Greco-Arab and Islamic Herbal Medicine: Traditional System, Ethics, Safety, Efficacy, and Regulatory Issues PDF
Preview Greco-Arab and Islamic Herbal Medicine: Traditional System, Ethics, Safety, Efficacy, and Regulatory Issues
GRECO-ARAB AND ISLAMIC HERBAL MEDICINE GRECO-ARAB AND ISLAMIC HERBAL MEDICINE TRADITIONAL SYSTEM, ETHICS, SAFETY, EFFICACY, AND REGULATORY ISSUES By Bashar Saad, PhD Professor of Cell Biology andImmunology, Arab American University, Jenin, Palestine, andQasemiResearchCenter, Al-Qasemi Academic College,Israel Omar Said, PhD Pharmacologist, Senior researcher ofArabHerbal Medicine, Antaki Centerfor Herbal Medicine Ltd, Kufur Kannaand the Galilee Society R&D Center, Israel Copyright 2011byJohnWiley&Sons,Inc.Allrightsreserved PublishedbyJohnWiley&Sons,Inc.,Hoboken,NewJersey PublishedsimultaneouslyinCanada Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,ortransmittedinanyformorby anymeans,electronic,mechanical,photocopying,recording,scanning,orotherwise,exceptaspermitted underSection107or108ofthe1976UnitedStatesCopyrightAct,withouteitherthepriorwritten permissionofthePublisher,orauthorizationthroughpaymentoftheappropriateper-copyfeetothe CopyrightClearanceCenter,Inc.,222RosewoodDrive,Danvers,MA01923,(978)750-8400,fax(978) 750-4470,oronthewebatwww.copyright.com.RequeststothePublisherforpermissionshouldbe addressedtothePermissionsDepartment,JohnWiley&Sons,Inc.,111RiverStreet,Hoboken,NJ07030, (201)748-6011,fax(201)748-6008,oronlineathttp://www.wiley.com/go/permission. LimitofLiability/DisclaimerofWarranty:Whilethepublisherandauthorhaveusedtheirbesteffortsin preparingthisbook,theymakenorepresentationsorwarrantieswithrespecttotheaccuracyor completenessofthecontentsofthisbookandspecificallydisclaimanyimpliedwarrantiesof merchantabilityorfitnessforaparticularpurpose.Nowarrantymaybecreatedorextendedbysales representativesorwrittensalesmaterials.Theadviceandstrategiescontainedhereinmaynotbesuitablefor yoursituation.Youshouldconsultwithaprofessionalwhereappropriate.Neitherthepublishernorauthor shallbeliableforanylossofprofitoranyothercommercialdamages,includingbutnotlimitedtospecial, incidental,consequential,orotherdamages. Forgeneralinformationonourotherproductsandservicesorfortechnicalsupport,pleasecontactour CustomerCareDepartmentwithintheUnitedStatesat(800)762-2974,outsidetheUnitedStatesat(317) 572-3993orfax(317)572-4002. Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappearsinprint maynotbeavailableinelectronicformats.FormoreinformationaboutWileyproducts,visitour websiteatwww.wiley.com. LibraryofCongressCataloging-in-PublicationData: Saad,Bashar. Greco-ArabandIslamicherbalmedicine:traditionalsystem,ethics,safety, efficacy,andregulatoryissues/byBasharSaad,OmarSaid. p.;cm. Includesbibliographicalreferences. ISBN978-0-470-47421-1(cloth) 1. Medicine,Arab.2. Medicine,GreekandRoman.3. Herbs–Therapeutic use.4. Medicinalplants. I. Said,Omar.II. Title. [DNLM:1. Phytotherapy.2. DrugEvaluation.3. HerbalMedicine–history. 4. Medicine,Arabic.5. PlantPreparations–pharmacology.6. Plant Preparations–standards.WB925] R143.S232011 610–dc22 2010036842 PrintedinSingapore 10 9 8 7 6 5 4 3 2 1 CONTENTS Foreword vii Preface ix Acknowledgments xi 1. An Overview ofGreco-Arab and Islamic Herbal Medicine 1 2. History ofGreco-Arab and Islamic Medicine 17 3. HerbalMedicine 47 4. The Arab–IslamicRootsof Western Medicine 71 5. Contributions ofArab and Islamic Scholarsto Modern Pharmacology 87 6. Natural Drugsin Greco-Arabic and Islamic Medicine 101 7. Method of Therapy inGreco-Arab and Islamic Medicine 123 8. Commonly Used HerbalMedicinesin the Mediterranean 149 9. The Current State ofKnowledge ofArab Herbal Medicine 229 10. Greco-Arab and Islamic Medicine Practiced Outside the Middle East 253 11. Biosafety of Herbal Medicine 273 12. Arab MedicinalPlants:From TraditionalUsesto Scientific Knowledge 303 13. ModernIn Vitro Test Systems 339 14. ModernIn Vivo Evaluations and Clinical Trials 379 v vi CONTENTS 15. Medical Ethics inArab and Islamic Medicine 411 16. MedicinalHerbsand Extracting Their ActiveIngredients 425 17. Food Therapy 441 18. Drug Development from HerbalSources 477 19. Herbal Remedies: Use andDemographicand Regulatory Issues 499 Appendix A: Plant Naming 519 Index 523 FOREWORD TherewasahugeenlightenmentintheArabworldatatimewhenEuropewasinthe gripoftheDarkAges,stifledbyChurchauthority.Amajorpartofthisexplosionof intellectual freedom was the creation of an entirely new coherent medical system, basedonthemedicineoftheGreeks,theEgyptians,andevenofIndia,thatdeveloped into a rational, experimental, and thorough corpus with its theories and treatment protocols, pharmacies, hospitals, libraries, and thousands of new medicines and combinations used for the first time along with differential diagnosis. It became a foundationstoneofmodernmedicineandalsoofherbalmedicineintheWest.Andit stillexists.ArabicmedicinetodaystandsalongsideAyurvedicandChinesemedicine asoneofthegreattraditionalmedicalsystemsoftheworldandispopularlyusedinall MuslimcountriesfromPakistantoMorocco.However,itisrelativelyunknownand unappreciatedasasysteminitsownright,andtoday,atatimewhennaturalmedicine isaprimarysourceofnewtherapiesandremedies,thereisstillagreatdealtobelearnt from it. This book sets out to reveal the potential of Arabic medicine and especially medicinalplantsasalivingandvitalmedicalresourcetoday.Inthisitisquiteunique, especiallybecauseofitscoverageofresearchontheherbs,andmuchofitwascarried outintheauthors’ownlabs.AsfarasIamaware,nootherprofessional-levelbook coversthepharmacologyandscienceofsomanyimportantherbsthatarewidelyused inArabiccountriesbutarestillrelativelyunknownintheWest.Take,forexample, Nigella(blackseed).ItisacentralherbinArabicmedicineusedasapowerfulanti- inflammatoryandantiseptic.Theauthorshaveresearchedthisherbandtherearealso hundredsofpapers,includingclinicalstudies,publishedonitintheworldscientific literature,yettheherbisstillunknownandunusedintheWestexceptasaspice.This bookmightwellraiseitsprofileworldwide.Therehasbeenanassumptioninthepast that all the herbs of Arabic medicine are already known and used in modern professionalherbalismandthehealthindustry.Thisisnotso[1],andthisbookcan beveryhelpfulinintroducingahostofnovelplants,togetherwithresearchonthem. ProfessorBasharSaadandDr.OmarSaidhavewrittenwhatmaywellbecomea classictextonArabicmedicine,notonlybecauseofitspharmacologicalandscientific material,butalsobecauseofitsinterdisciplinarynature.Itisafascinatingexploration oftherichnessofthepastknowledge,combinedwithethnopharmacologyofArabic medicinetoday,safetyandpharmacologyofArabicmedicinalplants,botany,clinical aspects,Arabicmedicalprinciples,andsoon.Theauthorsareuniquelyqualifiedto write this book, because they themselves embody the interdisciplinary wisdom vii viii FOREWORD neededforit.Indeed,theywouldstandalongsidesomeofthegreatsofancientArabic medicine,whotranscendedboundariesofsubjectanddiscipline.ManytimesIhave walkedwiththeauthorsovertheGalileehillsandlistenedastheypickedoutasmall hiddenherb,identifiedit,describeditsLatin,Arabic,English,Hebrew,andancient names,describeditsusesandthedebatessurroundingitintheancientliterature,told mewhatisinitchemically,describedhowitperformsinthelabandhowitshouldbe formulated into a finished remedy, and told stories of, for example, of how the BedouinoftheNegevdesertortheDruzeofSyriamightuseittoday.Theauthorsare accomplishedscientistsinthefieldsofpharmacology,cellbiology,andimmunology and bring this unique and originalaspectof modernscience to the herbal wisdom. Besides, the authors are involved in the Galilee Society’s botanical garden of medicinalplants,thelargestgardendevotedtomedicinalplantsintheMiddleEast. Thousands of children go there every year and are taught about the traditional medicineoftheregion.Anditshouldalsobementionedthatworkingandresearching ontraditionalArabicmedicineinIsraelandPalestine,regionsofconflict,hasnotbeen easy. Today,itisacknowledgedthatmuchofmoderndrugdiscoverydependsonnatural productconcepts.Thefirststepsareusuallytheworkbyethnopharmacologistsinthe fieldandpharmacologistsinthelab.Thisbookbreaksnewgroundinopeningupa forgotten resource for both drug discovery andnew natural productmedicines. STEPHEN FULDER REFERENCE 1. FulderSJ,SaidO.StepstowardsrevivalofGraeco-ArabicmedicineintheMiddleEast:a newproject.HerbalGram2009;83:36–45. PREFACE Atthebeginningofthetwenty-firstcenturyanddespitethegreatprogressinmodern medicine, traditional Arab–Islamic medicine continues to be practiced within the MediterraneanaswellasmostArabandIslamiccountries.Averyimportantfactor that has enhanced the present popularity and widespread use of Arab herbal-based medicinesisthebeliefthattheyarepreparedaccordingtotheprinciplesofGreco- Arab and Islamic medicine, which was developed during the Golden Age of Arab–Islamiccivilization.Thiscivilizationspannedfromtheseventhtothefifteenth centuryandextendedfromSpaintoCentralAsiaandIndia.Itbecameawellspringof brilliantmedicaldevelopmentsandinnovations,aswellasofgreatachievementsin astronomy,mathematics,chemistry,philosophy,andarts.ArabandMuslimscientists significantly contributed to the development of modern Western medicine, accom- plishing far more than mere translation. A closer look at their activity during the medieval period shows that they translated classical medical texts not only from Greece,butalsofromPersia,India,andChina.Fromthis,ArabandMuslimscientists were able to synthesize and develop a rich and universal medical system based on scientific methods and experimentation. The works of Arab and Muslim scholars gainedwidespreaduseandwereusedinEuropeanmedicalschools.Forinstance,the ArabandMuslimphysiciansAlTabbari,Rhazes,Al-Zahrawi(Albucasis),Al-Biruni, Avicenna,Ibnal-Haitham,IbnalNafees,IbnKhaldun,andIbnZuhr(Avenzoar)are regardedasamongthegreatmedicalauthoritiesoftheancientworldandthemedieval world, physicians whose textbooks were used in European universities up to the sixteenthcentury.Theywereamongthefirsttomakeaccuratediagnosesofplague, diphtheria, diabetes, gout, cancer, leprosy, rabies, and epilepsy. Avicenna’s and Rhazes’s works on infectious diseases led to the introduction of quarantine as a means of limiting the spread of these diseases. Arab physicians laid down the principles of clinical investigation and drug trials, as well as animal tests. They masteredoperationsforherniaandcataracts,filledteethwithgoldleaf,andprescribed spectaclesfordefectiveeyesight.ThephysiciansandscientistsoftheIslamicGolden Age,whowereofdiversereligiousandethnicbackgrounds,passedonrulesofhealth, diet, and hygiene that are stilllargelyvalid. ThehighdegreeofdevelopmentachievedinGreco-ArabandIslamicmedicineis observable in a statement of Avicenna (980–1037), who defined medicine in his CanonofMedicineas“thesciencefromwhichwelearnthestatesofthehumanbody withrespecttowhatishealthyandwhatisnot;inordertopreservegoodhealthwhenit existsandrestoreitwhenitislacking.”Hefurtherstatedthat“wehavetounderstand ix x PREFACE thatthebestandmosteffectiveremedyforthetreatmentofpatientsshouldbethrough the improvement of the power of the human body in order to increase its immune system,whichisbasedonthebeautyofthesurroundingsandlettinghimlistentothe best music and allowing his best friends to be with him.” Another statement concerning therapeuticmethods was madeby Rhazes (846–930): “if the physician isabletotreatwithfoodstuffs,notmedication,thenhehassucceeded.If,however,he mustusemedications,thenitshouldbesimpleremediesandnotcompoundones.” Arab–IslamicmedicineinfluencedWesternmedicalcirclestosuchanextentthatit wasincludedinthecurriculumofEuropeanmedicalschoolsformanycenturies.It became afoundation stoneofmodernmedicine andalso ofherbal medicine inthe West. And it still exists. Arab-Islamic medicine today stands as one of the great traditionalmedicalsystemsoftheworldandispopularlyusedinallArabandIslamic countries from Pakistanto Morocco. TheEasternregionoftheMediterraneaniscoveredwithatleast3600plantspecies of which 700–800 are noted in medieval medical books for their use as medicinal herbs.Recentethnopharmacologicalstudieshavedemonstratedthatmorethan450 medicinalplantshavecontinuedtobeemployedinthetreatmentandpreventionof humandiseaseswithintheMediterraneanaswellasmostIslamiccountries.Someof theseplantspecieshavebeeninvestigatedandtheirbioactiveingredientsextractedto treat various human diseases. This book is the first academic book in the field of Arab herbal medicine that exploresandintroduces aspectsofArabherbal medicine using original ethnophar- macologicalsurveysconducted byourgroup intheMediterranean area.Thisbook includes 19 chapters, embracing particularly historical aspects and present uses of traditional Arab–Islamic herbal medicine. Chapters 1–5 focus on historical back- ground,medicalinnovationsintroducedbyArabphysicians,commonrootsofArab medicineandWesternmedicine,andmethodologyofdrugdiscoveryandtherapyin ArabicandIslamicmedicine.Chapters6–10presentacomprehensivereviewofthe methodology of drug discovery, method of therapy, and commonly used herbal medicinesintheArab–Islamicworldandtheirtremendouspotentialinmoderndrug discovery.Chapters11–14combineoverviewsofstate-of-the-artinvitroandinvivo techniques,aswellasclinicaltrialsoftraditionalherbalmedicine.Chapters15and16 covermedicalethicsinArabicandIslamicmedicine,usesofmedicinalplants,and methodsofextractingtheiractiveingredients.Chapter17examinestheuseoffood therapy in Arab–Islamic medicine. Chapters 18 and 19 focus on demographic and regulatory issues, aswell as ondrug development fromherbalsources. Forconvenience,alldatesgiveninbookarethoseoftheChristiancalendar,unless otherwise specified. The designation AD is used only when there is a need to distinguish a date from an earlier BC date. General references to a century rather than toa specificyear refer tocenturies ofthe Christian era. ACKNOWLEDGMENTS Inthecourseofwritingthisbook,wehaveaccumulatedmanydebtsofgratitude.First andforemost,wethankthosewhoreadtheentiremanuscriptwithgreatcareandmade numerous suggestions, namely, Bahaa Hadia, Jonathan Langer, Anne Gough, Dr. LuciaRackova,ArishaAshraf,HishamShaheen,HishamSaad,ImanSaid,Dr.Hilal Zaid, Dr. Cailin Mackenzie, Assad Dahamshi, Alaa Abo Much, and Basheer Abo Farekh.Wewerefortunateinbeingabletoincludeinthisbookanumberofattractive paintingsofArabandMuslimscholars,andwethankJamellAnbtawiforpermitting their reproductioninthis book. xi
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