Hindawi Evidence-Based Complementary and Alternative Medicine Volume 2018, Article ID 6849317, 17 pages https://doi.org/10.1155/2018/6849317
Research Article Yerba Mate (Ilex paraguariensis) Beverage: Nutraceutical Ingredient or Conveyor for the Intake of Medicinal Plants? Evidence from Paraguayan Folk Medicine
Monika Kujawska
Institute of Ethnology and Cultural Anthropology, University of Lodz, ul. Lindleya 3/5, 90-131 Lodz, Poland
Correspondence should be addressed to Monika Kujawska; [email protected]
Received 29 November 2017; Accepted 7 February 2018; Published 14 March 2018
AcademicEditor:RainerW.Bussmann
Copyright © 2018 Monika Kujawska. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Te use of medicinal plants mixed with yerba mate (Ilex paraguariensis) has been poorly studied in the ethnopharmacological literature so far. Te Paraguayan Mestizo people have the longest tradition of using the yerba mate beverage, apart from the indigenous Guarani people. Tis study analyses the role of yerba mate and medicinal plants in the treatment of illnesses within Paraguayan folk medicine. Te research was conducted among 100 Paraguayan migrants living in Misiones, Argentina, in 2014 and 2015. Yerbamate is not considered to be a medicinal plant by its own virtues but is culturally a very important type of medicinal plant intake. Ninety-seven species are employed in hot and cold versions of the yerba mate beverage. Te most important species are as follows: Allophylus edulis (highest number of citations), Aristolochia triangularis (highest relative importance value), and Achyrocline faccida and Achyrocline tomentosa (highest score by Index of Agreement on Species). Te plants are used in the treatment of 18 medicinal categories, which include illnesses traditionally treated with plants: digestive system, humoral medicine, and relatively new health conditions such as diabetes, hypertension, and high levels of cholesterol. Newly incorporated medicinal plants, such as Moringa oleifera, are ingested predominantly or exclusively with the mate beverage.
1. Introduction the expulsion of the Jesuits in 1768, the plantations went wild. Bythistime,theyerbamatebeveragewasalreadypopular Yerba mate (Ilex paraguariensis A.St.-Hil., Aquifoliaceae) is among Mestizo people (of Spanish and Guarani origin). Since a native tree growing in the subtropics of South America, theendofthe19thcentury,italsobecameadailybeveragefor present in Southern Brazil, Northeastern Argentina, Eastern Paraguay, and Uruguay [1]. Te yerba mate beverage has the European migrants who partly colonized Southern Brazil, been consumed traditionally by Guarani indigenous people Northeastern Argentina, and, to a lesser extent, Eastern since before the conquest of South America by the Spaniards Paraguay [4]. Nowadays yerba mate is consumed at the rate of [2]. Te commercial potential of this plant was discovered more than one litre per day by millions of people in the above- bytheJesuits,whobroughtwildgrowingyerbamateinto mentioned countries [4, 5]. It plays a very special social role cultivation.PedrodeMontenegro,aJesuitmonk,inhis and constitutes a very important form of cafeine intake [2, MateriaMedicaMisioneradescribed the use of the most 4, 5]. Its popularity is also increasing outside South America important species for the Guarani people, in which yerba due to its pharmacological properties, proven to be benefcial mateappearedonthetopofthelist[3].TeGuaraninamefor tohealth[4,6,7].ItisalsoaveryimportantdrinkinSyriaand yerba mate is ka’a which means “a plant” or “a herb”; hence Lebanon due to Syro-Lebanese migration to Argentina in the yerba mate has been considered by this group as the plant second half of the 19th century. Many migrants who returned par excellence [3]. Yerba mate was also known as Jesuit tea to the Levant in the 1920s took the habit of drinking mate with or Paraguayan tea and shipped as such to Europe [2]. With them [8, 9]. 2 Evidence-Based Complementary and Alternative Medicine
Over the last 20 years there has been an increase in studies challenges and new medicinal plants, previously unknown to of the pharmacologic properties of Ilex paraguariensis,which the Paraguayan people? havebeenreviewed[4,6,7,10].Numerousactivecompounds have been identifed in yerba mate. Phenolic compounds 2. Material and Methods predominate cafeoyl derivatives (cafeic acid, chlorogenic acid) [11, 12], xanthines (cafeine and theobromine), which are 2.1. Study Area and Ethnographic Setting. Te research was a class of purine alkaloids found in many other plants such as conducted among Paraguayan migrants living in the province tea and cofee, favonoids (quercetin, kaempferol, and rutin), of Misiones, Argentina. Misiones borders with Paraguay and and tannins [7]. Numerous triterpenoid saponins have also Brazil and is primarily a semideciduous Atlantic Forest. Te been identifed, including those derived from ursolic acids Atlantic Forest is one of the most diverse ecosystems in the known as metasaponins [4, 7]. Saponins are responsible for world [32]. Te climate is subtropical humid with no dry the distinct favour of yerba mate extracts [7]. Yerba mate also seasons, a mean annual rainfall of 2,000 mm, and a mean ∘ contains minerals (P,Fe, and Ca) and vitamins (C, B1, and B2) annual temperature of 20 C[33].Currently,nearly40%of [13]. original forest cover is preserved in Argentina, in contrast Research on extracts and isolated compounds from to Brazil and Paraguay, where it comprises approximately yerba mate has provided a number of pharmacological 8% [34]. Te fora of Misiones comprise 3000 vascular applications. Studies have demonstrated that yerba mate plants, of which more than 500 species have been used for leaves have antioxidant [11], antiobesity [14, 15], antidiabetic, phytotherapeutic purposes by the diferent ethnic groups digestive improvement and cardiovascular properties [16, 17], living there: the indigenous Guarani people, Mestizos of and chemopreventative ones (preventing cellular damage diferent origins (Argentinean, Paraguayan, and Brazilian) that may cause chronic diseases) [18]. Te consumption and European migrants [35]. of yerba mate infusion reduces LDL-cholesterol in parallel Te colonial policy in Paraguay, which was based not with an increase in HDL-cholesterol, as observed in studies on mineral extraction but on settlement, resulted in the on humans [19]. Yerba mate extract also reduces acute early emergence of an entirely new Paraguayan Mestizo lung infammation, as observed in the animal model [4]. culture, neither Spanish nor Guarani, but infuenced by Antimicrobial activity of Ilex paraguariensis has been recently both of them [36, 37]. Within Mestizo culture, the Guarani studied as well [20]. languagewaspreserved,aswellasnativecustomsandknowl- Some ethnobotanical studies from the south cone of edge. Paraguayan Mestizo people have had the contact with South America report medicinal uses of yerba mate bever- European phytotherapeutic traditions since early colonial age [21, 22]. Few ethnobotanical and ethnopharmacological times, when they were introduced by Catholic nuns and studies mention that various medicinal plants are consumed monks, who promoted the use of well-known medicinal together with the yerba mate beverage by Mestizo and plants from the Mediterranean region, such as Artemisia, European migrants living in Argentina and Paraguay [23– Ruta, Mentha, and Rosmarinus,aswellasAsianspecies, 26]. However, very little is known about how medicinal plants such as Cymbopogon citratus and Citrus spp. [38]. Te basic are combined with yerba mate beverage by local people. Hippocratic and humoral concepts were introduced through Additionally, medicinal plant use by Paraguayan Mestizo thesamechannels[39,40]. people is poorly documented in the English-language sci- Since the 19th century, Criollos (the local name for entifc literature, with very few exceptions [23, 26–30]. Te Mestizos) have been coming to Misiones from Paraguay. documentation of medicinal plants and analysis of traditional According to the 2010 census, the Paraguayan community in knowledge related to the yerba mate beverage by Paraguayan Argentina accounts for 550.713 persons. Tis fgure represents Mestizo people is of paramount importance for two reasons: 30.5% of all immigrants in the country and approximately (1) apart from indigenous Guarani peoples, they have the 8.6% of the total population of Paraguay [41]. Te push and longest tradition of using yerba mate and mixing it with pull factors for migration were both economic and political in medicinal plants; (2) Te Paraguayan people are described character. Paraguayan migrants have been regarded as having in the literature as knowledgeable about medicinal plants low formal educational levels, especially those migrating to [30, 31]. Nearly 80% of the population of Paraguay consume Argentinainthe1970s,whocomprisethemajorityofthe medicinal plants on a daily basis [30]. However, the relation- study population. In Misiones, Paraguayan people found ship between traditional uses and pharmaceutical properties employment in the agricultural and forestry sectors. is poorly studied. Given that in Misiones the natural environment is gener- Te objectives of this contribution were to (1) document ally better preserved than it is in Paraguay [32], Paraguayan andanalysetheroleofyerbamateinprophylaxisand migrants originating from the same ecoregion of the Atlantic treatment by Paraguayan Mestizo people; (2) evaluate the role Forest have presumably found better conditions for imple- of medicinal plants in yerba mate beverages, and (3) describe menting and transmitting their traditional ethnomedicine the scope of illnesses treated with yerba mate beverage and than they did in their own country of origin. medicinal plants. Additionally, two questions guided my research and analysis: (1) Does any pattern exist showing that 2.2. Data Collection. Te research was conducted among 100 particular illnesses are treated with a hot version of yerba Paraguayan migrants, 61 women (aged between 30 and 95, mate beverage and others with a cold one? (2) How receptive mean 61) and 39 men (aged between 28 and 90, mean 61,5). is this traditional mode of plant administration to new health Tirty-two participants were born in Misiones, Argentina, Evidence-Based Complementary and Alternative Medicine 3
∘ ∘ ∘ ∘ ∘ 56 30 W 56 W 55 30 W 55 W 54 30 W 54 W
∘ 25 30 S
∘ 26 S
∘ 26 30 S
∘ 27 S
∘ 27 30 S
025 ∘ (Km) 28 S
Capital of the province
Research places
River Figure 1: Distribution of the study localities, Misiones, Argentina. while 68 hailed from the Eastern provinces of Paraguay Argentino de Ciencias Naturales “Bernardino Rivadavia” in within the same ecoregion of the Atlantic Forest. Te data Buenos Aires (BA). Prior to each interview, study participants were collected during two phases of feldwork, lasting three gave oral informed consent for their participation. Tere months each in 2014 and 2015. Te free listing technique was no requirement for the project to pass any ethical was applied [42]. Each informant was asked to name all the commission, either in Argentinian or in Polish institutions, as medicinal plants she/he knew and used (emphasis was placed theinformantswerenotsubjecttoanyothertreatmentthan on personal experience). When a list of names was produced, voluntary interviews. further questions were asked relating to parts used, medicinal uses, forms of administration, and modes of obtaining the 2.3. Data Analysis. Inordertoanalysethescopeofmedicinal plants. categories, which include body systems, and determine the Te research took place in three localities, on a gradient most important illnesses treated with yerba mate extracts, from rural to urban, with the semirural component predom- twomeasureswereusedasaproxy:numberofspeciesand inating. Te three localities—Wanda with Puerto Wanda as use reports (UR). A use report is defned here as a description one unit, Piray Km 18 (Puerto Piray municipality), and Puerto by an informant (i) of species (s) used for a medicinal purpose Leoni—are situated on the bank of the Parana River, the (p); hence two diferent medicinal uses of a given species border between Argentina and Paraguay (Figure 1). In general reported by the same informants are counted as two use terms, the study participants can be described as small scale reports [43]. farmers working on 1-2-hectare plots (chacras),wherethey Te relative importance (RI) value was calculated for cultivate staple crops such as manioc and maize. In addition, each plant species based on the normalized number of male participants usually fnd of-farm employment, mainly medicinal uses attributed to it and the number of body sys- in the forestry industry. tems/medicinal categories it treated [38]. Relative importance Te documented botanical taxa are supported with is a versatile index, which shows the extent of medicinal voucher herbarium specimens stored in the CTES herbar- application of a given species. Te reasons for versatile use of ium in the Instituto de Botanica´ del Nordeste (IBONE), a species may be very diverse; for example, this may refect Corrientes, Argentina, and in the herbarium of the Museo a trial-and-error efort—a constant search for accurate or 4 Evidence-Based Complementary and Alternative Medicine new medicinal applications for some widely available species. Taking this into account, another index was also used, the Index of Agreement on Species (IAS) [43], to measure the consistency of medicinal uses of a given species. Tis is a modifed version of Index on Agreement of Remedies developed by Trotter and Logan [44]. Te Sørensen similarity coefcient was used to check whether similar plants were used in the treatment of appar- ently similar illnesses. Te formula is as follows: Ss = 2�/(2� + � + �), where � is number of shared species, � is number of exclusive species in group 1, and � is number of exclusive species in group 2. Te result is then multiplied by 100, in order to express it as a percentage.
3. Results and Discussion 3.1. Social and Medicinal Context of Drinking Mate and Figure 2: Terere´ with kokuˆ leaves (Allophylus edulis) prepared for Terere.´ Te sources describe four diferent forms of drinking a noon round on a hot summer day (Piray Km 18, Puerto Piray processed minced leaves and stems of yerba mate [10], but Municipality, Misiones, 2014). the representatives of the Paraguayan community in Misiones use two basic forms of ingesting it—a hot version called mate and a cold one: terere´. In general terms, mate is drunk all theyearround,usuallyinthemorningandintheafernoon. On hot summer days the afernoon mate may be replaced by terere´. Additionally, terere´ may be drunk at noon, before lunch, and during the summer (December–March). On a few occasions, male informants mentioned that they would drink terere´ the whole year round, independently of the weather. Tese observations stay in line with reports from rural areas of Paraguay [23, 26]. Te hot beverage, mate, is normally prepared in a gourd (Lagenaria spp.) also called mate.Ametalstraw,bombilla, is used to ingest the extract. Industrialized yerba mate is Figure 3: Medicinal plants, additives to terere´, and mortars in the always chosen, preferably the one with stems (con palo). Asuncion´ market. According to the informants, such yerba mate does not wash away rapidly and less powder is ingested, compared to yerba mate without stems (sin palo). Small amounts of hot water prepared, all the medicinal plants are placed in a container ∘ (77–80 C) are repeatedly poured over a serving, ca. 50 g of with cold water, and sometimes ice is added. If time permits, packed processed yerba mate. Yerba mate may be poured plants are lef for several minutes to macerate. Sometimes from a thermos or directly from a steel kettle. Te second the maceration process is accelerated, by squeezing leaves in method normally takes place in the kitchen with a stove, thehandstostimulatethereleaseofjuicesintothewater.I wherethekettlecanbeheatedup. have never, however, observed the use of mortars to crush Te cold beverage—terere´—is drunk virtually from any medicinal plants before adding them to cold water in order container. Normally plastic, metal, or glass cups are used to prepare the medicinal maceration for terere—´ something or those made from bamboo-like plants (Chusquea spp.). A widely practiced in Paraguayan cities, for example, Asuncion´ metal or bamboo bombilla is used. Another bigger container and Encarnacion´ (Figure 3). is flled with cold water and some other additives (Figure 2). Drinking yerba mate is social behaviour par excellence. In this case, industrially processed yerba mate is also used, People avoid drinking mate or terere´ on their own. Te but there is also yerba canchada—especially processed for afernoon mate, especially, is shared with family, neighbours, drinking terere´, in which leaves are crushed into large pieces. friends, and other visitors. Sometimes the addition of medic- Te medicinal plants used with mate are placed in a inal plants is negotiated among the participants, and in other thermos or in the gourd. Whenever hard plant parts are used, situations the invited persons ingest the plants which the host such as bark or roots, they are placed in a thermos with hot is currently drinking with his/her yerba mate. Of anecdotal water or in a kettle. Leaves, stems, and fowers are placed characteristhestorytoldbylocaldoctorsthatMestizo directly in the gourd with yerba mate. Some Paraguayans women (not necessarily of Paraguayan origin) in Misiones also add sugar to mate—a spoonful is added to the yerba would add contraceptive pills to mate and then drink it with mate every round or every second round (the mate server family and relatives. starts from her/himself and then pours water into a gourd Yerba mate itself is not perceived as a medicinal plant for each person in a clockwise order). When the terere´ is by the study community. Just one person mentioned its Evidence-Based Complementary and Alternative Medicine 5
Plantago australis Mentha spp. Verbena spp. Sida cordifolia Moringa oleifera Baccharis trimera Achyrocline spp. Cymbopogon citratus Aristolochia triangularis Rosmarinus officinalis Maytenus ilicifolia Allophylus edulis
0 20 40 60 80 100
Number of citations Tereré Relative importance Both Mate
Figure 4: Species with the highest number of citations and relative importance value.
sole use as medicinal. Nor is it conceived as a nutraceutical thewild(39);however12specieshavebeenreportedas ingredient; at least this was never expressed explicitly by cultivated by some informants and collected from ruderal informants. Hence, it is the medicinal plants, used together areas by others. Only four species were purchased in the with mate or terere,´ that determine the medicinal properties market or from Paraguayan ambulatory sellers—women who of a yerba mate beverage. Occasionally, plants are used to bring plant for sale from Paraguay through the border on the improve the taste or give a favour to yerba mate without Parana River. clear medicinal cues; rosemary (Rosmarinus ofcinalis),mint Allophylus edulis, kokuˆ, is the plant with the highest (Mentha spp.), and lemon grass (Cymbopogon citratus) are number of citations (30) and UR (34) (Figure 4). It is used used in this way. Te importance of the yerba mate beverage only with terere´ and is a “cold” remedy par excellence for as a vehicle for medicinal plants intake was also reported Paraguayan people. It is also widely used in the treatment in another study from Paraguay. Goyke [26] stated that, for of digestive tract illnesses, hepatitis, and hypertension. Some all the top scoring plants, yerba mate was either the typical pharmacologicalpropertiesofthisspeciesareknown,which or the exclusive way people consumed them. Tis shows largely coincide with the folk use, according to which A. how important yerba mate is medicinally, though not by its edulis acts as a hepatoprotector (favonoids) and angiotensin own virtue. In this sense, these fndings difer from what is converting enzyme (ACE) inhibitor [47]. reported in pharmacological literature [7]. Te most versatile plant species (with the highest RI Some epidemiological studies have reported an associa- value) is Aristolochia triangularis, ysypo milhombre(s).Tis tion between the consumption of yerba mate and increased species is only applied in mate.Itisusedinthetreatmentof risk of various types of cancer, including oral, laryngeal, and nine diferent categories, the most important being humoral bladder cancer [7, 45, 46]. During my feld campaign in 2014 medicine (blood cleansing), but also urinary (infections) this message was spread by radio, television, and newspapers cardiovascular (hypertension), reproductive, digestive, and to the general audience in Argentina. Information about musculoskeletal (rheumatism) systems, and for general infec- the potential carcinogenic efects of drinking yerba mate tions. Its use in the reproductive health category is unclear. produced serious concern among informants about the future For some informants, A. triangularis is a contraceptive or of their habit. Nonetheless, the subsequent message that an abortifacient agent, when used in greater doses, and spread rapidly among them was that drinking mate too hot for others it cures venereal diseases and enhances male might produce cancer, which was heard with deep relief. potency—this latter information is inscribed in the plant name ysypo [liana] milhombre(s) [thousand-men]. All infor- 3.2. Characteristics of Plants Used with Mate and Terere.´ Te mants agreed that it should be used with caution; however Paraguayan community in Misiones uses 97 medicinal plant they could not explain what the exact side efects might species (552 UR) together with mate (58 species), terere´ (17), be. Given its popularity among the Paraguayan community, or both (22) (Table 1). Of these 97 species, 63 are native, 30 thereissurprisinglylittleinformationpublishedonthe introduced, and four naturalized. Most of the plants come folk medicinal use of A. triangularis, just two reports from from cultivation (43), followed by species gathered from Argentina [48, 49], one from Brazil [50], and a few general 6 Evidence-Based Complementary and Alternative Medicine 1 0 0 0 0 0,5 0,5 0,75 0,74 0,72 0,875 on Species (IAS) Index of Agreement 13 13 32 9,5 9,5 9,5 9,5 18,5 18,5 Relative importance (RI) Number of use reports Status ´ ´ e Native 34 64,5 e Native 3 In mate Introduced 2 In mate Native 12 In mate Native 17 26,5 In mate Native 1 In mate Native 1 Mode of In terer administration beverages by Paraguayan migrants living in Misiones, Argentina. ´ e terer Cancer Infecctions and Heart problem ache, hot remedy Digestion problem In mate Native 1 hangover, prophylactic mate cleansing, hypertension, Ulcers, digestion problems In mate Native 5 heartburn, hapatitis, blood Digestion problem, stomach Digestion problem, stomach ache, hypertension, prophylactic Cold remedy, digestion problem, parts Leaves Cancer, heart problem In mate Introduced 3 Flower Leaves, aerial ˆ uLeaves ´ on Leaves ka’a Coco Leaves Hypertension, digestion problem In terer Kok Poleo Leaves Eneldo Seeds Digestion problem, stomach ache In mate Introduced 2 Burrito Leaves angosta Cedr Tapekue Local name Plant part used Medicinal use Aloe de hoja Poleo de palo Leaves Marcela, jate’i Table 1: List of medicinal plants used with Rusby, L., Apiaceae, (Weinm.) (Jacq.) Lodd. (Griseb.) (Gillies & Palau, L., Annonaceae Graviola Leaves (A.St.-Hil., A. Mill., (Briq.) Asteraceae, CTES0049806 ex Mart., Arecaceae BA92101 Juss. & Cambess.) Radlk., Sapindaceae, CTES0026306 Xanthorrhoeaceae Botanical name Acanthospermum australe (Loef.) Kuntze, Asteraceae, CTES0049658 Achyrocline faccida DC. Asteraceae, CTES0032301; Achyrocline tomentosa Acrocomia aculeata Allophylus edulis Aloe arborescens Aloysia citriodora Verbenaceae, CTES0026156 Aloysia gratissima Hook.) Tronc., Verbenaceae, CTES0049841 Aloysia polystachya Aloysia pulchra Moldenke, Verbenaceae, CTES0049842 Anethum graveolens Annona muricata Moldenke, Verbenaceae, CTES0032292 Evidence-Based Complementary and Alternative Medicine 7 1 0 0 0 0 0 0,55 0,72 0,25 0,67 0,67 on Species (IAS) Index of Agreement 28 30 9,5 9,5 9,5 31,5 Relative importance (RI) Number of use reports Status NativeNative 2 7 22,5 ´ ´ Ntv1950 9,5 eNative1 Itoue19,5 eIntroduced1 ´ ´ e e terer terer In mate Native 5 In mate Native 3 22,5 In mate Introduced 10 In mate Native 19 50,5 In mate Native 28 100 In mate Native 1 In mate Native 1 Mode of In terer In terer In mate and In mate and administration Table 1: Continued. Aphtha gastritis Diabetes Diarrhea hangover Stomach ache Kidney infection retention, diabetes cure-all, prophylactic problem, stomach ache Stomach ache, digestion Urinary infection, liquid Blood cleansing, urinary Blood cleansing, digestion problem, diabetes, cure-all internal cold, rheumatism, ache, diabetes, high level of Digestion problem, stomach cholesterol, blood cleansing, digestion problem, infections, menstruation, venereal disease, abortive, contraceptive, restores Cough, bronchitis, rheumatism, infection, hypertension, cramps, Liana Liana shoots Leaves Aerial parts Prostate, diabetes, hot remedy In mate Native 3 Leaves, young ´ ´ ai mi Tree bark on pic Ysypo Agrial Leaves Ajenjo Leaves Amba’y Guavira Leaves carqueja Yva h Ka’arurupe Aerial parts Amor seco, Local name Plant part used Medicinal use Ka’i escalera, Pata del buey Leaves milhombre(s) Jaguarete ka’a, Chirca melosa Leaves pata del buey’i DC., ´ ecul, Cham., (Raddi) Tr L., DC., Link, (Less.) DC., Willd., L., sp., Myrtaceae, L., CTES0049811, Urticaceae, CTES0032286 Asteraceae, CTES0030264 Fabaceae, J.F.Macbr., CTES0032148 Botanical name Aristolochia triangularis Artemisia absinthium Baccharis gaudichaudiana Baccharis trimera Asteraceae, CTES0032297 Bauhinia forfcata Fabaceae, CTES0049618 Bauhinia microstachya Begonia cucullata Begoniaceae, BA92089 Bidens pilosa Boerhavia difusa Campomanesia Campomanesia xanthocarpa (Mart.) O.Berg, Myrtaceae, CTES0055662 Cecropia pachystachya Bidens subalternans Nyctaginaceae, CTES0055777 CTES0049691 Aristolochiaceae, CTES0026276 Asteraceae, CTES0026286 Asteraceae, CTES0026269 8 Evidence-Based Complementary and Alternative Medicine 1 1 0 0 0 0 0,5 0,5 0,5 0,72 0,79 0,66 on Species (IAS) Index of Agreement 41 9,5 9,5 9,5 9,5 18,5 18,5 18,5 18,5 27,5 Relative importance (RI) Number of use reports Status Native 12Native 20,5 7 Introduced 20 Introduced 2 Naturalized 2 ´ ´ ´ e Native 5e 22,5 Native 5 Ntv1950 9,5 eNative1 ´ ´ ´ ´ ´ e e e e e terer terer terer terer terer In mate Introduced 1 In mate Introduced 5 In mate Native 1 In mate Native 2 In mate Introduced 3 Mode of In terer In terer In mate and In mate and In mate and In mate and In mate and administration Table 1: Continued. Diabetes Cold sore cholesterol Hot remedy hypertension kidney stones Nervous tension Liquid retension level of cholesterol Hypertension, all-cure problems, cold remedy problems, prophylactic hypertension, digestion Kidney infection, urinary Kidney infection, urinary problems, liquid retention, Nervous tension, headache, Diabetes, hypertension, high Nervous tension, high level of Heart problems, nervous tension, shoots Leaves, young ´ on Leaves ˆ ´ e Leaves ai Leaves ´ on Leaves ıspero ´ Apio’i Aerial parts Cold remedy, hangover, cold sore In terer Ka’ar Apepu Leaves, fruit Yva h Cedr Naranja Leaves N ˜ Insulina Leaves na de gato Rhizome Gramilla Root Mandarina Leaves Local name Plant part used Medicinal use U Kapi’i cedr Cola de caballo Leaves Sangre de grado Tree bark Diabetes, lack of appetite In mate Native 2 18,5 0 (L.) (L.) L.G. L., (DC.) Stapf, (Tunb.) L., Rutaceae, Cambess. var. (Spreng.) (L.) Pers., (L.) Nicolson & Blanco, (L.) Osbeck, aurantium sp., Euphorbiaceae, × Poaceae, CTES0048733 Lohmann, Bignoniaceae, CTES0049524 Botanical name Cissus verticillata Citrus CTES0032134 Citrus reticulata Citrus sinensis Rutaceae, CTES0032133 Croton Cyclospermum leptophyllum (Pers.) Sprague, Apiaceae, CTES0049517 Cymbopogon citratus Cynodon dactylon Poaceae, CTES0025340 Dolichandra unguis-cati Dysphania ambrosioides Elionurus muticus Kuntze, Poaceae, CTES0026294 Equisetum giganteum Eriobotrya japonica Lindl., Rosaceae, CTES0032147 Eugenia pyriformis pyriformis, Myrtaceae, CTES0048743 C.E.Jarvis, Vitaceae, CTES0055762 Rutaceae, CTES0032133 CTES0049687 Mosyakin & Clemants, Amaranthaceae, CTES0032130 Equisetaceae, CTES0049521 Evidence-Based Complementary and Alternative Medicine 9 1 0 0 0 0 0 0 0 0 0 0,83 0,82 0,67 on Species (IAS) Index of Agreement 13 9,5 9,5 9,5 31,5 18,5 18,5 18,5 18,5 18,5 18,5 Relative importance (RI) Number of use reports Status Native 3 Native 11 18,5 Introduced 2 ´ ´ ´ e 1 9,5 Native 4 9,5 eNative6 eIntroduced1 ´ ´ ´ e e e terer terer terer In mate Native 1 In mate Native 4 In mate Native 1 Mode of In terer In mate and In mate and In mate and administration Table 1: Continued. stomach Cold remedy Hypertension blood cleansing Blood cleansing Muscle pains, overheated Vaginal discharge, irregular menstruation, bladder infection, Leaves Hypertension In terer Leaves Hypertension, cold remedy Tree bark Hypertension, infection In mate Native 2 Root, leaves ı kurusu ˆ Tilo Leaves, fower Heart problem, nervous tension In mate Native 2 ˜ na brava Root Karoba Tree bark Blood cleansing, cure-all In mate Native 7 pitanga silvestre Cedrillo Trunk Inernaljabandwound Lechuga japonesa Jakarati’a Leaves Perudilla Aerial parts Cold remedy, cold sore In terer Doradilla Leaves Achicoria ˜ Nangapiry, Local name Plant part used Medicinal use ˜ Aipo, hinojo Aerial parts Nuat Tupasy kamby Aerial parts Liquid retension, blood cleansing In mate Native 2 Tupasy kamby Aerial parts Cold remedy, vaginal discharge In mate Native 2 Mart. f. (Griseb.) (Kunth) (Lam.) Cham., Vahl subsp. Aiton, Mill., Hook & Arn., Kunth, (Aubl.) A.DC., L., Myrtaceae, Habl., Asteraceae, spp., Poaceae Ca (Chodat & Hassl.) (A.Juss.)T.D.Penn., Euphorbiaceae Taub., Fabaceae, CTES0026088 spicifora Meliaceae, CTES0026272 Botanical name Eugenia unifora CTES0026288 Euphorbia prostrata Euphorbia serpens Foeniculum vulgare Apiaceae, CTES0049511 Gleditsia amorphoides Gomphrena celosioides roseifora Guarea macrophylla Gynerium Hemionitis tomentosa Raddi, Pteridaceae, CTES0049653 Heteropterys glabra Malpighiaceae, CTES0026280 Hypochaeris chillensis Hieron., Asteraceae, CTES0026099 Jacaranda micrantha Bignoniaceae, CTES0026265 Jacaratia spinosa Lactuca virosa Pedersen, Amaranthaceae, CTES0055763 Caricaceae, CTES0032144 CTES0030265 Euphorbiaceae, CTES0026291 10 Evidence-Based Complementary and Alternative Medicine 1 1 0 0 0 0 0 0 0,5 0,53 0,76 0,43 0,43 0,67 on Species (IAS) Index of Agreement 77 28 9,5 9,5 18,5 18,5 18,5 18,5 18,5 Relative importance (RI) Number of use reports Status Native 2 Introduced 4 Introduced 2 18,15 Introduced 15Introduced 2 69,25 Introduced 2 Introduced 16 58,25 ´ Ntv13, 0,85 eNative1431,5 ´ ´ ´ ´ ´ ´ ´ e e e e e e e terer terer terer terer terer terer terer In mate Introduced 2 In mate Native 3 In mate Introduced 9 50,5 In mate Native 1 In mate Native 8 50,5 In mate Native 30 In mate Introduced 3 Mode of In terer In mate and In mate and In mate and In mate and In mate and In mate and In mate and administration Table 1: Continued. Ulcers all-cure tension, hot remedy hot remedy prophylactic prophylactic Prophylactic Kidney infection yerba mate additive prophylactic, all-cure Diabetes, high level of hot remedy, infections, hypertension, headache, hot remedy, prophylactic, cholesterol, hypertension, internal infections, ulcers, cholesterol, cancer, ulcers, digestion problem, kidney infection, urinary problem, Abdomen pain, hot remedy, Blood cleansing, high level of intestinal problems, abdomen Menstrual pain, stomach pain, Menstrual pain, stomach pain, pain, hot remedy, cold remedy, Prophylactic during pregnancy, Cold remedy, cold sore, nervous Nervous tension, heart problem, abdomen pain, urinary infection, bark Leaves, root, ıs Leaves ´ An Mora Leaves Hypertension, excessive libido Salvia Leaves, fower Alfalfa Aerial parts Rheumatism, eye problem Mango Leaves, seed Hypertension, constipation Toronjil Leaves Heart problem, cold remedy Incienso Tree bark Moringa Leaves Ka’a piky Aerial parts Kangorosa Manzanilla Inforescence Local name Plant part used Medicinal use Menta, menta’i Leaves Cola de caballo Leaves Malva de castilla Leaves Jate’i ka’a ka’aguy Leaves Steud., L., [ Mentha Allemao, var. Mart. ex (Link) T.R.S. L., Lamiaceae, L., G. Forst., L., Malvaceae, Lam., basilicum L., Moraceae, (Mill.) N.E.Br. ex Benth, Lamiaceae, sp., Fabaceae cf. sp., Lamiaceae L. CTES0030909 ] CTES0049514 Anacardiaceae CTES0032129 Moringaceae, CTES0049652 Urticaceae, CTES0055778 Botanical name Lippia alba Britton & Verbenaceae, P.Wilson, BA92110 Lippia brasiliensis Silva, Verbenaceae, CTES0049516 Malva parvifora Mangifera indica Matricaria chamomilla Maytenus ilicifolia Reissek, Celastraceae, CTES0048746 Melilotus Melissa ofcinalis Mentha Moringa oleifera Morus alba CTES0049525 Myrocarpus frondosus Fabaceae Ocimum Panicum tricholaenoides Poaceae, CTES0032493 Parietaria debilis Asteraceae, CTES0026285 CTES0030915 anisatum spicata Evidence-Based Complementary and Alternative Medicine 11 0 0 0 0 0 0 0 0,5 0,5 0,33 0,65 0,67 on Species (IAS) Index of Agreement 17 28 28 9,5 9,5 9,5 9,5 18,5 Relative importance (RI) Number of use reports Status Native 7 Naturalized 3 ´ ´ ´ Ntv1950 9,5 eNative1 Ntv2951 9,5 9,5 eNative2 eIntroduced1 ´ ´ e e terer terer In mate Naturalized 1 In mate Native 10 54,5 In mate Native 3 22,5 In mate Native 5 In mate Introduced 32 84,5 In mate Introduced 1 Mode of In terer In terer In mate and In mate and administration Table 1: Continued. hot remedy cold remedy Cold remedy Constipation ache, diabetes Nervous tension Kidney infection Digestion problem In mate Native 1 Digestion problem In mate Introduced 1 yerba mate additive prophylactic, cure-all sore, blood cleansing, high level of cholesterol, Kidney infection, urinary problems, liquid retention Digestion problem, stomach abdomen pain, stomach pain, Heart problem, liver problem, hypertension, blood cleansing, Heart problem, abdomen pain, memory, prophylactic, all-cure, Flu, sore throat, infections, cold hot remedy, headache, imporves Heart problem, nervous tension, Seeds Aerial parts ˆ uAerialparts ıs Leaves ´ ıl Leaves ´ ´ en Leaves Rosa Flower Palta Ruda Leaves Sore throat, prophylactic In mate Introduced 3 Perej Llant Aratiku Leaves, fower Hypertension, diabetes In mate Native 4 18,5 0,67 Romero Leaves Palta an para’parai Buscapina Leaves Jatevu ka’a Entire plant Hypertension In terer Pariparoba Leaves Mburukuja Leaves Local name Plant part used Medicinal use quebrapiedra, Chuchu, xuxu Leaves Hypertension In mate Naturalized 1 9,5 0 Rompepiedras, Typycha kurat Yerba del lucero Leaves L., drimyfolia (Mill.) Link, (Kunth) L., L., Urticaceae, Schltdl., Lam., Mill., var. Less., L., Rutaceae, Curtis, L., (Jacq.) Sw., Piperaceae, CTES0049675 Passiforaceae, CTES0032140 Botanical name Parietaria judaica CTES0049674 Passifora alata Peperomia circinnata Persea americana Lauraceae Persea americana (Cham. & Schltdl.) S.F.Blake, Lauraceae, BA92058 Petroselinum crispum Fuss, Apiaceae, CTES0049501 Phyllanthus niruri Phyllanthaceae, CTES0026299 Piper mikanianum Plantago australis Plantaginaceae, BA92072 Pluchea sagittalis Asteraceae, CTES0048748 Rollinia salicifolia Annonaceae, CTES0026257 Rosa sp., Rosaceae, CTES0049673 Rosmarinus ofcinalis Lamiaceae, CTES0049845 Ruta chalepensis CTES0026289 Scoparia dulcis Sechium edule Plantaginaceae, CTES0049830 Cucurbitaceae, CTES0026263 Steud., Piperaceae, CTES0032289 12 Evidence-Based Complementary and Alternative Medicine 1 0 0 0 0 0 0 0,33 0,33 0,55 0,78 0,67 0,67 on Species (IAS) Index of Agreement 13 32 28 62 28 9,5 9,5 18,5 18,5 18,5 Relative importance (RI) Number of use reports Status Native 2 Native 7 Introduced 3 22,5 ´ ´ ´ Itoue19,5 eIntroduced1 Ntv16 0,59 e NativeeNative1866 4 22,5 ´ ´ ´ e e e terer terer terer In mate Native 4 In mate Native 1 In mate Native 2 In mate Introduced 2 In mate Native 19 In mate Native 15 Mode of In terer In terer In mate and In mate and In mate and administration Table 1: Continued. cure-all problem (folk illness) prophylactic Prophylactic Urinary problem Urinary infection In terer infection, irregular Heartburn, diabetes, problem, cold remedy Diabetes, high level of Urinary problem, liquid Stomach ache, digestion Digestion problem, liver High level of cholesterol, kidney infection, urinary cholesterol, stomach ache Vaginal discharge, vaginal retension, blood cleansing diabetes, cold remedy, blood hot remedy, blood cleansing, Intestinal parasites, empacho menstruation, menstrual pain, cleansing, hangover, headache, problem, lack of appetite, fever, prophylactic during pregnancy, diabetes, obesity, blood cleansing Root Leaves Flower Stomach ache In mate Introduced 1 9,5 0 Aerial parts Aerialparts Prostate,maleaphrodisiac Root, leaves ˆ a ´ ai, ˆ eLeaves ´ ai ıpyt ˆ Suico Leaves, fower guasu rugu abrojito ˜ Verbena Leaves Ka’a he’ Nandypa ˜ del lagarto Nuat Manzanilla Local name Plant part used Medicinal use Horquetero Leaves Diabetes, high level of cholesterol In mate Native 2 Tatu rugu Jaguarete po Leaves verbena tatu Cepacaballo, Malva blanca Leaves, fower Ortiga grande Root Carne de vaca Tree bark Diabetes, high level of cholesterol In mate Native 4 Teju ka’a, yerba Barba de choclo Flower Lam., (L.) Sch. Spreng., (Spreng.) L., (Baill.) W.C. (Bertoni) Meyen, Kunth, (L.) Gaudich. ex L., Asteraceae, Hook. & Arn., L., Malvaceae, L., Poaceae Asteraceae, CTES0049655 Botanical name Sida cordifolia CTES0026266 Smallanthus connatus H.Rob., Asteraceae, CTES0049444 Solanum sisymbriifolium Solidago chilensis Sorocea bonplandii Stachytarpheta cayennensis (Rich.) Vahl, Verbenaceae, CTES0055765 Stevia rebaudiana Bertoni, Asteraceae, CTES0049664 Styrax leprosus Styracaceae, CTES0026167 Tabernaemontana catharinensis A.DC., Apocynaceae, CTES0049506 Tagetes minutaCTES0026292 Tanacetum parthenium Urera baccifera Verbena litoralisVerbenaceae, CTES0026305; Verbena montevidensisVerbenaceae, BA92064 Xanthium spinosum Asteraceae, CTES0049666 Zea mays Wedd., Urticaceae, CTES0026278 Solanaceae, CTES0032288 Burger, Lanj.&Wess. Boer, Moraceae, CTES0026282 Bip., Asteraceae, CTES0049661 Evidence-Based Complementary and Alternative Medicine 13 ones from South America [51]. Te only pharmacologically tested antidiabetic properties have an additive or synergetic tested properties found so far are cytotoxic [49]. Te known function in the beverage. chemical compounds are alkaloids, essential oils, lignans, A similar question was posed in the context of terpenoids, saponins, tannins, and aristolochic acids (AAs) hypertension—another chronic problem for which the [52–54]. In the ethnopharmacological review by Heinrich et Paraguayan community in Misiones uses 19 diferent species. al. [51], diferent Aristolochia spp. were described, including From this list, only Eugenia unifora has been assigned clear A. triangularis. Since it also contains aristolochic acids, the hypotensiveactivity[65,66].Indeed,thisspeciesisappliedin consumption of the species poses a risk. In China and mate and terere´ with the highest frequency, with the function Europe species of Aristolochia have been associated with of decreasing blood pressure. nephropathy, but there is a lack of data about the potential Tesetwohealthproblemshavebeenincorporatedinto risk of renal toxicity from consuming AAs in South American phytotherapy most recently by the Paraguayan people, and literature [51]. comparison with the pharmaceutical literature shows that Te species with the highest consistency and consen- Paraguayan people are still in the process of using trial- sus on use, measured by Index of Agreement on Species and-error to fnd adequate herbal medicines, efcacious in (IAS), were those with just one use mentioned by two or the treatment of these health conditions. Te relatively high three respondents. One of the taxa with a parallel high number of species used for these events also indicates a number of citations and IAS score was Achyrocline spp. personalistic approach to the search for the right drug. Tere are two species used indiscriminately within this genus: Achyrocline faccida and Achyrocline tomentosa called 3.3. Characteristics of Illnesses Treated with Mixtures Based on jate’i ka’a and marcela. Tese taxa are used for digestion the Yerba Mate Beverage. Medicinal plants are used for their problems and as “hot” remedy and they are always applied in preventiveandcurativeproperties.Tescopeofillnesses mate by Paraguayan people. Te importance of Achyrocline treated with medicinal plants used in mate and terere´ is very species in Paraguayan folk medicine was already highlighted wide. Eighteen use categories have been reported, including by Schmeda-Hirschmann and Bordas [23]. According to 10 body systems (Figure 5). Te most important categories pharmaceutical studies, A. faccida possesses antiviral and are digestive, followed by humoral medicine, cardiovascu- antibacterial activity [55, 56]. It contains cafeoyl deriva- lar, endocrinological, and urinary categories. Interestingly, tives, essential oils, favonoids, and sesquiterpenes [57]. respiratory system disorders are rarely treated in this way Phytochemical studies of A. tomentosa reported the pres- (eight use reports for respiratory tract illnesses). Te lack of ence of favonoids as well as 27 mayor and trace elements dermatological problems is understandable—these ailments [58, 59]. are treated mainly by the external application of medicinal Other species from the list of the most cited ones and plants. with the highest RI value, include native plants such as Te illnesses treated with the highest number of species Maytenus ilicifolia, Baccharis trimera, Sida cordifolia, and Ver- are digestive problems (Figure 6). On one hand, emerging bena litoralis/Verbena montevidensis—used indiscriminately. illnesses and symptoms such as hypertension, diabetes, and All of them have been studied phytochemically [60]. Tere high levels of cholesterol are among the most important are also four introduced plants on this list, all of them health problems treated with plants and yerba mate beverage. well studied: Rosmarinus ofcinalis, Cymbopogon citratus, On the other hand, old humoral imbalances such as “hot” and and Mentha spp. with a long tradition of use and Moringa “cold” syndromes and blood cleansing—another Hippocratic oleifera which has only recently (in the last 5-6 years) been concept—are treated in this way. Other illnesses treated with incorporated by Paraguayan migrants in Misiones. a relatively high number of plants are urinary and kidney How many antidiabetic properties can be found in the infections, heart problems, and nervous tension and fnally plants used to treat diabetes by Paraguayan people? Te menstrual problems related to women’s reproductive health. study community uses 17 diferent plant species with mate Blood cleansing is an old concept, widely used by the and terere´ to treat diabetes mellitus type 2. From this Paraguayan people. According to informants, it is desirable group only Moringa oleifera [61, 62] and Scoparia dulcis to clean the blood periodically from impurity and to make [63] have been confrmed to possess antidiabetic properties. it more fuid—thick blood is considered a symptom of Interestingly, Paraguayan migrants, through their family and illness. Medicines used for high levels of cholesterol and friendship channels, obtain seedlings of Cissus verticillata and diabetes mellitus type 2 act on a similar conceptual basis Smallanthus connatus from Paraguay, as potent antidiabetic as blood cleansers for the Paraguayan people. Terefore, plants. C. verticillata is called insulina by them; however my working hypothesis was that, due to this conceptual so far only antifungal activity has been ascribed to this similarity, Paraguayan people would adopt plants used for species [64]. Terefore, only a small portion of the plants blood cleansing to treat new illnesses: diabetes and high used as antidiabetic by Paraguayan people have been proven levels of cholesterol. Tis assumption turned out to be wrong, to possess pharmacologically tested properties for diabetes. as informants clearly distinguished the diferences between Most probably the pharmacological action in the treatment these three health problems (though all concentrated in the of this health problem may be ascribed directly to Ilex blood). Actually, the similarities of plants used for blood paraguariensis, whileinformantsseeitinthepropertiesof cleansing and diabetes are at 19% and for blood cleansing and medicinal plants used with yerba mate. Te question here high levels of cholesterol are at 32% and between diabetes may be whether medicinal plants with pharmacologically and high levels of cholesterol are at 52%, meaning that if 14 Evidence-Based Complementary and Alternative Medicine
Cultural syndromes Ocular Nervous Respiratory Symptoms Immunological Functional food Musculoskeletal Infections Psychological problems All-cure Reproductive Prophylactic Urinary Endocrinological Cardiovascular Humoral medicine Digestive 0 20 40 60 80 100 120 140
Number of species Number of use reports
Figure 5: Medicinal categories, including body systems, for which medicinal plants are used together with the yerba mate beverage.
Menstruation problems Nervous tension Heart problems Kidney infections All-cure High level of cholesterol Hot remedy Urinary infections Blood cleansing Diabetes Refreshing remedy Hypertension Digestion problem 0 20 40 60 80
Number of species Number of use reports
Figure 6: Particular illnesses treated with the highest number of species. any cluster of plants exists, it only occurs between diabetes with medicinal plants than blood cleansing but longer than and high levels of cholesterol. Diabetes, of these three health diabetes. Tere are 10 species (28 UR) used to treat high levels problems, is treated with the greatest number of plants. of cholesterol, but two of them were most ofen reported: Seventeen diferent species (29 UR) have been reported, but Sorocea bonplandii (9 UR) and Maytenus ilicifolia (7). Tis most of them were cited by single respondents, with only comparison of the consistency of/consensus on used plants is Smallanthus conatus and Sorocea bonplandii mentioned by yet another point in favour of the idea that Paraguayan people 4 participants. Blood cleansing is treated with 15 medicinal are in a constant search for adequate medicinal plants to treat plants (40 use reports) and there is much more consensus on diabetes and, to a lesser extent, high levels of cholesterol. the use of some of these species, compared with diabetes. Two Another cluster of illnesses and corresponding plants species especially may be distinguished: Maytenus ilicifolia used with yerba mate extract I expected to be observed (15 UR) and Aristolochia triangularis (10 UR). High levels was composed of heart problems, nervous tension, and of cholesterol have a shorter trajectory of being treated hypertension. However, the results confrm this assumption Evidence-Based Complementary and Alternative Medicine 15 only partly, which may be due to the uneven number of 97 plant species in hot and cold versions of the yerba mate species used in the treatment of hypertension (19 species), beverage. Most of the plants are native to the south cone of heart problems (9), and nervous tension (9). Te greatest South America and come from cultivation. similarity was between heart problems and nervous tension at Tere is a certain pattern of administration of plants 44%. Tree introduced species were used to treat these three with mate and terere´ inrespecttotheillnessesthatare health problems: lemon grass, mint, and rosemary. treated. Mate is a vehicle to ingest hot remedies (for “cold” Similarities can be observed between plants used for syndrome) and plants which treat women’s reproductive kidney and urinary infections: seven diferent species are health. Refreshing plants (for “hot” syndrome) are always used for both health conditions (58% of similarity), of prepared with terere´. Most species used for urinary infections which the most important ones are Bauhinia microstachya, and kidney problems are used with terere´ too. Some plants are Equisetum giganteum, and Phyllanthus niruri. associated with either the hot or the cold version because of their favour and taste. Bitter and sharp favoured plants are 3.4. Forms of Administration. Tere is a certain pattern to more ofen used in mate. Sour tasting plants are used only the administration of plants with mate and terere´ in respect with terere´. to the illnesses that are treated. Mate is a vehicle to ingest Te plants are used for a wide array of medicinal hot remedies (for “cold” syndrome) and plants which treat categories from which the digestive system and humoral women’s health conditions (vaginal discharge, menstrual concept prevail—traditionally treated with medicinal plants. regulation, and pregnancy prophylaxis). Te convergence of On the other hand, relatively new chronic health conditions: plants used in both cases is at 50%. In fve cases these are diabetes, hypertension, and high levels of cholesterol are “hot” remedies such as Aristolochia triangularis, Lippia alba, also treated with a large number of species. Terefore, this Malva parvifora, Matricaria chamomilla, and Sida cordifolia traditional form of administration of medicinal plants proves used in both categories. Interestingly all panacea plants are to be receptive for treating new health problems. Newly incor- employed with the hot mate drink, except Verbena spp. On porated medicinal plants, such as Moringa oleifera or Annona the other hand, refreshing plants (for “hot” syndrome) are muricata, are applied predominantly or exclusively with the prepared with terere´. Most species used for urinary infections mate beverage. Te question which remains unanswered is and kidney problems are used with terere´ too. However, whether medicinal plants with pharmacological properties the similarity in these two medicinal categories: refreshing similar to yerba mate have an additive or synergetic function plants and urinary/kidney problems is very low, at 13%, which in the beverage. means that in both cases quite diferent plants are prepared together with the terere´. Schmeda-Hirschmann and Bordas Conflicts of Interest [23] also observed that Paraguayan folk medicine recognizes “hot” and “cold” remedies, whose uses dictate the manner of Te author declares that there are no conficts of interest preparation and administration, namely, either in mate or in regarding the publication of this paper. terere´. According to Goyke [26], some plants are associated Acknowledgments with either the hot or the cold version because of their favour. Bitter and sharp favours such as wormwood and Te author is grateful to the study community—Paraguayan an´ıs are preferred in hot drinks while smooth favours like migrants in Misiones, Argentina—who generously shared mint, lemon grass, and safron are preferred with the cold their knowledge, to Bernard Kujawski and Piotr Klepacki version [26]. Among 97 medicinal plants used by Paraguayan for help with preparing the fgures, and to Lukas Pawera for migrants with the yerba mate beverage, 23 are distinguished comments on the manuscript. Te project was funded by the by their specifc favour (some of them contain essential oils) National Science Centre, Poland, on the basis of Decision or taste (bitter, sour, or sweet). Fourteen of these plants are DEC-2013/09/N/HS3/02226. used with mate,fvewithterere,´ and four with both. Bitter and sharp favoured plants are used more ofen in mate, for example, Artemisia absinthium, Baccharis trimera and B. 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