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Use of Medicinal Plants: Interindividual Variability of Their Effects from a Genetic…
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Medicine. 2019;(1):26. DOI:10.3390/
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[83] Orellana-Paucar A, Vintimilla-Rojas D.
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Chapter 20
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Complementary or Alternative
Plant Based Medicines and Its
Active Cons
tituents Responsible for
Overall Therapeutic Efficacy
RakhiMishra and BinitDwivedi
Abstract
Complementary or Alternative Medicine, like Homeopathic medicine, is made
from plant, animal, and mineral kingdoms and sometimes from biochemical
substances. Most of the Homeopathic remedies come from plant-based drugs. The
presences of the bioactive compound in the plants are responsible for the overall
therapeutic efficacy of Homeopathic medicines. The presence of bioactive compounds such as alkaloids, flavonoids, and phenols in plant drugs acts as a natural
source of antioxidant substances of high importance. The concentration of these
bioactive compounds and their antioxidant activity indicates that these compounds
contribute to the intense antioxidant activity of Homeopathic drugs. The scope of
the present research is to provide detailed information on plant-based Homeopathic
medicines containing specific active compounds, which justify their typical medicinal
usage in Homeopathy. It is one of the big reasons for the cure and healing properties
of Complementary or Alternative Medicine medicines.
Keywords: homeopathy, antioxidant, digitoxin, reserpine, potency
. Introduction
One of the Complementary or Alternative medicine-based systems like
Homeopathy is a belief that the body can cure itself [1]. Homeopathy developed in
the late 1700s in Germany, and the two primary principles of Homeopathy are [2,3]
“Like cure likes” principles. According to this principle, patients with particular
signs and symptoms are treated with homeopathy remedies that produce signs and
symptoms in healthy individuals [4]. Homeopathy is a medical system devised by
German physician Samuel Hahnemann (1755–1843). The first edition in which he
summarized homeopathy is Organon [5]. In his first fifteen years as a physician,
Hahnemann struggled a lot. One day, however, he discovered that he started taking
regular doses of cinchona or the bark “which contains quinine, a medicine to treat
malaria. The results produced symptoms like intermittent fever (malaria) and mild
degree characteristic rigors diseases [6]. This article was first published in 1796 as
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an essay on a new principle for ascertaining the curative power of Drugs which was
included in his famous work “The Organon of the Healing Art” [7]. Homeopathy
is based on using highly diluted solutions of substances selected by matching
the patient’s symptoms with the symptoms these substances produced in healthy
individuals [8].
Homeopathy preparations are termed remedies and are made using homeopathic
dilution, where selected substances are repeatedly diluted until the final product
is chemically indistinguishable from the diluents. Homeopaths hit or shake the
product in each dilution, claiming this makes the diluents remember the original
substance after its removal [9]. Homeopathic medicine is made from plant, animal,
and mineral kingdoms. Homeopathic medicines are made from plants such as
belladonna, arnica, and chamomile, minerals such as sulfur and mercury, animal
products such as Sepia, Lachesis, and sometimes biochemical substances such as
histamine or human growth factor. Remedies are prepared by the process of serial
dilution and succession. The greater the succession, the greater will be the potency
of the remedy.
. Homeopathic mother tincture and potencies
In homeopathy, Mother Tincture (Q ) is defined as the original drug substance
prepared with the aid of ethyl alcohol and water directly from the crude drug. They
are the precursors of the corresponding potencies of the respective drug and the starting point for the preparation of homeopathic medicines. The original drug substance
is used in extremely minute quantities to prepare a given homeopathic medicine,
and the method of preparing homeopathic medicines is called potentization; in this
method, one part of the original drug substance is mixed with nine parts of a vehicle
(ethyl alcohol and water) and shaken vigorously by a special device that converts the
preparation into the one tenth potency (1X) one tenth. On the other hand, one part
of the original drug substances is mixed with 99 parts of the carrier (ethyl alcohol) is
denoted as 1C potency (1:100). This process continued until the required potency is
reached and homeopathic medicines are available in certain standard potencies such
as 3X, 6X, 12X, 30X, 200X, 30C, 100C, 200C and 1000C etc. The potencies are nothing but energized dilutions (or attenuations) of the Mother Tinctures of homeopathic
remedies [10].
In homeopathy, practitioners select a drug that would, if given to a healthy volunteer, cause the presenting symptoms of the patient example Allium cepa is derived
from the common onion. While in contact with raw onion typically causes lacrimation, stinging and irritation around the eyes and nose, and clear nasal discharge.
Allium cepa might be prescribed to patients with hay fever, significantly if both nose
and eyes are affected.
Phytochemicals are biologically active naturally occurring chemical compounds
found in plants. These phytochemical compounds are highly beneficial for human
health. Generally, phytochemical compounds are classified as primary constituents
and secondary constituents. The phytochemicals are generally present in the roots,
stems, flowers, leaves, fruits, and seeds like various parts of the plant. This is the
reason all complementary medicines are made from different parts of the plants
depending upon the phytochemicals present therein to get maximum efficacy.
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Chlorophylls, nucleic acid, common sugar, amino acid, proteins, and purines
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areknown as primary constituents present in the plant. Chlorophyll forms
duringthe photosynthesis process, responsible for giving green color to the plant.
Italso plays a beneficial role for humans and helps in the binding to the carcinogeniccompounds in the body and inhibit their absorption in your intestine which
helps to prevent their reach to our liver tissues which can cause further harm to
thebody.
Alkaloids, phenols, flavonoids, terpenes, lignans, steroids, glucosides, and sapo
nins are known as secondary constituents present in the plant. Phenolic compounds
are the widely distributed phytochemicals present in various parts of the plant.
Flavonoids, phenolic acids, and polyphenols are the largest group of phenolic phytochemicals present in the plant kingdom. They act as strong antioxidant agents which
help the human body to fight against free radical groups and protect it from free–
radical mediated disease processes.
. Flavonoids
Flavonoids are the polyphenolic phytochemical compounds present in vegetables,
fruits, and beverages like tea, coffee, and fruit drinks [11]. Generally, flavonoids
are found in conjugated form in nature and are characterized as monoglycosidic
and diglycoscidic [12]. Flavonoids have many biological properties including antiinflammatory, anti-microbial, cytotoxic, and anti-tumor activities [13].
. Phenolic acids
Phenolic acids are a diverse group of hydroxyl benzoic and hydroxycinnamic acids
and esters with glucose and carboxylic acid, hydroxycinnamic acid-like molecules.
Phenolic acids act as a strong antioxidant agents and prevent the human body from
degenerative diseases [14]. The degenerative diseases are cardiovascular disease,
inflammation, and cancer. Phenolic acids have properties to act as strong antidiabetic
agents [15]. Phenolic acids can influence the role of insulin and glucose receptors [16].
Phenolic compounds also have properties to inhibit the activities of α-glucosidase and
α-amylase which are the main component of the conversion of dietary carbohydrates
into glucose hydroxybenzoic and hydroxyl cinnamic acids [17]. Phenolic acids known
for the prevention and treatment of cancer [18].
. Tannins
Tannins are a group of polyphenolic compounds with a high molecular weight
that can form complexes with polysaccharides, alkaloids, proteins, nucleic acid, and
minerals [19]. As per epidemiological studies [20] tannins are beneficial for human
health as they decrease the chance of creating chronic diseases. The tannins present in
plants are used as astringent, used against diarrhea, used as diuretics against stomach
problems, and duodenal tumors. Tannins have many biological properties including
anti-inflammatory [21], antiseptic, and antioxidant properties. Major phenolic compounds found in various plants are quercetin, oleanolic acid, ursolic acid, kaempferol,
luteolin, chlorogenic acid, curcumin, ascorbic acid, tannic acid, gallic acid [22] and,
rutin etc.
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. Alkaloids
Alkaloids are heterocyclic nitrogen atoms naturally synthesized by a large number
of organisms, including plants, animals, bacteria, and fungi [23]. Based on the type
of heterocyclic ring system present in the molecule, they are pyrrolidine alkaloids,
pyridine alkaloids, pyrrolidine-pyridine alkaloids, pyridine-piperidine alkaloids,
quinoline alkaloids and isoquinoline alkaloids [24].
. Essential oils
Essential oils are extracted from plants by a distillation process i.e. (liquid
extracts), also obtained by the physically squeezed method in which essential oil
squeeze out of some plants (like orange peels) in the case of flowers, extracted with a
nonpolar solvent i.e. lemon oil [25].
Lemon contains essential oil like limonene, sesquiterpene, limonene, sesquiterpenes, aldehydes (citral, and citronellal), and geranyl acetate). Eucalyptusoil contains
1,8-cineol and α-pinene, and chamomile oil contains (Bisabolol oxide, Chamazulene,
and α-Terpineol).
Essential oil like lemon oil is used as flavoring agent and are primarily used for
adding fragrance to cosmetics, foods, or your home via a diffuser, clove oil used as an
antimicrobial agent. Clove oil is used as a pain reliever such as toothache and muscle
pain, kills bacteria, and is also recommended for digestive upset. Eucalyptus oil is
commonly used in cold remedies like vapor rub.
. Triterpenes
Triterpenes are six isoprene units like Lanosterol and squalene. Triterpenes are
found in wheat germ and olives. Acyclic triterpene hydrocarbon squalene constitutes
more than half of the liver oil of various species which are widely distributed in
nature. These are found in fish liver oil, vegetable oil, fungi, human earwax, and
sebaceous secretions.
. Saponin
Saponins are secondary metabolites of the plant kingdom and are stable in aqueous
solutions such as soap, hence the name “saponin” is given to these compounds.
Saponins are a group of compounds that includes glycosylated steroids, triterpenoids,
and steroid alkaloids. Spirostan and furostan derivatives are the two main types of steroid aglycones. The main triterpene aglycone is a derivative of oleanane. The steroidal
saponins are essential precursors for steroid drugs. These steroid drugs act as strong
anti-inflammatory effects for example androgens, oestrogens, and progestins [26].
. Sterols
Sterols are a group of fat-like substances which occur naturally in the animal and
plant kingdom. Animal sterol is known as cholesterol whereas plant sterols are known
as ß-sitosterol, campesterol, and stigmasterol [27]. They have a similar structure to
cholesterol. The basis of their molecular framework is a double bond. If this double
bond is hydrolyzed, then the saturated plant sterols are formed from the unsaturated
plant sterols.
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. Some important Homeopathic plant-based drugs and their active
constituents responsible for the overall therapeutic efficacy of
Homeopathic drugs
. Leucas aspera
Leucas aspera
[29, 30]. It is a common weed in India and is widely distributed throughout the country. L. aspera whole plant is traditionally used as an antipyretic [31] and insecticide
[32, 33] drug. In homeopathy, L. aspera, mother tincture is used to treat dysentery,
jaundice, fever, a bite from venomous animals [34], and enlargement of the liver and
spleen. The main bioactive constituents of L. aspera are ursolic and oleanolic acid
[35]. Due to the presence of ursolic [36] and oleanolic acid-like triterpenes [37], it
possesses many pharmacological [38, 39] properties. L. aspera plant possesses antiinflammatory, hepatoprotective [40], antitumor [41], anticancer [42], antimicrobial
anti-HIV, antifungal, gastroprotective, hypoglycemic, and antihyperlipidemic
properties (Table ).
S. no. Part used Different pharmacological activity
1. Aerial Part Arthritis, Ulcer protective effect, Diabetes, Anticancer
2. Leaf Hepatoprotective activity, Cytotoxic activity, Antidiabetic
3. Roots Analgesic activity, antinociceptive activity, Central
4. Whole plant Cytotoxic activity, anti-inflammatory activity,
5. Shoot system including stem,
(Wild) Linn, family Lamiaceae [28], is commonly called “Thumbai”
activity, antipsoriatic activity
activity, antivenom activity
nervous system depressant activity
Hepatoprotective activity, Antihyperglycemic activity,
Antimutagenic activity, anthelminthic activity
leaves, and flower
anti-inflammatory activity
Table 1.
Leucas aspera plant parts responsible for different pharmacological activity [43, 44].
. Rauwolfia serpentina
Rauwolfia serpentina (Family: Apocynaceae) is a medicinally famous herb in
Homeopathy [45, 46]. Rauvolfia serpentina is therapeutically used as a sedative, a
hypnotic drug, and in hypertension. Reserpine (indole alkaloid) was isolated in 1952
from the dried root of R. serpentina (Indian snakeroot) [47], which had been known
as sarpagandha [48], and used for the treatment of insanity, fever, snakebites anxiety,
and neuropsychiatric conditions. Reserpine has ability to deplete catecholamines
[49]. Reserpine reduces glycemia in some cases, but the effect is short-lived. In some
patients, it has a stimulating effect on prothrombin activity. Reserpine produces
sedation and a lowering of blood pressure if administered orally, in hypertension;
the impact of Reserpine is slow, seldom appearing before 3–6days of administration
and continuing for some time after the withdrawal of the drug a cumulative effect.
It is most valuable in young patients with mild labile hypertension and tachycardia.
In long-established hypertension, it is best used in conjunction with more potent
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hypertensive drugs such as hexamethonium or hydralazine. Combined with polythiazide; it is a useful hypertensive in mild to moderate thiazide, it is a useful hypotensive
in mild to moderate conditions. The response to Reserpine varies in patients, and the
dosage must be adjusted to individual requirements. In severe hypertension, it may be
given by intravenous or intramuscular injection when the effect begins within a few
hours. Parenteral therapy of Reserpine is indicated in the treatment of hypertension
only when oral administration is impracticable [50]. Different alkaloids are present
in Rauwolfia, viz. ajmaline, ajmalinine, ajmalicine, scrpentine, and serpentinine [51].
Reserpine, yohimbine [52], recinnamine, reserpinine, rauwolfinine, renoxidine, rescinnamine, reserpiline, sarpagine, serpentinine, tetraphyllicine, 3-epi-a-yohimbine. It also
contains small amounts of phytosterol and fatty substances [53]. R. serpentina is one of
the essential drugs for various disorders, including hypertension (Table ).
S. no. Alkaloid Different pharmacological activity
1. Reserpine Antipsychotic activity and antihypertensive activity
2. Reserpiline Antihypertensive activity
3. Rescinnamine Antihypertensive activity
4. Ajmaline Antiarrhythmic activity
5. Ajmalicine Vasodilator
6. Serpentine Tranquilizer
7. Alstonine Antipsychotic activity
Table 2.
Rauwolfia serpentina major alkaloids responsible for different pharmacological activity [54].
. Digitalis purpurea
Digitalis purpurea, commonly known as Foxglove [55], is a biennial plant belonging to the family Plantaginaceae. It is indigenous to part of western and southwestern
Europe. In India, Digitalis purpurea is found in the Nilgiri hills of Tamil Nadu,
southern Sikkim, and the eastern Himalayan region. Its leaves contain both primary
and secondary glycosides. Digitoxin is the main active constituent of the D. purpurea
plant, which is used as cardiac glycoside in medicines. Digitoxin is generally known
as a highly toxic by-product [56]. In Homeopathy, D. purpurea is used for treating
heart-related diseases where the heart is primarily involved where the pulse is weak,
irregular, intermittent, abnormally slow, and dropsy of external and internal parts. In
females, during labor-pain in the abdomen and back before menses, and for uterine
hemorrhage [57] D. purpurea homeopathic medicine is recommended in Homeopathy.
As per the information given in the homeopathic book Materia Medica Pura, D.
purpurea is mainly used for diseases where the heart is primarily involved [58], such
as atrial flutter, atrial fibrillation, and in case of congestive heart failure conditions.
Cardiac glycosides [59], such as digitoxin in the leaves of D. purpurea [60], help to
prevent congestive heart failure by increasing the force of contractions of the heart in
the body. In previous suggested studies, digitoxin present in the leaves of Digitalis has
the highest gastrointestinal (GI) absorption of 90–100% with a half-life of 4–5days
[61] which is more significant than other commercially available cardiac steroids such
as Digoxin, Deslanoside, Ouabain [62]. D. purpurea, being rich in active constituents,
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shows cardiovascular, cytotoxic [63], antioxidant, anti-diabetic [64], insecticidal,
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immunological, cardioprotective, hepatoprotective, and neuroprotective effects and
has greater importance in Homeopathy.
. Hydrocotyle asiatica
Hydrocotyle asiatica
belongs to the family of perennial plants in the flowering plant Umbelliferae
(Apiaceae) [65]. H. asiatica is an essential Homeopathic medicinal plant widely used
as a medicine due to the benefit of its bioactive compounds such as asiatic acid [66],
rutin, kaempferol, quercetin, gallic acid, luteolin, and catechin [67]. Hydrocotyle
asiatica possess diverse pharmacological activities such as neuroprotective, nerve
regenerative, immunomodulatory, anti-depressive, memory enhancing [68], gastroprotective, cardioprotective, radioprotective, anti-cancer, antimicrobial, anti-inflammatory, anti-diabetic and antioxidative properties. H. asiatica contains the most
abundant triterpene glycoside asiatic acid, which shows cytotoxic activity on cancer
cells. Asiatic acid is a triterpene glycoside, commonly used for wound healing. Asiatic
acid has antioxidant, anti-inflammatory, and neuroprotective properties. H. asiatica
has been used in folk herbal medicine for centuries for memory enhancement, antidepressants [69], wound healing [70] and psoriasis remedy [71], and chronic disease
treatments [72]. In homeopathy, H. asiatica acts as a curative in disorders that exhibit
interstitial inflammation, cellular proliferation, leprosy, lupus, granular ulceration of
the womb, profuse leucorrhœa, psoriasis gyrates, and syphilitic affections [73].
. Nux vomica
Nux vomica,
homeopathy, N. vomica seed part is used. N. vomica is one of the most prescribed
medicines in homeopathy [74]. The main bioactive compounds of N. vomica seeds
are strychnine and brucine. Brucine in N. vomica is responsible for its anti-tumor,
anti-inflammatory, analgesic, and effects on the cardiovascular and nervous systems.
The presence of brucine makes N. vomica an analgesic agent and can be used to relieve
arthritis and traumatic pain [75]. The alkaloids in N. vomica seeds are protostrychinine, isostrychinine, vomicine, n-oxystrychinine, pseudostrycheinine, chlorogenic
acid, and glycoside. In the homeopathy system of medicine, N. vomica is prescribed
for anger effect, colic, constipation, dyspepsia, gastrodynia, hemorrhoids, tobacco
habit, insomnia, nightmares, lumbago, diabetes, asthma, aphrodisiac and to improve
appetite [76]. N. vomica has an anti-alcoholism effect. In homeopathy, Nux vomica
30C, 200C, and 1000C are recommended for anti-alcoholism effects [77]. In recent
years brucine displayed an excellent anti-tumor effect on various tumors. For hepatocellular carcinoma, brucine inhibits the proliferation of Hep G2 cells by regulating
calcium concentration and depolarization of mitochondria [78].
, synonym Centella asiatica commonly known as brahami,
commonly known as Kuchla, belongs to the family Loganiaceae. In
. Matricaria chamomilla
Matricaria chamomilla is, commonly known as chamomilla and belongs to the
Asteraceae family which is referred to as the star among medicinal species. M.
chamomilla was introduced in India during the Mughal period. In India, M. chamomilla is grown in Punjab, Uttar Pradesh, Maharashtra, Jammu, and Kashmir [79].
In Homeopathy, M. chamomilla part used is the whole plant. The whole chamomilla
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plant contains over 120 constituents [80]. M. chamomilla acts as a natural antioxidant
and antimicrobial agent. The latest research has proved the presence of 52 active
components in the M. chamomilla plant in which the highest contents are β-farnesene
α-farnesene, α-bisabolol, and its oxide chamazulene, germacrene, and spiroether
[81]. M. chamomilla homeopathic extracts contains active groups of phenol, flavo-
noids, and coumarins. It act as strong antioxidant, antibacterial, antifungal, antiparasitic agents [82]. In general, M. chamomilla is used for many ailments in humans such
as fever, inflammation, menstrual disorder, insomnia, and ulcers; very good in wound
healing, muscle spasms, gastrointestinal upset, rheumatic pain, and hemorrhoids
[83]. This plant has immense curative properties. In Homeopathy, M. chamomilla
is used for tooth problems in infants [84]. The symptoms are twitching, convulsion
during teething, intolerant pain, frantic irritability, ugly, cross, uncivil, quarrelsome,
and colic after anger [85].
. Aconitum napellus
Aconitum napellus belongs to the family Ranunculaceae, commonly known as
Monkshood. The main active constituent present in A. napellus is “aconitine”, which
is present throughout the plant, with incredibly high levels in the leaves and roots. In
homeopathy A. napellus plant part used is the whole plant. A. napellus plant contains
various diterpenes alkaloids, isonapelline, luciculine, and napelline [86]. Aconitine
present in A. napellus acts as a voltage-gated sodium channel activator. These sodium
channel act as transmembrane proteins that are responsible for the rapid depolarization that underlies the upstroke of action potentials in neurons and is responsible
for crucial nerve impulse conduction [87]. A. napellus has solid neuroprotective
properties. A. napellus is a constituent of Ayurvedic, Unani medical preparation, and
polyherbal formulation to treat diabetes, as a nerve tonic with potent antioxidant
properties [88]. A. napellus is very useful in numbness [89], a sensation of cold, and
pain in the extremities, associated with diabetic neuropathy, and is also used for the
treatment of rheumatoid and joint pain [90]. A. napellus is the first homeopathic
medicine that is recommended for the onset of acute croup [91]. In homeopathy, A.
napellus is used in case of shock, sudden or violent onset ailments from shock, fright
or fear, intense fear, terror-struck, restlessness with fear of death and diseases from
exposure to cold and dry wind [92].
. Rhus toxicodendron
Rhus toxicodendron synonym Toxicodendron pubescens is commonly known as
poison ivy and belongs to the Anacardiaceae family [93]. This plant family produces
the chemical substance pentadecylcatechols. The main active constituent in R. toxi-
codendron is fisetin, rhamnose, and gallic acid [94]. This plant’s main habitat is in the
forest of the United States. In Homeopathy, the leaves part is used. In Homeopathy, R.
toxicodendron is used for joint pains [95], stiffness worse in damp weather, irritability, restlessness [96], back pains, and asthma alternating with skin eruptions [97].
R. toxicodendron is used for anti-inflammatory activities for arthritis [98] and rheumatism [99]. In homeopathy, Rhus tox 6C, 12C, 30C, and 200C are recommended
[100]. R. toxicodendron retains its anti-arthritis properties at 1M (potency 1000C),
10M (potency 10,000C), and CM (potency 100,000C) homeopathic dilution [101].
R. toxicodendron also possesses immune stimulatory activity in its crude form and
in homeopathically diluted forms [102]. It is commonly used for strains [103]. This
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