Implementation of telepharmacy in the United States began in the 2000s. A combination of factors, including  changes in Medicare reimbursement for medications [ 10 ]  and the  recession of 2007–8 , led to a decline in the number of independent pharmacies in rural areas. [ 11 ]  In response to the need for alternative means of delivering pharmacy in services in rural communities lacking a full-time pharmacist, several  midwestern  and  northwestern  states with extensive rural areas have led much of the development of policy and implementation methods for telepharmacy.


In 2001, North Dakota became the first U.S. state to pass regulations allowing retail pharmacies to operate without requiring a pharmacist to be physically present. The next year, state agencies and grants established the North Dakota Telepharmacy Project, which now supports more than fifty remote retail and hospital pharmacy sites throughout North Dakota. [ 12 ]  In this program, a licensed pharmacist at a central site communicates with remote site  pharmacy technicians  and patients through  videoconferencing . A 2004 study of the program found that telepharmacy delivered the same quality of pharmacy services as traditional facilities, [ 13 ]  and a study of the operation of one North Dakota telepharmacy business from 2002 through 2004 found that, while medication inventory turnover was lower than the industry average, the remote sites were able to be operated profitably. [ 14 ]  The success and expansion of this program were an inspiration and model for programs and laws in other states. [ 15 ]


The Community Health Association of Spokane, a network of  community health centers  in  Spokane, Washington , started a telepharmacy program in 2001. The program delivers remote medication dispensing and health counseling to patients at six urban and rural clinics; remote site personnel are connected to pharmacists at the base site by  videoconferencing . A survey found that most patients at the remote sites strongly agreed or agreed that they would have had difficulty affording their medications without this program. [ 16 ]


The  Alaska Native Medical Center , a hospital in  Anchorage ,  Alaska , providing telehealth services to  Alaska Native  populations, established a telepharmacy program in 2003 to improve its pharmaceutical services in rural native settlements. The  American Society of Health-System Pharmacists  gave the program its 2006 Award for Excellence in Medication-Use Safety, concluding that the use of telepharmacy had improved access to pharmaceutical care and enabled pharmacists to monitor medication safety and encourage medication adherence, as well as making pharmacy care more cost-effective. [ 17 ]


The  U.S. Navy  Bureau of Medicine operates a large-scale telepharmacy program for the use of service personnel. After piloting the program in 2006 at  Naval Hospital Pensacola  in Florida and Naval Hospital Bremerton in Washington, in 2010 the Navy expanded it to more sites throughout the world. This program represents the largest implementation of telepharmacy to date. [ 18 ]


California  passed a Telehealth Advancement Act in 2011 to update the state's legal definitions of telehealth, simplify approval processes for telehealth services, and broaden the range of medical services that may be provided via telehealth. The law establishes legal parity between the direct and remote delivery of pharmacy care. [ 19 ]   Iowa 's first telepharmacy opened in September 2012 after receiving a three-year waiver from the Iowa Board of Pharmacy that allows the facility to operate without a pharmacist on-site. [ 20 ]


A 2010 study of the various American states'  rural health  offices found that telepharmacy in rural medical facilities varied in prevalence across the United States but was still not widespread, and that many states had not yet clearly defined regulations for telepharmacy in hospitals. [ 21 ]  Adoption and implementation of telepharmacy methods has been slow compared to the spread of the basic technologies involved ( internet access ,  audio/video compression  algorithms,  microphones  and  video cameras ), despite periodic predictions of a forthcoming boom in the industry. Aside from more intangible factors (such as physicians' and pharmacists' personal uneasiness with the lack of physical interaction with patients), the major obstacles to telepharmacy implementation appear to have been the lack of clear legal regulations for telepharmacy, and the lack of network and software systems to manage (and secure) all of the data used in a professional pharmacy. [ 22 ]  As of 2010, many of the telepharmacy facilities in active operation were operating as pilot programs or under temporary waivers issued by state regulators because many states still had no clear legal framework for the regulation of remote pharmaceutical sites without pharmacists. Even in states that had regulated retail telepharmacy practices, regulations were often not in place to permit the implementation of telepharmacy in hospital settings. [ 21 ] [ 23 ]  For some pharmacy facilities that might otherwise consider telepharmacy, the cost and complexity of the infrastructure needed to manage patient data across multiple sites can be prohibitive. In addition to the computer hardware required for patient data storage, distribution and teleconferencing, telepharmacy programs must deploy network security tools and procedures adequate to  protect patient medical information  in compliance with  HIPAA  and other patient privacy regulations. In 2010 the North Dakota Telepharmacy Project estimated that the computer hardware needed for a typical retail installation costs US$17,300 per site, with an additional cost of US$5,000 to buy a mobile cart for a hospital installation. [ 24 ]


Adoption of telepharmacy in  Canada  began as a response to a nationwide shortage of pharmacists. Canada's first telepharmacy service was started by a hospital in  Cranbrook, British Columbia , in June 2003 in order to assist a hospital in a nearby town that was unable to hire a pharmacist. To meet the need for service, a hospital pharmacist in Cranbrook began using telepharmacy technology to oversee pharmacy technicians at the other hospital. A similar service was subsequently extended to other small hospitals in the province; it is also used to provide coverage when a hospital's sole pharmacist is absent due to illness or vacation. [ 25 ]   Remote dispensing  machines for medication began operation in  Ontario , Canada, in 2007. After a patient inserts a prescription into the dispensing machine, the prescription is scanned and the patient is connected by telephone videoconference to a pharmacist at a remote site. The pharmacist reviews the prescription, discusses the patient's medication history, and authorizes the machine to dispense medication to the patient. The machines proved successful, with one assessment revealing that 96% of patients using them had their prescription filled in under five minutes. [ 26 ]  As of 2009, a hospital in  Ontario , Canada, was using telepharmacy services in addition to retaining a pharmacist at the hospital; the telepharmacist reviews medication orders, while the on-site pharmacist works with patients and oversees medication safety in the facility. Thus telepharmacy support allows the on-site pharmacist to focus on the more sensitive and nuanced tasks for which physical presence is most helpful. [ 27 ]


After their success in Canada, remote medication dispensing machines were scheduled to be tested at several hospital locations in the  United Kingdom  beginning in 2010. [ 26 ]  In 2013, Maxor National Pharmacy Services, a U.S. company, reported that its remote dispensing machines for medication were being used in  Bahrain ,  Belgium ,  Cuba ,  England ,  Germany ,  Guam ,  Italy ,  Japan ,  Spain  and  Venezuela . [ 28 ]


In 2010,  Mannings  drugstores became the first in  Hong Kong  to use videoconferencing to allow patients at outlets without full-time pharmacists to consult with pharmacists at other sites. [ 29 ]  In Malaysia, a health startup called Esyms provides a telepharmacy service that has a live chat and video feature which allows you to speak to a licensed pharmacist. [ 30 ]


Nostradamus 's  Traité des fardemens et confitures , variously entitled  Moult utile opuscule...  and  Le vrai et parfaict embellissement de la face... , was first published in 1555, even though it contained a  Proem , or prologue, dated 1552. Clearly the work of an  apothecary , it contained recipes for preparing  cosmetics  and  preserves , the latter based largely on  sugar , which was controlled at the time by the apothecaries' guilds. [ 1 ]


Among the topics covered (which include removing spots from the face  with mercury ) were:


A. THE COSMETICS MANUAL


B. THE COOKBOOK


The book was translated into  German  in 1574, then the German was revised in 1994, and finally the  German  was translated into  English  under the title  The Elixirs of Nostradamus  (Moyer Bell, 1996). Needless to say, the fourth-hand results of this process were unreliable, if not downright dangerous: the term  roses rouges incarnées , for example, was routinely translated as 'black orchids', and  urines  (urine) came out as 'drinking wells'.


USP 800  ( Hazardous Drugs—Handling in Healthcare Settings ) is a guideline created by the  United States Pharmacopeia  Convention (USP), as one of their General Chapters through which the USP "sets quality standards for medicines, dietary supplements and food ingredients". USP 800 provides guidance about the handling of  hazardous drugs  (HDs) in the healthcare setting. It was published on February 1, 2016, and originally planned for implementation in December 2019; however, implementation has been delayed. [ 1 ]


USP 800 describes practice and quality standards for the handling of HDs involving but not limited to the receipt, storage,  compounding , dispensing, administration, and disposal of sterile and non-sterile products. This chapter applies to any personnel who may be exposed to HDs. Personnel likely to be exposed may include  pharmacists , pharmacy technicians,  nurses ,  physician assistants , home healthcare workers,  veterinarians , and  veterinary technicians . [ 2 ]


Facilities that handle HDs must follow the standards outlined in USP 800. At minimum the facilities's management system must include:


The National Institute for Occupational Safety and Health ( NIOSH ) maintains a list of  antineoplastic  and HDs that are used in healthcare settings. The site must maintain a list of any drugs they use that are on the NIOSH list and it must be updated every 12 months. If the facility begins using a new medication on the NIOSH list it must be added to their HD list.


Each facility must have a designated person who develops, implements, and maintains USP 800 compliance. This person is also responsible for overseeing the training of personnel and reporting hazardous situations to the management team. All personnel who handle HDs must be trained on the fundamental practices and precautions to contain HDs. [ 4 ]


HDs must be handled in ways to limit contamination. HD storage areas must be separated from break rooms and refreshment areas.
Designated areas must be available for:


Antineoplastic HDs and all HD active pharmaceutical ingredients (APIs) must be unpacked in an area that is neutral/normal or negative pressure. [ 6 ]


HDs must be stored properly to prevent spillage or breakage. HDs should not be stored on the floor or areas prone to natural disaster such as earthquakes.
Antineoplastic HDs that require further manipulation other than repackaging or counting must be stored separately from non-HDs. Sterile and non-sterile HDs must not be stored together. Refrigerated HDs must be stored in a dedicated refrigerator located in a negative pressure area.


The  World Pharmacy Council  (WPC) is an international non-profit organization dedicated to representing and advancing the role of community pharmacies in global healthcare systems.  Established in 2017, building upon the foundation of Pharmintercom (founded in 1987), the WPC aims to provide a unified voice for community pharmacists, advocating for their critical role in patient care and public health.


The origins of the World Pharmacy Council date back to 1987 with the formation of Pharmintercom. [ 1 ]  This group consisted of community pharmacy organizations from seven countries that met annually to share information, discuss best practices, and address challenges facing community pharmacy. Recognizing the need for a more formal and influential global body, Pharmintercom members agreed to establish the World Pharmacy Council (WPC) in 2016, officially launching in 2017.  Since its inception, the WPC has expanded its membership to include numerous national community pharmacy organizations across Europe, North America, Asia and Australasia. [ 2 ]


The WPC's primary purpose is to advocate for the recognition and integration of community pharmacists' skills and services within healthcare systems worldwide. The organization strives to highlight the vital role community pharmacies play in providing accessible healthcare, managing medication therapies, delivering public health services, and contributing to positive patient outcomes. The WPC works to influence health policy at both national and international levels, promoting the full scope of practice for community pharmacists and their inclusion in integrated care models. [ 3 ]


The World Pharmacy Council operates as a not-for-profit public company registered in Australia, with its registered office located in Melbourne, Victoria. It is regulated by the Australian Securities & Investments Commission (ASIC). [ 4 ]  The WPC is governed by a Board of Directors composed of representatives from its member organizations.


Since 2021 the WPC's President has been Douglas Hoey, pharmacist and CEO of the USA's National Community Pharmacists Association. [ 5 ]


The WPC engages in various activities to achieve its objectives, including:


The WPC comprises full and affiliate members.  Full members are national pharmacy organizations representing community pharmacists in their respective countries. Affiliate members are companies and other organizations with an interest in the field of community pharmacy.  As of November 2024, the full members include [ 8 ] :


Chamaelirium  is a genus of flowering plants containing the single species  Chamaelirium luteum , commonly known as  blazing-star , [ 2 ]   devil's bit , [ 2 ]   false unicorn , [ 2 ]   fairy wand , [ 2 ]  and  helonias . [ 2 ]  It is a  perennial  herb native to the eastern United States. It can be found in a variety of habitats, including wet  meadows  and  deciduous  woodlands.


Chamaelirium luteum  has a basal rosette of around six 8–15 cm leaves, from which a single spike-like raceme  inflorescence  (1–1.5 cm diameter, 8–30 cm length) emerges. The plants are generally  dioecious , with male-biased gender ratios in a given population. This is due to higher mortality of female plants, and the tendency of female plants to flower less frequently. Female stalks tend to be taller, giving a total maximum plant height of about 1.2 m, but also tend to have about ten times fewer  flowers . [ 3 ]


Chamaelirium luteum  is the only member of its  monotypic  genus, and is quite rare at the fringes of its range. [ 4 ]


Chamaelirium luteum  can be found in temperate  North America , United States and Canada. It occurs in the east of the  Mississippi  and it is historically known from southern  Ontario . [ 4 ]


The  etymology  of  Chamaelirium luteum  comes from the Greek and means: chamai = "on the ground" and leirion = "lilly", and the Latin luteus = "yellow". [ 5 ]


Because  Chamaelirium luteum  is normally collected wild, it is at risk of extinction. Cultivation techniques are still under development to satisfy the demand from the market. [ 6 ]


Chamaelirium luteum  prefers moist, well  drained  and  acidic soil  ( pH : 4.5 – 6) with a high  humus  content. In open fields it should be shaded by a shading structure, to protect it from the direct radiation of the sun. For forest cultivation it should be preferably planted in an area with tall hardwood trees. [ 6 ]


Chamaelirium luteum  can be propagated through seeds or root division.


For propagation through root division the  rhizomes  can be divided by cutting them into pieces of  1 ⁄ 4  inch (6.4 mm). This disc-shaped pieces should be left to  callus  over night and can be planted in pots on the next day. The soil should be kept moist and shaded until the plants emerge. Young plants can be transplanted in a well prepared growing bed with a high organic matter in a planting distance of 6–10 inches (15–25 centimetres). To support the plants with nutrients, pine needles, rotted conifer-derived  sawdust  or bark mulch should be added to the top soil. [ 6 ] [ 7 ]


For propagation through seeds, the seeds should be sown in late Fall or early Winter to a depth of  1 ⁄ 8  inch (3.2 mm) in breeding beds with high humus content. For a good germination the seed should go through  stratification . [ 8 ]  The plants grow best in soil mixture of  peat moss  and decomposed  pine  needles. When the young plants emerge they should be left in undisturbed at least for one growing season. Then they can be transplanted as for the propagation method through root division. [ 6 ]


The plant should be moist and shaded and protected from herbivory by  snails  and  slugs  or  deer  in woods. Weeds should always be removed. [ 7 ]


Chamaelirium luteum  is used as ornamental or medical herb. Historically it has been used widely by  Indigenous peoples . [ 9 ]


It was traditionally used to prevent miscarriages and it has the reputation of improving fertility. [ 9 ]
Today it is used to treat  menstrual  problems,  pregnancy  complaints,  fertility issues ,  ovarian cysts
and  diuretic [ 7 ]


The  rhizomes  can be harvested after six years and is done in Fall after collecting the mature seeds.
After removing the soil and the roots from other plants, the rhizome should be stored unwashed until further processing. It should be prevented from drying out and also from too high moisture, which could lead to mold  infestation . Before processing, the rhizome should be washed carefully. [ 7 ]


The bioactive components are a mixture of steroidal  saponins , including chamaelirin and  aglycone   diosgenin . These bioactive substances act as an  emmenagogue ,  diuretic  and  emetic . [ 7 ]


Chinese herbology  ( traditional Chinese :  中藥學 ;  simplified Chinese :  中药学 ;  pinyin :  zhōngyào xué ) is the theory of traditional Chinese herbal therapy, which accounts for the majority of treatments in  traditional Chinese medicine  (TCM). A  Nature  editorial described TCM as "fraught with  pseudoscience ", and said that the most obvious reason why it has not delivered many cures is that the majority of its treatments have no logical  mechanism of action . [ 1 ]


The term  herbology  is misleading in the sense that, while plant elements are by far the most commonly used substances, animal, human, and mineral products are also used, some of which are poisonous. In the  Huangdi Neijing  they are referred to as  毒藥  (pinyin:  dúyào ) which means toxin, poison, or medicine.  Paul U. Unschuld  points out that this is similar etymology to the Greek  pharmakon  and so he uses the term  pharmaceutic . [ 2 ]  Thus, the term  medicinal  (instead of  herb ) is usually preferred as a translation for  藥  (pinyin:  yào ). [ 3 ]


Research into the effectiveness of traditional Chinese herbal therapy is of poor quality and often tainted by bias, [ 4 ]  with little or no rigorous evidence of efficacy. [ 5 ]  There are concerns over a number of potentially toxic Chinese herbs. [ 6 ]


Chinese herbs have been used for centuries. Among the earliest literature are lists of prescriptions for specific ailments, exemplified by the manuscript  Recipes for 52 Ailments , found in the  Mawangdui  which were sealed in 168   BCE.


The first traditionally recognized herbalist is  Shénnóng  ( 神農 ,  lit.   ' Divine Farmer ' ), a mythical god-like figure, who is said to have lived around 2800   BCE. [ 7 ]  He allegedly tasted hundreds of herbs and imparted his knowledge of medicinal and poisonous plants to farmers. His  Shénnóng Běn Cǎo Jīng  ( 神農本草經 ,  Shennong's  Materia Medica ) is considered as the oldest book on Chinese herbal medicine. It classifies 365 species of roots, grass, woods, furs, animals and stones into three categories of herbal medicine: [ 8 ]


The original text of Shennong's  Materia Medica  has been lost; however, there are extant translations. [ 9 ]  The true date of origin is believed to fall into the late Western Han dynasty [ 7 ]  (i.e., the first century BCE).


The  Treatise on Cold Damage Disorders and Miscellaneous Illnesses  was collated by  Zhang Zhongjing , also sometime at the end of the  Han dynasty , between 196 and 220 CE. Focusing on drug prescriptions, [ 10 ]  it was the first medical work to combine  Yinyang  and the  Five Phases  with drug therapy. [ 11 ]  This  formulary  was also the earliest Chinese medical text to group symptoms into clinically useful "patterns" ( zheng ,  證 ) that could serve as targets for therapy. Having gone through numerous changes over time, it now circulates as two distinct books: the  Treatise on Cold Damage Disorders  and the  Essential Prescriptions of the Golden Casket , which were edited separately in the eleventh century, under the  Song dynasty . [ 12 ]


Succeeding generations augmented these works, as in the  Yaoxing Lun  ( 藥性論 ;  药性论 ; 'Treatise on the Nature of Medicinal Herbs'), a 7th-century  Tang dynasty  Chinese treatise on herbal medicine.


There was a shift in emphasis in treatment over several centuries. A section of the  Huangdi Neijing  Suwen including Chapter 74 was added by Wang Bing in his 765 edition. In which it says:  主病之謂君，佐君之謂臣，應臣之謂使，非上下三品之謂也。  "Ruler of disease it called Sovereign, aid to Sovereign it called Minister, comply with Minister it called Envoy (Assistant), not upper lower three classes (qualities) it called."  The last part is interpreted as stating that these three rulers are not the three classes of Shénnóng mentioned previously. This chapter in particular outlines a more forceful approach. Later on Zhang Zihe ( a.k.a.  Zhang Cong-zhen, 1156–1228) is credited with founding the 'Attacking School' which criticized the overuse of tonics.


Arguably the most important of these later works is the  Compendium of Materia Medica  ( Bencao Gangmu ,  本草綱目 ) compiled during the  Ming dynasty  by  Li Shizhen , which is still used today for consultation and reference.


The use of Chinese herbs was popular during the  medieval age  in western Asian and Islamic countries. They were traded through the Silk Road from the East to the West.  Cinnamon ,  ginger ,  rhubarb ,  nutmeg  and  cubeb  are mentioned as Chinese herbs by medieval Islamic medical scholars Such as  Rhazes  (854–925 CE),  Haly Abbas  (930–994 CE) and  Avicenna  (980–1037 CE). There were also multiple similarities between the clinical uses of these herbs in Chinese and Islamic medicine. [ 13 ]


There are roughly 13,000 medicinals used in China and over 100,000 medicinal recipes recorded in the ancient literature. [ 14 ]  Plant elements and extracts are by far the most common elements used. [ 15 ]  In the classic  Handbook of Traditional Drugs  from 1941, 517 drugs were listed – out of these, only 45 were animal parts, and 30 were minerals. [ 15 ]  For many plants used as medicinals, detailed instructions have been handed down not only regarding the locations and areas where they grow best, but also regarding the best timing of planting and harvesting them. [ 16 ]


Some animal parts used as medicinals can be considered rather strange such as cows' gallstones. [ 17 ]


Furthermore, the classic  materia medica   Bencao Gangmu  describes the use of 35  traditional Chinese medicines derived from the human body , including bones, fingernail, hairs, dandruff, earwax, impurities on the teeth, feces, urine, sweat, and organs, but most are no longer in use. [ 18 ] [ 19 ] [ 20 ]


Typically, one batch of medicinals is prepared as a  decoction  of about 9 to 18 substances. [ 21 ]  Some of these are considered as main herbs, some as ancillary herbs; within the ancillary herbs, up to three categories can be distinguished. [ 22 ]  Some ingredients are added to cancel out toxicity or side-effects of the main ingredients; on top of that, some medicinals require the use of other substances as  catalysts .


Chinese patent medicine ( 中成藥 ;  中成药 ;  zhōngchéng yào ) is a kind of  traditional Chinese medicine . They are standardized  herbal  formulas. From ancient times, pills were formed by combining several herbs and other ingredients, which were dried and ground into a powder. They were then mixed with a binder and formed into pills by hand. The  binder  was traditionally honey. Modern teapills, however, are extracted in stainless steel extractors to create either a water decoction or water-alcohol decoction, depending on the herbs used. They are extracted at a low temperature (below 100 °C (212 °F)) to preserve essential ingredients. The extracted liquid is then further condensed, and some raw herb powder from one of the herbal ingredients is mixed in to form a herbal dough. This dough is then machine cut into tiny pieces, a small amount of excipients are added for a smooth and consistent exterior, and they are spun into pills. [ citation needed ]


These medicines are not patented in the traditional sense of the word. No one has  exclusive rights  to the formula. Instead, "patent" refers to the  standardization  of the formula. In China, all Chinese patent medicines of the same name will have the same proportions of ingredients, and manufactured in accordance with the PRC Pharmacopoeia, which is mandated by law. However, in western countries there may be variations in the proportions of ingredients in patent medicines of the same name, and even different ingredients altogether. [ citation needed ]


Several producers of Chinese herbal medicines are pursuing FDA clinical trials to market their products as drugs in U.S. and European markets. [ 23 ]


Chinese herbal extracts are herbal decoctions that have been condensed into a granular or powdered form. Herbal extracts, similar to patent medicines, are easier and more convenient for patients to take. The industry extraction standard is 5:1, meaning for every five pounds of raw materials, one pound of herbal extract is derived. [ 24 ] [ better source needed ]


There are several different methods to classify traditional Chinese medicinals:


The Four Natures are: hot ( 熱 ;  热 ), warm ( 溫 ;  温 ), cool ( 涼 ), cold ( 寒 ) or neutral ( 平 ). [ 25 ]  Hot and warm herbs are used to treat  cold  diseases, while cool and cold herbs are used to treat hot diseases. [ 25 ]


The Five Flavors, sometimes also translated as  Five Tastes , are: acrid/pungent ( 辛 ), sweet ( 甘 ), bitter ( 苦 ), sour ( 酸 ), and salty ( 鹹 ;  咸 ). [ 25 ]  Substances may also have more than one flavor, or none (i.e., a bland ( 淡 ) flavor). [ 25 ]  Each of the Five Flavors corresponds to one of the  zàng organs , which in turn corresponds to one of the  Five Phases : [ 26 ]  A flavor implies certain properties and presumed therapeutic "actions" of a substance: saltiness "drains downward and softens hard masses"; [ 25 ]  sweetness is "supplementing, harmonizing, and moistening"; [ 25 ]  pungent substances are thought to induce sweat and act on  qi  and  blood ; sourness tends to be astringent ( 澀 ;  涩 ) in nature; bitterness "drains  heat , purges the bowels, and eliminates dampness".


These categories mainly include:


Many herbs earn their names from their unique physical appearance. Examples of such names include  Niu Xi  ( Radix cyathulae seu achyranthis ), 'cow's knees,' which has big joints that might look like cow knees;  Bai Mu Er  ( Fructificatio tremellae fuciformis ), 'white wood ear', which is white and resembles an ear;  Gou Ji  ( Rhizoma cibotii ), 'dog spine,' which resembles the spine of a dog. [ 30 ]


Color is not only a valuable means of identifying herbs, but in many cases also provides information about the therapeutic attributes of the herb. For example, yellow herbs are referred to as  huang  (yellow) or  jin  (gold).  Huang Bai  ( Cortex Phellodendri ) means 'yellow fir," and  Jin Yin Hua  ( Flos Lonicerae ) has the label 'golden silver flower." [ 30 ]


Unique flavors define specific names for some substances.  Gan  means 'sweet,' so  Gan Cao  ( Radix glycyrrhizae ) is 'sweet herb,' an adequate description for the licorice root.  Ku  means 'bitter', thus  Ku Shen  ( Sophorae flavescentis ) translates as 'bitter herb.' [ 30 ]


The locations or provinces in which herbs are grown often figure into herb names. For example,  Bei Sha Shen  ( Radix glehniae ) is grown and harvested in northern China, whereas  Nan Sha Shen  ( Radix adenophorae ) originated in southern China. And the Chinese words for north and south are respectively  bei  and  nan . [ 30 ]


Chuan Bei Mu  ( Bulbus fritillariae cirrhosae ) and  Chuan Niu Xi  ( Radix cyathulae ) are both found in Sichuan province, as the character  chuan  indicates in their names. [ 30 ]


Some herbs, like  Fang Feng  ( Radix Saposhnikoviae ), literally 'prevent wind,' preventing or treating wind-related illnesses.  Xu Duan  ( Radix Dipsaci ), literally 'restore the broken,' treating torn soft tissues and broken bones. [ 30 ]


Many herbs indigenous to other countries have been incorporated into the Chinese materia medica.  Xi Yang Shen  ( Radix panacis quinquefolii ), imported from North American crops, translates as 'western ginseng,' while  Dong Yang Shen  ( Radix ginseng Japonica ), grown in and imported from North Asian countries, is 'eastern ginseng.' [ 30 ]


From the earliest records regarding the use of medicinals to today, the toxicity of certain substances has been described in all Chinese materia medica. [ 31 ]  Since TCM has become more popular in the Western world, there are increasing concerns about the potential toxicity of many traditional Chinese medicinals including plants, animal parts and minerals. [ 6 ]  For most medicinals, efficacy and toxicity testing are based on traditional knowledge rather than laboratory analysis. [ 6 ]  The toxicity in some cases could be confirmed by modern research (i.e., in  scorpion ); in some cases it could not (i.e., in  Curculigo ). [ 32 ]  Further, ingredients may have different names in different locales or in historical texts, and different preparations may have similar names for the same reason, which can create inconsistencies and confusion in the creation of medicinals, [ 33 ]  with the possible danger of poisoning. [ 34 ] [ 35 ] [ 36 ] [ unreliable source? ]   Edzard Ernst  "concluded that adverse effects of herbal medicines are an important albeit neglected subject in dermatology, which deserves further systematic investigation." [ 37 ]  Research suggests that the toxic heavy metals and undeclared drugs found in Chinese herbal medicines might be a serious health issue. [ 38 ]


Substances known to be potentially dangerous include  aconite , [ 32 ]  secretions from the  Asiatic toad , [ 39 ]  powdered centipede, [ 40 ]  the Chinese beetle ( Mylabris phalerata , Ban mao), [ 41 ]  and certain fungi. [ 42 ]  There are health problems associated with  Aristolochia . [ 6 ]  Toxic effects are also frequent with  Aconitum . [ 6 ]  To avoid its toxic adverse effects  Xanthium sibiricum  must be processed. [ 6 ]   Hepatotoxicity  has been reported with products containing  Reynoutria multiflora  ( synonym   Polygonum multiflorum ),  glycyrrhizin ,  Senecio  and  Symphytum . [ 6 ]  The evidence suggests that hepatotoxic herbs also include  Dictamnus dasycarpus ,  Astragalus membranaceus , and  Paeonia lactiflora ; although there is no evidence that they cause liver damage. [ 6 ] [ clarification needed ]  Contrary to popular belief,  Ganoderma lucidum  mushroom extract, as an adjuvant for cancer immunotherapy, appears to have the potential for toxicity. [ 43 ]


Also, adulteration of some herbal medicine preparations with conventional drugs which may cause serious adverse effects, such as  corticosteroids ,  phenylbutazone ,  phenytoin , and  glibenclamide , has been reported. [ 44 ] [ 45 ]


However, many adverse reactions are due to misuse or abuse of Chinese medicine. [ 6 ]  For example, the misuse of the dietary supplement  Ephedra  (containing  ephedrine ) can lead to adverse events including gastrointestinal problems as well as sudden death from  cardiomyopathy . [ 6 ]  Products adulterated with  pharmaceuticals  for weight loss or erectile dysfunction are one of the main concerns. [ 6 ]  Chinese herbal medicine has been a major cause of  acute liver failure  in China. [ 46 ]


Most Chinese herbs are safe but some have shown not to be. Reports have shown products being contaminated with drugs, toxins, or false reporting of ingredients. Some herbs used in TCM may also react with drugs, have side effects, or be dangerous to people with certain medical conditions. [ 47 ]


Only a few trials exist that are considered to have adequate methodology by scientific standards. Proof of effectiveness is poorly documented or absent. [ 4 ]  A 2016  Cochrane review  found "insufficient evidence that Chinese Herbal Medicines were any more or less effective than placebo or hormonal therapy" for the relief of menopause related symptoms. [ 48 ]  A 2012 Cochrane review found no difference in decreased  mortality  for  SARS  patients when Chinese herbs were used alongside Western medicine versus Western medicine exclusively. [ 49 ]  A 2010 Cochrane review found there is not enough robust evidence to support the effectiveness of traditional Chinese medicine herbs to stop the bleeding from  haemorrhoids . [ 50 ]  A 2008 Cochrane review found promising evidence for the use of Chinese herbal medicine in relieving  painful menstruation , compared to conventional medicine such as  NSAIDs  and the oral contraceptive pill, but the findings are of low methodological quality. [ 51 ]  A 2012 Cochrane review found weak evidence suggesting that some Chinese medicinal herbs have a similar effect at preventing and treating  influenza  as  antiviral  medication. [ 52 ]  Due to the poor quality of these medical studies, there is insufficient evidence to support or dismiss the use of Chinese medicinal herbs for the treatment of influenza. [ 52 ]  There is a need for larger and higher quality randomized clinical trials to determine how effective Chinese herbal medicine is for treating people with influenza. [ 52 ]  A 2005 Cochrane review found that although the evidence was weak for the use of any single herb, there was low quality evidence that some Chinese medicinal herbs may be effective for the treatment of acute  pancreatitis . [ 53 ]


The traditional practice of using now- endangered species  is controversial within TCM. Modern Materia Medicas such as Bensky, Clavey and Stoger's comprehensive Chinese herbal text discuss substances derived from endangered species in an appendix, emphasizing alternatives. [ 54 ]


Parts of endangered species used as TCM drugs include tiger bones [ 55 ]  and  rhinoceros horn . [ 56 ]  Poachers supply the  black market  with such substances, [ 57 ] [ 58 ]  and the black market in rhinoceros horn, for example, has reduced the world's rhino population by more than 90 percent over the past 40 years. [ 59 ]  Concerns have also arisen over the use of turtle  plastron [ 60 ]  and  seahorses . [ 61 ]


TCM recognizes  bear bile  as a medicinal. In 1988, the Chinese Ministry of Health started controlling bile production, which previously used bears killed before winter. Now bears are fitted with a sort of permanent  catheter , which is more profitable than killing the bears. [ 62 ] [ verification needed ]  More than 12,000  asiatic black bears  are held in "bear farms", where they suffer cruel conditions while being held in tiny cages. The catheter leads through a permanent hole in the abdomen directly to the  gall bladder , which can cause severe pain.
Increased international attention has mostly stopped the use of bile outside of China; gallbladders from butchered cattle ( 牛胆 ;  牛膽 ;  niú dǎn ) are recommended as a substitute for this ingredient. [ citation needed ]


Collecting  American ginseng  to assist the Asian traditional medicine trade has made ginseng the most harvested wild plant in North America for the last two centuries, which eventually led to a listing on  CITES Appendix II . [ 63 ]


Chinese medicinal plant materials (CMPMs) release chemicals that attracts the  Drugstore beetle , leading to the accumulation of this pest and further infestation and damage to these plants. [ 64 ]


Chinese herbology is a pseudoscientific practice with potentially unreliable product quality, safety hazards or misleading health advice. [ 65 ] [ 66 ] [ 67 ]  There are regulatory bodies, such as China GMP (Good Manufacturing Process) of herbal products. [ 68 ]  However, there have been notable cases of an absence of  quality control  during herbal product preparation. [ 69 ]  There is a lack of high-quality scientific research on herbology practices and product effectiveness for anti-disease activity. [ 65 ] [ 66 ]  In the herbal sources listed below, there is little or no evidence for efficacy or proof of safety across consumer age groups and disease conditions for which they are intended. [ 65 ] [ 66 ]


There are over 300 herbs in common use. Some of the most commonly used herbs are  Ginseng  ( 人参 ;  人參 ;  rénshēn ),  wolfberry  ( 枸杞子 ;  gǒuqǐzǐ),  dong quai  ( Angelica sinensis ,  当归 ;  當歸 ;  dāngguī ),  astragalus  ( 黄耆 ;  黃耆 ;  huángqí ),  atractylodes  ( 白术 ;  白朮 ;  báizhú ), bupleurum ( 柴胡 ;  cháihú ), cinnamon (cinnamon twigs ( 桂枝 ;  guìzhī ) and cinnamon bark ( 肉桂 ;  ròuguì )),  coptis  ( 黄连 ;  黃連 ;  huánglián ), ginger ( 姜 ;  薑 ;  jiāng ), hoelen ( 茯苓 ;  fúlíng ),  licorice  ( 甘草 ;  gāncǎo ),  ephedra sinica  ( 麻黄 ;  麻黃 ;  máhuáng ),  peony  (white:  白芍 ;  báisháo  and reddish:  赤芍 ;  chìsháo ),  rehmannia  ( 地黄 ;  地黃 ;  dìhuáng ), rhubarb ( 大黄 ;  大黃 ;  dàhuáng ), and salvia ( 丹参 ;  丹參 ;  dānshēn ).


In Chinese herbology, there are 50 "fundamental" herbs, as given in the reference text, [ 70 ]  although these herbs are not universally recognized as such in other texts. The herbs are:


In addition to the above, many other Chinese herbs and other substances are in common use, and these include:


Traditional Chinese herbs are used either standalone, or in a grouping, jointly with other herbs. When several herbs are used together, this amalgamation is called a 'herbal formula'. [ medical citation needed ]


There are, generally speaking, three types of herbal formulas used in TCM:


1.  Classic Formulas  - these are formulas which TCM practitioners believe have withstood the test of time over the centuries, and are mentioned in classical texts, such as the  Shanghan Lun .


2. Patent Formulas - these are either classic formulas, or newer commonly-used formulas created in recent decades. The patent formulas stand out in that their usage is common enough, that they are frequently mass-produced by large companies, in China, the United States, and elsewhere.


3. Custom-Made Formulas - these formulas are composed by a TCM Practitioner, to match the specific diagnosis and medical condition of a patient. These formulas are often partially-based on the older, classic formulas.


The prescription of TCM formulas, is based on 4-tier system of hierarchy. [ 90 ]  The 4-tiers are: Jun (君), Chen (臣), Zuo (佐) and Shi (使). [ 91 ] [ 92 ]  These four tiers are often translated as: Sovereign, Minister, Assistant, Courier; or Monarch, Minister, Assistant, Envoy (also: 'Guide'). [ 93 ]


This feudal-like hierarchy denotes the power and role of each herb in a given formula. [ 94 ] [ 95 ]  The Jun is the herb which is usually of the highest relative dosage, and leads the main action of the formula. In the majority of formulas, there is only one Jun (Monarch) herb. Sometimes, a formula may feature 2-3 Jun herbs, or lack a dominant Jun herb altogether. The Chen support the Jun in its actions, and provide additional uses for the medical purpose of the formula. The Zuo assist the Jun and Chen, but are given at a much lower dosage (relative to themselves), to deemphasize their influence, for various reasons. The Shi's main role is to help guide the formula to the correct bodily areas or organ systems inside of which it is meant to act. [ 96 ] [ 97 ] [ 98 ]  The Shi are also sometimes used "to harmonize the properties of other herbs in the formula". [ 99 ] [ 100 ]


Most herbs can serve as either Jun (Monarch), Chen (Minister) or Zuo (Assistant) - the first three tiers in the herbal hierarchy. But only certain herbs, are considered fit to serve as Shi. This is because only some herbs are believed to have the ability, to guide other herbs into a given bodily area or organ system. [ 101 ]


Within TCM formulas, there are also strict rules about which herbs pair well together (Dui Yao), and which are either contradictory, incompatible, or may cause a reaction amongst themselves, or with Western Medicine Drugs. [ 102 ]  For example: Gan Cao (Licorice) is incompatible with the herbs Yuan hua, Jing Da Ji, Hai Zao and Gan Sui. It may also alter the therapeutic effects of corticosteroids. [ 103 ] [ 104 ]


Clerodendrum infortunatum , known as  bhat [ 2 ]  or  hill glory bower , is a  perennial   shrub  belonging to the  family   Lamiaceae , also sometimes classified under  Verbenaceae . It is the  type species  among ~150  species  of  Clerodendrum . It is one of the most well-known natural health remedies in traditional practices and  siddha medicine .


The species is native to  tropical  regions of  Asia  including  Bangladesh ,  India ,  Myanmar ,  Pakistan ,  Thailand ,  Malaysia , the  Andaman Islands , and  Sri Lanka . [ 1 ] [ 3 ]


Clerodendrum infortunatum  is a flowering  shrub  or small  tree , and is so named because of its rather ugly leaf  [ citation needed ] . The stem is erect, 0.5–4 m (1.6–13.1 ft) high, with no branches and produce circular leaves with 15 cm (5.9 in) diameter. Leaves are simple, opposite; both surfaces sparsely villous-pubescent, elliptic, broadly elliptic, ovate or elongate ovate, 3.5–20 cm (1.4–7.9 in) wide, 6–25 cm (2.4–9.8 in) long, dentate,  inflorescence  in terminal, peduncled, few-flowered cyme; flowers white with purplish pink or dull-purple throat, pubescent. Fruit  berry ,  globose , turned bluish-black or black when ripe, enclosed in the red accrescent fruiting- calyx . The stem is hollow and the leaves are 15–20 cm (5.9–7.9 in) long, borne in whorls of four on very short  petioles . The inflorescence is huge, consisting of many tubular snow white flowers in a terminal cluster up to 0.6 m (2 ft) long. The tubes of the flowers are about 10 cm (3.9 in) long and droop downward, and the expanded  corollas  are about 5 cm (2.0 in) across.


The fruits are attractive dark metallic blue  drupes , about 1 cm (0.4 in) in diameter. Fruit usually with four dry nutlets and the seeds may be with or without  endosperm . It flowers from April to August. [ 3 ]


The major compounds are  sterols ,  sugars ,  flavonoids  and  saponins . Novel crystalline compounds such as  clerodolone ,  clerodone ,  clerodol , and a sterol designated  clerosterol  have been isolated from the root. Seven sugars namely  raffinose ,  lactose ,  maltose ,  sucrose ,  galactose ,  glucose  and  fructose  were identified. [ 2 ]   Fumaric acid ,  caffeic acid  esters,  β-sitosterol  and β-sitosterol glucoside were isolated from the flowers. [ 4 ]   Apigenin ,  acacetin  and a new flavone glycoside, characterised as the methyl ester of acacetin-7-0-glucuronide are isolated from the flowers. [ 5 ]  Saponin is one of the major compounds of the leaf. [ 6 ]  24 beta-ethylsterols, clerosterol and 22-dehydroclerosterol, 24-methyl-sterols (24-methylcholestanol, 24-methylcholesterol, 24-methyl-22-dehydrocholesterol, and 24-methyllathostero) and 24 beta-ethyl-22-dehydrocholestanol are found in the seeds. [ 7 ]   Scutellarin  and hispidulin-7-O-glucuronide are present in the leaf. [ 8 ]  Poriferasterol and  stigmasterol  are the components of the aerial parts. [ 9 ]


Clerodendrum infortunatum  is used in  Ayurvedic  and  Siddha   traditional medicines .  Fresh leaves are given for  diarrhea ,  liver  disorders, and  headache . [ 10 ]   The leaf and root are used as  antidandruff ,  antipyretic ,  ascaricide ,  laxative ,  vermifuge ,  anticonvulsant ,  antidiabetic , and for  gravel ,  malaria ,  scabies ,  skin diseases ,  sores ,  spasm ,  scorpion sting ,  snake bite , and  tumors . [ 11 ] [ 12 ]  In many traditional practices the leaves and root are widely used as  antihyperglycemic . [ 13 ]


Crude drugs  are drugs of plant, animal and microbial origin [ clarification needed ]  that contain natural substances that have undergone only the processes of collection and drying. [ dubious  –  discuss ]  The term natural substances refers to those substances found in  nature  that have not had man-made changes made in their molecular structure. They are used as  medicine  for humans and animals, internally and externally for curing  diseases , e.g.,  Senna  and  Cinchona .


A crude drug is any naturally occurring, unrefined substance derived from  organic  or  inorganic  sources such as plant, animal, bacteria, organs or whole organisms intended for use in the  diagnosis ,  cure , mitigation,  treatment , or prevention of disease in humans or other animals.


Crude drugs are unrefined natural  medications  in their raw forms.  Prior to the 1950s, every pharmacy student learned about crude drugs in  pharmacognosy  class. Pharmacognosy is the study of the proper  horticulture ,  harvesting  and uses of the raw medications found in nature.


Raising, harvesting and selling crude drugs was how many large pharmaceutical companies started out.  Companies such as  Eli Lilly and Company  sold crude drugs to pharmacists to save them time and money, but the early pharmacy graduate would know how to raise their own crude drugs if need be. [ citation needed ]


Identification of the crude drug by organoleptic characters is one of the important aspects of pharmacognostical study. Morphological study follows a special terminology which must be known to a pharmacognostist. The morphological terminology is derived from botany and zoology, depending upon the source of the crude drug. In general, color, odor, taste, size, shape, and special features, like touch, texture, fracture, presence of trichomes, and presence of ridges of crude drugs are studied under morphology. Aromatic odor of umbelliferous fruits and sweet taste of liquorice are the example of this type of evaluation. The study of form of a crude drug is  morphology , while description of the form is  morphography .


However, shape and size of crude drugs as described in official books should only be considered as guidelines and may vary depending upon several factors. For example, color of the crude drug may fade if it gets exposed to sunlight for very long duration or if, the drug is not stored properly. Depending upon the condition under which the drug is growing or cultivated, i.e., availability of proper irrigation, fertilizers or even high temperature, may influence the size may be available and the crude drugs if grown in adverse conditions may be of small size.


Color of the flowers as in case  Catharanthus roseus  and  Catharanthus alba,  presence of thorns in case of  Asparagus recemosus  and absence in  Asparagus officinalis , arrangement of flowers in case of  Withania semnifera   or   Witharia coagulens   can help in differentiating the varieties of the same plant.


Arrangement of cracks and wrinkles in case of stem bark of varieties of Cinchona bark, or the color of aloe can separate in varieties.


The adulteration of seed of Strychnos nux-vomica with the seed of Strrychnos nux-blanda or Strychnos potatorum, caraway with Indian dill, Alexandrian senna with dog senna or palthe senna are identified by morphological means.


In case of cellular products (unorganized drugs), form of the drug depends totally on the method of preparation of the drug. Thus, gum acacia is found in the form of ovoid tears, while tragacanth is marketed as vermiform ribbon with longitudinal striations.


To evaluate means to identify it and to determine its quality and purity, the identity of a drug can be established by actual collection of the drug from a plant or animal that has been positively identified. The evaluation of drug involves a number of methods that may be classified as follows:


The usage of crude drugs dates to  prehistoric times . Traditional medicine often incorporates the gathering and preparation of material from natural sources, particularly herbs. In such practice, the active ingredients and method of action are largely unknown to the practitioner.


In recent history, the development of modern chemistry and application of the scientific method shaped the use of crude drugs. Eventually, the use of crude drugs reach a zenith in the early 1900s and eventually gave way to the use of purified active ingredients from the natural source. Currently the use and exploration of crude drugs has again gained prominence in the medical community. The realization that many completely unknown substances are yet to be discovered from crude drugs has created a new interest in pharmacognosy and has led to many medical breakthroughs.


In 1907, the  Pure Food and Drug Act  was implemented and standardization of crude drugs took place. Often the  USP  would specify what percentage of active ingredient was needed to claim a crude drug met USP standards.


An example of standardization would be as follows (from the  United States Pharmacopeia ): [ 1 ]


Opium  is the air-dried milky exudate obtained by incising the unripe capsules of  Papaver somniferum  Linne or its variety album De Candolle (Fam. Papaveraceae). Opium in its normal air-dried condition yields not less than 9.5 percent of anhydrous  morphine .


Crude medicine ( simplified Chinese :  药材 ;  traditional Chinese :  藥材 ;  pinyin :  yàocái ), (also known as crude drug in the  Chinese materia medica ) are bulk drugs from the Chinese materia medica basic processing and treatment.


Ethnobotany  is an interdisciplinary field at the interface of natural and social sciences that studies the relationships between humans and plants. [ 1 ] [ 2 ]  It focuses on  traditional knowledge  of how plants are used, managed, and perceived in  human societies . [ 3 ] [ 4 ]  Ethnobotany integrates knowledge from  botany ,  anthropology ,  ecology , and  chemistry  to study plant-related customs across cultures. Researchers in this field document and analyze how different societies use local  flora  for various purposes, including  medicine ,  food ,  religious use ,  intoxicants ,  building materials ,  fuels  and  clothing . [ 5 ]   Richard Evans Schultes , often referred to as the "father of ethnobotany", [ 6 ]  provided an early definition of the discipline:


Ethnobotany simply means investigating plants used by primitive societies in various parts of the world. [ 7 ]


Since Schultes' time, ethnobotany has evolved from primarily documenting traditional plant knowledge to applying this information in modern contexts, particularly in  pharmaceutical development . [ 8 ]  The field now addresses complex issues such as  intellectual property  rights and equitable benefit-sharing arrangements arising from the use of traditional knowledge. [ 8 ]


The idea of ethnobotany was first proposed by the early 20th century botanist  John William Harshberger . [ 9 ]  While Harshberger did perform ethnobotanical research extensively, including in areas such as  North Africa ,  Mexico ,  Scandinavia , and  Pennsylvania , [ 9 ]  it was not until  Richard Evans Schultes  began his trips into the  Amazon  that ethnobotany became a more well known science. [ 10 ]  However, the practice of ethnobotany is thought to have much earlier origins in the first century AD when a Greek physician by the name of  Pedanius Dioscorides  wrote an extensive botanical text detailing the medical and culinary properties of "over 600 mediterranean plants" named  De Materia Medica . [ 5 ]  Historians note that Dioscorides wrote about traveling often throughout the Roman empire, including regions such as " Greece ,  Crete ,  Egypt , and  Petra ", [ 11 ]  and in doing so obtained substantial knowledge about the local plants and their useful properties. European botanical knowledge drastically expanded once the New World was discovered due to ethnobotany. This expansion in knowledge can primarily be attributed to the substantial influx of new plants from the Americas, including crops such as potatoes, peanuts, avocados, and tomatoes. [ 12 ]  The French explorer  Jacques Cartier  learned a cure for scurvy (a tea made from the needles of a  coniferous  tree, likely  spruce ) from a local  Iroquois  tribe. [ 13 ]


During the medieval period, ethnobotanical studies were often conducted in connection with  monasticism . However, most botanical knowledge was kept in gardens, such as  physic gardens  attached to hospitals and religious buildings. It was thought of in practical use terms for culinary and medical purposes and the ethnographic element was not studied as a modern  anthropologist  might approach ethnobotany today. [ 14 ]


In 1732,  Carl Linnaeus  carried out a  research expedition  in Scandinavia asking the  Sami people  about their  ethnological  usage of plants. [ 15 ]


The  Age of Enlightenment  saw a rise in economic  botanical  exploration.  Alexander von Humboldt  collected data from the New World, and  James Cook 's voyages brought back collections and information on plants from the South Pacific. [ 16 ]  At this time major botanical gardens were started, for instance the  Royal Botanic Gardens, Kew  in 1759. The directors of the gardens sent out  gardener-botanist explorers  to care for and collect plants to add to their collections.


As the 18th century became the 19th, ethnobotany saw expeditions undertaken with more colonial aims rather than trade economics such as that of  Lewis and Clarke  which recorded both plants and the peoples encountered use of them.  Edward Palmer  collected  material culture  artifacts and botanical specimens from people in the North American West ( Great Basin ) and Mexico from the 1860s to the 1890s. Through all of this research, the field of "aboriginal botany" was established—the study of all forms of the vegetable world which  aboriginal peoples  use for food, medicine,  textiles , ornaments and more. [ 17 ]


The first individual to study the  emic  perspective of the plant world was a German physician working in Sarajevo at the end of the 19th century: Leopold Glück. His published work on traditional medical uses of plants done by rural people in Bosnia (1896) has to be considered the first modern ethnobotanical work. [ 18 ]


Other scholars analyzed uses of plants under an indigenous/local perspective in the 20th century:  Matilda Coxe Stevenson , Zuni plants (1915);  Frank Cushing , Zuni foods (1920);  Keewaydinoquay Peschel , Anishinaabe fungi (1998), and the team approach of Wilfred Robbins,  John Peabody Harrington , and  Barbara Freire-Marreco , Tewa pueblo plants (1916).


In the beginning, ethonobotanical specimens and studies were not very reliable and sometimes not helpful. This is because the botanists and the anthropologists did not always collaborate in their work. The botanists focused on identifying species and how the plants were used instead of concentrating upon how plants fit into people's lives. On the other hand, anthropologists were interested in the cultural role of plants and treated other scientific aspects superficially. In the early 20th century, botanists and anthropologists better collaborated and the collection of reliable, detailed cross-disciplinary data began.


Beginning in the 20th century, the field of ethnobotany experienced a shift from the raw compilation of data to a greater methodological and conceptual reorientation. This is also the beginning of academic ethnobotany. The so-called "father" of this discipline is  Richard Evans Schultes , even though he did not actually coin the term "ethnobotany". Today the field of ethnobotany requires a variety of skills: botanical training for the identification and preservation of plant specimens; anthropological training to understand the cultural concepts around the perception of plants; linguistic training, at least enough to transcribe local terms and understand native morphology, syntax, and semantics.


Mark Plotkin , who studied at  Harvard University , the  Yale School of Forestry  and  Tufts University , has contributed a number of books on ethnobotany. He completed a handbook for the  Tirio people  of  Suriname  detailing their medicinal plants;  Tales of a Shaman's Apprentice  (1994);  The Shaman's Apprentice,  a children's book with  Lynne Cherry  (1998); and  Medicine Quest: In Search of Nature's Healing Secrets  (2000).


Plotkin was interviewed in 1998 by  South American Explorer  magazine, just after the release of  Tales of a Shaman's Apprentice  and the  IMAX  movie Amazonia. In the book, he stated that he saw wisdom in both traditional and Western forms of medicine:


No medical system has all the answers—no shaman that I've worked with has the equivalent of a polio vaccine and no dermatologist that I've been to could cure a fungal infection as effectively (and inexpensively) as some of my Amazonian mentors. It shouldn't be the doctor versus the witch doctor. It should be the best aspects of all medical systems ( ayurvedic ,  herbalism ,  homeopathic , and so on) combined in a way which makes health care more effective and more affordable for all. [ 19 ]


A great deal of information about the traditional uses of plants is still intact with tribal peoples. [ 20 ]  But the native healers are often reluctant to accurately share their knowledge to outsiders. Schultes actually apprenticed himself to an Amazonian shaman, which involves a long-term commitment and genuine relationship. In  Wind in the Blood: Mayan Healing & Chinese Medicine  by Garcia et al. the visiting acupuncturists were able to access levels of Mayan medicine that anthropologists could not because they had something to share in exchange. Cherokee medicine priest David Winston describes how his uncle would invent nonsense to satisfy visiting anthropologists. [ 21 ]


Another scholar, James W. Herrick, who studied under ethnologist  William N. Fenton , in his work  Iroquois Medical Ethnobotany  (1995) with Dean R. Snow (editor), professor of Anthropology at Penn State, explains that understanding herbal medicines in traditional Iroquois cultures is rooted in a strong and ancient  cosmological  belief system. [ 22 ]  Their work provides perceptions and conceptions of illness and imbalances which can manifest in physical forms from benign maladies to serious diseases. It also includes a large compilation of Herrick's field work from numerous Iroquois authorities of over 450 names, uses, and preparations of plants for various ailments. Traditional Iroquois practitioners had (and have) a sophisticated perspective on the plant world that contrast strikingly with that of modern medical science. [ 23 ]


Researcher Cassandra Quave at Emory University has used ethnobotany to address the problems that arise from antibiotic resistance. Quave notes that the advantage of medical ethnobotany over Western medicine rests in the difference in mechanism. For example, elmleaf blackberry extract focuses instead on the prevention of bacterial collaboration as opposed to directly exterminating them. [ 24 ]


Many instances of  gender bias  have occurred in ethnobotany, creating the risk of drawing erroneous conclusions. Anthropologists would often consult with primarily men. In Las Pavas, a small farming community in Panama, anthropologists drew conclusions about the entire community's use of plant from their conversations and lessons with mostly men. They consulted with 40 families, but the women only participated rarely in interviews and never joined them in the field. Due to the division of labor, the knowledge of wild plants for food, medicine, and fibers, among others, was left out of the picture, resulting in a distorted view of which plants were actually important to them. [ 25 ] [ 26 ]


Ethnobotanists have also assumed that ownership of a resource means familiarity with that resource. In some societies women are excluded from owning land, while being the ones who work it. Inaccurate data can come from interviewing only the owners. [ 27 ]


Other issues include ethical concerns regarding interactions with  indigenous populations , and the International Society of Ethnobiology has created a code of ethics to guide researchers. [ 28 ]


Media related to  Ethnobotany  at Wikimedia Commons


Crotalaria macrophylla   Willd.
 Flemingia angustifolia   Roxb.
 Flemingia bhottea   Buch.-Ham.
 Flemingia capitata   Buch.-Ham.
 Flemingia congesta   Roxb. ex  W. T. Aiton
 Flemingia latifolia   Benth.
 Flemingia nana   Roxb.
 Flemingia prostrata   Roxb.
 Flemingia semialata   W.T.Aiton
 Moghania cumingiana   (Benth.)  Kuntze
 Moghania macrophylla   ( Willd. ) Kuntze
 Moghania semialata   (W.T.Aiton) Mukerjee


Flemingia macrophylla  is a tropical woody  leguminous   shrub  in the family  Fabaceae . It is a multipurpose plant widely used in  agriculture ,  crop  improvement,  fodder ,  dyes  and for various  therapeutic  purposes.  Perhaps, it is the most versatile species of  Flemingia  in terms of  adaptation , medicinal and agricultural applications.


Flemingia macrophylla  is a woody,  perennial , deep-rooting, and leafy shrub. It is about 0.6-2.4 m high (rarely 3 m).  The main  stem  is  prostrate  or erect, with numerous stems arising from a single base.  The young branches are greenish, ribbed, triangular in section and silky; while the old stems are brown, almost round in section. The leaves are  trifoliate .  leaflets  are papery, with a glabrous upper surface.  Inflorescences  are densely spicate- racemose  or paniculate, and  bracts  are foliaceous or dry, persistent or  deciduous . Pods are small and turn brown when ripening; they are  dehiscent , generally with two shiny black seeds in the vessel. Seeds are globular, 2–3 mm in diameter, and shiny black. The leaves are disproportionately large, hence origin of the  specific name ,  macrophylla  meaning ‘large leaved’ (Greek  makros  = large;  phyllon  = leaf). [ 1 ] [ 2 ]


It is a native plant of subhumid to humid (sub-)  tropics  where average annual rainfall is typically 1100–3500 mm with up to 6 dry months,  at  altitude  up to 2000 m above  msl . Thus its natural habitat is found in Asia including Bhutan, southern China, Cambodia, India, Indonesia, Laos, Myanmar, Malaysia, Nepal, northern Pakistan, Papua New Guinea, Philippines, Sri Lanka, Taiwan, Thailand and Vietnam.  It has been  cultivated  and  naturalised  in  sub-Saharan Africa  (such as Côte d'Ivoire, Ghana, Nigeria, Cameroon), Central and South America (e.g. Costa Rica, Panama, Colombia), and tropical Australia. [ 1 ] [ 3 ] [ 4 ]


Its natural habitat is often in shaded locations, scrub,  woodlands ,  grasslands , gallery forest edges and alike, and on soils with fertility ranging from very low to intermediate (and even high) acidic contents. The shrubs are mostly seen under trees along watercourses and in  grasslands , on  clay  and  lateritic   soils . The plant is tolerant of light shade and is moderately able to survive fires. It can tolerate fairly long dry spells and is capable of surviving on very poorly drained soils with  waterlogging . It can strive well on a wide variety of soils within a  pH  range from 4–8, and high soluble  aluminium  (80% saturation). It requires a minimum rainfall of about 1,100 mm, and up to 3,500 mm/year for normal propagation, and is very  drought  tolerant. It can flower and fruit throughout the year. [ 3 ]


A number of  bioactive  compounds have been reported from  F. macrophylla . Like other members of  Fabaceae , it is rich in  Flavonoids .  Genistein , 5, 7,3’, 4’-tetrahydroxyisoflavone, 5, 7, 4’-trihydroxyisoflavone-7-O-β-D-glucopyranoside, 5, 7,4’-trihydroxy-8,3’-diprenylflavanone, 5, 7,4’-trihydroxy-6-prenylisoflavone, flemichin D, lespedezaflavanone A and ouratea-catechin are isolated from the root, in which genistein and its  isoflavones  analogs are the main constituents. [ 5 ] [ 6 ]  A novel  flavanone , named fleminone,  was isolated from a petrol extract of the stems. [ 7 ]   A new isoflavone, called flemiphyllin was also isolated. [ 8 ]  Three new flavonoids, fleminginin (1), flemingichromone (2), and flemingichalcone (3), and other twenty known compounds were isolated from the aerial parts. [ 9 ]


Flemingia macrophylla  is used in a variety of agricultural practices and by-products. Due to slow decomposition rate of its leaves, along with its dense growth, moderate drought tolerance, ability to withstand occasional  flooding , and  coppicing  ability, it is commonly used for  mulching ,  weed control  and  sod  protection. It is most commonly used in contour hedgerows for  erosion  control, often in association with  Desmodium cinereum .  Prunings are used for  mulch   and green  manure  in alley cropping systems. [ 1 ] [ 2 ]  Probably the most interesting feature of the species is the relative resistance of its leaves to decomposition. It is experimentally demonstrated that  F. macrophylla  is superior over the common  Leucaena leucocephala  as mulch for  plantain  production. [ 10 ]


It is also often used to shade young  coffee  and  cocoa  plants, for weed suppression and soil enrichment in  orchards , and to provide  fuel wood  and stakes for climbing crop species.  However, it is considered a poor  forage  since its leaves have a high  fibre  and  condensed tannin  concentrations and is not readily eaten by stock.  Yet it is used as dietary supplement by mixing with grasses and other legumes, particularly during dry season when regular forages are scarce. [ 11 ] [ 12 ]


In India it is used as a host plant to the  Lac insect , and is sometimes  intercropped  with food crops during its establishment period. It is also one of the major sources of the  resinous  powder, called in Arabic  ورس  ( wars ), with variants  waras ,  wurs  and  wurus , obtained from fruits of the plant. It is a coarse purple or orange-brown powder, consisting of the glandular hairs rubbed from the dry pods, principally used for  dyeing   silk  to brilliant orange color; the active compound for it is flemingin. In  Arabia , the powder is used as cosmetic. [ 2 ]


Extracts from  Flemingia  species have been used as a traditional medicine for treating  rheumatism . [ 13 ]


Flemingia procumbens   Roxb.
 Moghania procumbens   (Roxb.) Mukerjee
 Moghania vestita   (Benth.) ex Baker Kuntze


Flemingia vestita ,  famously known as  sohphlang , is a  nitrogen fixing   herb  with characteristic  tuberous  root, belonging to the  genus   Flemingia .  The root is edible and is a common vegetable in some  Asian   tribal  communities. In addition, it has been traditionally used as an  anthelmintic , the basis of which is scientifically validated.


It is found as a wild herb along the mountain slopes of  Himalayas . It is distributed in  Sichuan  and  Yunnan  provinces of  China ,  Nepal  and  Khasi hills ,  Jaintia Hills  of  Meghalaya  in Northeast  India . It is also sparsely found in  Laos ,  Philippines  and  Vietnam . [ 1 ] [ 2 ]


Flemingia vestita  is a  perennial  herb, having a prostrate but weak  stem , measuring about ~60 cm in average. It is highly branched with hairy  rhizome  and  hirsute  stems. The roots are tuberous (6 cm or longer). Leaves are  pinnately  compound with obovate-cuneate leaflets. Leaves are  digitately  3-foliolate; and also pubescent like the stem. Lateral leaflets are obliquely  elliptic , and slightly smaller.  Raceme  is axillary or terminal, about 2–10 cm, and densely pubescent;  bracts   lanceolate .  Calyx  is 5-lobed; lobes are linear-lanceolate, lower one is longest, longer than the tube.  Corolla  is slightly longer than calyx and elliptical. Fruits are hairy sub-cylindrical pods.  Seed  is  globose , brown or black in colour. Flowers are bright-red. It flowers during August and September. [ 3 ] [ 4 ]


It is rich in bioactive  isoflavones  such as  genistein ,  daidzein ,  formononetin  and  pseudobaptigenin . [ 5 ]


This juicy tuber is a highly priced food   among the  Garo ,  Khasi  and  Jaintia  tribes of  Meghalaya , India. In fact its demand as foodstuff has increased so much that it has been cultivated as a  cash crop  and is regularly available in the local markets. [ 1 ]  The delicate skin is easily peeled off to expose a smooth cream-coloured flesh that has a sweet, nut-like flavour. In terms of nutritional value, it is particularly rich in  phosphorus  and  proteins .


The tuber has been an indigenous  vermifuge  among the Khasis, to whom it is called  soh-phlang . The raw tuber or the root peel is directly consumed for the treatment of  soft-bodied   intestinal worms . [ 6 ]  Experimental investigation started in 1996 when the  in vitro  activity of tuber peel extract was tested against different  helminth  parasites, including the  nematodes  such as  Ascaris suum ,  Ascaris lumbricoides ,  Ascaridia galli ,  Heterakis gallinarum , a  cestode   Raillietina echinobothrida  and  trematodes  such as  Paramphistomum  sp., [ 7 ]   Artyfechinostomum sufrartyfex  and  Fasciolopsis buski . [ 8 ]  In 1991 an  isoflavone , genistein was isolated from the tuber extract [ 5 ]  which was demonstrated to be the major anthelmintic principle, highly potent against trematodes and cestodes. It was further demonstrated effective against the sheep liver fluke  Fasciola hepatica [ 9 ]  and  human tapeworms  such as  Echinococcus multilocularis  and  E. granulosus  metacestodes. [ 10 ]


Its property of nitrogen fixation has been put to experimental use. Mixed cropping with  F. vestita  was found to give better economic returns, mainly due to improved soil fertility with a net gain in  nitrogen  of up to 250 kg/ha/year. [ 11 ]


A traditional  glycerite  is a  fluid extract  of an herb or other medicinal substance made using  glycerin  as the majority of the fluid extraction medium.


According to  King's American Dispensatory  (1898), glycerite is:


Glycerita.—Glycerites.
By this class of preparations is generally understood solutions of medicinal substances in glycerin, although in certain instances the various Pharmacopoeias deviate to an extent. The term Glycerita as here applied to fluid glycerines, or solutions of agents in glycerin, is preferable to the ordinary names, "glyceroles," "glycerates," or "glycemates," etc., and includes all fluid preparations of the kind referred to, whether for internal administration or local application. [ 1 ]


Glycerites may consist of either  vegetable  source glycerin,  animal  source glycerin or a combination of the two.  In the case of liquid herbal products (a segment of the dietary supplements industry), the general rule is to utilize vegetable glycerin only, while  nutraceuticals  (another segment of the dietary supplements industry) might use a combination of both vegetable and animal source derived glycerin.


Alcohol-free (as opposed to alcohol-removed) glycerite products, in which alcohol is never used or added at any time, are preferred by those desiring or requiring that no alcohol be used in making products or added thereafter. The reasons are typically for personal or religious beliefs.


Muslims  for instance, represent the largest population requiring an alcohol-free standard.  Halal , the Islamic dietary law, lists alcohol as one of the 'explicitly forbidden substances' (called  Haram ) in which anything made with and/or at any time containing alcohol is forbidden.  USP grade  vegetable glycerin is acceptable for Halal certifying and in some instances a Halal standard may (but not always) accept  Kosher  certified USP Grade vegetable glycerin as meeting Halal standards (i.e. to be Halal 'compliant'). Where the issue of Halal Alcohol-Free versus Haram Alcohol-Removed glycerites is concerned, even though U.S. FDA Title 21 rules forbid referring to or labeling a product as being 'Alcohol-Free' that has at any time come into contact with alcohol, the Islamic community has taken the stance that products listed as alcohol-free often does not always mean "Alcohol-Free" as defined by Halal standards or U.S. FDA Title 21 rules, since many products listed as alcohol-free may in fact have been made using alcohol as an ingredient after which the alcohol is removed, which would still make any such products Haram by Islamic Dietary Law and in breach of U.S. FDA Title 21 labeling rules. The Islamic community is therefore encouraged to first ascertain whether a botanical glycerite is actually Halal 'Alcohol-Free' (e.g. Halal Certified or Halal compliant) or is Haram 'Alcohol-Removed' with glycerin thereafter added.


Glycorandomization , is a  drug discovery  and  drug development  technology platform to enable the rapid diversification of bioactive small molecules, drug leads and/or approved drugs through the attachment of sugars. Initially developed as a facile method to manipulate carbohydrate substitutions of naturally occurring glycosides to afford the corresponding differentially glycosylated  natural product  libraries, [ 1 ] [ 2 ] [ 3 ]  glycorandomization  applications have expanded to include both small molecules (drug leads and approved drugs) and even macromolecules ( proteins ). [ 4 ]  Also referred to as 'glycodiversification', [ 5 ]  glycorandomization has led to the discovery of new glycoside analogs which display improvements in potency, selectivity and/or  ADMET  as compared to the parent molecule.


The traditional method for attaching sugars to natural products, drugs or drug leads is by  chemical glycosylation . This classical approach typically requires multiple protection/deprotection steps in addition to the key anomeric activation/coupling reaction which, depending upon the glycosyl donor/acceptor pair, can lead to a mixture of  anomers . Unlike classical chemical glycosylation, glycorandomization methods are divergent ( i.e. , diverge from a common starting material, see  divergent synthesis ) and are not dependent upon sugar/ aglycon  protection/deprotection or sugar anomeric activation. Two complementary strategies to achieve glycorandomization/diversification have been developed: an enzyme-based strategy referred to as 'chemoenzymatic glycorandomization' and a chemoselective method known as 'neoglycorandomization'. Both methods start with free  reducing sugars  and a target  aglycon  to afford a library of compounds which differ solely by the sugars appended to the target natural product, drug or drug lead.


Chemoenzymatic glycorandomization was inspired by the early pathway engineering work of Hutchinson and coworkers that suggested natural product glycosyltransferases were capable of utilizing non-native sugar nucleotide donors. [ 6 ]  The initial platform for chemoenzymatic glycorandomization was based upon a set of two highly permissive sugar activation enzymes (a sugar anomeric  kinase  and sugar-1-phosphate  nucleotidyltransferase ) to afford sugar nucleotide libraries as donors for these promiscuous  glycosyltransferases  where the permissivity of the corresponding sugar kinase [ 7 ]  and nucleotidyltransferase [ 8 ] [ 9 ]  was expanded by  enzyme engineering  and  directed evolution . The first application of this three enzyme (kinase, nucleotidyltransferase and glycosyltransferase) strategy enabled the product of a set of >30 differentially glycosylated  vancomycins , some members of which were further diversified chemoselectively by virtue of the installation of sugars bearing chemoselective handles. [ 10 ] [ 11 ] [ 12 ]  This enzymatic platform has been further advanced through glycosyltransferase evolution [ 13 ]  and capitalizing upon the discovery of the reversibility of glycosyltransferase-catalyzed reactions first discovered in the context of  calicheamicin  biosynthesis. [ 14 ] [ 15 ]


Neoglycorandomization is a chemoselective glycodiversification method inspired by the alkoxyamine-based ‘neoglycosylation’ reaction first described Peri and Dumy. [ 16 ]  This reaction proceeds via an oxy-iminium intermediate to ultimately provide the more thermodynamically-favored closed ring neoglycoside. The neoglycosylation reaction is compatible with a wide range of saccharide and aglycon functionality where neoglycoside anomeric stereospecificity is a thermodynamically-driven. Importantly, structural and functional studies reveal neoglycosides to serve as good mimics of their  O -glycosidic comparators. The first neoglycorandomization proof of concept focused upon  digitoxin  where the rapid generation and cancer cell line cytotoxicity screening of 78 digitoxigenin neoglycosides revealed unique analogs with improved anticancer activity and reduced potential for cardiotoxicity. [ 17 ]  This platform has since been automated and used as an effective medicinal chemistry tool to modulate the properties of a range of  natural products  and  pharmaceutical drugs . [ 18 ]


Both chemoenzymatic glycorandomization and neoglycorandomization use free reducing sugars and unprotected aglycons and are thereby a notable advance over classical glycosylation methods. A notable advantage of the enzymatic approach is the use of the corresponding genes encoding for the permissive kinases, nucleotidyltransferases and/or glycosyltransferases for in vivo  synthetic biology  applications to afford in vivo glycorandomization. [ 19 ]  However, it is important to note the enzymatic platform is dependent upon the permissivity of the enzymes employed. In contrast, the main hurdle to chemoselective neoglycorandomization is installation of the alkoxylamine handle. Unlike the enzymatic approach, the anomeric stereoselectivity of the chemoselective method depends upon the reducing sugar used and can, in some cases, lead to anomeric mixtures.


Glycorandomization is used in the  pharmaceutical industry  and academic community to alter glycosylation patterns of sugar-containing natural products or to append sugars to drugs/drug leads. It provides a fast way to investigate the effect of subtle sugar modification on the pharmacological properties of the natural products analogues, [ 20 ]  thus, affording a new approach to drug discovery.


Herbal distillates , also known as  floral waters ,  hydrosols ,  hydrolates ,  herbal waters , and  essential waters , [ 1 ]  are aqueous products of  hydrodistillation . They are  colloidal suspensions  of  essential oils  as well as  water-soluble  components obtained by  steam distillation  or hydrodistillation (a variant of steam distillation) from plants and herbs. These herbal distillates have uses as  flavorings  and  cosmetics . Common herbal distillates for  skincare  include  rose water , [ 2 ]   orange flower water , [ 3 ]  and  witch hazel . [ 4 ]   Rosemary , [ 5 ]   oregano , [ 6 ]  and  thyme [ 7 ]  are hydrosols that may be used in  food manufacturing  industries.


Herbal distillates are produced in the same or similar manner as essential oils. However, essential oils will float to the top of the distillate where it can be removed, leaving behind the watery distillate. For this reason, the term  essential water  is an apt description. In the past, these essential waters were often considered a byproduct of distillation, but are now considered an important co-product. [ 8 ]  The produced herbal waters are essentially diluted essential oils at less than 1% concentration (typically 0.02% to 0.05%). [ 9 ]  Several factors, such as temperature and a herb's growth cycle, impact the characteristics of a distillate, and therefore influence the timing of the distillation. Rosemary, for example, should be distilled in the peak of  summer  before it flowers. [ 10 ]


1. Food industry:  Herbal distillates are often used in culinary applications to add subtle flavors to foods and beverages. Their mild nature makes them ideal for infusing delicate flavors into dishes without the overpowering intensity of essential oils. Commonly used distillates in this context include rose water, orange blossom water, and peppermint hydrosol. Herbal distillates are also used to preserve food, and have been shown to be effective in achieving desirable effects, like reducing the degree of oxidation of some meats. [ 11 ]


2. Cosmetics:  In the cosmetic industry, herbal distillates are prized for their gentle, skin-friendly properties. They are used in a variety of products, including:


3. Herbal Treatments:  Herbal distillates are also employed in traditional and  holistic medicine  for their therapeutic benefits. Due to their lower concentration compared to essential oils, they are often used for:


4. Agriculture:  Herbal distillates are also used as insecticides, herbicides, and antibacterial and antifungal agents in agriculture. Additionally, herbal distillates may be used in  allelopathy , with possible applications including the manipulation of the timing of sprouting (see  vivipary ) and  germination . [ 11 ]


5. Clothing:  Herbal distillates can be added to water in a  clothes iron  to add a delicate scent into clothing. Since herbal distillates do not contain hard minerals such as  plastic  and  metal , [ 13 ]  it will also help keep clothing irons working properly for much longer. [ 12 ]


The science of  distillation  is based on the fact that different substances  evaporate  at different temperatures. Unlike other extraction techniques based on  solubility  of a compound in either  water  or  oil , distillation will separate components regardless of their solubility. The distillate will contain compounds that vaporize at or below the temperature of distillation. The actual chemical components of these orange herbal distillates have not yet been fully identified, but plant distillates will usually contain essential oil compounds as well as organic acids and other water-soluble plant components. Compounds with a higher vaporization point will remain behind and will include many of the water-soluble  plant   pigments  and  flavonoids . [ 14 ]


Because hydrosols are produced at high temperatures and are somewhat acidic, they tend to inhibit  bacterial growth  but not  fungal growth . They are not  sterile , and should be kept refrigerated to preserve freshness. [ 15 ]  Herbal distillates degrade over time and will degrade faster than essential oils, which are more stable. [ 16 ]  Small-scale producers of hydrosols must be particularly aware of the risk of bacterial contamination and take steps to prevent it. Despite concerns that there may be significant amounts of  heavy metals  in popular herbal distillates, this has not shown to be the case. [ 13 ]


Iberogast , also known as  STW5 , is a liquid formulation of nine  herbs  used for  functional dyspepsia  and  irritable bowel syndrome .  A proprietary blend, it was developed in Germany in 1961 and is available (without prescription) in other countries.  Named after the genus ( Iberis ) of one of its ingredients, it is also claimed to possess  anti-inflammatory ,  antioxidative  and  free radical –inhibiting properties as well as the ability to reduce  gastric acid  secretion. [ 1 ]


Iberogast is a mixture of extracts from bitter candytuft ( Iberis amara ), angelica root ( Angelicae radix ), milk thistle fruit ( Silybi mariani fructus ), celandine herb ( Chelidonium majus ), caraway fruit ( Carvi fructus ), liquorice root ( Liquiritiae radix ), peppermint herb ( Menthae piperitae folium ), balm leaf ( Melissae folium ), and chamomile flower ( Matricariae flos ). [ 2 ]


A 2004  meta-analysis  comprising three randomized placebo-controlled studies with a total of 173 patients suggested that iberogast was more effective than placebo in relieving "the most bothersome gastrointestinal symptom" of  functional dyspepsia  as identified by each patient. Additionally, a single  reference-controlled study  was discussed, comparing iberogast to the prokinetic cisapride in the treatment of "'functional dyspepsia of the dysmotility type'" and finding no significant differences in efficacy or tolerability. This paper noted that, while iberogast seems to consistently provide symptomatic relief to patients, its efficacy is more evident "with associated symptoms of  gastro-oesophageal reflux  or predominance of epigastric pain." It suggests a synergy of therapeutic mechanisms provided by the complex interactions between the GI tract and each individual component of iberogast. It also supports a promising safety profile for the formulation, but notes that its results must be confirmed in larger studies in order to provide any recommendations regarding the efficacy or safety of iberogast in the treatment of functional dyspepsia. [ 3 ]


In Germany, Iberogast has come under investigation after one patient died of liver failure. In 2018, the company producing Iberogast ( Bayer ) has been forced by authorities to print warnings about rare cases of liver toxicity. A former employee of Bayer was under criminal investigation related to Bayer's long resistance to declare the dangers of Iberogast. [ 4 ]


The  Boletin latinoamericano y del caribe de plantas medicinales y aromaticas  (English:  Latin American and Caribbean Bulletin of Medicinal and Aromatic Plants ) is a bimonthly  peer-reviewed   scientific journal  covering research on all aspects of  medicinal  and  aromatic plants . Articles are published in Spanish or English. [ 1 ]


The journal was established in 2002 as a communication tool to keep the Latin-American community informed on events and news related to medicinal and aromatic plants taking place around the world. This primary objective is still achieved by means of the so-called "supplements" issued in between each bulletin. The official launch of the publication took place in  Buenos Aires, Argentina , during the first  Latin-American Congress of Phytochemistry .


The journal started to publish scientific contributions during its second year of publication. In 2007, the journal officially changed from a newsletter format to a more traditional journal format, typically publishing more than five original papers per issue. Articles are published under a  Creative Commons Attribution  license and access to its repository is free.


Congreso Latinoamericano de Plantas Medicinales


This article about a  botany   journal  is a  stub . You can help Wikipedia by  expanding it .


Malabathrum ,  malabathron , or  malobathrum  is the name used in classical and medieval texts for certain  cinnamon -like aromatic plant leaves and an ointment prepared from those leaves.  Cinnamomum tamala  (sometimes given as  Cinnamomum tejpata ), grown most commonly in the eastern Himalayas, but also in the Western Ghats, is thought to be a notable source of these leaves, [ 1 ]  although other species of  Cinnamomum  and even plants in other genera [ 2 ]  may have been used. In ancient  Greece  and  Rome , the leaves were used to prepare a fragrant oil, called  oleum malabathri , and were therefore valuable.


Malabathrum is mentioned in the first century  Greek  text  Periplus Maris Erythraei  and sourced to a people called 'Sêsatai', identified with Kirradai ( Kirata ) of Ptolemy. [ 3 ]  Though malabathrum was a product of  Northeast India , it was rarely traded by the western traders at the mouth of the Ganges (which is much closer to the source) but at southwestern Indian ports of  Muziris / Nelcynda . [ 4 ]  It is mentioned in the  Periplus  that some people collected the green leaves after the Sêsatai in the northeast prepared them and carried them to the ports of trade. [ 5 ]  In the language of Kerala, Malayalam, the plant is called  vazhana . It is also known as  edana  in Malayalam. The name malabathrum is used in mediaeval texts to describe the dried leaves of a number of trees of the genus  Cinnamomum , which were thought to have  medicinal  properties. [ citation needed ]


The Greeks used  kásia  ( cassia ) or  malabathron  to flavour wine, with absinth wormwood ( Artemisia absinthium ). Malabathrum leaves ( folia ) were used in cooking and for distilling an oil used in a caraway-sauce for oysters by the Roman gourmet Gaius Gavius  Apicius . [ 6 ]  Malabathrum is among the spices that, according to Apicius, any good kitchen should contain.


Malabathrum from Egypt (Dioscorides I, 63) was based on beef fat and contained cinnamon, as well; one pound cost 300  denarii .


The word "malabathrum" is the Hellenization of the  Sanskrit  word  tamālapattram  (तमालपत्त्रम्), literally meaning "dark-tree leaves", with the  ta  being mistaken for the Greek definite article. [ 1 ]


Marine  pharmacognosy  is the investigation and identification of medically important plants and animals in the marine environment. It is a sub branch of terrestrial pharmacognosy. Generally the drugs are obtained from the marine species of bacteria, virus, algae, fungi and sponges. It is a relatively new field of study in western medicine, although many marine organisms were used in  traditional Chinese medicine . It was not until 2004 that the first FDA approval of a drug came directly from the sea:  ziconotide , which was isolated from a marine cone snail.


With 79% of the Earth's surface covered by water, research into the chemistry of marine organisms is relatively unexplored and represents a vast resource for new medicines to combat major diseases such as  cancer ,  AIDS  or  malaria . Research typically focuses on sessile organisms or slow moving animals because of their inherent need for chemical defenses.


Standard research involves an extraction of the organism in a suitable solvent followed by either an assay of this crude extract for a particular disease target or a rationally guided isolation of new chemical compounds using standard  chromatography  techniques.


Over 70% of the Earth's surface is covered by oceans which contain 95% of the Earth's biosphere. [ 1 ]  It was over 3500 million years ago that organisms first appeared in the sea. Over time, they have evolved many different mechanisms to survive the various harsh environments which include extreme temperatures, salinity, pressure, different levels of aeration and radiation, overcoming effects of mutation, and combating infection, fouling and overgrowth by other organisms. [ 1 ] [ 2 ]  Adaptations to survive the different environments could be by physical or chemical adaptation. Organisms with no apparent physical defense, like  sessile  organisms, are believed to have evolved chemical defenses to protect themselves. [ 1 ]  It is also believed that the compounds would have to be extremely potent due to the dilution effect of seawater. This has been described to be analogues to pheromones but with the purpose of repelling instead of attracting. [ 3 ]  As well, predators have evolved chemical weapons in order to paralyze or kill prey.  Conus magus  is an example of a cone snail that has a poisoned harpoon-like projectile which it uses to paralyze prey like small fish. [ 4 ]  Some organisms, like the  Viperfish , are believed to attract small fish or prey by using its  photophore . [ 5 ]


Many different marine organisms have been explored for bioactive compounds. Some vertebrate animals include fish, sharks and snakes. Some examples of invertebrates are sponges, coelenterates, tunicates, echinoderms, corals, algae, molluscs and bryozoans. Some microorganisms include bacteria, fungi and cyanobacteria. [ 6 ]


There is an ongoing debate on what organisms are the actual true producers of some compounds. About 40% of the biomass of sponges can be from microorganisms. It's not surprising that some compounds may actually be produced by symbiotic microorganisms rather than the host.


Marine environments are considered more biologically diverse than terrestrial environments. [ 4 ] [ 7 ]  Thirty-two different animal phyla are represented in the oceans of the 33 recognized phyla. Fifteen different phyla are represented only in marine environments, while only 1 is exclusively terrestrial. Marine phyla also contain functionally unique organisms such as filter feeders and sessile organisms which have no terrestrial counterpart. Also, marine autotrophs are more diverse than their terrestrial counterparts this is extremely important. Marine autotrophs are believed to stem from at least 8 ancient clades while terrestrial organisms mainly stem from one clade,  Embyrophyta . [ 7 ]  Marine environments may contain over 80% of the world's plant and animal species. [ 6 ]  The diversity of coral reefs can be extraordinary with species diversity reaching 1000 species per meter squared. The greatest marine tropical biodiversity is reported to be in the Indo-Pacific Ocean. [ 8 ]


Collecting marine samples can range from very simple and inexpensive to very complicated expensive. Samples from near or on shores are readily accessible via  beach combing ,  wading  or  snorkeling . [ 3 ] [ 9 ]  Sample collection from deep water can be completed via  dredging  however, this is a very invasive technique which destroys the local habitat, does not allow for repeated sampling from the same location and compromises sample integrity.  Corers  can be used for sediment sample collection from deep locations quickly, easily and inexpensively.  SCUBA diving  was introduced in the 1940s however, [ 3 ]  it was not widely used until it became popular in the 1970s. SCUBA diving is limited in the duration that divers can spend underwater when conducted from the surface. If prolonged dives were necessary, an underwater laboratory could be used.  Aquarius  is the only underwater laboratory dedicated to marine science. [ 10 ]  For sample collection from depths that cannot be achieved by SCUBA diving,  submersibles  may be used. Sample collection by submersibles can be extremely expensive with costs for a submersible, support ship, technicians and support staff ranging between $10,000 to $45,000 per day. [ 11 ]


For the isolation of biologically active compounds from organisms, several different steps need to be completed. The different steps required to obtain a biologically active compound are:  Extraction ,  chromatographic purification , dereplication,  structure elucidation  and  bioassay  testing. The steps do not have to follow that particular order and many steps may be completed simultaneously. In the first step, the sample may be  triturated  and  extracted  with a suitable solvent or  macerated . Some solvents used are  methanol : chloroform ,  ethanol ,  acetonitrile , or others. The purpose is to remove organic compounds that have a medium polarity which are considered more  "drug-like" . Ideally, polar compounds like  salts ,  peptides ,  sugars  as well as very non-polar compounds like  lipids  are left behind to simplify chromatography since they are not generally considered "drug-like". Drying of the sample could be completed before extraction by  lyophilisation  to remove any excess water and therefore limit the amount of highly polar compounds extracted.


The next step depends on the methodology of individual laboratories. Bioassay-guided fractionation is a common method to find biologically active compounds. This involves testing the crude extract or preliminary fractions from chromatography in an assay or multiple assays, determining what fractions or crude extracts show activity in the specific assays, and further fractionating the active fractions or extracts. This step is than repeated where the new fractions are tested and the active fractions are further fractionated. This continues until the fraction only contains one compound. Dereplication is ideally performed as early as possible to determine if the active compound has been previously reported in order to prevent "rediscovering" a compound. This can be performed using  Liquid Chromatography- Mass Spectrometry  (LC-MS) data or  Nuclear Magnetic Resonance  (NMR) data obtained in the biological assay-guided process and then comparing the information to that found in databases of previously reported compounds.


Structure elucidation is performed by using NMR data obtained of the compound and High Resolution Mass Spectrometry (HR-MS) Data.  Tandem Mass Spectrometry  can also be useful, especially for large molecules like  glycolipids ,  proteins ,  polysaccharides  or  peptides . Completed characterization for publication purposes may require  Infrared (IR) ,  Ultraviolet-visible (UV-vis) ,  specific rotation  and  melting point  data. Obtaining a  crystal structure  via  X-ray crystallography  can greatly accelerate and simplify structure elucidation however, obtaining crystals can be quite difficult.


There are many different bioassays available for testing. There are  anticancer ,  antimicrobial ,  antiviral ,  anti-inflammatory ,  antiparasitic ,  anticholesterolemic , and many other differ assays. For  MTT assay  and  cytosolic   Lactate dehydrogenase (LDH)  release are common  cytotoxicity  or  cell viability assays .


A common problem that plagues drug development is obtaining a sustainable supply of the compound. Compounds isolated from invertebrates can be difficult to obtain in sufficient quantity for clinical trials. Synthesis is an alternate source of the compound of interest if the compound is simple otherwise, it is generally not a viable alternative. Aqua culture is another alternative if the organism is readily grown otherwise, it may not be good sustainable source of a compound. Also, the small quantity the compound is usually found in from organisms makes this alternative even more expensive. For example,  ET-743  (INN name trabectedin, brand name Yondelis) can be isolated from the tunicate  Ecteinascidia turbinata  with a yield of 2 g per ton. [ 3 ]  This would require thousands of tons of tunicate to be grown and extracted to produce the kilograms of ET-743 that would be required for the treatment of thousands of people. Some success has been had in producing compounds of interest from microorganisms. Microorganisms can be used as a sustainable source for the production of compounds of interest. They can also be used for the production of intermediates so that semisynthesis can be used to produce the final compound. This has been achieved for ET-743 with the production of the intermediate Safracin B from  Pseudomonas fluoresens  and the subsequent semisynthesis into ET-743. This is currently the industrial production method for the production of Yondelis. [ 12 ]


α Includes natural products or natural product derivatives or analogues;
 β Number of active trials/number of total trials from  http://www.clinicaltrials.gov/  as of July 2011