Plants that heal

Plant screenLng has often yielded poor results because traditional healers were not involved; but the advice of good healers ensures at least a 50/50 chance of success

I When, some years ago, I started showing interest in African tra­ditional medicine, like many other investigators in this field I doubted the efficacy of ahy of

the claims made by our local healers . Time soon proved me wrong, and luck too came to my aid. It was not difficult to establish contact with two well-known herbalists in my district and they were most willing to pass on their age-long knowledge. They were both octoge­narians with long years of practice behind them and were trusted and re­spected by their patients .

I also learned to respect them for their wide knowledge of plants and diseases , their frankness and wealth of human experience. Every other week I would go with one of them into the bush, collect plants and learn about their uses. These old herbalists were great botanists and knew something about every plant we saw in the bush. They each identified at least 200 plants with healing properties.

These traditional herbalists treated a wide variety of diseases and injuries, apart from offering maternal and child care. One day, one of our modern-trained district midwives was faced with a case of severe post-partum haemorrhage, and she later told me that she actually ran to

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BY OI(U AMPOFO

find a taxi to carry the patient to my clinic. On her return she was surprised to see the patient washing her baby. Her bleed­ing had been arrested by one of the old herbalists who lived a few yards away. It was this incident which first put me in touch with this herbalist. I later learnt of some interesting cures from other local herbalists, found out about their methods and tried them out in my practice . As Director of the new Centre for Scientific Research into Plant Medi­cine in Ghana, I now have greater oppor­tunity for doing clinical trials with tradi­tional methods.

It is my contention that to achieve any success in the field of research into tradi­tional medicine, we have first to acquire our knowledge from the traditional heal­er himself, try out his methods clinically and then, if successful, subject them to scientific analysis. Many plant screening programmes have not yielded any fruit­ful results because traditional healers have not been involved in these trials; but experience shows that with the ad­vice of the good healers there is at least a 50/50 chance of success.

In our clinical trials with medicinal plants, our aim has not only been to find cures for diseases in which "Western" medicine is ineffective but also more

particularly to find substitutes for im­ported drugs. Here are two examples.

The Public Health Department of our Medical School recently asked us to help them to fight an epidemic of guinea­worm in three nearby villages. In pre­vious years, attempts had been made to treat the yearly epidemic with a combi­nation of procaine penicillin and dif­ferent proprietary drugs. The 88 people involved in this trial included 18 chil­dren , 20 bed-ridden adults and 50 ambu­lant adults . These were divided into two groups of 44 people each. The first group was put on a decoction of pieces of root of Combretum mucronatum, a known worm-expeller, at a calculated dose of .03 gmjkilo. The second group was given a decoction of Mitragyna stipulosa which looks like Combretum mucronatum ; the calculated dose was .06 gm/kilo. Patients were examined twice weekly .

After one week , examination revealed that there was complete extrusion of the worms in 43 out of 44 in the first group (i.e . 97.7 per cent) and there was marked reduction in the inflammation around

Herbalists at a centre for African traditional t> medicine learn how to prepare and process roots so as to make the best of their healing properties . ( Photo WHO/R . da Silva )

Hille ria latifolia -Phyto­laccaceae

Myrianthus arboreus - Moraceae

the lesions. The wounds healed com­pletely after two weeks with local appli­cation of sterile palm oil. In the second group, there was complete extrusion of worms in 23 out of the 44 cases (i.e. 52.2 per cent), with healing of the wounds after local application of palm oil in two weeks. Thus, it was proved that Combre­tum mucronatum-as the traditional her­balists claim- is indeed a true expellent of guinea-worm.

We were also able to prove that the leaves of Elaeophorbia drupifera and Hil­leria latifolia, taken in combination in a palm soup preparation, act as a filaricide in guinea-worm infestation.

Skin diseases have particularly en­gaged our attention and we have had success in the treatment of coccal infec­tions, epidermophytons, allergy and herpes zoster. Four traditional treat­ments of herpes zoster are particularly interesting. The local application of the flowers of Hoslundia opposita and red cola nut, chewed together and sprayed on the lesion twice a day, often heals it within a fortnight. The local application of guava leaves, ground into paste with

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Securidaca longipedunculata -Polygalaceae

Picralima nitida­Apo­cynaceae

kaolin or white clay and Piper guineense twice a day, heals the infection in about ten days. Alternatively, the root of Picra­lima nitida is charred with Piper guineense and ground into fine powder, mixed with kernel oil and applied to the infected area with cotton wool twice daily; for internal application, the black powder is mixed in alcohol and taken, one dessertspoonful thrice daily, to allay pains; this treatment is very effective and healing takes place in 10-14 days. But perhaps the most dramatic form of treat­ment is the use of the root bark of Bala­nites aegyptiaca, ground into fine pow­der, then made into a paste with water and applied to the infected area morning and night; healing occurs from five to seven days. A similar result is obtained with Securidaetl- longipedunculata root bark, which is also useful in treating psoriasis and possesses anti-convulsive properties.

Guinea-worm and herpes zoster are some of the diseases for which modern medicine has so far no effective remedy. Traditional African medicine appears to be more effective.

Plants that heal

Left: Hille ria latifolia has been proved to act as a filaricide in cases of guinea-worm infesta­tion. The bark of Securidaca longipedunculata is useful in treating psoriasis and also has anti­convulsive properties. Myrianthus arboreus ; a decoction made from its bark appears effective against diabetes. When suitably prepared, the root of Picralima nitida can heal the sk in disease herpes zoster in the space of two weeks.

Right: This woman has come to consult a healer at a centre for traditional medicine. Such healers are respected in their local com­munities for their wide knowledge of plants and diseases as well as for their understanding and wealth of human experience.

(Photo WHO JR . da Silva)

Two other diseases for which tradi­tional African medicine appears to be more effective and less risky than mod­ern medicine are diabetes mellitus and bronchial asthma. For some years now, we have been studying the work of her­balists who treat diabetes mellitus, some of whose remedies come mainly from herbal preparations. In particular, the anti-diabetic activity of herbs of the Loganiaceae family has been confirmed by our University of Science and Tech­nology. One teacher herbalist claims as high as 75 per cent of "cures" among his diabetic patients treated with the Loga­niaceae family. He has successfully treat­ed a patient who developed gangrene and ketosis even though he was on insulin injections. A thorough investigation into the anti-diabetic property of the Loga­niaceae seems to be called for.

The combination of Canthium and Myrianthus bark as decoction or alcohol­ic "bitters" also appears effective. One patient had his diabetes mellitus arrested when he was treated with this extract for two months. His fasting blood sugar has been normal since. Another colleague

who practises dentistry in England per­suaded a physician friend to try the alcoholic extract on two English patients with juvenile diabetes five years ago. After two months treatment, it made no impression on one case but the second improved considerably and her fasting blood sugar has remained normal ever since. They were both on insulin. Costus schlechteri is another plant claimed by some herbalists to be effective against diabetes mellitus, and our observation is that this plant is effective in some early cases.

It is in the use of Bridelia ferruginea for controlling diabetes mellitus that I have acquired more experience and hope for the treatment of diabetes. Of the 12 cases under treatment, I have selected three as showing typical reactions to the plant.

Patient M.A. , a woman aged 49 years, reported in May 1976 and had been receiving insulin injections, 44 units daily for the last two years. Her fasting blood sugar was 242 mgm/ 100 ml. The patient looked worried , did not want any more insulin and preferred herbal treatment. She was put on one dessertspoonful of

powdered Sclerocarya birrea leaves twice daily but at the end of the third week, her fasting blood sugar had risen to 340 mgm/ 1 00 ml. Treatment was discon­tinued and the patient was put on a chlor­propamide preparation, 250 mg twice daily for ten weeks. There was mild im­provement but the patient wanted to try another herbal treatment. In August 1976, she was put on Costus schlechteri as recommended by a herbalist. Her fast­ing blood sugar rose to 250 mgm% and it was decided to try Bridelia ferruginea­ten leaves boiled with one pint of water, one teacupful to be taken three times daily as recommended by a herbalist. There was a steady lowering of the fast­ing blood sugar till it became normal after 12 weeks, and it has since remained normal.

Patient L.B., a woman aged 45 years, reported for treatment of her hyperten­sion. Routine examination revealed that she had diabetes mellitus with fasting blood sugar of 370 mgm% . We decided not to give her any "Western" drugs and put her straight on Bridelia ferruginea-20 leaves boiled in a pint of water, one

teacupful being taken three times daily. After one week the fasting blood sugar came down by 120 mgm% and conti­nued to fall till it became normal after 11 weeks. It has since remained normal. Incidentally, no treatment was given for her hypertension which also automati­cally fell from 180/90 to 140/90.

Mrs T. 0. , aged 59 years, is another typical case. She has been a diabetic since 1969, and first reported to us in April 1975 for a prescription for more of the proprietary tablets which she had been taking daily . Her fasting blood sugar was 252 mgm% and it ranged between 190 mg and 285 mg for 16 months until October 1976 when we decided to put her on Bridelia leaves. There was no signifi­cant change for three months and the dosage was increased by 50 per cent. After another two months, the dose was doubled as the fasting blood sugar conti­nued to rise. There was still no significant change for two months and the patient was put back on her tablets. It was then discovered that the patient had been secretly taking both Bridelia and the tablets together and we concluded that

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Watched by two village women, a herbalist explains the contents of a pot of mixed herbs and roots to a visiting official (in white suit ) .

(Photo WHO/R . da Silva )

this may have accounted for the ineffec­tiveness of the former. It would appear that the traditional drug and the modern one acted as antagonists here. This is true of other patients who are over­anxious to get well and take both drugs, while patients who take alcohol during Bridelia treatment also show no im­provement.

My own experience in the prophylactic use of plants for bronchial asthma will be supported by Professor Marian Addy, who has used the same materials in ex­perimental animals. Drugs used for bronchial asthma in modern medicine are mainly applied during attacks whereas medicinal plants can be used prophylactically until attacks are well reduced or completely eliminated. Of the

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many plants available for bronchial asth­ma the following have been most widely used at our Centre: Desmodium adscen­dens- Papilionaceae, Thonningia san­guinea- Balanophoraceae, and Deinbol­lia pinnata- Sapindaceae.

The leaves of Desmodium adscendens can be given in the form of dry powder, one to two teaspoonfuls, according to age, in warm water in three divided doses per day, or it can be made into alcoholic extract. Thonningia sanguinea root is pul­verized and dried . Two dessertspoonfuls of the powder are mixed thoroughly in ten ounces of honey and given in doses of one teaspoonful to one tablespoonful thrice daily. This too can also be pre­pared in the form of alcoholic extract. Dry, powdered Deinbollia pinnata root bark is used differently : one to two teas­poonfuls of the powder may be taken according to age in palm soup every other day for two to three weeks, and it can also be taken in soda water.

Each of these preparations is capable of deferring bronchial asthma attacks or

even stopping them, especially in chil­dren. But the best result we have ob­tained at our Centre is the administra­tion of a combination of Desmodium adscendens and either Thonningia or Deinbollia.

We undertook a "double blind" clini­cal trial during which 12 randomly selected patients were treated with place­bo herbs, that is, drugs having no therapeutic value, for three months and then for a second period of three months with combinations of Desmodium, Dein­bollia and Thonningia. The results were quite clear. All the patients continued to have asthmatic attacks during placebo treatment, but eight of them had no attacks during the herbal therapy . Some of the remaining four had decreased attacks, but the response to the com­bined herbs was judged less than satis­factory . From our point of view there is no question that Desmodium and the other herbal preparation produced a satisfactory response in 75 per cent of the patients . •