Medicinal plants used for dermatological disorders: a study of Uttarakhand State in India.
Since the human skin is directly exposed to the outer environment, it is the most sensitive body part to changes in the environment and hence most susceptible to diseases based on environmental health. Being a barrier and defensive layer between pathogens including external damages and internal environment of human body the skin not only functions as the protection but also contains a variety of nerve endings that react to heat, cold, pressure, vibration and tissue injury (Madison, 2003, Proksch 2008). The skin regulates heat, acts as a storage center for lipids and water and is a water resistant barrier preventing loss of essential nutrients from the body (Connor 2003, Madison 2003, Proksch 2008). Therefore any abnormality in skin and its function may have a large impact on human health due to increasing susceptibility of internal body organs to the external environment.
Historically skin diseases have had serious impacts on the quality of human life across the world. Some 3000 varieties of skin diseases, including many rare ones, are known to medical science (Anon 2005). Despite this fact skin diseases generally have been given low priority by health authorities. Although many people do not see these diseases as a major problem, skin diseases impose a severe impact on wellbeing. Many skin diseases have a long history and in many cases are restricted to geographical areas and the local culture. Besides a number of environmental factors, heredity plays an important role in transmission of some skin diseases from one generation to another (Thappa 2009). Skin cancer is the most common form of cancer in some developed countries, even though it is largely preventable.
Although little attention is being paid to skin diseases in comparison to other fatal diseases, skin diseases are among the most common diseases seen in the primary health care setting in tropical areas, causing unnecessary suffering and even death. At any given time one out of every three people in the United States suffers from a skin disease (Thorpe 2004, Anon 2005). The World Health Organisation showed that skin diseases were associated with mortality rates of 20 000 in Sub Saharan Africa in 2001 (Mathers 2006). Although mortality rates are comparatively lower than other diseases, skin diseases are common and enhance morbidity through disfigurement, disability or symptoms such as intractable itch, reducing the quality of life (Hay 1994). In America skin diseases are placed in the top 15 groups of medical conditions for which the health care costs have grown since 1987 (Thorpe 2004).
In the present era of global climate change with the explosion of human population and increasing interactions among people of different countries, the risk of spreading skin related diseases is quite high. Learning the causes and practices used in curing skin diseases can help people to make better choices and reduce the risk of developing disabling and potential deadly diseases. This study was conducted in the Uttarakhand state of India with a view to understanding the use of plant species for curing various skin diseases.
The Indian state of Uttarakhand is well known for its rich biodiversity and cultural mosaic of diverse nature. The state is comprised of 13 districts and is bounded on the northwest by Himachal Pradesh, on the north by Tibet (China), on the east by Nepal, and on the south by Uttar Pradesh. The state possesses a wide altitudinal range from 210 m to 7,817 m over the total area of 53,485 [km.sup.2]. Uttarakhand covers about 12.18% of the total Indian Himalaya, 40% of its total area falls under different forest types, some of the major vegetation types classified along the altitudinal gradient are tropical, sub tropical, temperate, sub alpine and alpine (Kala 2010).
The total human population of the state is close to 8 480 000 of which 78% live in rural areas. Due to the geographical diversity and inaccessibility, a well known feature of the mountainous region, Uttarakhand has remained isolated from the rest of the agricultural plains of northern India and has thus preserved some of the old practices, traditions and ethnic norms for various resource use patterns. The sociocultural fabric in this region is characterised by diverse ethnic groups which have developed their own cultures based on available natural resources, giving rise to a cultural diversity. The rich plant diversity, geographical isolation and long period of people dependency on plants for curing diseases are some of the important factors for selection of Uttarakhand to carry out the present study.
The extensive literature survey (including CSIR 1989, Paliwal 1990, Negi 1991, Jain 1991, Kala 2002, 2006, 2010, Gaur 1999, Maikhuri 2000, Badoni 2001, Phondani 2010) was carried out for the compilation of medicinal plants used in curing different types of skin diseases by various ethnic communities of Uttarakhand. The data was compiled on plant parts used in therapy and on the number of skin diseases cured by a plant species.
Although the majority of information was collected from secondary sources, field surveys were also undertaken for gathering data on the availability and uses of medicinal plant species across various localities in the study area from tropical to alpine zones. The survey focused on collecting information using a semistructured questionnaire on types of ailments being cured by the traditional use of medicinal plants and plant parts used.
The information on skin diseases and their treatments was gathered from 60 traditional herbal healers. The healers were selected randomly for interviewing from a list of 200 traditional healers who were identified during community workshops. Five workshops were organised in different districts of Uttarakhand and various groups of indigenous people including herbal healers were invited to interact and help in documentation of their knowledge on medicinal plants for curing diseases. The data was cross checked by interviewing more than three healers on the specific uses of a plant species. In order to verify the identity of medicinal plant species field visits were undertaken with herbal healers.
A large number of medicinal plants growing in various habitats and elevations were used by local people of Uttarakhand for curing dermatological problems. The present study resulted in the documentation of 132 plant species of which herbaceous plants were highest (n=77) followed by trees (26), shrubs (25) and 2 each in under shrub and woody climbers (Table 1). Species were used for curing 19 different types of skin diseases including frost bite, goiter, pimples, itching, eczema, leprosy, sores, bruises, carbuncles, burns, small pox, scabies, boils, gout, removal of lice, blisters, swelling, septic wounds, cuts and wounds (Table 2). Most of the species were used for curing a limited number of skin diseases, whereas a few species were used for curing over 5 types of skin diseases. Ageretum cornyzoides was used in curing 9 types of skin diseases including burns, septic wounds, scabies, swelling, boils, sores and cuts and wounds. Azadirachta indica, Vitex negundo, Woodfordia fruticosa, Allium cepa, Cuscuta reflexa, Shorea robusta and Skimmia laureola were other important species in their uses for curing 4-5 types of skin related diseases.
There were variations in the species used for curing particular skin diseases by the local people and traditional herbal healers. A total of 65 plant species were used for curing cuts and wounds, the highest number of species used for curing one particular type of skin related problem. Contrary to this Solanum nigrum was the only species used by healers and documented during the present investigation for treatment of goiter. Similarly for treatment of frost bite Juglans regia and Solanum tuberosum were the only herbs used. A total of 22 plant species were used in treatment of sores, 21 for boils, 17 for swelling, 15 each for leprosy and scabies, 13 for septic wounds, 12 for eczema, 11 for burns, 8 for small pox and 7 for itching.
The plant species used for skin diseases is dependent on their availability in nature. Of 132 medicinal plant species the following 22 are considered rare and endangered; Aconitum atrox, Dactylorhiza hatagirea, Fritillaria roylei, Thalictrum foliolosum, Berberis aristata, Artemisia maritime, Delphinium cashmerianum, Gloriosa superb, Saussurea obvallata, Betula utilis, Nardostachys jatamansi, Swertia chiraita, Rheum austral, Rheum webbianum, Podophylum hexandrum, Hippophea salicifolia, Bergenia ligulata, Bergenia stracheyi, Arnebia benthamii, Rhododendron arboretum, Aegle marmelos, Lyonia ovalifolia and Waldhemia glabra.
Although the specific uses of species for skin ailments were disclosed by the interviewees, the specific dermatological use of 14 plant species was not disclosed, only that the species was used for certain types of skin diseases. These species were Arisaema jacquemontii, Artemisia japonica, Astragalus candolleanus, Berberis jaeschkeana, Chenopodium album, Convolvulus arvensis, Corydalis govaniana, Jasminum humile, Raphanus sativus, Saussurea costus, Thymus linearis, Annona squamosa, Pupulia lappacea and Drosera peltata.
Traditionally the knowledge of treating skin diseases in India was restricted to a few specialised herbal healers and generally passed from one generation to another by word of mouth. Written documents were limited in which only a few dermatological problems were described. It is reported that the knowledge of allergic diseases harmful to the skin did not exist at that time (Thappa 2009). In 1991 the Ministry of Health and Family Welfare, Government of India had about 2000 dermatologists for a population of 843 million. Although the situation has now changed and the number of dermatologists has increased, these dermatologists are concentrated in the cities and large towns (Thappa 2002). It is estimated that one in 20 people in India has some kind of skin disease (Kumar 1996). Seventy five percent of India's population lives in rural areas, with such a large population mainly treated by traditional healers with the help of bioresources available in the village and surrounding forest areas.
Furthermore the modern system of medicine is unable to afford treatments for all types of skin diseases. There are reports claiming shortage of basic skills in the management of skin diseases hence the failure rate of treatment is quite high (Figueroa 1998, Hiletework 1998). However the treatment of skin diseases using medicinal plants in Uttarakhand is quite common and effective. The local people of adjacent areas of Uttarakhand such as Himachal Pradesh, use 18 species of medicinal plants for treating 6 types of skin disease, of these the highest number was used for the treatment of boils, followed by healing of cuts and wounds (Lal 2008).
The environmental degradation and pollutants are also responsible for causing skin diseases. Many people have developed sensitivities to different pollen grains causing skin allergies. The local people of Uttarakhand perceive that the pollen grains of chir pine are the source of a skin allergy (Kala 2010). Skin diseases are often infectious and transmissible. The intensity of disease may vary with the environmental and climatic conditions. Fungal infections commonly affect skin during the rainy season. Such infection causes irritation and discomfort. The use of Azadiracta indica for removing such fungus from the skin is considered quite effective.
Although the healers did disclose the specific uses of most of the plant species used, it was noticed that for some specific treatments healers would not disclose their procedures. This may be one of the ways of a traditional patent system, which not only helps the healers in protecting their intellectual knowledge but also protect the species from overexploitation.
Many medicinal plant species have become rare and endangered partly due to overharvesting from nature in the recent past. There is now a ban on collection of many such plant species from the wild, however many of these species are essential for making particular types of herbal formulations for skin diseases. The herbal healers admit that they face difficulty in making those specific formulations due to less availability and bans on collection of some rare and endangered species (Kala 2000, 2005). The low availability of such plant species has affected the traditional system of plant use for treating specific skin diseases.
Since the modern system of medicine is unable to afford treatments for all types of skin diseases, the effective treatment of skin diseases by using medicinal plants, as evident from the Uttarakhand state of India, will help to improve the quality of human life. Therefore attempts need to be made to strengthen the alternative system of medicine in view of its wide acceptability, effectiveness and centuries of practical experimentation, especially in developing countries.
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Chandra Prakash Kala
Ecosystem & Environment Management, Indian Institute of Forest Management Nehru Nagar, PB No 357, Bhopal, Madhya Pradesh India 462 003
Table 1: Medicinal plants and plants parts used for treatment of dermatological problems No Species Habit Plant part used 1 Achillea millefolium Herb Whole plant 2 Aconitum atrox Herb Tuber 3 Acorus calamus Herb Root 4 Aegle marmelos Tree Leaf, Fruit, Root 5 Aesculus indica Tree Fruit, Bark, Root 6 Ageretum cornyzoides Herb Root, Leaf 7 Ajuga bracteosa Herb Root, Leaf, WP 8 Albizia lebbeck Tree Seed, Bark, Root 9 Allium cepa Herb Bulb 10 Allium sativum Herb Bulb 11 Annona squamosa Herb Bark 12 Anogeissus latifolia Tree Bark 13 Argemone maxicana Herb Leaf Seed Root WP 14 Arisaema flavum Herb Bulb 15 Arisaema jacquemontii Herb Bulb 16 Arnebia benthamii Herb Root 17 Artemisia absinthium Herb Leaf 18 Artemisia japonica Herb Leaf 19 Artemisia maritima Herb Whole plant 20 Astragalus candolleanus Shrub Root 21 Astragalus himalayanus Shrub Seed 22 Azadiracta indica Tree Leaf, Bark, Seed, bud 23 Bambusa arundinacea Grass Stem, Leaf 24 Bauhinia variegata Tree Bark, Flower, Leaf 25 Berberis aristata Shrub Root, Bark 26 Berberis jaeschkeana Shrub Root, Fruit 27 Bergenia ligulata Herb Root, Leaf 28 Berginia stracheyi Herb Root 29 Betula utilis Tree Bark, Root 30 Biebersteinia odora Herb Whole plant 31 Botrychium lunaria Herb Whole plant 32 Butea monosperma Tree Flower, Bark, Seed 33 Cannabis sativa Herb Leaf, Seed 34 Carissa carandus Shrub Leaf, Seed, Root 35 Cassiope fastigiata Shrub Whole plant 36 Celtis australis Tree Bark 37 Centauria iberica Herb Leaf 38 Centella asiatica Herb Fruit, Leaf, Root 39 Chenopodium album Herb Seed, Leaf 40 Cinnamomum tamala Shrub Bark, Leaf 41 Clematis barbellata Woody Leaf 42 Coculus hirsutus Climber Leaf 43 Codonopsis ovata Herb Root 44 Convolvulus arvensis Herb Root, Whole plant 45 Corydalis govaniana Herb Root, Whole plant 46 Corydalis meifolia Herb Whole plant 47 Cuscuta capitata Climber Whole plant 48 Cuscuta reflexa Climber Whole plant 49 Cyananthus integer Herb Whole plant 50 Cyananthus lobatus Herb Root, Flower, Leaf 51 Cyanodon dactylon Herb Root, Leaf 52 Dactylorhiza hatgirea Herb Tuber 53 Delphinium brunonianum Herb Root 54 Delphinium cashmerianum Herb Whole plant 55 Drosera peltata Herb Whole plant, Leaf 56 Euphorbia hirta Herb Whole plant 57 Euphorbia hispida Herb Whole plant 58 Euphorbia royleana Shrub Latex 59 Ficus bengalensis Tree Latex 60 Ficus racemosa Tree Bark, Fruit, latex 61 Ficus religiosa Tree Leaf, Bark, Fruit 62 Fritillaria roylei Herb Bulb 63 Fumaria indica Herb Leaf 64 Galium elegans Herb Shoot 65 Gaultheria nummularioides Shrub Leaf 66 Geranium himalayense Herb Root 67 Geranium nepalense Herb Root 68 Gloriosa superba Herb Root, Rhizome, Leaf 69 Hippophae salicifolia Shrub Bark, Fruit 70 Jasminum humile Shrub Bark, Root 71 Juglans regia Tree Bark, Leaf, Fruit 72 Jurinea dolomiaea Herb Root 73 Lantana camera Shrub Fruit, Leaf 74 Lyonia ovalifolia Tree Stem, Leaf, WP 75 Malvastrum coromendalianum U Shrub Leaf 76 Melia azedarach Tree Fruit, Leaf 77 Mentha longifolia Herb Whole plant 78 Morus alva Shrub Fruit, Bark 79 Nardostachys jatamansi Herb Rhizome 80 Neolitsea pallens Tree Fruit 81 Ocimum sanctum Herb Leaf, Seed, WP 82 Ophioglossum vulgatum Herb Rhizome 83 Oxalis corniculata Herb Leaf, Whole plant 84 Phoebe lanceolata Tree Berries 85 Picea smithiana Tree Resin 86 Pinus roxburghii Tree Resin 87 Plantago major Herb Whole plant, Seed 88 Podophyllaum hexandrum Herb Rhizome, Fruit 89 Polygonum amplexicaule Herb Root 90 Polygonum nepalense Herb Whole plant 91 Potentilla atrosanguinea Herb Leaf 92 Principia utilis Shrub Seed, Fruit 93 Punica granatum Shrub Root, Stem, Fruit 94 Pupalia lappacea Shrub Fruit 95 Quercus leucho-trichophora Tree Seed 96 Ranunculus arvensis Herb Leaf 97 Raphanus sativus Herb Leaf, Seed 98 Rheum australe Herb Root 99 Rheum webbianum Herb Root 100 Rhododendron arboretum Tree Leaf 101 Rhododendron campanulatum Shrub Root, Leaf 102 Ricinus communis Shrub Seed, Leaf 103 Rumex hastatus Herb Leaf 104 Rumex nepalensis Herb Leaf 105 Saussurea costus Herb Root 106 Saussurea obvallata Herb Root 107 Senecio laetus Herb Leaf 108 Shorea robusta Tree Seed, Fruit 109 Siegesbeckia orientalis Herb Whole plant 110 Skimmia laureola Shrub Leaf 111 Solanum nigrum Herb Fruit, Leaf, Seed 112 Solanum tuberosum Herb Tuber 113 Stellaria media Herb Whole plant 114 Swertia chiraiyta Herb Root, Whole plant 115 Syzygium cuminii Tree Bark, Fruit, Seed 116 Taraxacum officinale Herb WP, Leaf, Root 117 Taxus buccuta Shrub Leaf, Fruit, twig 118 Tectona grandis Tree Wood 119 Terminalia chebula Tree Fruit, Seed 120 Thalictrum foliolosum Herb Root 121 Thymus linearis Herb Whole plant 122 Toona ciliata Tree Bark, Fruit, Leaf 123 Tylophora indica Shrub Leaf, Stem, WP 124 Urtica dioica Herb Root, Leaf, WP 125 Verbascum thapsus Herb Whole plant, Leaf 126 Viola bioflora Herb Flower, Leaf 127 Vitex negundo Shrub Stem, Flower, Leaf 128 Waldhemia glabra Herb Root, Leaf, 129 Woodfordia fruticosa Shrub Flower 130 Zanthoxylum armatum Shrub Fruit, Stem, Bark 131 Ziziphus mauritiana Shrub Fruit 132 Ziziphus officinale Shrub Rhizome Table 2: Dermatological problems and plant species used to cure these skin problems by local people of Uttarakhand Dermatological No of Species problems species Goiter 1 Solanum nigrum Frost bite 2 Juglans regia, Solanum tuberosum Lice 3 Acorus calamus, Ageretum cornyzoides, Cuscuta reflexa Bruises 3 Codonopsis ovata, Geranium himalayense, Saussurea obvallata Gout 3 Gloriosa superb, Melia azedarach, Verbascum thapsus Pimples 4 Butea monosperma, Punica granatum, Syzygium cuminii, Celtis australis Carbuncle 6 Albezia lebbeck, Anogeissus latifolia, Cyanodon dactylon, Ficus religiosa, Shorea robusta, Woodfordia fruticosa Blisters 7 Allium cepa, Ficus bengalensis, Ficus recemosa, Ficus religiosa, Syzygium cuminii, Taraxacum off, Vitex negundo Itching 7 Allium cepa, Carissa carandus, Cassiope fastigiata, Cuscuta reflexa, Lantana camera, Vitex negundo, Zanthoxylum armatum Small pox 8 Azadirachta indica, Ficus racemosa, Ficus religiosa, Nardostachys jatamasi, Shorea robusta, Skimmia laureola, Woodfordia fruticosa, Zanthoxylum armatum Burns 11 Ageretum cornyzoides, Ajuga bracteosa, Bergenia ligulata, Euphorbia royleana, Fritillaria roylei, Plantago major, Principia utilis, Ricinus communis, Shorea robusta, Waldhemia glabra, Woodfordia fruticosa Eczema 12 Allium sativum, Arisaema flavum, Centauria iberica, Centella asiatica, Euphorbia hirta, Ranunculus arvensis, Tectona grandis, Terminalis chebula, Thalictrum foliolosum, Vitex negundo, Zanthoxylum armatum Septic wounds 13 Ageretum cornyzoides, Arnebia benthamii, Artemisia maritima, Azadirachta indica, Cuscuta capitata, Gaultheria nummularioides, Jurinea dolomiaea, Melia azedarach, Mentha longifolia, Skimmia laureola, Toona ciliata, Urtica dioica, Viola biflora Leprosy 15 Aconitum atrox, Ageretum cornyzoides, Argemone maxicana, Astragalus himalayanus, Azadiracta indica, Bauhinia variegata, Centella asiatica, Corydalis meifolia, Ficus racemosa, Stellaria media, Swertia chiraiyta, Pinus roxburghii, Ocimum sanctum, Gloriosa superb, Vitex negundo Scabies 15 Ageretum cornyzoides, Argemone maxicana, Azadirachta indica, Euphorbia hirta, Ficus bengalensis, Ficus racemosa, Ficus religiosa, Gloriosa superba, Quercus leucho-trichophora, Skimmia laureola, Swertia chiraita, Vitex negundo, Ziziphus officinale, Neolitsea pallens, Clematis barbellata Swelling 17 Achillea millefolium, Aconitum atrox, Ageretum cornyzoides, Albezia lebbeck, Codonopsis ovata, Cuscuta reflexa, Delphinium cashmerianum, Pinus roxberghii, Polygonum nepalense, Rheum australe, Ricinus communis, Rumex nepalensis, Solanum nigrum, Taxus baccata, Urtica dioica, Vitex negundo, Cocculus hirsutus Boils 21 Ageretum cornyzoides, Ajuga bracteosa, Albezia lebbeck, Argemone maxicana, Azadirachta indica, Berberis aristata, Euphorbia hirta, Allium cepa, Butea monosperma, Lyonia ovalifolia, Mentha longifolia, Pinus roxberghii, Rheum webbianum, Rhododendron campanulatum, Ricinus communis, Siegesbeckia orientalis, Skimmia laureola, Solanum nigrum, Thalictrum foliolosum, Urtica dioica, Vitex negundo Sores 22 Ageretum cornyzoides, Cannabis sativa, Carissa carandus, Cinnamomum tamala, Cyanodon dactylon, Ficus bengalensis, Ficus religiosa, Galium elegans, Gloriosa superba, Juglans regia, Morus alva, Ricinus communis, Senecio laetus, Shorea robusta, Siegesbeckia orientalis, Solanum nigrum, Terminalia chebula, Vitex negundo, Woodfordia fruticosa, Ziziphus mauritiana, Picea smithiana, Phoebe lanceolata Cuts and wounds 65 Aconitum atrox, Acorus calamus, Aegle marmelos, Aesculus indica, Ageretum cornyzoides, Allium cepa, Allium sativum, Botrychium lunaria, Cynanthus integer, Arnebia benthamii, Artemisia absinthium, Artemisia maritima, Azadirachta indica, Bambusa arundinacea, Bergenia ligulata, Bergenia stracheyi, Betula utilis, Biebersteinia odora, Butea monosperma, Cannabis sativa, Carissa carandus, Centella asiatica, Cuscuta capitata, Cuscuta reflexa, Cyananthus lobatus, Dactylorhiza hatagirea, Delphinium brunonianum, Delphinium cashmerianum, Euphorbia hirta, Euphorbia hispida, Euphorbia royleana, Geranium nepalense, Hippophea salicifolia, Lyonia ovalifolia, Melia azedarach, Mentha longifolia, Ocimum sanctum, Ophioglossum vulgatum, Oxalis corniculata, Plantago major, Podophyllum hexandrum, Polygonum amplexicaule, Potentilla atrosanguinea, Principia utilis, Ranunculus arvensis, Rheum australe, Rheum webbianum, Rhododendron arboreum, Ricinus communis, Saussurea obvallata, Shorea robusta, Siegesbeckia orientalis, Stellaria media, Taraxacum officinale, Tylophora indica, Urtica dioica, Vitex negundo, Woodfordia fruticosa, Ziziphus mauritiana, Picea smithiana, Phoebe lanceolata, Coculus hirsutus, Fumaria indica, Rumex hastatus, Malvastrum coromendalianum
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|Title Annotation:||Global dispensary|
|Author:||Kala, Chandra Prakash|
|Publication:||Australian Journal of Medical Herbalism|
|Date:||Sep 22, 2011|
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