Title: Medicinal plants of the Achuar (Jivaro) of Amazonian Ecuador: Ethnobotanical survey and comparison with other Amazonian pharmacopoeias. Published on: Journal of Ethnopharmacology Cite as: Giovannini, P., (2015). Medicinal plants of the Achuar (Jivaro) of Amazonian Ecuador: Ethnobotanical survey and comparison with other Amazonian pharmacopoeias. Journal of Ethnopharmacology 164(4), 78-88. Author: Dr. Peter Giovanninia, b a: Natural Capital and Plant Health Department, Royal Botanic Gardens Kew, Wakehurst Place, Ardingly, West Sussex RH17 6TN, U.K. b: Centre for Biocultural Diversity, School of Anthropology and Conservation, Marlowe Building, University of Kent, Canterbury, Kent CT2 7NR, UK. Tel. +44 (0) 1444 894116 Fax. +44 (0) 1444 894110 e-mail: [email protected] Abstract Aim of the Study and Ethnopharmacological relevance This paper presents the first ethnobotanical survey conducted among the Achuar (Jivaro), indigenous people living in Amazonian Ecuador and Peru. The aims of this study are: (a) to present and discuss Achuar medicinal plant knowledge in the context of the epidemiology of this population (b) to compare the use of Achuar medicinal plants with the uses reported among the Shuar Jivaro and other Amazonian peoples. Materials and methods The author conducted field research in 9 indigenous villages in the region of Morona Santiago and Pastaza in Ecuador. Semi-structured interviews on local illnesses and herbal remedies were carried out with 82 informants and plant specimens were collected and later identified in Quito. A literature research was conducted on the medicinal species reported by Achuar people during this study. Results The most reported medicinal plants are species used by the Achuar to treat diarrhoea, parasites infection, fractures, wounds, and snakebites. Informants reported the use of 134 medicinal species for a total of 733 recorded usereports. Of these 134 species, 44 are reported at least 3 times for one or more specific disease condition for a total of 56 uses. These species are considered a core kit of medicinal plants of the Achuar of Ecuador. Most of these medicinal species are widely used in the Amazon rainforest and in many other parts of Latin America. Conclusion The author documented a core kit of 44 medicinal plants used among the Achuar of Ecuador and found that this core set of medicinal plants reflects local epidemiological concerns and the pharmacopoeias of the Shuar and other Amazonian groups. These findings suggest that inter-group diffusion of medicinal plant knowledge had a prominent role in the acquisition of current Achuar knowledge of medicinal plants. 1. Introduction The Achuar are indigenous people living in Amazonian Ecuador and Peru. They belong to the Jivaroan linguistic family together with the Shuar, the Aguaruna, and the Humabisa (Descola, 1996). To date no ethnobotanical and ethnopharmacological survey has been conducted among the Achuar. Some information on the plants used by the Achuar can be found as part of the ethnographical work about the Achuar compiled by Descola but this information has a limited ethnobotanical value as it is not backed by a collection of voucher specimens (Descola, 1996; Descola, 1997). Two other studies have described the ritualistic use of Ilex guayusa (Lewis et al., 1991) and reported about the medicinal use of Cyperus spp. (Lewis and Elvin-Lewis, 1990) among Achuar people. Therefore, this paper presents the first comprehensive ethnobotanical survey conducted among the Achuar. The aims of this paper are: (a) to present and discuss the medicinal plants known by the Achuar of Ecuador in the context of the epidemiology of this population (b) to compare the use of Achuar medicinal plants with the uses reported among the Shuar and other Amazonian peoples. The author expects to find a large overlap between Achuar pharmacopeia and Shuar pharmacopeia, as Achuar and Shuar have lived in contiguous areas for a long time and many cultural traits such as language are very related to each other (Descola, 1996). 2. Methods 2.1 Site description: The Achuar are an Amazonian indigenous group inhabiting north-eastern Peru and southern Ecuador in the basins of the Pastaza, Corriente and Morona river. Differently from many other indigenous people in the Americas, and facilitated by the fact that they inhabit a remote area of the Amazon forest, the Achuar have been able to defend their land and, to a certain degree, their lifestyle (Enfermeras para el mundo, 2009). Before their contact with missionaries at the end of the 1960s, the Achuar were semi-nomadic horticulturalist and hunters living in small and temporary settlements scattered in a vast territory (Descola, 1996). Although Achuar people living in Peru have traded with outsiders (white and mestizos) for more than a century, facilitated by the fact that Achuar territory in Peru can be accessed through the Marañon river (Descola, 1996), the Achuar of Ecuador had almost no peaceful contact with foreigners until the first contacts with missionaries (Salesians and American protestants) at the end of the 1960s (Descola 1996). In this period missionaries of the Summer Institute of Linguistics (SIL) started to work among the Achuar of Peru and later with the Achuar of Ecuador. They initially promoted the formation of permanent settlements (centros) around the landing strips that they used to enter in the area (Descola 1996) and in 1975 they started a program of cattle raising in Achuar settlements. Missionaries introduced also a formal education system (Descola, 1996). In the 1970s oil companies started petrol exploration in Achuar territory and began extracting oil from some of the Achuar territory in Peru. In the area where oil extraction took place, contamination of natural resources and their overexploitation has severely damaged the ecosystem and the health of Achuar people (Martínez et al., 2007). 2.2 Current population and lifestyle of the Achuar. As of 2006 the total population of the Achuar in both Ecuador and Peru was estimated to be 20000 (Ministerio de Salud del Peru, 2006). This population is distributed in small communities scattered over a territory of about the size of Belgium. Achuar’s subsistence economy is mostly based on horticulture and hunting but it is complemented by other activities such as cattle-raising and in few communities the cultivation of cash crops or the harvesting of wild plants. Both of these are sold for cash to external actors, such as NGOs and commercial companies, which use them as ingredients for herbal products and cosmetics. In Ecuador an estimated 6000 Achuar people live in 75 communities scattered in a territory (Figure 1 and 2) of about 681218 Hectares in the Cuenca Alta del Rio Pastaza in the Provinces of Morona Santiago and Pastaza (Enfermeras para el mundo, 2009). From outside the territory, the Achuar communities can be reached only by canoe or with small airplanes but these communities are connected to each other through a network of forest paths maintained by their inhabitants. The Achuar of Ecuador are organized politically through the Nacionalidad Achuar Ecuador (N.A.E.), an organization founded in the 1990s and formally recognised by the Ecuadorian state. Figure 1. The map shows the territory of the Achuar of Ecuador Figure 2. The map shows the territory of the Achuar of Ecuador. Achuar communities are grouped in several associations (associaciónes) indicated on the map. 2.3 Health and healing among the Achuar Information on the epidemiology and health system of the Achuar before their sedentarisation, which started in the late 1960s, is scarce. Descola (1996) reports that in the 1970s the Achuar considered witchcraft the major cause of sickness and illness. Accordingly, Descola observed that, although Achuar used many medicines, ill people mostly attended a Shaman (wishin). Currently, the most common health problems among the Achuar population are acute infectious diseases of the respiratory tract and of the gastrointestinal system, intestinal parasitic infections, dermatophytosis, bacterial infections of the skin, gastritis, malaria, leishmaniasis, urinary tract infections, arthritis, and tuberculosis. Dental disorders, snakebites, malnutrition, wounds and traumas are other frequent medical problems (Ministerio de Salud Peru 2006; personal communication Dr. B.RodrÍguez; Enfermeras para el mundo 2009). As of 2012 there is a main health post (subcentro de salud) in Wasakentsa, the Salesian mission, and in five other Ecuadorian Achuar communities there are other smaller health posts (puestos de salud) where patients can be attended and medicines are dispensed at no cost. These health posts are under the jurisdiction of the Ecuadorian Ministry of Health. In several communities there are also Achuar health workers (promotores de salud) mostly men, elected by the community to be trained by external actors (a local NGO) on primary health care. They manage the botiquin, a place where the medicines are stocked, and dispense medicines to patients that visit them. Achuar health workers also refer severe cases to the health personnel (auxiliares de salud) based in the health posts who decide if it is necessary to call by radio a flight to transfer the patient into an hospital outside of the Achuar territory. While Achuar communities have received few times medicines at no cost from the government and from other external actors, several communities are now organised to buy collectively medicines, which are considered essential, when the stocks are depleted. With an increasing trust toward the efficacy of biomedicine, the abuse of pharmaceuticals, such as lack of compliance with recommended mode of use and administration, has become widespread in the last 20 years (Vanesa Mojena personal communication). In many cases pharmaceuticals are used empirically and local knowledge about their use is developing among Achuar people as it has been observed elsewhere in Latin America (Giovannini and Heinrich, 2009). 2. 4 Field research Field research was conducted by the author between July and October 2011 in the Salesian missionary centre of Wasakentsa and in 9 indigenous villages in the region of Morona Santiago and Pastaza in Ecuador: Sewastian, Kaiptach, Tsunkintsa, Mashumarentsa, Juyukamentsa, Saapapentsa, Wichimi, Achuar, Yutsuntsa. Herbarium specimens were collected and dried following standard ethnobotanical methods and identified and deposited in Quito at the Herbario de la Universidad Central del Ecuador (QCA), Herbario Nacional de Ecuador en Quito (QCNE) and Herbario de la Universidad Central del Ecuador (QAP). Table 3 in Appendix A shows voucher numbers and where these are deposited. Plant names were later checked with The Plant List (www.ThePlantList.org). The research was part of a larger EU-funded project1 that aimed to reduce contamination in the Achuar territory and was motivated by the observation that pharmaceuticals discarded in the environment are contributing significantly to contaminate Achuar territory. Therefore, as part of a wider strategy to reduce contamination, the project aimed to support the use of medicinal plants among the Achuar as part of a health care system that integrates the use of both traditional and western medicine and minimise contamination caused by the misuse of pharmaceuticals. Permits to conduct the research were obtained from both Ecuadorian (Ministry of the Environment) and Achuar institutions (N.A.E.). According to Article 8(j) of the Convention of Biological Diversity, the objectives, methodology and expected outputs of this study, including the benefits shared with the Achuar and the publication of a research paper, were agreed with the president and the coordinator of the N.A.E. Before starting the research in each community, the aims and outputs of the research were explained and discussed in Achuar language during community meetings. As part of the benefit sharing outputs that were agreed with Achuar leaders a deliverable of this project was a manual on Achuar medicinal plants that was distributed to health promoters in 1 ACRA/EU -ECUMON ProjectWaste management and pollution reduction in the Municipality of Taisha and in the Achuar territory - NSAPVD/2010/259-173 all 75 communities and to Achuar general population a few months after the research took place. In total 1000 copies of the manual of Achuar medicinal plants were also distributed among the population and 22 workshops were conducted to disseminate the results of the research with the participation of more than 330 individuals. The results were also used to design a nursery of medicinal plants in Wasakentsa. In March 2013, the results of the research were also shared at the annual assembly of the N.A.E. . 2.5 Data collection and data analysis The author collected epidemiological data from both the perspective of the medical personnel working in the area and from the perspective of the Achuar people. More specifically, the author conducted open and semi-structured interviews with the medical doctor (Dr. B. RodrÍguez) who has worked for about 30 years in the area and with two nurses. This information, together with pilot interviews with 7 Achuar informants, were used to select a list of common medical problems in the area (table 1) that were used as the main focus of the semi-structured interviews on medicinal plants carried out with 82 informants (49 males and 33 females). This sample includes any adult (age≥18) respondent, in the 9 villages where the study was conducted, that was willing to participate in the study. Considering that 63% of Achuar population is under 18 (this figure was estimated by calculating the average from 14 communities where demographic data were available), the sample of this study represents 3.7% of the estimated Achuar adult population in Ecuador (6000 individuals). In the first part of each interviews the researcher asked the informant to list “the most common health problems in the area”, this methodology is commonly referred as freelisting (Borgatti, 1999). These data complemented the epidemiological data collected at the beginning of the study. The second part of the interview focused on the informant’s knowledge of medicinal plants that can be used to cure the illnesses in table 1. Informants were asked which medicinal plants they know to cure each of these illnesses and, for each use report described, information on the preparation and administration of the remedy was recorded. In some case informants spontaneously reported the use of medicinal plants for illnesses not in table 1 and the author recorded this information. Interviews were tape recorded (verbal permission to record the interviews was asked at the beginning of the interview). With the exception of few interviews conducted with informants fluent in Spanish, interviews were conducted in Achuar language and facilitated by a bilingual Achuar-Spanish translator. Plant specimens were collected by means of walks in the woods with the informants, walks in households’ gardens following interviews, or by asking people to collect them and bring them to the researcher. Plant specimens were conserved with alcohol (Schweinfurth method) during fieldwork and later pressed and dried in Macas, Morona Santiago, Ecuador. TABLE 1. Medical problem (English) Diarrhoea Malaria Common cold Leishmaniasis Intestinal parasites Snakebite Wounds Splints, sprains and broken bones Rheumatism Medical problem (Spanish) Diarrea Paludismo Gripe Leishmaniasis Bichos Picadura de culebra Heridas Huesos quebrados Dolor de huesos Table 1. List of common medical problems in the area selected as focus of the semi-structured interviews on medicinal plants carried out with 82 informants Data analysis Each use reported during an interview was entered in a database. To discern plant uses that are idiosyncratic from plant uses that are shared and part of the “basic medical kit” of the Achuar, plant uses that have been reported independently by at least 3 informants were selected for further analysis. 3. Results and discussion 3. 1 Ethnoepidemiology: The result of the free list on most common illness and medical problems is shown in table 2. These ethno-epidemiological data match well with the epidemiological data available in literature (Ministerio de Salud del Peru 2006) and the epidemiological information given by the medical doctor working in the area. The Achuar perceive acute infective disease of the gastrointestinal system, acute respiratory infection and malaria as the most common illnesses in the area. Rheumatism, tuberculosis, leishmaniasis, gastritis and snakebites are also perceived as common health concerns in the area. Only 9% of the respondents reported witchcraft as a common cause of health problems. This is a relatively low percentage considering that previous ethnographic work on the Achuar emphasizes the role of witchcraft in their medical system (Descola, 1996). This low rate is likely due both to response bias caused by the researcher and changes in medical beliefs that have occurred in the last 40 years. According to the medical doctor that worked in the area since 1980s, belief in witchcraft was predominant when she started to work in the area. While Achuar beliefs in witchcraft has diminished (but not disappeared) the Achuar have acquired new beliefs regarding the use and efficacy of biomedicine and there is a growing concern for the misuse of pharmaceuticals. TABLE 2. English Spanish 1 2 3 4 5 6 7 Diarrhoea Fever Malaria Common cold Headache Cough Rheumatism 8 9 10 11 12 13 Stomach ache Tuberculosis Leishmaniasis Hepatitis Gastritis Whooping cough Intestinal parasites Snakebite Abscess Witchcraft Pneumonia Vomiting Wounds Measles Body aches Urinary infections Toothache Dizziness Diarrea Fiebre Paludismo Gripe Dolor de cabeza Tos Reumatismo, Dolor de huesos Dolor de estomago Tubercolosis Leishmaniasis Hepatitis Gastritis Tos ferina 14 15 16 17 18 19 20 21 22 23 24 25 Frequency Percentage 51 38 36 24 18 18 15 65 49 46 31 23 23 19 Smith's S index 0.491 0.359 0.346 0.221 0.144 0.126 0.111 14 12 8 7 10 5 18 15 10 9 13 6 0.106 0.083 0.069 0.064 0.063 0.054 Bichos 5 6 0.051 Picadura de culebra Absceso Brujeria Pneumonia Vomito Herida Sarampion Dolor de cuerpo Problema de orina 8 8 7 7 8 4 3 6 4 10 10 9 9 10 5 4 8 5 0.049 0.049 0.045 0.043 0.038 0.031 0.024 0.023 0.022 Dolor de muela Mareo 3 3 4 4 0.02 0.02 Table 2. The result of the freelist on most common illness problems. Frequency: frequency of mention during freelisting. Percentage: percentage of informants that mentioned the item (illness); Smith’s S index: Smith’s S index (Smith, 1993) of salience varies between 0 (least salient) and 1 (most salient) and it takes in accounts both frequency and rank order of the item in each list. 3. 2 Medicinal plants of the Achuar: In total, informants reported the use of 134 medicinal species for a total of 733 recorded use-reports. Of this 134 species 44 are reported at least 3 times for one or more specific disease condition for a total of 56 uses for which consensus was found. These medicinal plants are shown in the Table 3 in Appendix A. The most represented botanical families are Solanaceae (3 species), Leguminosae (3 species), Rubiaceae (2 Species), Cyperaceae (2 species), Euphorbiaceae (2 species), Moraceae (2 species). These families are well known for having a high percentage of medicinal species, which reflect their phytochemistry. Cyperaceae are usually underrepresented as medicinal species but several studies have already reported the wide medicinal use of Cyperaceae among Amazonian peoples (Lewis and Elvin-Lewis, 1990; Plowman et al., 1990). Preparations of Achuar herbal remedies The most common way of preparing remedies among the Achuar consists of preparing decoctions by boiling plant parts in a large amount of water until this is considerably reduced and coloured by plants phytochemicals. In some of the decoctions sugarcane is added to prepare medicinal syrups. These preparations are administered orally and in many cases the patient is expected to vomit after having taken the medicine. Respondents explained also that children that have not yet “learnt how to vomit” are not allowed to take these remedies. Accordingly, Lewis (1990) described how Achuar emesis after the consumption of a drink of Ilex guayusa is learned rather than physiological. Some of these remedies are prepared with several plant species and in few cases respondents explained that they “invented” the mixtures. Achuar people are also aware of the possible adverse effects that can arise from mixing some plant species in medicinal preparations, as several respondents warned that some species must not be used together. For example, using the leaves of Ilex guayusa and Psidium guajava in the same decoction is said to produce a poisonous beverage. Some remedies are prepared without cooking the ingredients but rather by crushing, grating and mashing plant parts in water and then filtering the water with a sieve. For example, the rhizome of Cyperus spp. are chewed and then mixed with water, which is finally filtered before administration. Oral preparations (both decoctions and uncooked preparations) are often administered three times a day in a dosage that is related to the age of the individual treated. In some preparations Achuar people grate part of the bark, or the seed, of some species and then use the powder obtained either as ingredients for oral preparations or for topical application. For example the bark of Ceiba pentandra is applied to external lesions. The raw latex of some plant species is used internally and/or externally such as, for example, the latex of Croton lechleri and Ficus insipida. Another type of preparation consists in reducing herbal mixtures to ashes and then apply these on leshmaniasis lesions. A cloth may be used to hold the preparation on the lesions. Young tender leaves of some species, such as Jacaranda copaia, are rubbed on the skin to treat skin mycosis and other dermatological problems. 3. 2.1 Medicinal uses Musculoskeletal disorders and traumatic injuries Brugmansia insignis (19 Use Reports or UR) is commonly used by the Achuar to treat fractures and sprains. Other species with thick leaves or stems, such as Hylocereus sp. (11 UR), Phthirusa pyrifolia (4 UR), Opuntia ficus-indica (4 UR) are also used to treat fractures and sprains. Hay et al. (2012) reported the same use of Brugmansia insignis Among the Shuar and De Feo (2004) reports similar uses of this species in the Peruvian Andes. P. pyrifolia is used similarly among the Quichua (Alarcón, 1988) . Decoctions of the leaves of Mansoa alliaceae (4 UR) and Brunfelsia grandiflora (4 UR) are warmed and applied externally with bandages to treat the same condition. Previous studies reported the use of M. alliaceae to treat arthritis among Quichua (Alarcón, 1988) and the use of B. grandiflora to treat rheumatism and other ailments (Broseghini and Frucci, 1986; Schultes and Raffauf, 1990). To treat rheumatisms and body aches the Achuar use also the urticant leaves of Urera baccifera (6 UR) and Urera laciniata (3 UR). Affected areas of the body are hit with the leaves and are then massaged. U. baccifera is used similarly among the Shuar of Ecuador (Bennett et al., 2002) and the Sionas of the Columbian Putumayo uses U. baccifera and U. laciniata to treat muscular pains (Schultes and Raffauf, 1990). Gastrointestinal complaints Psidium guajava (40 UR), Croton lechleri (14 UR), Crematosperma cauliflorum (13 UR), Cyperus prolixus (12 UR), Musa x parisidiaca (18 UR), Zingiber officinale (18 UR) and Citrus aurantifolia (19 UR) are the most reported medicinal plants used to treat diarrhoea and dysentery. Croton lechleri (3 UR) is also used to treat stomachache. P. guajava is widely used in tropical regions to treat gastrointestinal conditions (Gutiérrez et al., 2008). Similarly there are many reports of the use of C. lechleri to treat diarrhoea (Carlson and King, 2000; Odonne et al., 2009; Ubillas et al., 1994). The Shuar and other Amazonian indigenous group use Z. officinale to treat diarrhoea and other gastrointestinal conditions (Schultes and Raffauf, 1990). Musa x paridisiaca is used similarly among the Shuar (Bennett et al., 2002). The use of Cyperus prolixus to treat several illnesses including diarrhoea has been already reported among indigenous Amazonian people (Plowman et al., 1990). C. aurantifolia is a widely used ingredient of herbal remedies and a similar use was documented among the Chayahuita of the Peruvian Amazon (Odonne et al., 2013). Citrus sinensis is used similarly by indigenous people living in the Indigenous Territory and National Park Isiboro-Secure (Thomas and Vandebroek, 2006) and in other parts of Latin America (Heinrich et al., 1998). Carica papaya (22 UR) and Ficus insipida (16 UR) are the most commonly reported species used to treat intestinal parasites. Bennett (2002) reported the same use of C. papaya among the Shuar and the use of both species for intestinal parasites have been widely documented in Amazonian societies (Schultes and Raffauf, 1990). Skin-disorders Wounds are treated by applying directly on the lesions the latex of C. lechleri (24 UR), a poultice made of leaves of Brugmansia insignis (UR 5), a powder obtained from the bark of Parkia multijuga (UR 4), the chewed leaves of Ilex guayasa (3 UR) or the chewed liverwort Plagiochila cf. subplana (UR 5). The Shuar use C. lechleri (Bennett et al., 2002) and Brugmansia insignis (Hay, Gottshcalk and Holguin 2012) similarly. Alarcon (Ríos et al., 2007) reported the use of Parkia sp as vulnerary among the Quichua. Himathanthus sucuuba is used to treat abscess (3 UR). This species has been reported as a remedy used for wound healing (Bourdy et al., 2000; Villegas et al., 1997) and to treat leishmaniasis lesions in other parts of the Amazon (Castillo et al., 2007; Odonne et al., 2009). Snakebites Adenostemma fosbergii (15 UR), Mucuna sloaneii (6 UR), and an unidentified Leguminosae species are the most reported remedies to treat snakebite. The use of the first has been reported also among the Shuar (Bennet et al 2002) while several Mucuna species have been reported as remedies for snakebites in different part of the world (Coe and Anderson, 2005; Molander et al., 2012). Respiratory disorders Decoctions made with the rhizome of Zingiber officinale (14 UR) or the leaves of Cymbopogon citratus (6 UR) and Mansoa alliacea (5 UR) are the most reported remedies used to treat common cold and cough. Bennett et al. (2002) and Gerique-Zipfel (2011) reported the use of these species to treat respiratory disorders among the Shuar. C. citratus and Z. officinale are widely used worldwide to treat common cold and cough (Bennett and Prance, 2000; Ross, 2005). Alarcon (1988) reported the use of M. alliacea among Quichua to treat fever. Parasitic diseases To treat malaria the Achuar use several medicinal plants. The leaves of Nicotiana tabacum (8 UR) are crushed in water and sometimes mixed with Chicha (a drink based on fermented manioc). A decoction of the roots of Urera baccifera (7 UR) is drunk and vomited. The roots of Bactris gasipaes (UR 3), the internal part of the bark of Guarea grandifolia (3UR), and the roots of Euterpe precatoria (3 UR) are prepared and administered similarly. A decoction made with the leaves of Hamelia patens (6 UR) is drunk to treat malaria. Similarly a decoction of the leaves Banisteriopsis capii (5 UR) is drunk and then vomited to treat the same condition. A decoction of the bark of Grias neuberthii is used to treat malaria (UR 3). Previous studies showed similar uses in Amazonia for Hamelia patens (Valadeau et al., 2009), Grias neuberthii (Schultes and Raffauf, 1990), Bactris gasipaes (Balslev et al., 2008) and Euterpe precatoria (Bertani et al., 2005; Kvist et al., 2006; Ruiz et al., 2011). Valadeau et al. (2010) reported the use of Urera laciniata to treat malaria among the Yanesha and Sans-biset el al. (2009) reported the use of Guarea macrophilla to treat the same condition in the Peruvian Amazon. Interestingly a bark infusion of Guarea grandifolia was reported “to cause vomiting and intoxication” (Boom and Moestl, 1990) two of the physiological reactions that Achuar expect when treating malaria. Banisteriopsis capii is widely used throughout the Amazon to treat many diseases (Schultes and Raffauf, 1990) but there are no reports of the use of this species to treat malaria among the Shuar. To treat mucosal leishmaniasis the Achuar use also the juice extracted from the leaves and stem of Mansoa alliacea (UR 3). A powder obtained from the bark of Minquartia guianensis (3 UR) is applied externally on lesions and remedies from Cedrela odorata (3 UR) and Ceiba pentandra (3 UR) are prepared and administered similarly. Finally, the Achuar use also a poultice made with the leaves of Jacaranda copaia (3 UR) to treat leishmaniasis. Previous studies reported the same use of M. guianensis (Gachet et al., 2010), C.odorata (Kvist et al., 2006; Odonne, 2010), J. copaia (Gachet and Schühly, 2009), and C. pentandra (Odonne et al., 2011) by other peoples inhabiting the Amazon but there are no reports of the use of these species to treat leishmaniasis among the Shuar. Gynaecological or reproductive conditions Cyperus articulatus (3 UR) and Zingiber officinale (4 UR) are used to limit pain during childbirth. Zingiber officinale (5 UR) is also used after copious blood loss during childbirth. 4. Discussion The epidemiological profile of the population of the Achuar of Ecuador, with a high incidence of acute infectious diseases, it is typical of societies that transitioned from a nomadic, semi-nomadic lifestyle to a sedentary lifestyle (Alexiades and Peluso, 2009; Dounias et al., 2004; Dounias and Froment, 2011; Freedman and Kroeger, 1984; Hern, 1991). Accordingly, the most reported medicinal plants are species used by the Achuar to treat diarrhoea, parasitic infection, fractures, wounds, and snakebites, although the author of this paper recognises that this result may have been biased by the focus of the interviews on the diseases in Table 1. Interestingly, while wounds, fractures and snakebites are likely to have been an important cause of illness and death in the pre-sedenterised Achuar society, gastrointestinal infections and parasites are likely to have been minor illnesses in the past as these are unlikely to spread in semi-nomadic societies (Dunn, 1968; Polunin, 1967). Most of these medicinal species are widely used in the Amazon and most of them in many other parts of Latin America. 21 out of 56 (37%) uses on which there is consensus at species level have been reported also among the Shuar and 49 out of the 56 uses reported (i.e. 87%) at the species level have been reported also among other Amazonian peoples. However, it is interesting to note that the most reported medicinal plant, Zingiber officinale, is an introduced species native of Asia (Ross, 2005). Similarly to the observations of Descola (1996), a Salesian priest who has spent considerable time in Achuar communities at the beginning of their contact with western culture (Salesian priest personal communication) stated that, while some medicinal plants were commonly used, pre-sedenterisation Achuar medical system was mainly based on witchcraft and the consultation of a wishin (Shaman) rather than the use of medicinal plants. Although no baseline data is available as a benchmark of comparison, the findings of this study suggest that today’s Achuar pharmacopoeia is likely the result of how local knowledge of medicinal plants has adapted to a relatively recent epidemiological change and of the effect of the increasing contact with other indigenous groups and outsiders rather than the results of the accumulation of botanical lore during centuries of isolation. The epidemiological shift and the arrival of new diseases likely fostered the acquisition of new ethnobotanical knowledge through exchange of information and experimentation. However, the introduction of western medicine by missionaries during the process of sedenterisation may have diminished the incentive for the acquisition of new ethnobotanical knowledge. The findings of this study suggest that inter-group diffusion of knowledge (exchange of information) had a prominent role in the acquisition of Achuar botanical knowledge. For example, it is likely that contact with the Shuar, facilitated by linguistic and geographic proximity, highly influenced Achuar pharmacopeia. The Shuar have been in contact with western civilization long before the Achuar (Descola, 1996; Rubenstein, 2001) and its possible that also their pharmacopeia was highly influenced by the changes due to sedenterization that took place later among the Achuar. If this occurred, than the Achuar would have conveniently found in the ethnobotanical knowledge of the Shuar remedies for the new diseases introduced through the epidemiological shift. The findings and observations of this study fit with Davis and Yost hypothesis that the pharmacopeias of some Amazonian indigenous people “reflect at least in part the chaos of contact and the accelerated experimentation that took place in post-contact times” (Davis and Yost, 1983). 5. Conclusion In conclusion, the author documented a core kit of 44 medicinal plants used among the Achuar of Ecuador and found that this core kit of medicinal plants reflects local epidemiological concerns and the pharmacopeia of the Shuar and other Amazonian groups. Future studies on Achuar medicinal plants, could use the findings of this first ethnobotanical study of the Achuar of Ecuador as a baseline data to evaluate change in ethnobotanical knowledge and practices among this Amazonian people. Acknowledgements: Thanks to all the Achuar people and communities that have participated in this study. Thanks to Pietro Graziani and to Adriana Sousa for assistance in organising the logistical aspects of the field research. Thanks to the staff of the Herbario de la Universidad Central del Ecuador (QCA), Herbario Nacional de Ecuador en Quito (QCNE) and Herbario de la Universidad Central del Ecuador (QAP) for assisting with plant identification. Thanks to Dr. Sarah Edwards and Dr. Melissa Ceuterick for useful feedback on this manuscript. This research was funded by ACRA/EU -ECUMON Project-Waste management and pollution reduction in the Municipality of Taisha and in the Achuar territory - NSAPVD/2010/259-173. References: Alarcón, R., 1988. Etnobotánica de los Quichuas de la Amazonía Ecuatoriana. Miscelánea Antropológica Ecuatoriana Ser. Monogr 7, 1– 183. Alexiades, M.N., Peluso, D.M., 2009. 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Villegas, L.F., Fernández, I.D., Maldonado, H., Torres, R., Zavaleta, A., Vaisberg, A.J., Hammond, G.B., 1997. Evaluation of the wound-healing activity of selected traditional medicinal plants from Peru. Journal of Ethnopharmacology 55(3), 193–200. Appendix A Species Family Specimens Asteraceae APG20, 2 APG67 , 3 APG77 Arecaceae APG89 - Malpighiaceae APG23 - Brosimum sp. Moraceae APG62 - Brugmansia insignis (Barb. Rodr.) Lockwood ex R.E. Schultes Solanaceae APG10 - Brugmansia insignis (Barb. Rodr.) Lockwood ex R.E. Schultes Solanaceae Brunfelsia grandiflora D. Don Solanaceae APG10 1 APG60 1 APG74 2 APG78 Carica papaya L. Caricaceae Cedrela odorata L. Meliaceae Adenostemma fosbergii R.M.King & H.Rob. Bactris gasipaes Kunth Banisteriopsis caapi (Spruce ex Griseb.) C.V. Morton PU Use L R or L Snakebite (15) 2 Nateem L 1 Kustanch Lx Malaria (5) Dysentery (5), Diarrhea (4) 1 Maikua, Floripondio S Fractures and sprains (19) 1 Maikua, Floripondio S& L Wound healing (5) Chirikiasip L Rheumatism (4) Papaya Kanu, Cedro Se Parasites (22) Leishmaniasis (3) 1 Preparation Use reported in the Amazon Use reported among the Shuar (Use Reports) Araraats Uwi, Chonta 1 APG13 Local name (Achuar in italics) B Malaria(3) Leaves are crushed and mixed with water, used orally. Decoction, used orally and then vomited (Balslev et al., 2008) Decoction is drunk and then vomited (Ruiz et al., 2011) - raw latex used orally The stem is scraped and squezed to extract juice, the juice is drunk and applied externally with bandage. The stem is scraped and squezed to extract juice and applied externally with bandage. The leaf is roasted, grounded and then applied on the wound na na (Schultes and Raffauf, 1990) (Hay et al., 2012) - (Hay et al., 2012) Decoction is used orally Seeds are crushed and mixed with water, used orally Internal part of the bark is scraped and (Schultes and Raffauf, 1990) (Broseghini and Frucci, 1986) (Rutter, 1990) (Kvist et al., 2006; Odonne, 2010) (Bennett et al., 2002) - (Broseghini and Frucci, 1986) - Species Family Ceiba pentandra (L.) Gaertn. Bombacaceae Citrus aurantifolia (Christm. ) Swingle Rutaceae Citrus sinensis (L.) Osbeck Cremastosperma cauliflorum R. E. Fr. Cremastosperma cauliflorum R. E. Fr. Croton lechleri Müll. Arg. Croton lechleri Müll. Arg. Croton lechleri Müll. Arg. Cymbopogon citratus (DC.) Stapf. Specimens APG15 1 Local name (Achuar in italics) PU Use Preparation Rutaceae Annonaceae Mente' B Leishmaniasis (3) Limon F& J Diarrhea (19) Naranja L Annonaceae Euphorbiaceae Euphorbiaceae Euphorbiaceae Poaceae APG90 APG90 APG90 1 1 1 Mantach, Quinina Mantach, Quinina Uruch numi, Sangre de drago Uruch numi, Sangre de drago Uruch numi, Sangre de drago Hierba luisa Use reported among the Shuar (Odonne et al., 2011) - (Use Reports) applied on the lesion Bark powder is applied externally Fruit or juice is added to preparations with other species Decoction, used orally B Diarrhea (4) Diarrhea (10), Dysentery (3), Colic (1), Stomach pain (1) (Odonne et al., 2013) (Thomas and Vandebroek, 2006) Decoction - Decoction - Lx Malaria (4) Wound healing (24), Leishmaniasis (1) 1 APG97 1 APG128 3 APG107 , 3 APG115 , APG115b 2 , 1 APG129 - Use reported in the Amazon Lx Diarrhea (13), Dysentery (1), Latex is applied on the lesion Raw latex is used orally (Maxwell, 1990) (Carlson and King, 2000; Odonne et al., 2009; Ubillas et al., 1994) - (Bennett et al., 2002) (Bennett et al., 2002) (Bennett et al., 2002) (Bennett et al., 2002) Lx Stomach ache (3) L Common cold (6), fever (2) Raw or cooked, used orally Decoction is drunk or the water is used to bath (Vásquez, 1994) (Grenand et al., 1987) (Bennett et al., 2002) Species Family Specimens Local name (Achuar in italics) PU Use Preparation R (Use Reports) To limit childbirth pain (3) Root chewed with water and then the water is drunk 2 Cyperus prolixus Kunth Cyperaceae APG22 , 2 APG50 2 APG51 3 APG24 , 3 APG55 , 1 APG68 , 3 APG146 Dieffenbachia sp. Araceae APG121 Arecaceae APG101b 2 , APG101 Moraceae APG19 , 2 APG111 , Malvaceae APG45 , 1 APG117 Cyperus articulatus L. Euterpe precatoria Mart. Cyperaceae 1 1 22 Ficus insipida Willd. Gossypium barbadense L. Gossypium barbadense L. Grias neuberthii J. F. Macbr. Guarea grandifolia (L.) Sleumer 2 2 Lecythidaceae APG45 , 1 APG117 3 APG32 , 2 APG12 , 1 APG131 , 1 APG141 Rubiaceae APG81 - Malvaceae 1 Piripiri Piripiri R Sunkip (camacho) S Diarrhea (12) Wound healing (3), Snakebite (1) Saké R Malaria (3) Seem, Wampu' Lx Intestinal parasites (16) Uruch, Algodon L Diarrhea (5) Uruch, Algodon uF Ear ache (8) Apai, Huevo de burro B Malaria (3) Pamasuki B Malaria (3) Crushed with water or chewed and then used orally Stem is scraped and applied on lesion Decoction is used orally Latex with water (somtimes cooked) is used orally Decoction sometimes P.guayava leaves and bark and lemon fruits are added Fruit is roasted and then the tip is cut, the fruit is squeezed and drops are appliead inside the ear scraped bark is mixed with water and boiled, decoction is drunk and vomited Powdered bark is mixed with water and Use reported in the Amazon Use reported among the Shuar (Bennett et al., 2002) (Duke, 2008) (Bennett et al., 2002) (Plowman et al., 1990) na (Bertani et al., 2005; Kvist et al., 2006; Ruiz et al., 2011) na (Vásquez, 1994) - - (Rengifo-Salgado, 2010) (Grenand et al., 1987; Luziatelli et al., 2010) - (Schultes and Raffauf, 1990) - - - Species Family Specimens Local name (Achuar in italics) PU Use Hamelia patens Jacq. Rubiaceae Himatanthus sucuuba (Spruce ex Müll.Arg.) Woodson Apocynaceae APG4 Hylocereus sp. Cactaceae Ilex guayusa Loes. Aquifoliaceae APG93 1 Ilex guayusa Loes. Aquifoliaceae APG93 1 Inga edulis Mart. Mimosaceae APG44 1 Bignoniaceae Leguminosae Leguminosae Euphorbiaceae Tsapuk L Malaria (7) Apach B Abscess (3), Ikiamanch S Fractures and sprains (10) Wayus L L Wampaa, Guava 2 Jacaranda copaia (Aubl.) D.Don Manihot esculenta Crantz 1 APG109 1 APG14 1 APG149 1 APG152 Diarrhea (3) Wound healing (3) used orally and then vomited Decoction is used orally Bark is scraped and applied on the lesion Gel/Juice is extracted and then both applied externally and used orally Decoction is used orally Chewed and applied on lesion Decoction is used orally mixed with P. guayava Kuiniap (Kuiship) L Diarrhea (5), Dysentery (1), Leishmaniasis (3), Dermatological (1) Kuup B Snakebite (16) Leaves are crushed and applied externally Scraped bark releases liquid, which is drunk Malaria (3) Peeled and cooked roots are fermented to make chicha and then juice from leaves of Nicotiana tabacum are added, used orally Yuca Use reported in the Amazon Use reported among the Shuar (Use Reports) 2 APG42 1 APG28 Preparation B R (Valadeau et al., 2009) (Odonne et al., 2013; Schultes and Raffauf, 1990) na (Schultes and Raffauf, 1990) antiseptic use in (De Feo, 1992) - - na - - (Gerique-Zipfel, 2011) (Gachet and Schühly, 2009; Plotkin, 1993) (De la Torre et al 2007) na (Vásquez, 1994) reported for Fever. (In this case the plant is used to create the administration drink while the active ingredient is probably na - Species Family Specimens Local name (Achuar in italics) PU Use Preparation Use reported in the Amazon Use reported among the Shuar (Use Reports) nicotiana tabacum) Mansoa alliacea (Lam.) A.H. Gentry Mansoa alliacea (Lam.) A.H. Gentry Mansoa alliacea (Lam.) A.H. Gentry Bignoniaceae APG3 Kaip, Ajo del monte Kaip, Ajo del monte 1 Bignoniaceae L L Bignoniaceae Kaip, Ajo del monte L or R Mansoa alliacea (Lam.) A.H. Gentry Bignoniaceae Kaip, Ajo del monte Mansoa alliacea (Lam.) A.H. Gentry Bignoniaceae Kaip, Ajo del monte L& S L, S& R Minquartia guianensis Aubl. 2 Olacaceae APG82 1 APG63 Paini, Wambula B Common cold (6) Disease prevention (4) Decoction used orally and to bath Fumigation by burning leaves on a fire Leaves are boiled in water, which is used to bath. Root is boiled in water and the decoction is drunk Crushed and squeezed to extract juice, which is applied on lesion (Grenand et al., 1987) (Grenand et al., 1987) Leishmaniasis (3) Decoction is drunk External layer of the bark is reduced in powder and applied on lesion Snakebite (6) Diarrhea (18) The seed is split and the internal part is scraped and mixed with water. Used orally. Latex is used orally Fever (3) Mucosal leishmaniasis (3) Rheumatism (4) 3 Mucuna sloanei Fawc. & Rendle Musa x paridisiaca L. Fabaceae Musaceae APG76 2 APG76b 1 APG72 1 APG94 Wapaa Majench, Se Lx - (Grenand et al., 1987; Schultes and Raffauf, 1990) - (Odonne et al., 2009) - (Vásquez, 1994) - (Gachet et al., 2010; Odonne et al., 2009) Duke and Vasquez (1994) reports the use of Mucuna pruriensis in the Amazon. Mucuna rostrata used elsewhere for snakebite (Soukup, 1970) (Branch and (Bennett et al., Species Musa x paridisiaca L. Nicotiana tabacum L. Ocimum micranthum Willd. Opuntia ficus-indica L. Mill Parkia multijuga Benth. Phthirusa pyrifolia Kunth Eichler Plagiochila cf. subplana Psidium guayava L. Family Specimens Majench, Guineo, Orito Musaceae Solanaceae Lamiaceae Local name (Achuar in italics) Guineo, Orito APG95 APG1 1 Use S Fractures and sprains (4) Wound healing (4) Liquid from the stem is used to wash the bite Leaves are crushed in water, sometimes mixed with Chicha. The remedy is drunk and then vomited Decoction of the leaves, Cymbopogon citratus leaves may be added. Administered orally or as a steam bath Cladode is split in two and the internal gel is drunk and applied on the affected part Powdered bark is used externally Fractures and sprains (4) Wound healing (5) Decoction is used orally Chewed and applied on the lesion Diarrhea (40) Decoction Snakebite (3) Malaria (8) Albahaca L Common cold (3) Ikiamanch, Tuna Cl Tankam B Au arake L 3 Juu 3 Kirim, Guayaba All L, F, B 2 Mimosaceae APG16 APG127 Loranthaceae APG30 2 APG30b Plagiochilaceae APG11 Myrtaceae APG88 1 APG88b Preparation Use reported in the Amazon Use reported among the Shuar Silva, 1983; Odonne et al., 2013) [(Samy et al., 2008) reported the use elsewhere] 2002) (Use Reports) L 1 Cactaceae Tsaank, Tabaco PU 1 - (Schultes and Raffauf, 1990) [as treatment for chills] - (Rodrigues, 2006; Schultes and Raffauf, 1990) - - - (Alarcón, 1988) (Alarcón, 1988; Odonne et al., 2013) - - - (Duke and Vasquez, 1994) - Species Family Specimens Local name (Achuar in italics) PU Use Urera baccifera (L.) Gaudich. Ex Wedd. Urticaceae Urera baccifera (L.) Gaudich. Ex Wedd. Urticaceae Zingiberaceae APG98 1 Zingiberaceae APG98 1 Rh Zingiberaceae APG98 1 Rh Zingiberaceae APG98 1 Rh Zingiberaceae APG98 1 Rh Cough (5), Blood loss during childbirth (5) Pain during childbirth (4) Zingiberaceae APG98 1 Rh Snakebite (3) IC Colics (3) Diarrhea (2) Zingiber officinale Roscoe Zingiber officinale Roscoe Zingiber officinale Roscoe Zea mays L. Poaceae Use reported in the Amazon Use reported among the Shuar Decoction is drunk and then vomited leaf hit body parts, which are then massaged Decoction or rhizome crushed in water and then used internally (Valadeau et al., 2010) - (Use Reports) APG35 2 APG48 2 APG138 APG35 2 APG48 2 APG138 Zingiber officinale Roscoe Zingiber officinale Roscoe Zingiber officinale Roscoe Preparation Tuntun nara, Ortiga R Malaria (7) Tuntun nara, Ortiga L Rheumatism (5), body aches (1) Ajej, Jengibre Rh Diarrhea (17) Common cold (9) (Cayon and Aristizabal, 1980) (Grenand et al., 1987; Vickers and Plowman, 1984) Decoction or chewed Decoction or chewed Decoction, used orally. Decoction, used orally. Chewed together with roots of Cyperus sp. Internal part of the cob is reduced to ahses, these are mixed with water, which is drunk (Duke and Vasquez, 1994) (Bennett et al., 2002) (Bennett et al., 2002) (Bennett et al., 2002) - (Bennett et al., 2002) (Bennett et al., 2002) (Bennett et al., 2002) - - (Branch and Silva, 1983) Table 3. Plants with medicinal uses reported during this study Specimens: 1= Herbario de la Universidad Central del Ecuador , Quito (QCA); 2= Herbario Nacional de Ecuador en Quito (QCNE); 3= Herbario de la Universidad Central del Ecuador (QAP). PU: Part used, L=leaves;R=root; Rh=Rhyzome; Lx=Latex; S=stem; B=Bark; Se=Seeds; F=Fruit; J=Fruit juice; uF=unripe fruit; Cl=cladodes; IC=internal part of the corn cob. Use reports: Number of independent reports of the same use is shown within parentheses. Plant names were checked with www.theplantlist.org (accessed on May 2014); na=not applicable
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