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The use of medicinal plants in the trans-himalayan arid zone of Mustang district, Nepal

The use of medicinal plants in the trans-himalayan arid zone of Mustang district, Nepal Background: This study documents the use of medicinal plants from the Mustang district of the north-central part of Nepal. Traditional botanical medicine is the primary mode of healthcare for most of the population of this district and traditional Tibetan doctors (Amchi) serve as the local medical experts. Methods: Field research was conducted in 27 communities of the Mustang district in Nepal from 2005-2007. We sampled 202 interviewees, using random and snowball sampling techniques. After obtaining prior informed consent, we collected data through semi-structured interviews and participant-observation techniques. Voucher specimens of all cited botanic species were deposited at TUCH in Nepal. Results: We recorded the traditional uses of 121 medicinal plant species, belonging to 49 vascular plant and 2 fungal families encompassing 92 genera. These 121 species are employed to treat a total of 116 ailments. We present data on 58 plant species previously unknown for their medicinal uses in the Mustang district. Of the medicinal plants reported, the most common growth form was herbs (73%) followed by shrubs, trees, and climbers. We document that several parts of individual plant species are used as medicine. Plant parts were generally prepared using hot or cold water as the ‘solvent’, but occasionally remedies were prepared with milk, honey, jaggery, ghee and oil. Amchis recommended different types of medicine including paste, powder, decoction, tablet, pills, infusion, and others through oral, topical, nasal and others routes of administration. Conclusions: The traditional pharmacopoeia of the Mustang district incorporates a myriad of diverse botanical flora. Traditional knowledge of the remedies is passed down through oral traditions and dedicated apprenticeships under the tutelage of senior Amchi. Although medicinal plants still play a pivotal role in the primary healthcare of the local people of Mustang, efforts to ensure the conservation and sustainable use of medicinal species are necessary. Background traditional Chinese medicine (TCM), Unani and various Plants and plant products are the primary source of forms of indigenous medicine including Tibetan Amchi medicine and a highly valued resource in Nepal. Plant medicine [6-9]. Traditional medicine in Nepal comprises constituents continue to be a vital part of Western med- those practices based on beliefs that were in existence icine, and are still considered an important source of often for hundreds to thousands of years before the novel compounds in the field of drug discovery [1]. development and spread of modern medicine, and There are between 35,000 and 70,000 plant species that which are still in use today [10]. In the past in many have been used for medicinal purposes in the world [2], rural areas of Nepal, traditional medicinal knowledge and about 6,500 species of which occur in Asia [3]. In and practice was passed down entirely via oral tradition Nepal, at least 1,600 to 1,900 species of plants are com- based on a lineage mode of transmission and personal monly used in traditional medicinal practices [4,5]. experience [11]. More recently, however, knowledge Traditional medicine in Nepal is used extensively by transfer has also occurred through formally recognized majority of the population, and includes Ayurveda, school level education [12-14]. Approximately 90% of the Nepalese people reside in rural areas where access to government health care facil- * Correspondence: bhattaraishandesh@yahoo.com itiesislacking [11,15].Itisestimated that thereisa Nepal Academy of Science and Technology, Khumaltar, Lalitpur, Nepal © 2010 Bhattarai et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 2 of 11 http://www.ethnobiomed.com/content/6/1/14 ratio of one physician for 6,500 (1:6500) people and one between 246-310 species of flowering plants are ende- healer for fewer than 100. The physician to population mics to Nepal and the great majority of these species ratio of Nepal is lower then that of India (1:2000), Ban- are located in Mustang (78 species) [10,42]. Many of gladesh (1:3500 respectively), and Sri Lanka (1:4500) theseplantshavebeenusedbylocal indigenous people [16,17]. In Nepal, a total of 4,088 government health for centuries, with medicinal uses playing an important posts have been established and the ratio of health posts role in both health and culture. to the population it serves (1:5663) is very low. The Research has shown that the Mustang district is an Mustang district, where field research was conducted, important area for many useful plant resources has 17 health posts for a total of 14,981 people. While [13,43-46] and the district has not been adequately the health post to population ratio (1:881) in the Mus- explored. We chose the Mustang district for this ethno- tang district is better much than the national average medicinal study for the following reasons: (i) The study (1:5663) [18], the remote location and rugged terrain do area is rich in diversity of medicinally used plant species not permit easy access to these facilities. Due to these [13,47]; (ii) The society (communities) possess rich tra- issues of accessibility and other socioeconomic and cul- ditional knowledge (i.e. cultural diversity) [13,48]; and tural factors, local people rely more heavily on tradi- (iii) There is a culture of tradition in which healers or tional forms of medicine. knowledgeable persons transmit their traditional knowl- The Mustang district covers 3,639 sq. km [19] and is edge from generation to generation, usually through located in the trans-Himalayan Arid Zone, in the Mid- apprentices [13]. In this study, we aimed to address the Western Development region of north-central Nepal following questions: (a) How are plant resources being and is bounded to the south by Myagdi, to the west by used by the local communities in primary health care? Dolpa, to the east by Manang, and to the north by the (b) Are the indigenous people involved in conservation Tibetan Autonomous region of the Peoples Republic of activities? (c) How is the traditional knowledge of indi- China. The district lies within the Annapurna Conserva- genous people transmitted, conserved and utilized? tion Area Project (ACAP), which covers five districts In remote villages of Mustang, traditional medicines and is the largest protected area in Nepal covering 7629 are of great importance in the primary healthcare of th sq. km [19]. It is ranked in 17 position on the socioe- indigenous people due to the lack of sufficient and reli- nd conomic and infrastructural development index, 22 in able government health facilities and modern Western nd the Health and Development Index and 42 in the medicines. Therefore, local plant resources are the prin- Health institutions density among 75 districts in Nepal cipal source of medicine, and are prescribed by tradi- [20]. The Mustang district is mountainous with fragile tional healers as medicines. However, loss of biodiversity ecosystems where local biodiversity plays an important in Nepal due to several factors may also contribute to role in meeting the basic daily needs of the indigenous the loss of valuable indigenous knowledge of plants of peoples inhabiting this region. several indigenous communities in Nepal [49,50], The vegetation of Mustang has been categorized into including Mustang. To overcome this problem, we have 8 types namely: mixed forest (Pinus wallichiana forest, undertaken this ethnobotanical research project with the Betula utilis forest, Hippophae salicifolia forest, Cara- aim of documenting medicinal plant uses and the asso- gana gerardiana forest, Caragana gerardiana and Loni- ciated indigenous knowledge of local people of Mustang. cera spinosa forest, Juniperus forest) and grasslands with pure stocks of Poaceae [21]. The area is characterized Materials and methods by the high altitude, cold climate, semi-desert environ- Plant collection and identification ment [22], with altitudinal variations of 1,500 to 8,000 The plants were collected in and around the villages of m.a.s.l. The district has characteristic vegetation with a Ghasa (2010 m), Lete (2480 m), Sekung Taal (2620 m), freezing season of about 73-119 days (Marpha-Lo-Man- Larjung (2550 m), Kalopani (2510 m), Tukuche (2950 thang) [23], and is dominated by shrubby and dwarf m), Kobang (2640 m), Kokhethanti (2520 m), Marpha plant communities [24]. The influence of such charac- (2670 m), Jomsom (2720 m), Thini (2800 m), Kagbeni teristic environmental conditions in the Himalayan (2810 m), Eklebhatti (2740 m), Jharkot (3270 m), region including Mustang established favourable growth Mukthinath (3300 m), Chhuksang (2940 m), Chele conditions for some of the medicinal plant species at (3050 m), Samar (3660 m), Syangboche (3820 m), altitudes as high as 6000-6300 m.a.s.l. [14]. Ghemi (3490 m), Dhakmar (3535 m), Ghiling (3510 m), Documentation of ethnobotanical knowledge of Tamagaon (3480 m), Jhaite (3570 m), Bhena (3690 m), unique plant species has gained importance in the Tsarang (3620 m) and Lomanthang (3720 m), in the remote arid trans-Himalayan region of Nepal (Mustang, Mustang district of Nepal from 2005-2007 (Figure 1). Manang, Dolpa, and Tibet), which have similar geogra- Plants were selected based on of their use by inhabi- phy and bioclimate [25-41]. It has been estimated that tants of Mustang. Only species that were consistently Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 3 of 11 http://www.ethnobiomed.com/content/6/1/14 Mu stan g Di strict CHHONHUP CHHOSER LOMATHAN CHARANG GHAMI SURKHAN CHHUSANG KAGBENI JHONG MARPHA MUKTINATH TUKUCHE JOMSOM Main Trail KOBANG Main River KUNJO LETE 40 48 12Kilometers Figure 1 Mustang District, Nepal, site of three ethnobotanical field visits from 2005-2007. used to treat the same illness by several healers and vil- Godawari, Lalitpur (KATH) and the Royal Botanic Gar- lagers were selected. Voucher specimens were made for den (RBGE), Edinburgh, United Kingdom. each species collected in this study and deposited in the Tribhuvan University Central Herbarium (TUCH), Kath- Study Participants and Interviews mandu, Nepal. Plants were identified by two of us (SB Consent for this research project was obtained in writ- and RPC) with the help of standard botanical literature ing from the Annapurna Conservation Area Project [51-55]. Nomenclature of the identified species follows (ACAP), Pokhara, and prior informed consent (PIC) was standard literatures [56-61] and plant family assign- obtained verbally from each participant before they were ments follow the current Angiosperm Phylogeny Group interviewed. The project was approved by the Central [62]. Voucher specimens were also cross-checked with Department of Botany Research Committee of Tribhu- previously collected herbarium specimens from the van University. We followed the ethical guidelines Manang district that had been previously identified adopted by the ICE/International Society of Ethno- by the National Herbarium and Plant Laboratories, biology. We met with local community elders to explain Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 4 of 11 http://www.ethnobiomed.com/content/6/1/14 the research project methods and intent and initiated completed manuscript created as a result of this project participant recruitment only after approval by these will be returned to the participating communities, and community leaders. We employed random and snowball copies given to key people who collaborated in the sampling techniques to identify potential participants research. and interviewed a total of 202 people (109 men and 93 Interviews were conducted in the local Nepali or in women) representing a sample of the population across Gurung language dialect (translated by an interpreter), age groups (Figure 2). and data was collected by direct and participant-obser- Study participants included individuals from various vation of studyparticipantsinfieldsand forestsand ethnic and socioeconomic backgrounds, including through semi-structured interviews. Interview protocols Amchi healers, medicinal plant traders, farmers, hotel or and field observations all followed standard ethnobotani- shop owners or managers, footpath traders, home- cal methods [63-65]. Amchis who were influenced by makers, and village elders. However, the traditional deep practical knowledge of medicinal plants of Mus- senior and junior Tibetan doctors (Amchis) were the key tang district were interviewed during July 2005, Septem- source of information regarding medicinal plant use. ber 2006 and June 2007. A total of 75 days were spent The traditional healers of Mustang comprise senior in the study sites. At first interviews were conducted Amchis (Tibetan medicinal practitioners who see using the ‘specimen display’ method. After collecting patients in their clinics and teach students in medical plant specimens for research, we showed these fresh school), junior Amchis (student studying Amchi medi- specimens to the locals in order to elicit information. cine), plant traders (traders of Mustang medicinal plants The same plant specimens were shown to different peo- in major cities of Nepal), and knowledgeable villagers ple to confirm the accuracy of the results. When conve- (including herders, farmers, hotel owners etc). The local nient to the participants, they were asked to accompany knowledgeable villagers, healers and Amchis interviewed the researchers for a walk, allowing for both plant col- who consented to have their names and knowledge lection and detailed information gathering. A consensus published are listed in the acknowledgements. The index was created based on agreement in the medicinal Male Female 10-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 Informant Age (years) Figure 2 Study participants interviewed (villagers, healersand Amchis). Number of Informants Interviewed Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 5 of 11 http://www.ethnobiomed.com/content/6/1/14 use of the different species cited and is included in are popular throughout Nepal and are used to treat a Additional File 1. broad spectrum of ailments [12,15]. The study of the growth form of the medicinal plants Results and Discussion revealed that herbs made up the highest proportion of A total of 121 species belonging to 49 vascular plant medicinal plants represented 89 species followed by and 2 fungal families and 92 genera were reported and shrubs (17), trees (11), and climbers (4) (Figure 3). Simi- are indicative of the rich diversity of medicinal plant lar results were also obtained from previous studies on species found in this area. Study results are presented in the distribution pattern of life forms of medicinal plant alphabetical order by family and then followed by scien- species in the Nepalese Himalaya. Ghimire et al. 2008 tific name, voucher number, local vernacular names [14] revealed that 45-70% of the total naturally growing (Gurung/Thakali/amchi/Nepali), phenology, and detailed species are long-lived herbaceous perennials followed by uses - including methods of preparation, dosage and shrubs (16.6%), annual/biennial herbs (15.6%), tree administration of medicine (Additional File 1). The lar- (13.6%), woody climbers (6.5%), and herbaceous clim- gest number of medicinal species came from Asteraceae bers (2.3%). (18), which was followed by Ranunculaceae (8), Rosa- This study recorded that several parts of individual ceae (7), Lamiaceae (6), and Fabaceae (5) (Table 1). plant species are used as medicine. The most commonly These 121 species were found to treat 116 ailments used medicinal plant part was the root (30 species), fol- (Table 2), 92 of which were used to treat more than one lowed by flowers (23), fruits and leaves (19 each), stem disease and the remaining 29 species were used to treat (17), seed (11), bark and cone (2 each), and bulb (1). In only one disease (Additional File 1). We have added 58 addition to the above common parts used, whole plant new medicinal plants, noted with asterisks (Additional (49 species, 29%), were commonly uprooted (Figure 4). File 1), in addition to the previous works of [13,44,47]. The most commonly selected plant parts may be pre- Many of these newly added plant species for Mustang ferential because such parts contain more active Table 1 Division of medicinal plants and fungi documented by family designation. Families Species Proportion Families Species Proportion Alliaceae 3 2.48% Malvaceae 1 0.83% Amaranthaceae 1 0.83% Menispermaceae 1 0.83% Apiaceae 2 1.65% Morchellaceae 1 0.83% Araceae 2 1.65% Nyctaginaceae 1 0.83% Asparagaceae 1 0.83% Orchidaceae 1 0.83% Asteraceae 18 14.88% Orobanchaeae 1 0.83% Berberidaceae 4 3.31% Papaveraceae 3 2.48% Betulaceae 1 0.83% Phrymaceae 1 0.83% Bignoniaceae 1 0.83% Pinaceae 1 0.83% Boraginaceae 3 2.48% Plantaginaceae 2 1.65% Brassicaceae 3 2.48% Polygonaceae 4 3.31% Cannabaceae 1 0.83% Primulaceae 3 2.48% Caprifoliaceae 2 1.65% Ranunculaceae 8 6.61% Chenopodiaceae 1 0.83% Rosaceae 7 5.79% Clavicipitaceae 1 0.83% Salicaceae 1 0.83% Convolvulaceae 1 0.83% Saxifragaceae 2 1.65% Crassulaceae 1 0.83% Scrophulariaceae 1 0.83% Cupressaceae 4 3.31% Solanaceae 4 3.31% Elaegnaceae 2 1.65% Tamariaceae 1 0.83% Ephedraceae 1 0.83% Taxaceae 1 0.83% Ericaceae 2 1.65% Thymelaeaceae 1 0.83% Fabaceae 5 4.13% Urticaceae 1 0.83% Gentianaceae 2 1.65% Valerianaceae 2 1.65% Juglandaceae 1 0.83% Violaceae 1 0.83% Lamiaceae 6 4.96% Zingiberaceae 1 0.83% Liliaceae 1 0.83% TOTAL 121 100% Indicates fungal family. Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 6 of 11 http://www.ethnobiomed.com/content/6/1/14 Table 2 Aliments included in each illness category. Illness category Ailments Dermatological Allergy, boils, allergic skin, skin diseases, warts Fever Fever, chronic fever, lung fever, malarial fever Gastrointestinal Bile diseases, bile disorders, liver diseases, stomach diseases, diarrhoea, dysentery, gastritis, constipation, intestinal worms, anthelmintic, stomach swelling General health Chronic diseases, inappropriate medication, to counteract the effect of poison, anti-poison, food poisoning, hair long, hair black, gingivitis, mouth swelling, snake bite, vomiting, to remove lodged bones or spines, dehydration, cancer, eye diseases, poor vision, bone fractures, joint swelling, typhoid, diseases of air, diseases of wind, vitamin, tonic, nutritious, loss of appetite, periods of fatigue, low energy, edema, nose swelling, burns, cold, cuts, child birth, over flow of blood in menstruation, over flow of blood in child birth, menstrual disorders, pregnant women, nerve diseases, nerve dispersed condition, communicable diseases, bone spurs, hemorrhoids, pneumonia, digestive, blood diseases, to increase blood, blood circulation, blood deficiency, blood purifier, reduces fats, thins blood in coagulation period, blood pressure, vertigo/dizziness, nose bleeding, pulse rate, tuberculosis, heart diseases, pain near the side of heart Infections Infected wounds, skin wounds, wounds, infection, infection diseases Pain Headache, stomachache, rheumatism, body pain, leg pain, backbone pain, joint pain, hand pain, ear pain, chest pain, ribs pain, bodyache, numbness of limbs, black worms of teeth, tooth pain, tootache Respiratory Cough, sinusitis, tonsillitis, chronic lung diseases, chronic respiratory diseases, respiration, asthma, bronchitis Urinary Kidney stone, Kidney diseases, red color urine, diseases of urine, painful urination, excessive urination, diuretic, difficulty in passing urine Jaundice Jaundice principles in comparison to the least used parts. Leaves, roots, stems and flowers are physically more vulnerable to attack by herbivores or pathogens than the hardier bark or cones and may contain more chemical defense compounds in the form of biologically active secondary metabolites. However, several studies have indicated that large scale harvesting of roots, leaves, stems and flowers can have a negative influence on the survival and continuity of useful medicinal plants and hence Herb Shrub Tree Climber impacts sustainable utilization of plants [66]. Habi t Plant parts were generally prepared using hot or cold water (100 species) as the solvent, but occasionally Figure 3 Growth forms (habits) of the reported medicinal plant species. remedies were prepared with milk (14), honey (2), jag- gery (gur - unrefined, whole sugar- 2 species), ghee (2) and oil (1) (Figure 5). The Amchi explained that water is a common, readily available, and cheap solvent and the good solubility of active components in water made it Seed Cone Bulb Bark 6% 1% 1% commonly used in the traditional medicine preparation. 1% Other infusion materials such as milk, honey, oils, jag- Stem gery, and ghee are expensive and not always available Wh o le p lan t 10% 29% when needed. In addition, milk, oil, honey and ghee may be used for their properties to dissolve active phy- Root tochemicals that are not water soluble. Leaf 17% 11% Amchis recommended different forms of medication including paste (60 species), powder (48), decoction (35), tablet (7), pills (5), cold infusion (5), and others Flow er Fru it (Figure 6). This study often recorded the use of paste, 13% 11% powders and decoctions in comparison to tablet, pills Figure 4 Plant parts used in the preparation of medicine. and infusions. Most often standard medicines are Num ber of speci es Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 7 of 11 http://www.ethnobiomed.com/content/6/1/14 medicine is unique. For centuries, Amchi have been stor- Jaggery ing herbal medicine in a bag created from the skin of 2% Gh ee 2% M. chrysogaster skin, which is tied twice with thread. Tying the herbal medicine in M.chrysogaster skin allows it to remain effective for one to two years. Amchi use a Ho ney 2% Oil 1% stone slab in place of the electric grinder in the prepara- tion of medicine because theyfeelthatheatcreated by the grinder may degrade the active chemical constituents Milk 11% of plant powder and thus reduce the quality of the medi- cine. The powder is then mixed with water and a suffi- cient amount of additives - honey, jaggery, etc. Additives are added according to the need of the specific plant Water 82% powder to aid with the shape of the prepared pills Figure 5 Typesofdrugexcipientsused inthe preparationof (rounded, rectangular, etc). The process of boiling con- medicine. tinues and complete evaporation of the water makes it easy to form the medicinal mixture into the preferred prescribed in mixed ingredient form by mixing several shape. valuable medicinal plants and additives. Amchi believe The medicinal plant preparations were administered that using plant mixtures in the preparation of a medi- to the local people of Mustang through different routes cine is important as a single plant alone may not be suffi- including oral, topical, nasal and others. Oral (115 spe- cient to cure any disease completely, whereas the cies) was the most commonly used route of administra- combination of several medicinal plants increases the tion, and was followed by topical (36), nasal and others quality and efficacy of medicine. Similar observations (12) (Figure 7). Similar observations have also been have also been recorded amongst the Kani communities obtained in other ethnobotanical studies [66,68]. in India [67]. Amchis always collect local medicinal plants themselves. Certain zootherapeutic remedies, or medicines based on They stress that this is very important because they have animal products, were also recorded. Some common ani- extensive experience in the identification of Himalayan mal products used in the creation of medicines included medicinal plants. They worry that a misnamed or falsely tortoise bones and the horn and urine of the Himalayan collected sample may be dangerous and cause the death musk deer (Moschus chrysogaster). The Amchi traditional of a patient. This is particularly true in the case of Aconi- method of maintaining the good quality of herbal tum orochryseum and A. spicatum (Ranunculaceae). Fo r ms o f M e d icat io n Figure 6 Forms of medication used. Paste Powder Decoction Tablet Pills Infusion Eaten Raw Vegetable Smoke Nu mb er o f s p ec ies Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 8 of 11 http://www.ethnobiomed.com/content/6/1/14 The 121 medicinal plant species recorded from Mus- Nas al & tang were also used in miscellaneous categories of uses Others and hence such additional uses have added the value to 7% medicinal plant species. The majority of medicinal plant Topical species were used for food (33 species), fuelwood (27), 22% fence (24), fodder and ritual & religious (19 each), dec- oration (8), organic manure (7), dyes & soap and psy- choactive (3 each), and construction (2). However, many Oral (50 species) have only medicinal use (Figure 8). 71% Most of the documented medicinal plant species were collected from wild habitats where very few species like Figure 7 Routes of administration of medicinal plants remedies. Allium carolinianum, Allium wallichii, Prunus arme- niaca, etc. were also cultivated for regular use. Medic- inal plant species were used both in dried and fresh forms and are also collected and stored for future pur- A. spicatum is highly poisonous and is difficult to differ- pose. Autumn has been considered the best season for entiate from Aconitum orochryseum. Using the wrong spe- the collection of roots and spring for collection of cies by mistake can result in death. The medicine from this plant can only be prepared by highly experienced stems. Important days or months for the collection of Amchi. Medicine must be made by Amchi with other individual plants vary greatly and are known best by medicinal plants of the Himalaya, so that the poison of Amchi. The time of collection of plant parts for medi- that plant is inactivated without inactivating the other cine is also very important in capturing the active prin- medicinal properties. In Mustang, A.spicatum whole plant ciples. Therefore, Amchi strictly collect specific plant (mainly root) is used to make medicinal tablets by the parts during a specific time and use them to prepare Amchi to treat infected wounds; as a tonic to provide relief traditional medicine. Overall, the majority of locals con- from general weakness; to counteract the effects of poison, sider Amchi medicines and medical system to be effec- including inappropriate self medication, poison ingested tive and local people have a deep faith in them. on purpose or accidentally, poisonous animal stings or Several medicinal plants including Allium wallichii, bites; boils; fever; allergy and edema. It is never used alone Aconitum orochryseum, Cordyceps sinensis, Dactylorhiza and is always mixed with several other medicinal plants of hatagirea and Neopicrorhiza scrophulariiflora are col- the Himalaya. A paste of the roots is applied for allergy, lected from the local habitat as a source of cash income. boils, cuts, wounds and edema after mixing with other Such illegal mass collection of the important species is a type of unsustainable harvesting which leads to the medicinal plants. Di fferent categori es of use Figure 8 Other uses of medicinal plant species. No u se Food Fuelwood Fence Fodder Ritual & Religious Decoration Organic man ure Dye & soap Psychoactive Construction Percent Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 9 of 11 http://www.ethnobiomed.com/content/6/1/14 peoples of Mustang district of Nepal for providing us with their valuable exploitation from the natural habitat in the future. ethnobotanical information and co-operation, without which this work Therefore over-harvesting of important medicinal plants would not have been possible. We thankfully acknowledge Annapurna should be prohibited and monitored and immediate Conservation Area project (ACAP) for providing research permission for the field work. We would especially like to recognize and thank the following conservation and management approaches should be people for their participation in this study: Seta Nepali, Dhanbir BK, Man followed for the sustainable use of natural ecosystem of Prasad Thakali, Rupa Thakali, Maina Devi Thakali, Sana Devi Thakali, Bhim Mustang. Prasad Thakali, Suresh Sherchan, Lal Kumari Gauchen, Seram Gurung, Sonam Gurung, Maila Gurung, Chyaa Lama, Ram Chandra Thakali, Mangala Lalchan, Shyam Prasad Lalchan, Amchi Tsampa Ngawang Gurung, Amchi Thurthock Conclusion Lama, Amchi Nengma Lama, Chendhen Gurung, Laxhi Gurung, Nathue Traditional Amchi medical practitioners maintain a Gurung, Nophue Chiring, Indra Gurung, Bisnu Gurung, Rajhendra Thakuri, Chiring Gurung, Ghulii Chamang, Asmitha Gurung, Prem Gurung, Pasang great depth of knowledge on the subject of medicinal Gurung, Chiring Yanghung Gurung, Ghyangh Chusang Bista, Raju Bista, Maya plants. Medicinal plants still play a pivotal role in the Bista, Amchi Gyasto Bista, Tsering Wangmo Bista, Amchi Tensing Bista Lama, primary healthcare of the local people in the study area. Pema Dolma Bista, Chandup Gyato Bista, Chime Dolkar Bista, Tsewang Bista, Tashi Bista, Sonam Sangmo Bista, Rinzin Wangmo Bista, Tenzing Gurung, Due to the lack of Western medicine, modern govern- Khyamo Chiring Gurung, and Maya Gurung. ment health posts, difficult geography of the district as well as a strong cultural belief in the power of folk med- Author details Nepal Academy of Science and Technology, Khumaltar, Lalitpur, Nepal. icines, the Amchi system serves as a popular provider of Central Department of Botany, Tribhuvan University, Kirtipur, Kathmandu, primary healthcare in Mustang. Although such health- Nepal. University of Arkansas for Medical Sciences, College of Medicine, care practices have been in place for centuries in Mus- Little Rock, AR, USA. Community Medicine, Queens University, Kingston, Ontario, Canada. tang, they are at risk of being lost to future generations. This is due primarily to changes in socioeconomics of Authors’ contributions the region as younger generations are eager to migrate Author SB performed the interviews with the healers, identified the herbarium specimens with RPC and drafted and finalized the manuscript outside the country for employment. The continued with RPC, CLQ, and RSLT. Author RPC identified herbarium specimens with practice of training as an Amchi apprentice is necessary SB, supervised the research works and finalized the manuscript with SB. for the survival of this traditional medical knowledge. Author CLQ drafted and finalized the manuscript with SB. Author RSLT supervised the research works and drafted and finalized the manuscript with Although local efforts to conserve medicinal plant SB. All authors read and approved the final manuscript. resources are still inadequate, the long held traditional beliefs of the population regarding folk medicine has its Competing interests The authors declare that they have no competing interests. own unintentional role in conservation, management and sustainable utilization. While over-harvesting of Received: 19 September 2009 Accepted: 6 April 2010 some important medicinal plants has increased, many Published: 6 April 2010 Amchi are working towards both biological conservation References of the medicinal plants through sustainable harvesting 1. Hamilton AC: Medicinal plants, conservation and livelihoods. Biodiversity and protection of wild species and conservation of their and Conservation 2004, 13:1477-1517. cultural heritage. In some villages (Lete, Lomanthang, 2. Farnsworth NR, Soejarto DD: Global Importance of Medicinal Plants. 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Dev S: Ancient-modern concordance in Ayurvedic plants: some Additional file 1: Medicinal plants and fungi used by the people of examples. Environmental Health Perspectives 1999, 107:783-789. Mustang district, Nepal. 9. Shengji P: Ethnobotanical approaches of traditional medicine studies: some experience from Asia. Pharmaceutical Botany 2001, 39:74-79. 10. Hamilton AC, Radford EA: Identification and Conservation of Important Plant Areas for Medicinal Plants in the Himalaya. Plantlife International, Acknowledgements Salisbury, United Kingdom, and Ethnobotaniocal Society of Nepal, The authors (SB and RPC) are thankful to the Volkswagen Foundation, Kathmandu, Nepal 2007. Germany for financial support for the field work. We are grateful to the Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 10 of 11 http://www.ethnobiomed.com/content/6/1/14 11. Bhattarai NK: Traditional medicine, medicinal plants and biodiversity 38. Bhattarai S, Chaudhary RP, Taylor RSL: Antibacterial activity of selected conservation in the global and Nepalese contexts. Plant Research 1998, ethnomedicinal plants of Manang district, central Nepal. Journal of 1(1):22-31. Theoretical and Experimental Biology 2008, 5(1 & 2):01-09. 12. Lama YC, Ghimire SK, Thomas YA: Medicinal Plants of Dolpo: Amchis 39. Bhattarai S, Chaudhary RP, Taylor RSL: Screening of selected Knowledge and Conservation. WWF Nepal Program, Kathmandu, Nepal ethnomedicinal plants of Manang district, central Nepal for antibacterial 2001. activity. Ethnobotany 2008, 20:9-15. 13. Bista T, Bista G: Himalayan Doctors and Healing Herbs: The Amchi 40. Bhattarai S, Chaudhary RP, Taylor RSL: Wild edible plants used by the Tradition and Medicinal Plants of Mustang. Mera Publications for Lo- people of Manang district, central Nepal. Ecology of Food and Nutrition Kunphen Mentsikhang 2005. 2009, 47:1-20. 14. 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ICIMOD-Nepal: Districts of Nepal - Indicators of Development. Central 46. Bhattarai S, Chaudhary RP, Taylor RSL: The use of plants for fencing and Bureau of Statistics (CBS) Nepal: International Centre for Integrated fuelwood in Mustang District, Trans-Himalayas, Nepal. Scientific World Mountain Development (ICIMOD): SNV-Nepal 2003. 2009, 7(7):59-63. 21. Anonymous: Mustang - The Land of Fascination. King Mahendra Trust for 47. Chetri M, Chapagain NR, Neupane BD: Flowers of Mustang: A Pictorial Nature Conservation, Jawalakhel, Kathmandu, Nepal 2004. Guidebook. National Trust for Nature Conservation, Annapurna 22. KMTNC: Annual Progress Report 2003-2004. King Mahendra Trust for Conservation Project, Upper Mustang Biodiversity Conservation Project, Nature Conservation, Annapurna Conservation Area Project, Unit Kathmandu, Nepal 2006. Conservation Office, Lo-Manthang 2004. 48. Bista DB: People of Nepal. Ratna Pustak Bhandar, Kathmandu, Nepal 2004. 23. Noshiro S: Climatic conditions of Mustang. Flora of Mustang, Nepal 49. Bhattarai S: Ethnobotanical study of Manang District (Central Nepal) and Kodansha Scientific LTD., TokyoOhba H, Iokawa Yu, Sharma LR 2008, antibacterial activities of some selected medicinal Plants. Central 1xii-1xiv. Department of Botany (MSc. Dissertation), Tribhuvan University, Kirtipur, 24. Subedi MN: Vegetation of Mustang. Flora of Mustang, Nepal Kodansha Kathmandu, Nepal 2003. Scientific LTD., TokyoOhba H, Iokawa Yu, Sharma LR 2008, x1vi-1xi. 50. Bhattarai S: Ethnobotany and antibacterial activities of selected medicinal 25. Kletter C, Kricchbaum M: Tibetan Medicinal Plants. Med-Pharm GmbH Plants of Nepal Himalaya. Central Department of Botany (PhD Scientific Publishers, Birkenwaldstr, Stuttgart, Germany 2001. Dissertation), Tribhuvan University, Kirtipur, Kathmandu, Nepal 2009. 26. Manandhar NP: An ethnobotanical profile of Manang valley, Nepal. J 51. Polunin O, Stainton A: Flowers of the Himalaya. Oxford Press, New Delhi, Econ Tax Bot 1987, 10:207-213. India 1984. 27. Pohle P: Useful Plants of Manang District: A Contribution to the 52. Stainton A: Flowers of the Himalayas - A Supplement. Oxford University Ethnobotany of the Nepal-Himalaya. Franz Steiner Verlag Wiesbaden Press, New Delhi, India 1988. GMBH, Stuttgart 1990. 53. Grierson AJC, Long DG: Flora of Bhutan. Vol. I & II, Part I-III Royal Botanic 28. KMTNC: Fuel Energy in Upper Mustang: Demand, Supply and Action Garden, Edinburgh and Royal Government of Bhutan; 1983-2000. Plan for Management. King Mahendra Trust for Nature Conservation, 54. Adhikari MK: Morels and their production in natural environment of Annapurna Conservation Area Project, Research report series number 9. (NEP/ Jumla district, Nepal. Banko Janakari 2000, 10(1):11-14. 99/GEF); NEP/99/021 (TRAC) 2002. 55. Ohba H, Iokawa Yu, Sharma LR: Flora of Mustang, Nepal. Kodansha 29. Chhetri HB, Gupta VNP: NTFP potential of upper Mustang - a trans- Scientific LTD., Tokyo 2008. Himalayan region in western Nepal. Scientific World 2006, 4(4):38-43. 56. The Angiosperm Phylogeny Group II: An update of the angiosperm 30. Chhetri HB, Gupta VNP: A survey of non-timber forest products (NTFPs) in phylogeny group classification for the orders and families of flowering upper Mustang. Scientific World 2007, 5(5):89-94. plants: APG II. Botanical Journal of the Linnean Society 2003, 141:399-436. 31. Bhattarai S, Chaudhary RP: Ethnobotany of wild rose in Manang district, 57. Bista MS, Adhikari MK, Rajbhandari KR: Flowering Plants of Nepal central Nepal. Environmental Biology and Conservation 2005, 10:33-36. (Phanerogams) 18. HMGN, Bull. Dept. Res 2001. 32. Bhattarai S, Chaudhary RP: Ethnobotany of wild Allium species in Manang 58. Hara H, Stearn WT, Williams LHJ I: An Enumeration of the Flowering district, central Nepal. Plant Archives 2006, 6(2):471-476. Plants of Nepal. British Museum of Natural History, London 1978. 33. Bhattarai S, Chaudhary RP, Taylor RSL: Ethnobotany of wild Junipers 59. Hara H, Charter AO, Williams LHJ III: An Enumeration of the Flowering (Juniperus species) in Manang district, centralNepal. Scientific World 2006, plants of Nepal. British Museum of Natural History, London 1982. 4(4):109-112. 60. Hara H, Williams LHJ II: An Enumeration of the Flowering Plants of Nepal. 34. Bhattarai S, Chaudhary RP, Taylor RSL: Ethnomedicinal plants used by the British Museum of Natural History, London 1979. People of Manang district, central Nepal. Journal of Ethnobiology and 61. Press JR, Shrestha KK, Sutton DA: Annotated Checklist of the flowering Ethnomedicine 2006, 2:41. Plants of Nepal. Natural History Museum, London and Central Department 35. Bhattarai S, Chaudhary RP, Taylor RSL: Plants used as fence and fuelwood of Botany, Tribhuvan University, Kathmandu 2000. in Manang district, central Nepal. Scientific World 2007, 5(5):107-111. 62. Stevens PF: (2001 onwards): Angiosperm Phylogeny Website. Version 9 36. Bhattarai S, Chaudhary RP, Taylor RSL: Prioritization and Trade of 2008 [http://www.mobot.org/MOBOT/research/APweb/]. Ethnomedicinal Plants by the People of Manang District, Central Nepal. 63. Martin GJ: Ethnobotany: A Methods Manual. Chapman and Halls, London Local Effects of Global Changes in the Himalayas: Manang, Nepal Tribhuvan 1995. University, Nepal and University of Bergen, NorwayChaudhary RP, Aase TH, 64. Alexiades M: Collecting ethnobotanical data. An introduction to basic Vetaas OR, Subedi BP 2007, 151-169. concepts and techniques. Selected Guideline for ethnobotanical research: A 37. Bhattarai S, Chaudhary RP, Taylor RSL: Ritual and religious plants of Field Manual Alexiades M. U.S.A. Sheldon JW: The New York Botanical Manang district, central Nepal. Plant Archives 2008, 8(2):973-980. Garden 1996, 53-94. Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 11 of 11 http://www.ethnobiomed.com/content/6/1/14 65. Cotton CM: Ethnobotany: Principles and applications Chichester, New York: John Wiley and Sons Ltd 1996. 66. Lulekal E, Kelbessa E, Bekele T, Yineger H: An ethnobotanical study of medicinal plants in Mana angetic District, southeastern Ethiopia. Journal of ethnobiology and Ethnomedicine 2008, 4:10. 67. Ayyanar M, Ignacimuthu S: Traditional knowledge of Kani tribals in Kouthalai of Tirunelveli hills, Tamil Nadu, India. Journal of ethnopharmacology 2005, 102:246-255. 68. Hunde D, Asfaw Z, Kelbessa E: Use and management of ethnoveterinary medicinal plants by indigenous people in ‘Boosat’ Welenchiti area. Ethiopian Journal of Biological Sciences 2004, 3:113-132. doi:10.1186/1746-4269-6-14 Cite this article as: Bhattarai et al.: The use of medicinal plants in the trans-himalayan arid zone of Mustang district, Nepal. Journal of Ethnobiology and Ethnomedicine 2010 6:14. 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The use of medicinal plants in the trans-himalayan arid zone of Mustang district, Nepal

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Springer Journals
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Copyright © 2010 by Bhattarai et al; licensee BioMed Central Ltd.
Subject
Medicine & Public Health; Complementary & Alternative Medicine; Life Sciences, general
eISSN
1746-4269
DOI
10.1186/1746-4269-6-14
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20370901
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Abstract

Background: This study documents the use of medicinal plants from the Mustang district of the north-central part of Nepal. Traditional botanical medicine is the primary mode of healthcare for most of the population of this district and traditional Tibetan doctors (Amchi) serve as the local medical experts. Methods: Field research was conducted in 27 communities of the Mustang district in Nepal from 2005-2007. We sampled 202 interviewees, using random and snowball sampling techniques. After obtaining prior informed consent, we collected data through semi-structured interviews and participant-observation techniques. Voucher specimens of all cited botanic species were deposited at TUCH in Nepal. Results: We recorded the traditional uses of 121 medicinal plant species, belonging to 49 vascular plant and 2 fungal families encompassing 92 genera. These 121 species are employed to treat a total of 116 ailments. We present data on 58 plant species previously unknown for their medicinal uses in the Mustang district. Of the medicinal plants reported, the most common growth form was herbs (73%) followed by shrubs, trees, and climbers. We document that several parts of individual plant species are used as medicine. Plant parts were generally prepared using hot or cold water as the ‘solvent’, but occasionally remedies were prepared with milk, honey, jaggery, ghee and oil. Amchis recommended different types of medicine including paste, powder, decoction, tablet, pills, infusion, and others through oral, topical, nasal and others routes of administration. Conclusions: The traditional pharmacopoeia of the Mustang district incorporates a myriad of diverse botanical flora. Traditional knowledge of the remedies is passed down through oral traditions and dedicated apprenticeships under the tutelage of senior Amchi. Although medicinal plants still play a pivotal role in the primary healthcare of the local people of Mustang, efforts to ensure the conservation and sustainable use of medicinal species are necessary. Background traditional Chinese medicine (TCM), Unani and various Plants and plant products are the primary source of forms of indigenous medicine including Tibetan Amchi medicine and a highly valued resource in Nepal. Plant medicine [6-9]. Traditional medicine in Nepal comprises constituents continue to be a vital part of Western med- those practices based on beliefs that were in existence icine, and are still considered an important source of often for hundreds to thousands of years before the novel compounds in the field of drug discovery [1]. development and spread of modern medicine, and There are between 35,000 and 70,000 plant species that which are still in use today [10]. In the past in many have been used for medicinal purposes in the world [2], rural areas of Nepal, traditional medicinal knowledge and about 6,500 species of which occur in Asia [3]. In and practice was passed down entirely via oral tradition Nepal, at least 1,600 to 1,900 species of plants are com- based on a lineage mode of transmission and personal monly used in traditional medicinal practices [4,5]. experience [11]. More recently, however, knowledge Traditional medicine in Nepal is used extensively by transfer has also occurred through formally recognized majority of the population, and includes Ayurveda, school level education [12-14]. Approximately 90% of the Nepalese people reside in rural areas where access to government health care facil- * Correspondence: bhattaraishandesh@yahoo.com itiesislacking [11,15].Itisestimated that thereisa Nepal Academy of Science and Technology, Khumaltar, Lalitpur, Nepal © 2010 Bhattarai et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 2 of 11 http://www.ethnobiomed.com/content/6/1/14 ratio of one physician for 6,500 (1:6500) people and one between 246-310 species of flowering plants are ende- healer for fewer than 100. The physician to population mics to Nepal and the great majority of these species ratio of Nepal is lower then that of India (1:2000), Ban- are located in Mustang (78 species) [10,42]. Many of gladesh (1:3500 respectively), and Sri Lanka (1:4500) theseplantshavebeenusedbylocal indigenous people [16,17]. In Nepal, a total of 4,088 government health for centuries, with medicinal uses playing an important posts have been established and the ratio of health posts role in both health and culture. to the population it serves (1:5663) is very low. The Research has shown that the Mustang district is an Mustang district, where field research was conducted, important area for many useful plant resources has 17 health posts for a total of 14,981 people. While [13,43-46] and the district has not been adequately the health post to population ratio (1:881) in the Mus- explored. We chose the Mustang district for this ethno- tang district is better much than the national average medicinal study for the following reasons: (i) The study (1:5663) [18], the remote location and rugged terrain do area is rich in diversity of medicinally used plant species not permit easy access to these facilities. Due to these [13,47]; (ii) The society (communities) possess rich tra- issues of accessibility and other socioeconomic and cul- ditional knowledge (i.e. cultural diversity) [13,48]; and tural factors, local people rely more heavily on tradi- (iii) There is a culture of tradition in which healers or tional forms of medicine. knowledgeable persons transmit their traditional knowl- The Mustang district covers 3,639 sq. km [19] and is edge from generation to generation, usually through located in the trans-Himalayan Arid Zone, in the Mid- apprentices [13]. In this study, we aimed to address the Western Development region of north-central Nepal following questions: (a) How are plant resources being and is bounded to the south by Myagdi, to the west by used by the local communities in primary health care? Dolpa, to the east by Manang, and to the north by the (b) Are the indigenous people involved in conservation Tibetan Autonomous region of the Peoples Republic of activities? (c) How is the traditional knowledge of indi- China. The district lies within the Annapurna Conserva- genous people transmitted, conserved and utilized? tion Area Project (ACAP), which covers five districts In remote villages of Mustang, traditional medicines and is the largest protected area in Nepal covering 7629 are of great importance in the primary healthcare of th sq. km [19]. It is ranked in 17 position on the socioe- indigenous people due to the lack of sufficient and reli- nd conomic and infrastructural development index, 22 in able government health facilities and modern Western nd the Health and Development Index and 42 in the medicines. Therefore, local plant resources are the prin- Health institutions density among 75 districts in Nepal cipal source of medicine, and are prescribed by tradi- [20]. The Mustang district is mountainous with fragile tional healers as medicines. However, loss of biodiversity ecosystems where local biodiversity plays an important in Nepal due to several factors may also contribute to role in meeting the basic daily needs of the indigenous the loss of valuable indigenous knowledge of plants of peoples inhabiting this region. several indigenous communities in Nepal [49,50], The vegetation of Mustang has been categorized into including Mustang. To overcome this problem, we have 8 types namely: mixed forest (Pinus wallichiana forest, undertaken this ethnobotanical research project with the Betula utilis forest, Hippophae salicifolia forest, Cara- aim of documenting medicinal plant uses and the asso- gana gerardiana forest, Caragana gerardiana and Loni- ciated indigenous knowledge of local people of Mustang. cera spinosa forest, Juniperus forest) and grasslands with pure stocks of Poaceae [21]. The area is characterized Materials and methods by the high altitude, cold climate, semi-desert environ- Plant collection and identification ment [22], with altitudinal variations of 1,500 to 8,000 The plants were collected in and around the villages of m.a.s.l. The district has characteristic vegetation with a Ghasa (2010 m), Lete (2480 m), Sekung Taal (2620 m), freezing season of about 73-119 days (Marpha-Lo-Man- Larjung (2550 m), Kalopani (2510 m), Tukuche (2950 thang) [23], and is dominated by shrubby and dwarf m), Kobang (2640 m), Kokhethanti (2520 m), Marpha plant communities [24]. The influence of such charac- (2670 m), Jomsom (2720 m), Thini (2800 m), Kagbeni teristic environmental conditions in the Himalayan (2810 m), Eklebhatti (2740 m), Jharkot (3270 m), region including Mustang established favourable growth Mukthinath (3300 m), Chhuksang (2940 m), Chele conditions for some of the medicinal plant species at (3050 m), Samar (3660 m), Syangboche (3820 m), altitudes as high as 6000-6300 m.a.s.l. [14]. Ghemi (3490 m), Dhakmar (3535 m), Ghiling (3510 m), Documentation of ethnobotanical knowledge of Tamagaon (3480 m), Jhaite (3570 m), Bhena (3690 m), unique plant species has gained importance in the Tsarang (3620 m) and Lomanthang (3720 m), in the remote arid trans-Himalayan region of Nepal (Mustang, Mustang district of Nepal from 2005-2007 (Figure 1). Manang, Dolpa, and Tibet), which have similar geogra- Plants were selected based on of their use by inhabi- phy and bioclimate [25-41]. It has been estimated that tants of Mustang. Only species that were consistently Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 3 of 11 http://www.ethnobiomed.com/content/6/1/14 Mu stan g Di strict CHHONHUP CHHOSER LOMATHAN CHARANG GHAMI SURKHAN CHHUSANG KAGBENI JHONG MARPHA MUKTINATH TUKUCHE JOMSOM Main Trail KOBANG Main River KUNJO LETE 40 48 12Kilometers Figure 1 Mustang District, Nepal, site of three ethnobotanical field visits from 2005-2007. used to treat the same illness by several healers and vil- Godawari, Lalitpur (KATH) and the Royal Botanic Gar- lagers were selected. Voucher specimens were made for den (RBGE), Edinburgh, United Kingdom. each species collected in this study and deposited in the Tribhuvan University Central Herbarium (TUCH), Kath- Study Participants and Interviews mandu, Nepal. Plants were identified by two of us (SB Consent for this research project was obtained in writ- and RPC) with the help of standard botanical literature ing from the Annapurna Conservation Area Project [51-55]. Nomenclature of the identified species follows (ACAP), Pokhara, and prior informed consent (PIC) was standard literatures [56-61] and plant family assign- obtained verbally from each participant before they were ments follow the current Angiosperm Phylogeny Group interviewed. The project was approved by the Central [62]. Voucher specimens were also cross-checked with Department of Botany Research Committee of Tribhu- previously collected herbarium specimens from the van University. We followed the ethical guidelines Manang district that had been previously identified adopted by the ICE/International Society of Ethno- by the National Herbarium and Plant Laboratories, biology. We met with local community elders to explain Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 4 of 11 http://www.ethnobiomed.com/content/6/1/14 the research project methods and intent and initiated completed manuscript created as a result of this project participant recruitment only after approval by these will be returned to the participating communities, and community leaders. We employed random and snowball copies given to key people who collaborated in the sampling techniques to identify potential participants research. and interviewed a total of 202 people (109 men and 93 Interviews were conducted in the local Nepali or in women) representing a sample of the population across Gurung language dialect (translated by an interpreter), age groups (Figure 2). and data was collected by direct and participant-obser- Study participants included individuals from various vation of studyparticipantsinfieldsand forestsand ethnic and socioeconomic backgrounds, including through semi-structured interviews. Interview protocols Amchi healers, medicinal plant traders, farmers, hotel or and field observations all followed standard ethnobotani- shop owners or managers, footpath traders, home- cal methods [63-65]. Amchis who were influenced by makers, and village elders. However, the traditional deep practical knowledge of medicinal plants of Mus- senior and junior Tibetan doctors (Amchis) were the key tang district were interviewed during July 2005, Septem- source of information regarding medicinal plant use. ber 2006 and June 2007. A total of 75 days were spent The traditional healers of Mustang comprise senior in the study sites. At first interviews were conducted Amchis (Tibetan medicinal practitioners who see using the ‘specimen display’ method. After collecting patients in their clinics and teach students in medical plant specimens for research, we showed these fresh school), junior Amchis (student studying Amchi medi- specimens to the locals in order to elicit information. cine), plant traders (traders of Mustang medicinal plants The same plant specimens were shown to different peo- in major cities of Nepal), and knowledgeable villagers ple to confirm the accuracy of the results. When conve- (including herders, farmers, hotel owners etc). The local nient to the participants, they were asked to accompany knowledgeable villagers, healers and Amchis interviewed the researchers for a walk, allowing for both plant col- who consented to have their names and knowledge lection and detailed information gathering. A consensus published are listed in the acknowledgements. The index was created based on agreement in the medicinal Male Female 10-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 Informant Age (years) Figure 2 Study participants interviewed (villagers, healersand Amchis). Number of Informants Interviewed Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 5 of 11 http://www.ethnobiomed.com/content/6/1/14 use of the different species cited and is included in are popular throughout Nepal and are used to treat a Additional File 1. broad spectrum of ailments [12,15]. The study of the growth form of the medicinal plants Results and Discussion revealed that herbs made up the highest proportion of A total of 121 species belonging to 49 vascular plant medicinal plants represented 89 species followed by and 2 fungal families and 92 genera were reported and shrubs (17), trees (11), and climbers (4) (Figure 3). Simi- are indicative of the rich diversity of medicinal plant lar results were also obtained from previous studies on species found in this area. Study results are presented in the distribution pattern of life forms of medicinal plant alphabetical order by family and then followed by scien- species in the Nepalese Himalaya. Ghimire et al. 2008 tific name, voucher number, local vernacular names [14] revealed that 45-70% of the total naturally growing (Gurung/Thakali/amchi/Nepali), phenology, and detailed species are long-lived herbaceous perennials followed by uses - including methods of preparation, dosage and shrubs (16.6%), annual/biennial herbs (15.6%), tree administration of medicine (Additional File 1). The lar- (13.6%), woody climbers (6.5%), and herbaceous clim- gest number of medicinal species came from Asteraceae bers (2.3%). (18), which was followed by Ranunculaceae (8), Rosa- This study recorded that several parts of individual ceae (7), Lamiaceae (6), and Fabaceae (5) (Table 1). plant species are used as medicine. The most commonly These 121 species were found to treat 116 ailments used medicinal plant part was the root (30 species), fol- (Table 2), 92 of which were used to treat more than one lowed by flowers (23), fruits and leaves (19 each), stem disease and the remaining 29 species were used to treat (17), seed (11), bark and cone (2 each), and bulb (1). In only one disease (Additional File 1). We have added 58 addition to the above common parts used, whole plant new medicinal plants, noted with asterisks (Additional (49 species, 29%), were commonly uprooted (Figure 4). File 1), in addition to the previous works of [13,44,47]. The most commonly selected plant parts may be pre- Many of these newly added plant species for Mustang ferential because such parts contain more active Table 1 Division of medicinal plants and fungi documented by family designation. Families Species Proportion Families Species Proportion Alliaceae 3 2.48% Malvaceae 1 0.83% Amaranthaceae 1 0.83% Menispermaceae 1 0.83% Apiaceae 2 1.65% Morchellaceae 1 0.83% Araceae 2 1.65% Nyctaginaceae 1 0.83% Asparagaceae 1 0.83% Orchidaceae 1 0.83% Asteraceae 18 14.88% Orobanchaeae 1 0.83% Berberidaceae 4 3.31% Papaveraceae 3 2.48% Betulaceae 1 0.83% Phrymaceae 1 0.83% Bignoniaceae 1 0.83% Pinaceae 1 0.83% Boraginaceae 3 2.48% Plantaginaceae 2 1.65% Brassicaceae 3 2.48% Polygonaceae 4 3.31% Cannabaceae 1 0.83% Primulaceae 3 2.48% Caprifoliaceae 2 1.65% Ranunculaceae 8 6.61% Chenopodiaceae 1 0.83% Rosaceae 7 5.79% Clavicipitaceae 1 0.83% Salicaceae 1 0.83% Convolvulaceae 1 0.83% Saxifragaceae 2 1.65% Crassulaceae 1 0.83% Scrophulariaceae 1 0.83% Cupressaceae 4 3.31% Solanaceae 4 3.31% Elaegnaceae 2 1.65% Tamariaceae 1 0.83% Ephedraceae 1 0.83% Taxaceae 1 0.83% Ericaceae 2 1.65% Thymelaeaceae 1 0.83% Fabaceae 5 4.13% Urticaceae 1 0.83% Gentianaceae 2 1.65% Valerianaceae 2 1.65% Juglandaceae 1 0.83% Violaceae 1 0.83% Lamiaceae 6 4.96% Zingiberaceae 1 0.83% Liliaceae 1 0.83% TOTAL 121 100% Indicates fungal family. Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 6 of 11 http://www.ethnobiomed.com/content/6/1/14 Table 2 Aliments included in each illness category. Illness category Ailments Dermatological Allergy, boils, allergic skin, skin diseases, warts Fever Fever, chronic fever, lung fever, malarial fever Gastrointestinal Bile diseases, bile disorders, liver diseases, stomach diseases, diarrhoea, dysentery, gastritis, constipation, intestinal worms, anthelmintic, stomach swelling General health Chronic diseases, inappropriate medication, to counteract the effect of poison, anti-poison, food poisoning, hair long, hair black, gingivitis, mouth swelling, snake bite, vomiting, to remove lodged bones or spines, dehydration, cancer, eye diseases, poor vision, bone fractures, joint swelling, typhoid, diseases of air, diseases of wind, vitamin, tonic, nutritious, loss of appetite, periods of fatigue, low energy, edema, nose swelling, burns, cold, cuts, child birth, over flow of blood in menstruation, over flow of blood in child birth, menstrual disorders, pregnant women, nerve diseases, nerve dispersed condition, communicable diseases, bone spurs, hemorrhoids, pneumonia, digestive, blood diseases, to increase blood, blood circulation, blood deficiency, blood purifier, reduces fats, thins blood in coagulation period, blood pressure, vertigo/dizziness, nose bleeding, pulse rate, tuberculosis, heart diseases, pain near the side of heart Infections Infected wounds, skin wounds, wounds, infection, infection diseases Pain Headache, stomachache, rheumatism, body pain, leg pain, backbone pain, joint pain, hand pain, ear pain, chest pain, ribs pain, bodyache, numbness of limbs, black worms of teeth, tooth pain, tootache Respiratory Cough, sinusitis, tonsillitis, chronic lung diseases, chronic respiratory diseases, respiration, asthma, bronchitis Urinary Kidney stone, Kidney diseases, red color urine, diseases of urine, painful urination, excessive urination, diuretic, difficulty in passing urine Jaundice Jaundice principles in comparison to the least used parts. Leaves, roots, stems and flowers are physically more vulnerable to attack by herbivores or pathogens than the hardier bark or cones and may contain more chemical defense compounds in the form of biologically active secondary metabolites. However, several studies have indicated that large scale harvesting of roots, leaves, stems and flowers can have a negative influence on the survival and continuity of useful medicinal plants and hence Herb Shrub Tree Climber impacts sustainable utilization of plants [66]. Habi t Plant parts were generally prepared using hot or cold water (100 species) as the solvent, but occasionally Figure 3 Growth forms (habits) of the reported medicinal plant species. remedies were prepared with milk (14), honey (2), jag- gery (gur - unrefined, whole sugar- 2 species), ghee (2) and oil (1) (Figure 5). The Amchi explained that water is a common, readily available, and cheap solvent and the good solubility of active components in water made it Seed Cone Bulb Bark 6% 1% 1% commonly used in the traditional medicine preparation. 1% Other infusion materials such as milk, honey, oils, jag- Stem gery, and ghee are expensive and not always available Wh o le p lan t 10% 29% when needed. In addition, milk, oil, honey and ghee may be used for their properties to dissolve active phy- Root tochemicals that are not water soluble. Leaf 17% 11% Amchis recommended different forms of medication including paste (60 species), powder (48), decoction (35), tablet (7), pills (5), cold infusion (5), and others Flow er Fru it (Figure 6). This study often recorded the use of paste, 13% 11% powders and decoctions in comparison to tablet, pills Figure 4 Plant parts used in the preparation of medicine. and infusions. Most often standard medicines are Num ber of speci es Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 7 of 11 http://www.ethnobiomed.com/content/6/1/14 medicine is unique. For centuries, Amchi have been stor- Jaggery ing herbal medicine in a bag created from the skin of 2% Gh ee 2% M. chrysogaster skin, which is tied twice with thread. Tying the herbal medicine in M.chrysogaster skin allows it to remain effective for one to two years. Amchi use a Ho ney 2% Oil 1% stone slab in place of the electric grinder in the prepara- tion of medicine because theyfeelthatheatcreated by the grinder may degrade the active chemical constituents Milk 11% of plant powder and thus reduce the quality of the medi- cine. The powder is then mixed with water and a suffi- cient amount of additives - honey, jaggery, etc. Additives are added according to the need of the specific plant Water 82% powder to aid with the shape of the prepared pills Figure 5 Typesofdrugexcipientsused inthe preparationof (rounded, rectangular, etc). The process of boiling con- medicine. tinues and complete evaporation of the water makes it easy to form the medicinal mixture into the preferred prescribed in mixed ingredient form by mixing several shape. valuable medicinal plants and additives. Amchi believe The medicinal plant preparations were administered that using plant mixtures in the preparation of a medi- to the local people of Mustang through different routes cine is important as a single plant alone may not be suffi- including oral, topical, nasal and others. Oral (115 spe- cient to cure any disease completely, whereas the cies) was the most commonly used route of administra- combination of several medicinal plants increases the tion, and was followed by topical (36), nasal and others quality and efficacy of medicine. Similar observations (12) (Figure 7). Similar observations have also been have also been recorded amongst the Kani communities obtained in other ethnobotanical studies [66,68]. in India [67]. Amchis always collect local medicinal plants themselves. Certain zootherapeutic remedies, or medicines based on They stress that this is very important because they have animal products, were also recorded. Some common ani- extensive experience in the identification of Himalayan mal products used in the creation of medicines included medicinal plants. They worry that a misnamed or falsely tortoise bones and the horn and urine of the Himalayan collected sample may be dangerous and cause the death musk deer (Moschus chrysogaster). The Amchi traditional of a patient. This is particularly true in the case of Aconi- method of maintaining the good quality of herbal tum orochryseum and A. spicatum (Ranunculaceae). Fo r ms o f M e d icat io n Figure 6 Forms of medication used. Paste Powder Decoction Tablet Pills Infusion Eaten Raw Vegetable Smoke Nu mb er o f s p ec ies Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 8 of 11 http://www.ethnobiomed.com/content/6/1/14 The 121 medicinal plant species recorded from Mus- Nas al & tang were also used in miscellaneous categories of uses Others and hence such additional uses have added the value to 7% medicinal plant species. The majority of medicinal plant Topical species were used for food (33 species), fuelwood (27), 22% fence (24), fodder and ritual & religious (19 each), dec- oration (8), organic manure (7), dyes & soap and psy- choactive (3 each), and construction (2). However, many Oral (50 species) have only medicinal use (Figure 8). 71% Most of the documented medicinal plant species were collected from wild habitats where very few species like Figure 7 Routes of administration of medicinal plants remedies. Allium carolinianum, Allium wallichii, Prunus arme- niaca, etc. were also cultivated for regular use. Medic- inal plant species were used both in dried and fresh forms and are also collected and stored for future pur- A. spicatum is highly poisonous and is difficult to differ- pose. Autumn has been considered the best season for entiate from Aconitum orochryseum. Using the wrong spe- the collection of roots and spring for collection of cies by mistake can result in death. The medicine from this plant can only be prepared by highly experienced stems. Important days or months for the collection of Amchi. Medicine must be made by Amchi with other individual plants vary greatly and are known best by medicinal plants of the Himalaya, so that the poison of Amchi. The time of collection of plant parts for medi- that plant is inactivated without inactivating the other cine is also very important in capturing the active prin- medicinal properties. In Mustang, A.spicatum whole plant ciples. Therefore, Amchi strictly collect specific plant (mainly root) is used to make medicinal tablets by the parts during a specific time and use them to prepare Amchi to treat infected wounds; as a tonic to provide relief traditional medicine. Overall, the majority of locals con- from general weakness; to counteract the effects of poison, sider Amchi medicines and medical system to be effec- including inappropriate self medication, poison ingested tive and local people have a deep faith in them. on purpose or accidentally, poisonous animal stings or Several medicinal plants including Allium wallichii, bites; boils; fever; allergy and edema. It is never used alone Aconitum orochryseum, Cordyceps sinensis, Dactylorhiza and is always mixed with several other medicinal plants of hatagirea and Neopicrorhiza scrophulariiflora are col- the Himalaya. A paste of the roots is applied for allergy, lected from the local habitat as a source of cash income. boils, cuts, wounds and edema after mixing with other Such illegal mass collection of the important species is a type of unsustainable harvesting which leads to the medicinal plants. Di fferent categori es of use Figure 8 Other uses of medicinal plant species. No u se Food Fuelwood Fence Fodder Ritual & Religious Decoration Organic man ure Dye & soap Psychoactive Construction Percent Bhattarai et al. Journal of Ethnobiology and Ethnomedicine 2010, 6:14 Page 9 of 11 http://www.ethnobiomed.com/content/6/1/14 peoples of Mustang district of Nepal for providing us with their valuable exploitation from the natural habitat in the future. ethnobotanical information and co-operation, without which this work Therefore over-harvesting of important medicinal plants would not have been possible. We thankfully acknowledge Annapurna should be prohibited and monitored and immediate Conservation Area project (ACAP) for providing research permission for the field work. We would especially like to recognize and thank the following conservation and management approaches should be people for their participation in this study: Seta Nepali, Dhanbir BK, Man followed for the sustainable use of natural ecosystem of Prasad Thakali, Rupa Thakali, Maina Devi Thakali, Sana Devi Thakali, Bhim Mustang. Prasad Thakali, Suresh Sherchan, Lal Kumari Gauchen, Seram Gurung, Sonam Gurung, Maila Gurung, Chyaa Lama, Ram Chandra Thakali, Mangala Lalchan, Shyam Prasad Lalchan, Amchi Tsampa Ngawang Gurung, Amchi Thurthock Conclusion Lama, Amchi Nengma Lama, Chendhen Gurung, Laxhi Gurung, Nathue Traditional Amchi medical practitioners maintain a Gurung, Nophue Chiring, Indra Gurung, Bisnu Gurung, Rajhendra Thakuri, Chiring Gurung, Ghulii Chamang, Asmitha Gurung, Prem Gurung, Pasang great depth of knowledge on the subject of medicinal Gurung, Chiring Yanghung Gurung, Ghyangh Chusang Bista, Raju Bista, Maya plants. Medicinal plants still play a pivotal role in the Bista, Amchi Gyasto Bista, Tsering Wangmo Bista, Amchi Tensing Bista Lama, primary healthcare of the local people in the study area. Pema Dolma Bista, Chandup Gyato Bista, Chime Dolkar Bista, Tsewang Bista, Tashi Bista, Sonam Sangmo Bista, Rinzin Wangmo Bista, Tenzing Gurung, Due to the lack of Western medicine, modern govern- Khyamo Chiring Gurung, and Maya Gurung. ment health posts, difficult geography of the district as well as a strong cultural belief in the power of folk med- Author details Nepal Academy of Science and Technology, Khumaltar, Lalitpur, Nepal. icines, the Amchi system serves as a popular provider of Central Department of Botany, Tribhuvan University, Kirtipur, Kathmandu, primary healthcare in Mustang. Although such health- Nepal. University of Arkansas for Medical Sciences, College of Medicine, care practices have been in place for centuries in Mus- Little Rock, AR, USA. Community Medicine, Queens University, Kingston, Ontario, Canada. tang, they are at risk of being lost to future generations. This is due primarily to changes in socioeconomics of Authors’ contributions the region as younger generations are eager to migrate Author SB performed the interviews with the healers, identified the herbarium specimens with RPC and drafted and finalized the manuscript outside the country for employment. The continued with RPC, CLQ, and RSLT. Author RPC identified herbarium specimens with practice of training as an Amchi apprentice is necessary SB, supervised the research works and finalized the manuscript with SB. for the survival of this traditional medical knowledge. Author CLQ drafted and finalized the manuscript with SB. Author RSLT supervised the research works and drafted and finalized the manuscript with Although local efforts to conserve medicinal plant SB. All authors read and approved the final manuscript. resources are still inadequate, the long held traditional beliefs of the population regarding folk medicine has its Competing interests The authors declare that they have no competing interests. own unintentional role in conservation, management and sustainable utilization. While over-harvesting of Received: 19 September 2009 Accepted: 6 April 2010 some important medicinal plants has increased, many Published: 6 April 2010 Amchi are working towards both biological conservation References of the medicinal plants through sustainable harvesting 1. Hamilton AC: Medicinal plants, conservation and livelihoods. Biodiversity and protection of wild species and conservation of their and Conservation 2004, 13:1477-1517. cultural heritage. In some villages (Lete, Lomanthang, 2. Farnsworth NR, Soejarto DD: Global Importance of Medicinal Plants. 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