, caffeine, ephedrine,
Introducion 30
dextroamphetamine, and cocaine work against heavy sedation and may elevate mood
in distressed patients as do the antidepressants. The use of medicinal cannabis remains
a debated issue.
1.11 INFLAMMATION58-61
Inflammation (Latin, īnflammō, "I ignite, set alight") is part of the complex biological
response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or
irritants.[1] Inflammation is a protective attempt by the organism to remove the
injurious stimuli and to initiate the healing process. Inflammation is not a synonym
for infection, even in cases where inflammation is caused by infection. Although
infection is caused by a microorganism, inflammation is one of the responses of the
organism to the pathogen. However, inflammation is a stereotyped response, and
therefore it is considered as a mechanism of innate immunity, as compared to adaptive
immunity, which is specific for each pathogen. Without inflammation, wounds and
infections would never heal. Similarly, progressive destruction of the tissue would
compromise the survival of the organism. However, chronic inflammation can also
lead to a host of diseases, such as hay fever, periodontitis, atherosclerosis, rheumatoid
arthritis, and even cancer (e.g., gallbladder carcinoma). It is for that reason that
inflammation is normally closely regulated by the body.
Inflammation can be classified as either acute or chronic. Acute inflammation is the
initial response of the body to harmful stimuli and is achieved by the increased
movement of plasma and leukocytes (especially granulocytes ) from the blood into the
injured tissues. A cascade of biochemical events propagates and matures the
inflammatory response, involving the local vascular system, the immune system, and
various cells within the injured tissue. Prolonged inflammation, known as chronic
inflammation, leads to a progressive shift in the type of cells present at the site of
inflammation and is characterized by simultaneous destruction and healing of the
tissue from the inflammatory process.
Causes
• Burns• Chemical irritants• Frostbite• Toxins• Infection by pathogens• Physical injury, blunt or penetrating
Introducion 31
• Immune reactions due to hypersensitivity• Ionizing radiation• Foreign bodies, including splinters, dirt and debris• Stress• Trauma
• The traditional names for signs of inflammation come from Latin:
• Dolor (pain)• Colour (heat)• Rubor (redness)• Tumor (swelling)• Functio laesa (loss of function)
The first four (classical signs) were described by Celsus (ca 30 BC–38 AD), while
loss of function was added later by Galen ] even though the attribution is disputed and
the origination of the fifth sign has also been ascribed to Thomas Sydenham and
Virchow.
Redness and heat are due to increased blood flow at body core temperature to the
inflamed site; swelling is caused by accumulation of fluid; pain is due to release of
chemicals that stimulate nerve endings. Loss of function has multiple causes.
These five signs appear when acute inflammation occurs on the body's surface,
whereas acute inflammation of internal organs may not result in the full set. Pain only
happens where the appropriate sensory nerve endings exist in the inflamed area—e.g.,
acute inflammation of the lung (pneumonia) does not cause pain unless the
inflammation involves the parietal pleura, which does have pain-sensitive nerve
endings.
Anti-inflammatory refers to the property of a substance or treatment that reduces
inflammation. Anti-inflammatory drugs make up about half of analgesics, remedying
pain by reducing inflammation as opposed to opioids, which affect the central nervous
system.
Treatment
Steroids
Many steroids, to be specific glucocorticoids, reduce inflammation or swelling by
binding to glucocorticoid receptors. These drugs are often referred to as
corticosteroids.
Non-steroidal anti-inflammatory drugs
Introducion 32
Non-steroidal anti-inflammatory drugs (NSAIDs), alleviate pain by counteracting the
cyclooxygenase (COX) enzyme. On its own, COX enzyme synthesizes
prostaglandins, creating inflammation. In whole, the NSAIDs prevent the
prostaglandins from ever being synthesized, reducing or eliminating the pain.
Some common examples of NSAIDs are: aspirin, ibuprofen, and naproxen. The newer
specific COX-inhibitors - although, it is presumed, sharing a similar mode of action -
are not classified together with the traditional NSAIDs.
On the other hand, there are analgesics that are commonly associated with anti-
inflammatory drugs but that have no anti-inflammatory effects. An example is
paracetamol, called acetaminophen in the U.S. and sold under the brand name of
Tylenol. As opposed to NSAIDS, which reduce pain and inflammation by inhibiting
COX enzymes, paracetamol has recently been shown to block the reuptake of
endocannabinoids, which only reduces pain, likely explaining why it has minimal
effect on inflammation.
Long-term use of NSAIDs can cause gastric erosions, which can become stomach
ulcers and in extreme cases can cause severe haemorrhage, resulting in death. The risk
of death as a result of use of NSAIDs is 1 in 12,000 for adults aged 16–45. The risk
increases almost twentyfold for those over 75. Other dangers of NSAIDs are
exacerbating asthma and causing kidney damage. Apart from aspirin, prescription
and over-the-counter NSAIDs also increase the risk of myocardial infarction and
stroke.
Immune Selective Anti-Inflammatory Derivatives (ImSAIDs)
ImSAIDs are a class of peptides being developed by IMULAN BioTherapeutics,
LLC, which were discovered to have diverse biological properties, including anti-
inflammatory properties. ImSAIDs work by altering the activation and migration of
inflammatory cells, which are immune cells responsible for amplifying the
inflammatory response. The ImSAIDs represent a new category of anti-inflammatory
and are unrelated to steroid hormones or non-steroidal anti-inflammatories.
The ImSAIDs were discovered by scientists evaluating biological properties of the
submandibular gland and saliva. Early work in this area demonstrated that the
submandibular gland released a host of factors that regulate systemic inflammatory
responses and modulate systemic immune and inflammatory reactions. It is now well
accepted that the immune, nervous, and endocrine systems communicate and interact
Introducion 33
to control and modulate inflammation and tissue repair. One of the neuroendocrine
pathways, when activated, results in the release of immune-regulating peptides from
the submandibular gland upon neuronal stimulation from sympathetic nerves. This
pathway or communication is referred to as the cervical sympathetic trunk-
submandibular gland (CST-SMG) axis, a regulatory system that plays a role in the
systemic control of inflammation.
Early work in identifying factors that played a role in the CST-SMG axis lead to the
discovery of a seven amino acid peptide, called the submandibular gland peptide-T.
SGP-T was demonstrated to have biological activity and thermoregulatory properties
related to endotoxin exposure. SGP-T, an isolate of the submandibular gland,
demonstrated its immunoregulatory properties and potential role in modulating the
cervical sympathetic trunk-submandibular gland (CST-SMG) axis, and subsequently
was shown to play an important role in the control of inflammation.
One SGP-T derivative is a three-amino acid sequence shown to be a potent anti-
inflammatory molecule with systemic effects. This three-amino acid peptide is
phenylalanine-glutamine-glycine (FEG) and its D-isomeric form (feG) have become
the foundation for the ImSAID category. Cellular Effects of feG: The cellular effects
of the ImSAIDs are characterized in a number of publications. feG and related
peptides are known to modulate leukocyte (white blood cells) activity by influencing
cell surface receptors to inhibit excessive activation and tissue infiltration.
One lead ImSAID, the tripeptide FEG (Phe-Glu-Gly) and its D-isomer feG are known
to alter leukocyte adhesion involving actions on αMβ2 integrin, and inhibit the
binding of CD16b (FCyRIII) antibody to human neutrophils. feG has also been shown
to decrease circulating neutrophil and eosinophil accumulation, decrease intracellular
oxidative activity, and reduce the expression of CD49d after antigen exposure.
Table 1.3: Plants with analgesic and anti inflammatory activity
Plant Family Part used Place DoseAbutilon indicum Malvaceae Fixed oil India 400 and 600 mg/kgAcacia ferruginea Fabaceae Stembark India 50 mg/kgAcacia nilotica Fabaceae od Saudi 500 mg/kgAchillea ageratum Asteraceae Dried aerial Spain 187 and 254 mg/kgAcicarpha Calyceraceae Dried aerial Peru 50 mcg/kgAconitum japonicum Ranunculaceae Dried root Japan 30 mg/kgAcorus calamus Araceae Rhizome, root India not statedAdansonia digitata Bombacaceae Dried fruit Sudan 400 and 800 mg/kgAfrormosia laxiflora Fabaceae Dried leaf Africa 0,5 mg/kg
Introducion 34
Agastache sinense Lamiaceae Dried root Taiwan 1,3 , 3,8mg/kgAlhagi maurorum Fabaceae Aerial parts Saudi 500 mg/kgAnchomanes Araceae Dried rhizome Nigeria 100 mg/kgAnnona squamosa Annonaceae Defatted seed India 250 mg/kgApium graveolens Apiaceae Dried seed Jordan 200 mg/kgAraujia sericifera Asclepiadaceae Dried fruit Spain 200 mg/kgAstragalus siculus Fabaceae Dried root Italy 0,5 mg/kgBaphia nitida Fabaceae Fresh leaf Nigeria 100 mg/kgBerlinia grandiflora Fabaceae Dried bark Nigeria 10 mg/kgBrassica rapa Brassicaceae Seed Saudi 500 mg/kgBuddleja cordata Buddlejaceae Dried leaf Mexico 25 and 100 mg/kg not Calotropis procera Asclepiadaceae Dried aerial Saudi 500 mg/kgCannabis sativa Cannabaceae Entire plant India 250 mg/kgCanthium Rubiaceae Aerial parts India not statedCarthamus Asteraceae Flowers Saudi 500 mg/kgCedrus deodara Pinaceae Wood India 100 mcg/kgCelastrus Celastraceae Dried flowersPakistan 300 mg/kgCentella asiatica Apiaceae Dried entire India 100 mg/kgChasmanthera Menispermacea Fresh leaf Nigeria 0,2 ml/kgChelidonium majus Papaveraceae Entire plant Austria 9,5 and 28 mg/kgChrozophora Euphorbiaceae aerialparts Egypt 500 mg/kgCinnamomum Lauraceae Dried bark Jordan 200 and 400 mg/kgCitrullus colocynthis Cucurbitaceae Aerial parts Saudi 500 mg/kgClematis chinensis Ranunculaceae Dried root Taiwan 6 and 12 mg/kgCleome viscose Capparidaceae Dried seed Jamaica 20 mg/kgClerodendrum Verbenaceae Entire plant India 500 mg/kgClitoria ternatea Fabaceae Dried aerial India 230 and 460 mg/kgCocculus pendulus Menispermacea Seed Saudi 500 mg/kgCommiphora Burseraceae Gun-resin Italy 10 ml/kgCordia francisci Boraginaceae Dried leaf Italy 5 ml/kgCordia martinicensis Boraginaceae Freeze-dried Italy 1 mg/kgCordia myxa Boraginaceae Leaf Italy 500 mg/kgCordia ulmifolia Boraginaceae Freeze-dried Italy 1 mg/kgCucumis trigonus Cucurbitaceae Dried fruit India 2,5 mg/kgCulcitium canascens Asteraceae Dried aerial Peru 2 mg/kgCuscuta chinensis Convolvulacea Dried entire India 1 mg/kgCyathea nilgirensis Cyatheaceae Aerial parts India 0,25 mg/kgCymbopogon Poaceae Entire plant Saudi 500 mg/kgCystoseira usneoides Cystoseiraceae Dried thallus Spain 6,25 mg/kgDesmodium Fabaceae Dried entire USSR not statedDioclea grandiflora Fabaceae rootbark Brazil 12,5 and 50 mg/kgDiodia scandens Rubiaceae Dried entire Nigeria 50 mg/kgDolichos falcatus Fabaceae Dried root China 5 mg/kgDucrosia ismaelis Apiaceae Essential oil Saudi 1 mg/kgEgletes viscosa Asteraceae Flower Brazil 400 mg/kgElaeagnus kologa Elaeagnaceae Aerial parts India not statedElaeocarpus Elaeocarpaceae Fruit India 100 mg/kgEriobotrya Rosaceae Aerial parts India not statedErvatamia coronaria Apocynaceae Dried stem Brazil 150 mg/kgEryngium foetidum Apiaceae Dried leaf D. 250 mg/kgEucaluptus Myrtaceae Dried leaf Jordan 100 mg/kgEuphorbia hirta Euphorbiaceae Dried entire New 20 and 141 mg/kg
Introducion 35
Fagraea racemosa Loganiaceae Fresh root Malaysia 3 mg/kgFicus glomerata Moraceae Dried leaf Africa 0.5 mg/kgFoeniculum vulgare Apiaceae Dried fruit Saudi 500 mg/kgGanoderma lucidum Ganodermatacefruitbody japan 100 and 300mg/kgGenista patens Fabaceae Dried leaf- Spain 200 mg/kgGlaucium flavum Papaveraceae Dried fruit- Spain 400 mg/kgHarpagophytum Pedaliaceae Driet root South 20 and 200 mg/kgHedera rhombea Araliaceae Dried leaf South 0,5 and 1 mg/kgHeracleum Apiaceae Dried root Taiwan 11 mg/kgHibiscus sabdariffa Malvaceae Calyx Saudi 500 mg/kgHimanthalia Himanthaliacea Dried thallus Spain 20; 40 and 100 mg/kgHimulus lupulus Cannabaceae Strobilus South 100 mg/kgHypericum Clusiaceae Dried aerial Turkey 125 and 250 mg/kgHypericum Clusiaceae Dried aerial Turkey 125 and 250 mg/kgInula crithmoides Asteraceae Dried aerial Spain 200 mg/kgIpomoea leari Convolvulacea Deffated seedIndia 60 and 90 mg/kgIrvingia gabonensis Simaroubaceae stembark Nigeria 500 mg/kgJuniperus oxycedrus Cupressaceae Dried leaf- Spain 200 mg/kgLaminaria Laminariaceae Dried thallus Spain 100 mg/kgLantana camara Verbenaceae Dried leaf Africa 0.5 mg/kgLawsonia inermis Lyrthraceae Leaf Saudi 500 mg/kgLedebouriella Apiaceae Entire plant China not statedLepidium sativum Brassicaceae Seed Saudi 500 mg/kgLeucas aspera Lamiaceae Dried entire India 50 and 400 mg/kgLeucojum aestivum Amaryllidaceae Dried bulb Turkey 500 mg/kgLigusticum sinense Apiaceae Dried root Taiwan 8,3 mg/kgLippia alba Verbenaceae Fresh leaf Brazil 1 mg/kgLippia geminata Verbenaceae Dried leaf Africa 0,5 mg/kgLuvunga scandens Rutaceae Fruit India 100 mg/kgclavatum Lycopodiaceae Dried aerial Taiwan 4,1 and 8,2 mg/kgLysimachia Primulaceae Dried aerial China 150 and 250 mg/kgMaesa ramentacea Myrsinaceae Dried aerial India not statedMelaleuca elliptica Myrtaceae Fresh aerial Egypt 0,36 mg/kgMelaleuca Myrtaceae Dried leaf Egypt 16.8 mg/kgMentha piperita Lamiaceae Dried leaf Jordan 400 mg/kgMikania cordata Asteraceae Root India 100 mg/kgMorinda citrifolia Rubiaceae Decorticated France 800 mg/kgMorus alba Moraceae Rootbark Japan 2 mg/kgMyrica nagi Myricaceae stembark India 250 mg/kgMyrtus communis Myrtaceae Dried leaf Iraq 150 mg/kgNepeta italica Lamiaceae Leaf essentialTurkey 0,03 mg/kgNeurolaena lobata Asteraceae Dried aerial Brazil 100 mg/kgNigella sativa Ranunculaceae Seed oil India 1 mg/kgNyctanthes arbor- Verbenaceae Shade dried India 2 mg/kgOcimum sanctum Lamiaceae Shade dried India 250 mg/kgOplopanax elatus Araliaceae Root China not statedOriganum onites Lamiaceae Essential oil Turkey 0,03 ml/kgPaeonia moutan Paeoniaceae Dried root South 200 mg/kgPanax ginseng Araliaceae Leaf Japan 400 mg/kgPanax ginseng Araliaceae Dried root India 50 mg/kgPanax eudoginseng Araliaceae Dried leaf China 100 mg/kgPancratium Amaryllidaceae Dried bulb Turkey 1,2 mg/kg
Introducion 36
Paullinia cupana Sapindaceae Dried seed Brazil 200 mg/kgPeganum harmala Zygophyllacea Dried entire Iraq 150 mg/kgPersea americana Lauraceae Dried seed Brazil 80 mg/kgPhotinia serrulata Rosaceae Dried Taiwan 25 mg/kgPhyla nodiflora Verbenaceae Dried leaf Africa 0,5 mg/kgPinus koraiensis Pinaceae Leaf essentialChina 0,217 ml/kgPiper abutiloides Piperaceae Fresh leaf Brazil 1 mg/kgPiper cincinnatoris Piperaceae Fresh leaf Brazil 1 mg/kgPiper lindbergii Piperaceae Fresh leaf Brazil 1 mg/kgPiper longum Piperaceae Unripe-dried China 125 mg/kgPiscidia erythrina Fabaceae Dried bark USA 600 mg/kgPlatycodon Campanulaceae Dried root Roumania 2 mg/kgPolygala cyparissias Polygalaceae Dried leaf- Brazil 3; 50 and 100 mg/kgPolypodium vulgare Polypodiaceae Dried root India 300 mg/kgPongamia pinnata Fabaceae Dried root India 50 mg/kgPortulaca Portulacaceae Dried aerial United 400 mg/kgPortulaca oleracea Portulacaceae Dried aerial United 400 mg/kgPrunus spinosa Rosaceae Dried Spain 750 mg/kgPsammosilene Caryophyllacea Dried root China 5 mg/kgPsidium pohlianum Myrtaceae Leaf essentialBrazil 40 and 100 mg/kgPsychotria Rubiaceae Dried leaf Brazil 350 mg/kgPsychotria colorata Rubiaceae Dried flowersBrazil 25 mg/kgPtychopetalum Olacaceae Dried leaf Brazil 200 mg/kgPycnocomon Dipsacaceae Dried aerial Spain 300 mg/kgQuercus infectoria Fabaceae Galls Iran not statedQuercus lineata Fabaceae Stembark India 50 mg/kgRandia siamensis Rubiaceae not specified Thailand 300 mg/kgRanunculus Ranunculaceae Dried entire China 1 and 2,5 mg/kgRhamnus Rhamnaceae Bark India 200 mg/kgRhazya stricta Apocynaceae Dried aerial Saudi 500 mg/kgRicinus communis Euphorbiaceae ootbark India 250 mg/kgRoylea elegans Lamiaceae Dried leaf India 350 and 500 mg/kgSalvia haematodes Lamiaceae Fresh root India 500 mg/kgSantolina Asteraceae Dried aerial Spain 60 and 300 mg/kgSaussurea Asteraceae Entire plant China 20 mg/kgSenna italica Fabaceae Dried leaf United 0,25 and 0,5 mg/kgSerjania communis Sapindaceae stembark Brazil 1 mg/kgSideritis Lamiaceae Dried aerial Spain not statedSiphocampylus Campanulaceae Dried leaf- Brazil 300 mg/kgStephania dinklagei Menispermacea Dried stem Nigeria 0,5 ml/kgStefania wightli Menispermacea Dried entire India 20 mg/kgStrychnos nux- Loganiaceae Dried seed China mcg/kgSynedrella nodiflora Asteraceae Dried entire Africa 0,5 mg/kgTabebuia Bignoniaceae Dried wood Brazil 200 mg/kgTabernaemontana Apocynaceae Dried stem Thailand 0,5 and 250 mg/kgTamarix milotica Tamaricaceae Pod Saudi 500 mg/kgTaraxacum officinaleAsteracea Dried leaf Italy 0,1 mg/kgTeclea nobilis Rutaceae Dried leaf Ethiopia 50 mg/kgTecomella undulata Bignoniaceae Dried entire Pakistan 300 mg/kgTeucrium Lamiaceae Dried leaf- Spain 200 mg/kgTheobroma Sterculiaceae Dried seed Brazil 80 mg/kgThymus vulgaris Lamiaceae Aerial parts S. Arabia 500 mg/kg
Introducion 37
Tinospora cordifolia Menispermacea Not specified India not statedTorresea cearensis Fabaceae stembark Brazil 200 and 400 mg/kgTrachelospermum Apocynaceae Dried stem Taiwan 26,8 mg/kgTrema guineensis Ulmaceae Dried leaf Tanzania 500 and 1000 mg/kgTrianthema Alzoaceae Dried entire India 100 mg/kgTribulus terrestris Zygophyllacea Dried aerial Iraq 150 mg/kgTrigonella anguina Fabaceae Dried entire
plant
Saudi
Arabia
500 mg/kg
Unidentified species Lamiaceae Dried leaf Jordan 400 mg/kgUrtica dioica Urticaceae Dried Spain 1200 mg/kgValeriana jatamansi Valerianaceae Dried leaf India 2 mgVernonia condensata Asteraceae Dried leaf Brazil 241 mg/kgViola mandshurica Violaceae Dried aerial Korea 5 mg/kgVitex negundo Verbenaceae Fruit India 3 mgZingiber officinale Zingiberaceae Dried Brazil 200 mg/kg
1.12 DIABETES62-65
Diabetes was known even in ancient times. The name of this disease, which is
characterised by excessive flow of urine and insatiable thirst, was coined by the
Graeco-Roman physician Aretaeus of Cappadocia (approx. 80–130 A.D.) and is
derived from the Greek word diabainein (‘to flow through’). The adjective mellitus,
which comes from Latin and means ‘honey-sweet’, was added by the German
physician Johann Peter Frank (1745–1821) in order to distinguish diabetes mellitus, or
‘sugar diabetes’, from diabetes insipidus. Johann Peter Frank was also who in 1790,
by introducing a yeast fermentation test for the quantitative determination of urinary
glucose, relieved the physicians of his time of the need to taste their patients’ urine.
In diabetes insipidus an excessive amount of urine is produced as a result of a
disturbance of the hormonal control of reabsorption of water in the kidneys. Untreated
diabetes mellitus, by contrast, is characterised by high blood glucose levels due either
to diminish or absent insulin production or to reduce effectiveness of insulin in the
body. Various types of diabetes mellitus are distinguished on the basis of their causes
and natural history. The classification of diabetes mellitus put forward in 1997 by the
American Diabetes Association.
In people with diabetes, blood sugar levels remain high. This may be because insulin
is not being produced at all, is not made at sufficient levels, or is not as effective as it
should be. The most common forms of diabetes are type 1 diabetes (5%), which is an
autoimmune disorder, and type 2 diabetes (95%), which is associated with obesity.
Introducion 38
Gestational diabetes is a form of diabetes that occurs in pregnancy, and other forms of
diabetes are very rare and are caused by a single gene mutation.
For many years, scientists have been searching for clues in our genetic makeup that
may explain why some people are more likely to get diabetes than others are. "The
Genetic Landscape of Diabetes" introduces some of the genes that have been
suggested to play a role in the development of diabetes.
Physicians have observed the effects of diabetes for thousands of years. For much of
this time, little was known about this fatal disease that caused wasting away of the
body, extreme thirst, and frequent urination. It wasn't until 1922 that the first patient
was successfully treated with insulin.
“Insulin is not a cure for diabetes; it is a treatment. It enables the diabetic to burn
sufficient carbohydrates, so that proteins and fats may be added to the diet in
sufficient quantities to provide energy for the economic burdens of life”.
Definition
The term diabetes mellitus describes a metabolic disorder of multiple aetiology
characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and
protein metabolism resulting from defects in insulin secretion, insulin action, or both.
The effects of diabetes mellitus include long-term damage, dysfunction and failure of
various organs. Diabetes mellitus may present with characteristic symptoms such as
thirst, polyuria, blurring of vision, and weight loss. In its most severe forms,
ketoacidosis or a non-ketotic hyperosmolar state may develop and lead to stupor,
coma and, in absence of effective treatment, death. Often symptoms are not severe, or
may be absent, and consequently hyperglycaemia sufficient to cause pathological and
functional changes may be present for a long time before the diagnosis is made. The
long-term effects of diabetes mellitus include progressive development of the specific
complications of retinopathy with potential blindness, nephropathy that may lead to
renal failure, and/or neuropathy with risk of foot ulcers, amputation, Charcot joints,
and features of autonomic dysfunction, including sexual dysfunction. People with
diabetes are at increased risk of cardiovascular, peripheral vascular and
cerebrovascular disease.
Several pathogenetic processes are involved in the development of diabetes. These
include processes which destroy the beta cells of the pancreas with consequent insulin
deficiency, and others that result in resistance to insulin action. The abnormalities of
Introducion 39
carbohydrate, fat and protein metabolism are due to deficient action of insulin on
target tissues resulting from insensitivity or lack of insulin.
Signs and symptoms
The classical symptoms of diabetes are polyuria (frequent urination),
polydipsia (increased thirst) and polyphagia (increased hunger). Symptoms may
develop rapidly (weeks or months) in type 1 diabetes while in type 2 diabetes they
usually develop much more slowly and may be subtle or absent.
Prolonged high blood glucose causes glucose absorption, which leads to changes in
the shape of the lenses of the eyes, resulting in vision changes; sustained sensible
glucose control usually returns the lens to its original shape. Blurred vision is a
common complaint leading to a diabetes diagnosis; type 1 should always be suspected
in cases of rapid vision change, whereas with type 2 changes is generally more
gradual, but should still be suspected.
People (usually with type 1 diabetes) may also present with diabetic ketoacidosis, a
state of metabolic dysregulation characterized by the smell of acetone; a rapid, deep
breathing known as kussmal breathing; nausea; vomiting and abdominal pain; and
altered states of consciousness.
A rarer but equally severe possibility is hyperosmolar nonketotic state, which is more
common in type 2 diabetes and is mainly the result of dehydration. Often, the patient
has been drinking extreme amounts of sugar-containing drinks, leading to a vicious
circle in regard to the water loss.
A number of skin rashes can occur in diabetes that are collectively known as diabetic
dermadromes.
Classification
Earlier classifications
The first widely accepted classification of diabetes mellitus was published by WHO in
1980 and, in modified form, in 1985 . The 1980 and 1985 classifications of diabetes
mellitus and allied categories of glucose intolerance included clinical classes and two
statistical risk classes. The 1980 Expert Committee proposed two major classes of
diabetes mellitus and named them, IDDM or Type 1, and NIDDM or Type 2. In the
1985 Study Group Report the terms Type 1 and Type 2 were omitted, but the classes
IDDM and NIDDM were retained, and a class of Malnutrition-related Diabetes
Introducion 40
Mellitus (MRDM) was introduced. In both the 1980 and 1985 reports other classes of
diabetes included Other Types and Impaired Glucose Tolerance (IGT) as well as
Gestational Diabetes Mellitus (GDM). These were reflected in the subsequent
International Nomenclature of Diseases (IND) in 1991, and the tenth revision of the
International Classification of Diseases (ICD-10) in 1992. The 1985 classification was
widely accepted and is used internationally. It represented a compromise between
clinical and aetiological classification and allowed classification of individual subjects
and patients in a clinically useful manner even when the specific cause or aetiology
was unknown. The recommended classification includes both staging of diabetes
mellitus based on clinical descriptive criteria and a complementary aetiological
classification.
Revised classification
The classification encompasses both clinical stages and aetiological types of diabetes
mellitus and other categories of hyperglycaemia, as suggested by Kuzuya and
Matsuda.
The clinical staging reflects that diabetes, regardless of its aetiology, progresses
through several clinical stages during its natural history. Moreover, individual subjects
may move from stage to stage in either direction. Persons who have, or who are
developing, diabetes mellitus can be categorized by stage according to the clinical
characteristics, even in the absence of information concerning the underlying
aetiology. The classification by aetiological type results from improved understanding
of the causes of diabetes mellitus.
Application of the new classification
The new classification contains stages which reflect the various degrees of
hyperglycaemia in individual subjects with any of the disease processes which may
lead to diabetes mellitus.
All subjects with diabetes mellitus can be categorized according to clinical stage, and
this is achievable in all circumstances. The stage of glycaemia may change over time
depending on the extent of the underlying disease processes. The disease process may
be present but may not have progressed far enough to cause hyperglycaemia. The
aetiological classification reflects the fact that the defect or process which may lead to
diabetes may be identifiable at any stage in the development of diabetes even at the
stage of normoglycaemia. Thus the presence of islet cell antibodies in a
Introducion 41
normoglycaemic individual makes it likely that that person has the Type 1
autoimmune process. Unfortunately there are few sensitive or highly specific
indicators of the Type 2 process at present, although these are likely to be revealed as
aetiology is more clearly defined. The same disease processes can cause impaired
fasting glycaemia and/or impaired glucose tolerance without fulfilling the criteria for
the diagnosis of diabetes mellitus. In some individuals with diabetes, adequate
glycaemic control can be achieved with weight reduction, exercise and/or oral agents.
These individuals, therefore, do not require insulin and may even revert to IGT or
normoglycaemia. Other individuals require insulin for adequate glycaemic control but
can survive without it. These individuals, by definition, have some residual insulin
secretion. Individuals with extensive beta-cell destruction, and therefore no residual
insulin secretion, require insulin for survival. The severity of the metabolic
abnormality can either regress (e.g. with weight reduction), progress (e.g. with weight
gain), or stay the same.
Major types of diabetes mellitus
Most cases of diabetes mellitus fall into three broad categories: type 1, type 2
and gestational diabetes. A few other types are described. The term diabetes, without
qualification, usually refers to diabetes mellitus. The rare disease diabetes
insipidus has similar symptoms as diabetes mellitus, but without disturbances in the
sugar metabolism (insipidus meaning "without taste" in Latin).
The term "type 1 diabetes" has replaced several former terms, including childhood-
onset diabetes, juvenile diabetes, and insulin-dependent diabetes mellitus (IDDM).
Likewise, the term "type 2 diabetes" has replaced several former terms, including
adult-onset diabetes, obesity-related diabetes, and non-insulin-dependent diabetes
mellitus (NIDDM). Beyond these two types, there is no agreed-upon standard
nomenclature. Various sources have defined "type 3 diabetes" as: gestational
diabetes insulin-resistant type 1 diabetes (or "double diabetes"), type 2 diabetes which
has progressed to require injected insulin, and latent autoimmune diabetes of adults.
Type 1 diabetes
Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of
the islets of Langerhans the pancreas leading to insulin deficiency. This type of
diabetes can be further classified as immune-mediated or idiopathic. The majority of
type 1 diabetes is of the immune-mediated nature, where beta cell loss is a T-cell
Introducion 42
mediated autoimmune attack. There is no known preventive measure against type 1
diabetes, which causes approximately 10% of diabetes mellitus cases in North
America and Europe. Most affected people are otherwise healthy and of a healthy
weight when onset occurs. Sensitivity and responsiveness to insulin are usually
normal, especially in the early stages. Type 1 diabetes can affect children or adults but
was traditionally termed "juvenile diabetes" because it represents a majority of the
diabetes cases in children.
Type 2 diabetes
Type 2 diabetes mellitus is characterized by insulin resistance which may be
combined with relatively reduced insulin secretion. The defective responsiveness of
body tissues to insulin is believed to involve the insulin receptor. However, the
specific defects are not known. Diabetes mellitus due to a known defect are classified
separately. Type 2 diabetes is the most common type.
In the early stage of type 2 diabetes, the predominant abnormality is reduced insulin
sensitivity. At this stage hyperglycaemia can be reversed by a variety of measures
and medications that improve insulin sensitivity or reduce glucose production by
the liver.
Gestational diabetes
Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects,
involving a combination of relatively inadequate insulin secretion and responsiveness.
It occurs in about 2%–5% of all pregnancies and may improve or disappear after
delivery. Gestational diabetes is fully treatable but requires careful medical
supervision throughout the pregnancy. About 20%–50% of affected women develop
type 2 diabetes later in life.
Even though it may be transient, untreated gestational diabetes can damage the health
of the fetus or mother. Risks to the baby include macrosomia (high birth weight),
congenital cardiac and central nervous system anomalies, and skeletal muscle
malformations. Increased fetal insulin may inhibit fetal surfactant production and
cause respiratory distress syndrome. Hyperbilirubinemia may result from red blood
cell destruction. In severe cases, perinatal death may occur, most commonly as a
result of poor placental perfusion due to vascular impairment. Labor induction may be
indicated with decreased placental function. A caesarean section may be performed if
Introducion 43
there is marked fetal distress or an increased risk of injury associated
with macrosomia, such as shoulder dystocia.
A 2008 study completed in the U.S. found that the number of American women
entering pregnancy with preexisting diabetes is increasing. In fact the rate of diabetes
in expectant mothers has more than doubled in the past 6 years. This is particularly
problematic as diabetes raises the risk of complications during pregnancy, as well as
increasing the potential that the children of diabetic mothers will also become diabetic
in the future.
Other types
Pre-diabetes indicates a condition that occurs when a person's blood glucose levels are
higher than normal but not high enough for a diagnosis of type 2 diabetes. Many
people destined to develop type 2 diabetes spend many years in a state of pre-diabetes
which has been termed "America's largest healthcare epidemic."
Latent autoimmune diabetes of adults is a condition in which Type 1
diabetes develops in adults. Adults with LADA are frequently initially misdiagnosed
as having Type 2 diabetes, based on age rather than etiology.
Other Specific Types:
Genetic defects of beta-cell function• Chromosome 20, HNF4alpha (MODY1)• Chromosome 7, glucokinase (MODY2)• Chromosome 12, HNF1alpha (MODY3)• Chromosome 13, IPF-1 (MODY4)• Mitochondrial DNA 3243 mutation
Genetic defects in insulin action
• Type A insulin resistance• Leprechaunism• Rabson-Mendenhall syndrome• Lipoatrophic diabetes
Diseases of the exocrine pancreas
• Fibrocalculous pancreatopathy• Pancreatitis• Trauma / pancreatectomy• Neoplasia• Cystic fibrosis• Haemochromatosis
Endocrinopathies
• Cushing's syndrome
Introducion 44
• Acromegaly• Phaeochromocytoma• Glucagonoma• Hyperthyroidism• Somatostatinoma
Drug- or chemical-induced Infections
• Congenital rubella• Cytomegalovirus• Others
Uncommon forms of immune-mediated diabetes
• Insulin autoimmune syndrome (antibodies to insulin)• Anti-insulin receptor antibodies• "Stiff Man" syndrome
Other genetic syndromes
Genetic defects of beta-cell function
Several forms of the diabetic state may be associated with monogenic defects in beta-
cell function, frequently characterized by onset of mild hyperglycaemia at an early
age (generally before age 25 years). They are usually inherited in an autosomal
dominant pattern. Patients with these forms of diabetes, formerly referred to as
maturity-onset diabetes of the young (MODY), have impaired insulin secretion with
minimal or no defect in insulin action. Abnormalities at three genetic loci on different
chromosomes have now been characterized. The most common form is associated
with mutations on chromosome 12 in a hepatic nuclear transcription factor referred to
as HNF1alpha. A second form is associated with mutations in the glucokinase gene on
chromosome 7p. Glucokinase converts glucose to glucose-6-phosphate, the
metabolism of which in turn stimulates insulin secretion by the beta cell. Thus,
glucokinase serves as the "glucose sensor" for the beta cell. Because of defects in the
glucokinase gene, increased levels of glucose are necessary to elicit normal levels of
insulin secretion. A third form is associated with a mutation in the HNF4alpha gene
on chromosome 20q. HNF4alpha is a transcription factor which is involved in the
regulation of the expression of HNF1alpha. A fourth variant has recently been
ascribed to mutations in another transcription factor gene, IPF-1, which in its
homozygous form leads to total pancreatic agenesis. Specific genetic defects in other
individuals who have a similar clinical presentation are currently being defined.
Introducion 45
Point mutations in mitochondrial DNA have been found to be associated with diabetes
mellitus and deafness. The most common mutation occurs at position 3243 in the
tRNA leucine gene, leading to an A to G substitution. An identical lesion occurs in the
MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic Acidosis, and
Stroke-like syndrome); however, diabetes is not part of this syndrome, suggesting for
unknown reasons different phenotypic expressions of this genetic lesion.
Genetic abnormalities that result in the inability to convert proinsulin to insulin have
been identified in a few families. Such traits are usually inherited in an autosomal
dominant pattern and the resultant carbohydrate intolerance is mild. Similarly, mutant
insulin molecules with impaired receptor binding have been identified in a few
families. These are also associated with autosomal inheritance and either normal or
only mildly impaired carbohydrate metabolism.
Genetic defects in insulin action
There are some unusual causes of diabetes which result from genetically determined
abnormalities of insulin action. The metabolic abnormalities associated with
mutations of the insulin receptor may range from hyperinsulinaemia and modest
hyperglycaemia to symptomatic diabetes. Some individuals with these mutations have
acanthosis nigricans. Women may have virilization and have enlarged, cystic ovaries.
In the past, this syndrome was termed Type A insulin resistance. Leprechaunism and
Rabson-Mendenhall syndrome are two paediatric syndromes that have mutations in
the insulin receptor gene with subsequent alterations in insulin receptor function and
extreme insulin resistance. The former has characteristic facial features while the
latter is associated with abnormalities of teeth and nails and pineal gland hyperplasia.
Diseases of the exocrine pancreas
Any process that diffusely injures the pancreas can cause diabetes. Acquired processes
include pancreatitis, trauma, infection, pancreatic carcinoma, and pancreatectomy.
With the exception of cancer, damage to the pancreas must be extensive for diabetes
to occur. However, adenocarcinomas that involve only a small portion of the pancreas
have been associated with diabetes. This implies a mechanism other than simple
reduction in beta-cell mass. If extensive enough, cystic fibrosis and
haemochromatosis will also damage beta cells and impair insulin secretion.
Fibrocalculous pancreatopathy may be accompanied by abdominal pain radiating to
Introducion 46
the back and pancreatic calcification on X-ray and ductal dilatation. Pancreatic
fibrosis and calcified stones in the exocrine ducts are found at autopsy.
Endocrinopathies
Several hormones (e.g. growth hormone, cortisol, glucagon, epinephrine) antagonize
insulin action. Diseases associated with excess secretion of these hormones can cause
diabetes (e.g. Acromegaly, Cushing's Syndrome, Glucagonoma and
Phaeochromocytoma). These forms of hyperglycaemia typically resolve when the
hormone excess is removed.
Somatostatinoma, and aldosteronoma-induced hypokalaemia, can cause diabetes, at
least in part by inhibiting insulin secretion. Hyperglycaemia generally resolves
following successful removal of the tumour.
Drug- or chemical-induced diabetes
Many drugs can impair insulin secretion. These drugs may not, by themselves, cause
diabetes but they may precipitate diabetes in persons with insulin resistance. In such
cases, the classification is ambiguous, as the primacy of beta-cell dysfunction or
insulin resistance is unknown. Certain toxins such as Vacor (a rat poison) and
pentamidine can permanently destroy pancreatic beta cells. Fortunately, such drug
reactions are rare. There are also many drugs and hormones which can impair insulin
action. Examples include nicotinic acid and glucocorticoids. The list shown in Table 4
is not all-inclusive, but reflects the more commonly recognized drug-, hormone-, or
toxin-induced forms of diabetes and hyperglycaemia.
Drug- or Chemical-induced Diabetes
• Nicotinic acid• Glucocorticoids• Thyroid hormone• Alpha-adrenergic agonists• Beta-adrenergic agonists• Thiazides• Dilantin• Pentamidine• Vacor• Interferon-alpha therapy
Uncommon but specific forms of immune-mediated diabetes mellitus
Diabetes may be associated with several immunological diseases with a pathogenesis
or aetiology different from that which leads to the Type 1 diabetes process.
Postprandial hyperglycaemia of a severity sufficient to fulfil the criteria for diabetes
Introducion 47
has been reported in rare individuals who spontaneously develop insulin
autoantibodies. However, these individuals generally present with symptoms of
hypoglycaemia rather than hyperglycaemia. The "stiff man syndrome" is an
autoimmune disorder of the central nervous system, characterized by stiffness of the
axial muscles with painful spasms. Affected people usually have high titres of the
GAD autoantibodies and approximately one-half will develop diabetes. Patients
receiving interferon alpha have been reported to develop diabetes associated with islet
cell autoantibodies and, in certain instances, severe insulin deficiency.
Anti-insulin receptor antibodies can cause diabetes by binding to the insulin receptor
thereby reducing the binding of insulin to target tissues. However, these antibodies
also can act as an insulin agonist after binding to the receptor and can thereby cause
hypoglycaemia. Anti-insulin receptor antibodies are occasionally found in patients
with systemic lupus erythematosus and other autoimmune diseases. As in other states
of extreme insulin resistance, patients with anti-insulin receptor antibodies often have
acanthosis nigricans. In the past, this syndrome was termed Type B insulin resistance.
Other genetic syndromes sometimes associated with diabetes
Many genetic syndromes are accompanied by an increased incidence of diabetes
mellitus. These include the chromosomal abnormalities of Down's syndrome,
Klinefelter's syndrome and Turner's syndrome. Wolfram's syndrome is an autosomal
recessive disorder characterized by insulin-deficient diabetes and the absence of beta
cells at autopsy. Additional manifestations include diabetes insipidus, hypogonadism,
optic atrophy, and neural deafness.
Other Genetic Syndromes Sometimes Associated with Diabetes
• Down's syndrome• Friedreich's ataxia• Huntington's chorea• Klinefelter's syndrome• Lawrence-Moon-Biedel syndrome• Myotonic dystrophy• Porphyria• Prader-Willi syndrome• Turner's syndrome• Wolfram's syndrome
Table 1.4: Medicinal Herbs used in the treatment of diabetes from India
Introducion 48
Botanical Name
(Family)
Local
Name
Part Use Habit Traditional therapy
Abelomoschus
esculentus well
(Malvaceae)
Dheros Fruit Herb Two vertically
dissected fresh fruit are
soaked overnight in ½
glass cold water and
that leech ate water is
taken every morning.Abrus precatorius
L. (Fabaceae)
Ratti
(Gumchi)
Leaves Climbing Juice twice a 25 day.
Aegle marmelos
Correa.
(Rutaceae)
Beal Leaves Tree One gram gum is eaten
along with betleafe
once daily.Allium cepa. (L.)
(Liliaceae)
Pyaz Bulb Herb Use of raw vegetable
along with rice.Allium sativum
(L.) (Liliaceae)
Lesun Bulb Herb A raw bulbet are eaten
once dailyArtocarpus
heterophyllus
Lamk (Moraceae)
Katahal Leaves Tree About ½ cup juice of
fresh tender leaves is
taken once dailyAndrographis
paniculata Nees
Nilavembu.
(Acanthaceae)
Kalmegh Leaves Herb Decoction drink 3 time
per day
Annona squamosa
L. Sita
(Annonaceae)
Sitaphal Leaves Tree Powder with water
daily in the morning
Aristolochia
bracteolata Retz.
Israrmuli
(Aristolochiaceae)
Kidmar Leaves Herb Powder with water
daily in the morning
Asparagus
racemosus Willd.
(Liliaceae)
Satawar Tubrous
root
Herb Powder mixed with leaf
powder Gymina
salvester twice per day
for 30 days
Introducion 49
Azadirachta indica
(A) Juss.
(Meliaceae)
Neem Flower Tree Roasted flower or bark
powder with bulfer
milk for 40 daysAcalypha Indica
(L.)
(Euphorbiaceae)
Kuppi Leaves Herb Leaf juice two tea
spoon full is given
daily a one month for
diabetesArgyreia nervosa
(Burm. F.) Boj
(Convolvulaceae)
Samdar
kapat
Leaves Herb Pills made from the leaf
past is given to diabetes
patients for a long
times.Alpinia galanga
(L.) SW.
(Zingiberaceae)
Kulangan Root Herb -
Aloe barbadensis
(L.) Burm. F.
(Liliaceae)
Gwarpatha Leaf Herb -
Atropa belladonna
(Solanaceae)
Cheelatubar Seed Tree -
Bauhinia
variegata L.
(Caesalpiniaceae)
Kachnar Root Tree -
Boerhaavia diffusa
L. (Nyctaginaceae)
Itsit Leaves Herb -
Benincasa hispida
(Cucurbitaceae)
Petha Seed Climber -
Bacopa monnieri
(L.) Penn.
(Scrophulariaceae
)
Nariabrahmi Leaves Herb Agueous leaf juice is
given twice a day for
one month for diabetes.
Butea
monosperma
(Lamk) Taub
(Fabaceae)
Dhak
(Palas)
Leaves Tree Aqueous extract of
leaves and fruit is given
2 tea spoon full once
day for diabetes for a
long times.Bougainvillea
spectabilis (Willd)
Bogainvilla Leaves Shrub Past made into pills
twice per day for 25
Introducion 50
(Nyctaginaceae) days
Berrya cordifolia
(Tiliaceae)
Burret Leaves Tree -
Chonemorpha
fragrans
(Apocynaceae)
Garphedaro Root Shrub -
Chlorophytum
borivilianum
Roxb. (Liliaceae)
Safed Musli Root Herb -
Caesalpinia
pulcherrima L.
Roxb.
(Caesalpiniaceae)
Mayilkonnal
(Gulutora)
Leaves Shrub -
Crocus sativus L.
(Iridaceae)
Kesar Flower Herb -
Cassia sophera L.
(Caesalpiniaceae)
Thaonum Bark Shrub Bark and powder seed
mixed with honey is
given in diabetesCassia fistula (L.)
(Caesalpiniaceae)
Amaltas Fruit Tree Fruit pulp is given for
diabetesCassia auriculata
L.
(Caesalpiniaceae)
Aauaria Leaves Shrub Juice for 20 days
Cassia tora L.
(Caesalpiniaceae)
Chakora Leaves Herb Leaf juice for 20 days
Cassia
occidentalis L.
(Caesalpiniaceae)
Pelaya Leaves Shrub Powder with milk twice
a day for 20
Catharanthus
roseus (L.) G Don
(Apocynaceae)
Sadabahar Leaves Herb Leaf juice is given for
diabetes
Centella asiatica
(L.) Urban.
(Apiaceae)
Brahmi Leaves Herb Leaf juice is given for
the treatment to
diabetes for a long timeCissampelos
pareira (L.)
Akanadi Root Climber The root powder with
water is taken once a
Introducion 51
(Menispermaceae) day for 40 days treating
diabetes.Clerodendrum
multiflorum
(Burmf) O.Ketze
(Verbanceae)
Arni Whol plant Shrub Aqueous extract of the
plant is given for
treatment of diabetes
Clitoria ternatea
(L.) (Fabaceae)
Aparajita Flower Twining The flower juice is
given for controlling
diabetes.Coccinia grandis
(L.) voigt.
(cucurbitaceae)
Kundru Leaves Shrub Aqueous extract of the
roots leaves and
mucilage from our fruit
used for diabetesCajanus cajan (L.)
millsp.
(Papilionaceae)
Arher Leaves Shrub About 2 tea spoon full
juice is given once
daily with few drop of
honey
Camellia sinensis
(L.) O Ktze.
(Theaceae)
Cha Leaves Tree Eatern raw
Cinnamomum
verum J.S. Presl
(Lauraceae)
Daruchini Bark Tree ½ tea spoon dust with
tea is given twice daily
in empty stomachCocos nucifera L.
(Arecaceae)
Coconut Fruit Tree Kernal and eaten daily
Cocolus hirsutus
(L.) diels
(Menipermaceae)
Jamtikibel Leaves Climber Leaf of juice given for
diabetes
Costus mercicanus
(kocnig)
(Zingiberaceae)
Costus Leaves Herb One leaves daily eaten
Cucumis sativus
Roxb.
(Cucurbitaceae)
Shasha Fruit Climber To reduce Sugar a
freshly collected green
fruit should beCuminum
cyminum m.L.
Jeera Seed Herb About 2mg. Seed
powder is taken with
Introducion 52
(Apiaceae) once dailyCarica papay L.
(Cariaceae)
Papeta Fruit Tree Juice is drunk 2 times
per daily.Cornus officinalis
Siebddet Zuee
(Cornaceae)
Cherry Peeudocarp Shrub -
Cressa cretical L.
(Conveolvulance)
Rudrar anti Whol plant Shrub -
Cyamopsis
tetragonoloba (L.)
(Leguminosceae)
Guargum Seed Shrub -
Hyptis suaveolens
is Well.
(Ranunculaceae)
Mameera Rhizome Herb -
Datura metel Linn.
(Solanaceae)
Dhatura
(Black)
Seed Shrub Crushed seed Ca25
mg/kg body Wight ore
given once dailyDaucas carota
Linn. Var. sativa
(Umbelliferaceae)
Gajara Root Herb Extract is used in
biosweets for reducing
blood suggerDiospyros
malabarica (Desr.)
Kostel.
(Ebenaceae)
Tendu Bark Tree About 5ml. extract if
taken orally daily acts
hypoglycamic
Dioscorea alata
(Dioscoreaceae)
Chuprialu Tubrous
root
Herb -
Dalbaergia sisso
Roxb. (Fabaceae)
Talhi
(Shishum)
Gum Tree Anti diabetes
Emblica officinalis
(Euphorbiaceae)
Amla Dry fruit Tree Powder on tea spoon
ful with milk twice per
dayEupatorium
purpureum L.
(Asteraceae)
Queen of
the meadow
root
Root Herb -
Ficus carica L.
(Moraceae)
Anjir Fruit Tree Fruit used as tonic 2
fruits used daily after
sowing early in the
Introducion 53
morning.Ficus
benghalensis L.
(Moraceae)
Bergad Bark Tree About 5mg bark is
sowked overnight in
water and the teechate
water is take orallyFicus religiosa L.
(Moraceae)
Pipal Bark Tree Bark extract is given
for diabetesFicus comosus L.
(Moraceae)
Gular Fruit Tree Flower used in jaundice
one flower eats daily
one week to cure
jaundice.Ficus glomer
Roxb. (Moraceae)
Atthi Young fruit Tree Juice twice a day for 20
daysFoeniculum
vulgare Mill
(Apiaceae)
Sonf Leaves Herb -
Fraxinus excelsior
(oleaceae)
Sum Seed Tree Anti diabetic
Gymnema
sylvestre (Retz.)
schult
(Asclepiadaceae)
Gudmar Leaves Climber -
Glycosmis
pentaphylla (Retz.)
DC. (Rutaceae)
Bannimb Leaves Shrub Leaf oil is given for
diabetes
Glycine max L.
(Merr.)
(Papilionaceae)
Soyabean Seed Herb Used of vegetable in
curry
Gossypium
herbaceum L.
(Malvaceae)
Kapas Seed Shrub About 2m. raw seed are
eaten twice daily
Galega officinalis
(Leguminosae)
Goat'srue Whol plant Herb -
Gardenia taitensis
D. (Rubiaceae)
Tiare Flower Tree -
Hemidesmus
indicus
Anantmul Root climber Aqueous extract of the
roots one table spoon
Introducion 54
(Asclepiadaceae) full is given for 9 day
for the treatment of
diabetes.Holarrhena
pubescens Wall.
Exg. Don
(Apocynaceae)
Kuchi Seed Tree About 2gm. Seed are
soaked in water
overnight and glass of
lecchate cold water is
taken in emply
stomach.Hydnoearpus
kurzii Warb.
(King)
(Flaciourtiaceae)
Chalmugura Seed Tree About 1gm seed
powder is taken orally
twice daily.
Holoptelea
Integrifolia
(Roxb.) planch.
(Ulmaceae)
Chilbil Leaves Tree -
Ipomoea
Mauritiana Jacq.
(Convolvulaceae)
Bhuikumra Root Climber About ½ cup fresh root
extract is taken once
dailyKyllinga
nemoralis
(Forester) Dandy
(Cyperaceae)
Gothubi Root Herb -
Madhuca indica
(Koenig)
Macbride
(Sapotaceae)
Mahua Inner bark Tree -
Muhiamatera
spatona
(Cucurbitaceae)
Agumaki Leaves Climber -
Mangifera indica
Linn.
(Anacardiaceae)
Aam Leaves Tree Oral administration of
aqueous extract of the
leaves gm/kg body
weight is commended.
Introducion 55
Manilkara zapota
(L.) P. Rosen
(Sapotaceae)
Safeda Root Tree The root are soaked
overnight and the
alcohol extract of the
some is given 20 gm/kg
body Wight.Moringa oleifera
Lam.
(Moringaceae)
Munga Fruit Tree The juice is
recommended the rice
daily for 7 days.Momordica
charantia L.
(Cucurbitaceae)
Karela Fruit Herb About bitter gourd if
eaten daily there will be
no chonce of diabetes.Musa paradisiaca
L. (Musaceae)
Kela Fruit Herb 23 tea spoon full juice
of plant is taken daily
along withMentha piperita L.
Emend. Huds.
(Lamiaceae)
Podina Fruit Herb -
Oxalis corniculata
L. (Oxalidaceae)
Khatkurla Wood Herb -
Ougeinia
oojeinensis
(Roxb.) Hochr.
(Fabaceae)
Sandan Seed Tree -
Oryza sativa Linn.
(Poaceae)
Dhan Root Herb -
Olea europaea
(Oleaceae)
Olive Oile Seed Tree Powder with milk twice
a day for 25 day.Phyllanthus
emblica L.
(Euphorbiaceae)
Amlaki Fruit Tree About 3-4 gm. Dry rind
powder is coten daily
along with a pinch of
rock solt.Psidium guajava
L. (Myrtaceae)
Amrud Fruit Tree Powder with buter milk
twice per day for days.Portulaca
oleracea
(Portulacaceae)
Golbhaji Leaves Herb About 10 mg. fresh
plant is boiled in cup of
water and the filtered
juice is taken twice
Introducion 56
dailyPunica granatum
L. (Punicoceae)
Anar Pericarp Tree One fruit daily eaten
Pterocorpus
Marsupium Roxb.
(Fabaceae)
Bijasal Bark Tree Aqueous extract of the
heard wood is given for
diabetes about 1 gm.
Past is taken.Pandanus
odoratisssimus
L.F. (Pandanaceae)
Kevda Root Tree -
Phascolus vulgaris
(Fabaceae)
French bean Seed Climber -
Picrorhiza kurroa
Pennell.
(Scrophulariaceae)
Kutki Rhizome Herb
-
Rhizphora
apiculate
(Rhizophoraceae)
Garjan Leaves Herb The extract of leaves
4mg/kg body Wight
given once daily
aqueous extract of the
heard wood is given for
diabetes about 1 gm.
Paste is taken.Ruta graveolens
(Rutaceae)
Aru Leaves Herb Powder 1 to 2 tea
spoon full once in a
week for 4 weeks.Rosa rugosa
thunb. (Rosaceae)
Japanese
rose
Flower Shrub -
Rubia cordifolia L.
(Rubiaceae)
Majith Root Herb -
Santalum album L.
(Santalaceae)
Swet
chandan
Stem Tree About 1 gm. Paste is
takenShorea rubusta
Gaertn. F.
(Dipterocarpaceae)
Sal Leaves Tree About 2 leaves are
crushed in ½ cup water
the juice is taken once
dailyStevia rubbendian
L. (Astraceae)
Sweet plant Leaf Herb -
Introducion 57
Syzgium jambos
L. (Myrtaceae)
Jamun Seed Tree One tea spoon full of
seed powder is given
twice daily
Strychonos
potatorum. L. F.
(Loganiaceae)
Nirmah Seed Tree -
Tectona grandis
L.F. (Verbenaceae)
Sagvan Seed Tree -
Terminalia arjuna
(Roxb. ex. DC.)
Arjun Stem bark Tree Extract is used in
biosweets for reducing
blood sluggerTerminala catappa
L. (Combretaceae)
Deshir
badam
Fruit Tree About 50 gm. Fruit is
sufficient for daily dose
about 2 in chess.Tragia involucrata
L. (Euphorbiaceae)
Barhan Root Herb -
Tragopgon
pratensis
(Astearaceae)
Goat's beard Root Herb
-
Trigonella
corniculata (L.)
(Papilioaceae)
Methi Seed Herb Soaked the 5 gm. Seed
over night drunk ½ cup
leech ate water once
daily.Vaccinium
myrthillus L.
Bilber Fruit Shrub -
Withania
somnifera (L.)
Dunal
(Solanaceae)
Aswagandh Root Shrub About 3 gm. Root
disconcotion is give
once daily long with
m.l. leaves extract of
thamkumi.Zanthoxytum or
matium DC.
(Rutaceae)
Tejphal Fruit Shrub -
Zingiber zerumbet
Rose. ex. Sm.
(Zingiberaceae)
Narkachur Rhizome Herb -
Introducion 58
1.13 HYPERLIPIDEMIA66-68
Hyperlipidemia, hyperlipoproteinemia, or hyperlipidaemia (British English) involves
abnormally elevated levels of any or all lipids and/or lipoproteins in the blood. It is
the most common form of dyslipidemia (which also includes any decreased lipid
levels).
Lipids (fat-soluble molecules) are transported in a protein capsule. The size of that
capsule, or lipoprotein, determines its density. The lipoprotein density and type of
apolipoproteins it contains determines the fate of the particle and its influence on
metabolism.
Hyperlipidemias are divided in primary and secondary subtypes. Primary
hyperlipidemia is usually due to genetic causes (such as a mutation in a receptor
protein), while secondary hyperlipidemia arises due to other underlying causes such
as diabetes. Lipid and lipoprotein abnormalities are common in the general
population, and are regarded as a modifiable risk factor for cardiovascular disease due
to their influence on atherosclerosis. In addition, some forms may predispose to acute
pancreatitis.
Classification
Hyperlipidemias may basically be classified as either familial (also called primary)
caused by specific genetic abnormalities, or acquired (also called secondary) when
resulting from another underlying disorder that leads to alterations in plasma lipid and
lipoprotein metabolism. Also, hyperlipidemia may be idiopathic, that is, without
known cause.
Hyperlipidemias are also classified according to which types of lipids are elevated,
that is hypercholesterolemia, hypertriglyceridemia or both in combined
hyperlipidemia. Elevated levels of Lipoprotein(a) may also be classified as a form of
hyperlipidemia.
Familial (primary)
Familial hyperlipidemias are classified according to the Fredrickson classification
which is based on the pattern of lipoproteins on electrophoresis or ultracentrifugation.
It was later adopted by the World Health Organization (WHO). It does not directly
account for HDL, and it does not distinguish among the different genes that may be
Introducion 59
partially responsible for some of these conditions. It remains a popular system of
classification, but is considered dated by many.
Hyperlipoproteinemia type I
Type I hyperlipoproteinemia exists in several forms:
Lipoprotein lipase deficiency (Type Ia), due to a deficiency of lipoprotein lipase
(LPL) or altered apolipoprotein C2, resulting in elevated chylomicrons, the particles
that transfer fatty acids from the digestive tract to the liver.
Familial apoprotein CII deficiency (Type Ib), a condition caused by a lack of
lipoprotein lipase activator.
Chylomicronemia due to circulating inhibitor of lipoprotein lipase (Type Ic)
Type I hyperlipoproteinemia usually presents in childhood with eruptive xanthomata
and abdominal colic. Complications include retinal vein occlusion, acute pancreatitis,
steatosis and organomegaly, and lipaemia retinalis.
Hyperlipoproteinemia type II
Hyperlipoproteinemia type II, by far the most common form, is further classified into
type IIa and type IIb, depending mainly on whether there is elevation in the
triglyceride level in addition to LDL cholesterol.
Type IIa
Main article: Familial hypercholesterolemia
This may be sporadic (due to dietary factors), polygenic, or truly familial as a result of
a mutation either in the LDL receptor gene on chromosome 19 (0.2% of the
population) or the ApoB gene (0.2%). The familial form is characterized by tendon
xanthoma, xanthelasma and premature cardiovascular disease. The incidence of this
disease is about 1 in 500 for heterozygotes, and 1 in 1,000,000 for homozygotes.
Type IIb
The high VLDL levels are due to overproduction of substrates, including
triglycerides, acetyl CoA, and an increase in B-100 synthesis. They may also be
caused by the decreased clearance of LDL. Prevalence in the population is 10%.
Familial combined hyperlipoproteinemia (FCH)
Lysosomal acid lipase deficiency, often called (Cholesteryl ester storage disease)
Secondary combined hyperlipoproteinemia (usually in the context of metabolic
syndrome, for which it is a diagnostic criterion)
Introducion 60
Hyperlipoproteinemia type III
This form is due to high chylomicrons and IDL (intermediate density lipoprotein).
Also known as broad beta disease or dysbetalipoproteinemia, the most common cause
for this form is the presence of ApoE E2/E2 genotype. It is due to cholesterol-rich
VLDL (β-VLDL). Its prevalence has been estimated to be approximately 1 in 10,000.
Hyperlipoproteinemia type IV
Familial hypertriglyceridemia is an autosomal dominant condition occurring in
approximately 1% of the population.[6]
Hyperlipoproteinemia type V
Hyperlipoproteinemia type V is very similar to type I, but with high VLDL in addition
to chylomicrons.
It is also associated with glucose intolerance and hyperuricemia
Unclassified familial forms
Non-classified forms are extremely rare:
• Hyperalphalipoproteinemia
• Polygenic hypercholesterolemia
Acquired (secondary)
Acquired hyperlipidemias (also called secondary dyslipoproteinemias) often mimic
primary forms of hyperlipidemia and can have similar consequences. They may result
in increased risk of premature atherosclerosis or, when associated with marked
hypertriglyceridemia, may lead to pancreatitis and other complications of the
chylomicronemia syndrome. The most common causes of acquired hyperlipidemia
are:
• diabetes mellitus
• Use of drugs such as diuretics, beta blockers, and estrogens
• Other conditions leading to acquired hyperlipidemia include:
• Hypothyroidism
• renal failure
• nephrotic syndrome
• alcohol
• Some rare endocrine disorders and metabolic disorders
Treatment
Introducion 61
Treatment of the underlying condition, when possible, or discontinuation of the
offending drugs usually leads to an improvement in the hyperlipidemia. Specific lipid-
lowering therapy may be required in certain circumstances.
Another acquired cause of hyperlipidemia, although not always included in this
category, is postprandial hyperlipidemia, a normal increase following ingestion of
food.
Table 1.5: Fredrickson classification of Hyperlipidemias
Hyperli
po-
proteine
mia
OM
IMSynonyms Defect
Increase
d
lipoprot
ein
Main
symptoms
Treatm
ent
Serum
appear
ance
Estimat
ed
prevalen
ce
Type
I
a2386
00
Buerger-
Gruetz
syndrome, or
Familial
hyperchylomic
ronemia
Decrea
sed
lipopro
tein
lipase
(LPL) Chylomi
crons
Abdominal
pain (from
pancreatitis),
lipemia
retinalis,
eruptive skin
xanthomas,
hepatosplen
omegaly
Diet
control
Creamy
top
layer
1 in
1,000,00
0[4]b2077
50
Familial
apoprotein CII
deficiency
Altered
ApoC2
c1188
30
LPL
inhibit
or in
bloodType
II
a1438
90
Familial
hypercholester
olemia
LDL
recepto
r
deficie
ncy
LDL
Xanthelasma
, arcus
senilis,
tendon
xanthomas
Bile
acid
sequestr
ants,
statins,
niacin
Clear
1 in 500
for
heterozy
gotes
b 1442
50
Familial
combined
hyperlipidemi
Decrea
sed
LDL
LDL and
VLDL
Statins,
niacin,
fibrate
Clear 1 in 100
Introducion 62
Hyperli
po-
proteine
mia
OM
IMSynonyms Defect
Increase
d
lipoprot
ein
Main
symptoms
Treatm
ent
Serum
appear
ance
Estimat
ed
prevalen
ce
a
recepto
r and
increas
ed
ApoB
Type III1077
41
Familial
dysbetalipopr
oteinemia
Defect
in Apo
E 2
synthes
is
IDL
Tubo-
Eruptive
Xanthomas
& Palmar
Xanthomas
Fibrate,
statinsTurbid
1 in
10,000[5]
Type IV1446
00
Familial
hypertriglycer
idemia
Increas
ed
VLDL
produc
tion
and
Decrea
sed
elimina
tion
VLDL
Can cause
pancreatitis
at high
triglyceride
levels
Fibrate,
niacin,
statins
Turbid1 in
100[6]
Type V1446
50
Increas
ed
VLDL
produc
tion
and
Decrea
sed
LPL
VLDL
and
Chylomi
crons
Niacin,
fibrate
Creamy
top
layer &
turbid
bottom
Introduction 63
1.14 PLANT PROFILE
1.14.1 Abutilon muticum69-106
Abutilon is a large genus of approximately 150 species of broadleaf evergreens in the
mallow family, Malvaceae. The genus includes annuals, perennials, shrubs, and small
trees from 1–10 m tall, and is found in the tropical and subtropical regions of all
continents. The leaves are alternate, unlobed or palmately lobed with 3-7 lobes. The
flowers are conspicuous, with five petals, mostly red, pink, orange, yellow or white.
Common names include Abutilon, Chinese Bell Flower, Chinese Lantern, Mallow,
Indian Mallow, and Flowering Maple (for the maple-like leaves of some species,
although the genus is not related to the true maples). Abutilon species are used as food
plants by the larvae of some lepidoptera species including Yellow-banded Skipper
(which feeds exclusively on A. avicennae) and Chionodes mariona.
Common name: Abutilon, Indian Mallow
Fig. 1.1: Plant of Abutilon muticum
Scientific classification
Introduction 64
Kingdom PlantaePhylum AngiospermsClass Eudicot
Sub-Class RosidsOrder MalvalesFamily MalvaceaeGenus AbutilonSpecies muticum
Description
Perennial herb or shrub, 0.5-2 m tall, stellate pubescent. Leaves 2-16 cm across, ovate
to orbicular-ovate or orbicular, irregularly and minutely to coarsely serrate or
subentire or crenate, usually cordate at base, obtuse to acute or shortly acuminate at
apex, 7-9 nerved, stellate pubescent on both sides, scabrous above, more densely hairy
and velvety beneath, sometimes 3-angular near the apex; petiole 2-12 (-18) cm long,
stellate pubescent, velvety; stipules 6-8 mm long, 1 mm broad, linear, reflexed.
Flowers axillary, solitary or fascicled; pedicel 0.5-1.5 cm long, in fruit up to 3.5 cm,
articulate in the middle to near the apex. Calyx 7-8 mm long, in fruit up to 10 mm,
fused to the middle, pubescent on both sides; lobes ovate to deltoid, acuminate, 4-5
mm broad. Corolla 2-2.6 cm across, yellow to orange-yellow, 2-2.5 times the length
of calyx; petals 10-12 mm across, obovate, claw hairy on the margin. Staminal tube 4-
5 mm long, stellate pubescent. Fruit usually globose, sometimes truncate, 9-12 mm in
diameter; mericarps 27-39, usually obtuse, 6-7 mm long, 5-6 mm broad, separating
after dehiscence. Seeds usually 2 in each mericarp, rarely only 1 by abortion, 2 mm
across, pubescent, reniform.
Distribution
Tropical Africa, Arabia, India and Pakistan. It occurs in plains throughout Pakistan,
more common in Sindh.
Habitat
Present in sub-himalayan tract and hills upto 1,200 m and in hotter parts of India.
Cultivation
Abutilons are popular garden plants in subtropical areas. The hardiest species, A.
ochsenii and A. vitifolium from Chile, are hardy in warm temperate areas with
moderate frost down to about −10 °C (14.0 °F)
Introduction 65
Abutilon × hybridum is a popular group of hybrids that are semi-tropical, frost-tender
shrubs typically growing 2–3 m tall. The lantern-like buds open to solitary, pendulous,
bell- to cup-shaped flowers to 8 cm diameter with five overlapping petals and
significant staminal columns typical of the mallow family. Flowers come in red, pink,
yellow, white and pastel shades. Lobed, maple-like, light green leaves are often
variegated with white and yellow.
Velvetleaf has been grown in China since around 2000 BCE for its strong, jute-like
fibre. The seeds are eaten in China and Kashmir. The leaves are also edible. The
flowers and plants have a fruity scent. Velvetleaf grows primarily in cropland,
especially corn fields, and it can also be found on roadsides and in gardens. Velvetleaf
prefers rich and cultivated soils, such as those used in agriculture.
After being introduced to North America in the 1700s, velvetleaf has become an
invasive species in agricultural regions of the eastern and midwestern United States. It
is one of the most detrimental weeds to corn causing decreases of up to 34% of crop
yield if not controlled and costing hundreds of millions of dollars per year in control
and damage. Velvetleaf is an extremely competitive plant, so much so that it can steal
nutrients and water away from crops. Velvetleaf is controllable by herbicides.
Uses
It is sweet, cooling, digestive, laxative, expectorant, diuretic, astringent, analgesic,
anti-inflammatory, anthelmintic, demulcent and aphrodisiac. It is useful in gout,
tuberculosis, ulcers, bleeding disorders, and worms. Decoction used in toothache and
tender gums. Demulcents of leaves are locally applied to boils and ulcers. Roots are
prescribed in fever, chest affection and urethrities.
1.14.2 Celosia argentea107-153
Celosia is a small genus of edible and ornamental plants, similar in appearance and
uses to the amaranths. They are sometimes called cockscombs or wool flowers for
their brightly colored, woolly flower heads which resemble cockscombs. The name
"cockscomb" may be restricted to those whose flower heads are crested by fasciation.
Celosia argentea is a tender annual that is often grown in gardens. It is propagated by
seeds. The seeds are extremely small, up to 43,000 seeds per ounce.
The Century cultivars are usually taller (1-2 feet), and are bright red, yellow, orange,
or pink. The Kimono cultivars are generally smaller (4 inches - 1 foot), and have more
Introduction 66
muted colors, though similar to the Century cultivars. Other colors, such as white,
burgundy, orange-red, etc., can be found. Certain varieties will grow to 3-4 feet in
height.
Common names
Quail Grass or White Cock's Comb (Safed Murg), Cockscomb, Feathered amaranth,
Woolflower, Red fox, Prince, Anne Greens
Fig. 1.2: Plant of Celosia argentea
Scientific classification
Kingdom PlantaePhylum AngiospermsClass Magnoliopsida
Order CaryophyllalesFamily AmaranthaceaeGenus CelosiaSpecies argentea
Introduction 67
Description
Celosia argentea Plumosa' is a crop we produce in the summer and fall when it is
nearly impossible (because of the heat) to produce good quality stocks. The vibrantly
coloured spikes of these Celosia's draw attention to themselves. Besides the plumes
there are also Celosia's shapes like a "brain". These are called the Celosia argentea
Cristata.
The range of colours is red, orange, yellow and pink. Various shades in each colour
are available. Some production starts in July, with major production in August,
September and October. The "Fall colours" are really appreciated by all consumers.
Celosia is usually shipped in bunches of 5 stems. Normally there is no sleeve around
the bunch but a sleeve can be requested when bunches are intended for cash and carry
sales.
The celosias or cockscombs are erect, branching plants with oval or lance-shaped,
strongly veined leaves 2-6 in (5.1-15.2 cm) long and hundreds of tiny flowers packed
in dense, brightly colored flowerheads which usually stand above the foliage. The
wild form, Celosia argentea var. argentea is a weedy annual or short-lived perennial to
6 ft (1.8 m) tall, with erect plumes of silvery white flowers. C. argentea var. cristata
(a.k.a. C. cristata) is a tetraploid cultigen of garden origin with many cultivars
classified into several groups. These cultivars come with flowerheads in a variety of
shapes (some rather weird), and brilliant hot colors including red, orange, yellow,
purple and creamy white.
The Plumosa Group of cultivars (sometimes sold as Celosia 'Plumosa' or feathered
amaranth) have feathery plumelike flowerheads, 4-10 in (10.2-25.4 cm) tall, that look
a little like tiny Christmas trees. 'Apricot Brandy' is freely branched, to 20 in (50.8
cm) tall, with orange flowerheads. 'Forest Fire' has maroon leaves and bright scarlet
flowerheads. 'New Look' has purplish leaves and crimson flowerheads. 'Kimono
Series' cultivars are small, to 8 in (20.3 cm) tall, with flowerheads in rose, pink,
creamy white and red.
Cultivars in the Cristata Group have compact rounded, crested or fan-shaped
flowerheads with bizarre convoluted ridges. The flowerheads are 3-12 in (7.6-30.5
cm) across and look a little like velvety brains, cauliflower heads or roosters' combs.
'Big Chief Mix' is tall, to 3 ft (0.9 m), with cauliflower-shaped flowerheads to 6 in
Introduction 68
(15.2 cm) in diameter. 'Jewel Box Mix' is very small, to 8 in (20.3 cm), with bronzy
leaves and flowerheads in hot, bright colors including yellow, pink, salmon, gold and
red; the flowerheads are fan-shaped, like a rooster's comb.
The Spicata Group (often classified as a distinct species, C. spicata) includes cultivars
with slender, cylindrical pink or rose flowerheads which have a metallic sheen
because the individual flowers are silvery-white at their bases. 'Flaming Series'
cultivars are typical of this group.
Cultivation
These plants are of tropical origin, they grow best in full sunlight. The flowerheads
can last up to 8 weeks, and further growth can be promoted by removing dead
flowers.
Celosia plumosa, also known as "Prince of Wales Feathers," is a synonym for Celosia
argentea. "Flamingo Feathers" is a specific annual that can grow up to 2 feet in height.
The colors are predominantly pink to light violet, and the leaves are a darker green,
when compared to C. argentea.
Celosia requires rich, well-drained soil, with humus and manure added, and should be
kept constantly moist. It needs sun, and shelter from the wind, and grows to a height
of 1.5 to 2 feet.
Flowers
Its crested inflorescence is ornately rippled and brilliantly colored.
Propagation
Celosia is propagated from seed, and should be raised under glass in cooler climates.
Location
Celosia argentea occurs widely as a weed in the equatorial tropics of Africa, Asia and
South America. It may have originated in Asia and then spread to Africa and South
America with the help of people.
Moisture: The celosias require constant moisture, but a well drained soil. Water
before the soil dries out. Plants that survive periods of drought may become stunted
and flower only poorly if at all.
Hardiness: Celosias are warm weather annuals. They can be stunted if exposed to
temperatures below about 60ºF (15.5ºC). Celosias thrive in hot, humid weather.
Propagation: Many gardeners purchase their celosias in the bedding plant section at
Introduction 69
their local garden center. The best plants to get are those that haven't flowered yet.
Celosias are easy to start from seed. Sow shallowly in soil or potting mix at 70-75ºF
(21-24ºC), and set out when nighttime temperatures stay above 45º or 50ºF (7-10ºC).
Six week old seedlings should bloom in about two months.
Uses
Use celosias, especially the Plumosa types, in masses in the annual flower bed, or for
edging in front of taller flowers and perennials. (Some of the flower colors may be
just too dramatic to go well with other flowers.) The Cristata cultivars are good in
containers, and prized for Japanese flower arrangements. The flowerheads of the
Plumosa and Spicata cultivars are beautiful in fresh flower arrangements. The dried
flowerheads of all groups are excellent in dried arrangements where they retain their
color and don't disintegrate all over the place. Cut off flowerheads before the seeds
develop, strip off all the leaves, and dry as quickly as possible by hanging upside
down is a warm, well ventilated area. The leaves and flowers are edible and are grown
for such use in Africa and Southeast Asia.
As a food
A traditional food plant in Africa, this little-known vegetable has potential to improve
nutrition, boost food security, foster rural development and support sustainable
landcare. Celosia argentea var. argentea or Lagos spinach (a.k.a. quail grass, Soko,
Celosia, feather cockscomb) is a broadleaf annual leaf vegetable belonging to the
Amaranth family (Amaranthaceae). It grows widespread across northern South
America, tropical Africa, the West Indies, South, East and Southeast Asia where it is
grows as a native or naturalized wildflower, and is cultivated as a nutritious leafy
green vegetable. It is traditional fare in countries of Central and West Africa, and is
one of the leading leafy green vegetables in Nigeria, where it is known as ‘soko
yokoto’, meaning ‘make husbands fat and happy. Fresh Swiss chard Fresh water
spinach Creamed spinach Steamed kale Leaf vegetables, also called potherbs, greens,
or leafy greens, are plant leaves eaten as a vegetable, sometimes accompanied by
tender petioles and shoots.
As a garden plant
Seed production in these species can be very high, 200-700 kg per hectare. One ounce
of seed may contain up to 43,000 seeds. One thousand seeds can weigh 1.0-1.5 grams.
Depending upon the location and fertility of the soil, blossoms can last 8-10 weeks.
Introduction 70
1.14.3 Crotalaria burhia154-165
A low undershrub, c. 30-60 cm tall; branches numerous, hoary with dense appressed
pubescence. Leaves few, deciduous, simple, c. 0.6-2.5 cm long, c. 3-10 mm broad,
oblong, obtuse, pubescent on both sides. Inflorescence a 6-12-flowered, elongated
raceme. Pedicels very short; bracteoles 2. Calyx c. 8-9 mm long, pubescent, teeth
lanceolate. Corolla yellow, slightly exserted. Style slightly bearded at the top. Fruit c.
8-9 mm long, c. 4 mm or less wide, hairy, 3-4-seeded.
Common names
Benth, Saniya
Scientific classification
Kingdom Plantae
Phylum Angiosperms
Class Magnoliopsida
Order Fabales
Family Fabaceae
Genus Crotalaria
Species Burhia
Fig. 1.3: Plant of Crotalaria burhia
Introduction 71
Description
Crotalaria is a genus of herbaceous plants and woody shrubs in the Family Fabaceae
(Subfamily Faboideae) commonly known as rattlepods. Some 600 or more species of
Crotalaria are described world-wide, mostly from the tropics; at least 500 species are
known from Africa. Some species of Crotalaria are grown as ornamentals. The
common name rattlepod or rattlebox is derived from the fact that the seeds become
loose in the pod as they mature, and rattle when the pod is shaken. The name derives
from the Greek, κροταλον, meaning "castanet", and is the same root as the name for
the rattlesnakes (Crotalus).
Crotalaria species are used as food plants by the larvae of some Lepidoptera species
including Endoclita sericeus, Etiella Zinckenella and Utetheisa ornatrix. The toxic
alakaloids produced by some members of this genus are known to be incorporated by
Utetheisia larvae and used to secure their defense from predators. (Eisner et al., 2003)
Crotalaria spectabilis Roth was introduced to the US from India for green manure. As
a legume that supports nitrogen fixing bacteria, it is considered a "soil builder."
However, it is also poisonous to cattle (as are many legumes), and has spread rapidly
Introduction 72
throughout the Southeastern United States where it is now considered an invasive
species.
Alkaloid monocrotaline, the main toxic principle of Crotalaria spectabilis, is used to
induce experimental pulmonary hypertension in laboratory animals.
Crotalaria longirostrata, also known as "longbeak rattlebox" or as "chipilín", is a
common leafy vegetable in Oaxaca and Central America. It is considered a weed in
the United States
Distribution
Pakistan (Punjab, Sind, Baluchistan); India; Afghanistan. The origin is uncertain, but
is believed to be native to India and Pakistan. Now cultivated throughout India (from
the foothills of the Himalayas to Ceylon), Pakistan, in Uganda and Rhodesia, and in
the western Hemisphere (e.g. Brazil) where it was introduced early in the 19th
century.
Ecology
Sunnhemp is the fastest growing species of the genus and is very effective in
smothering weeds. Almost any well-drained soil is suitable for the kharif crop.
Sunnhemp grown during the rainy season is utilized mainly as a green manure, the
fiber not considered of good quality. For fiber sunnhemp is grown on fairly light well-
drained soils that retain sufficient moisture during the growing season. Sunnhemp is a
short-day crop, but vegetative growth is favored by long days, although seed set may
be poor. Although tolerant of drought, sunnhemp has low tolerance to salt and frost.
Ranging from Cool Temperate Steppe to Tropical Very Dry through Tropical Wet
Forest Life Zones, sunnhemp is reported to tolerate annual precipitation of 4.9 to 42.9
dm (mean of 29 cases = 14.9 dm), annual mean temperature of 8.4 to 27.5°C (mean of
29 cases = 22.5°C), and pH of 5.0 to 8.4 (mean of 24 cases = 6.2).
Cultivation
After plowing, seed is broadcast by hand or a device consisting of a canvas bag
containing the seed with a blower attached. Then the land is cross-plowed. Seed is
sown at different rates at different times depending on the use of the crop. In India
seed is broadcast for fiber at a rate of 96 kg/ha under dry growing conditions, and less
on irrigated fields. In Pakistan seed is sown at rate of 120 to 240 kg/ha. The heavy
seed rate insures upright erect stems which help to smother weeds, produces a finer
fiber and increases the yield. Height of stalks in crops varied from 1.15 m to 1.75 m
Introduction 73
(to 2 m), with an average thickness of 1.2 cm about the middle of the stalk. Seed is
sown in Africa in late Nov. and Dec., even as late as Jan., except for weeding, which
is usually not necessary if the land has been well prepared; no cultivation is required.
Sunnhemp is a dryland crop. Where irrigated, furrows are opened in fields separating
them into small plots. If there is no rain after sowing, field is irrigated along these
furrows. Crop is irrigated once in 10-15 days, lightly compared to other crops, like
tobacco and chilies. Too much moisture is harmful during the first 2 weeks after
germination. Seeds germinate rapidly. In about 3 days seedlings appear above ground
and soon form a thick cover. No manure is applied. Sunnhemp is often grown as a
green manure, in rotation with tobacco, vegetables, dry grains, rice, corn, cotton, also
sugar cane, pineapples, coffee, and orchard crops.
Uses
It is good soil binder and has got medicinal value.
1.14.4 Salvadora persica166-240
Salvadora persica (Arak, Galenia asiatica, Peelu, Pīlu, Salvadora indica, or
toothbrush tree), is a species of Salvadora
Common name
Salt Bush, Toothbrush, Pilu
Scientific classification
Kingdom Plantae
Phylum Angiosperms
Class MagnoliopsidaOrder Brassicales
Family Salvadoraceae
Genus SalvadoraSpecies persica
Fig. 1.4: Plant of Salvadora persica
Introduction 74
Description
Salvadora persica is a small tree or shrub with a crooked trunk, seldom more than one
foot in diameter. Its bark is scabrous and cracked, whitish with pendulous extremities.
The root bark of the tree is similar to sand, and the inner surfaces are an even lighter
shade of brown. It has a pleasant fragrance, as well as a warm and pungent taste.
Botanical Description
Salvadora persica is an evergreen shrub or small tree to 6-7 m; main trunk erect or
trailing with profusely branched, wide crown of crooked, straggling and drooping
branches; young branches green in colour; bark slightly rough, greyish-brown on
main stem, paler elsewhere. Leaves oblong-elliptic to almost circular, 3 x 7 cm, light
to dark green, rather fleshy, sometimes with wartlike glandular dots and dense, rather
loose hairs; apex broadly tapering to rounded, sharp-tipped; base broadly tapering;
margin entire; petiole up to 10 mm long; leaves in opposite pairs. Flowers greenish to
yellowish, very small, in loose, slender-branched axillary or terminal panicles, up to
10 cm long. Fruit spherical, fleshy, 5-10 mm in diameter, pink to scarlet when mature,
single seeded; seeds turn from pink to purple-red and are semi-transparent when
Introduction 75
mature. The generic name was given in 1749 in honour of an apothecary of
Barcelona, Juan Salvador y Bosca (1598-1681), by Dr Laurent Garcin, botanist,
traveller and plant collector. The true specimen of this species came, as the specific
name indicates, from Persia.
History
Salvadora persica is a popular chewing stick throughout the Indian subcontinent, as
well as the wider Muslim world.[9]Also commonly referred to as Miswak, many
Muslims consider chewing Salvadora persica to be a practice recommended by the
Prophet Muhammad. As of 2009, Botanic Gardens Conservation International has a
total of 8 Salvadora persica in conservation.
Scientific analysis
According to chemical and phytochemical analysis of Salvadora persica, there was an
occurrence of carbohydrates and/or trimethylamine; an alkaloid which may effectively
be salvadorine; chlorides; sulphur; terpenes; vitamin C; glycosides; large amounts of
fluoride and silica; small amounts of tannins, saponins, flavonoids and sterols.
Ecology
Natural Habitat
S. persica is widespread, notably in thorn shrubs, desert floodplains, river and stream
bank vegetation, and grassy savannahs. Prefers areas where groundwater is readily
available, by riverbanks, on perimeters of waterholes, in seasonally wet sites, and
along drainage lines in arid zones.
Also found in valleys, on dunes and on termite mounds. The tree is able to tolerate a
very dry environment with mean annual rainfall of less than 200 mm. highly salt
tolerant, it can grow on coastal regions and inland saline soils.
Geographic distribution
Native : Algeria, Angola, Cameroon, Chad, Egypt, Eritrea, Ethiopia, India, Iran,
Israel, Jordan, Kenya, Libyan Arab Jamahiriya, Malawi, Mali, Mauritania,
Mozambique, Niger, Nigeria, Oman, Pakistan, Saudi Arabia, Senegal, Somalia, South
Africa, Sri Lanka, Sudan, Syrian Arab Republic, Tanzania, Uganda, Yemen, Republic
of, Zambia, Zimbabwe.
Habitat
On saline lands and black cotton soil of peninsular India and Sri lanka.
Propagation methods
Introduction 76
Readily germinates from seed. Seeds exhibit no dormancy but the fruit pulp contains
germination inhibitors that should be removed before sowing. The process of seed
germination starts with imbibition in water at 30-35 deg. C for 24-72 hours, but under
saline conditions the absorption of water is dependent upon osmotic pressure of the
media and cell sap. Soaked, depulped seeds of S. persica will germinate in 24 hours.
Seeds have been raised in the nursery for up to 3 years prior to transplanting in the
field.
Tree Management
For high seed settings and seed oil content, harvesting is recommended 3 months after
seed setting. This may be due to the utilization of food reserve in the cotyledons for
the development of fruit pulp, and can be seen as the pulp content of fruit increases.
Coppicing is advantageous for the tree’s use as a fuel, and the branches are repeatedly
cut to produce short stems that are harvested for toothbrushes. S. persica is grown in
plantations or hedges. Salvadoras persica is generally a slow-growing tree.
Germplasm Management
Seed storage is orthodox; seeds can be stored with low moisture content. There are
about 3400 seeds/kg.
Uses
Root bark is tonic, stimulant and emmenagogue and used to relieve splenalgia. The
stem bark is good for gastropathy. Leaves are antiscorbutic, diuretic, anthelmintic,
astringent, expectorant and tonic. They are useful in asthma, bronchitis, cough,
strangury, painful tumors, constipation, verminosis and haemorrhoids. Shoots and
leaves are bitter and used in all types of poisons, cough and bronchitis. Fruits are
sweet, acrid, bitter, thermogenic, aphrodisiac, emollient, stomachic, purgative and
digestive. They are useful in constipation, flatulence and seminal weakness. Tender
twigs are used as toothbrush. The extract of the root is said to relive the pain due to
spleen troubles. Seed oil is applied on the skin in rheumatism. Used for centuries as a
natural toothbrush, its fibrous branches have been promoted by the World Health
Organization for oral hygiene use. Research suggests that it contains a number of
medically beneficial properties including abrasives, antiseptics, astringent, detergents,
enzyme inhibitors, and fluoride.
Functional uses
Food
Introduction 77
Fruits have a sweet, agreeable, aromatic, slightly pungent and peppery taste. They can
be eaten raw, cooked, or dried and stored. Fruit with or without seeds is said to
contain 1.7-1.86% sugars when ripe. Fermented drinks are also made from the fruit.
The leaf is somewhat bitter and aromatic, with a taste likened to mustard. The leaves
are also cooked as a sauce and eaten with couscous or as a green vegetable. Tender
shoots, seeds and seed oil are also edible. Edible salts are obtained from ashes.
Fodder: Leaves and young shoots are browsed by all stock, but normally cattle do not
occur in the driest part of the S. persica distribution range and hence it tends to be
valued more as a camel, sheep and goat forage. Leaves make good fodder as their
water content is high (15-36%). The high salt content of the leaves is said to affect the
taste of milk, but the leaves are said to increase lactation in cows. Apiculture: S.
persica is reported as a good source of nectar.
Fuel
The wood is sometimes used for firewood and charcoal. However, it is not used for
cooking meat, as it leaves a foul taste Services
Pests and diseases
When S. persica occurs on river terraces, it is a preferred host of Cistanche tubulosa,
an obligate phanerogamic root parasite. Defoliating larvae of several beetles attack the
tree, and leaves are often attacked by the lepidopteran Colotis ephiae. The mite
Eriophyes causes leaf gall. A number of fungi such as Cercospora udaipurensis,
Placosoma salvadorae and Sephogloeum salvadorae damage the leaves.
1.14.5 Salvadora oleiodes241-247
Salvadora oleiodes is a small bushy evergreen tree found in India and Pakistan and
southern Iran. In Iran it is called Tuch. Common names in Indian subcontinent include
Vann, (Punjabi), Pilu (Hindi), and jar (Sindhi language), in Saraiki language in Saraiki
Wasib called jall.
Common names
Bahapilu, chootapilu, jhal, pilu
Scientific classification
Kingdom PlantaePhylum AngiospermsClass Magnoliopsida
Introduction 78
Order Brassicales
Family SalvadoraceaeGenus SalvadoraSpecies oleiodes
Fig. 1.5: Plant of Salvadora oleiods
Description
It is a small tree with drooping branches, rarely with proper bole or exceeding a height
of 20 feet and a girth of 3 feet. It is very common plant in arid tracts but becomes
scarce where rainfall conditions are better. It can withstand great soil salinity. It
produces new leaves during April, which on maturity become thick and leathery. The
tree coppices fairly well but regenerates freely by root suckers and natural layering. It
is, however, very slow growing but a dense growth is often formed around the parent
plant by root suckers and some natural seedlings. The plant provides a dense shade. It
is often lopped for camel and goat fodder.
Introduction 79
Fruit
Small greenish white flowers are produced in March-April. The fruit is yellow and
ripens in the months of May and June. It forms one of the main grazing sources for
livestock owned by local farmers. It is often dried and preserved in large quantities.
The seeds are spread by birds. The seedlings come up under the parent plant or under
other bushes and are somewhat frost-tender.
Habitat
The vann is commonly found in and around Sandal Bar, and is reserved for use as
grazing sources for local peasant villages. In addition, a number of trees have been
preserved to provide shade for cattle.
Wood
The vann is mostly non-woody and the small amount of wood that it has is soft, light,
and not particularly useful for any of wood's normal uses, notably building and heat.
When burnt, it leaves a large quantity of ash, which can then be boiled down into a
substance for treating mange in camels.
Botanic description
Salvadora oleoides is a shrub or small tree, attaining 6-9 m height under favourable
conditions; trunk short, often twisted or bent, up to 2 m in diameter; branches
drooping, numerous, stiff, often swollen at forks; bark grey or whitish-grey. Leaves
glaucous, linear-or ovate-lanceolate, coriaceous and somewhat fleshy, dark greenish-
yellow when young, grey when mature. Flowers sessile, greenish-white, minute in
paniculate spikes, often clustered; calyx cup-shaped, in 4 rounded, obtuse lobes. Fruit
a drupe, globose, about 6 cm in diameter, usually yellow when ripe, dark brown or red
when dry. Seeds greenish-yellow, about 3 mm in diameter. The generic name was
given in 1749 in honour of an apothecary of Barcelona, Juan Salvador y Bosca (1598-
1681), by Dr Laurent Garcin, botanist, traveller and plant collector.
Uses
It is used as stimulant and emmenagogue and used to relieve splenalgia and as tonic.
The sbark is good for gastropathy. Leaves are antiscorbutic, diuretic, anthelmintic,
astringent, expectorant and tonic. They are useful in asthma, bronchitis, cough,
strangury, painful tumors, constipation, verminosis and haemorrhoids. Shoots and
leaves are bitter and used in all types of poisons, cough and bronchitis. Fruits are
sweet, acrid, bitter, thermogenic, aphrodisiac, emollient, stomachic, purgative and
Introduction 80
digestive. They are useful in constipation, flatulence and seminal weakness. Tender
twigs are used as toothbrush.