traditional arabic and islamic medicine, a re-emerging

Advance Access Publication 13 June 2008 eCAM 20107(4)419ndash424doi101093ecamnen039

Review

Traditional Arabic and Islamic Medicine a Re-emerging Health Aid

Hassan Azaizeh1 Bashar Saad123 Edwin Cooper4 and Omar Said15

1The Galilee Society RampD Center PO Box 437 Shefa-Amr 20200 2Qasemi Research Center Al-QasemiAcademic College Baga Algharbiya Israel 3Faculty of Allied Medical Sciences Arab American University JeninPO Box 240 Jenin Palestine 4Laboratory of Comparative Neuroimmunology Department of NeurobiologyDavid Geffen School of Medicine at UCLA Los Angeles CA USA and 5Antaki Center for Herbal Medicine LtdKufur Kanna (Cana of Galilee) Israel

Complementary medicine is a formal method of health care in most countries of the ancientworld It is expected to become more widely integrated into the modern medical systemincluding the medical curriculum Despite the perception of modern medicine as more effica-cious traditional medicine continues to be practiced More than 70 of the developing worldrsquospopulation still depends primarily on the complementary and alternative systems of medicine(CAM) In rural areas cultural beliefs and practices often lead to self-care home remedies orconsultation with traditional healers Herbal medicine can be broadly classified into four basicsystems as follows Traditional Chinese Herbalism Ayurvedic Herbalism Western Herbalismmdashwhich originally came from Greece and Rome to Europe and then spread to North and SouthAmerica and Traditional Arabic and Islamic Medicine (TAIM) There is no doubt that todaythe concept of Arabic traditional herbal medicine is a part of modern life in the Middle Eastand it is acquiring worldwide respect with growing interest among traditional herbalistsand the scientific community TAIM therapies have shown remarkable success in healing acuteas well as chronic diseases and have been utilized by people in most countries of theMediterranean who have faith in spiritual healers TAIM is the first choice for many in dealingwith ailments such as infertility epilepsy psychosomatic troubles and depression In parallelissues of efficacy and safety of complementary medicine have become increasingly importantand supervision of the techniques and procedures used is required for commercial as well astraditional uses More research is therefore needed to understand this type of medicine andensure its safe usage The present review will discuss the status of traditional Arab medicine(particularly herbal medicine) including the efficacy and toxicity of specific medicinal prepara-tions with an emphasis on the modern in vitro and in vivo techniques

Keywords Arab herbal medicine ndash efficacy ndash toxicity

Traditional Arabic and Islamic Medicine JoinsTCM CAM Kampo and Ayurveda

There are several well-known and established medicinal

plant heritages worldwide including the Kampo TCM

TIM and Ayurveda There has been increased global

interest in traditional medicine and there are effortsunderway to monitor and regulate herbal drugs and tradi-tional medicine China has been successful in promot-ing its therapies with more research and a science-basedapproach while Ayurveda still needs more extensivescientific research and evidence bases Kampo medicineis widely practiced in Japan where it is fully integratedinto the modern health care system Kampo is basedon traditional Chinese medicine but adapted to Japaneseculture With only slight modifications it has been

For reprints and all correspondence Dr Hassan Azaizeh or ProfBashar Saad The Galilee Society RampD Center PO Box 437 ShefaAmr 20200 Israel Tel +972-4-95045234 Fax +972-4-9504525E-mail bsaadgal-socorg or hazaizigal-socorg

2008 The Author(s)This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (httpcreativecommonsorglicensesby-nc20uk) which permits unrestricted non-commercial use distribution and reproduction in any medium provided the original work isproperly cited

adopted also in Taiwan and exported from Taiwan to theWest Kampo spread rapidly during the period 1985ndash95after that the number of practitioners stabilized at a near-constant level (12) By 1985 it was reported that about20ndash25 of the medical doctors in Japan were prescribingsome herbal medicines in their practice However aspointed out by Terasawa Katsutoshi only about 100 or sodoctors were routinely prescribing Kampo medicinesto their patients The proportion of doctors that providesome Kampo medicines has risen to about 50 or moreby some estimates with a proportional increase in Kampospecialists by more than 200 In addition there areabout 10 000 pharmacies in Japan that dispense herbalformulas In Japan unlike Western countries some partof Kampo remedies and acupuncture are covered bypublic health insurance (12) Therefore Japanese practi-tioners of Kampo and acupuncture would object to theirinclusion in Complementary and Alternative Medicine(CAM) and would rather regard themselves as belongingto the authentic traditional medicine Ayurveda tradi-tional Indian medicine (TIM) and traditional Chinesemedicine (TCM) remain the most ancient yet livingtraditionsThe history and development of TCM in Taiwan

started during the end of the Ming dynasty when large-scale migration from Mainland China took place (3) Themigrants brought with them a 2000 year old knowledgeof TCM complemented by the rich flora and faunaof Taiwan and the local knowledge of the aboriginalpeople TCM has now become the highest priority in theTaiwanrsquos blueprint for the development of biotechnologyWith thousands of years of accumulated knowledge andexperience in herbal medicine there is a will to preserveit at any cost although in early communist China it wasdiscouraged A utilization pattern for herbal medicine isjust emerging in Taiwan Uninformed patients unscru-pulous traders adulterated preparations unlicensed prac-titioners and illegal sources for herbal medicines havebeen blamed for creating a bad image of herbal medi-cine use in Taiwan (45) The decision to cover ChineseHerbal Medicine (CHM) treatment under TaiwanrsquosNational Health Insurance (NHI) in 1992 had a bigimpact on the pattern of CHM unitization in TaiwanSome researchers tried to find some link between theTCM and Ayurveda from the Indian subcontinent andtheir integration with other systems of medicine includ-ing Western medicine to realize the concept of sustain-able medicine (6) In this aspect several herbal medicinesfor potential steroidogenic activity have been screenedboth in vivo and in vitro to analyze their effect on steroidhormonesTraditional Chinese herbal therapy can be characterized

by the use of a large number of multi-herb formulaeTo provide modern and Western scientists who do notpossess background knowledge of Chinese literature andculture easy access to information a database with more

than 11 000 traditional Chinese herbal formulae wasconstructed (6) All information was then translated intounderstandable scientific terms in English TraditionalArabic and Islamic Medicine Joins (TAIM) on the otherhand is based on single plant species or a mixture ofa small number of local plant speciesAccording to Olalde Rangel et al (7) recent past

and current naturalists and phytotherapeutic practitionersshare a long and impressive tradition of knowledge andpride in curing illnesses These qualities have been sub-stantiated by the success of Chinese Kampo AyurvedicChumash or Mayan among many other traditionalmedicines From these traditional medicines it has beendemonstrated that every culture is capable of under-standing and lsquoinventingrsquo the meaning of disease andfinding probable cures (7) They may even be differentfrom our modern medical views The variety and extentof cultures to provide answers to traditional medicinesand to unsolved pathologies are firmly grounded inthe curiosity and observational capabilities of humansTo ensure this culture there are collective factorslsquoa background of extensive family practice in traditionalmedicinersquo crucial in the transmission and survival ofmedicinal plant knowledge among ethnic groups How-ever there is a possible curtailment of the wisdom andtherapies of traditional medicines that comes with geo-graphical and ethnic boundaries In addition the numberof plants potential formulations or properties is a for-midable concern for individual caregivers or groups tounderstand store and transmit (7)TAIM started hundreds of years ago and were used

until recently in many of the primary books in librariesthroughout Europe Research into the TAIM herbs hasbeen conducted in many Arab countries such as SyriaMorocco Yemen Egypt and others The most recentsurveys conducted on the potential uses of plant speciesin the Mediterranean region by ethnopharmacologistsrecorded 250ndash290 plant species belonging to differentfamilies still in use (89) The remedies are administeredby practitioners in forms of standard decoction preparedby boiling plant parts in hot water infusion in water oroil or inhalation of essential oils It is also taken as juicesyrup roasted material fresh salad or fruit maceratedplant parts oil milky sap poultice and paste In recentyears remedies based on TAIM herbs have been tested incooperation with physicians and started to be routinelyprescribed in Europe and in Mediterranean countries totheir patientsAccording to the World Health Organization (WHO)

more than three-quarters of the worldrsquos populationrely upon traditional medicine mainly herbs (medicinalplants) for health care Phytotherapy existed in oneway or another in different culturescivilizations butthe systematic and comprehensive works of Ibn Sina(Avicena in the West) in the form of Al-Qanun-fil-Tib(Canon of Medicine) occupies an eminent place in the

420 TAIM a re-emerging health aid

history of medicine This book has remained relevantover 600 years During the 15th and 16th centuries aloneit was published more than 35 times In addition to theuse of plants in their crude form for health care theyhave been the main source for chemical drugs Todaythere is a revival of interest in the use of medicinal plantsin the form of standardized extractsbotanicals partlydue to the high cost involved in the development ofpatentable chemical drugs and their multiple side effectsBotanicals such as Ispaghol Garlic Ginseng GingerGinkgo St Johnrsquos Wort Mucuna prureins and Sawpalmetto are gaining popularity for the purpose of healthcare The impact of journals publishing data on medicinalplants is increasing and there is a rising trend to includephytotherapy in the curriculum of medical schools inNorth America and Europe Over 70 of Germanphysicians prescribe herbs and St Johnrsquos Wort is morecommonly used than any chemical medicine to treat mildto moderate depression Phytotherapy is consideredrelatively safe as it contains multiple chemicals with aspecific composition acting as lsquoeffect-enhancing andorside-effects neutralizingrsquo though there is limited scientificevidence for this assumption Multidisciplinary teamwork including ethnobotanists pharmacologists physi-cians and phytochemists is essential for the fruitful out-come of medicinal plants research and such internationalsymposia as the aforementioned conference help toachieve this goal

Revival and Preservation of TAIM Knowledge

Parallel to the increasing interest in lsquomodernrsquo CAMtherapies and the historical importance of TAIM there isa similar trend in research activities dealing with theefficacy and safety of medicinal plants in the MiddleEast Historical and current studies indicate that theEastern region of the Mediterranean has been distin-guished for long periods with a rich inventory of naturalmedicinal herbs It is well documented that TAIM hascontributed greatly to the development of modern medi-cine in Europe and remains one of the closest forms oforiginal European medicine In recent years researchers atthe Galilee Society Research and Development Centerin cooperation with different institutes have publishedmore than 20 articles and review papers in peer reviewedJournals on this subject (8ndash16) These articles demon-strate the importance of traditional Arabic medicine andindicate that the Eastern region of the Mediterranean hasbeen distinguished from other regions by a rich inventoryof complementary alternative medicine in particularherbal medicine The data collected during these studiesindicated that 200ndash250 herbs are still used in treatinghuman diseases and are sold or traded in market placesin the Mediterranean region or internationally Some ofthese plant species have been investigated and bioactive

ingredients extracted to treat various human diseases and

as botanical pesticides (17ndash20)The modern use of Arab botanical medicines has

historical roots in ancient Arabic medicine Arab herbal-

ists pharmacologists chemists and physicians in the

middle ages adopted the ancient medicinal practices of

Mesopotamia Greece Rome Persia and India Medical

innovations introduced by Arab physicians included

the discovery of the immune system the introduction of

microbiological science and the separation of medicine

from pharmacological science Recent ethnopharmaco-logical surveys conducted by different groups in the

Middle East support the necessity of proper handling of

herbal medicine used in TAIM which requires suitable

regulation and licensing in order to ensure supply of

appropriate and safe products (89) Fortunately today

there is a countertrend underway to preserve natural

botanical resources through an increasing emphasis on

conservation by way of botanical gardens greenhouses

herbariums tissue cultures propagation and seed banksIn an effort to help revive and preserve the knowledge

of TAIM an international conference on the current

state of research and practice in the field was organized

in 2007 This three-day conference took place in AmmanJordan during August 8ndash10 and included an exhibition

and poster session The conference intended to (i) estab-

lish an institution to serve as a network for all stake-

holders in TAIM as a prerequisite to revitalizing this

important subject and to coordinate research and

different activities in this field (ii) revive the heritage of

TAIM in order to present it in its normal environment

in order to release it from the political restrictions of the

Middle East (iii) revitalize this heritage as a scientific

discipline and raise awareness of TAIM (iv) explore the

economic and sustainability aspects of this heritage and

encourage investment to develop pharmaceutical prod-

ucts based on this culture and (v) increase the number

of practitioners and quality of the practice of TAIMby training new and existing practitioners (21) The con-

ference was designed for research scientists local and

regional traditional healers international pharmaceutical

and medical research companies medical doctors ethno-

pharmacologists and other parties interested in the study

of traditional Arabic and Islamic medicine All bodies

and institutions research centers and interested parties

working in the field of Arab medicinal plants were invited

to participate in the conference which was structured

into six sessions Discussions touched on the historical

and cultural aspects of Arabic Islamic medicine and its

contribution to modern medicine and to human well-

being The global scientific research on medicinal and

aromatic plants pharmaceutical research clinical trials

as well as international legislation and intellectual prop-erty rights on Arabic and Islamic medicinal plants of

the region were also reviewed Each of the six sections

eCAM 20107(4) 421

discussed a different issue related to TAIM Their mainpoints are delineated as described subsequently

Ethnopharmacology of Medicinal Plants used in TAIM

Historical and current studies indicate that the Easternregion of the Mediterranean has been distinguished fromother regions by a rich inventory of CAM in particularherbal medicine Data also indicate that there is a flour-ishing and well-developed trade of herbs some of whichare rare or endangered species Unfortunately withregard to the status of the herbalistsrsquo knowledge herbalmedicine in our region is mostly prescribed symptom-atically by ethnopharmacologists that is based on signsand symptoms alone rather than on a full understand-ing of the underlying disease In other cases herbs usedtoday may not even correspond to the plants describedoriginally in the old literature as the former are culti-vated from herbs that went through different breedingprocedures over several centuries (10)

TAIM Heritage

During the 8th until the 11th centuries Arab physiciansupgraded the existing knowledge about herbs and theirpotential medical efficacy and safety Their greatest con-tributions to modern medicine were the immune systemand introduction of microbiological science [(22) formore details see review in Ref (12)] The Eastern regionof the Mediterranean has been distinguished throughoutgenerations by a rich inventory of natural medicinalherbs (822ndash24) The Middle Eastern region was coveredwith gt2600 plant species of which gt700 were notedfor their use as medicinal herbs or botanical pesticidesUnfortunately recent ethnopharmacological surveysreveal that 200ndash250 plant species are still in use in Arabtraditional medicine for the treatment of various diseases(825ndash28) There are several factors endangering plantdiversity or even causing eradication of these herbsincluding habitat loss habitat degradation and over-harvesting (29) Recent ethnopharmacological surveysconducted by different groups in the Middle East supportthe necessity of proper handling of herbal medicine whichrequires suitable regulation and licensing in order toensure supply of suitable and safe products (1325)Medicinal plants in the Middle Eastern region andworldwide are becoming increasingly rare due to theongoing destruction of their natural habitat and detri-mental climatic and environmental changes As a resultit is predicted that in semi-arid regions such as theMiddle East a number of species will disappear withinthe next 10 years particularly in desert or dry areasThis gives an added sense of urgency to initiate preserva-tion programs of regional medicinal plant geneticresources (15)

Al-Maissam

Al-Maissam the Galilee Societyrsquos Medicinal PlantsCenter was established based on in-depth study ofTAIM and intended to provide an efficient modelfor preserving and developing traditional knowledge onArabic medicinal plants A comprehensive survey oftraditional Palestinian herbal medicine practitioners wasconducted in order to assess the current status of theherbal medicinal practice (810) Results demonstratedthat unfortunately most practitioners have very limitedknowledge about herbal medicine and younger practi-tioners had even poorer knowledge than their oldercounterparts while many practitioners are turning tolsquomysticalrsquo or lsquomagicalrsquo methods of healing In additionplants used in certain regions are not used in others theeducation level of practitioners is in decline some medic-inal plant species are endangered and plant mixtures areof poorer quality and less variety in comparison to thepast (810) As a result of this survey it became clear thatindigenous plant knowledge is disappearing across recentgenerations The conclusion to be drawn was clearmdashthattraditional Palestinian medicinal practice is suffering andthat in time if action is not taken to ensure its survivalimportant parts of this heritage may disappear com-pletely and a wide variety of methods of treating variousdiseases may be lost to humanity The first effort madeby the Galilee Society to revive the Palestinian traditionalmedicinal heritage was the establishment of Al-MaissamAl-Maissam the Galilee Societyrsquos Medicinal PlantsCenter was founded in 1999 with main objectives ofpreserving and rediscovering the ancient Arab legacy ofherbal medicine Its activities include preserving nativemedicinal plants preserving and advancing ethnobotanyof the native flora and spreading this knowledge to alllevels of society (especially among the younger genera-tion) It is a unique biotechnology center and the first inour region where modern advanced research is used withtraditional Arab herbal medicine rendering it compatiblewith modern phytotherapy

In vitro Studies

In general in vitro test systems represent the first phaseof the evaluation procedure The in vitro cell culturemethods have the advantage of relatively well-controlledvariables and are generally accepted as a very effectivemethod for safety testing Advantages of these systemsover classical methods (such as long term studies onexperimental animals) include relatively well-controlledvariables decreased costs a reduced time to completionand reduced numbers of animals necessary to completethe study The fact that cells and tissues in vivo do notexist in isolation but communicate with and are inter-dependent of neighboring tissue makes it essential tosimulate the in vivo situation (1314)


Some studies on this subject were presented duringthe conference (21) including anti-colon-cancer effectsof Thymoquinone a natural drug with pro-oxidantactivities Also promising data was shown aboutSalograviolide A isolated from the indigenous Lebaneseplant Centaurea ainetensis Salograviolide A causesgrowth inhibition and cell death in skin cancer cells

In vivo and Clinical Trials

The use of in vivo experimentation and clinical trialsare important methods and despite the limitations ofanimal experimentation they are still crucial in herbaldrug development Developing a therapeutic remedy fromherbal origins is a complex process that has to passthrough various important preclinical steps These stepsinclude standardization of the herbal extract providingevidence of pharmacological activity and providingevidence of safetyPharmacological screening has to be carried out ulti-

mately on laboratory animals and this has many ethicalconsiderations regarding the proper conduct of suchscreening and the expected value of its outcomes The useof laboratory animals is unavoidable but should berationalized through careful planning Preliminary in vitrotesting should give some idea of the possible mechanismsof action and potential therapeutic usefulness of anherbal extract but obviously has its shortcomings Suchtests provide no information regarding biotransformationof the extract in the body pharmacokinetic aspects ofabsorption and fate To determine potential therapeuticusefulness in a certain disease state however appropri-ate animal models have been developed that mimic thehuman condition to some extent Animal models havebeen developed for many conditions including hyperten-sion myocardial infarction atherosclerosis ischemiabronchial asthma arthritis diabetes Parkinsonismdepression epilepsy gastric ulcers reflux oesophagitisinflammatory bowel disease cancer etc Extrapolation ofresults from animal to human should be carried out withgreat caution Animal models only mimic the symptomsin humans but not the etiology or the overall clinicalpicture Thus it is not possible to say that an extractwhich lowers blood pressure in rats rendered hypertensiveby L-NAME where the hypertension is due to endothe-lial dysfunction would function as well in a patientwhose hypertension is due to any other cause Strepto-zotocin induced diabetes in rat is not exactly the same asdiabetes in humans not only is the condition different inetiology but the human response may be quite differentfrom that of the rat particularly since diabetes in humansis normally associated with a number of events that maynot be seen in the ratThe metabolism and pharmacokinetic behavior of

active constituents may differ from species to speciesand accordingly the interpretation of animal findings may

not necessarily be applicable to humans In generaltherefore animal models are artificially induced condi-tions said to be analogous to the human diseases they areintended to simulate but they differ substantially fromtheir human lsquocounterpartsrsquo in both cause and clinicalcourse This also holds true for toxicological studiesSuch studies should always be performed according tointernational guidelines and are a prerequisite for eval-uating the safety of potentially useful therapeutic agents

Market Authorization Regulations for Herbal Products

Regulations are needed to ensure safety quality and effi-cacy of herbal medicines Countries define herbal medic-ines differently and have adopted various approaches tolicensing dispensing manufacturing and trading theseproducts The main differences in the regulations govern-ing herbal medicines in different countries were discussedat the conference Within Europe and according to thecountry using them herbal medicines are either fullylicensed as medicines with efficacy proven by clinicaltrials or have a more simplified approach toward proofof efficacy In the USA most herbal products areconsidered dietary supplements and thus are not requiredto meet the more stringent standards for drugs specifiedin the Federal Food Drugs and Cosmetic Act Thesedifferent approaches have resulted in differences in theavailability of some herbal medicines

Acknowledgements

The authors would like to thank Ms Arisha Ashraf andMs Jamie Mandell from the Galilee Society Shefa-AmrIsrael for their constructive comments

References1 Yu F Takahashi T Moriya J Kawaura K Yamakawa J

Kusaka K et al Traditional Chinese medicine and Kampo areview from the distant past for the future J Int Med Res200634231ndash9

2 WHO 2001 Legal Status of Traditional Medicine andComplementaryAlternative Medicine A Worldwide Review httplibdocwhointhq2001WHO_EDM_TRM_20012pdf

3 Chen CF Shum YC Yang SP The modernization of traditionalChinese medicine in Taiwan- past present and futureIn Cooper EL Yamaguchi N (eds) Complementary and AlternativeApproaches to Biomedicine Santiana Med New York KluwerAcademicPlenum Publishers 2004 35ndash42

4 Yeh CH Tsai JL Li W Chen HM Lee SC Lin CF et al Useof alternative therapy among pediatric patients in Taiwan PediatrHematol Oncol 20001755ndash65

5 Deng JF Clinical toxicity of herbal medicine in TaiwanIn Wang HH Li J (eds) Proceedings of the 7th InternationalConference on Health Problems Related to the Chinese in NorthAmerica New York 1994

6 Kaphle K Wu L-S Yang N-YJ Lin JH Herbal medicine researchin Taiwan Evid Based Complement Altern Med 20063149ndash55

7 Olalde Rangel JA Magarici M Amendola F del Castillo O Thesystemic theory of living systems Part IV systemic medicinemdashthePraxis Evid Based Complement Altern Med 20052429ndash39

eCAM 20107(4) 423

8 Said O Khalil K Fulder S Azaizeh H Ethnopharmacologicalsurvey of medicinal herbs in Israel the Golan Heights and the WestBank region J Ethnopharmacol 200283251ndash65

9 Azaizeh H Saad B Khalil K Said O The state of the art oftraditional Arab herbal medicine in the Eastern region of theMediterranean a review Evid Based Complement Altern Med20063229ndash35

10 Azaizeh H Fulder S Khalil K Said O Ethnobotanical survey oflocal practitioners of the Middle Eastern region the status oftraditional Arabic medicine Fitoterapia 20037498ndash108

11 Azaizeh H Ljubuncic P Portnaya I Said O Cogan U Bomzon AFertilization-induced changes in growth parameters and antioxidantactivity of medicinal plants used in traditional Arab medicineEvid Based Complement Altern Med 20052549ndash56

12 Saad B Azaizeh H Said O Tradition and perspectives of Arabherbal medicine a review Evid Based Complement Altern Med20052475ndash9

13 Saad B Azaizeh H Abu Hijleh G Said O Safety of TraditionalArab herbal medicine Evid Based Complement Altern Med20063433ndash9

14 Saad B Dakwar S Said O Abu-Hijleh G Al Battah F Kmeel Aet al Evaluation of medicinal plant hepatotoxicity in co-cultures ofhepatocytes and monocytes Evid Based Complement Altern Med2006393ndash8

15 Saad B Azaizeh H Said O Arab botanical medicinesIn Ron Watson Victor Preedy (eds) The Encyclopedia ofBotanicals in Clinical Practice 31ndash39

16 Said O Fulder S Khalil K Azaizeh H Kassis E Saad BMaintaining a physiological blood glucose level with the help oflsquoGlucolevelrsquo a combination of four anti-diabetes plants used intraditional Arab herbal medicine Evid Based Complement AlternMed 200742

17 Mansour F Azaizeh H Saad B Tadmor Y Abo-Moch F Said OThe potential of Middle Eastern Flora as a source of new safe bio-acaricides to control tetranychus cinnabarinus ndash the carmine spidermite Phytoparasitica 20043266ndash72

18 Ljubuncic P Azaizeh H Portnaya I Cogan U Said O AbuSaleh K et al Antioxidant activity and cytotoxicity of eight

plants used in traditional Arab medicine J Ethnopharmacol20059943ndash7

19 Azaizeh H Kobaisy M Dakwar S Saad B Shaqir I Said OBotanical pesticides as a source of safe bio-acaricides for thecontrol of tetranychus cinnabarinus mites Fitoterapia ActaPhytopathologica et Entomologica Hungarica 200742143ndash52

20 Said O Khalil K Fulder S Azaizeh H Kassis E Saad B Safetytolerability and anti-obesity effects of weighlevel a combination ofAlchemilla vulgaris Olea europaea Mentha arvensis and Cuminumcyminum L J Integr Med Insights 2008 (in review)

21 Azaizeh H Saad B Cooper E Said O Traditional Arabic andIslamic medicine (TAIM) now join TCM CAM Kampo andAyurveda Evid based Complement Altern Med 2007 doi101093ecamnem157

22 Bin Murad I Research into the History of the Medicine andPharmacology of the Arabs Beirut Lebanon Dar AlGarb AlIslami1991 (in Arabic)

23 AlTurkimany JOA AlMoatamad Fi Aladweah Almofradah(The source of the single Pharmaceuticals) Revised by AlSakaM Beirut Lebanon Dar AlKalam Publishing 1993 (in Arabic)

24 Bacher W Scham als Name Palastinas Jewish Q Rev190618564ndash5

25 Abu-Irmaileh BE Afifi FU Herbal medicine in Jordan with specialemphasis on commonly used herbs J Ethnopharmacol 200389193ndash7

26 Halberstein RA Davis JE Biosocial aspects of high blood pressurein the Bahamas Hum Biol 198456317ndash28

27 Lev E Amar Z Ethnopharmacological survey of traditional drugssold in Israel at the end of the 20th century J Ethnopharmacol200072191ndash205

28 Lev E Amar Z Ethnopharmacological survey of traditional drugssold in the kingdom of Jordan J Ethnopharmacol 200282131ndash45

29 Hamilton AC Threats to plants an analysis of centers of plantdiversity In Touchell DH Dixon KW (eds) Conservation into the21st Century Proceedings of 4th International Botanic GardensConservation Congress Vol Perth Australia Kings Park andBotanic Garden 1997 309ndash22

Received November 29 2007 accepted May 9 2008


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adopted also in Taiwan and exported from Taiwan to theWest Kampo spread rapidly during the period 1985ndash95after that the number of practitioners stabilized at a near-constant level (12) By 1985 it was reported that about20ndash25 of the medical doctors in Japan were prescribingsome herbal medicines in their practice However aspointed out by Terasawa Katsutoshi only about 100 or sodoctors were routinely prescribing Kampo medicinesto their patients The proportion of doctors that providesome Kampo medicines has risen to about 50 or moreby some estimates with a proportional increase in Kampospecialists by more than 200 In addition there areabout 10 000 pharmacies in Japan that dispense herbalformulas In Japan unlike Western countries some partof Kampo remedies and acupuncture are covered bypublic health insurance (12) Therefore Japanese practi-tioners of Kampo and acupuncture would object to theirinclusion in Complementary and Alternative Medicine(CAM) and would rather regard themselves as belongingto the authentic traditional medicine Ayurveda tradi-tional Indian medicine (TIM) and traditional Chinesemedicine (TCM) remain the most ancient yet livingtraditionsThe history and development of TCM in Taiwan

started during the end of the Ming dynasty when large-scale migration from Mainland China took place (3) Themigrants brought with them a 2000 year old knowledgeof TCM complemented by the rich flora and faunaof Taiwan and the local knowledge of the aboriginalpeople TCM has now become the highest priority in theTaiwanrsquos blueprint for the development of biotechnologyWith thousands of years of accumulated knowledge andexperience in herbal medicine there is a will to preserveit at any cost although in early communist China it wasdiscouraged A utilization pattern for herbal medicine isjust emerging in Taiwan Uninformed patients unscru-pulous traders adulterated preparations unlicensed prac-titioners and illegal sources for herbal medicines havebeen blamed for creating a bad image of herbal medi-cine use in Taiwan (45) The decision to cover ChineseHerbal Medicine (CHM) treatment under TaiwanrsquosNational Health Insurance (NHI) in 1992 had a bigimpact on the pattern of CHM unitization in TaiwanSome researchers tried to find some link between theTCM and Ayurveda from the Indian subcontinent andtheir integration with other systems of medicine includ-ing Western medicine to realize the concept of sustain-able medicine (6) In this aspect several herbal medicinesfor potential steroidogenic activity have been screenedboth in vivo and in vitro to analyze their effect on steroidhormonesTraditional Chinese herbal therapy can be characterized

by the use of a large number of multi-herb formulaeTo provide modern and Western scientists who do notpossess background knowledge of Chinese literature andculture easy access to information a database with more

than 11 000 traditional Chinese herbal formulae wasconstructed (6) All information was then translated intounderstandable scientific terms in English TraditionalArabic and Islamic Medicine Joins (TAIM) on the otherhand is based on single plant species or a mixture ofa small number of local plant speciesAccording to Olalde Rangel et al (7) recent past

and current naturalists and phytotherapeutic practitionersshare a long and impressive tradition of knowledge andpride in curing illnesses These qualities have been sub-stantiated by the success of Chinese Kampo AyurvedicChumash or Mayan among many other traditionalmedicines From these traditional medicines it has beendemonstrated that every culture is capable of under-standing and lsquoinventingrsquo the meaning of disease andfinding probable cures (7) They may even be differentfrom our modern medical views The variety and extentof cultures to provide answers to traditional medicinesand to unsolved pathologies are firmly grounded inthe curiosity and observational capabilities of humansTo ensure this culture there are collective factorslsquoa background of extensive family practice in traditionalmedicinersquo crucial in the transmission and survival ofmedicinal plant knowledge among ethnic groups How-ever there is a possible curtailment of the wisdom andtherapies of traditional medicines that comes with geo-graphical and ethnic boundaries In addition the numberof plants potential formulations or properties is a for-midable concern for individual caregivers or groups tounderstand store and transmit (7)TAIM started hundreds of years ago and were used

until recently in many of the primary books in librariesthroughout Europe Research into the TAIM herbs hasbeen conducted in many Arab countries such as SyriaMorocco Yemen Egypt and others The most recentsurveys conducted on the potential uses of plant speciesin the Mediterranean region by ethnopharmacologistsrecorded 250ndash290 plant species belonging to differentfamilies still in use (89) The remedies are administeredby practitioners in forms of standard decoction preparedby boiling plant parts in hot water infusion in water oroil or inhalation of essential oils It is also taken as juicesyrup roasted material fresh salad or fruit maceratedplant parts oil milky sap poultice and paste In recentyears remedies based on TAIM herbs have been tested incooperation with physicians and started to be routinelyprescribed in Europe and in Mediterranean countries totheir patientsAccording to the World Health Organization (WHO)

more than three-quarters of the worldrsquos populationrely upon traditional medicine mainly herbs (medicinalplants) for health care Phytotherapy existed in oneway or another in different culturescivilizations butthe systematic and comprehensive works of Ibn Sina(Avicena in the West) in the form of Al-Qanun-fil-Tib(Canon of Medicine) occupies an eminent place in the






















































eCAM 20107(4) 421




TAIM Heritage


Al-Maissam


In vitro Studies











Acknowledgements










eCAM 20107(4) 423































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of




































































eCAM 20107(4) 421




TAIM Heritage


Al-Maissam


In vitro Studies











Acknowledgements










eCAM 20107(4) 423































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of



















TAIM Heritage


Al-Maissam


In vitro Studies











Acknowledgements










eCAM 20107(4) 423































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of
























Acknowledgements










eCAM 20107(4) 423































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of














































of






Disease Markers



OncologyJournal of





PPAR Research



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traditional arabic and islamic medicine, a re-emerging

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