Journal of Ethnopharmacology, 2 (1980) 37 - 41 0 Elsevier Sequoia S.A., Lausanne - Printed in the Netherlands

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TRADITIONAL MEDICINE IN LATIN AMERICA, WITH PARTICULAR REFERENCE TO MEXICO*

CARLOS ZOLLA

Research Program on Medicinal Plants, Third World Center for Economical and Social Studies (CEESTEM), Mexico, and Department of Ethnobotany, Mexican Institute for Studies on Medicinal Plants (IMEPLAM), Mexico City (Mexico)

Summary

The present research on Mexican traditional medicine points to the resources made available by the Mexican Institutions for the study of the plants used in popular medicine which, in rural areas, follows the Aztec and Maya traditions.

The most interesting feature of traditional medicine is its partial integration with many elements of modern medicine.

The study of medicinal plants has been undertaken mostly by a research institute, IMEPLAM, which, under the auspices of CEESTEM, has informa- tion on computer on over 5000 plants.

The screening of these plants is in progress with the aim of evaluating their therapeutic properties, both at the pharmacological and chemical level.

The definition of traditional medicine is by no means an easy task, considering the different viewpoints of contemporary sociology, medicine, and anthropology.

I do not intend to define traditional medicine. Nevertheless, a frame of reference is certainly necessary to understand the wide and complicated field which we generally refer to as traditional, folk, parallel, indigenous or popular medicine.

Considering that each culture is characteristic of a given society, the “art of healing” constitutes an indivisible part of the culture. The contem- porary world has seen the impressive development of different forms of medicine as a result of the predominance of certain cultural patterns which involve social, economic and political aspects. But in no way does this

*Paper Presented at the Joint Istituto Italo-Africano/World Health Organization neeting on Research and Training in Traditional Systems of Medicine in Developing buntries, with Particular Reference to Medicinal Plantsand Herbs, Rome, April 2 - 6,1979.

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necessarily imply the disappearance of the local subjacent medical mani- festations. The survival of these manifestations is the object of our study.

The challenge of giving a panoramic view about the state of develop- ment of traditional medicine in such an extensive area as Latin America can be approached by delineating the main common factors which have determined each particular aspect of traditional medicine.

First of all we must consider that different societies in America were at different levels of development when they first established contact with the European World during the first decades of the 16th century. For instance, in South America, the dominant culture at that time was that of the Inca society, which had an important degree of medical knowledge. On the other hand, in Central America, the indigenous medical knowledge is undoubtedly representative of the Aztec and Maya cultures.

Modern countries throughout America reflect in one way or another the influence of those pre-Hispanic cultures, and it seems that indigenous medical knowledge has been better preserved in those geographical regions where the local societies achieved substantial agricultural development.

The conquest of the Continent by Europeans, and the colonial period that followed, resulted in the implantation of a new culture and led to the disappearance of many of the indigenous medical concepts, and also to the beginning of a complex process of combination of ideas - interculturation that constitutes the starting point for our understanding of contemporary Latin American traditional medicine.

Nevertheless, for historical reasons, some areas with minor contact with the new culture preserved more deep-rooted forms of healing.

Three factors at least have to be considered historically in order to understand the cultural roots of contemporary Latin American traditional medicine as a whole:

(1) the indigenous medical basis; (2) the cultural influence of 16th century European medicine through

the expanding societies of that time ; (3) the important cultural influence of African contingents in America. Actual traditional medicine in Latin America is the result of dynamic

transformations over 300 years, having undergone the evolution inherent in every cultural process. It is incorrect, therefore, to think about traditional medicine as the static product of a simple combination of historical circum- stances; on the contrary, the continuous interaction with the modern world is a major characteristic of this process. Contemporary traditional medicine has thus incorporated many elements of modern medicine through a process of continuous interculturation.

I shall summarize the results of our study of Mexican traditional medicine, emphasizing those aspects which characterize the whole Latin American tendency.

Mexican traditional medicine has been characterized by its strong indigenous roots, particularly with respect to the existing therapeutical re- sources among which the use of herbs is the dominant characteristic (Aguirre-Beltran, 1963).

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Mexico is a country of over 60 million people where the official medical services - mainly of Western orientation - are insufficient to provide a large percentage of the population with basic prophylactic and curative medical attention. On the other hand, the existence of a widespread traditional medicine, supported mainly by the use of medicinal plants, repre- sents a therapeutic alternative which has its basis in the knowledge gained from ancestral popular experience.

In the primary stages of health care, as in all Latin American traditional medicine, herbal medicine plays an important role as a curative element, for example, for the treatment of common diseases such as dysenteries, gastrointestinal disturbances, respiratory diseases, infectious diseases, etc., which characterize the socioeconomic status of underdeveloped countries. This should not lead us to the misconception that traditional herbal medicine only represents a resource for the development of new drugs as conceived by the modern pharmaceutical industry; it also offers a concrete local alternative to public health care in the primary stages. The possibility of the systematic use of herbal medicine as a first element of medical assis- tance may result in the more advantageous use of other more sophisticated and scarce medical resources. This is a particularly important point, because we have been asked to analyze the existing relationships between the so- called Western medicine and the traditional therapeutic alternatives, and to define the possible links of mutual interaction in such a way that scientific research can be directed towards concrete objectives with a real possibility of their application. Otherwise, we could find ourselves only emphasizing the existing contradictions between modem and traditional medicine related to the future utility of medicinal plants.

The most frequent therapeutic alternative in Mexico, as in Latin America, is the use of herbal medicine before people can reach official medical attention. It can be argued that there exist cultural, political and economic reasons for this, but experience has shown that the population resorts to the methods of healing within its reach, and in certain ways has combined methods and therapeutic resources from traditional and modern medicine. The important task is, therefore, to increase the popular know- ledge about such remedies in order to attain a more equilibrated level of interaction with all available modern medical resources.

The work which we are committed to at IMEPLAM consists of multi- disciplinary research based on the following schedule (Lozoya, 1976).

The information about the use of medicinal herbs is obtained through two different approaches :

(1) bibliographical, historical data which constitute the main body of our computerized information;

(2) ethnographical fieldwork involving the continuous screening of different geographical areas of the Country with the collaboration of healers and other specialists and practitioners of traditional medicine.

These two inputs of information are evaluated by the Ethnobotanical Department of the Institute which concentrates on the anthropological,

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botanical and medicinal data. This we consider to be the basic work before the start of any pharmacological or chemical projects; it ensures a greater feedback between the specialist devoted to the search of the active principles present in the plants and the continuous field work of the ethnobotanists.

This working schedule has led us to the creation of a unique data bank of medicinal plants existing in Latin America which contains infor- mation about over 5000 medicinal plants.

A second result has been the creation of the IMEPLAM medicinal herbarium which contains around 2000 botanical vouchers of Mexican plants.

The chemical and pharmacological teams are in close contact with the Ethnobotanical Department from which correct identification of the plants together with the exhaustive evaluations of the popular use and attributed properties of every specimen under study can be obtained.

We have established categories of plants for pharmacological research concerned with those health problems which have priority in this Country. So, only those plants with possible gastrointestinal, abortive, cardiotonic, antibiotic and antidiabetic effects are under study.

Pharmacological and chemical investigations are developed in a simultaneous research program. The main objective of such studies is the evaluation of the therapeutic properties of the popular remedies; it involves the scientific work necessary to establish the properties of infusions, extracts, etc. as they are used in traditional medicine. Isolation of the active principles is considered as a logical step in the process, but not as the prin- cipal objective. Once those active compounds are isolated, the comparative evaluation of their properties with respect to the whole infusion is begun. During the phytochemical study, continuous monitoring of the pharma- cological activity is conducted with all the fractions obtained, avoiding the exhaustive analysis of those compounds non-related to the initial biological activity detected.

The results of this very briefly described schedule are significant. Every year around 50 medicinal plants undergo screening studies. At least 50% of them are demonstrated to possess biological activity related to the use assigned to them by the population. From these 25 plants per year, five are incorporated in more detailed projects which include: isolation of pure active compounds, structural analysis, toxicology, etc., together with more exhaustive pharmacological tests of the original infusion.

Clinical trials are not conducted in our Institute, but are developed in collaboration with other national research institutions closely related to that particular field.

Finally, I would like to say that, although communication with other Latin American groups devoted to similar investigations is not very great, we maintain contact with some of them in Brazil, Venezuela, Guatemala and Colombia, particularly through our periodical publications. Our Institute produces a journal in the Spanish language, Medicina Traditional, specifi-

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tally devoted to the studies on traditional medicine in the world, as well as other monographical series related to our investigations.

Any effort leading to the creation of an active network of transfer of information between developing countries must be welcomed, particularly in the field of traditional medicine.

References

Aguirre-Beltrin, G., Medicina y Magia, Instituto National Indigenista, Mexico, 1963, pp. 70 - 75.

Lozoya, X., El Instituto Mexican0 para el Estudio de las Plantas Medicinales. In Estado Actual de1 Gonocimiento en Plantas Medicinales Mexicanas, IMEPLAM, Mexico, 1976, pp. 243 - 248.