**1. Introduction**

This chapter is primarily to appraise the pertinent determinants of the safety of medicinal plants or herbal medicines used in African traditional medicine and the implications of their toxicity. In view of the current global upsurge in their usage, it has become necessary to

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review issues related to herbal medicines toxicity within appropriate contexts to allow for their beneficial use. In this regard, the safety implications of medicinal plants used in traditional medicine and or in diets are discussed and some literature on animal toxicity, acute and chronic toxicities, and cytotoxicity of some African medicinal plants are reviewed.

or superior beings as a gift to man through the medium of dwarfs or spirit beings who 'abducted' some individuals and took them away from human habitation into the spirit world either in the forest or in the water bodies. Such persons returned to human habitation trained and equipped to fight the diseases that threaten the well-being of not only individual sufferers but also the entire family or community. Some other knowledge of medicines is claimed to have come by revelation through dreams, visions and extrasensory perception. The above postulates on the origin of herbal medicines formed the basis of a sophisticated traditional medical system in Africa, a time-tested system where information on medicinal plants use was methodically collected over several years, and which provides remedies for most diseases today in Africa. The African Traditional Medicine practitioners' own experience, added to the accumulated knowledge passed on, usually orally, through generations, allow them to offer effective remedies for treating ailments that afflict the community [5].

Toxicity and Safety Implications of Herbal Medicines Used in Africa

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Lately, the knowledge and use of traditional medicine have also been acquired through apprenticeship by individuals understudying a recognized practitioner over defined periods of time. More recently, with increased access to information, some practitioners, especially those outside the indigenous cultures, acquire the knowledge about medicinal plants and their uses from Internet sources including online scientific journals and books including e-books. Another avenue of knowledge acquisition has been through formal education and training in exclusively scientific settings as at colleges or universities where degrees or diplo-

Ever since the dawn of the scientific era, prejudice against traditional medicine has been noted [7]. This has resulted in a situation described as 'passionate ambivalence' toward TM, fuelled by the influence of Western religion and education, urbanization and globalization phenomena in Africa [2]. The result has been continued as negative pronouncements from some segments of western-educated African elites concerning the use of TM especially concerning the quality, efficacy and safety of African medicinal products, creating doubts about the benefits of the medicines. This is in spite of the fact that TM still plays an important role in health-care delivery in Africa and had rarely witnessed major reported cases of adverse effects even after

Besides, some persons with little or no knowledge of herbal medicines tend to focus on reported toxicities and criticize the practice often out of context. Moreover, mass media reports of adverse events tend to be sensationalized and give a negative impression about the outcomes from the use of herbal medicines, instead of identifying the causes of these events, which may relate to a variety of issues [8]. Several scientific studies conducted on the biochemical properties of medicinal plants used in traditional medicines to treat various illnesses have confirmed their efficacy and safety especially in animals. As seen in several publications, the efficacy [9] and sometimes the safety of some medicinal plants and herbal medicines have

mas are awarded on graduation.

hundreds of years of practice [2].

been validated through research [10–12].

**4. Attitudes toward traditional medicine**

Plants have been used since time immemorial for diverse purposes in the life of mankind particularly as food, and medicines for nutrition and the treatment of diseases, respectively, in both humans and animals. They are used in all cultures of the world and have been relied upon for several millennia to support, promote and restore human health. They form a vital component of traditional medicine (TM) and their use for the maintenance of health and wellbeing is a common practice in all African societies. They are used as remedies for the prevention and treatment or management of a plethora of disease conditions including relatively new ones such as HIV/AIDS [1].

Traditional medicine used to be the only health-care system available to the whole of the African population prior to the introduction of allopathic or conventional medicine [2]. The practice received international recognition after the 1978 Alma Ata Conference Declaration, which aimed to achieve primary health care for all by the year 2000 through the use of traditional medicine [3]. TM, especially herbal medicine, still forms the backbone of rural health care in Africa, supporting an estimated 80–90% of the population.
