Medicinal Plants and Formulations of Tribal Healers of the Chekla Clan of the Patro Tribe of Bangladesh

Abstract

Justicia adhatoda.

Averrhoa carambola.

Andrographis paniculata.

Bombax ceiba.

Introduction

The exact number of indigenous communities in Bangladesh (commonly referred to as tribes by the Government of Bangladesh) remains unknown. While previous estimates put the number of tribes as not more than 20, recent ethnographic studies have shown that the actual number of individual tribes certainly exceeds 100.¹ The reasons for this difference lie in the absence of proper ethnographic studies within Bangladesh, because the tribal population of a large number of tribes has dwindled to such an extent that they are no longer differentiated in population censuses, and because most tribes to a small or large extent have begun to lose their traditional culture and have started to become assimilated with the mainstream Bengali-speaking population.

The plant kingdom has been and still forms a reservoir for discovery of newer and more efficacious drugs, and no better way can be found to explore the plant kingdom for possible new drugs than observing the practices of tribal healers.^2,3 Tribal healers are the most knowledgeable about the medicinal properties of plants around their vicinity, and this knowledge is transmitted and enriched from generation to generation.

Aims

Tribal medicinal practices need to be documented before they can be worked upon in a scientific laboratory. Toward achieving that objective, for the last few years, we had been systematically conducting ethnomedicinal surveys among various large and small tribes of Bangladesh.^4

–11 The Patro tribe is one of the smallest tribes of Bangladesh, with their present population not exceeding 2000. They are presently localized in several small villages, namely, Fatehpur, Khadimnagar, Jaintapur, Saheb Bazar, Ramnagar, Alaibahar, and Kushirgul of Sylhet district in the country. Our preliminary survey indicated that they are divided among 16 clans (rois), some of which are Langtu roi, Tongraba roi, Kelang roi, and Chekla roi. The objective of the present study was to conduct an ethnomedicinal survey among the tribal medicinal practitioners (TMPs) of the Chekla clan of the Patro tribe, who reside in Fatehpur and Jaintapur villages of Sylhet district in the northeastern part of Bangladesh.

Methods

The present survey period lasted from April 2011 until February 2012. Monthly visits from Dhaka were made to the Chekla clan of the Patro tribe (Fig. 1), each visit lasting from 3 to 10 days. Three (3) objectives were aimed for during these periodic visits: to build up a close rapport with the TMPs, tribal Headman, and the tribal population; to collect plants as well as plant parts mentioned by the TMPs (for instance, various plants were seasonal, and both plant and plant parts such as flowers or fruits can only be obtained during a certain period; note that our visits covered nearly a year, and collection of all plant parts was made to enable a complete identification of the plant species); and to collect as much information as possible from the TMPs. The clan had three TMPs, namely, Sukumar Patro, Jogendra Patro, and Upendra Patro, Patro being the title carried by every male of the clan. Informed consent was obtained from the TMPs and the Headman to publish their names and any other given information both nationally and internationally. Permission was further obtained from the Headman to photograph and collect plants and plant parts. Interviews were done with the help of a semistructured questionnaire and the guided field-walk method of Martin¹² and Maundu.¹³ It was observed that the Patro tribe was quite conversant in Bengali, the language spoken by the interviewers, and all interviews were carried out in that language. Plant specimens were brought to Dhaka and identified at the Bangladesh National Herbarium. Voucher specimens were deposited with the Medicinal Plant Collection Wing of the University of Development Alternative, where plant identification was doubly checked by a trained botanist from the University. At their request, the three TMPs were interviewed as a group. In fact, apart from two formulations, all TMPs gave similar formulations of medicinal plants, suggesting a great deal of identical opinion and knowledge of medicinal plants among the TMPs.

FIG. 1.

Patro women and children.

The Patro population (Chekla clan) numbered about 500 in the two villages surveyed. This was observed to be quite a large clan by Patro standards, considering that the other 15 clans among themselves were estimated to have about 1500 individuals in total. In appearance, they had distinct Mongoloid features. However, they could not tell us where they originated from except that they were here in their present habitats from as long as they can remember. They told us that they were originally animistic in religious practices but have now converted to the Hindu religion. They used to worship Khemu Laram (House God) as their chief God, but now like the Hindus, they worship Narayan, Kali, and Durga, but they do not create idols like the Hindus. Also unlike the Hindus, they bury their dead instead of cremating. They told us that their society is patriarchal. Their main food consists of rice, fish, pork, and vegetables. They mostly work as agricultural laborers in the adjacent fields of the mainstream Bengali-speaking population. Apart from this work-related contact with the mainstream population, they keep mostly to themselves. They visit their TMPs for treatment and do not visit allopathic doctors or clinics, which are also absent in their villages.

Results

The Patro TMPs used a total of 67 plants distributed into 39 families in their various formulations. The Asteraceae and Zingiberaceae families were the major families used by the healers, contributing six plant species per family. The results are shown in Table 1. The ailments treated were most often simple such as fever, pain, respiratory tract disorders (coughs, asthma), jaundice, urinary problems, ear infections, bleeding from cuts and wounds, vomiting tendency, rheumatism, bone fracture, burns, puerperal fever, dandruff, helminthiasis, chicken pox, and skin disorders. However, fever was distinguished between ordinary fever (simple rise in body temperature, see Serial Number 1), or shannik jor (fever with trembling, see Serial Number 31), or bath jor (fever with trembling and pain, see Serial Number 51). We have used the TMP terms for several diseases, because of the difficulty in identifying the actual disease. For instance, while bath jor symptoms resemble malaria, the TMPs mentioned that it was not malaria. They knew the term malaria but did not have any plants for treatment. Bath locally means rheumatism, and jor means fever, so the disease could be rheumatic fever, the symptoms of which disease include fever, pain, and uncontrollable body movements. It is also interesting that while malaria is prevalent in Sylhet district, the TMPs did not treat this disease. This is similar to what has been observed with another tribe of Sylhet district, namely, the Khasias (M. Rahmatullah, unpublished observations).

Table 1.

Medicinal Plants and Formulations of the Patro Tribal Medicinal Practitioners of Bangladesh

Serial number	Scientific name	Family name	Local name	Utilized part	Ailment(s) and formulation(s)
1	Andrographis paniculata (Burm. F.) Wall. ex Nees	Acanthaceae	Kalomegh	Stem	Severe body pain, fever. About eight finger lengths of stem is cut into small pieces and soaked in ½ cup water. The water is taken three times daily.
2	Justicia adhatoda L.	Acanthaceae	Bashok pata	Leaf	Stomachache, coughs, asthma. Crushed leaves of Justicia adhatoda are taken with ginger (rhizome of Zingiber officinale) slices. Jaundice, passing of blood with urine of males, tatrangi (symptoms: burning sensations during urination of females), appetite stimulant, blood purifier. ½ kg whole plants of Cyathula prostrata is mixed with 1 kg bark of Melia sempervirens, ½ kg bark of Syzygium formosanum, ½ kg bark of Mangifera indica, 1 poa (local measure approximates 250 g) leaves of Combretum pilosum, ½ poa leaves of Mikania cordata, 100 g leaves of Clerodendrum viscosum, 1 poa leaves of Justicia adhatoda, 1 kg fruits of Phyllanthus emblica, and ½ kg whole plants of Leucas indica. The mixture is macerated to obtain juice. One cup of juice is taken three times daily until cure. Usually for jaundice the time period is 1 week, and for passing of blood with urine or tatrangi, the time period is 2 weeks for taking the juice.
3	Justicia gendarussa L.	Acanthaceae	Meda pata	Leaf	Asthma. One spoonful of juice obtained from crushed leaves is taken for 3 days.
4	Sansevieria hyacinthoides (L.) Druce	Agavaceae	Pata bahar	Leaf	Ear infection, waist pain. Three drops of juice are put into the ear canal for 1 week for ear infections. The outer portion of leaf is removed and the soft inner portion tied to the waist for 1 week for waist pain.
5	Aerva sanguinolenta (L.) Blume	Amaranthaceae	Laal rokto phool	Leaf	Cuts. Juice obtained from 3 to 4 macerated leaves is applied to cuts.
6	Celosia argentea L.	Amaranthaceae	Murgi phool, Morog phool	Leaf	Vomiting tendency. ½ spoonful of juice obtained from macerated leaves is taken twice daily in the morning and evening.
7	Cyathula prostrata (L.) Blume	Amaranthaceae	Langra gach	Whole plant	See Serial Number 2.
8	Mangifera indica L.	Anacardiaceae	Aam	Bark	See Serial Number 2.
9	Dieffenbachia maculata (Loddiges) D. Don	Araceae	Bagdar	Root	Joint pain, diabetes (bohu mutro, symptoms: frequent urination, frequent thirsts, sweet taste of urine). One spoonful of juice obtained from macerated roots of D. maculata is taken with honey and juice obtained from macerated rhizomes of Z. officinale three times daily for 1 month.
10	Homalomena aromatica Gagnep	Araceae	Gondhi kochu	Whole plant	Gatae bath (rheumatism, symptoms: joint pain, pain on motion of the affected areas, stiffness of the affected parts). Whole plants are boiled in water and eaten or whole plants are cooked with other vegetables and eaten.
11	Lasia aculeata Lour.	Araceae	Lugati	Root	Gatae bath. Roots are cooked with other vegetables and eaten.
12	Pothos scandens L.	Araceae	Har bhanga pata	Leaf, stem	Bone fracture. Crushed leaves and stems are applied to fractured area for at least 1 hour.
13	Dischidia bengalensis Colebr.	Asclepiadaceae	Kando kola	Leaf, stem	Stomachache. One teaspoonful of juice obtained from crushed stems of Cuscuta reflexa and crushed leaves and stems of D. bengalensis is taken.
14	Asplenium finlaysonianum Wall. ex Hook.	Aspleniaceae	Horin paya	Root	Bath rogh (another term for gatae bath). The bark of the roots is removed and the inner soft core is taken three times daily. Note that the inner core should be taken by itself and not mixed with anything else.
15	Ageratum conyzoides L.	Asteraceae	Rujot pata	Leaf	Sutika rogh (puerperal fever, symptoms: postpartum fever sometimes accompanied with abdominal pain and foul-smelling vaginal discharge). Leaves are cooked and eaten as vegetable.
16	Eclipta prostrata L.	Asteraceae	Kechra pata, Kerara pata	Leaf	Fever in children accompanied by redness of body and appearance of small abscess-like black spots. Two spoonfuls of juice obtained from macerated leaves is administered.
17	Elephantopus scaber L.	Asteraceae	Okkho phool	Flower	Burns. ½ cup of juice obtained from crushed flowers is applied twice daily to burns in the morning and evening.
18	Mikania cordata (Burm.f.) B. L. Robinson	Asteraceae	Refoogee pata	Leaf	Bleeding from external cuts and wounds, pain, helminthiasis. Crushed leaves are applied to cuts and wounds. Three spoonfuls of juice obtained from macerated leaves is taken three times in the morning on an empty stomach for helminthiasis. Juice obtained from macerated leaves is applied topically to painful areas. See Serial Number 2.
19	Spilanthes paniculata Wall. ex DC.	Asteraceae	Ossho phool	Leaf	Dandruff. ½ cup juice obtained from crushed leaves is applied to the head.
20	Synedrella nodiflora (L.) Gaertn.	Asteraceae	Megh pata	Leaf	Diarrhea in children. ½ spoonful of juice obtained from macerated leaf is taken twice daily in the morning and evening for 2 days.
21	Bombax ceiba L.	Bombacaceae	Shimul	Root	Dhatu rogh (whitish discharge in urine of men or women). Roots are soaked in water and taken.
22	Combretum pilosum Roxb.	Combretaceae	Junia mul, Jaliloth	Leaf, root, stem	Helminthiasis (roundworm). Juice obtained from macerated leaves and roots of C. pilosum is taken with juice obtained from macerated rhizomes of Z. officinale. Helminthiasis (hookworm). Half spoonful of juice obtained from macerated stems of C. pilosum is mixed with half spoonful of juice obtained from macerated stem of Merremia umbellata and administered orally. Gastritis (symptoms: burning sensations in the stomach and chest). Top of young stems are crushed with powdered rice (atap) and round balls made from the mixture. The balls are taken in the morning for 2–3 days. See Serial Number 2.
23	Terminalia arjuna (Roxb. ex DC.) Wight & Arn.	Combretaceae	Arjun	Bark	Burning sensations during urination, frequent urination. Bark is soaked overnight in water followed by taking the bark the following morning.
24	Terminalia belerica (Gaertn.) Roxb.	Combretaceae	Bohera	Seed	Body pain. Seeds are crushed to a fine powder, boiled in water, and then orally taken following cooling of the decoction.
25	Terminalia citrina (Gaertn) Roxb. ex Fleming	Combretaceae	Hortoki	Fruit, seed	To increase brightness of skin. Unripe fruits are eaten. Tooth- and gumache, appetite stimulant, blood purifier. Dried seeds are soaked in water. They are then crushed and boiled in water, followed by drinking of the water following cooling. Alternately, seeds are soaked in one cup water overnight, followed by drinking the water the following morning on an empty stomach.
26	Merremia umbellata (L.) Hallier f.	Convolvulaceae	Kaliloth	Stem	See Serial Number 22.
27	Kalanchoe pinnata (Lam.) Pers.	Crassulaceae	Pathorkuchi	Leaf	Stone formation in stomach. Two cups of juice obtained from macerated leaves are strained through a piece of cloth and taken twice daily in the morning and evening.
28	Trichosanthes cordata Roxb.	Cucurbitaceae	Boi kumra	Root	Nimno roktochap (hypotension; symptoms: weakness in body leading to senselessness, if one feels dizziness and things go black after suddenly getting up). Half cup of juice obtained from macerated roots is applied to the scalp in the morning.
29	Cuscuta reflexa Roxb.	Cuscutaceae	Shunyo lota	Stem	See Serial Number 13.
30	Dioscorea glabra Roxb.	Dioscoreaceae	Shuksomi	Root	Blood purifier. Roots are chewed.
31	Phyllanthus acidus (L.) Skeels	Euphorbiaceae	Aola	Leaf, fruit	Chicken pox, shannik jor (fever with trembling), conjunctivitis. Macerated leaves are applied to body. Leaves are also boiled in water and the water is used for bathing during chicken pox. Fruits are taken during shannik jor. Fruit juice is applied topically to eyes (one drop) for conjunctivitis.
32	Phyllanthus emblica L.	Euphorbiaceae	Amloki	Fruit	Appetite stimulant. One fruit is taken daily. See Serial Number 2.
33	Cajanus cajan (L.) Millsp.	Fabaceae	Orol gach	Leaf, fruit	Jaundice (symptom: yellowish coloration of skin). ½ cup of juice obtained from macerated leaves and fruits is taken three times daily for 2 days.
34	Mimosa pudica L.	Fabaceae	Lojjaboti	Root	Pneumonia. Roots of M. pudica are boiled in water and then taken with juice obtained from macerated rhizomes of Z. officinale.
35	Hyptis suaveolens (L.) Poit.	Lamiaceae	Tukma	Root	Constipation. Seeds are soaked overnight in water followed by drinking the whole mixture the following morning on an empty stomach.
36	Leucas indica L.	Lamiaceae	Don kolosh	Leaf	To increase lactation in nursing mother. Leaves are fried and eaten. See Serial Number 2.
37	Ocimum tenuiflorum L.	Lamiaceae	Kalo tulshi	Leaf, root	Asthma. Crushed leaves and roots of Ocimum tenuiflorum are taken with honey and ginger (rhizomes of Zingiber officinale) three times daily.
38	Litsea salicifolia (Roxb. ex Nees) Hook. f.	Lauraceae	Seng pisol	Bark	Blood dysentery. Bark is soaked in water overnight. The following morning, one glass of water is taken. Note that the water would be slippery to touch.
39	Asparagus racemosus Willd.	Liliaceae	Shotomul	Root	Gastritis (symptoms: burning sensations in the stomach). Half cup amount of juice obtained from macerated roots is taken three times daily.
40	Hibiscus rosa sinensis L.	Malvaceae	Rokto joba	Flower	To stop bleeding postdelivery, diarrhea. Crushed flowers are applied to head to stop postdelivery bleeding. For diarrhea, juice obtained from three macerated flowers (a little less than half cup) is mixed with tal mishri (crystalline sugar prepared from sap of Borassus flabellifer) and taken for 3 days in the morning on an empty stomach.
41	Azadirachta indica A. Juss.	Meliaceae	Neem pata	Leaf, stem, root	Toothache, gum swellings (infections), helminthiasis (hookworm), skin diseases like eczema, scabies, chicken pox, diabetes. Crushed leaves of A. indica are mixed with crushed rhizomes of Z. officinale and small pills prepared from the mix. Pills are dried in the sun and one pill is taken three times daily for helminthiasis. Barks of roots are also orally administered for helminthiasis. Stems are used to brush teeth and gums for toothache and gum infections. Leaves are boiled in water and the water topically applied to skin disorders such as scabies or eczema. Leaves of A. indica are boiled in water with crushed rhizomes of Curcuma longa and applied topically to the body during chicken pox. Ten leaves of A. indica are chewed every morning with five seeds of Piper nigrum as treatment for diabetes.
42	Melia sempervirens Sw.	Meliaceae	Kawanar gach	Bark	See Serial Number 2.
43	Stephania glabra Miers	Menispermaceae	Pir khuruz	Root	Sutika rogh (puerperal fever) in women. Root bark is removed and the inner portion is crushed. One spoonful of the crushed inner portion is added to one cup of tea. The tea is taken three times daily.
44	Tinospora crispa (L.) Hook.f. & Thoms.	Menispermaceae	Aam buruj, Poddo buruj	Stem	Scabies (symptoms: intense itching and rash in areas of the body). Half spoonful of juice obtained from macerated stems (after removal of thorns) is taken three times daily.
45	Ficus hederacea Roxb.	Moraceae	Dumra	Fruit	Physical weakness, diabetes. One spoonful of juice obtained from macerated root is taken three times daily for 3 days. Note that the juice cannot be taken for prolonged periods because it is addictive.
46	Syzygium formosanum (Hayata) Mori	Myrtaceae	Pahari jam	Bark	See Serial Number 2.
47	Rhynchostylis retusa Blume	Orchidaceae	Meghna kola	Stem	Sudden toothache, swelling of gum. One stem is chewed and eaten once daily.
48	Averrhoa carambola L.	Oxalidaceae	Kamranga	Leaf	Tingling sensations in hands or legs. Two spoonfuls of juice obtained from crushed leaves is taken twice daily.
49	Pandanus fascicularis Lam.	Pandanaceae	Keowa phol	Seed	Sudden dizziness. ½ spoonful juice obtained from crushed seeds is applied to the scalp twice daily in the morning and evening.
50	Piper nigrum L.	Piperaceae	Gol morich	Seed	See Serial Number 41. Coughs. One spoonful of juice obtained from macerated roots of Drynaria quercifolia from which bark has been removed is taken with dried powdered seeds of P. nigrum for 3 days.
51	Plumbago indica L.	Plumbaginaceae	Agni shita	Leaf, root	Bath jor (fever with trembling and pain), jaundice, to expedite delivery. For bath jor, root is tied for half an hour every day to the arm. For jaundice, leaf is crushed in the hand until soft and then tied to the hand for half an hour. This is done every day. To expedite delivery, root is tied to the upper part of the leg. As soon as delivery occurs, the root is taken off from the leg and tied to the throat to stop postdelivery bleeding. So long as bleeding does not stop, the root is kept tied to the throat.
52	Drynaria bonii Christ.	Polypodiaceae	Hayate mursalim	Root	To strengthen bones. The inner part (core) of roots (about half a finger in length) is chewed and taken three times daily.
53	Drynaria quercifolia (L.) J. Smith	Polypodiaceae	Hupot pata, Upod gorol	Leaf, root	Headache, to keep head cool. Crushed leaves are applied to head. See Serial Number 50.
54	Morinda angustifolia Roxb.	Rubiaceae	Holdi kad	Root	Jaundice (symptoms: yellow coloring of body and eyes, also yellow color of urine). Roots are taken three times daily with honey and ginger [rhizomes of Z. officinale Roscoe (Zingiberaceae)] slices.
55	Paederia foetida L.	Rubiaceae	Badali lota	Leaf	Flatulency. Leaves are macerated and taken either raw or mixed with other cooked vegetables.
56	Smilax prolifera Roxb.	Smilacaceae	Kumarir aga	Stem	To increase sexual longevity. Four fingers length of stem is chewed every day.
57	Datura metel L.	Solanaceae	Dhutura	Seed	Insomnia, pain, dilated pupil in eyes. Seeds are administered orally for insomnia, pain, and to dilate pupil in eyes.
58	Abroma augusta L.f.	Sterculiaceae	Olot kombol	Root	Dhatu rogh (symptoms: whitish discharge in urine of men or women). Roots are soaked in water overnight and taken the following morning.
59	Centella asiatica (L.) Urb.	Umbelliferae	Khoda manti	Leaf	Blood purifier, to increase lactation in nursing mother, stomachache, to keep body cool. Leaves are boiled, mashed, and taken with warm rice to increase lactation in nursing mothers. Juice obtained from macerated leaves is taken for the rest.
60	Clerodendrum viscosum Vent.	Verbenaceae	Batir gach	Leaf	Helminthiasis (tapeworm, finding segments of the worms during bowel movement, diarrhea, abdominal pain), stomachache. Four spoonfuls of juice obtained from macerated leaves is mixed with tal mishri and taken on an empty stomach twice daily in the morning and night for 3 days. See Serial Number 2.
61	Vitis assamica M.A. Lawson	Vitaceae	Nag pot	Stem	Vomiting tendency. Stems are smelled.
62	Alpinia allughas (Retz.) Roscoe	Zingiberaceae	Tara fol	Rhizome	Eczema (symptoms: patches of chronically itchy, dry, thickened skin, usually on the hands, neck, face, and legs). The outer bark of rhizome is removed and the inner core taken three times daily.
63	Alpinia conchigera Griff.	Zingiberaceae	Tejmol	Rhizome	Swelling due to pain. One spoonful of juice obtained from macerated rhizome is taken three times daily.
64	Alpinia nigra (Gaertn.) B. L. Burtt.	Zingiberaceae	Terar mul	Rhizome	Heartburn. Rhizomes are chewed.
65	Curcuma amada Roxb.	Zingiberaceae	Bou ada	Rhizome	If any part of the body starts to rot following infection. Crushed rhizomes are applied to affected area.
66	Curcuma longa L.	Zingiberaceae	Holud	Rhizome	See Serial Number 41.
67	Zingiber officinale Roscoe	Zingiberaceae	Ada	Rhizome	See Serial Number 2. See Serial Number 9. See Serial Number 22. See Serial Number 34. See Serial Number 37. See Serial Number 41. See Serial Number 54.

Similarly to their ability to distinguish various types of fever, the TMPs could distinguish between different forms of helminthiasis such as tapeworm, hookworm, and roundworm infestations. Apparently, distinctions were made on the basis of certain symptoms and analysis such as distended abdomen, anemia, blood in stool, stomachache, and any presence of worms in feces. All sorts of worms could be treated with a single plant, Mikania cordata (Serial Number 18); roundworms, hookworms, and tapeworms were also observed to be treated separately with different plant species (Serial Numbers 22, 41, and 60). Some diseases for which TMP terms have been used in Table 1 could be easily identified because in these instances, the Patro term for the disease(s) was the same as the Bengali term. For instance, diabetes is referred to both by Bengali and Patro TMPs as bohu (much) mutro (urine) (Serial Number 9). Gatae (joint) bath (rheumatism, Serial Numbers 10 and 11) in Bengali means rheumatism. Nimno rokto chap (low blood pressure, Serial Number 28) is the same term used by Bengali and Patro TMPs to denote hypotension, while sutika rogh (Serial Numbers 15 and 43) is a common term used in Bangladesh to denote puerperal fever. On the other hand, tatrangi (Serial Number 2) was used by the Patro TMPs to denote burning sensations during urination of females, which could be due to a variety of causes. The same applies to dhatu rogh (Serial Numbers 21 and 58), denoting whitish discharge in urine of men or women. This can also be due to a variety of causes, including leukorrhea in women and presence of semen in urine of men. In such cases, where the actual disease was not possible to identify properly, the Patro TMP terms have been maintained. It is to be noted that most of the Patro TMP names and symptoms for diseases treated also have similar names in the Ayurvedic traditional system of medicine (which is also practiced in Bangladesh). As such, an Ayurvedic medicinal practitioner (also titled a doctor in Bangladesh, and who has knowledge of both Ayurvedic and allopathic medical terms), who has graduated from the Ayurvedic College of Medicine in Dhaka, Bangladesh was also consulted to convert Patro TMPs' names of diseases to allopathic terminology and maintain accuracy of allopathic medical terms used in the present instance. The Ayurvedic system of medicine is believed to be practiced in the Indian subcontinent (including Bangladesh) for over the last 5000 years, and so it is quite possible that there may have been exchanges between Patro healers and Ayurvedic practitioners, who, like the Patros, reside and practice mostly in villages (i.e., rural areas).

Five formulations were used for treatment of respiratory tract disorders, seven for gastrointestinal disorders, and four for helminthiasis. Under the unhygienic living conditions by the Patros because of poor income status, and lack of proper sanitation systems and quality drinking water, these types of disorders are prevalent in almost all rural areas of Bangladesh. Nineteen (19) formulations were used for various types of pain treatment. Agricultural labor is back-breaking work and is done under hot and humid conditions or under torrential downpours and involves frequent bending of the body to sow or harvest crops. The Patro women also have heavy household duties involving collecting firewood, cooking, washing, and taking care of the children. Thus, it is not surprising that the abovementioned disorders, particularly pain, were the most common ailments affecting the Patro people. The hard labor ages men and women quickly, which may be one of the reasons for prevalence of rheumatism.

Most of the formulations were simple, involving one or, at the best, two plants. However, one formulation was exceedingly complex (Serial Number 2) involving plant parts of Cyathula prostrata, Melia sempervirens, Syzygium formosanum, Mangifera indica, Combretum pilosum, Mikania cordata, Clerodendrum viscosum, Justicia adhatoda, Phyllanthus emblica, and Leucas indica. This formulation was used for treatment of a variety of disorders including jaundice, passing of blood with urine of males, tatrangi, and loss of appetite as well as a blood purifier. Among the 67 plants used by the Patro TMPs, Azadirachta indica had the most diverse uses, being used for treatment of toothache, gum swellings, helminthiasis, eczema, scabies, chicken pox, and diabetes (Serial Number 41). Rhizomes or juice obtained from macerated rhizomes of Zingiber officinale was the most used plant part in combination with other plants (Serial Number 67), but was not observed to be used alone. When asked about this, the TMPs mentioned that rhizome juice of this plant potentiates therapeutic properties of other plants.

The Patro TMPs were mostly unanimous in their selection of various plant-based formulations for treatment of ailments. Two exceptions were observed (Serial Numbers 22 and 25). In the first case, one Patro healer used the plant, namely, Combretum pilosum, for treatment of roundworms; a second healer used it for treatment of hookworms, while a third healer used it for gastritis treatment. In the second case, one healer used unripe fruits of Terminalia citrina to increase brightness of skin, while a second healer used seeds of the plant for treatment of toothache and gumache, as an appetite stimulant, and as a blood purifier.

Discussion

It is a common assumption in most mainstream as well as tribal traditional healers that a number of ailments are due to poisoning of blood as a result of accumulation of “toxins” in blood. The toxins are believed to be created from undigested food materials in the intestine from where they enter blood (and eventually other organs of the body) because of improper emptying of bowels. There may be various types of toxins, each of which can result in different diseases or symptoms following accumulation. From the viewpoint of the healers, plants are used, which through long-term experiences have proven themselves to get rid of or neutralize the accumulated toxins and so cure the body from the resulting disease. However, according to the healers, not all diseases can be attributed to accumulation of toxins. Other causes for diseases include aging (which is more associated with rheumatism), as well as coming in contact with “evil wind” or “evil spirits” (which is sometimes associated with shannik jor). In these latter cases, plants can also prove useful either through delaying the aging process, or through repelling “evil spirits.”

The various plants mentioned by the Patro healers could prove interesting for scientific research, leading to discovery of better drugs. We are most interested in the plants used for analgesic purposes by the healers. These plants include Andrographis paniculata, Justicia adhatoda, Sansevieria hyacinthoides, Dieffenbachia maculata, Homalomena aromatica, Lasia aculeata, Dischidia bengalensis, Asplenium finlaysonianum, Mikania cordata, Terminalia belerica, Terminalia citrina, Azadirachta indica, Rhynchostylis retusa, Plumbago indica, Drynaria quercifolia, Datura metel, Centella asiatica, Clerodendrum viscosum, and Alpinia conchigera. Some of the plants used by the Patro TMPs against pain have already been shown in scientific studies to be effective against pain. To cite a few examples, antinociceptive activity has been reported for andrographolide isolated from A. paniculata.¹⁴ Antinociceptive activity has been reported for A. indica extracts in mice.¹⁵ An analgesic sesquiterpene dilactone has been reported from M. cordata.¹⁶ Crude extract of T. belerica has been reported to have analgesic activities.¹⁷ Methanolic leaf extract of R. retusa reportedly exhibited analgesic activity in acetic acid-induced writhing models in mice.¹⁸ Extract of D. quercifolia has been shown to exhibit anti-inflammatory and analgesic properties.¹⁹

About one third of the population of Bangladesh lives under the poverty level and have to perform hard physical labor to maintain their daily existence. This is also true for countless other peoples from all over the world, particularly the developing countries. These people, because of their workload, suffer from pain arising from a multitude of causes, including hard labor. Even affluent people can suffer from pain arising out of mental or physical stress or a variety of diseases. Common pain-killing drugs such as aspirin or paracetamol, when taken over prolonged periods, can lead, respectively, to ulceration and hepatotoxicity. As such, the discovery of a new and safer drug from the medicinal plants used by the Patro TMPs for pain treatment can be a boon for humankind. In our laboratory, we have begun systematic screening of the medicinal plants of the Patros for their analgesic activities against acetic acid–induced pain in murine models. Also important will be the discovery of an efficacious drug from the Patro medicinal plants against diabetes, which is reaching almost endemic proportions because of changes in lifestyle and eating habits of people in virtually all countries of the world.

Footnotes

Acknowledgments

Grants/financial support were provided by internal funding from the University of Development Alternative.

Disclosure Statement

No competing financial interests exist.

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