Clinical Pharmacognosy

Clinical Pharmacognosy
 A branch of Pharmacognosy which deals with uses, efficacy,
adverse effects, contraindications and precautions of natural
products or herbal drugs and also their interactions with food.
 Clinical pharmacognosy also involves clinical trials of
botanical and dietary supplements. Use of herbal drugs has
increased in the recent times. Use of herbal drugs demands for
standardization and research on quality control (identity,
purity and efficacy), therapeutic indications, safety profile.
 Medical herbalism
 Medical herbalism may be defined as the practice of using
products in which all active ingredients are of herbal origin to
treat the sick. In practice rather more detail is required.
 According to the World Health Organization (WHO)
Guidelines, herbal medicines are considered to be:
“Plant-derived materials or products with therapeutic or
other human health benefits which contain either raw or
processed ingredients from one or more plants”
In some traditions materials of inorganic or animal origin may also
be present.
The European Directive defines a herbal medicine thus:
“A substance or combination of substances
of herbal origin presented for treating or preventing
disease or with a view to making a medical diagnosis or
to restoring, correcting or modifying physiological
functions.”
 History
 The exact origins of herbalism are unknown. Probably it was
several different groups of prehistoric peoples who discovered
that some herbs were good to eat, whereas others had curative
powers.
 Humans also discovered plants with peculiar, reality altering,
stimulating and inebriating effects. In ancient cultures these
were considered to be ‘plants of the gods.
 The mechanism of action of herbs remained a mystery for
centuries – and in some cases still remains a mystery. Only the
development of sophisticated techniques of chemical analysis
in the last century has begun to provide some of the answers.
 The first medical records date from ancient China, Egypt and
India.
 History
 William Turner was the first person to study plants scientifically in the
sixteenth century. He travelled widely throughout Europe and grew plants in
his gardens in south-west London (later the Royal Botanical Gardens, Kew).
 At this time the Doctrine of Similar determined how plants were used. It was
promoted by Paracelsus (1493–1541). The basic principle of homeopathy is
that a substance that triggers a certain disease can also be used to treat that
disease
 Nicholas Culpepper (1616–54) was an influential proponent of the Doctrine of
Signatures (The Doctrine of Signatures posits that nature provides clues about
the therapeutic value of its creations. If a plant resembles a body part, it might
be used to treat ailments of that part) as well as various astrological theories,
by which herbs were set under the domination of the sun, moon or one of the
five planets then known. His herbal, published in 1652, was extremely
successful, being reprinted many times.
 18th–19th Century (Scientific Revolution)
• Rise of modern science led to the isolation of active compounds from
plants:
• E.g., Morphine from opium poppy, quinine from cinchona bark,
digitalis from foxglove.
• Herbal medicine became more formalized, and pharmacology (the study of
drugs) was born.
 20th Century: Decline and Revival
• The discovery of synthetic drugs (like antibiotics) caused a decline in
herbal medicine use.
• However, from the 1970s onward, a resurgence of interest in natural
therapies grew due to concerns about side effects of synthetic drugs and a
return to "natural healing.“
 21st Century: Integration with Modern Medicine
• Today, herbal medicine is increasingly used alongside conventional
medicine (called complementary or integrative medicine).
• WHO estimates that around 80% of the world's population still uses
herbal medicines for some part of their primary healthcare needs.
 Theory
Traditionally, the herbalist has recognised four clear
stages when offering treatment for any particular
condition, individualising the prescription according to
holistic methodology to take account of their patients’
particular needs:
1. Cleansing the body.
2. Mobilising the circulation.
3. Stimulating digestion.
4. Nourishment and repair.
 Theory
1. Cleansing the body: removal of toxins and other
noxious influences – real or imagined – that might cause
a physical or mental barrier to treatment. Diuretics,
expectorants and laxatives are involved here.
2. Mobilizing the Circulation:
Once the body is cleansed, improving blood and lymph
circulation is essential to ensure that nutrients, oxygen,
and immune cells reach all tissues efficiently. This helps
in removing any lingering toxins and inflammation.
Herbs like cayenne, ginger, or hawthorn may be used to
stimulate and support cardiovascular function.
 Theory
3 Stimulating Digestion
A healthy digestive system is crucial for absorbing nutrients. This
stage enhances the function of digestive organs, promotes enzyme
production, and ensures efficient breakdown and assimilation of
food. Common herbs include peppermint, fennel, and chamomile,
which support gut motility and reduce discomfort.
4. Nourishment and repair: in this phase the herbalist deals with the
debility arising from disease in the body. The term ‘tonic’ covers a
wide range of medicines used to support the body. Examples
include:
 Hawthorn (Crataegus oxyacanthoides): Strengthens the heart
and improves blood circulation.
 Milk Thistle (Silybum marianus): Protects and restores liver
function.
 St. John's Wort (Hypericum perforatum): Supports nervous
system health and uplifts mood.
 Study of Treatment by Herbal
Medicines
 Use of herbal drugs should be rational. Para herbalism must be
discouraged and avoided. In Para herbalism claims made for
herbalism are often not supported by scientific evidence or the
use of drug lack scientific logic. There are usually following
types of misunderstanding about herbal drugs:
1. Herbs can’t harm, only cure.
2. Whole herbs are more effective than their isolated active
constituents.
3. Natural herbs are more effective than synthetic drugs.
4. The doctrine of signature is meaningful.
5. Physiological tests in animals are not applicable to human
beings.
 Rational herbalism should be emphasized, as plants have long
served as sources of therapeutic agents.
 Drugs like digitalis, cinchona, rauwolfia, and belladonna have
provided valuable pharmaceuticals and inspired many
synthetic medicines.
 It is important to distinguish between conditions suitable for
self-medication and those requiring professional care.
 Herbal use is discouraged for pregnant or lactating women,
infants, and children under six.
 Elderly patients should use herbal drugs cautiously due to
reduced kidney and liver function, which can lead to toxic
accumulation.
Active constituents in herbal medicines
 Bitters stimulate appetite and gastric juice by activating bitter taste
receptors (e.g., quassia, quinine, strychnine).
 Hot herbs like black pepper, cayenne, and ginger act as metabolic
stimulants and enhance herbal effectiveness.
 Resins are sticky, protective plant substances used in herbal medicine;
balsams and propolis are notable examples.
 Saponins are foaming glycosides found in plants like Quillaia and
sarsaparilla, used as detergents and in beverage.
 Tannins are protein-binding glycosides used in tanning and preservation,
known for their astringent properties.
 Volatile oils are aromatic, steam-volatile compounds (e.g., clove,
peppermint) used in medicine, cosmetics, and food.
 Alkaloids: Potent plant compounds (e.g., morphine, atropine) used for pain
relief, respiratory support, and central nervous system effects.
 Glycosides: Bioactive plant molecules (e.g., cardiac glycosides from
foxglove) used for heart stimulation and laxative effects.
 Flavonoids: Antioxidant-rich compounds (e.g., quercetin, rutin) used for
anti-inflammatory, vascular protection, and immune support.
 Herbal Medicines
Herbal medicines exist in different forms as:
1. Crude drugs Crude drugs are raw, unrefined natural substances such as
dried roots, leaves, bark, seeds, or flowers that retain their original structure
and are used directly in herbal preparations like infusions, decoctions, or
powders.
2. Herbal Tea: Herbal teas are blended formulations with active, supportive,
and sensory-enhancing ingredients for therapeutic use. Examples are
chamomile tea, peppermint tea etc.
3. Decoctions: Boiled water extracts made from tougher, woody plant
materials. Examples: Licorice root decoction (for sore throat), cinnamon bark
decoction (for circulation).
4. Infusion: Liquid herbal preparation made by steeping soft plant parts (like
leaves or flowers) in hot water. Examples: Chamomile tea (for calming),
peppermint tea (for digestion).
5. Extracts: Concentrated herbal liquids produced using alcohol, water, or
other solvents.
 Applications of herbalism
1. Generalised conditions
-Autoimmune conditions
-Acute inflammation of muscles, joints and connective tissues
-Psoriasis and other skin conditions
2. Cardiovascular system
-Hypertension
-Angina
-Ongoing symptoms of cardiac disease
Patients with heart disease are reported to benefit
from treatment with herbal medicine with fewer side effects
 Applications of herbalism
3. Debility
-Chronic fatigue syndrome
-Fatigue and debility after illness
-Fatigue linked to depression
-Support during terminal illness
4. Fevers
-Fevers resulting from infectious causes
-Febrile symptoms of non-infectious origin
5. Respiratory system
-Upper respiratory tract infections
-Allergic rhinitis
-Bronchitis
-Asthma
 Applications of herbalism
6. Infectious disease
-Acute gastrointestinal, respiratory, and urinary
infections
-Topical bacterial infections
-Minor-to-moderate febrile infections
-Minor-to-moderate chronic bacterial, fungal and viral
infections
7. Malignant diseases
-Cancers of varying types
-Symptoms resulting from cancer
-Problems with body systems
 Applications of herbalism
8. Gastrointestinal (GI) system
-Dyspepsia
-GI reflux
-Food intolerance and allergies
-Constipation and diarrhoea
9. Genitourinary system
-Urinary tract infections
-Benign prostate hypertrophy Impaired lactation
10. Skin diseases
-Acne
-Allergic reactions
-Eczema.
 Applications of herbalism
11. Menopausal problems
-Premenopausal syndrome (PMS)
12. Nervous system
-Anxiety states
-Insomnia
-Nervous exhaustion
-Pain control
-Stress symptoms
HERBS USED TO TREAT
DIABETES
 1. Gymnema sylvestre
Common names
Gurmarboti, Gurmar (Sugar Destryoing),
Miracle fruit
Family
Asclepiadaceae
Geographical Source
A climbing plant native to India and Srilanka.
Part used:
Dried Whole herb is used.
Constituents:
Gymnemic acids
Gymnemasides
Gymnemasaponins
Flavones
Anthraquinones
Resins
Quercitol
Tartaric acid
Stigmasterol
Mechanism of Actions:
Gymnema contains substances that decrease the absorption of
sugar from the intestine.
Gymnema may also increase the amount of insulin in the body
and increase the growth of cells in the pancreas, which is the
place in the body where insulin is made.
Therapeutic Uses
1.The drug is blessed with a number of uses like
 Astringent
 Stomachic
 Diuretic
2. Anti-Diabetic Activity of Gymnema Leaves
Early research suggests that taking a specific gymnema extract
by mouth, in combination with insulin or diabetes
medications, can enhance blood sugar reduction in people with
type 1 or type 2 diabetes
3. Roots of Gymnema sylvestre
Remedy for snakebite
Adverse Effects
1.Diabetes: Gymnema can affect blood sugar levels in people
with diabetes. Watch for signs of low blood
sugar (hypoglycemia) and monitor your blood sugar carefully
if you have diabetes and use gymnema.
2. Surgery: Gymnema might affect blood sugar levels and could
interfere with blood sugar control during and after surgical
procedures. Stop using gymnema at least 2 weeks before a
scheduled surgery.

Contraindications:
Contraindicated in pregnancy. Stay on the safe side and avoid
use.
 2. Melia azadirachta
Common name
Neem, Indian lilac
Family
Meliaceae
Part used :
Dried leaves and bark
Constituents:
 Azadirachtin
 Nimbin
 Nimbidine
 β-sitosterol
 Amino acids
 Volatile oils, Tannins
Uses
 Anti diabetic
 Anthelmintic
 Anti fungal
 Anti bacterial
 Antiviral
 It is also prescribed for skin disease.
 Neem oil is used for healthy hair, to improve liver function, detoxify the
blood and balance the blood sugar levels.
Mechanism of Action (α- glucosidase inhibitor )
α-Glucosidase is an intestinal enzyme that catalyzes the breakdown of α-1,4-
glycosidic bond in oligosaccharides into glucose molecules which can be
absorbed by the intestine.
Development of α- glucosidase inhibitor derived from natural products is an
opportunity for a more economic management of diabetes mellitus
prevention.
M.azedarach leaves is potential candidate for development of anti-
hyperglycemic formulation.
Adverse effects:
1) It includes vomiting, diarrhea, drowsiness,
blood disorders, seizures, loss of
consciousness, coma, brain disorder and death.
2)If taken by mouth during pregnancy it can
cause miscarriage.
3) It can also cause hypoglycemia.
4) In very rare cases, it can also affect fertility.
 3. Momordica charantia:
Common name:
Bitter melon, bitter gourd or bitter squash.
Family
Cucurbitaceae
Part used
Dried ripen Fruit
Geographical Source:
M. charantia grows under a very wide range of conditions
throughout the tropics and subtropics.
Constituents
Dietary fiber, Vitamin A, β carotene, Zeaxanthine, Trace metals
Ca, Zn, Mg, Mn, P, charantin, Polypeptide-p
Mechanism of Action:
Polypeptide-p
 Bitter melon is one of the most commonly used
vegetable that contains polypeptide-p and is used to
control diabetes naturally. Polypeptide-p or p-insulin
is an insulin-like hypoglycemic protein, shown to
lower blood glucose levels in animals and humans
when injected subcutaneously.
 The p-insulin works by mimicking the action of
human insulin in the body and thus may be used as
plant-based insulin replacement in patients with type-
1 diabetes.
Uses:
 Anti diabetic, stomachic, Laxative, emetic, anthelmintic agent,
For the treatment of respiratory diseases, skin diseases,
wounds, ulcer, gout, and rheumatism.
Adverse effects:
 Diarrhea,
 Abdominal pain,
 Fever,
 Hypoglycemia,
 Chest pain

Contraindications:
Contraindicated in pregnant women because it can induce
bleeding, contractions and abortion.
 4. Syzygium jambolanum

Common name
Jamun, Malabar plum
Family
Myrtaceae
Part used
Fruit & seeds, bark is also used.
Geographical source:
Plant is an evergreen plant grows in tropical and
subtropical regions.
Constituents:
Jamboline,
vitamins (B1, B2, B3, B6 and C) and water,
Anthocyanine.
Glycosides.
 Ellagic acid, isoquercitin, kaemferol.

Mechanism of action:.
Syzygium Jambolanum seed shows
hypoglycemic effect by inhibiting α-amylase
activity on starch in vitro even at lower
concentration.
Uses
 Anti-diabetic
 It is used for digestion disorders including gas (flatulence),
bowel spasms, stomach problems, and severe diarrhea.
 Another use is treatment of lung problems such as bronchitis
and asthma.
 It is also applied directly to the skin for skin ulcers and
inflammation of skin.
 In combination with other herbs jambolan seed is used for
constipation, diseases of pancreas, stomach problems, nervous
disorders, depression and exhaustion.
Contraindication:
Contraindicated in pregnancy
Adverse Effects:
 Hypoglycemia
Herbs used in the treatment of
Respiratory diseases
 1. Adhatoda vasica
Common names: Adusa, Bansa, Arosa, ‫ بانسہ‬،‫اڑوسہ‬,Vasaka
Family: Acanthaceae
Parts Used: Leaves, roots, flowers and stem bark
Constituents:
• Alkaloids: Vasicine is the major alkaloid available in different
parts of the herb.
• The leaves contain alkaloids like vasicinone, vasicinol,
adhatonine, and adhatodine
• The roots contain vasicinol, vasicinolone, and vasicol.
• Phytosterols
• Flavonoids
Mechanism:
The possible mechanism of action may be blockade of H1 and Ach receptors
leading to inhibition of smooth muscle to respond to histamine and Ach
induced spasm leading to inhibition of bronchoconstriction.
Uses:
Adhatoda vasica is a valuable plant and it has been proven for its medicinal
properties against a broad array of diseases specially, for the respiratory
ailments like:
•Cough (with yellow thick sputum and fever)
•Chronic cough due to Tuberculosis along with anti-tubercular medicines
•Upper respiratory infections (with a fever and productive cough)
•Chronic Bronchitis
•Tonsillitis (swelling or inflammation of tonsils with redness)
•Throat ulcers
•Angina pectoris
•Heart diseases (including high blood pressure)
•Dengue Fever
Safety Profile
• All parts of Adhatoda Vasica are likely safe to consume as per
dosage described.
Side effects of Vasaka (Adhatoda Vasica)
• There are no side effects observed with Adhatoda Vasica when
it is used in a natural form including leaf powder, leaf juice,
decoction etc.
Pregnancy & Lactation
• There is no study available for the crude form of
Vasaka safety in breastfeeding and pregnancy.
• In Ayurveda, Adhatoda Vasica is used during pregnancy to
reduce symptoms of nausea, vomiting, acidity along with
ginger. Therefore, it might be safe during pregnancy and
breastfeeding for short-term use. The long-term use should be
discouraged.
 2. Ficus religiosa
Common name: Pippal
Family:
Moraceae
Part used:
Dried bark, fruits and leaves
Constituents: Tannins, wax, arabinose,
mannose, phenolic glucosides, vitamins
Mechanism:
It was found that the leaf extract of Ficus religiosa has
potential anti-inflammatory activity .The inhibitory activity was
found due to inhibition of release of histamine, Kinins and PG’s.

Further, various studies revealed that tannin present in the bark

possess anti-inflammatory effect.
Mast cell degranulation cause inflammation and Ficus religiosa
extract significantly reduced the percentage Of degranulation.
SAFETY PRECAUTIONS AND SIDE EFFECTS
It is always advisable to use any herb or herbal product after
consulting a medical practitioner. Over dosage may lead to
serious complications.
Uses
•Peepal Leaf: The leaves of Peepal tree serve as an expectorant, diuretic,
ointment. The juice of these leaves brings down nausea, cleanses digestive
system and maintains skin health. Being strongly astringent in properties,
Peepal leaf when heated exudes purgative properties and is recommended for
those with severe digestive issues.
•Peepal Bark: Brown in colour, thick and rough to touch, Peepal tree bark is
a powerhouse of vitamin K and the extracts perform a wide range of functions
related to skin health.
The bark extract when applied on dull skin tone for balances the complexion,
heals bruises, pigmentation, acne and scars.

•For Diarrhea: Take 2 grams of Peepal leaves powder, add it to 250 ml

drinking water and let it boil. Sip on it thrice a day to cure diarrhea.

•For Menorrhagia: Swallow 1 gram of Peepal bark powder along with

drinking water twice a day or as directed by the physician.
• Constipation: Peepal leaf juice works best in treating constipation, acidity
and other digestive related issues. Drink 1 tsp of Peepal leaf juice mixed
with lukewarm water and consume it before going to bed for
curing constipation.

• Improves Lung Power: Peepal tree emits 2400 kgs of oxygen in a day
and spending time under this tree at the crack of dawn can miraculously
treat various lung related ailments including asthma.

• Cures Poor Appetite: Eat ripe Peepal fruits that are purple in colour to
trigger digestive juices and for improving appetite.

• Arrests Nasal Bleeding: Put 1 to 2 drops of Peepal leaf juice in both

nostrils to stop it immediately

• Diarrhea With Blood: Pick softer stems from a Peepal branch, wash it
clean and grind it into paste. Mix it with coriander seeds, granulated sugar
in equal measurements and consume it in small quantities for 3 times in a
day for curing the condition.

• It also Heals Toothache, Purifies Blood, Pacifies Ear Pain, Boosts Cardiac
Health, Soothes Eczema And Itching, Brightens Complexion,
Herbs Used In The Treatment of
Hepatitis
 1.Berberis vulgaris
Common Name:
Common barberry
European barberry
Jaundice berry

Family
Berberidaceae

Part Used
When barberry is intended as herbal medicine it is primarily the stem, root
bark, and fruit that are used.
Constituents
The chief constituents are isoquinoline alkaloids like
• Berberine,
• Palmatine
• Berbamine,
• Hydroxycanthine ,
• Steroid stigmasteols
• Quercitin(Flavonoids)
• Rutin(Flavonoids)
• Resins
• Tannins
Medicinal Action and Uses
 Tonic
 Purgative
 Anti viral
 Anti Bacterial.
 It is used in all cases of jaundice (Hepatoprotective)
 Anti -pyretric
 Cough suppressant
Mechanism :
• Ethanolic extract of berberine inhibits HCV replication.
• The extract could protect liver against the CCl4-induced
oxidative damage in rats and this hepatoprotective effect
might be contributed to its modulation on detoxification
enzymes and its antioxidant and free radical scavenger effects.
Adverse Effects
Hypersensitivity reactions ( burning, itching, redness)
Contraindications
It should not be used in pregnancy as berberine
stimulates uterine contractions.
 2. Picrorhiza kurroa
Common name
Kutki or Katuki
Family
Scrophulariaceae
Parts used
Roots and rhizomes.
Constituents :
Main chemical constituents are glycosides, picroside
I, II and III, picrorhizin and kutkoside
D-mannitol, phenolic glycosides picein and androsin
and seven cucurbitacin glycoside.
Uses
1. It is antibacterial and anti-inflammatory in action.
2. It is useful in curing fever and stomach disorders.
3. It shows hepatoprotective properties and protects liver against
toxins.
4. It shows antioxidant activity.
5. It is used to lowers the high cholesterol level.
6. It helps in getting relief from viral hepatitis
7. It provides the cooling effect to the body.
8. It also helps in promoting the secretion of bile juices.
9. It also helps in solving skin problems.
Mechanism Of Action
The hepatoprotective action of Picrorhiza kurroa is not fully
understood but may be attributed to Picrorhiza’s ability to inhibit
the generation of oxygen anions and to scavenge free radicals.
Adverse Effects
Prolong use can cause vomiting, rash, diarrheoa, and itching.
It might cause the immune system become more active that could
increase the symptoms of autoimmune diseases.

Safety And Precautionary Measures

•Pregnancy and lactating women must avoid this.
•Should be used only after proper knowledge and prescription
 3. Lawsonia inermis
Common Name:
Hina, Henna, Mehndi
Family:
Lythraceae
Part Used:
Whole plant
Constituents:
 Lawsone(2-Hydroxy-1, 4- napthoquinone) is the principle
natural dye in the leaves of Henna.
 Flavonoids, Coumarins, Sterols, Tannins
 Glucose, mannitol, fat, resin and mucilage.
Uses:
1. Lawsonia inermis is useful against heat stroke and used against
a headache.
2.Henna bark and root are used for the treatment of liver
enlargement and jaundice.
3.It acts against hair loss and strengthens hair. Hence, henna is
used as a natural agent for baldness.
4.People suffering from fever or high-temperature use as a home
remedy for the treatment..
5.It is used for treatment of arthritis. Massage of Lawsonia
inermis oil for a month can give relief.
6.A decoction of the bark is used as an emmenagogue, and also
to treat liver problems .
7.The stembark is chewed and then kept between the teeth for
about 25 minutes in order to treat toothache
Mechanism Of Action:
Hepatoprotective effect is due to the
presence of polyphenols and gallic acid
which are potent free radical scavenging
agents and antioxidants.
Adverse Effect:
Inflammation of the skin (dermatitis). Rarely, allergic
reactions can occur such as hives, runny nose,
wheezing, and asthma.
Contraindications:
 It’s unsafe to take henna by mouth if you
are pregnant can lead to miscarriage.
 It’s also unsafe to take henna if you are
breast-feeding.