196 American-Eurasian Journal of Sustainable Agriculture, 7(3): 196-209, 2013 ISSN 1995-0748

ORIGINAL ARTICLES

A randomized survey of differences in medicinal selection as well as diseases treated among folk medicinal practitioners and between folk and tribal medicinal practitioners in

Md. Abu Mannaf, Md. Ariful Islam, Sharmin Akter, Ratna Akter, Tanjima Nasrin, Iffat Zarin, Syeda Seraj, Mohammed Rahmatullah

Faculty of Life Sciences, University of Development Alternative, Dhanmondi, Dhaka-1205, Bangladesh

ABSTRACT

Ethnomedicinal surveys were carried out among folk and tribal medicinal practitioners of Maulvibazar district and a folk medicinal practitioner of Brahmanbaria district of Bangladesh. Altogether four medicinal practitioners were interviewed, one folk medicinal practitioner each from Maulvibazar and Brahmanbaria district, as well as one Khasia and one Manipuri tribal medicinal practitioner from Maulvibazar district. The survey showed wide differences in the plant species selected and diseases treated among the four medicinal practitioners. The present survey indicates that various medicinal practitioners, whether they belong to mainstream folk medicine or various tribes, differ in their choices of medicinal and the diseases treated, suggesting that a certain degree of specialization exists between traditional medicinal practitioners on the type of diseases treated. Different species of plant were observed to be used by the different practitioners, and even when a plant species was used in common, the disease(s) treated by the practitioners varied. The survey strongly indicates several things: that medicinal practitioners whether they be folk or tribal medicinal practitioners, differ in their selection of plants and the type of disease treated with the plants selected; that practitioners specialize in treating diseases and not all types of diseases are treated by the same practitioner; and that to get a comprehensive knowledge of the medicinal plants used for treatment in Bangladesh, ethnomedicinal surveys need to be carried out among as many folk medicinal and tribal medicinal practitioners as possible. The diversity of treatment with any given plant species by the practitioners further suggests that a database comprising the various modes of treatment can be of considerable interest to scientists in further experimentation and determining the various pharmacological properties of any given plant species.

Key words: Medicinal plants, tribal medicine, folk medicine, Bangladesh

Introduction

Folk medicine constitutes an important part of the various traditional medicinal systems of Bangladesh. Traditional medicinal systems like Ayurveda and Unani has deep roots and goes back to thousands of years ago, and has well developed philosophy of diseases, body systems, and formulations and mode of preparation of the formulations. Practitioners of these two forms of medicine also need to be trained in Government recognized institutions, and only after successful completion of their training receive degrees and are registered prior to being allowed to practice. Unlike the above two mentioned traditional medicinal systems, folk medicine is a form of popular medicine and can be practiced by anybody who claims to know about any formulation for treatment of any given disease. Folk medicinal practitioners are known as Kavirajes or Vaidyas; they may receive their training from their parents or somebody in the family, from reading books, from dreams, from trial and error experiments with various formulations, or from a ‘guru’ who has been practicing folk medicine for a number of years. As suc h, there is a wide variation in the formulations of various Kavirajes, and two Kavirajes practicing within the same area may have altogether different formulations. Kavirajes usually rely on medicinal plants for treatment. The medicinal plants or a single plant part or a combination of plants or plant parts may be used in the formulations, which may consist of administering orally or topically juice obtained from crushed whole plant(s) or plant part(s). Other types of formulations may be decoctions, pastes, crushed or macerated whole plant or plant parts. Often Ayurvedic or Unani influences are observed in a Kavirajes’ treatment. The formulations may also contain animal, fish or insect parts as well as minerals by themselves as well as in combination with plants. The treatment process can also further consist of wearing amulets, uttering incantations, and worship of various deities. Bangladesh has more than a hundred tribes and each tribe more or less has their own form of medicinal formulations consisting of plants, animals, insects, and minerals. Incantations, wearing amulets, and worship of

Corresponding Author: Professor Dr. Mohammed Rahmatullah, Pro-Vice Chancellor, University of Development Alternative, House No. 78, Road No. 11A (new), Dhanmondi R/A, Dhaka-1205, Bangladesh Ph: 88-01715032621 Fax: 88-02-8157339 E mail: [email protected] 197 Am. Eurasian J. Sustain. Agric., 7(3): 196-209, 2013 deities also form an integral part of tribal medicines. Two tribes residing in the same area may have formulations, which totally differ from one another. The same plant species may be used but to treat another disease. Or else, the same disease may be treated among two tribes with two different plant species. As such, tribal medicinal system is not much different from folk medicinal system in its preparations and uses except that Kavirajes belong to the mainstream Bengali-speaking population and tribal medicinal practitioners (TMPs) belong to a specific tribe. In fact, some tribes also refer to their medicinal practitioners as Vaidyas. Taken together, it may be said that medicinal formulations are almost always unique for any particular Kaviraj or any particular TMP. Kavirajes and TMPs, through generations of practice spanning centuries, have acquired considerable knowledge on medicinal plant species and their ability for curing diseases. This knowledge is important for scientists towards further research leading to possible discovery of better drugs. However, since the knowledge acquired by Kavirajes and TMPs vary so widely, it is important to document the formulations of these practitioners in the widest possible manner. Towards that, we had been conducting ethnomedicinal surveys among various Kavirajes and TMPs for the last few years (Nawaz et al., 2009; Rahmatullah et al., 2009a-c; Chowdhury et al., 2010; Hasan et al., 2010; Hossan et al., 2010; Mollik et al., 2010a,b; Rahmatullah et al., 2010a-g; Akber et al., 2011; Biswas et al., 2011a-c; Haque et al., 2011; Islam et al., 2011; Jahan et al., 2011; Rahmatullah et al., 2011a,b; Sarker et al., 2011; Shaheen et al., 2011; Das et al., 2012; Hasan et al., 2012; Hossan et al., 2012; Khan et al., 2012; Rahmatullah et al., 2012a-d; Sarker et al., 2012). The objective of the present study was to do a comparative analysis of medicinal plants used by a folk medicinal practitioner in Brahmanbaria district, one folk medicinal practitioner in Maulvibazar district, and one TMP each belonging to the Khasia and Manipuri tribe, respectively, also in Maulvibazar district.

Materials and Methods

Interviews were conducted among the following four medicinal practitioners. Motaleb Mia, a folk medicinal practitioner, was from Donuchora village in Kamalgang, Sreemangal, Maulvibazar district. His age was 53 years, and he had been practicing for 10 years. He learnt his formulations from a ‘pir’ (local term for a holy man who is well versed in the Quran and may sometimes practice medicine). Fatema Begum, the second folk medicinal practitioner was from Mukundapur village in Brahmanbaria district. Her age was 50 years. She had been practicing for 5-6 years and learnt her formulations from her mother, who also practiced folk medicine. Nil Khongla, age 75 years was from the Khasia tribe residing in Lawachora Khasia Palli, Kamalganj, Sreemangal, Maulvibazar district. He had been practicing for about 15-20 years and medicinal practice ran in his family for generations. Ingliali Devi, age 57 years belonged to the Manipuri tribe residing at Nilkontho Manipuri Para in Sreemangal, Maulvibazar district. She had been practicing for 6-7 years and learnt her techniques from her mother. Medicinal practice also ran in her family for generations. Informed consent was at first obtained from all four practitioners. All practitioners were informed about the nature of our visit and consent obtained to disseminate any information provided both nationally and internationally. The two folk medicinal practitioners (Kavirajes) belonged to the mainstream Bengali-speaking population, while the TMPs belonged to their respective tribes. All four practitioners, however, spoke fluent Bengali and interviews were conducted in the . Each practitioner was visited in turn because they resided separately; in fact, one practitioner was from Brahmanbaria district, while the other practitioners resided separately, albeit in Sreemangal area of Maulvibazar district. Actual interviews were conducted with the help of a semi-structured questionnaire and the guided field- walk method of Martin (1995) and Maundu (1995). In this method, the practitioners took the interviewers on guided field-walks through areas from where they collected their medicinal plants, pointed out the plants, and described their uses. Plant specimens were photographed and collected, dried and brought back to Dhaka for identification by Mr. Manjur-Ul-Kadir Mia, ex-Curator and Principal Scientific Officer of the Bangladesh National Herbarium. Voucher specimens were deposited with the Medicinal Plant Collection Wing of the University of Development Alternative.

Results and Discussion

The Kaviraj from Maulvibazar district (Kaviraj 1) was observed to use a total of 52 plants distributed into 32 families for treatment of various ailments. The results are shown in Table 1. The various ailments treated included diabetes, respiratory disorders like coughs, asthma, bronchitis and mucus, bed wetting in children, liver problems, burning sensations during urination, abscess, chest pain, bleeding from external cuts and wounds, pain, jaundice, skin disorders, lung disorder, heart disorder, spermatorrhea, physical and mental weakness, measles, gastrointestinal disorders, vitamin C deficiency, irregular menstruation with wasting away of body, swelling and pain of patella, measles, helminthiasis, and bone fracture.

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Table 1: Medicinal plants and formulations of the folk medicinal practitioner of Maulvibazar district. Serial Scientific Family Name Local Parts used Disease, Number Name Name Symptoms, Formulations, and Administration 1 Andrographis Acanthaceae Chilta Bark Diabetes, coughs, mucus. Juice obtained from paniculata crushed bark is taken 2-3 times daily for 1 Nees month (for diabetes), till cure for coughs and mucus. 2 Achyranthes Amaranthaceae Upot Stem Bed wetting in children (urinating in bed during aspera L. lengra sleep at night). On any Saturday or Tuesday, stems are plucked in one breath in the evening. One part of the stem is kept underneath the bed where the child sleeps and the other part is tied to the waist of the child. This is done for 2-3 days. 3 Amaranthus Amaranthaceae Kata sur Whole plant Liver problems. One cup of juice obtained from spinosus L. (apart from a mixture of crushed plants of Amaranthus roots) spinosus and fruits of Ficus racemosa is orally taken 2-3 times daily for 3 days. Burning sensations during urination. One cup of juice obtained from crushed whole plants of Amaranthus spinosus (apart from roots) is taken 2-3 times daily. 4 Mangifera Anacardiaceae Aam Leaf See Serial Number 14. indica L. 5 Alstonia Apocynaceae Chatni Leaf (white sap Abscess with pain, swelling, pus formation and scholaris (L.) gach coming out from redness of surrounding skin). White sap is R. Br. leaf stalk when applied around the abscess 2-3 times daily for 3 leaves are days. The abscess will burst during this period plucked), bark following application of the sap. Hook worm (symptoms: abdominal swelling, abdominal pain). Bark is soaked in water overnight followed by drinking the water the following morning. This is done for three consecutive days. 6 Calotropis Asclepiadaceae Akondo Leaf Chest pain. Old ghee (clarified butter) is applied gigantea R. to surface of leaves. Leaves are then warmed Br. and applied to the chest and kept tied to the chest. This is done 2-3 times daily till cure. 7 Ageratum Asteraceae Rujot pata Leaf See Serial Number 47. conyzoides L. 8 Chromolaena Asteraceae Mutki gach Young leaf Bleeding from external cuts and wounds. odorata (L.) Young leaves are applied once to the area of King & H. bleeding. Rob. 9 Mikania Asteraceae Refugee If bleeding does not stop after delivery of a cordata lota child. One cup of juice obtained from crushed (Burm. f.) B. of Mikania cordata is mixed with one L. Robinson teaspoonful of juice obtained from crushed leaves of Cynodon dactylon. The mixture is taken orally thrice daily for 1 week. Note that some type of medication needs to be taken during this one week for gastric problems. 10 Spilanthes Asteraceae Bing raj Stem Toothache along with swelling of gums. Soft paniculata stems are chewed and then applied to the Wall. ex DC. swollen area. After some time the chewed portion is discarded. Note that this treatment also gets rid of foul odor from the mouth and alleviates inertia of the body. 11 Xanthium Asteraceae Ghagra Leaf Abscess (particularly when accompanied by indicum pata pain, swelling, pus formation and a reddish Koenig appearance around the sides). Leaves of Xanthium indicum are mixed with soil brought to the surface by earthworms and a bulb of Allium cepa. The mixture is crushed and applied as poultice on the abscess. This is done only once. Also see Serial Numbers 43, 48. 12 Oroxylum Bignoniaceae Kanai Bark Jaundice (symptoms: yellowish color of urine indicum L. dinga and body, even nails). Juice obtained from crushed bark is mixed with 1 cup water and then taken orally twice daily for 1 week. 13 Carica Caricaceae Paypay Leaf sap ‘Boisha daud’ (symptoms: black spots on the papaya L. gach skin which swells and itches). Leaf sap is topically applied to affected areas and kept for 30 minutes followed by washing away the sap.

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14 Terminalia Combretaceae Arjun Leaf, bark Lung disorder, heart disorder, bone fracture. arjuna Juice obtained from crushed bark is orally taken (Roxb. ) W. for lungs or heart disorders. During bone & A. fracture and if the fractured area has not got infected, the fractured bone is positioned correctly and the smooth part of leaves are placed on the area and tied with a cloth. The bandage has to be maintained for 18-30 days depending on the healing, and has to be changed daily. Spermatorrhea (symptoms: excessive accidental ejaculation, frequent urge for urination). Bark of Terminalia arjuna is soaked and then crushed along with five young leaves of Mangifera indica and five young leaves of Syzygium cumini and katila gum (a vegetable gum produced as an exudate by trees of the genus Sterculia, powdered candle in appearance) and taken twice daily on an empty stomach for 3 weeks if spermatorrhea is severe, or else for a week if not severe. Also see Serial Number 24. 15 Cuscuta Cuscutaceae Swarna Stem See Serial Numbers 34, 50. reflexa Roxb. lota 16 Dioscorea Dioscoreaceae Bish lota Whole plant ‘Bongdula’ (local name for physical and mental pentaphylla weakness). A portion of the plant from the top L. of the soil which is equal to the patient’s length is cut in one breath and tied around the waist of the patient up to 3 days. Note that this treatment cannot be done for females. 17 Phyllanthus Euphorbiaceae Lebur, Bark Measles. Crushed bark is mixed with one cup of acidus L. Orbori water and taken orally after meals once daily for 1 week. 18 Phyllanthus Euphorbiaceae Khai char Leaf White colored stool in children. One reticulatus teaspoonful of juice is obtained from crushed Poir. leaves. If the child is more than one year old, one teaspoonful of the juice is orally administered along with one teaspoonful of mother’s breast milk thrice daily for three consecutive days. 19 Erythrina Fabaceae Bath madal Leaf Skin infections (severe). Young leaves of variegata L. Erythrina variegata are crushed with 3-4 cloves of Allium sativum and applied topically to affected areas of the skin. This is done for 3 days. Before application, the infected area is to be washed with warm water. 20 Lablab Fabaceae Shim, Uri Leaf Formation of black patches on skin (locally purpureus known as ‘daud’). Crushed leaves and juice (L.) Sweet obtained from crushed leaves are applied as poultice on the b lack patches. The poultice is kept for 2-3 hours daily and continued for 7 days. 21 Mimosa Fabaceae Lojjaboti Leaf See Serial Number 50. pudica L. 22 Senna alata Fabaceae Daud gach, Leaf Scabies (symptoms: itching, may turn L. Sonali infectious). Several leaves of Senna alata and gach 3-4 cloves of Allium sativum are crushed together and topically applied to affected areas once daily for 1 week. The affected areas are scratched and washed with warm water and then dried with a soft piece of cloth prior to application. Note, for small children, cloves of Allium sativum are to be avoided. 23 Tamarindus Fabaceae Tetul Fruit See Serial Number 28. indica L. 24 Flacourtia Flacourtiaceae Lukluki Fruit Vitamin C deficiency (symptoms: oral lesions, jangomas bleeding from gums). Fruits are eaten daily. (Lour.) Raeus 25 Hyptis Lamiaceae Tokma Leaf To keep head cool (symptoms: protrusions from suaveolens gach scalp, warm scalp). Several leaves of Hyptis Poit. suaveolens and young leaves of Terminalia arjuna and a little amount of yellow or red color soil (local name: ‘mati sindoor’) are made into a paste and applied to the scalp for 3 consecutive days.

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26 Leucas Lamiaceae Dom Flower Coughs and mucus in children. ½ teaspoonful aspera kolosh of juice obtained from crushed flowers is mixed (Willd.) Linn. with ½ teaspoonful of mother’s milk and orally administered 2-3 times daily for 2-3 days. 27 Ocimum Lamiaceae Shada tulsi Leaf Coughs with mucus in children below one year basilicum L. age. One teaspoonful of juice obtained from crushed leaves is mixed with one teaspoonful of lactating mother’s milk. The mixture is divided into 3 equal portions and one portion is administered daily thrice for 3 days. 28 Ocimum Lamiaceae Krishna Leaf Coughs, mucus in children. ½ teaspoonful of tenuiflorum tulsi juice obtained from macerated leaves mixed L. with milk obtained from a lactating mother is orally administered. Alternately 1/3 teaspoonful of the juice is taken thrice daily for 3 days. Note that this medication cannot be given to infants under one year age. Coughs, asthma, bronchitis, frequent coughs, mucus in adults. Paste of leaves of Ocimum tenuiflorum, several old fruits of Tamarindus indica, and several cloves of Allium sativum is prepared. The paste is taken thrice daily for 3-7 days. Also see Serial Number 46. 29 Allium cepa Liliaceae Peyaz Bulb See Serial Numbers 11, 43. L. 30 Allium Liliaceae Roshun Clove See Serial Numbers 19, 22, 28, 42, 51, 52. sativum L. 31 Hibiscus rosa Malvaceae Joba phul Flower Dysentery (symptoms: abdominal pain, sinensis L. gach, frequent passing of stool). Five flowers are Rokto joba chewed every morning on an empty stomach along with molasses prepared from sugarcane juice for one week. 32 Azadirachta Meliaceae Neem Leaf Stomach ache, itching and other skin disorders. indica A. Juice obtained from crushed leaves is taken for Juss. abdominal pain. Leaves are boiled in water followed by bathing in the water for itching and other skin disorders. 33 Ficus Moraceae Joggo Fruit See Serial Number 3. racemosa L. dumur 34 Streblus Moraceae Sheora Leaf sap, leaf Pain in any part of the body (symptoms: asper Lour. gach, bud swelling and hardness in any part of the body Modhu accompanied by pain). Sap from young leaves gach is applied to affected part(s) 3-4 times daily for 3-4 days. Irregular menstruation followed by wasting away of body. ½ cup juice obtained from crushed leaf buds of Streblus asper is mixed with ½ cup cow milk and 1 teaspoonful of juice obtained from crushed stems of Cuscuta reflexa and taken once daily on an empty stomach in the morning. This is continued for 7 days. Note that one liter water has to be taken after taking the above formulation and an antacid tablet. 35 Psidium Myrtaceae Peyara Leaf Tooth ache, swelling of gums. Leaves are guajava L. boiled in a little amount of water. The liquid portion of the warm decoction is separated and a small amount of salt added. The mixture is used for gargling 5-6 times daily. Alternately, several leaves of Psidium guajava and several leaves of Ziziphus mauritiana are combined and crushed with salt. The crushed mixture is applied to base of teeth and also used for brushing teeth. 36 Syzygium Myrtaceae Jaam Leaf See Serial Number 14. cumini (L.) Skeels 37 Averrhoa Oxalidaceae Kamranga Young leaf See Serial Number 47. carambola L. 38 Piper betle L. Pan Leaf See Serial Number 44. 39 Piper Piperaceae Paad pata Leaf Bleeding from external cuts and wounds and sylvaticum quick growing of skin in the wounded area. Roxb. Paste of leaves is applied to the affected area(s).

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40 Cynodon Poaceae Durba Leaf See Serial Number 9. dactylon (L.) Pers. 41 Ziziphus Rhamnaceae Boroi Leaf See Serial Number 35. mauritiana Lam. 42 Paederia Rubiaceae Gondho Leaf Chronic diarrhea (symptoms: excessive passing foetida L. badal of watery stool accompanied by abdominal pain). Paste of leaves of Paederia foetida, 3-4 cloves of Allium sativum and leaves of Centella asiatica is taken with rice thrice daily for 3-4 days. 43 Xeromphis Rubiaceae Mokondo Young leaf Acne. Paste of young leaves of Xeromphis spinosa chun, Mon spinosa, leaves of Xanthium indicum, and (Thunb.) gach cloves of Allium cepa are applied to areas Keay. around the spot where acne has developed. 44 Clausena Rutaceae Pan bahar Leaf Digestive problem. Leaves of Clausena heptaphylla heptaphylla are chewed with leaves of Piper (Roxb.) betle 2-3 times daily. This has to be done only Wight & Arn. when indigestion occurs. 45 Murraya Rutaceae Kamini Leaf Toothache accompanied with swelling of gums paniculata gach and pain in gums. Leaves are boiled in water (L.) Jack with the addition of a little table salt. When the water has cooled a little bit, it is used for gargling. This is done 3-4 times daily. 46 Scoparia Scrophulariaceae Chini pata Leaf Coughs and mucus in children. One teaspoonful dulcis L. of juice obtained from crushed leaves of Scoparia dulcis is mixed with one teaspoonful of milk from a lactating mother and one teaspoonful of juice obtained from crushed leaves of Ocimum tenuiflorum. One teaspoonful of the mixture is taken twice daily for 3 days. If the age of the child is one year then 1/5th of a teaspoonful of juice obtained from leaves of Ocimum tenuiflorum is mixed. 47 Solanum Solanaceae Gud baigin Fruit Irregular menstruation with wasting away of torvum Sw. body. Fruits of Solanum torvum are cooked as vegetable with shrimp (any type), several young leaves of Averrhoa carambola and leaves of Ageratum conyzoides and taken orally with rice and lentils thrice daily for 3-4 days. 48 Grewia Tiliaceae Pichli gach Young leaf Swelling and pain of patella. Paste of young microcos L. leaves of Grewia microcos and Xanthium indicum is applied once daily to the patella 2-3 hours before bathing. This is continued for 2-3 days. 49 Centella Umbelliferae Thankuni Leaf See Serial Number 42. asiatica (L.) Urban 50 Clerodendru Verbenaceae Batir pata Young leaf Jaundice (symptoms: yellowish color of urine m viscosum and body, burning sensations in hands and Vent. legs). One cup of juice obtained from crushed leaves of Clerodendrum viscosum is mixed with juice obtained from 5 leaves of Mimosa pudica and 1 teaspoonful of juice obtained from crushed vines of Cuscuta reflexa and taken 2-3 times daily for 1 week. 51 Lippia Verbenaceae Sundari Young leaf Abdominal pain due to gastric problems. ½ cup javanica gach, of juice obtained from crushed leaves of Lippia (Burm. f.) Motmoti javanica is mixed with 3-4 cloves of Allium gach sativum and taken orally. Dosage is half-cup for adults and half teaspoonful for children. Note that when the pain occurs, the medication is prepared immediate and administered. 52 Cissus Vitaceae Har Leaf Bone fracture. Leaves of Cissus quadrangularis quadrangular bhanga are crushed with one or more cloves of Allium is L. gach sativum and applied as poultice on the fracture area. The fracture area is also kept tight with the help of a small stick so that it cannot be disturbed. The poultice is kept in place for 1 week.

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Table 2: Medicinal plants and formulations of the folk medicinal practitioner of Brahmanbaria district. Serial Scientific Family Name Local Name Parts used Disease, Number Name Symptoms, Formulations, and Administration 1 Ananas Bromeliaceae Anarosh Leaf See Serial Number 9. comosus (L.) Merr. 2 Terminalia Combretaceae Arjun Bark See Serial Number 2. arjuna (Roxb. ) W. & A. 3 Ricinus Euphorbiaceae Lal berol Stem Vomiting in children. One inch portion of stem communis L. is cut and hung around the throat with a piece of thread. Note that the stem should be cut from the plant on a Saturday or Tuesday after Dhuhr and before Asr prayers in the Muslim religion. 4 Malachra Malvaceae Ha pata Leaf Asthma, cardiovascular disorders (symptoms; capitata L. respiratory difficulties, fluttering of the heart, chest pain). Leaves of Malachra capitata are crushed with bark of Terminalia arjuna and orally taken once daily in the morning on an empty stomach for one week. 5 Urena lobata Malvaceae Bon habash Leaf, stem Low semen density. ½ cup juice obtained from L. crushed leaves is orally taken in the morning on an empty stomach for 1 week. Alternately, 1 inch portion of stem is cut and tied to the waist on a Saturday or Tuesday. 6 Psidium Myrtaceae Peyara Leaf See Serial Number 8. guajava L. 7 Plumbago Plumbaginaceae Dorer gach Root, stem Children being afraid (symptoms: crying out or zeylanica L. shivering or fever arising during sleep). About an inch portion of stem or root is tied to the left hand in the evening. After tying, 2-3 drops of water are put on the stem or root. Note that the stem or root has to be untied after 15-20 minutes. If not untied, the skin will develop a black color where tied, or a skin eruption will develop in that place. 8 Ziziphus Rhamnaceae Boroi gach Leaf Swelling and pain in gums with occasional mauritiana bleeding. Several leaves of Ziziphus mauritiana Lam. and several leaves of Psidium guajava are thoroughly crushed and a little table salt added to the mixture. The mixture is then applied to the swelled area or the area is brushed with the mixture. This is done every morning or evening and is continued for 1-2 months. 9 Glycosmis Rutaceae Bon jami Leaf Helmintic infections (symptoms: abdominal pentaphylla pain, abdominal swelling, lack of appetite for (Retz.) A. food, vomiting tendency). One cup juice is DC. prepared by crushing leaves of Glycosmis pentaphylla and leaves of Ananas comosus. A red-hot iron is dipped inside the juice. The juice is then taken on an empty stomach. 10 Scoparia Scrophulariacea Mishti gach Leaf, root Blood dysentery. Several leaves are chewed dulcis L. e followed by drinking of water. This is done in the morning on an empty stomach. The process is continued till cure. Alternately, root of the plant is collected on a Saturday or Tuesday evening and tied just below the navel. 11 Physalis Solanaceae Futka gach Stem Pain starting from the navel to the whole body. micrantha Stem is tied to the navel on a Saturday or Link. Tuesday after Dhuhr and before Asr prayers in the Muslim religion. 12 Sterculia Sterculiaceae Shal bishal Leaf Acne, red spots on the skin of face. Leaves are villosa Roxb. taken orally with molasses prepared from ex Sm. sugarcane juice. Prior to eating, leaves are made into a paste with molasses. The formulation should be taken for 7 consecutive days in the morning on an empty stomach. 13 Centella Umbelliferae Thankuni Leaf Gastrointestinal disorders like dysentery, asiatica (L.) diarrhea, amebic dysentery, stomach pain. Urb. Leaves are boiled and orally taken. Alternately, the leaves are cooked as vegetable and eaten. This is done twice daily. Note that this will also increase breast milk of lactating mother.

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14 Curcuma Zingiberaceae Bao ada Rhizome Stomach disorders (symptoms: abdominal aromatica swelling, abdominal pain, indigestion). Salisb. Rhizomes are crushed to obtain one teaspoonful of juice. A red-hot piece of iron is dipped inside that juice. ½ teaspoonful of this juice is administered orally to children and full teaspoonful to adults.

Table 3: Medicinal plants and formulations of the Khasia tribal medicinal practitioner of Maulvibazar district. Serial Scientific Family Name Local Name Parts used Disease, Number Name Symptoms, Formulations, and Administration 1 Achyranthes Amaranthaceae Kaua luli Leaf Loss of appetite, diabetes, aversion to food, aspera L. gach mucus. Leaves are cooked and eaten as vegetable. 2 Costus Costaceae Tor gach Whole plant Pain following hard work, abdominal pain, loss speciosus (J. except roots of appetite. One cup of juice obtained from Koenig) Sm. crushed whole plant (except roots) is taken daily in the morning on an empty stomach for 1 week. Note that the plant, if chewed any time, leads to purification of blood and maintaining a healthy body. The taste of the plant is like water. 3 Macaranga Euphorbiaceae Bon mala Young leaf Infections or itching between the fingers of denticulata hands or legs. Young leaves of Macaranga Muell.-Arg. denticulata are combined with young leaves of Tectona grandis and leaves of Lawsonia inermis. Paste prepared from the combination is topically applied to affected areas. 4 Litsea Lauraceae Cheng Bark Low semen density, burning sensations during glutinosa pichol urination. Bark of Litsea glutinosa is soaked in (Lour.) C. B. water for 1 day. The water is then orally taken Rob. with husk of Plantago ovata (one glass in the morning on an empty stomach for 7 days). 5 Litsea Lauraceae Menda gach Leaf Dysentery (slippery stool and sometimes monopetala presence of blood with stool). The leaves are (Roxb.) Pers. soaked in a cup of water and crushed with the fingers within the water to extract juice. The water containing the juice is taken 3-4 times daily for 3-4 days on an empty stomach. 6 Lawsonia Lythraceae Mehedi pata Leaf See Serial Number 3. inermis L. 7 Plantago Plantaginaceae Isabgol Husk See Serial Number 4. ovata Forsk. 8 Thysanolaena Poaceae Suro, Jharu Top of stem Swelling of eyes, itching in eyes, injury to eye, maxima gach accumulation of whitish material in corner of Kuntze eye, redness of eyes, heavy feeling in eyes, pain in eyes, watery eyes. Juice obtained from crushed top portion of stems is applied (one drop thrice daily for one week). 9 Tectona Verbenaceae Segun Leaf See Serial Number 3. grandis L. 10 Alpinia nigra Zingiberaceae Chera gach Middle portion Waist pain. The middle portion of the stem is (Gaertn.) of stem tied to the waist. Note that the stem should be Burtt. cut in one breath on the night of a full moon or no moon.

Table 4: Medicinal plants and formulations of the Manipuri tribal medicinal practitioner of Maulvibazar district. Serial Scientific Family Name Local Name Parts used Disease, Number Name Symptoms, Formulations, and Administration 1 Justicia Acanthaceae Bashok pata Leaf Diabetes, coughs, mucus. Juice obtained from adhatoda L. crushed leaves is orally taken with honey 2-3 times daily. 2 Mangifera Anacardiaceae Aam Seed Gastric trouble (symptoms: burning sensations indica L. in the chest and throat, sour taste in mouth or sour taste while belching). One seed of Mangifera indica is dried and powdered and mixed with 2-3 cloves of Allium sativum and crushed together. The mixture is taken twice daily on an empty stomach. 3 Catharanthus Apocynaceae Noyon tara Leaf Diabetes. Leaves are either chewed or juice roseus L. obtained from crushed leaves is orally taken 2-3 times daily.

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4 Alocasia Araceae Bish kochu Sap Snake or mole bite. Sap is massaged on the acuminata bitten area as quickly as possible followed by Schott tightly binding a piece of cloth about 6 inches above the bitten area. 5 Kalanchoe Crassulaceae Pathorkuchi Leaf Stomach pain. Juice obtained from crushed pinnata leaves is taken 2-3 times daily for 7 days. (Lam.) Pers. 6 Euphorbia Euphorbiaceae Bojro maan Whole plant To avoid lightning striking the house. Plants are tirucalli L. planted near the homestead. 7 Arachis Fabaceae Badam Seed See Serial Number 11. hypogaea L. 8 Hyptis Lamiaceae Tokma gach Root See Serial Number 12. suaveolens Poit. 9 Allium Liliaceae Roshun Clove See Serial Numbers 3, 11. sativum L. 10 Moringa Moringaceae Sojne gach Root Heavy accumulation of mucus (symptoms: oleifera Lam. having difficulties in breathing, headache). Roots are crushed and taken orally to lighten up mucus. 11 Sesamum Pedaliaceae Til Seed Mental disorders (loss of memory). 100g seeds indicum L. of Sesamum indicum without seed coat are crushed and turned into ‘moas’ (round balls) in a clear vessel. 10g of slightly black salt (i.e. not totally pure) and 10-12 peanut (Arachis hypogaea) seeds and a pinch of turmeric (powdered rhizome of Curcuma longa) and 2 cloves of garlic (Allium sativum) are added to the crushed seeds and the mixture is also crushed. If memory loss is severe, then 2-3 liters of water is put in a vessel and the vessel covered with a thin cloth. The crushed mixture is placed on the cloth and the vessel put in an oven to boil the water. Note that the boiling water should not touch the mixture on the cloth rather the mixture is boiled with the water vapor. This process is done for 20-25 minutes. Then the mixture is put in a strong piece of cloth and squeezed to extract juice. The juice is applied to the scalp of the patient every 6 hours. This is done for 3 months on a daily basis. Also note that for every ten years increment of age, the seeds of Sesamum indicum are to be increased by 100g. 12 Sterculia Sterculiaceae Udal gach, Stem Burning sensations during urination with villosa Roxb. Ulot komol yellow color of urine. Stems of Sterculia villosa ex Sm. are cut into small pieces and soaked in water followed by crushing to extract the juice. The roots of Hyptis suaveolens are soaked in the juice and soaked roots with the juice is taken once daily in the morning on an empty stomach. This is continued for 7 consecutive days. 13 Curcuma Zingiberaceae Holud Rhizome See Serial Number 11. longa L.

There were several distinctive features in the treatment by this Kaviraj. The most interesting feature was that the Kaviraj possessed at least some rudimentary knowledge about allopathic medications and terms like vitamins and understood what deficiency of vitamin C may cause. For instance, the Kaviraj treated continuation of bleeding after delivery of a child with a combination of the plants Mikania cordata and Cynodon dactylon. During the time this formulation was taken, the mother was also advised to take some sort of allopathic medication like antacids for alleviation of gastric problems likely to arise from taking the plant-based medication. Similarly, the Kaviraj understood vitamin C and also understood that lack of this vitamin in the body may result in oral lesions and bleeding from gums. To make up for deficiency of vitamin C in the body, the Kaviraj advised eating the fruits of Flacourtia jangomas. On the other hand toothache and swelling of gums (i.e. problems arising from tooth or gum infections and not vitamin C deficiency) were treated with leaves of Psidium guajava and Ziziphus mauritiana to which a little table salt was added. The Kaviraj advised brushing the teeth with a crushed mixture of leaves of the two plants. Alternately, the Kaviraj advised gargling with a warm decoction of leaves of Psidium guajava to which a little table salt has been added. It is to be noted that allopathic treatment of toothache and swelling in gums also consist of gargling with warm water to which a little table salt has been added. Thus overall, it seemed that the Kaviraj had at least some sense of modern

205 Am. Eurasian J. Sustain. Agric., 7(3): 196-209, 2013 medications or treatment even though he may not have known or understood the significance or mechanism of action of such allopathic medication in its totality. Occasionally, an ailment was treated with more than one formulation. Bleeding from external cuts and wounds was treated with Piper sylvaticum, as well as Chromolaena odorata. The need for different plants was according to the Kaviraj, a necessity for the same plant may not be available throughout the whole year. Coughs and mucus were treated with Andrographis paniculata, as well as flowers of Leucas aspera. The Kaviraj understood the need for different doses of medication with varying of age. For instance, half teaspoonful of juice obtained from leaves of Ocimum tenuiflorum was advised to be given to children suffering from coughs and mucus, but the Kaviraj advised not to give this medication to children under one year age. The Kaviraj advised half cup of juice obtained from young leaves of Lippia javanica and cloves of Allium sativum for treatment of gstric pain in adults, but half teaspoonful for children. An interesting feature of treatment of coughs and mucus in children with either Leucas aspera or Ocimum tenuiflorum was that the juice of flowers or leaves of these plants was administered with breast milk obtained from the nursing mother of the child. It is quite possible that administration with mother’s milk helped in the effective absorption of the medication in the body of the child, as well as made the medication palatable to a young child, who would otherwise refuse to take this medication. The cloves of Allium sativum were used in a number of formulations. In combination with young leaves of Erythrina variegata, the cloves were used to treat severe skin infections. The cloves were combined with Senna alata leaves for treatment of scabies, which again is an infection of the skin. In combination with leaves of Ocimum tenuiflorum and fruits of Tamarindus indica, the cloves were used for treatment of coughs, asthma, bronchitis and mucus in adults. In combination with leaves of Paederia foetida and leaves of Centella asiatica, the cloves were used to treat chronic diarrhea. The cloves were used in combination with young leaves of Lippia javanica for treatment of abdominal pain due to gastric problems. The cloves were also used in combination with leaves of Cissus quadrangularis for treatment of bone fracture. Allium sativum is considered by Kavirajes in Bangladesh to have multiple medicinal properties, and the use by the present Kaviraj of cloves of this plant in multiple formulations for treatment of diverse ailments only confirms the information obtained in other ethnomedicinal studies conducted among other Kavirajes. It may be noted that various pharmacological activities of Allium sativum (garlic) like hepatoprotective, anti-inflammatory, anti-oxidant, anti-fungal, wound healing, anti-hypertensive, and anti-cancer activities has been reviewed (Londhe et al., 2011). The use of some other plants by Kaviraj 1 has also been scientifically validated. For instance, anti-diabetic property has been reported for ethanolic extract of Andrographis paniculata (Zhang and Tan, 2000), a plant used by Kaviraj 1 for treatment of diabetes. Cissus quadrangularis, a plant used by Kaviraj 1 for treatment of bone fracture reportedly also accelerated healing process of experimentally fractured radius-ulna of dog (Deka et al., 1994). The analgesic activity of Alstonia scholaris has been reported (Shekhar et al., 2011); notably, Kaviraj 1 used the plant for treatment of pain associated with abscess. The analgesic and anti-inflammatory activities of Spilanthes paniculata has been shown (Chakraborty et al., 2004); the plant was used by Kaviraj 1 for treatment of toothache and swelling of gums. Analgesic (pain-relieving) activity has been reported for ethanol extracts of Xanthium indicum (Mishuk et al., 2012), a plant used by the Kaviraj for treatment of abscess with accompanying pain. Kaviraj 1 used Oroxylum indicum for treatment of jaundice; the hepatoprotective activity of leaf extracts of the plant has been shown (Tempe et al., 2009). The therapeutic potential of bark of Terminalia arjuna has been shown (Pingali et al., 2013); the Kaviraj used bark of this plant for treatment of heart disorders. Suffice it to say that the few instances mentioned above demonstrate that Kaviraj 1 possessed considerable knowledge on the medicinal properties of plants which he used in his formulations, and which knowledge is getting shown to be correct in the existing scientific literature. In contrast to Kaviraj 1 from Maulvibazar district, the Kaviraj (Kaviraj 2) from Brahmanbaria district used only 14 plants distributed into 13 families in her treatment. The results are shown in Table 2. The plants were used for treatment of ailments like vomiting in children, asthma, cardiovascular disorders, low semen density, children being afraid, swelling and pain in gums, helminthiasis, gastrointestinal disorders, pain, and acne. Several diseases were treated in common by both Kavirajes 1 and 2. However, a commonly treated disease like asthma was treated by Kaviraj 1 with Ocimum tenuiflorum, but with Malachra capitata by Kaviraj 2. Malachra capitata was used along with Terminalia arjuna by Kaviraj 2 also to treat cardiovascular disorders, while Kaviraj 1 used only Terminalia arjuna for the same purpose. Both Kavirajes used in common Psidium guajava and Ziziphus mauritiana for treatment of swelling and pain in gums. Kaviraj 1 used the plant Scoparia dulcis to treat coughs and mucus in children, while Kaviraj 2 used the same plant to treat blood dysentery. Centella asiatica was used alone by Kaviraj 2 for treatment of gastrointestinal disorders like diarrhea, dysentery, and stomach pain but Kaviraj 1 used the same plant in combination with Paederia foetida and Allium sativum for treatment of chronic diarrhea. Kaviraj 2 used Ananas comosus for treatment of helminthiasis. The leaves of this plant contain a cysteine proteinase, bromelain, which can be effective as a natural anthelmintic (Stepek et al., 2004). Scoparia dulcis, a plant used by Kaviraj 2 also has uses in traditional medicines of for stomach problems (Murti et al., 2012).

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Several conclusions emerge from the above observations. First, while some diseases were treated in common by both Kavirajes, the treatment mode or formulation was different. Second, while some plants were used in common by both Kavirajes, the diseases treated were different. Third, the plant species used by the Kavirajes, differed to a great extent and while geographical location and plant availability with change of location may be a factor, it is not a big factor for Brahmanbaria and Maulvibazar districts are not far from each other. The Khasia TMP in Maulvibazar district (denoted as Kaviraj 3) used 10 plants distributed into 9 families for treatment of various ailments including loss of appetite, diabetes, pain, gastrointestinal disorders, mucus, low semen density, and eye disorders. The results are shown in Table 3. Once again differences were noted in the selection of plants and diseases treated. Kaviraj 3 used Achyranthes aspera for treatment of loss of appetite, diabetes, aversion to food, and formation of mucus. Notably, Kaviraj 1 used the same plant for treatment of bed wetting in children. Diabetes was treated by Kaviraj 1 with Andrographis paniculata versus Achyranthes aspera by Kaviraj 3. It is interesting that the anti-diabetic potential of Achyranthes aspera has been reported in alloxan- induced diabetic animals (Vidhya et al., 2012). Dysentery was treated with Hibiscus rosa sinensis by Kaviraj 1, with Centella asiatica by Kaviraj 2, and with Litsea monopetala by Kaviraj 3. Pain was treated by Kaviraj 3 with Costus speciosus; anti-inflammatory, analgesic and anti-pyretic activities have been reported for aerial parts of this plant (Srivastava et al., 2013). Thus once again the results point to differences in selection of medicinal plants among Kavirajes for treatment of the same ailment. The Manipuri TMP in Maulvibazar district (denoted as Kaviraj 4) used 13 plants distributed into 13 families for treatment. The results are shown in Table 4. Once again the majority of plants used were different from the other three Kavirajes; the few cases where common plants were used, they were used for treatment of different ailments. For instance, Kaviraj 4 used Mangifera indica for treatment of gastric trouble; the same plant was used by Kaviraj 1 for treatment of spermatorrhea. Cloves of Allium sativum were used in combination with other plants for treatment of diabetes and loss of memory by Kaviraj 4. Kaviraj 1 used the cloves of Allium sativum in combination with other plants for treatment of scabies and severe skin infections, respiratory disorders, gastric pain, and bone fracture. Diabetes was also treated with Justicia adhatoda or Catharanthus roseus by Kaviraj 4, but with Achyranthes aspera by Kaviraj 3. Notably, both Catharanthus roseus and Justicia adhatoda has reported anti-diabetic potential (Jayanthi et al., 2010; Gulfraz et al., 2011). For treatment of burning sensations during urination, Kaviraj 1 used Amaranthus spinosus, Kaviraj 3 used Litsea glutinosa, and Kaviraj 4 used Sterculia villosa. Once again, the observations highlight the fact that folk and tribal medicinal practitioners of Bangladesh differ widely among themselves in their selection of diseases for treatment and selection of plants for treatment of any specific disease. The observed differences between Kavirajes 3 and 4 on the selection of diseases treated and the plants used for treatment of diseases is surprising for both tribes reside in the same Maulvibazar district. However, tribes tend to remain separate and there is very little or no intermingling among the Khasia and the Manipuri tribe. Folk medicinal practitioners and tribal medicinal practitioners also tend to remain separate; thus it comes as no surprise that the plant species selected by TMPs for treatment of any given ailment differed from that of the Kavirajes. What was surprising were the marked differences between Kavirajes 1 and 2, both regarding choice of treatment of ailments as well as selection of plant species for treatment of any given ailment. It may be noted in this regard that the Kaviraj profession usually runs in families, and knowledge is carefully preserved and kept secret within the family and is passed on from generation to generation. Thus each Kaviraj has his or her own unique repertoire of plants for treatment of diseases, and if any plant species be found to be especially effective against any particular disease, the Kaviraj carefully preserves that secret and concentrates on treatment of that disease more than other diseases. This leads to the observed differences among the Kavirajes regarding plant selection and ailments treated. Another interesting observation was that irrespective of Kavirajes or TMPs, a number of medicinal plants used by the practitioners could be seen scientifically validated in their uses following perusal of available scientific literature. This observation underscores the fact that traditional medicinal practitioners possess extensive knowledge on the medicinal properties of plants and which knowledge can be utilized by the scientific community for discovering newer and better drugs.

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