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Folk medicinal practices among tea estate workers: a study in Moulvibazar district, Bangladesh.

INTRODUCTION

Folk medicinal practice, practiced by folk medicinal practitioners (Kavirajes) is a common feature among the generally rural population of Bangladesh. A large degree of similarity can be observed between folk and tribal medicinal practices, the latter being practiced by the various tribes of the country. The similarity lies in the fact that both groups of practitioners, even though they may differ in plant selection to treat a particular ailment, relies largely on medicinal plants for treatment of diseases. The diseases treated may range from common disorders affecting the rural population like gastrointestinal disorders to more complex diseases like rheumatoid arthritis or cancer. Despite this similarity, considerable differences exist between Kavirajes or tribal medicinal practitioners on the medicinal plants selected for treatment of a particular ailment. This occurs even between Kavirajes of the same area or tribes living in a common area. While this diversity of selection, in practical terms, means conducting interviews of Kavirajes or tribal medicinal practitioners of as many areas or tribal groups as possible, it also means that the knowledge acquired through documentation of these traditional practices can in the long run result in a comprehensive account of the variety of ethnomedicinal uses of a certain plant, and thus can lead towards scientific discovery of new drugs.

Promotion and scientific validation of traditional uses of medicinal plants can not only be effective in lowering health costs of low income groups in rural and remote area populations of an underdeveloped country like Bangladesh, but also lower dependency on imported allopathic drugs, which may be costly and beyond the reach of the common people. However, proper documentation of the medicinal plants of a country is a huge undertaking needing an enormous number of surveys of traditional medicinal practitioners. We have undertaken such a project and have conducted extensive surveys among the mainstream Kavirajes and tribal medicinal practitioners of the country [33-36,8,15,17,28,29,3745, 2,5-7,14,20,21,46,47,56,58,9,16,18,24,48-51,57,4, 31,52,53]. However, it is our finding that these surveys concluded so far are not adequate enough towards a full documentation of the medicinal plants and traditional medicinal practices. More documentation is necessary and towards that, this study was conducted with the objective of documenting the medicinal practices of a Kaviraj practicing in Alinagar Tea Estate in Moulvibazar district of Bangladesh, whose patients included a large number of different tribal tea estate workers.

Materials and Methods

The Kaviraj whose practices have been documented in this study was named Md. Abdur Rob, practicing in Alinagar Tea Estate under Kamalganj Police Station in Moulvibazar district of Bangladesh. The tea estate employed a large number of tribal workers belonging to the Bihari, Mudi, Goala Rajbongshi, and Nayek tribes. The Kaviraj was aged 60 years and according to his statement been practicing for about 12 years. He learnt his practicing methods from a 'guru'.

Prior Informed Consent was first obtained from the Kaviraj. The Kaviraj was explained the full purpose of our visit and consent obtained to disseminate any information provided in both national and international venues. Actual interviews were conducted with the help of a semi-structured questionnaire and the guided field-walk method of Martin [26] and Maundu [27]. In this method, the Kaviraj took the interviewers on guided field-walks through areas from where he collected his medicinal plants, pointed out the plants, and described their uses. Plant specimens were photographed and collected on the spot, pressed, dried and brought back to Dhaka to be identified at the Bangladesh National Herbarium. Interviews were carried out in the Bengali language, which was spoken by both the Kaviraj and the interviewers. It was noted that the Kaviraj collected most of his plants from wild areas within the tea estate or wild areas adjoining the tea estate.

Results and Discussion

The Kaviraj was observed to use 26 plants distributed into 17 families in his various formulations. The formulations were used to treat diverse diseases like hemorrhoids, menstrual disorders, infections, pain, gastrointestinal problems, hydrocele, tooth and gum problems, eye disorders, urinary problems, tongue lesions, stone formation, lack of breast milk, pain or pus in ears, poisonous snake or insect bite, helminthiasis, respiratory tract disorders, night blindness, bone fracture, and sprains. The results are shown in Table 1.

With few exceptions, the Kaviraj used a single plant or single plant part to treat a single or multiple diseases. The leaves of Aloe vera were used to treat multiple diseases like hemorrhoids, irregular menstruation and unusual menstruation (like excessive bleeding during menstruation, commencement of menstrual period prior to due date, prolonged menstrual period). On the other hand, sap from leaf stalk of Calotropis gigantea was used to treat hydrocele in children (an instance of single plant part - single disease). Occasionally, two different plant parts from the same plant were used to treat two different diseases, like roots of Amaranthus spinosus were used to treat infection of finger nails, while a combination of roots and leaves of the same plant were used to treat infections due to burns. Interestingly, the Kaviraj used the roots of the same plant along with fruits of Piper longum to treat headache.

There were several instances of the Kaviraj using multiple plants for treating diseases. However, the number of plants did not exceed two in number. For instance, to treat constipation and diarrhea, the Kaviraj advised taking a paste of leaves of Centella asiatica along with cloves of Allium satvum and rice. Although in this case, rice is also a plant product, this item was used to make the paste easier for taking. In Bangladesh, various products are taken as 'bharta' or in the mashed form with rice. These items commonly include potatoes or leafy vegetables, but may also include dried fish as well as fruits. Thus rice was not used in a medical sense but as a medium to partake of the bharta or paste of the two medicinal plant items. It is to be noted that Allium sativum or garlic is also used in Bangladesh as a spice. Cloves of Allium sativum were also used with Cissus quadrangularis to treat bone fractures and sprains by the Kaviraj.

It was of interest to search the scientific literature for any scientific validation of the medicinal plants used by the Kaviraj. Aloe vera was used to treat hemorrhoids by the Kaviraj. The beneficial effects of Aloe vera cream on posthemorrhoidectomy patients in wound healing and alleviating pain has been reported [12]. The pulp of leaves of the plant is a jelly-like substance and it can give a soothing effect on topical application to wounds, sores or burns; however, the interesting feature of the Kaviraj was that he used the leaves of the plant orally. However, the leaves of the plant reportedly possess analgesic and anti-inflammatory properties [11], and so the leaves can be beneficial in reducing pain and inflammation associated with hemorrhoids after oral partaking. It is also of interest that the Kaviraj used leaves of the plant for menstrual dysfunctions. Modern Ayurvedic practitioners use dried inner leaf gel as a tonic for female reproductive systems [3].

Amaranthus spinosus was used by the Kaviraj to treat infections of nails, burn infections and headache. A common feature of these ailments is pain. The analgesic properties of the plant have been reviewed [23]. Piperine is present in Piper longum fruits, which was used by the Kaviraj along with Amaranthus spinosus to treat headache. Piperine has reportedly analgesic activities [59], so the combination of Amaranthus spinosus and Piper longum can have a synergistic powerful effect in alleviating pain associated with headache.

Centella asiatica has been shown to prove inhibitory against enteric pathogens [25]. Notably, the plant was used by the Kaviraj against constipation and diarrhea. Holarrhena antidysenterica was used by the Kaviraj against tooth pain. The analgesic and anti-inflammatory properties of leaves of the plant has been reported in animal models [54]. Nerium oleander, a plant used by the Kaviraj against blood dysentery, has been reported to be inhibitory against bacterial pathogens like Bacillus subtilis and Escherichia coli [22]. Hemidesmus indicus was used by the Kaviraj, among other diseases, for treatment of pain from stones. The analgesic, anti-inflammatory and antipyretic activities of the plant has been reported [13]. Hoya parasitica was used by the Kaviraj against pain in ears; analgesic activity of the plant has been reported [1]. Eclipta prostrata, used by the Kaviraj against headache, has also been reported for its analgesic activity [19].

The Kaviraj used Heliotropium indicum to treat snake bite. Although no scientific validation exists on such use, the Bagata tribe of Eastern Ghats, Visakhapatnam district, Andhra Pradesh, India also uses the plant to treat snake bites [55]. Ocimum sanctum, used by the Kaviraj for coughs in children, has been shown to antitussive action [30]. Methanolic extract of Cissus quadrangularis has been found to accelerate healing process of experimentally fractured radius-ulna of dogs [10]; the Kaviraj used the plant to treat bone fracture.

The available scientific reports show that quite a number of the plants used by the Kaviraj for treatment and healing of diverse diseases can be validated on their reported pharmacologically relevant activities. It shows that the traditional practitioners of Bangladesh are quite knowledgeable about medicinal plants even though they may not have had or still have access to scientific literature. On the other hand, since the practices of these traditional healers have been going on for time immemorial, science can benefit by taking advantage of their medicinal formulations to find out new and efficacious drugs. As such, the plants used by the Kaviraj merit potential for serious scientific research in the quest for better drugs with little or no adverse side-effects.

Published Online 10 March 2015.

Corresponding Author: Professor Dr. Mohammed Rahmatullah, Pro-Vice Chancellor, University of Development Alternative House No. 78, Road No. 11A (new), Dhanmondi R/A, Dhaka-1209, Bangladesh.

Ph: 88-01715032621 Fax: 88-02-8157339

E-mail: rahamatm@hotmail.com

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Sadika Khan, Mehjaben Tumpa, M. Toreq-uz-Zaman, Shamima Akter, Md. Raziur Rahman, Ariful

Islam, Masud Rana, Sharmin Jahan, Md. Ashraful Islam, Mohammed Rahmatullah

Department of Pharmacy, University of Development Alternative, Dhanmondi, Dhaka-1209, Bangladesh

Received: 26 December 2014; Revised: 12 January 2015; Accepted: 12 February 2015
Table 1: Medicinal plants and formulations of the folk medicinal
practitioner at Alinagar tea estate.

Serial       Scientific Name        Family Name
Number

1        Aloe vera (L.) Burm. f.     Aloeaceae

2        Amaranthus spinosus L.    Amaranthaceae

3        Centella asiatica (L.)       Apiaceae
                  Urban

4        Calotropis gigantea R.     Apocynaceae
                   Br.

5              Holarrhena           Apocynaceae
          antidysenterica (L.)
                  Wall.

6          Nerium oleander L.       Apocynaceae

7           Plumeria rubra L.       Apocynaceae

8        Borassus flabellifer L.     Arecaceae

9        Hemidesmus indicus (L.)   Asclepiadaceae
                 R. Br.

10        Hoya parasitica Wall.    Asclepiadaceae

11       Eclipta prostrata (L.)      Asteraceae
                   L.

12       Heliotropium indicum L.    Boraginaceae

13       Opuntia dillenii (Ker-      Cactaceae
               Gawl) Haw.

14       Merremia umbellata (L.)   Convolvulaceae
               Hallier. f.

15        Lens culinaris Medik.       Fabaceae

16       Swertia chiraita (Roxb.    Gentianaceae
          ex Fleming) H. Karst.

17       Leucas aspera (Willd.)      Lamiaceae
                  Linn.

18          Ocimum sanctum L.        Lamiaceae

19          Allium saivum L.         Liliaceae

20         Asparagus racemosus       Liliaceae
                 Willd.

21        Tinospora cordifolia     Menispermaceae
             (Willd.) Miers.

22        Oxalis rubra A.-St.-      Oxalidaceae
                  Hil.

23           Piper longum L.         Piperaceae

24          Abroma augusta L.      Sterculiaceae

25           Cissus assamica          Vitaceae
             (Lawson) Craib

26        Cissus quadrangularis       Vitaceae
                   L.

Serial         Local Name               Parts used
Number

1             Ghritokumari                 Leaf

2               Kantanol                Root, leaf

3             Tunimankuni                  Leaf

4                Akondo             Sap from leaf stalk

5                Kurchi                    Bark

6             Rokto korobi         Bark of base of tree

7          Korobi, Chelim ful       Bark of root, root,
                                        bark, leaf

8                 Taal                      Sap

9              Anantamul             Whole plant, root

10              Kan pata                 Leaf sap

11         Caraiya, Kashrush            Whole plant

12             Hatishura                   Leaf

13            Foni-monsha                   Sap

14             Dudh lota                   Leaf

15             Masoor dal                  Seed

16              Chirota                 Leaf, stem

17             Goom shak                   Leaf

18            Kalo tulshi                  Leaf

19               Roshun                    Clove

20             Shotomuli                   Leaf

21              Guloncho                Leaf, stem

22             Amrul gach            Whole plant, leaf

23             Gol morich                  Fruit

24            Ulot kombol               Stem, bark

25       Tok pata, Pahar chukai            Leaf

26              Harjora                 Whole plant

Serial                             Disease,
Number            Symptoms, Formulations, and Administration

1          Hemorrhoids. A small amount of ghee is applied to leaf,
          which is then warmed and orally taken twice daily for 4-5
                                    days.

         Irregular menstruation, unusual menstruation. Pulp of leaves
         is dried and then soaked in warm water and taken twice daily
                               for a few days.

2          Infection of finger nails. Dried and powdered roots are
                 applied as poultice over the infected area.

          Infections due to burns. Young leaves and roots are boiled
         in water. The water is then strained and applied with cotton
               or soft cloth topically over the infected area.

          Headache. Roots of Amaranthus spinosus and fruits of Piper
          longum are made into a paste and applied topically to the
                                  forehead.

3        Constipation, diarrhea. Paste of leaves of Centella asiatica
           along with paste of cloves of Allium sativum are orally
                           taken with cooked rice.

                              See Oxalis rubra.

4        Hydrocele in children. Sap is topically applied with ghee to
                                   scrotum.

5         Toothache, decaying of tooth, bleeding from gums. Bark is
               dried and powdered and applied to base of tooth.

6        Blood dysentery. Paste of bark is mixed with water and taken
                              orally for 3 days.

7          Conjunctivitis. Leaf juice is topically applied to eyes.

          Graying of hair. Paste of bark of root is mixed with milk
          and applied to hair 2-3 hours before bathing. This is done
          for 7 consecutive days. Abortifacient. Roots are dried and
           powdered and taken orally with cold water. After taking,
          milk and ghee (clarified butter) is to be orally taken 15
                               minutes later.

            Hemorrhoids. Paste of bark of root is applied over the
                               hemorrhoid area.

8                            See Abroma augusta.

9           Urinary problems. 60-70g whole plant is cut into small
              pieces and soaked in 1 poa (local measure, 4 poas
          approximate 1 kg) water overnight. The following morning,
            the water is strained and the clear water taken orally
            during night to increase urine volume and frequency of
                                  urination.

          Tongue lesions. Dried whole plant is soaked in sheep milk
         and applied to the tongue. Irregular menstruation, excessive
          menstrual bleeding. Dried roots are soaked in cow milk and
                                orally taken.

         To increase lactation. Young plants are boiled in water. One
         cup amount of the resulting juice is taken orally every day.

          Pain from stones (kidney, gall bladder, stomach). Paste of
            young whole plant mixed with cow milk is taken orally.

10          Pain or pus in ears. Sap is slightly warmed and a tea
                spoonful of warm sap is poured into the ears.

11       Headache. Paste of whole plant is topically applied to head
                          for 2-3 consecutive days.

12        Antidote to poisoning from poisonous snake or insect bite.
                    Leaf juice is applied to bitten area.

13        Accumulation of mucus in children. Sap is slightly warmed
         and mixed with mishri (crystalline sugar). One tea spoon is
                       taken thrice daily for 2-3 days.

14         To increase lactation. Leaves of Merremia umbellata are
          mixed with seeds of Lens culinaris. Paste of the combined
                        mixture is taken for 3-4 days.

15                         See Merremia umbellata.

16        Indigestion, helminthic infestation. 4-5 leaves are soaked
           in water overnight. The following morning, the water is
          taken orally. This is continued for 2 weeks. Alternately,
             stems are cut into small pieces and soaked in water
            overnight followed by drinking the water the following
                                   morning.

17         Loss of appetite. Leaves are fried and taken orally with
                                 cooked rice.

18        Cough and mucus in children, headache. Paste of leaves is
                     orally taken twice daily for 3 days.

19            See Centella asiatica. See Cissus quadrangularis.

20        Night blindness, excessive nocturnal emissions, passing of
          blood with urine. Young leaves are fried in ghee and taken
           orally in the morning for night blindness. For the other
             ailments, leaf juice is taken orally with warm ghee.

21        Kamla' disease (symptoms: weakness, sleepiness, fluttering
         of heart). Stems are cut into small pieces, soaked in water
           and then made into a paste. Paste is mixed with warm cow
          milk and taken orally twice daily for 3 days. Alternately,
          young leaves are boiled in 810 ml water. The decoction is
         then cooled, and taken orally with cow milk. If any patient
           has problem with taking milk, leaf juice is orally taken
                        after mixing with warm water.

22       Stomach disorders, bloating, indigestion, acidity. Paste of
         whole plant of Oxalis rubra along with paste of whole plant
          of Centella asiatica are mixed with water and taken orally
                                for 2-3 days.

           Pain due to injury. 10-12 leaves are crushed by rubbing
           between the palms and applied topically to injured area.

23                         See Amaranthus spinosus.

24        Passing of sperm with urine. During the rainy season stems
           of the plant are cut into small pieces, soaked in water
         overnight, and the water taken orally the following morning
                      and at night before going to sleep

          During spring, one tea spoon of dried and powdered bark of
           Abroma augusta in one glass of water and taken with taal
           mishri (crystalline sugar obtained from sap of Borassus
                     flabellifer) twice daily for 7 days.

25          Dysentery. Paste of leaves is taken orally for 2 days.

26          Bone fracture, sprain. Paste of whole plants of Cissus
         quadrangularis along with paste of cloves of Allium sativum
                  are applied to fractured or sprained area.
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Article Details
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Title Annotation:Research Article
Author:Khan, Sadika; Tumpa, Mehjaben; Toreq-uz-Zaman, M.; Akter, Shamima; Rahman, Md. Raziur; Islam, Ariful
Publication:American-Eurasian Journal of Sustainable Agriculture
Article Type:Report
Date:Jan 1, 2015
Words:5506
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