Would you expect traditional herbal medicine to include non-herbal ingredients, such as minerals or organic (animal) by-products? Welcome back again. In this session, we will familiarize ourselves with the rich world of traditional herbal medicine. Our journey will take us from the desert, and the forest, or garden to the state of the art research laboratories from the spice market in a typical Arab market, to the heart of conventional oncology care. The Middle East, with its rich mosaic of medical traditions, is situated at the crossroads of three continents: Asia, Africa, and Europe. The interaction between the widely varying climate and culture brings with it a diversity of medicinal herbs, each reflecting its own unique environment.The humid Mediterranean climate, brings a rich blossom of aromatic herbs such as Sage (Salvia Fruticose Mill) and Oregano(Origanum Syriacum). These herbs play a central role in Middle Eastern and Mediterranean cuisine, as well as in traditional herbal medicine. In contrast, the dry desert climate introduces other sense and healing qualities, such as that seen with Achillea Fragrantissima and Artemisia Sieberi, plants commonly used by Bedouin tribes and inhabitants of the desert. Finally, there is the high altitude flora of Iran and Central Asia, and the tropical influence from Africa. Each region offering its own blend of herbal products such as Moringa Peregrine and the Myrrh gum harvested from the species Commiphora myrrha. When going outside to the fields and valleys of these regions, one can observe the very intimate connection between traditional herbal medicine, and the environment in which these compounds are found. Many of these medicinal plants may be protected by law, and for many there has been an increase in government regulations requiring a special license to grow and harvest them. At the same time, medicinal plants are quickly becoming a leading commodity, and they are being mass-produced using modern and high-tech agricultural techniques in order to meet the demand while protecting and regulating their production. An example of this, is the Middle Eastern plant Origanum Syriacumm, a basic ingredient of the popular Za'atar flavoring for bread, cheese, and salads throughout the region. Modern technological advances in the cultivation of medicinal herbs has enabled producers to provide consistently high quality product, controlling the amount of active components while assuring quality control and preventing contamination such as lead, mercury, and so on. Still, in a region such as the Middle East, it is not uncommon to find the general population growing and picking seasonal plants including culinary and medicinal herbs from their backyards or surrounding areas. The most important step in preparing an herbal medicinal product, whether individually or as a formula, is the accurate botanical identification of the herb to be picked. Incorrect identification may lead to potentially harmful effects. For example, there have been many cases reported in which patients ingesting the herbal Datura Stramonium, were taken to the emergency room with delirium, bizarre, or even violent behavior, as a result of plants alkaloid components like scopolamine and atropine. Another example of potentially harmful effects of plant derived compounds, is the herb Nerium Oleander which has cardio stimulating Gliclazide activity and may cause delirium or bizarre even violent behavior. Clinical herbalists trained in both traditional herbal medicine and modern clinical or preclinical research, will go through the same process as their conventional medicine counterparts in their preparation of herbal remedies. Both traditional and science-based practitioners will collect and accurately identify the mother plant and its components based on the geography, seasonal, and diurnal characteristics, and weather-related conditions. These factors can significantly influence the quantity and quality of the plant extract, impacting both the effectiveness and safety of the final herbal product. Extracts may be derived from one or more plant parts such as the root, bark, stem, leaves, flowers, fruits, seeds, plant resins, and others. The herbal practitioner may create the remedy from the whole plant, or else as an extract of the mother plant using water, oil, alcohol, or other solvents. As such, the preparation process can result in a variety of plant remedies which though originating from the same plant source, will exhibit different medicinal propertines. In the following interview, we will speak with Sharon Kotzer, a medical herbalists and the Research and Development Director in Bara Enterprises, Israel, about the difference between how herbal remedies and conventional drugs are discovered and produced. Herbal medicine is really the use of the whole herb. It doesn't mean that we use all the parts of the herb, but it means that we take all the ingredients that is in the herbs. It means that we don't extract only one ingredient, what we call active ingredients, but we take the full spectrum. For every herbs, we use actually different parts. Sometime different parts from the same plant with different properties or different action in the body. So, sometimes we use the roots, sometime only the cortex of the root, only the upper part of the root. Sometimes we use the flowers, the seeds, the stems, the leaves, everything. Would you expect that an herbal tea with sage would have the same medicinal qualities as fresh sage leaves, which are often chewed by patients suffering from chemotherapy-induced stomatitis or mouth sores? As would be expected, fresh sage (Salvia Fruticose Mill) leaves have significantly more potent levels of active components, and would thus be more effective in relieving stomatitis sores in the mouth caused by chemotherapy or radiotherapy. Sage tea on the other hand, is a popular herbal remedy which is more often prescribed for the relief of abdominal pain and flatulence, which can also be caused by chemotherapy. The traditional herbal practitioner may also prescribe other forms of this herb. For example, as an aromatic spray for the treatment of sore throat. Sage-based remedies may also be prescribed in capsule form made with dried leaves of the plant as a tincture prepared from alcohol extracts, or as an essential oil extract for external use. Other herbal compounds are also provided in a number of forms: in overall preparation, in capsule form or tincture, or ampoules for injection. Like injection subcutaneously, intravenous, or other modes. Traditional herbal remedies may be prepared using either a single plant compound, or else as a formula containing many plant-derived products. In traditional Chinese medicine, the use of herbal formulas enables the creation of a synergistic effect which is more than a sum of the parts. Traditional herbal practitioners will select which ingredients will comprise the formula, with the component chosen for a number of goal increasing the effectiveness of the formula, directing the active plant components to the organs most affected by the patient's illness, harmonizing the energies of each component, and reducing toxicity and side effects caused by the formula. The preparation of herbal remedies is a complex process, and the herbalists may also use non-herbal ingredients such as minerals, animal-derived products, and other substances. The use of non-herbal components is as varied as the diverse traditional medicine cultures of the region. Many of these non-herbal ingredients can be found in the botanical setting such as Propolis and nature antibiotic found in the honeycomb of beehives, and used for alleviating stomatitis in the oncology setting. Other non herbal ingredients maybe mineral-based such as clay, salts or asphalt, bitumen or derived from animal related sources such as fish, scorpions, snakes, deer mask and more. In the following interview, we will meet with Professor Efraim Lev from the University of Haifa, who also served as Head of the Department of Humanistic Studies and out at the Technion, Israel. For my research, I know that they were about between 280-300 medicinal substances in the Medieval Middle East or Medieval Mediterranean. Now, about 80 percent of them are from vegetal origin and five-. Pure herbs? Pure herbs. Yeah. Some of them were fruits that people were eating. Raison that people were using for perfume and some other were spices and so on. But in general, we're talking about 80 percent, and the rest 20 percent are substances from animal origin or inorganic substances between 5-10 percent each of these groups. It's understandable because plants cannot move, so it's easier to get them. Plants we use to eat so it is safer. Now, when you talk about animals, you need to hunt them, you need to go and search for them which is harder, and that's why some of them are more expensive. Regarding the inorganic materials, usually interestingly enough, they were using them especially for external treatment, because people do not take inorganic material into their body on a regular basis.