Ethnomedicine and neuropsychopharmacology in Mesoamerica.

ETHNOPHARMACOLOGICAL RELEVANCE: The burden of disease caused by mental and neurological disorders is increasing globally, to a disproportionate degree in Latin America. In contrast to the many psychoactive plants with a use history in Mesoamerican cultures, the translation to the wider population of knowledge around numerous botanicals used contemporarily by indigenous Mesoamerican societies to treat psychological and neurological disorders did not receive the same attention. MATERIAL AND METHODS: We used the previously published Mesoamerican Medicinal Plant Database to extract species and associated botanical drugs used as treatments for illnesses associated with the nervous system by Mesoamerican cultures in Belize, Guatemala, and Mexico. With the critical use of published pharmacological literature, the cross-culturally most salient genera are systematically reviewed. RESULTS: From 2188 plant taxa contained in the database 1324 are used as treatments for illnesses associated with the nervous system. The ethnomedical data was critically confronted with the available biomedical literature for the 58 cross-culturally most salient genera. For a considerable proportion of the frequently used taxa, preclinical data are available, mostly validating ethnomedicinal uses. CONCLUSION: This quantitative approach facilitates the prioritization of taxa for future pre-clinical, clinical and treatment outcome studies and gives patients, practitioners, and legislators a fundamental framework of evidence, on which to base decisions regarding phytomedicines.

Traditional Herbal Medicine in Mesoamerica: Toward Its Evidence Base for Improving Universal Health Coverage.

The quality of health care in Mesoamerica is influenced by its rich cultural diversity and characterized by social inequalities. Especially indigenous and rural communities confront diverse barriers to accessing formal health services, leading to often conflicting plurimedical systems. Fostering integrative medicine is a fundamental pillar for achieving universal health coverage (UHC) for marginalized populations. Recent developments toward health sovereignty in the region are concerned with assessing the role of traditional medicines, and particularly herbal medicines, to foster accessible and culturally pertinent healthcare provision models. In Mesoamerica, as in most regions of the world, a wealth of information on traditional and complementary medicine has been recorded. Yet these data are often scattered, making it difficult for policy makers to regulate and integrate traditionally used botanical products into primary health care. This critical review is based on a quantitative analysis of 28 survey papers focusing on the traditional use of botanical drugs in Mesoamerica used for the compilation of the "Mesoamerican Medicinal Plant Database" (MAMPDB), which includes a total of 12,537 use-records for 2188 plant taxa. Our approach presents a fundamental step toward UHC by presenting a pharmacological and toxicological review of the cross-culturally salient plant taxa and associated botanical drugs used in traditional medicine in Mesoamerica. Especially for native herbal drugs, data about safety and effectiveness are limited. Commonly used cross-culturally salient botanical drugs, which are considered safe but for which data on effectiveness is lacking constitute ideal candidates for treatment outcome studies.

The taste of heat: How humoral qualities act as a cultural filter for chemosensory properties guiding herbal medicine.

ETHNOPHARMACOLOGICAL RELEVANCE: Organoleptic properties, and more specifically chemosensory cues, have been shown to guide therapeutic applications of medicinal plants. Humoral qualities, on the other hand, are widely believed to be an abstract concept, mainly applied post hoc to validate therapy. However, the nexus between humoral qualities, chemosensory properties, and medicinal plant uses has never been systematically assessed. AIM OF THE STUDY: To systematically analyse the correlations between chemosensory properties, humoral qualities, and medicinal uses of selected botanical drugs. METHODS: The issue was approached experimentally via an organoleptic testing panel, consisting of Zoque healers in Chiapas, Mexico. The healers smelled and tasted 71 selected herbal drugs and subsequently commented on their humoral qualities and therapeutic uses. The resulting dataset is analysed for correlations between these variables using Bayesian statistics. Qualitative data on the characteristics and role of the hot-cold dichotomy complement the quantitative analysis, facilitating meaningful interpretation. RESULTS AND DISCUSSION: The results reproduce and extend the findings of previous studies, which established specific correlations between chemosensory cues and nosological units. The key predictors of drugs' therapeutic uses, however, are their humoral qualities, which are themselves conditioned by taste and smell. These findings appear to be valid for drug samples known to the participants as well as for unfamiliar samples. Thus, this study establishes the role of the hot-cold dichotomy as an important cultural filter connecting organoleptic properties and therapeutic uses of herbal drugs. CONCLUSIONS: There is considerable cross-cultural consensus in Mesoamerica for the specific correlations described in this study. Given the continued pervasiveness of the hot-cold dichotomy, humoral qualities and the underlying organoleptic properties ought to be increasingly considered in the design of pharmaceutical products as well as public health strategies. Such culturally appropriate adjustments may considerably improve the perceived quality and effectiveness of healthcare.

Acculturation and ethnomedicine: A regional comparison of medicinal plant knowledge among the Zoque of southern Mexico.

ETHNOPHARMACOLOGICAL RELEVANCE: In rural areas of Mexico the impact of modernization has changed healthcare and health seeking behaviour to varying degrees. This has rarely been accounted for when discussing and comparing medicinal floras. The ethnomedical system of the Zoque has never before been systematically studied. AIM OF THE STUDY: The objective of this study was to document medical practices and medicinal plant knowledge of the Zoque of Chiapas and Oaxaca, the latter being more strongly affected by acculturation. The medicinal floras are compared in order to detect similarities and differences and establishing links to the cultural transformation. METHODS: Research was carried out in a total of nine Zoque municipalities, attempting to adequately represent the cultural and ecological diversity of the Zoque territory. Standard anthropological and ethnobotanical methods were used for data collection. The recorded medicinal uses were classified into 17 disease categories according to emic medical concepts. In each category, the recorded taxa were rank-ordered based on number of use-reports and the informant consensus factor was calculated. The characteristics of the disease categories and the most salient taxa were compared across the two field sites. RESULTS AND DISCUSSION: A total of 6598 use-reports on 544 species have been collected. With the strongly acculturated Zoque of Oaxaca we have documented a considerably less extensive medicinal flora. The ethnopharmacopoeias of the two Zoque groups share 144 species. These species are of over-proportionate salience, accounting for two-thirds of the total use-reports. In both field sites gastrointestinal disorders are of particular importance, followed by women's diseases, respiratory diseases and musculoskeletal ailments. Children's and spiritual illnesses seem to have lost their importance in Oaxaca, as the underlying concepts are often considered backwards and superstitious. CONCLUSION: While it is difficult to establish a quantitative causal relation between acculturation and medicinal plant knowledge, in qualitative terms there are clear indicators for the changes acculturation has brought about in the medical system of the Zoque of Oaxaca. The results suggest the development of an increasingly homogenized pan-Mesoamerican medicinal flora.

Classifying diseases and remedies in ethnomedicine and ethnopharmacology.

ETHNOPHARMACOLOGICAL RELEVANCE: Ethnopharmacology focuses on the understanding of local and indigenous use of medicines and therefore an emic approach is inevitable. Often, however, standard biomedical disease classifications are used to describe and analyse local diseases and remedies. Standard classifications might be a valid tool for cross-cultural comparisons and bioprospecting purposes but are not suitable to understand the local perception of disease and use of remedies. Different standard disease classification systems exist but their suitability for cross-cultural comparisons of ethnomedical data has never been assessed. Depending on the research focus, (I) ethnomedical, (II) cross-cultural, and (III) bioprospecting, we provide suggestions for the use of specific classification systems. MATERIALS AND METHODS: We analyse three different standard biomedical classification systems (the International Classification of Diseases (ICD); the Economic Botany Data Collection Standard (EBDCS); and the International Classification of Primary Care (ICPC)), and discuss their value for categorizing diseases of ethnomedical systems and their suitability for cross-cultural research in ethnopharmacology. Moreover, based on the biomedical uses of all approved plant derived biomedical drugs, we propose a biomedical therapy-based classification system as a guide for the discovery of drugs from ethnopharmacological sources. RESULTS: Widely used standards, such as the International Classification of Diseases (ICD) by the WHO and the Economic Botany Data Collection Standard (EBDCS) are either technically challenging due to a categorisation system based on clinical examinations, which are usually not possible during field research (ICD) or lack clear biomedical criteria combining disorders and medical effects in an imprecise and confusing way (EBDCS). The International Classification of Primary Care (ICPC), also accepted by the WHO, has more in common with ethnomedical reality than the ICD or the EBDCS, as the categories are designed according to patient's perceptions and are less influenced by clinical medicine. Since diagnostic tools are not required, medical ethnobotanists and ethnopharmacologists can easily classify reported symptoms and complaints with the ICPC in one of the "chapters" based on 17 body systems, psychological and social problems. Also the biomedical uses of plant-derived drugs are classifiable into 17 broad organ- and therapy-based use-categories but can easily be divided into more specific subcategories. CONCLUSIONS: Depending on the research focus (I-III) we propose the following classification systems: I. Ethnomedicine: Ethnomedicine is culture-bound and local classifications have to be understood from an emic perspective. Consequently, the application of prefabricated, "one-size fits all" biomedical classification schemes is of limited value. II. Cross-cultural analysis: The ICPC is a suitable standard that can be applied but modified as required. III. Bioprospecting: We suggest a biomedical therapy-driven classification system with currently 17 use-categories based on biomedical uses of all approved plant derived natural product drugs.

Incense and ritual plant use in Southwest China: a case study among the Bai in Shaxi.

BACKGROUND: Ritual and religious uses of plant-derived smoke are widespread throughout the world. Our research focuses on Southwest China, where the use of incense is very common. This study aims to document and analyze contemporary ritual plant uses by the Bai people of Shaxi Township (Jianchuan County, Dali Prefecture, Yunnan Province), including their related ethnobotanical knowledge, practices, and beliefs. METHODS: The present study builds on previous ethnobotanical research in Shaxi, which started in 2005. Interviews focusing on ritual plant use and associated beliefs were carried out with a total of 44 Bai informants in September 2009 and May and June 2010. The results are supplemented with information on the local religion collected from June to December 2010. All documented species were vouchered, and are deposited at the herbaria of Kunming Institute of Botany (KUN) and the University of Zurich (Z/ZT). RESULTS: A total of 17 species have been documented for use in incense. They are always used in mixtures and are either burned in the form of powders in a censer or as joss sticks. The smell of the smoke is the main criterion for the selection of the incense plants. Incense is burned for communication with spiritual entities at graves, temples, and cooking stoves, as well as for personal well-being. Cupressus funebris Endl., Gaultheria fragrantissima Wall., and Ligustrum sempervirens (Franch.) Lingelsh. are the most important incense species. Others serve as substitutes or are used to stretch incense powders. CONCLUSIONS: In Shaxi the use of incense mixtures at the household and community level is regularly practiced for communication with ancestors, ghosts, and deities and in some cases to strengthen self-awareness. Some of the documented species are widely used in central Asia and Europe, hinting at the well documented knowledge exchange that occurred in Shaxi, which was a major hub along the influential Southern Silk Road.