ENHANCE THE USE OF TRADITIONAL MEDICINE

Lo. 1
Use basic knowledge of organic chemistry

 The required basic knowledge on organic chemistry is obtained

 Works are done with a basic understanding of organic chemistry
LO 2 : Identify medicinal plants in their natural and dry state
 Recognition of Highly poisonous plants of Ethiopia
 medicinal plants of Ethiopia
 Proper drying of the medicinal plants
 botanical features of the medicinal plants
LO 3 : Using appropriate guidelines for plant collecting
 collection from appropriate locations
 collection of plant parts
 time of collection
Communicating knowledge of herbal medicine philosophy, principles
LO 4 :
and practice
 forms of herbal medicine diagnosis
 treatment practices
 Central philosophies and historical developments of traditional
medicine
 Extraction of Plant material using different menstruum
 integration of Recent developments and new practices into
client services
LO 5 : Manufacturing herbal medicines according to pharmacy guidelines
 preservation of Fresh medicinal plants
 Storage and drying of Medicinal plants
 Extraction of Plant material
 Manufacture of herbal medicines
LO 6: Operating and monitoring the dispensing process
  processing and dispensing requirements
 dispensing of Raw materials
 production process and equipment performance
 processing the waste products
 Response for Feedback and complaints
LO 7: Completing documentation
 Recording the Workplace information
 Labeling of Herbal medicines

LO 8: Ensuring ongoing development of self and team

 Individual performance is monitored
 formal and informal development of skills and
knowledge to optimize performance
 Coaching and advising
Lo. 1 Use basic knowledge of organic chemistry
1.1. The required basic knowledge on organic chemistry is obtained
1.2. Works are done with a basic understanding of organic chemistry

Organic chemistry
 Organic chemistry is the area of chemistry that involves the study of carbon and its
compounds. Carbon is now known to form a seemingly unlimited number of compounds.
The uses of organic compounds impact our lives daily in medicine, agriculture, and
general life.
 is the study of carbon and the study of the chemistry of life
 the study of molecules containing the carbon-hydrogen (C-H) bond and their reactions.
 is the study of compounds containing carbon with the exception of simple compounds
e.g. carbonates (CO3), carbon dioxide (CO2) and carbon monoxide (CO)
 is the science of the arrangement, structure, properties and reactions of substances,
especially of atomic and molecular systems called organic compounds
 deals with the compounds of carbon
 Compounds derived from plants and animals became known as organic and those
derived from nonliving sources were inorganic
organic compounds
 All organic compounds contain carbon in combination with one or more elements.
 The hydrocarbons contain only carbon and hydrogen.
 A great many compounds contain carbon, hydrogen, and oxygen, and they are
considered to be the major elements.
 Minor elements in naturally occurring compounds are nitrogen, phosphorus, and sulfur,
and sometimes halogens and metals.
Properties
Organic compounds, in general, differ greatly from inorganic compounds in seven respects:
Organic compounds are
1. usually combustible
2. have lower melting and boiling points
3. usually less soluble in water
4. exist for a given formula called isomerism = Compounds having the same molecular formula
5. Reactions usually molecular rather than ionic
6. The molecular weights may be very high, often well over 1000.
7. serve as a source of food for bacteria.
Sources
Organic compounds are derived from l sources:
1. Nature: fibers, vegetable oils, animal oils and fats, alkaloids, cellulose, starch, sugars, etc
2. Synthesis: A wide variety of compounds and materials prepared by manufacturing processes.
3. Fermentation: Alcohols, acetone, glycerol, antibiotics, acids, and the like are derived by the
action of microorganisms upon organic matter
Drugs that we use for the healing of various illnesses are chemical compounds, either organic or
inorganic. Nevertheless, most drugs are based on organic structural features. Aspirin is a well-
known example.
Aspirin
 analgesic drug
 usages in some cardiovascular related diseases
 structural simplicity and low cost
 chemically known as acetylsalicylic acid, an organic molecule
 The precursor of aspirin is salicin, which is found in willow tree bark
 easily be synthesized from phenol using the Kolbe reaction

Importance of Organic chemistry

Organic chemistry is important
 because the most of the biological molecules in living systems are largely made of
organic basis
 because it is the study of life and all of the chemical reactions related to life
 discovering new drug candidate molecules for the treatment of a vast of diseases
 to lead the preparation to medicinal features of the diseases on molecular levels based
on chemical structures
 role in the pharmaceutical industry to discover new molecules
 key driving forces in the drug development progression

Examples of Organic Chemistry

Glycerol or glycerin is a trihydroxy alcohol (1,2,3-trihydroxypropane).

Aloe
Key Constituents
 ■ Anthraquinones (aloin, aloe-emodin)
 ■ Resins
 ■ Tannins
 ■ Polysaccharides
 ■ Aloectin= Phenyl pyrones Glycosides include aloenin and aloenin B.( B

 CLOVE
Key Constituents
■ Volatile oil containing eugenol (up to 85%), acetyl eugenol, methyl salicylate, pinene, vanillin
■ Gum
■ Tannins
Key Actions
■ Antiseptic ■ Prevents vomiting
■ Carminative ■ Antispasmodic
■ Stimulant ■ Eliminates parasites
■ Analgesic
Ginger
Key Constituents
 ■ Volatile oil (about 1%) containing alpha-pinene, cineole, linalool
 ■ Sesquiterpene lactones (galangol, galangin)
 ■ Diterpenes
 ■ Flavonoids
 Carbohydrates Starch (major constituent, up to 50%).
 Lipids 6–8%. Free fatty acids (e.g. palmitic acid, oleic acid, linoleic acid, caprylic acid,
capric acid, lauric acid, myristic acid, pentadecanoic acid, heptadecanoic acid, stearic
acid, linolenic acid, arachidic acid, triglycerides, phosphatidic acid, lecithins;
 gingerglycolipids
Key Actions
■ Warming digestive tonic ■ Antibacterial
■ Carminative ■ Antifungal
■ Anti-inflammatory ■ Antitumor
■ Anti-emetic
7
LO2: Identifying medicinal plants in their natural and dry state
Definition of terms
 Traditional medicine (TM): It is the sum total of the knowledge, skill, and
practices based on the theories, beliefs, and experiences indigenous to different
cultures
 Complementary medicine (CM): The terms “complementary medicine” or
“alternative medicine” refer to a broad set of health care practices that are not part
of conventional medicine and are not fully integrated into the dominant health-care
system.
 Allopathic medicine: a system in which medical doctors and other health care
professionals treat symptoms and disease using drugs, radiation, or surgery.
 Complementary/Alternative medicine (CAM):-CAM is a group of diverse
medical and health care systems, practices, and products that are not generally
considered to be part of conventional medicine
Traditional medicine refers to
 the knowledge, skills and practices based on the theories, beliefs and experiences
indigenous to different cultures, used in the maintenance of health and in the prevention,
diagnosis, improvement or treatment of physical and mental illness.
 is often termed alternative or complementary medicine in many countries. Herbal
treatments are the most popular form of traditional medicine and 70% to 80% of the Region
has used a form as primary health care.
Main Popular System of TM/CAM
 Traditional Chinese Medicine  Homeopathy
 Indian Ayurveda Medicine  Chiropractic
 Arabic Unani Medicine
Categories of TM
Medication
 Medicinal plants  Animal materials
 Mineral materials
Non-medication
 Acupuncture: treatment derived from ancient Chinese medicine in which fine needles are
inserted at certain sites in the body for therapeutic or preventative purposes
 Ayurveda :
 belief that health and wellness depend on a delicate balance between mind, body

and spirit
 believed that the body constitution is made up of a combination of five universal
elements; space, air, fire, water and earth
 Herbalists
 Traditional birth attendants
 Bone-setters
 Traditional medicinal ingredient dealers
 Traditional psychiatrists
 Practitioners of therapeutic occultism
 Physical, mental and spiritual therapies

8
 Traditional Medicine vs Allopathic Medicine
Types of CAM
 Major domains of CAM (non allopathic)
• Manipulative and body-based practices:- chiropractic or osteopathic manipulation or
massage therapy
• Energy medicine:- therapies affecting “body energy fields” (qi gong, healing
touch, Reiki) or unconventional use of electro-magnetic fields.
• Mind-body medicine:- techniques designed to enhance the mind's capacity to affect
bodily function and symptoms e.g. meditation, mental healing.
• Biologically based practices:- herbs and other dietary supplements
• Alternative medical system
Allopathic medicine:
 a system in which medical doctors and other health care professionals treat
symptoms and disease using drugs, radiation, or surgery.
 Allopathic medicine refers to the broad category of medical practice that is
sometimes called Western medicine, biomedicine, scientific medicine, mainstream
medicine or modern medicine or conventional medicine.
 This system was developed in the Western countries.
 In this system drugs (tablets, capsules, injections, tonics etc.) are manufactured
using synthetic chemicals and / or chemicals derived from natural products like
plants, animals, minerals etc.
 This system also uses modern equipment for diagnosis, analysis, surgery etc.
 Medicines or drugs of this system are often criticized for its treatment of the
symptoms rather than the cause of the disease, harmful side effects of certain drugs
and unaffordable to poor people due to the high cost and treatment

Benefits of Herbal Medicine

9
 More affordable than conventional medicine.  emphasizes therapies that improve quality
 Promote natural healing. of life
 Strength in immune system.  prevent disease,
 Easier to obtain than prescription medicine.  address conditions that conventional
 Stabilizes hormones and metabolism. medicine has limited success in curing,
 Fewer side effects. such as chronic back pain and certain
 It is cost effective. cancers
 safer and more natural
Disadvantages of herbal medicines
– Herbal medicines are often not potent enough to treat severe illnesses by
themselves, except sometimes with a long-term course.
– Diseases may be drawn out unnecessarily when self-prescribed herbal drugs are
taken improperly.
– The improper long-term use of certain herbal preparations, such as the pyrrolizidine
alkaloid-containing herb comfrey, can lead to severe side effects.
 Teanicides – Blindness & changes in CNS function took over dosage of Hygeia abyssinica.
 Traditional healers may delays in the treatment of communicable diseases such as TB
 Other harmful practices: female genital mutilation, uvulectomy, and milk tooth extraction
Recognition of Highly poisonous plants of Ethiopia
No country in Africa enjoys as great a diversification of geology, land forms, soils, and climate as
Ethiopia.
 There are more than forty five vegetation types where forests, savannas, woodlands, steppes
and grasslands comprise 75% of the vegetation cover.
 possesses one of the richest floras in Africa, with no less than 7.000 species of Pteridophytes
and Spermatophytes.
 is one of the primary centers of origin of many of the world's cultivated crops, e.g. , wheat,
barley, teff, coffee, peas, okra, sorghum, millets, lentils.
 flora is 35% endemic and is an independent floristic region closely allied to the flora of tropical
East Africa and Central Africa.
Poisonous plants
 produce their toxic effects after being ingested and/or absorbed by animals which include
physical upset, loss of productivity and death.
 when pasture is dry while most poisonous plants remain green all the year round.
 Remain green and attractive for hungry and thirsty animals
 include both herbaceous and woody species.
The art of preparing and administering poisons is equally as rich in lore as more conventional
medicine. Ethiopians possess an extensive knowledge of poisonous plants and the art of preparing
poisons from diverse sources. Poisonous preparations applied to weapons were probably first used
for hunting game and arrow poisons are common in East, Central and West Africa.
A number of poison plants are used in Ethiopia
Euphorbia spp = Cassava
 Bitter cassava has large quantities of highly toxic glycosides and has caused many deaths,
and must be carefully soaked and cooked before it is safe to eat

Acokanthera schimperi (Carrissa schimperi) = merz =Qeraro
 used in the preparation of arrow poisons
Calotropis procera = tobbeya= Falfala Adal= Galiiloo
 Its latex is generally considered poisonous both to humans and stock.
 The latex causes heart paralysis

Cucumis prophetarum L.= yemder-inbuyi = Harragoogee

 Fruits, if eaten, are highly poisonous, perhaps due to a bitter principle (glycosides).
 An extract of the plant, if administered to a cow that has just calved, will help remove the
placenta quickly.
 The plant, is used to cause abortion in women.

Leonotis raineriana = ras-kimmir = Dunfure

 Root extract is bitter and poisonous.
Datura stramonium L. = attefaris, astenagrt = Banjii
 The black seeds are poisonous and a few seeds in a cup of tea or coffee are enough to
produce instant death resulting from heart paralysis
 All parts of the plant are considered poisonous

. Croton macrostachyus Hochst = bissana = makanissa

 The seeds and the resins are toxic and are used as a fish poison. The resin is more toxic than
rotenone
Phytolacca dodecandra L'Hérit.= endod = Handoodee
 The plant is generally toxic to stock

Ruta graveolens (Rutaceae)= Rue= Xalasaan

 Rue is toxic in excess.
 Never take during pregnancy.
 The fresh plant frequently causes dermatitis, so wear gloves while handling it.
 Taken internally, rue may cause an allergic skin reaction to sunlight.

SOME COMMON MEDICINAL PLANTS USED IN ETHIOPIAN

Adhatoda schimperiana Hochst. ex. Nees = sensel, simiza timisa = dhummuugaa

The whole plant is used
 in the treatment of excessive pellagra or "kurub
 a", native name of the disease
 a laxative.
 a live fence around native compunds.
Acokanthera schimperi (DC) Oln. (Carrissa schimperi) DC= merz (A) = keraro

 used in the preparation of arrow poisons.

 Whole plant is smoked to ward off or kill insects
 the smoke for the wood is inhailed to treat liver diseases.
Cordia africana Lam. ( C. abyssinica R. Br.) wanza (A)= wodessa
  Wood ash mixed with butter is used for skin troubles locally referred to as "Spider
disease"
Boswellia papyrifera (Del) Hochst. etan ( A )= libanat (
 Its use in religjous rites and customs is wide-spread both by the Christians and
Moslems.
 It is used with spices against fever and
 believed to have a tranquilizing effect
 smoke is also thought to relieve people from evil spirits. Administration is usually done
at niqht.

Commiphora hodai Sprague = kumb = karabee

 to expel the placenta after birth.
Opuntia vulgaris Mill. = kulkual = tini

 fruit is reportedly eaten for the treatment of asthma.

Artemisia afra = ariti = chukun, jukun

 Ariti is used to relieve stomach pains. The juice of the crushed leaves is mixed with
water or honey and is administered orally.
 It is also used to clean containers perhaps because of the pleasant odor. The plant
is harvested when in the flowering stage.
Veronia amygdalina Del. grawa (A)= hobichaa=ebicha
 The dried flower is used to treat
 stomach disorder.
 used in the treatment of malaria.
 leaves are sometimes used in the preparation of the local drink, tela in place of gesho
 cooked leaves arre edible.
Catha edulis = khat = jimaa
 The root is used in some parts of Africa as a remedy for influenza, for stomach troubles and
diseases of the chest
 The leaf has an inebriant narcotic and release from fatigue and hunger
Maytenus ovatus = kambolcha
  source of anti-cancer drug
 leaf decuction is used to control external parasites both in domestic animals and in humans
Lepidium sativum L.= fetto (A) = shufu
It has the following uses for
 The ripe, dried seeds are ground into a fine flour and mixed with water to use as a drench
for stomach disorders of livestock.
 A paste is made of the seed-flour and water and used on chapped lips, sunburn, and other
sking disorders.
 The flour is mixed with honey and taken as a treatment for amoeba.
 The paste is rubbed onto the skin to repel mosquitoes and other insects.
 In times past, the paste was rubbed onto the skin by warriors for warmth during cold nights.
 fetto, tukur-asmu (Nigella sativa) and salt are ground together to make a thick dough and
allowed to ferment for seven deys. One teaspoon of this is taken once a day for stomach
 used in the treatment of a disease of cows' udder called "gigo" solution is massaged onto
the surface.
 In humans, it is used in the treatment of acute side pains which often result from overeating
Juniperus procera Hochst ex Engl. tidh = gattira
 used in the treatment of stomach worms.
Ajuga remota Benth= akorarchigne= Harmaguusaa
An extract of the leaves is used
 against dysentery
 against swelling of the legs
 for the treatment of high blood pressure.
  make babies stop suckling by applying to the teats when such is desired by the mother
Croton macrostachyus Hochst. bissana (A)= Bakanissa,
 The fruits and a decoction of the roots are used as e medicine against venereal diseases
and seeds are used to cause abortion.
 The pulverized bark mixed with kosso (Hagenia abyssinica, Rosaceae) is a very
effective purgative and vermifuge
 The seeds and the resins are toxic and are used as a fish poison
 The paste is eaten with bread for at least three day so Plenty of milk is drunk but meat
and oily food must be avoided
Ricinus communis L. = gullo (A)= kobo = castor bean
 seed oil is used as a mild purgative and widely used in tannery work.
Thymus schimperi Ron. = tossigne (A)
 used in the control of gonorrhea.
 When it is added to boiling water and drunk, it is used against cough and liver disease.
Some prefer to smoke it as a cigarette.
 is used to flavor tea or drunk alone as tea.
Tamarindus indicus L. = homar (A)= roka = tamarind-hendi (Arabic)
 The fruit is used as refrigerant, digestive, carminative, laxative, and anti- scorbutic.
 With sugar and water, the fruit makes a colling drink and is use in place of lime juice.
 The leaves are high in acid and are used as poul
 tices in boils.
 The seeds are used against diarrhea.
 The over-ripe fruit is used to clean copper and brass perhaps because of acidity.
Linum usitatissimum L.= telba (A)= flax-seed (Eng) = Qonxar
 . It is generally used as a demulcent laxative drink.
 Cooked seeds are placed on wounds to cause quicker healing. A wound with a bullet
inside is stuffed with the same and wrapped. After a given time period, the flax "draws'
the bullet to the surface where it can be extracted easily.
Phytolacca dodecandra L'Hérit. = endod (A) = handode (G)
 The decoction of the root (1 in. long) is used in the treatment of genorrhea.
 the root to cause abortion. The dosage must necessarily be regulated to avoid death of the
woman.
 use in the control of schestosomiases (bilharzia) by destroying the snail (Lemma, 1971).
Rumex nervousus Vahl = embwacho (A) = dengego

 used in chat (Catha edulis) wrapping.

  leaves with their high exalic acid content keep the chat fresh for longer periods.
 The charcoal of the stem mixed with egg yolk is used to dress skin burns.
 Butter is added to prevent flaking and drying of the wound.
 used to treat skin itches
Runica granatum L. = Pomegranate = roman

 The fruit is astringen, and is taken for diarrhea

 The leaves are used as a vermifuge
Nigella sativa L. = tikur-azmud = Abasuudaa

 a spice, is used for flavoring quality

 it allegedly possesses the ability to dispel headaches and various diseases.
 dispel headache, the seeds, mixed with melted butter, are wrapped in a clean piece of
cloth, and sniffed.
Ziziphus mauritiana = kurkura

 The dried wood is used by Somali women to fumigate their hair.

 The bark is employed as a fish posion in some parts of Ethiopia.
 The roots may have enough tannin to be used as astringent and in the treatment of scrofula.
Hagenia abyssinica (Bruce) kosso = heexoo
 The dried pistillate flowers used of all tapeworm expellant preparations.
 Excess dosage of kosso can cause death, and repeated use is suspected to cause
blindness in man.
 sometimes used to cause abortion in women.
Capsicum annuum L.= Chili = mitmitta
 common spices
 People's think it is used to kill "germs" in the meat as well as in the stomach.
 Believe mitmitta against amoeba infections and stomach worms.
 used externally in ointment as an irritant.
Solanum incanum L. = inboye = hidi
 fruits = teeth are damaged and tarnished permanently.
 fruits are used to treat gohnorea and in leather tannery by mixing with urine.
Carum copticum D. C. = Nech Azmud= Abasudaa Adii
 Mixed with red pepper to reduce the "hotness".
 The roots of this herb are used in the in the treatment of stomach complaint.
Foeniculum vulgare Mill. = ensilal = kammoona

 The seeds and dried plant parts are used to flavor local drinks such as areke and tej.
 The boiled or roasted roots are used in the treatment of gonorrhea
Zingiber officinale = Roscoe = zingibil
 The rhizome, as much as it is a common spice in the preparatlon of traditional foods,
 medicine for stomach cramps
 chewed or masticated with feto for the treatment of stomach disorders
 The whole fresh plant is used to dress wounds and sores
Clerodendrum myricoides = missiritch= Tiiro

 used as a vermifuge, expellant and to cause diarrhea in stock.

  used to dress wounds
Dosage
 Except in Infants & Children all dosages given are for adults.
 Do not exceed the stated dose; doubling it will not make the medicine twice as effective.
 Before taking a remedy, check the cautions in the relevant herb entry
 Do not take more than 2 internal remedies at any one time or more than 1 internal and 1
external remedy for the same complaint, unless specified. Where different forms of a
remedy are given (e.g. take tincture or infusion), the first is preferable
How Long to Take Remedies
 Take remedies until symptoms disappear. If there is no improvement within 2 –3 weeks, if
the condition worsens, or if in doubt, consult a professional practitioner
Infants & Children
 Do not give babies under 6 months any internal herbal (or other) medicine without
professional advice.
 Infants & Children, gives children’s dosages
Remedies elsewhere can be used for children under 12. Reduce doses as follows:
• 6–12 months old—1⁄10 adult dose
• 1–6 years old—1⁄3 adult dose
• 7–12 years old—1⁄2 adult dose.
Older People
Older adults, due to slower metabolism, may require less than the standard dose. Those over 70
should usually take 3⁄4 of the adult dose.
Pregnancy
 During the first 3 months of pregnancy, avoid all medicines, herbal or otherwise, unless
absolutely essential.
 Avoid alcoholic tinctures in pregnancy.
 The herbs mentioned in Pregnancy are safe to use
 Always check the cautions for the remedy and in the relevant herb entry before taking an
herb during pregnancy
LO 3: Use appropriate guidelines for plant collecting
 Collection from appropriate locations
 Collection of plant parts
Parts of plants used for Medicine
 Roots and rhizomes  Fruits and seeds
 Whole plant
 Flowers
 Leaves  Sap and gel
 Bark materials and stems
 Berries
Harvesting of Herbs
• Roots & Rhizomes: collected when aerial parts are dried down (if not – fleshy & difficult
to dry)
• Bark: Damp weather

• Aerial parts – at flowering (active photosynthesis)

• Flowers e.g. clove – before fully expanded

• Fruits – vary

– Fully ripe: Anise, Fennel

– Nearly ripe: cardamoms (Before seed dispersal)

• Gums/Resins – dry weather

Preparation of Herbs

• Remove sand, stones • Peeling – ginger/liqourice

• Washing underground parts
• Removal (e.g nux vormica – fruit
• Remove rootlets, diseased portions pulp)

• Slicing – larger organs (ginger) • Packing into quills (cinnamon)

• Grading (senna, gum

Good collecting
General Advice
Harvesting medicinal herbs requires careful planning to ensure the parts are processed in peak
condition and fast enough to retain their active ingredients.
Equipment
 use a wooden tray or open basket for collecting herbs
 Always cut with a sharp knife or scissors to minimize damage to plant
 Wear gloves if gathering prickly or allergenic plants
What to Look For
 Collect material from healthy plants, free from insect damage and pollution.
 discard damaged plants because they can lead to disease or decay in dried plant material
 Do not mix cut plant material to avoid mistakes in identification
When to Harvest
 Gather herbs in dry weather, preferably on a sunny morning after the dew has evaporated.
Picking when the plant is at its peak of maturity ensures that it will have a high
concentration of active constituents.
 Leaves are best collected as they open during the spring or summer months,
 flowers as they start to bloom,
 fruit and berries just as they become ripe,
 roots in the autumn once the plant has drawn its vitality back beneath ground
 Bark must be gathered with great care if the shrub or tree is to survive—in most cases,
harvest it in spring or autumn.
 Roots and rhizomes: Best collected October to February, when the plants are more
vigorously storing food in their underground organs.
Processing Quickly
 Only collect plant material that you will be able to use or process immediately after
harvesting. This is because
o fresh plant material deteriorates very quickly and the medicinally active constituents
are often the first to be affected.
o aromatic herbs can lose their volatile oils within hours
o Salad leaves and culinary herbs are best eaten right away to make the most of their
nutrients, although they can be stored for a few days in a plastic bag filled with air
in a refrigerator.
Proper drying of the medicinal plants
 When medicinal plant materials are prepared for use in dry form, the moisture content of
the material should be kept as low as possible in order to reduce damage from mould and
other microbial infestation..
Medicinal plants can be dried in a number of ways:
1. in the open air (shaded from direct 5. drying ovens/rooms and solar dryers;
sunlight) 6. by indirect fire;
2. placed in thin layers on drying frames, 7. baking;
3. wire-screened rooms or buildings; 8. microwave;
4. by direct sunlight, if appropriate; 9. infrared devices
 When possible, temperature and humidity should be controlled to avoid damage to the
active chemical constituents.
 The method and temperature used for drying may have a considerable impact on the quality
of the resulting medicinal plant materials. For example,
 o shade drying is preferred to maintain or minimize loss of color of leaves and
flowers;

o lower temperatures should be employed in the case of medicinal plant materials

containing volatile substances.
In the case of natural drying in the open air,
 medicinal plant materials should be spread out in thin layers on drying frames and stirred or
turned frequently.
 the drying frames should be located at a sufficient height above the ground
 Avoiding mold formation.
Drying medicinal plant material directly on bare ground
 should be avoided.
 on concrete or cement surface use appropriate cloth or sheeting.
 keep away Insects, rodents, birds and other pests, and livestock and domestic animals from
drying sites
If the source of heat for direct drying (fire) used
 be limited to butane, propane or natural gas,
 temperatures should be kept below 60 °C

Commonly used Drying methods

Drying Methods
1. Air Drying
2. Artificial Drying
3. Vacuum Drying
Air Drying
1. Sun Drying
 When herbs are not adversely affected by excessive sunlight.
 Dried in thin layers à tuned over occasionally E.g. clove, cardamom
2. Shade Drying
– When sunlight causes discoloration & warp/shrivel
– E.g. cinnamon
4. Artificial Drying

– Generally the most acceptable form of drying herbs.

– Rapid (less exposure to heat à less chances of chemical alteration)

– Control temperature (normally 40ºC) & ventilation (allows dry air to replace wet
air).
5. Vacuum Drying
  Steam-heated ovens: pump used to extract air
 Low pressure to ensure rapid and complete drying
 Expensive method
 Reserved for expensive herbs and which cannot be sufficiently dried through other
methods.
General Drying Techniques
a) Leaves/Herbs:
– 40-50º C
– Maintains good colour
– Without over drying herbs
– Normally destalked first
– Best dried for short periods of time only à prevents shrivelling and discolouration
– Leaves may be bleached through the drying process à best dried in dark
b) Roots/Rhizomes
– Washed
– Sliced
– Dried between 30-65ºC
– Temperature too high: forms a tough crust on the outside à preventing the further
drying of deeper tissue
– Thick organs may require long periods of drying (10days-3weeks) to avoid mould
growth.
6. Flowers
 Normally destalk before drying
 Flowers may also be bleached when dried à best dried in dark.
 General Drying Techniques:
Volatile oil containing herbs
 Air-Dried at very low temperature
 Avoid volatilization of oil contents
 Should also be dried separately from other herbs.
7. Fruits & Seeds
 Normally partially dry before harvesting
 May be air-dried afterwards
 Seeds are normally separated from the fruits before drying
 Fruits are normally left whole
 Some fruits (cardamom) rupture due to excessive heat.
8. Bark
 Occasionally requires the removal of the outer layers

Storing Herbs
 It is vital to store dried herbs properly or they will not last.
 Leaves, flowers, roots, and other parts should be stored
o in sterilized, dark glass containers with airtight lids
o new brown paper bags, which must be kept dry and away from light.
  Metal and plastic containers are inadvisable because they may contaminate the herb.
 If stored in a cool, dark place, herbs can be kept for about 12 months after harvesting.
 Herbs frozen in plastic bags can be used for up to 6 months.
 Label the container with the herb, source, date of harvesting, and strength of preparation if
appropriate.
 Watch out for insect infestation
 Dirt and other foreign substances should be removed
 Many medicinal plants are seasonal, some not easily accessible, available only in deep
forests or mountain peaks.
 If washing is needed, it should be done quickly to minimize deterioration and loss of active
substances.
 As a rule, all parts of the plant collected should be dried as soon as possible to avoid
unnecessary waste of the drug materials through natural processes of denaturation, decay
and fungal attacks.
Storage materials
 The dried plant materials should be placed in
o plastic containers
o tightly covered bottles
o brown colored bottles are preferred as they minimize deterioration due to sunlight
o Dry charcoal (separated from the medicinal plant) may be placed inside the bottles
to absorb moisture.
o The storage place should be
 dry,
 well-ventilated, and
 spacious, lest fungi and insects may invade rampantly
o Dry drug materials after proper processing can be kept in large open wooden
shelves.
o Materials rich in volatile oils are advised to be kept in airtight containers.
o If all factors are favorable, prepared drugs can be used even after years of storage.
 Store in a cool (not cold), dark place, out of the reach of children.
 Discard after the expiration date.
Factors that can reduce the shelf life of herbal medicines:
 Exposure to air (keep in airtight bottles)
 Humidity
 Heat
 Light (leading to oxidation-related decomposition)
Lo 4: Communicating knowledge of herbal medicine philosophy, principles and
practice

Central philosophies of traditional medicine

The human body is considered to be made up of the following seven components:
1. Elements (Arkan) 5. Spirits (Arwah)
2. Temperament (Mizaj) 6. Faculties (Quwa)
3. Humors (Akhlat) 7. Functions (Afaal
4. Organs (Aaza)

(a) The body is made up of the four basic elements that have different temperaments, that is,
1) earth (cold), 3) water (wet), and
2) air (hot), 4) fire (dry)
(b) Mixing and interactions of the four elements result in the creation of new compounds
having new Mizaj (temperament), that is,
1) hot wet, 3) cold wet, and
2) hot dry, 4) cold dry.
(c) The body has simple and compound organs that receive their nourishment through four
Akhlaat (humors),
1) Dam (blood), 3) Safra (yellow bile), and
2) Balgham (phlegm), 4) Sauda (black bile).
(d) Each humor has its own temperament:
1) blood is hot and moist, 3) yellow bile is hot and dry, and
2) phlegm is cold and moist, 4) black bile is cold and dry.
(e) Every healthy person attains a temperament according to the preponderance of the humors
in the body. The temperament of a person may be
1) Sanguine = too much blood
2) Phlegmatic = too much phlegm
3) Choleric = too much yellow bile
4) melancholic = too much black bile
  Health represents a balance of the four humors and functions of the human body.
1) To maintain an optimal balance, there is a power of self-preservation or adjustment
called Quwwat-e-Mudabbira (medicatrix naturae) in the body.
 A disease is a result of a quantitatively or qualitatively imbalance in the equilibrium of the
humors
 The duty of physician is to determine the cause of the underlying imbalance of humors, so that it can be
corrected and disease can be cured.
 Imbalance of humors may be due to
1) external factors such as an injury, incorrect diet, environmental factors, and so on,
2) internal factors such as improper digestion, or both.
 External environmental factors and daily lifestyle can affect the human body, for example,
1) air quality,
2) food and drink,
3) movement and rest,
4) sleep and wakefulness, and
5) emotions
 It is believed that each of these five factors must be balanced in terms of quality, quantity,
and sequence in order to sustain good health.
 Imbalance of humors tends to occur as a result of
Imbalances of humors tend to occur in four ways:
1. Thinning of humor (Riqqat-e-Khilt): The consistency of humor becomes thinner.
2. Thickening of humor (Ghilzat-e-Khilt): The consistency of humor becomes thicker.
3. Plethora (Ghalba-e-Khilt): The humor becomes over active/ hyperactivity

4. Decay of humors (Afunat-e-Khilt): The humor becomes putrefied/

decayed
body is made different temperaments, new temperament organs that receive their nutrition
up of the four (Mizaj) through humors (Akhlaat),
basic elements
earth, cold, hot–wet Dam = Blood is hot and moist
air, hot, hot–dry Safra = Yellow bile is hot and dry
water wet, cold–wet Balgham = Phlegm is cold and moist
fire, dry, cold–dry Sauda = Black bile is cold and dry

Signs of Humoral Imbalances

An excess or over activity of one of the four humors can be detected according to the following
symptoms:
1) Sanguis Humor (Ghalba-e-Dam). When there is excess of blood in the body,
 the color of skin appears red,  pulse seems to be full, and
 veins appear more prominent,  urine becomes dark colored.
 Patients complain of
 breathlessness,
 headache, and
 scenes of blood in their dreams
2) Phlegm Humor (Ghalba-e-Balgham). In the case of excess of phlegm in the body,
  skin becomes whitish and cold,
 pulse becomes slow and deep,
 urine becomes thick and light colored.
 Patients complain of
 forgetfulness,  laziness, and
 loss of appetite,  scenes of water in their
 increased sleep, dreams
3) Choler Humor (Ghalba-e-Safra). An excess in the choler humor results in
 yellowness of the skin,
 swifter pulse than ordinary, and
 dark colored urine
 Patients appear
 irritated without any apparent cause
 complain of headache
 disturbed sleep
 bitterness in throat, and
 scenes of fire, lighting, anger, fighting in their dreams
4) Melancholer Humor (Ghalba-el-Sauda). When there is excess of black bile in the body,
 skin appears rough
 pulse becomes weak
 urine becomes thin
 patients complain of loss of appetite
 soreness in throat
 Patients
 remain busy with foolish imaginations
 appear fearful without any cause

The major and minor forms of diagnosis and treatment practices

Diagnosis
 Diagnosis involves investigating the cause of disease thoroughly and in detail
 Examination methods are the methods used to determine the circumstances (haala
akkamiin)of disease and to understand the manifestation(ibsa)of disease
 The diagnosis process in traditional medicine is dependent on
o observation /visual examination
o listening and smelling examination
o physical examination
o Pulse reading
o palpation(qaqqabachu) examination
o examination of urine and stool
o with the help of simple modern gadgets
Inspection
 refers to the physician using the visual(ka agarte) sense to recognize disease
 the first step in diagnosis
 includes inspecting the entire body, parts of the body and the tongue.
Listening and smelling(foolee àjawa)
 refer to the physician using the ears and nose to survey(waan jiru irràa dubbatu) the
condition
  From listening to the voice, to the language, etc., and by smelling odors, the condition can
be understood.
Inquiry[Qoranna]
 refers to questioning of the patient or the patient's companion(hiriyaa) about the condition,
about the entire course of the disease
 includes the onset of the condition, the development and appearance(fakki/fuula) of
symptoms, previous diagnoses and treatment, and any other factors relating to the disease.
Palpation(qaqqabachu)
 refers to Pulse examination
 includes pressing on the chest and abdomen, feeling the skin and the four limbs

FACE INSPECTION
CHANGES IN THE EXTERNAL FORM OF THE FACE
 Facial swelling and white coloration is spleen(rajjijji) and kidney vacuity.
 Swelling with hot pain, numbness or itching is wind(maruu fashan) evil(hama) heat toxin.
 Sudden facial swelling in enduring or serious disease is a symptom of earth being used up
by the spleen.
 Cheek swelling -Sudden swelling up of the face and cheeks, fever, red face, swollen and
painful throat, or no throat pain but swollen cheeks accompanied by deafness, is mumps, a
warm toxin pattern.

INSPECTION OF THE EYES

 The face and the eyes are both important areas of observation diagnosis.
1. The blood network vessels (conjunctiva) of the corners of the eyes ascribed(ni ibsa) to the
heart - the heart governs blood; the essence(hunde) of blood is the network vessels.
2. The dark of the eyes (cornea) is ascribed to the liver - the liver governs(moohuu) the
sinews(morgaya); the essence of the sinews is the dark of the eye.
3. The white of the eye (sclera) is ascribed to the lung - the lung governs is the white of the
eye
4. The pupil is ascribed to the kidney – the kidney governs the bones; the essence of the
bones is the pupil.
5. The eyelids(googa ijaa) (both upper and lower) are ascribed to the spleen(rajjijji)- the
spleen governs muscle; the essence of muscle is the retainer (eyelid
a. The upper lid is ascribed to the spleen and the lower lid is ascribed to the stomach.)

DISEASES GOVERNED BY THE FORM AND BEARING(sirritti

hubàchu) OF THE EYES
 Eyes without discharge or tears(imimmaan) and dry and rough(quqquqama) eyes are
usually due to warm disease heat burning and damaging the fluids.
 Swollen, painful eyes with frequent tearing are often due to stagnant(tortoru) heat in the
liver channel.
  Puffy(bokoku/afufamu) swelling in the eye and eyelid and bright eyelids are due to damp
governing water swelling
 If there is acute swelling of the eyelid and the color is red, this is spleen heat;
 chronic swelling without redness but with softness is spleen vacuity.
 Drooping eyelids are also usually due to spleen vacuity.
 Sudden bulging of the eyes accompanied by panting breath is usually lung distention;
 Sudden bulging of the eyes accompanied by swelling of the front of the neck it is goiter
swelling.
 Sudden sinking is usually consumption damage of the fluids.
 If both eyes sink inward relatively deeply, there is loss of sight and the manifestation of a
true visceral pulse
 Revealing of the eyes when sleeping is spleen and stomach vacuity weakness and insufficient
blood
 Strabismus and deviated movement of the mouth and eyes are usually liver wind stirring
internally.
 Eyes that are slightly fixed and do not turn often are due to phlegm-heat internal block or
desertion of original spirit.
 Scattering of the pupil and unclear visual acuity are usually insufficient kidney essence and an
inauspicious omen of kidney water withering exhaustion.

INSPECTION OF THE EARS

 An auricle/orakil/(qaawa gurraa) that is thick, with a red and moist color, indicates
congenital kidney essence(bu'ura) is full and sufficient.
 An auricle that is thin, dry and withered(qooru) indicates an insufficiency of congenital
kidney essence.
 burant(gurrachacilee) black auricle is an in auspicious(oospishas((milki gaari)) sign
(kidney water depletion(fixuu) damage)
 A pale(daaraa) white auricle is ascribed to cold
 A green blue- black auricle is ascribed to pain.
 A swollen and painful ear indicates evil (hamaa) repletion.
 Redness, swelling and pain on the sides of the ear are usually due to external over
whelming(ukkamsaa) of wind-heat or liver and gallbladder fire.
 Swelling and pain within the ear, deafness(duuddummaa)
 flowing of purulent(ka mala'uu) fluid from the ear is damp(jiidha)-heat in the liver and
gallbladder

INSPECTION OF THE NOSE

 green-blue color on the tip(jallatu) of the nose is vacuity cold or pain in the abdomen.
 yellow color is internal damp-heat
 white color is blood collapse.
 red color is heat in both the spleen and the lung channel.
 The generation of dots(bakka irra) in the form of acne(dhukkuba gogaa) is drinker's nose1
 A bright and moist color of the nose is ascribed to a normal condition
 dry nose that is black like ash is intense exuberance(quufaa) of heat toxins
 Nasal congestion with frequent sneezing and flowing nasal mucus is often due to external
contraction.
o If there is flowing of clear nasal mucus, this is wind-cold;
o if there is flowing of turbid nasal mucus, this is wind-heat.
1
  Ulcerations and sinking of the stem of the nose are seen in syphilis.
 Badly collapsed(kufuu) stem of the nose and dropping off of the eyebrow hairs are
leprosy(qomaaxummaa)

INSPECTION OF THE MOUTH AND LIPS

Lip
o Normal lip color is bright, red and moist.
o Red-purple lips indicate heat.
o Red lips that are dry are due to extreme heat damaging the fluids.
o Deep(fannafataa) red lips accompanied by vomiting usually show repletion heat in the
stomach.
o Pale red(diimaa) lips indicate vacuity and cold, and if accompanied by greasy lips then
cold-damp.
o Pale white lips are spleen vacuity with diminished blood;
o pale white and black lips are extreme cold;
o white and swollen(mallan iitahu) lips are spleen expiry.
o White lips like withered bones are a critical sign.
o Deep green-blue lips indicate pain;
o pale green blue lips are cold;
o green-blue-black and moist lips are extreme cold
o the appearance of green-blue around the lips of children is the first sign of fright wind.
o Black lips indicate impending expiry of the spleen and stomach,
o black lips in water disease indicate a poor prognosis

Mouth
o Ulceration of the mouth and tongue usually is heat evil (stomach fire or food accumulation
generating heat).
o Deviated mouth and eyes and stirring of the lips are wind stroke.
o Clenched jaw and inability to speak are tetany. P
o U
o lips with green-blue color and convulsive spasms indicate liver wind overwhelming the
spleen.
o White spots or patches like snowflakes in the mouth of infants are goose-mouth sores which
are generally due to depressed heat in the spleen channel.
o If in disease there is darkness around the lips, the opening of the mouth is like a fish's
mouth and air is exhaled but not inhaled, this is a critical sign of spleen expiry
o Swollen lips and burnt black teeth are expiry of the spleen and kidney
o Open mouth = Here the mouth opens but does not close. This governs vacuity.
o Clenched jaw =Here the mouth closes but there is difficulty in opening. This governs
repletion.
o Pursed = Here the upper and lower lips have a pursed-together form. This indicates that, in
the battle between evil and right, right is debilitated and evil is prevailing.
o Deviated = Here the left and right [sides of the mouth
o are in a condition of [one being] relaxed and the other tensed. The channel sinews are
stretched. The tense side shows the right qi and the relaxed side shows the evil qi.
 o Mouth biting = Here there is a slight movement, but the teeth do not open; the kidney is
being vanquished, the disease has thrust out from the stomach channel.

INSPECTION OF VOMIT
 Vomit comes from the stomach.
 Stomach cold causes the vomit to be relatively clear and thin without an odor.
 Food stagnation causes the retching of putrid smelling food dregs (food retention).
 Evening food vomited at dawn and dawn food vomited in the evening, and vomiting of
retained food indicates stomach reflux.
 Damage to the stomach network vessels causes the vomiting of blood.
 Vomiting of yellow-green bitter water is usually from liver and gallbladder damp-heat.

INSPECTION OF THE STOOLS

 Normal stools are created in strips, yellow colored and in between wet and dry.
 In vacuity cold patterns the stools are usually viscous and thin.
 In repletion heat patterns they are usually dry and hard.
 Yellow stools indicate heat, and a stool of a viscosity like a duck's is cold.
 Dry stools like a sheep's indicate insufficient fluids in the intestines and stomach.
 Stool that is yellow like gruel, viscous and sticky and with a malign odor shows damp-heat
in the intestines and stomach.
 In infants green stool with bubbles is due to poor digestion.
 Stools that are purulent and bloody, red and white together, indicate dysentery.
 Stools with blood, where the blood color is fresh red, indicate blood heat;
 If there are first stools and then blood, and the color is brownish black, then the blood has
come from the stomach (distal bleeding) and the disease is usually in the spleen and
stomach.
 If there is first blood and then stool and the color is fresh red or deep red, then the blood is
from the intestines (proximal bleeding) and the disease is usually in the large intestine and
anus.
Pulse Diagnosis
There are two phases of the heartbeat, or cardiac cycle:
1. Contraction, or systole; and
 With each systole, or heart contraction, blood is pumped out of the heart into the arteries,
which swell, or rise.
2. Relaxation, which is diastole.
 With each diastole, or heart relaxation, blood enters the heart, easing pressure on the
arteries, which deflate, or fall.
Three fingers are placed on three different positions
 beginning at the base of the wrist with the index finger representing the upper warmer
including the heart and lungs,
 the middle fingers over the thenar prominence indicating the liver-gall bladder on the left
and the spleen-stomach on the right,
  the ring finger higher just proximal to the thenar prominence with the kidney-bladder on the
left and the triple warmer-pericardium on the right.
Basic Qualities or Parameters of the Pulse
The basic qualities or parameters are:
1) Speed, also known as frequency, or tempo.
2) Force, also known as strength, or pressure.
3) Depth, or level at which the pulse prevails.
4) Width, or breadth, also known as volume.
5) Definition, also known as contour, or discreteness.
6) Quality of Expansion, or rise / systole / pulsation.
7) Quality of Interlude between Pulsations.
8) Rhythm, cadence, or Gait.
9) Regularity
10) Tension
The speed of the pulse = is the frequency of its pulsations, measured in beats per minute.
 A normal or moderate speed is about 70 Beats Per Minute (BPM);
 slow is under 70 BPM, to 60, or even below = coldness or hypoactivity = deep pulses
 A fast pulse is 80 BPM or higher = indicative of excess heat or physical activity
o heat can be from an infection, inflammation or fever, which is often systemic.
Exercise and digesting food also speed up the pulse.
The force of the pulse
 indicates the strength of the Vital Force and energy level of the organism
 The stronger the pulse, the more energy and vitality there is; the weaker the pulse, the
weaker and more devitalized the body is.
Depth refers to the level at which the pulse is felt. There are three basic levels
1. Superficial: Floating Pulse= right underneath the skin, with light or no pressure like the
common cold
2. Moderate: middle depth, in between superficial and deep
3. Deep: felt with heavy pressure, right above the bone
 can indicate two things:
o disharmonies of the deeper noble and principal organs;
o excessive interior cold sinking the pulse
Width refers to the volume or breadth of the pulse.
 A thin or skinny pulse is usually called a Thready Pulse
o is associated with conditions of emptiness, or deficiency
 a fat, broad pulse is usually called a Full Pulse
o a Full Pulse is associated with conditions of fullness, excess or superfluity;
conversely, a Thready Pulse.
 The thinner the pulse, the greater the deficiency; the thicker the pulse, the greater the
fullness or excess. The healthy pulse is moderate in width or breadth.
Definition refers to the clarity of the pulse's contour, or outline.
 Hard = dryness create a very clear, stark outline of the pulse
 Soft= moisture or wetness create a softness or fuzziness of pulse boundaries
Quality of Expansion refers to the quality of the rise, or pulsation of the artery. The quality
of the expansion or pulsation is a key factor in determining pulse gait.
Rhythm, or Gait is the overall characterization of the pulse, its particular feel, rhythm and
cadence.
Regularity is an important factor in the pulse, as irregularities can point to weaknesses or
 dysfunctions of the heart, whose contractions generate the pulse. Episodes of a Racing
Pulse are commonly associated with heart palpitations.
Pulse tension refers to the relative degree of tautness or laxness in the pulse. The healthy
pulse should have sufficient relaxation and suppleness without being too lax.
 Excessive tension in the pulse is more problematic than excessive laxness.
 A Tense or Wiry Pulse, also called a Twisted or Cordlike Pulse in Unani Medicine,
feels like a taut violin string or bow string.
o It is associated either with chronic pain or emotional / psychosomatic stress and
tension;
o it indicates Melancholic conditions of liver congestion and stagnation, portal
hypertension, or gastrointestinal colic
o indicate arterial hypertension.
Following are the six basic pulse qualities:
1. WEAK OR EMPTY PULSE= an empty pulse may feel rather big but soft. The pulse may
be rather big but empty on slightly stronger pressure. This type of pulse signifies deficient
chi. A weak pulse can also feel thin or thready which signifies deficient blood.
2. FULL PULSE= this pulse feels full, big, rather hard and long. If the pulse is full and rapid
it represent excess heat, if it is full and slow it indicates excess cold.
3. SLOW=COLD (less than four beats per complete respiration of the practitioner or less than
60 beats a minute)-- a slow and empty pulse indicates empty-cold from deficient yang, a
slow and full pulse indicates full-cold from excess yin.
4. FAST=HEAT (more than 5 beats per respiration of the practitioner or 80 or more beats per
minute) surface or floating=exterior or acute disease or in rare cases, it will appear as
floating for internal deficient conditions such as anemia, cancer or yin-wasting diseases.
This pulse is felt with a light pressure of the fingers, just resting on the artery.
5. DEEP PULSE= This pulse requires a deeper pressure to discern. It must be felt with a
heavy pressure of the fingers close to the bone. A deep and weak pulse indicates deficiency
of chi and yang, a deep and full pulse indicates stagnation of chi or blood in the interior, or
internal cold or heat.
6. FLOATING OR SUPERFICIAL PULSE= This is opposite of the previous. the pulse is felt
with a light pressure of the fingers just resting on the artery. A floating pulse indicates a
surface condition or in chronic disease, an exhaustion of the internal (yin) organs. A
floating and fast pulse indicates surface heat while a floating, slow pulse indicates surface
cold. Most often a floating pulse indicates a superficial acute condition such as a cold,
cough or flu. If the pulse feels floating and slow one would prescribe warming and
stimulating diaphoretics such as cayenne pepper or ginger for instance. If it is floating and
 fast, one might give relaxing diaphoretics such as lemon balm or catnip to relieve the
external condition.
Treatments
The various treatments recommended by traditional medicine physicians are :

A. Diet therapy
For old people
 Recommended that they should be given food
o in small amounts at a time and that they can have two to three meals a day
o divided according to the digestive capacity
o general condition of the old person in question
o fruits, such as figs and prunes
o Some laudable nutrition may be allowed at bedtime
o Milk is good for the aged, being nutritious and humectant in nature
o with a laxative action are most appropriate for the elderly
 avoid any gross aliment
o all hot, sharp or desiccative foods
o dishes made with vinegar, salt, hot aromatics, seasonings and pickles
B. Bloodletting
1. Cupping (Hijamah)
 is the sucking of blood by cupping
 is a method used for local evacuation or diversion of morbid blood in which a horn is
attached to the surface of the skin of the diseased part through negative pressure created by
vacuum.
 The vacuum is created by the introduction of suction.
Cupping is of two types;
2. wet cupping, that is, cupping with bloodletting and
3. dry cupping, that is, cupping without bloodletting.
 In the wet cupping,
o the skin site is shaved, cleaned, and marked by placing the mihjamah such as a bull
horn on the site and sucking the mouth end of the horn to mark the site for extraction
o The horn is removed and superficial incisions are made within the marked area. Then,
the horn is reapplied and the horn’s mouthpiece is vigorously sucked.
o Blood accumulates within the horn.
o After that, the wound is cleaned with dry cloth and either left uncovered or herbal
powder is applied.
o The patient is instructed to keep the wound dry for one day.
 For each complaint, there is a specific site for hijamah. For instance,
o for headache, the location is behind the head
o For chest pain, the location is on the shoulder, dorsally.
Bloodletting (Fasd)
o is phlebotomy or venesection,
o is rarely practiced nowadays in the Arab world
o is a procedure in which an incision is made to any of the superficial veins, and blood
containing “waste material” is allowed to flow
 o removes excess humors in the same proportion as present in the blood vessels,
abnormal humor, or both.
o applied for purification of vitiated humors in meningitis, pneumonia, pleurisy, sciatica,
gout, rheumatic arthritis, diphtheria, piles, and amnesia
o 30 blood vessels as suitable for venesection
o 16 vessels in the head,
o 5 in each arm and hand, and
o 3 veins in each leg and foot
Leech Therapy (Taleeq)
o is a unique method of removal of bad matters from the body
o is better than cupping for drawing the blood from deep tissues
o “Leave leeches in fresh water for a day and a night until they are hungry and nothing
is left in their bellies. Scrub the afflicted part until it is flushed; and then place the
leeches on it. When they are full they will fall off.”.
Used in
Microsurgery
o reduce blood coagulation (they produce an anticoagulant molecule called hirudin),
relieve venous pressure from pooling blood (venous insufficiency), and
o stimulate circulation in reattachment operations for organs with critical blood flow,
such as eyelids, fingers, and ears, in reconstructive surgery
Side effect
o prolonged bleeding, which can easily be treated,
o allergic reactions and bacterial infections may also occur

Cauterization (Kayy)
o burning of part of a body to remove or close off a part of it in a process
o destroys some tissue, in an attempt to mitigate damage, remove an undesired growth, or
minimize other potential medical harmful possibilities such as infections when
antibiotics are not available
o useful in stopping severe blood loss to close amputations and in preventing infections

Exercises and Massage

Moderate exercises
o to increase the “vital force of body”
o eliminate waste products through urine, stool, and sweat.
o strengthen the organs and increase the appetite.
Massage therapy
o is any method of applying pressure on or friction against, or stroking, kneading,
rubbing, tapping, pounding, vibrating, or stimulating of the external soft parts of the
body with the hands.
o rough cloth with or without rubbing oils, creams, lotions, ointments, or other similar
preparations are used to enhance the therapeutic effects of massages
o improves functioning of circulatory, lymphatic, muscular, skeletal, and nervous system
and improves the rate of body’s recovery from injury or disease
o useful in several symptoms and diseases such as anxiety, tension, depression,
insomnia, stress, backache, headache, muscular pain, and some forms of chronic pain
 Hard friction or massage makes the body firm
 soft massage relaxes the body
  prolonged massage reduces the fat of the body
 prolonged massage enhances weight gain in premature infants
Sweating and Fomentation
Sweat therapy
o the use of heat and humidity to cause the body to perspire freely
o varies depending on body temperament
o Diaphoresis is profuse sweating
o expulsion of waste product through skin, especially if kidneys are not functioning
properly.
o Several drugs exist that when used internally or externally may cause profound
sweating for example,
 Allium sativum = Garlic
 Raphanus sativus = Radish = fujuul
 Aconitum napellus.= Aconite, Monkshood
Fomentation
 is process in which warm covers are laid on a part of the body to relieve pain and
inflammation.
 restricted to a patient’s tolerance
 be used in a variety of acute conditions including
o chest colds
o muscle spasms
o Gallstones
o insomnia, and
o Backache
Diuresis
 The method is used to excrete poisonous matters, waste products, and excess of humors
through urine and to purify blood
 helpful in the treatment of cardiac, hepatic, and renal diseases
 herbal remedies used for this purpose, for example,
 Cichorium intybus, Gentiana dahurica, and Cuscuta reflexa
Purgation (Ishaal), Enema (Huqna), and Emesis (Qai)
Purgation
 is a process in which the whole body or intestines are cleansed of accumulated toxins
through the use of laxatives and purgatives.
 Mild, moderate, and strong laxatives may be used depending upon the prevailing condition.
o medicines used for purgation are Operculina turpethum, Agaricus alba,
Convolvulus scammonia, and Cuscuta epithymum
 used to
o achieve detoxicating effect
o resolve the body matter, and
o treat chronic constipation.
Enema therapy
 is a method used for the removal of the superfluities from the intestines
 used in the case of constipation (a condition of the digestive system in which a person
experiences hard feces that are difficult to expel).
 to elderly patients who become constipated must be avoided because they dry up the gut.
 natural medicines be used for this purpose, for example,
 o saline water,
o oil of castor plant (Ricinus communis).
Emesis (Qai) - vomiting
 is the reflex act of ejecting the contents of stomach through the mouth
 is to eliminate toxic substances from the stomach
 drugs used for this purpose, for example,
o Raphanus indicus and
o Oroxylum indicum.
Steam and Vaporization Therapy
 This therapy is a process in which steam from a bowl of boiling water is allowed to seep
into the face or any area of the skin.
 It is applied for 5–10 min
 essential oil, menthol, or incense is added to the boiling water
 The top of the head and sides of the face are covered with a towel to prevent evaporation
 Vaporization is useful for colds, flu, acne lesions, and as a freshener.

WATER THERAPY
 Water is a natural gift and is a part of the act of purification
 Water from the Zamzam well in Mecca is considered holy, and millions of Muslim
believers use it to cure diseases.
 The Prophet (SAW) described the water of the well of Zamzam saying,
o “It is blessed! It is a kind of food and cure for illness.”
o “So, if you drink it in order to be cured of illness, God cures you; if you drink it in
order to satisfy your appetite, God satisfies your appetite for you; and if you drink it
in order to quench your thirst, God quenches your thirst for you. It was dug up by
Gabriel and provided by God to Ishmael to drink.”
Thermal and Mineral Waters.
o cure a variety of illnesses
o heart diseases
o joint disorders
o respiratory inflammation
o and kidney stones
o relax muscles and the mind
o provide relief from muscular and joint pains
o heal infections
o Naturally occurring hot springs were particularly valued in colder climates
o considered curative due to their physical and chemical properties and also through
psychological effect
o Water containing hydrogen, sulfur, carbon dioxide, and bromides are useful
as a tranquilizer and a relaxant.
o waters are radioactive and contain high levels of iodides, iron, calcium, and
magnesium and are useful for the body as a whole.
o mineral water exerts an effect on
o the immunological and neuropeptidergic systems of the skin beyond the
antibacterial, antifungal, and keratolytic effects
o dermatological therapy through its hydrating, cooling, and cleansing effects
and as a vehicle for more effective delivery of active agents
SPIRITUAL THERAPY
o Spiritual medicine refers to the belief in a spiritual, ethical, or psychological cure for
diseases that may have physical or mental origin.
o Rhazes wrote al-Tibb al-Ruhani (Spiritual Medicine), which has been translated into
English as The Spiritual Physick of Rhazes.
Fasting
o means of providing the ideal conditions necessary for the repair of bodily damages and
for the elimination of toxins
o purifies the body and soul by feeling hunger and thus sympathizes with those who are
hungry and cannot afford to buy food
o during Ramadan every year includes meditation, contemplation, and cogitation
Siwak or Miswak
o oral hygiene is essential for a healthy body
DRUG THERAPY
o The drugs may be derived from plants, minerals, or animals.
Drug Temperament
o every drug has its specific temperament based on its ingredients.
o classified into five classes:
1. hot,
2. cold,
3. dry,
4. wet, and
5. sometimes neutral
 A drug may be hot and dry, hot and wet, cold and dry, or cold and wet.
 A drug used in a given pathological condition should have temperament opposite to the
prevailing temperament of the affected organ.
Potency of Drugs
1. The concept “temperament” by Hippocrates and Galen discussed only the
qualitative and not the quantitative nature of the temperaments of simple drugs
(single plants).
2. The term “degree” was considered as a sensation effect of a drug without any
quantitative scale based on scientific methods.
3. The four degrees of each drug temperament, which represent the strength of the
drug, or maybe, the harmacological and toxicological effects,
1. 1st degree understood as mathematical sum of each degree
2. second degree meant double of first degree
3. third degree meant three times of the first degree, and so on.
4. temperament of a drug, according to Al-Kindi, means the chemical properties,
toxicity, drug interactions, mechanism of action, and efficacy.
5. The temperaments were determined following their physiological action
examined and observed by physicians, animal tests, and clinical trials using both
single and compound drugs.
“Hot drugs,” for instance, indicate
o the first and second degrees hot drugs that can stimulate and enhance body
temperature / activating basic metabolic rates
o The third “hot” degree is quite toxic
o the fourth one is highly toxic with severe side effects and should be
controlled using ingredients with antidote or antagonistic effects
Herbal Remedies.
 o forms
o crude forms
o herbal teas,
o syrups,
o infusions, and
o powders in the treatment and prevention of diseases.
SURGERY
Abu al-Qasim al-Zahrawi (Albucasis) born in 936 in Zahra, Cordoba (Andalusia), is regarded as
the pioneer of modern surgery who contributed greatly to the discipline with his Kitab al-Tasrif
LO 5. Manufacturing herbal medicines according to pharmacy guidelines
Extraction: is the separation of medicinally active portion of plants by using selective solvent and
suitable methods of extraction
Methods of Extraction of Medicinal Plants

Infusions
 Macerating for a short period of time with cold or boiling water
 It is made in a similar way to tea, using either a single herb or a combination of herbs, and
may be drunk hot or cold
Standard Quantity
 CUP 1 tsp (2–3 g) dried or 2 tsp (4–6 g) fresh herb (or mixture of herbs) to a cup of water
(this makes 1 dose)
 POT 20 g dried herb or 30 g fresh herb (or a mixture of different herbs) to 2 cups
(500 ml) of water
1. Place the herb in the strainer of the teacup and place a strainer in the cup. Fill the cup with
freshly boiled water.
2. Cover the cup with the lid and infuse for 5–10 minutes before removing thetea strainer.
Add a tea spoon of honey to sweeten, if desired.

Pot Infusion
Warm the pot, then add the herb. Pour in water that has just boiled, replace the lid, and infuse for
10 minutes.
Strain some of the infusion into a cup. A teaspoon of honey may be added if desired.

Hot Infused Oils

Standard Quantity (infused oils)
250 g dried or 500 g fresh herb to 3 cups (750 ml) olive, sunflower, or other good-quality vegetable
oil
 1. Stir the chopped herb and oil together in a glass bowl over a saucepan of boiling water.
Cover and simmer gently for 2–3 hours.
2. Remove from the heat and allow the mixture to cool, then pour into the wine press (or jug if
not available) with a jelly bag in place. Collect the strained oil in a jug, pressing all the liquid out of the herb.
Cold Infused Oils

1. Place the herb in a clear glass jar. Pour in oil until it completely covers the herb, close the jar, and shake well.
Place the jar in a sunny spot, such as on a windowsill, and leave for 2–6 weeks.
2. Pour the oil and herb mixture into a jelly bag, secured to the rim of a jug or bowl with string (or use a wine press as
pictured above in hot infused oils). Allow the oil to filter through the bag.
3. Squeeze out the remaining oil from the bag. Pour the infused oil into dark glass bottles, label, and store. Alternatively,
repeat the whole process with the infused oil and fresh herbs

Decoctions
 simmering these tougher parts in boiling water
 Boiled in a specified volume of water for a defined Time
 Fresh or dried plant material cut or broken into small pieces before decocting. Like
infusions, decoctions can be taken hot or cold.
 made using roots, bark, and berries, but sometimes leaves and flowers
Standard Quantity
20 g dried or 40 g fresh herb (or mixture of herbs) to 3 cups (750 ml) cold water, reduced to about
2 cups (500 ml) after simmering (this makes 3–4 doses)
Procedure
1. Place the herbs in a saucepan. Cover with cold water and bring to a boil. Simmer for about
20–30 minutes, until the liquid is reduced by about one-third.
2. Strain the liquid through a sieve into a jug. Pour the required amount into a cup, then cover
the jug and store in a cool place.
Maceration :
 Solid ingredients are placed in a closed container with solvent and allowed to stand for at
least 3 days (3 - 7 days) with frequent agitation
Tinctures
Tinctures are made by soaking an herb in alcohol. This encourages the active plant constituents to
dissolve, giving tinctures a relatively stronger action than infusions or decoctions. They are
convenient to use and last up to two years.
Alcohol-reduced Tinctures
Alcoholic tinctures should sometimes be avoided, for example during pregnancy or a gastric
inflammation. Adding 1 tsp (5 ml) of tincture to a small glass of almost boiling water and leaving it
for 5 minutes allows the alcohol to evaporate. To make nonalcoholic tinctures, replace the alcohol
with vinegar or glycerol.
Tincture Ratios
Tinctures are made in different strengths, expressed as ratios. Example, a 1:5 ratio(1 part herb to 5
parts alcohol)
Standard Quantity
200 g dried or 300 g fresh herb chopped into small pieces to 1 quart (1 liter) alcohol—vodka of
35–40% alcohol is ideal, although rum hides the taste of bitter or unpalatable herbs
Procedure
1. Place the herb in a large, clean glass jar and pour on the alcohol, ensuring that the
herb is covered. Close and label the jar. Shake well for 1–2 minutes and store in a cool
dark place for 10–14 days, shaking the jar every 1–2 days.
2. Set up the wine press, placing a muslin or nylon mesh bag securely inside. Pour in the
mixture and collect the liquid in the jug.
3. Slowly close the wine press, extracting the remaining liquid from the herbs until no
more drips appear. Discard the leftover herbs.
4. Pour the tincture into clean, dark glass bottles using a funnel. When full, stopper with a
corkor screw top and label the bottles.
Syrups
Honey and unrefined sugar are effective preservatives and can be combined with infusions or
decoctions to make syrups and cordials. They have the additional benefit of having a soothing
action, and therefore make a perfect vehicle for cough mixtures as well as relieving sore throats.
With their sweet taste, syrups can disguise the taste of unpalatable herbs and are therefore greatly
appreciated by children.

A syrup is
 made with equal proportions of an herbal infusion or decoction and honey or unrefined
sugar.
 When making an infusion or decoction for a syrup, it needs to be infused or simmered for
the maximum time to optimize its medicinal action.
 Infusions should be infused for 15 minutes and decoctions should be simmered for 30
minutes.
 Press the soaked herb through the strainer or sieve to remove as much liquid as possible.
Small amounts of neat tincture can be added to the cooled syrup to increase its
effectiveness.

Standard Quantity
 2 cups (500 ml) infusion or decoction , infused or heated for the maximum time 500 g
honey or unrefined sugar
1. Pour the infusion or decoction into a pan. Add the honey or sugar. Gently heat, stirring constantly until all the honey or
sugar has dissolved and the mixture has a syrupy consistency. Remove from the heat and cool.
2. Pour the cooled syrup into sterilized glass jars using a funnel and store in a cool, dark place. Seal the jars with cork
stoppers, because syrups are prone to ferment and may explode if kept in screw-topped bottles

Ointments
 Ointments contain oils or fats heated with herbs and, unlike creams, contain no water

Standard Quantity
60 g dried or 150 g fresh herb (or mixture of herbs) to 500 g of petroleum jelly or soft paraffin wax

1. Melt the petroleum jelly or wax in a glass bowl set in a pan of boiling water, or use a
double boiler. Add the finely cut herb and simmer for 15 minutes, stirring continuously.
2. Pour the herb mixture into a jelly bag secured to the rim of a jug with string, and allow
the liquid to filter through
3. Wearing rubber gloves, squeeze as much of the hot herb mixture as possible through the
 bag into the jug.
4. Quickly pour the molten ointment into jars before it sets in the jug. Place the lid on each
jar without securing it firmly. When cool, tighten the lids and label.

Poultices
A poultice is a mixture of fresh, dried, or powdered herbs that is applied to an affected area.
Poultices are used to ease nerve or muscle pains, sprains, or broken bones, and to draw pus from
infected wounds, ulcers, or boils.

Standard Quantity
Sufficient herb to cover the affected area

1. Simmer the herb for 2 minutes. Squeeze out any excess liquid, rub some oil on the affected
area to prevent sticking, and apply the herb while hot.
2. Bandage the herb securely in place using gauze or cotton strips. Leave on for up to 3 hours,
as required

Percolation
 It is continuous downward displacement of the solvent through the bed of crude drug
material to get extract.
 Most frequently used to extract active ingredients in the preparation of tinctures and fluid
extracts.
 A percolator (a narrow, cone-shaped vessel open at both ends) is generally used.
Concentration
• The extract contains huge solvent quantity and small amount of active molecule.
• Evaporate the solvent and enrich the active content
• under vacuum, Thin film evaporator, Freeze

Factors influence the Extraction

• Length of the extraction time
• Solvent used,
• The solvent-to-sample ratio.
• pH of the solvent,
• Temperature,
• Particle size of the plant parts
LO6: Operating and monitoring the dispensing process
Processing and dispensing requirements
Dispensing refers to
 the process of preparing and giving medicine to a named person on the basis of a
prescription.
 Programs to improve rational use have often been concentrated on ensuring rational
prescribing habits, overlooking dispensing and the patient's use of medicines.
 the review of a prescription and the preparation, packaging, labelling, record keeping and
transfer of the medicine, including counseling, to a patient, their agent, or another person
who is responsible for the administration of the medicine to that patient
 the preparation, packaging, labeling, record keeping, and transfer of a prescription drug to
a patient or an intermediary, who is responsible for administration of the drug.

The dispensing process

When dispensing medicines, pharmacists should ensure that :
 the prescription is valid, according to relevant legislation
 the medicine is clinically appropriate for the patient
 information is provided to ensure safe and appropriate use of the medicine.

Throughout the dispensing process, pharmacists have a duty of care to:

 apply their expertise
 use professional judgment to protect and promote the safety, health and wellbeing of
patients
 Maximize therapeutic outcomes in partnership with patients and prescribers.
Dispensing activities should be guided by a standard operating procedure that outlines the :
 steps involved in the dispensing process
 responsibilities of pharmacy staff members in the dispensing process
 training plan for staff involved in the dispensing process
 risk management plan

The dispensing process

LO7: Completing documentation
Documentation
 refers to a set of records that exist online, on paper or hard drives.
 Recording Workplace information of the patient and the traditional medicine given to
him/her.
Recording and documentation
6 purposes for documentation
1. Communication
2. Legal documentation
3. Financial billing/reimbursement
4. Education
5. Research
6. Audit-monitoring/quality assurance

Documentation needs to be CC FLAT

o Concise o Legible
o Complete o Accurate
o Factual o Timely (current)
The Do’s and Don’ts of Workplace Documentation

Do’s
 Do establish clear performance expectations. .
 Do focus on the facts
 Do review patterns of problem behavior
 Do write a specific plan
 Do follow up

Don’ts

 Don’t generalize
 Don’t diagnose why the employee is performing poorly
 Don’t include your mental impressions or editorial comments
 Don’t embellish, stretch the truth, or call it something it isn’t
 Don’t apologize
 Practical Takeaway
documentation must:
 follow policy and procedures
 be clearly written so it can be understood
 be accurate
 be written down as soon as possible on the day it happened, not when you remember.
Appropriate and accurate records assist medication management and adequate documentation is an
important component of risk management and quality patient care.
Pharmacists
 are encouraged to use reliable systems for documenting critical actions taken in relation to
patient counseling
 should also record details of the circumstance and reasons after exercising professional
judgment.

The patient healthcare record should be created or updated in the pharmacy dispensing software at
time of dispensing, and the information confirmed as correct.
At the time of dispensing, the pharmacy dispensing software is used to:
 record the details of all prescriptions dispensed
 record any other legally required details of dispensing
 generate a dispensing label
 generate a repeat authorisation to attach to the duplicate of the prescription (if required).
The patient healthcare record may include:
 patient details (e.g. date of birth)
 medical history, including medical conditions, allergies and details of adverse reactions
 medicines the patient is taking, including non-prescription medicines and complementary
medicines
 details of any recent medication changes
 relevant patient notes including brand preferences, details of services provided,
communication with prescriber, reasons for early or multiple repeats supplied, and follow-
up actions required
Patient privacy
 Patient information collected and recorded during the dispensing process is confidential
 Patient information should only be disclosed with the patient’s consent, unless required by
law.
 Patient consent is required prior to disclosing patient information to a carer or authorised
representative collecting a medicine on behalf of the patient.
 If the patient is unable to consent to the disclosure of their information, the pharmacist may
disclose information to another healthcare professional treating the patient, or responsible
person, providing the pharmacist is satisfied the disclosure
Labeling of Herbal medicines

Dispensing label content required by legislation

  Brand and generic names of the medicine, the strength, the dose form and the quantity
supplied.
 Specific directions for use, including frequency and dose.
 Patient’s name or, in the case of an animal, the owner’s name and the kind of animal.
 Date of dispensing or supply.
 Initials of the dispensing pharmacist (and if different, the initials of the pharmacist
checking and issuing the medicine).
 A unique identifying code for the dispensed medicine.
 Name, address and telephone number of the pharmacy or pharmacy department at
which the medicine was dispensed.
 Applicable storage directions and expiry date of the medicine.
 The words ‘Keep out of reach of children’.

Labeling compounded medicines

In addition to the labeling requirements for dispensed medicines above, the label of a compounded
medicine must include :
 the name and concentration of each active ingredient (especially if a formulation other than
a standard pharmacopoeia formulation is used)
 the name and concentration of any added preservatives
 the name of the formula as described in a standard pharmacopoeial reference book (where
applicable)
 the words ‘This product has been compounded by the pharmacist

Counseling
 medicines. Counseling is a two-way communication process between the pharmacist and
the patient
 It provides an opportunity to elicit the necessary information from a patient, provide the
required information to enable safe and effective use of medicines, and is the final checking
process to ensure the correct medicine is supplied to the correct patient

 Face-to-face counseling is the best way of communicating information about medicines, .

Counseling for medicines should involve discussion of:
 the indication and instructions for use
 expected outcomes
  potential adverse reactions together with actions to be taken when adverse reactions or
interactions occur
 storage requirements

Circumstances requiring more detailed counseling

More detailed counseling may be required when:
 the patient is new to the pharmacy
 the medicine is new for the patient or there is a change in strength from a previous
prescription
 there are special administration instructions for the medicine
 the prescription is for a child, an older person, or a person at risk of medication
misadventure
 there are special patient needs (e.g. visual, auditory or cognitive impairment, or cultural and
linguistic diversity)
 there is a lack of, or inadequate, directions for use
 the medicine has a narrow therapeutic index or requires therapeutic monitoring
 the medicine is a Controlled Drug.
LO8: Ensuring ongoing development of self and team

Monitoring the Individual performance

Performance monitoring is about ensuring that people are:
 performing the tasks allocated to them (Are they doing what they should be doing?)
 achieving the output goals (Are they producing as much as they should be producing?) ™
 performing to the standard required (Are they doing it as well as they should?).

 Objectives Of Performance
1. To provide learning, training, and development opportunities to employees.
2. To improvise individual job performance as well as methods and techniques of
measuring performance.
3. To review the ways of defining and agreeing of performance criteria of teams and
individual employees at the performance planning level
4. To assess commitment and motivational level to accept and realize performance
feedback in positive perspectives.
5. To incorporate change necessitated by external environment and affect over-all
performance improvement of the organization

Factors Influencing Individual Job Performance Environmental Forces

 Individual Effort  Individual Direction
 Individual Ability  Environmental Forces
 Individual Job Performance
Monitoring Individual performance
 Performance management (PM) includes activities which ensure that goals are consistently
being met in an effective and efficient manner. Performance management can focus on the
performance of an organization, a department, employee, or even the processes to build a
product of service, as well as many other areas.
  PM is also known as a process by which organizations align their resources, systems and
employees to strategic objectives and priorities.

 Performance management as referenced on this page in a broad term coined by Dr. Aubrey
Daniels in the late 1970s to describe a technology (i.e. science imbedded in applications
methods) for managing both behavior and results, two critical elements of what is known as
performance.

Steps to a Performance Evaluation System

1. Develop an evaluation form.
2. Identify performance measures.
3. Set guidelines for feedback.
4. Create disciplinary and termination procedures.
5. Set an evaluation schedule.

Some ways to improve employee’s efficiency:

 Communicate employees' clear expectations about their work assignments.

 Determining the goals of every project and daily tasks.
 Regular conducting performance appraisals.
 Consistent appraisals.
 Matching tasks to employee skills.
 The priority of employee development.
 Improving morale: work environment, salary level, benefits, mission, role in the company.
 Authority to make decisions.
 Utilizing the right technologies.
 Regular meetings and discussions

Formal and informal development of skills and knowledge

It conducted through :
 Scheduled trainings like continuing pharmacy education
 Peer education
 Education through experience
What is learning?
 The process, the experience or experience to knowledge, skills or values to collect.
Types of Learning
 Formal learning refers to
o learning in courses or programs leading to nationally and internationally recognised
qualifications.
o learning takes place within the structured formal educational system.
 o learning methods are standardised
o It focuses on cognitive knowledge that is measurable.
 Non-formal learning refers to learning in structured programs for developing skills and
knowledge required by workplaces, communities and individuals. These do not lead to
nationally or internationally accredited formal qualifications.
 Informal learning refers to learning that is acquired through everyday work and life

Peer education is an approach to health promotion, in which community members are supported
to promote health-enhancing change among their peers. Peer education is the teaching or sharing of
health information, values and behavior in educating others who may share similar social
backgrounds or life experiences.

Coaching for career development

Coaching
 Is ‘an ongoing process of helping people achieve result
 is performance driven.
 The purpose of coaching is to improve the individual's performance on the job. This
through enhancing current skills or acquiring new skills
Different types of coaching
 Performance coaching. Coaching activities here are aimed at enhancing an individual’s

performance in their current role at work, to increase their effectiveness and productivity at
work. Generally, performance coaching derives its theoretical underpinnings and models
from business and sports psychology as well as general psychological theory.
 Skills coaching. This form of coaching focuses on the core skills an employee needs to
perform in their role. Skills coaching provides a flexible, adaptive, ‘just-in-time’
approach to skills development. Coaching programmes are tailored specifically to the
individual and are generally focused on achieving a number of skill development objectives
that are linked to the needs of the organisation.
 Career Coaching. Coaching activities focus on the individual’s career concerns, with the
coach eliciting and using feedback on the individual’s capabilities as part of a discussion
of career options. The process should lead to increased clarity, personal change and forward
action.
 Personal or life coaching. This form of coaching provides support to individuals wishing
to make some form of significant changes happen within their lives. Coaches help
 individuals to explore what they want in life and how they might achieve their aspirations
and fulfil their needs. Personal/life coaching generally takes the individual’s agenda as its
start point.
 Business coaching. Business coaching is always conducted within the constraints placed on
the individual or group by the organisational context.
 Executive coaching: One to one performance coaching is increasingly being recognised as
the way for organisations and individuals to improve performance. By improving the
performance of the most influential people within the organisation, the theory goes that
business results should improve. Executive coaching is often delivered by coaches
operating from outside the organisation whose services are requested for an agreed duration
or number of coaching sessions.
 Team facilitation: Coaching in its role as facilitator is particularly valuable during the
budget and strategy planning season. And coaching a team before a presentation can
dramatically improve performance – as well as self confidence.
 Work shadowing: As well as being a means of identifying an individual's behaviour and
performance, work shadowing is an excellent method of getting immediate feedback on
behaviour, with a discussion of alternative ways of handling future such situations.