OBJECTIVES General:

*Within 3 hours of lecture the student nurses will be able to broaden their knowledge and understanding on herbal medicines.
Specifically, the group 4 student nurses will be able to:

1. Define what is herbal medicines; 2. Discuss the republic act supporting the use of herbal medicines; 3. Enumerate some guidelines for using herbal medicines;

4. Enumerate the benefits of using herbal medicines; 5. Discuss the proper use of medicinal plants; 6. Discuss the general preparations of herbal medicines through a video; 7. Enumerate the different herbal plants used by the DOH; 8. Discuss the different preparations of herbal medicines based on the DOH; 9.Discuss the different preparations of herbal medicines based on the Silliman University Research Laboratory; 10.Enumerate the different nursing responsibilities of using herbal medicines.

The study or use of medicinal herbs to prevent and treat diseases and ailments or to promote health and healing.
1.

2. A drug or preparation made from a plant or plants and used for any of such purposes.

[REPUBLIC ACT NO.8423] An Act creating the PHILIPPINE INSTITUTE OF TRADITIONAL AND ALTERNATIVE HEALTH CARE (PITAHC) to accelerate the development of traditional and alternative health care in the Philippines, providing for a TRADITIONAL AND ALTERNATIVE HEALTH CARE DEVELOPMENT FUND and for other purposes

SOME GUIDELINES FOR USING HERBAL MEDICINES

1. Approach any herbal medicine as you would a prescription drug or over-the-counter (OTC) drug. Herbals can have adverse effects, drug interactions, contraindications (conditions when they should not be used), and all the other problems that go along with the kinds of medications you are used to Herbals are virtually unregulated. You are not protected by the same government controls exercised over prescription and OTC drugs. This means there is no assurance that what it says on the label is in the bottle. Also, because of lack of regulatory controls, herbals are marketed in a way that may make them look like what they aren't and they are held out with claims they can't fulfill. Their labels may not disclose their adverse effects and everything else you would expect on drug labels.

Lack of knowledge about herbals. Only now are medical, pharmacy and other professional schools gearing up to give their students the kind of intense instructions they should have on the subject.
Some herbal medicines are unsafe, ineffective, and potential killers. When initiating a course of herbal medicine treatment, start with one herb only so you can clearly identify its adverse effects and benefits. Otherwise, if you start with a bunch at one time, it may not be clear which one is causing problems or which one is working. The same process makes sense in initiating drug therapy.

2. People with special conditions should proceed with special caution, and get the advice of a doctor, pharmacist or other qualified professional before taking an herbal medicine.
People with special conditions include but are not limited to Pregnant and nursing mothers Anyone with impaired immune system Anyone with impaired liver or kidney function Anyone with chronic disease such as diabetes or heart disease, Young children (especially infants) Senior citizens Anyone taking prescription medicines

3. Don't fall for the idea that herbal medicines are perfectly safe because they are natural. 4. Avoid the widespread fallacy that if some is good, more is better. 5. While using an herbal medicine be alert for any possible adverse effects and report them to your doctor immediately. 6. Don't put off needed medical treatment with the hope that some self-prescribed herbal medicine will solve your problem.

Benefits of using medicinal plants:

* Medicinal plants are readily available and free. * If used or applied correctly, it can cure certain diseases. *Not all herbs/plants have medicinal properties. There are poisonous herbs/plants. Make sure to identify the right one. Like medicine, it can be dangerous if used in the wrong way or taken more than the recommended dose.

Guidelines on the Proper Use of the Medicinal Plants

1. HARVESTING PLANT MATERIALS * Gather leaves when flower is about to bloom. * Gather flowers before or shortly after the flowers have fully bloomed. * Gather seeds from ripe fruits. * Select and separate specified plant part (stem, leaves, flowers, seeds, bark or roots); remove dirt, insects and unhealthy plant part. * Wash quickly

2. STORING PLANT MATERIALS FOR LATER USE *Gather most plant materials during summer so that the materials can be dried properly. *Dry specified plant materials in a wellshaded and well ventilated place. It usually takes 4 days to dry the plant materials during summer or 2 weeks during the rainy season.

* Keep dried plant materials in sealed plastic bags or in tightly covered brown containers.

* Store in cool, dry place away from sunlight. * Label container with the name of the plant and the date of collection. * Keep away from children's reach. * Properly dried and stored materials an last for 6 months. * Discard materials that have molds.

3. PROPER USE OF MATERIALS

* Use only 1 kind of medicinal plant at a time. Do not mix different medicinal plants. * Decoctions should be freshly prepared. A few day's dose can be prepared and kept in a thermos. This can last for 3 days. Discard the decoction if the color has changed or molds are present. decoction - is prepared by boiling the specified plant portion

* Use a regular empty bottle of softdrink to measure 1 glassful of water that is needed in preparing decoction. * Stop herbal treatment after 3 days if the patient's symptom has not improved or has becomes worse. Consult a doctor immediately. *Use earthenware pot in preparing decoctions. Never use plastic, metal or aluminum containers because the chemicals may remain in the solution.

HERBAL PLANTS
1. FIVE-LEAF CHASTE TREE (Lagundi)

2. MARSH-MINT; PEPPERMINT (Yerba Buena) 3. SAMBONG 4. TSAANG GUBAT 5.ULASIMANG BATO OR PANSIT- PANSITAN

6. GARLIC 7. NIYOG-NIYOGAN 8. GUAVA 9. AKAPULKO

FIVE-LEAF CHASTE TREE (Lagundi) (Vitex Negundo) kamalan (Tagalog) Limo-Limo (Ilokano) Tugas (Cebuano) Dabtan (Ifugao) Molave aso (Sul)

How to plant Lagundi: * Plant cuttings of 20 centimeters long. Make sure that the cuttings have 3 or more nodes (where the new leaf comes out). How to care for the plants: * Water the newly planted cuttings everyday and remove weeds/grass around it. * Remove leaves or branches that have been destroyed by pests or by plant diseases to prevent them from spreading to the rest of the plant. * May use compost or organic fertilizer. NEVER use pesticides because the chemicals may remain in the plant

Harvesting and Proper Storage:

* It would be better if the leaves are collected during the following season. * Collect only the mature and healthy leaves. * Make sure that there are enough leaves left on the plant to prevent the plant from dying. * Completely dry the leaves before storing them and place them in a sealed plastic bag or tightly covered brown container.

Uses and Preparations:

1. Asthma, cough and fever - boil raw fruits or leaves in 2 glasses of water for 15 minutes until the water left is only 1 glass (decoction). Strain. Leaves be chopped and the following dosages of the decoction are given according to age group. Dried Leaves Adult - 4 tbsp. 7 - 12 yrs. - 2 tbsp. 2 - 6 yrs. - 1 tbsp. Fresh Leaves 6 tbsp. 3 tbsp. 1 tbsp.

2. Dysentery, colds and pain in any part of the body as in influenza - boil a handful of leaves and flowers in water to produce a glassful of decoction. Adults and children may drink a glassful of decoction three times a day. 3. Skin diseases (dermatitis, scabies, ulcer, eczema) and wounds - Prepare a decoction of the leaves. Wash and clean the skin/wound with the decoction.

4.

Headache - crushed leaves may be applied on the forehead. 5. Rheumatism, sprains, contusions, insect bites - pound the leaves and apply on affected part. 6.Aromatic bath for sick patients prepare leaf decoction and use for bathing sick and newly delivered patients

MARSH-MINT; PEPPERMINT (Yerba Buena)

(Mentha cordifolia Opiz)

Herba buena (most dialects)

Hierba/Yerba Buena (Spanish) Hilbas (Davao, Leyte) Opiz Ablebana (Ifugao) Malipuen (Als.) Peppermint, mint (English)

How to Plant Yerba Buena: * Cut branches to about 10-15 centimeters long to include 3 or 4 pairs of leaves. Plant them in a pot or in between two tall plants. Yerba Buena also grows in shady areas. The roots will come out after 1 week. * If Yerba Buena has been planted temporarily in a pot or can, transfer the plant to the prepared pot after 2 weeks.

How to Take Care of the Plant:

* Water the newly planted cuttings every to prevent them from drying. Remove the weeds and grass around them. * Remove branches or leaves that have been destroyed by pests or by plant diseases to prevent them from spreading to the rest of the plant. * If using fertilizer, use organic fertilizer only!

Harvesting and Proper Storage: * Harvest only mature and healthy leaves. * Make sure that there are enough leaves left on the plant to prevent the plant from dying. * Dry the leaves to be stored. Place the dried leaves in a sealed plastic bag or tightly covered brown jar or bottle.

Uses and Preparations:

1. For pain in different parts of the body as headache, stomachache - boil chopped leaves in 2 glasses of water for 15 minutes. Cool and strain. Dried Leaves Adult - 6 tbsp. 7 - 12 yrs. - of adult dose Fresh Leaves 4 tbsp.

Divide decoction into two parts and drink one part every three hours.

2. Rheumatism, Arthritis, and headache - crush the fresh leaves and squeeze sap. Massage sap on painful parts with eucalyptus. 3. Cough and colds - Get about 10 fresh leaves and soak in a (expectorant) glass of hot water. Drink as a tea. 4. Swollen gums - steep 6 g. of fresh plant in a glass of boiling water for 30 minutes. Use solution as gargle.

5. Toothaches- cut fresh plants and squeeze sap. Soak a piece of cotton in the sap and insert this in aching tooth cavity. Mouth should be rinsed by gargling salt solution before inserting the cotton. To prepare salt solution: Add 5 g. of table salt to one glass of water.

6. Menstrual and gas pain - soak a handful of leaves in a glass of boiling water. Drink infusion. It induces menstrual flow and sweating.

7. Nausea and fainting - crush leaves and apply at nostrils of patients. 8. Insect bites - 2 methods - Crush leaves and apply juice on affected part or pound leaves until paste-like. Rub this on affected part. 9. Pruritis - boil plant alone or with eucalyptus in water. Use decoction as a wash on affected area.
How to Use: * Divide the decoction into 2 parts and drink 1 part every 3 hours.

(Blumea balsamifera)
Alibhon, Alimon (p. Visayas) Kaliban (Tag.) Ayoban, Bukadkad, Gabuen Gintingintin, Haliban Kambihon, Lakdanbulan (Vis.) Camphor (English)

How to plant Sambong:

* Plant the sprout (with 3 or more leaves) taken from the sides of the main plant in a shady area.

How to Take Care of the Plant: * Water the plant everyday. Remove the weeds and grass around it. Harvesting and Proper storage: * Harvest only mature and healthy leaves. Make sure that there are leaves left on the plant to prevent the plant from dying. * Dry the leaves to be stored. * Store in a sealed plastic bag or tightly covered brown jar or bottle.

Uses and Preparations:

1. Anti-edema, diuretic, anti-urolithiasis - boil dropped leaves in a glassful of water for 15 minutes until 1 glassful remains. Cool and strain. Dried Leaves Adult - 2 tbsp. 7 - 12 yrs. - 1 tbsp. Fresh Leaves 3 tbsp. 1 tbsp.

- Divide decoction into 3 parts. Drink 1 part 3 times a day. Note: Sambong is not a medicine for kidney function.

How to Use:
* Divide the decoction into 3 parts and drink 1 part 3 times a day.Note: Sambong is not a medicine for kidney function.

(Carmona retusa)
Kalabonog, Maragued (Ilokano)

Alibungog (Vis.)

Kalimunog, Taglokot, Talibunog, Tsa (Tag.)

How to Plant Tsaang Gubat: * Plant seeds or cuttings of 20 centimeters long with 3 or more nodes in a shady area. It takes 6 to 8 weeks for it to grow roots, then may transfer the plant in the prepared plot.

How to Take Care of the Plant:

* Water the plant everyday. Remove the weeds and the grass around it. * Remove branches or leaves that have been destroyed by pests or by plant disease to prevent them from spreading to the rest of the plant. * DO NOT use pesticides because the chemicals may remain in the plant.

Uses and Preparations:

1. Diarrhea - boil the following amount of chopped leaves in 2 glasses of water for 15 minutes or until amount of water goes down to 1 glass. Cool and strain. Dried Leaves Adult - 10 tbsp. 7 - 12 yrs. - 5 tbsp. 2 - 6 yrs. - 2 tbsp. Fresh Leaves 12 tbsp. 6 tbsp. 3 tbsp.

Divide decoction into 4 parts. Let patient drink 1 part every 3 hours.

2. Stomach ache - wash leaves and chop. Boil chopped l eaves in 1 glass of water for 15 minutes. Cool and filter/strain. Dried Leaves Adult - 2 tbsp 7 - 12 yrs. - 1 tbsp. Fresh Leaves 3 tbsp. 1 tbsp.

How to Use: * Drink the warm decoction. If the stomachache is still present an hour after drinking the decoction. If there is no change in condition, consult a doctor.

ULASIMANG BATO (Peperonia pellucida)

How to Plant Pansit-pansitan: * Plant the seeds. You do not need to water them everyday Harvesting: * Harvest only the healthy leaves.

Use and Preparations:

1. Lowers uric acid (rheumatism and gout) - Wash the leaves well. One and a half cup leaves are boiled in two glassfuls of water over low fire. Do not cover pot. Cool and strain. Divide into three parts and drink each part three times a day after meals. - May also be eaten as salad. Wash the leaves well. Prepare one and a half cups of leaves (not closely packed). Divide into three parts and take as salad three times a day. How to Use: * Divide the decoction into 3 parts and drink 1 part 3 times a day after meals.

GARLIC Ajos (Span., Bis.) (Alium Sativum Linn)

Harvesting and proper storage: * Garlic is harvested during February to March. Store in a cool place. Uses and Preparations: 1.To lower cholesterol levels in blood; for hypertension; toothache. Preparation - may be fried, roasted, soaked in vinegar for 30 minutes, or blanch in boiled water for 5 minutes.

Take two pices three times a day after meals Caution: take on full stomach to prevent stomach and Intestinal ulcers.

2. For toothache - pound a small piece and apply to affected part.

(Quisqualis indica L.)

Balitadhan, Pnones, Pinio, Kasumbal, Talolong (Pamp.) Totoraok (Tag.), Tartarau (Ilokano) Burma creeper, Chinese honey suckle (English) Bonor (Bis.) Bawe-bawe (Bik.) Tagrau, Tagulo

How to Plant Niyog-niyogan: * Plant 20 centimeters long stem cutting with 2 or more nodes in a shady place (under a tree). After 2-3 weeks, the plant can be transferred to the herbal garden. It grows faster if it is placed under the sun. Harvesting and Proper Storage: * This plant bears fruit every year. Harvest only mature fruits colored gold). * Let the fruits dry through air drying. * Place the dried fruits in a can or brown jar and cover tightly.

Uses and Preparations:

1. Anti-helminthic - used to expel round worms which cause ascarisis. The seeds are taken 2 hours after supper. If no worms are expelled, the dose may be repeated after one week. Adult 8-10 seeds 7 -12 yrs. 6-7 seeds 6 - 8 yrs. 5-6 seeds 4 - 5 yrs. 4-5 seeds Caution: not to be given to children below four years old. * Then drink water. Repeat the same dose if it has no effect. Possible Side Effects: * Hiccups * Stomach pains * Diarrhea

(Posidium guajava L.) Guyabas, Kalimbahin, Tayabas (Tag.) Bagabas (Ig.) Bayabo (Ibm.) Bayawas (Bik., Pang.) Biabas (Sul) Guyabas (Ilokano)

How to Plant Guava: * Plant the seeds. The plant does not need much care. Harvesting and proper storage: * Harvest immature or young tender leaves. Make sure that there are no insects or dirt on the leaves.

Uses and Preparations:

1.For washing wounds - may be used twice a day 2. For diarrhea - may be taken 3-4 twice a day. 3. As a gargle and to relieve toothache. Warm decoction is used for gargle. Freshly pounded leaves are used for toothache. Guava leaves are to be washed well and chopped. Boil for 15 minutes at low fire. Do not cover pot. Cool and strain before use.

How to Use:
* for wound cleaning - Use the decoction for washing the wound 2 times a day. * for tooth decay/swelling of gums Gargle with warm decoction 3 times a day.

(Cassia, alata L.)

bayabas-bayabasan,kapurko,kantada, katandang aso, pakagonkon, sonting (Tag.) andadasi,andadasi-a,andadasi-bugbugtong (Ilokano) Kasitas (Bik., Bis.) Ringworm bush or shrub (Eng.)

How to Plant Akapulko: * Plant the seed or stem cutting (20 centimeters in length with 2-3 nodes). Harvesting: * Harvest mature and healthy leaves.

Uses and Preparation: 1.Anti-fungal: Tinea Flava, ringworm, athletes foot, and scabies. - Fresh, matured leaves are pounded. Apply sap to
the affected part 1-2 times a day.

How to Use:
* Apply the juice on the affected area 1 to 2 times a day. * If the person develops an allergy while using the above preparation, prepare the following:

-Put 1 cup of chopped fresh leaves in an earthen jar. Pour in 2 glassfuls of water. Cover it. - Bring the mixture to a boil until the 2 glassfuls of water originally poured have been reduced to 1 glassful. - Strain the mixture. You must use this strained liquid while it is warm. - Apply the warm decoction on the affected area 1 to 2 times a day.

Indications:
Cough Fever Colds

Materials:
sampalok leaves 2 thumb-size slices of ginger 1 glass of brown sugar chopping board pot kaki-colored bottle strainer candle stick water

Procedure:
1. Wash the sampalok leaves separating the leaves from the stem. Put 1 glass of sampalok leaves on the pot. 2. Wash the ginger without peeling it. Make thin slices of ginger. Then, place the ginger inside the pot on top of the sampalok leaves. Pour 1 glass of water and measure this using a stick. Mark the level of water on the stick. Pour the second glass of water and boil it until the water that will be left is leveled with the mark on the stick. Don't cover the pot.

3. Strain, and get the extracts. 4. Measure the extracts and add sugar as many as the measure of extracts. (1:1 ratio) 5. Boil again until it becomes sticky or viscous. And let it cool and add extracts from calamansi. 6. Place the syrup to a clean kaki-colored bottle. 7. Cover the bottle and put drops of candle at the side of the cover. Turn the bottle upside down until it will dry.

Dosage: Teenagers and Adults: 1 tbsp for 2 to 4 times a day Children: 7-12 years old - 1 tsp 3 times a day 2-6 years old - tsp once a day

Indications
Diarrhea

Materials
3 pieces of avocado leaves 3 pieces of guava leaves 3 pieces of star apple leaves knife pot burner/stove water

Procedure
1. Wash and chop the leaves of avocado, guava and star apple into small pieces. 2. Measure 1 glass of avocado leaves, guava leaves and star apple leaves and place it in the pot. 3. Put 6 glasses of water and boil until 3 glasses of water will be left. 4. Strain it into a clean cloth.

Dosage
Drink to 1 glass of boiled ABK after having diarrhea. Aside from this, let the patient also drink a lot of water with sugar and salt.

Warning
Dont use the ABK made after 24 hours.

Indications hoarseness of voice, fever, cough and colds, vomiting, hyperacidity and stomach gas pain Materials Ginger 1 glass brown sugar strainer glass or cup scraper pot

Procedure
1. Carefully clean the ginger and scrape it. 2. Extract the ginger. Then measure 1 glass of ginger extracts and stir it. Add/mix it with brown sugar with 1:1 ratio. 3. Place the mixed ginger extracts and brown sugar in the pot. Boil it over a slow fire. 4. Mix it well until it will become a syrup. Put it away from the fire. Mix it well. 5. Place it in a clean plastic or bottle.

Dosage
1 tbsp of salabat powder in 1 glass of hot water.

Indications
Diarrhea

Materials
green banana (tundan) knife plastic bag

Procedure
1. Peel the banana. 2. Slice it into thin slices. 3. Let it dry under the sun until it hardens. 4. Pound it using mortar and pestle until it is pulverized. 5. Hide the banana in to a sealed plastic bag.

Dosage
The banana powder can be mixed with pudding or soup. 2 tbsp of powder in 1 glass cup of soup and add 1 tsp of sugar.

Indications
Scabies, Skin allergies, mosquito and bug bites, Eczema, wound or vesicular skin lesions

Materials
Calachuchi branch (green part) Candle Knife Nescafe glass for measurement Alcohol lamp Chopping board Pot Oil or coconut oil (not the pork oil)

Procedure
1. Wash the calachuchi branch 3 to 5 times. Skin the thin brown part of the branch until the green part is visible. 2. Peel off/skin the green part of the calachuchi. Measure it in the glass and place it inside the pot. 3. Measure the oil the same as the measurement of the calachuchi with 1:1 ratio. 4. Boil for 5 minutes and strain using a net bag or clean cloth. 5. Place glass of melted candle every 1 glass of calachuchi extracts. Mix and let it cool until it solidifies.

6. Place the ointment into a plastic using a spoon and close the plastic. 7. Place a name and place it in another plastic and cover it with paper. Keep it away from heat.

Warning
- for

external use only

Indications
Tinea Flavea, athlete's foot, ringworm

Materials
Sunting leaves Chopping board Knife Candle Oil or coconut oil Measuring glass Plastic, bottle with wide opening/ big cover Lamp

Procedure
1. Clean the leaves and chop into small slices. 2. Measure 1 glass of chopped sunting leaves. Place it inside the pot. Then, measure 1 glass of cooking oil, place it on the pot and stir the sunting leaveas. (1:1 ratio). Boil for 5 minutes. 3. Strain it using a net bag. Strain it again using a clean cloth. Melt the candle. In every 1 glass of sunting extracts , place glass of melted candle.

4. Let it cool until it will solidify. Using a spoon, place/transfer the ointment into a plastic or bottle container. If you use a plastic, seal it using a lamp. 5. Name the bottle and place it in the plastic and seal it. Then, cover it with a paper and place it away from heat.

How to use
 Apply the ointment on the affected part of the body after taking a bath for 3 times a day for 3 weeks.

Indications
Rheumatism, neuralgia, muscle pain, skin scratches

Materials
1 glass or cup of garlic 1 glass or cup of ginger 1 glass or cup of chilli (labuyo) knife mortar and pestle pot burner/stove

Procedure
1. Measure 1 cup of ginger, garlic and chilli (labuyo). If no chilli available, you can use pepper. 2. Slice the ginger and garlic. Pound the chili. 3. Boil 3 cups of cooking oil then, place the slice ginger and garlic and pounded chilli. 4. Cook it on a slow fire within 5 to 10 minutes.

5. Strain and place it in a container. 6. Let it cool before using.

How to use
Apply it on the affected part

Warning
For external use only.

NURSING RESPONSIBILITIES:
1. Avoid the use of insecticides as these may leave poison on plants. 2. In the preparation of herbal medicine, use a clay pot and remove cover while boiling at low heat. dont boil it in an aluminum utensils. Aluminum reacts chemically with medicinal elements in plants. Not covering the cooking utensils when boiling is necessary to release toxins if there are any. 3. Boil for a one-day supply only. Any decoctions effectivity is good for only 8-12 hours after boiling.

4. Wash thoroughly any leaves, barks, flowers and roots with water before boiling or using it as poultice. 5. Take decoction either hot or cold. Strain decoction before taking it. 6. Do not use or boil two or more different herbal plants together, unless instructed to do so. 7. Follow instructions carefully, especially the measurements and the dosage.

8. Use only the part of the plant being advocated. 9. Use only one kind of herbal plant for each type of symptoms or sickness. the one available to you. 10. Some individuals are sensitive and allergic to certain leaves and plants. If symptoms of allergy are observed during and after the treatment, STOP the treatment immediately, and wash with water thoroughly (for skin applications).

Symptoms of allergy are: increased itching and swelling, nausea and vomiting, dizziness, and headache. Consult a physician immediately if symptoms persist. 11. Individuals known to be allergic to some plants are not encouraged to use the herbal medications.

12. These treatments and medications are of simple illnesses only with no known complications. After 3 to 4 days of treatment and medications with no curative effects, and with symptoms getting worse, STOP the treatment and consult a physician for further medical management. 13. If signs and symptoms are not relieved after 2 to 3 doses of herbal medication, consult a doctor.

What To Do As A Community Health Worker

1. Learn about the herbs/plants in your area and find out which herbs/plants have medicinal or healing qualities. 2. Talk with Traditional Healers and people in the community and learn from them about safe traditional remedies, their use and methods of using them. 3. Educate the community through the small group discussions on the correct way of using and preparing medicinal plants/herbs.

Advise the use of herbal medicine preparations in managing common illnesses over use of drugs, unless no herbal medicine is available for treating specific diseases. 5. Ensure the availability and easy accessibility of medicine plants proven to be safe and effective in testing common diseases in the community. 6. Mobilize the community or group of community members selected by the community to be actively involved in building and maintaining a Community Herbal Garden. 4.