**4. Clinical practice of African traditional/herbal medicine**

In African traditional medicine, the curative, training, promotive, and rehabilitative services are referred to as clinical practices Clinical practice can also be viewed as the process of evaluating conditions of ill-health of an individual and its management. These traditional health care services are provided through tradition and culture prescribed under a particular philosophy, in which the norms and taboos therein are strictly adhered to and form the basis for the acceptability of traditional health practitioners in the community they serve [26].

condition. This approach enables them to know how to handle the matter at hand. In some cases, the healer might require other family members to speak on behalf of the sick person in cases where the patient is not able to express him/herself. In modern times, after the healing process, they also advise their clients or patients to go for medical diagnoses to confirm that they are healed, and the medical reports sometimes serve for record keeping for future reference and are a way of assuring other clients of their ability and credibility. Due to the holistic approach of the healing process, the healers do not separate the natural from the spiritual or the physical from the supernatural [33]. Thus, health issues are addressed from two major

Herbal Medicines in African Traditional Medicine http://dx.doi.org/10.5772/intechopen.80348 199

**i. Spiritual protection**: If the cause of the disease is perceived to be an attack from evil spirits, the person would be protected by the use of a talisman, charm, amulets, specially designed body marks, and a spiritual bath to drive the evil spirits away. These are rites aimed at driving off evil and dangerous powers, spirits, or elements to eliminate the evils

**ii. Sacrifices**: Sacrifices are sometimes offered at the request of the spirits, gods, and ancestors. Sometimes, animals such as dogs and cats are slaughtered or buried alive at midnight to save the soul of the one at the point of death, with the belief that their spirits are strong enough to replace life [30]. There is also the view that because they are domestic animals and are very close to people, sometimes when they see that someone very close to them is about to die, they offer their lives for that person to live. This is true especially where the animal dies mysteriously; thus, it is believed that it had offered its life in place of the life of its owner. Rituals are sometimes performed in order to consecrate some herbs without which the medicine is meaningless. Divine and ancestral sanctions are considered necessary before and during the preparation and application of medicine [35].

**iii. Spiritual cleansing**: Spiritual cleansing may be required of the sick person to bathe at specific times for a prescribed number of days either with water or animal blood poured from head to toe. This practice is common among some communities in Ghana [34]. **iv. Appeasing the gods**: If a disease is perceived to be caused by an invocation of a curse or violation of taboos, the diviner appeases the ancestors, spirits, or the gods according to the severity of the case. The individual is often required to provide certain items for sacrifice and/or libation, such as spotless animals (dove, cat, dog, goat, and fowl), local gin, cola nut, eggs, and plain white, red, or black cloth. These items are usually specified by the gods. The used items may be thrown into the river, left to rot, or placed at strategic places, usually at cross roads at the outskirts of the community, depending on the nature

**v. Exorcism**: This is a practice of expelling demons or evil spirits from people or places that are possessed or are in danger of being possessed by them. Many of the traditional communities believe that illness, especially mental illness, is mostly caused by evil spirits. Exorcism can only be performed by a religious leader or a priest who has the authorities

perspectives—spiritual and physical.

and severity of the case [36].

Spiritual-based cases are handled in the following manner:

or dangers that may have befallen a family or community [34].

**4.3. Spiritual perspective**

According to the World Health Organization (WHO), health is defined as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" [15, 27] and views health as one of the fundamental rights of every human being. The combination of physical, mental/emotional, and social well-being is commonly referred to as the health triangle.

The recognition of disease and illnesses in traditional Africa meant that every society needed to devise means of containing its problem. Worldwide, different societies have different herbal traditions that have evolved over a long period of time. Similar to modern day Western treatment patterns, African traditional societies also involved herbalism, surgery, dietary therapy, and psychotherapy, in addition to traditional exorcism, rituals, and sacrifice [28]. These medical technologies had evolved even before the coming of the "white man" (Arabs and Europeans). Successful treatments became formalized, sometimes with prescriptions of correct methods of preparation and dosage. In addition, the ingredients and the manner of preparation varied with the ailment but were also dependent on various factors such as geographical, sociological, and economic, but the significant point was that in many cases, patients were cured of their physical or psychological ailments [29]. In African traditional medicine, traditional health practitioners (THP) assess patients in order to diagnose, treat, and prevent disease using their expertise by the following methods:
