Perspectives in ethnopharmacology: forging a closer link between bioscience and traditional empirical knowledge.

To what extent do ethnopharmacologists from diverse disciplines share a vision of what ethnopharmacology is and what it might become? This question was explored several years ago through content analysis of the Journal of Ethnopharmacology (JEP), the official journal of the International Society for Ethnopharmacology (ISE). The analysis revealed that although the published articles represent the breadth of natural and social sciences, most studies are themselves not synthetic or interdisciplinary. For the present study, analysis was extended through the most recently published issues of the JEP and compared, for the same time period, to the subject matter of another natural products journal, Pharmaceutical Biology. Whereas research published in the JEP better represents the interdisciplinary objectives of that journal, the difference is not striking. By way of illustration, several studies are reviewed that represent the unique, synthetic perspective that is highlighted in the mission statements of both the JEP and the ISE. The conclusion underscores the lack of clarity in research objectives and suggests that ethnopharmacologists of all backgrounds can enhance their work by projecting pharmacologic data against a backdrop of medical ethnography and by enriching cultural interpretations of medical actions by exploring the physiologic potential of plants.

Indigenous patterns of conserving biodiversity: pharmacologic implications.

The accelerating rate at which the world's botanical resources are being depleted today has inspired redoubled efforts on the part of global conservation programs. For the most part, this reflects the actions of outsiders who are culturally and politically detached from the threatened environments, and who identify species for conservation through western economic models. In view of this, ethnopharmacologists--and primarily those representing the social sciences--have drawn attention to the cogency of indigenous knowledge of biotic diversity and its conservation. This paper reviews how local paradigms of plant management promote conservation, and problematizes the issue specifically to the use of plants by Hausa peoples in northern Nigeria. The pharmacologic implications of indigenous patterns of plant use and conservation derive from the manifold and overlapping contexts in which plants, especially wild species, are used by local communities. These applications identify the importance of particular species and should be employed in assigning priority for the conservation of plants.

A changing Hausa diet.

We report results of a longitudinal study of shifting patterns of food consumption in a rural Hausa-Fulani village in northern Nigeria. While the broad outlines of diet did not change over the 12 years between two dietary surveys, important shifts occurred: a decline in the consumption of local cultigens, with a corresponding decrease in total caloric intake, as well as an embellishment of diet through the introduction of new foods. We suggest that this is best understood through the growing participation of this village in the wider economy. We juxtapose these dietary shifts to a model of disease risk that suggests, for the early period, that the coincidence of dietary elaboration and the periodicity of disease risk offered some degree of protection against malaria infection. For the more recent period, diet was no longer marked by conspicuous seasonal changes. To what extent these differences in diet patterns have affected the disease experience of this population is not yet clear.

Sociocultural factors in the use of prenatal care by Hmong women, Minneapolis.

Understanding the sociocultural context of prenatal care underuse by an immigrant population can suggest programmatic changes that result in more effective health care delivery. Ethnographic survey interviews of female Hmong clinic patients conducted in 1987/88 revealed that they objected to biomedical procedures and to being attended by several doctors; the women also reported poor communication with staff as a problem. Clinic reforms implemented in 1989/90 included hiring a nurse-midwife, reducing the number of pelvic examinations, expanding hours of operation, creating a direct telephone line to Hmong interpreters, and producing a Hmong-language prenatal health care education videotape. Women interviewed in 1993 reported a more positive clinic experience.

Anthropological methods in ethnopharmacology.

This paper reviews anthropological methods in ethnopharmacology to advance a critical and biobehavioral perspective for the construction of primary data in the light of indigenous paradigms of health and therapeutics. The unique contributions of anthropology are the conceptual and practical tools that allow one to develop the ethnography of plant use in sufficient depth to correlate with laboratory and clinical investigations of plant constituents and activities. This serves an ethnopharmacology that links bioscientific research to traditional empirical knowledge. Specific methods discussed include: key respondents, participant observation, focus groups, structured and unstructured interviews, survey instruments and questionnaires, lexical and semantic studies, and discourse and content analysis. The accommodation of rapid ethnographic techniques for ethnopharmacologic research is described, and several problem orientations based on assessments of efficacy are offered.

Should we set a place for diet in ethnopharmacology?

Ethnopharmacologic inquiry is most invincibly pursued by addressing "medicinals" across the divers contexts through which populations gain exposure to the material of their pharmacopoeia. Attention to multiple categories of use advances our comprehension of indigenous health care by providing a framework for laboratory investigations that explore the bioactive potential of the materia medica to influence the occurrence and expression of disease, and that determine how those physiologic outcomes may be further mediated by the context-specific vicissitudes of preparation, combination and consumption. Consideration of the dietary contexts of local "medicines" is central to this wider perspective.

The greater risk of fewer deaths: an ethnodemographic approach to child mortality in Hausaland.

"A Nigerian case study illustrates how local understandings of health influence perceptions of infant survival in ways that may juxtapose indigenous interpretations to other 'objective' data. Evidence from two extended field investigations of a Hausa-Fulani village, set 12 years apart, suggests a decline in childhood mortality rates attendant upon the increasing availability of biomedicines. We note, however, that local perceptions are that mortality risks are now greater for those less than five years old. Our discussion focuses on the circumstances that inform this ethnodemography and its applicability to other population studies." (SUMMARY IN FRE)

The indigenization of pharmaceuticals: therapeutic transitions in rural Hausaland.

A West African case study illustrates how indigenous understandings of disease and therapeutics may influence the utilization of biomedicines. This focus suggests a more comprehensive approach for the evaluation and design of health care delivery systems in developing world contexts.

Assessment of red cell sodium transport in essential hypertension.

Abnormal erythrocyte Na+ transport has been reported in patients with essential hypertension and some first-degree relatives. The two major techniques now employed for estimating Na+ transport--Na+/Li+ countertransport and Na+/K+ cotransport--are rather intricate and time consuming. Furthermore, the precise nature of the transport processes being measured is not clear. We have developed a simpler, more direct technique based on measurement of 22Na+ accumulation by erythrocytes. 22Na+ uptake by red cells from patients with essential hypertension averages twice normal. Indeed, of 21 patients with essential hypertension, only 2 patients had values within the upper end of the normal range. In 12 patients with secondary hypertension and no family history of essential hypertension, erythrocyte 22Na+ accumulation was within normal limits. Control experiments indicate that our technique for estimating red cell 22Na+ uptake is highly reproducible and shows little day-to-day variation. This procedure for the assessment of erythrocyte Na+ transport should be useful in differential diagnosis and the presymptomatic identification of individuals genetically prone to essential hypertension.

A Hausa herbal pharmacopoeia: biomedical evaluation of commonly used plant medicines.

Biochemical analysis of a selected sample of the Hausa (northern Nigeria) medicinal flora is presented in order to assess potential chemotherapeutic values. Laboratory investigation, supplemented by previously published phytochemical constituent analyses of pertinent taxa, suggests that a number of disorders can be effectively treated by the Hausa practitioner. The Hausa herbal pharmacopoeia is analysed first with reference to its efficacy in the treatment of oral disease. Examined subsequently are Hausa plant medicines considered to be of potential value in the treatment and/or prevention of malaria infection, with particular attention focussed on the malaria symptom complex and parasite-host cell biochemistry. Results are discussed in the context of the adaptive potential of non-Western medical systems and the significance of this aspect for medical policy development programs.