Phytotherapy an alternative way of treating diseases on scientific basis

Plants are one of the main sources of nutrition, cosmetics, and medical supplements and drugs. Certain characteristics of plants make them suitable for phytotherapeutic use: easy to access, low cost, and the common perception that they are natural and safe. Although conventional medical therapies have a reliable scientific basis and widespread use, there are several countries, from different socioeconomic levels, where the use of plant-based remedies is legally regulated. Traditional complementary and alternative therapeutic methods (TCAM) or remedy use is prevalent in both acute and chronic health conditions, in about one-third and two-thirds of cases, respectively. Additionally, about one-third of individuals who use phytotherapeutics do not inform their physicians about it. Phytotherapy is the most frequently used TCAM method. If plant secondary metabolites phenols, polyphenols, tannins and flavonoids, glycosides, terpenes, triterpenoids and saponins, essential oils and resins, fixed oils and alkamides, polysaccharides, alkaloids are used in certain doses for a particular duration of time to counteract certain metabolic processes, we may describe the process as conventional medical practice. On the other hand, plants are also used as remedies in TCAM procedures, according to humoral pathology theory; the contemporary medical method used until the 18th century. Still, we can not describe the process as a conventional medical method because phytochemicals are used to intervene in certain metabolic processes in order to rebalance the humoral disorder and certain elements may repair the disbalance that leads to disease.


Abstract
Plants are one of the main sources of nutrition, cosmetics, and medical supplements and drugs. Certain characteristics of plants make them suitable for phytotherapeutic use: easy to access, low cost, and the common perception that they are natural and safe. Although conventional medical therapies have a reliable scientific basis and widespread use, there are several countries, from different socioeconomic levels, where the use of plant-based remedies is legally regulated. Traditional complementary and alternative therapeutic methods (TCAM) or remedy use is prevalent in both acute and chronic health conditions, in about one-third and two-thirds of cases, respectively. Additionally, about one-third of individuals who use phytotherapeutics do not inform their physicians about it. Phytotherapy is the most frequently used TCAM method.
If plant secondary metabolites -phenols, polyphenols, tannins and flavonoids, glycosides, terpenes, triterpenoids and saponins, essential oils and resins, fixed oils and alkamides, polysaccharides, alkaloids are used in certain doses for a particular duration of time to counteract certain metabolic processes, we may describe the process as conventional medical practice. On the other hand, plants are also used as remedies in TCAM procedures, according to humoral pathology theory; the contemporary medical method used until the 18th century. Still, we can not describe the process as a conventional medical method because phytochemicals are used to intervene in certain metabolic processes in order to rebalance the humoral disorder and certain elements may repair the disbalance that leads to disease.
Keywords: Phytotherapy, traditional complementary and alternative medicine, conventional medicine, secondary metabolites.

Phytotherapy
Can phytotherapeutics be used in GP`s everyday practice? Which ones we most frequently use in Turkey and recommend to our patients either as medications or together with conventional medications?. Which ones are available and widely known?
Phytotherapy is a widespread intervention. Use of natural products, primarily plants, is a frequent habit of many people. They either use them on their own or they are prescribed by physicians or other he professionals 1,2 . The constitutes of medicinal plants; An introduction to the chemistry and therapeutics of herbal medicine. Second Ed. Singapore 2004; pp 1-13. Formal medical education provides information only about conventional drug therapy, surgery, nonsurgical interventions e.t.c. Use of phytotherapy in medical practice, as a tool, to both strengthen body health or as a medical therapy is scarce 3 . It may not be wise to expect medical doctors to prescribe phytotherapeutic remedies since they are neither educated nor given continuous medical education on the subject. On the other hand, phytotherapy is an option, completely or partially paid by health insurance or an unpaid option, depending on the country`s health politics. In daily practice, whatever the health politics is or whoever is prescribing them, it concerns healthy and ill people, just the same. People, healthy or ill, frequently use phytotherapy for many purposes, whether it is prescribed by a health professional or not 4 .
Use of phytotherapeutic remedies, as a tool of conventional medical practice or complementary and alternative medicine (CAM) practice, is not so easy. By definition CAM has a specific method of explaining the cause of medical disorders and their therapeutic process 5,6 .There are various reports about the validity and reliability of CAM methods in therapeutic purposes 7 . Current literature provides a great amount of knowledge on plants, but it may not be easy to interpret this information in the context of well-being, health improvement, diagnosis, therapy and rehabilitation by a single professional, such as a medical doctor or a pharmacist.
Historical background on using plants for healthy living and unhealthy conditions can be dated to ancient Egypt and Mesopotamia. Plants, animals and minerals may be regarded as the too easily used remedies for certain conditions. A few hundreds of them are described in ancient texts, dated back to more than 2000 years ago 8 .
Glycosides are compounds constituted of sugar and non-sugar chemicals. They carry the non sugar chemical to intestinal flora where it acts, depending on the character of insular chemical, as expectorant, sedative, cytotoxic substance or it may have antitussive, immunosuppressive effects etc. Terpens are plant chemicals that are produced via mevalonic acid pathway and their wide range of metabolic effects include anti-inflammatory, sedative, antipyretic, antispasmodic, local anaesthetic, antibacterial, antifungal, antimicrobial, antiprotozoal, vasodilatory, antihypertensive, bronchodilatory, and positive inotropic action. Terpens` therapeutic action depends on their isoprene units (monoterpenes, diterpens, triterpens etc.).
Essential oils are the source of plant aromas and although they constitute a very small percentage of plants and are found as a mixture of other chemicals, they have the potency to be used as drugs. According to their chemical properties essential oils are anti-inflammatory, antiseptic, antiviral, immune stimulators, tonifiers, carminatives, sedatives, mucolytics, spasmolytics etc.
The major problem, using plants as remedies, is difficulty in dose adjustment. Several factors may interfere with the chemical content of herbs, other than extraction and reparation procedures. These factors may be listed as: • Even the same plant, cultivated in the same location, may have different quantity of required phytochemical, • Even the same plant, cultivated in different locations, may have different quantity of required phytochemical, • Existence of several phytochemicals in the same plant may lead to undesired consequnces when they act together with the remedium cardinale, • Not every part of a plant may contain the required phytochemical (Table 1), • Not any part of a plant may contain the required phytochemical since the required phytochemical may not be produced until a specific period of growth (volatile oils can be extracted in the early periods of flowering and after that period they are lost gradually). Some herbs are easily found in our environment in European region.

Spices
They are not food, but are used to give special taste, in addition to foods` natural taste. Spices are parts of plants which have got special taste or they may interfere with the digestion of foods, in order for anybody to feel good, relaxed or avoid unpleasant side effects of foods. Allium cepa (onion), allium sativum (garlic), thymus vulgaris (thyme), mentha longifolia (horse mint), piper nigrum (black pepper), capsicum (red pepper) can be listed as frequently used spices. Although spices are also plant parts, according to their use we may classify them as: • Use of spices with foods may not be intended as a drug or health improver, but other uses are smilar to plant phytochemical`s use in certain disorders.

Toxicity of plant chemicals
Plants can be toxic to humans and toxic phytochemicals can be used as drugs in humans 17

Conclusion
A famous quote by French writer François Marie Arouet (Voltaire) describes physicians: "Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, to human beings of whom they know nothing". This statement may be an excellent description of the pattern of physician-patient relationship. Physicans` motivation of "intention to treat" can not be considered as bad faith of physicians. Neither use of pharmaceutical drugs nor plants, as therapeutic tools, is different intervention. Dose, duration of therapy, way of application, interaction with foods or other drugs is principally identical, both in pharmaceutical drugs and phytoherapeutic remedies.
Contrary to similarities between pharmaceutical drugs and phytotherapeutic remedies, chemicals in plants have different concentration of chemicals in different parts of the plant: onion, leave, flower, root, etc. Even in any part of a plant the concentration of phytochemical cannot be predicted. Sometimes edible, phytotherapeutic and poisonous plants may be very similar or even may be considered identical. As a conclusion we may say that detailed, botanical and pharmacognostic information, education and practice that is accredited by an official institution is essential. In addition to this initial requirement, the variability of phytochemical concentration should limit physician`s prescription behaviours, so it`s advisable to start with minimal dose, frequent check-ups for adverse effects and gradual use of plants as remedies in daily medical practice.