Herbal Recipes used by traditional healers towards Reproductive and Urinary healthcare in Wayanad (Kerala) India

1Phytopharmacology Laboratory, Department of Studies in Botany, Manasagangotri, University of Mysore, Karnataka, India. A b s t r a c t The traditional healers in Wayanad (Kerala), India possess rich aboriginal herbal medicinal knowledge (AHMK). This investigation has brought in to light many valuable therapeutic measures which were at the verge of extinction. Validation and documentation valuable ethno medicinal heritage. The study consists of three consecutive phases. In the first phase a methodology for the study including work plan was elu method was executed at a selected study site. In the second phase an extensive data collection cum field appraisal long three calendar years commences from July 2010 to July 2013 was conducted. In the final and third p responses was done. A total of 60 species distributed in 56 genera belong to 38 families were identified being used in 67 recipes meant for 15 reproductive and urinary healthcare measures in Wayanad (Kerala), Ind medicinal constituents. The therapeutic ingredients includes Fresh whole plants (12), dried whole plant (08), fresh root (2), dry root (29), fresh tuber (01), dried tuber (17), fresh bark ( dried bark (02), fresh leaves (04) dried leaf (01), dried stem (01), dried petiole (01), pith powder (01), dried gum (2), fresh inflorescence (01), dried inflorescence (01), fresh flower (03), dried stamen (01), dried fruits (07), dried seeds (11) when FPVS was four and minimum when FPVS was two. Among the 67 medicinal recipes 59 has highest FPVS and the remaining 08 has mediocre FPVS. Many of the aboriginal herbal medicinal cultures (AHMC) and the assoc in the district are at the verge of extinction. The present study hence pivots around the conservation issues of this aboriginal medicinal heritage, particularly in the cure and management of urinary an therapeutic system to contribute better to the national health repository.


Introduction
Every culture in the world has its own practices of treating the disease. The fund of knowledge developed over millennia by thousands of ethnic groups is largely unrecorded and faces the danger of becoming extinct. Ethno botanists can thus play a major role in the rescue of disappearing knowledge and returning it to the local communities, this will help in conserving at least a part of ethno botanical heritage as a living cultural ecosystem helping to maintain a sense of pride in local cultural knowledge an and reinforcing links between communities and the environment so essential for biological conservation [1]. Traditionally, local communities worldwide are extremely knowledgeable about local DOI: 10 . This investigation has brought in to light many valuable therapeutic measures which were at the verge of extinction. Validation and documentation valuable information was hence done in order to conserve at least a part of this aboriginal ethno medicinal heritage. The study consists of three consecutive phases. In the first phase a methodology for the study including work plan was elucidated. A field level testing of the method was executed at a selected study site. In the second phase an extensive data collection cum field appraisal long three calendar years commences from July 2010 to July 2013 was conducted. In the final and third phase, validation and recording of the valid responses was done. A total of 60 species distributed in 56 genera belong to 38 families were identified being used in 67 recipes meant for 15 reproductive and urinary healthcare measures in Wayanad (Kerala), India. 31 herbs, 28 trees, 22 climbers and 16 shrubs were among the medicinal constituents. The therapeutic ingredients includes Fresh whole plants (12), dried whole plant (08), fresh root (2), dry root (29), fresh tuber (01), dried tuber (17), fresh bark ( dried bark (02), fresh leaves (04) dried leaf (01), dried stem (01), dried petiole (01), pith powder (01), dried gum (2), fresh inflorescence (01), dried inflorescence (01), fresh flower (03), dried stamen (01), dried fruits (07), dried seeds (11), and seed oil (01). Validity stands maximum when FPVS was four and minimum when FPVS was two. Among the 67 medicinal recipes 59 has highest FPVS and the remaining 08 has mediocre FPVS. Many of the aboriginal herbal medicinal cultures (AHMC) and the associated therapeutic knowledge and practices still alive in the district are at the verge of extinction. The present study hence pivots around the conservation issues of this aboriginal medicinal heritage, particularly in the cure and management of urinary and reproductive ailments. This improves and sustains the aboriginal therapeutic system to contribute better to the national health repository. Keywords: Traditional medicine, Urinary and reproductive diseases, Traditional recipe, Wayanad district.
Every culture in the world has its own practices of treating the disease. The fund of knowledge developed over millennia by thousands of ethnic groups is largely unrecorded and faces the danger of becoming extinct. Ethno botanists can thus play a major e in the rescue of disappearing knowledge and returning it to the local communities, this will help in conserving at least a part of ethno botanical heritage as a living cultural ecosystem helping to maintain a sense of pride in local cultural knowledge and practices, and reinforcing links between communities and the environment so Traditionally, local communities worldwide are extremely knowledgeable about local plants and other natural resources, on which they ar immediately and intimately dependent The World Health Organization (WHO) estimates that 80% of world's population relies on traditional healing modalities. . This investigation has brought in to light many valuable therapeutic measures which were at the verge of extinction. Validation and documentation of some of such was hence done in order to conserve at least a part of this aboriginal ethno medicinal heritage. The study consists of three consecutive phases. In the first phase a cidated. A field level testing of the method was executed at a selected study site. In the second phase an extensive data collection cum field appraisal long three calendar years commences from July 2010 to July hase, validation and recording of the valid responses was done. A total of 60 species distributed in 56 genera belong to 38 families were identified being used in 67 recipes meant for 15 reproductive and urinary healthcare measures ia. 31 herbs, 28 trees, 22 climbers and 16 shrubs were among the medicinal constituents. The therapeutic ingredients includes Fresh whole plants (12), dried whole plant (08), fresh root (2), dry root (29), fresh tuber (01), dried tuber (17), fresh bark (01), dried bark (02), fresh leaves (04) dried leaf (01), dried stem (01), dried petiole (01), pith powder (01), dried gum (2), fresh inflorescence (01), dried inflorescence (01), fresh flower (03), dried , and seed oil (01). Validity stands maximum when FPVS was four and minimum when FPVS was two. Among the 67 medicinal recipes 59 has highest FPVS and the remaining 08 has mediocre FPVS. Many of the aboriginal herbal iated therapeutic knowledge and practices still alive in the district are at the verge of extinction. The present study hence pivots around the conservation issues of this aboriginal medicinal heritage, particularly in the cure and d reproductive ailments. This improves and sustains the aboriginal therapeutic system to contribute better to the national health repository.
Traditional medicine, Urinary and reproductive diseases, Traditional recipe, plants and other natural resources, on which they are so immediately and intimately dependent [2]. The World Health Organization (WHO) estimates that 80% of world's population relies on traditional healing modalities.  ne aboriginal therapeutics plays imperative role on integrated care of the human body rather removing the disease symptoms. However, there is often a decrease in the availability of wild plant resources related to of competition with other forms of land use. Modernization has encroached natural habitats removing ecological friends. This break in contact with the ecological counterparts and the original environment leads to brought up by folk medical practitioner over millennia. Many of these cultures and their associated therapeutic knowledge are in peril and may even . Hence present study attempted to validate and document Ethno Herbal Poly pharmacy towards Urinary and Reproductive healthcare in Wayanad, Kerala, India.
The study consists of three consecutive phases. In the first phase a methodology for the study including work plan was elucidated. A field level testing of the method was executed at a selected study site. In the second phase an extensive data collection cum field appraisal long three calendar years commences by July 2010 to July 2013 was conducted. In the final and third phase validation of data and recording of the valid responses was done.

Study area
The study area Wayanad lies at 11º 55' N, latitude and 75 º 59' E, longitude with altitude ranging 950 level ( Figure -1). Temperature goes down to 16 º C during winter and to 30 º C during summer months. Forest types includes ever green, semi ever green and grass land. Annual rainfall ranges from 300-1000mm. According to recent census total population of the district was 6, 72,128 of which there were 3, 41,958 males and 3, 30170 females. Population density was 316.2 per sq; kilometers. There were over 550 native or tribal communities within 227 ethnic groups [5].
Map of Wayanad (Kerala) in India showing settlements of traditional healers.

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The study consists of three consecutive phases. In the first phase a methodology for the study including work plan was elucidated. A as executed at a selected study site. In the second phase an extensive data collection cum field appraisal long three calendar years commences by July 2010 to July 2013 was conducted. In the final and third phase validation of id responses was done.
The study area Wayanad lies at 11º 55' N, latitude and 75 º 59' E, longitude with altitude ranging 950-1350 meter above main sea 1). Temperature goes down to 16 º C during winter and to 30 º C during summer months. Forest types includes ever green, semi ever green and grass land. Annual rainfall ranges from 1000mm. According to recent census total population of the

Data collection
The study adhered to the research guidelines and ethical protocols of University of Mysore, Karnataka, India. For the convenience, study area was divided in to two ecological zones such as dry and wet zones. Hamlets were selected from each ecological zone. A total of 120 traditional healers and medicinal vendors (both men and woman) of different age groups between 40 and 80 were interviewed appropriately during different seasons. Queries on the subject were made only to single herbalist or medicinal vendor a day. Responses were elucidated via questionnaire developed by the University of Mysore (Figure-2). Information supplied by the informant was recorded when at least five informants independently report the use of a recipe (s). Validated therapeutic prescription (s) was recorded pivoting, herbal ingredients of the recipe, part of the herb used, method of preparation of the recipe and the prescribed dosage. Age wise medicinal preference of the respondents was also elucidated [6]. Separate transect walks with traditional healers at different seasons were carried out. Constituent herbs of the medicinal recipes were collected, verified with the help of traditional healers, medicine vendors and the plant identification service (PIS) at the Herbarium Referral Centre (HRC), University of Mysore. Scientific names and authorships were confirmed using Flora of Presidency of Madras by Gamble. Consecutively the voucher specimens serially numbered and designated as THRI (Traditional herbal recipe ingredient) were deposited in the HRC (Table.3). A detailed information on availability of medicinal plants, people preference for a species over other and the gender difference in the collection and processing of medicinal plant was also obtained [7].

Validation of practices
Validation of ethno medical practices is considered as a preliminary step to establish the legitimacy of a medicinal recipe. The validation of remedies was accomplished non experimentally using four point validation score (FPVS) method used by [8]. The method consists of accurate validation of aboriginal herbal pharmacy and interpretation of the same by ways of modern scientific concepts and methodologies.

Four point validation score (FPVS)
In this method search of chemical, pharmaceutical and pharmacological literature in order to unwove the known therapeutic and physiological effects of the crude herbal ingredient, related species or the molecule known to contain in the species. This information was used to accesses whether the plant use is based on empirically verifiable principles or whether symbolic aspects of healing are of enough relevance. A preparation was assigned highest degree of confidence if pharmacological and phytochemical information supports the folk use of at least single herbal constituent of the recipe. The four levels of validity were as follows. If no ethno herbal, pharmacological or phytochemical information supports traditional use of herbal ingredients of a recipe-The herbal ingredient may be inactive.
Recipes used at geographically or temporally distinct areas attain lowest level of validity if phytochemical or pharmacological information validates the use. But use at other areas increases the validity. In addition to ethno herbal, phytochemical or pharmacological information, if the recipes exert physiological effects on patient are more likely effective than those with lower levels of validity.
If ethno botanical, phytochemical and pharmacological information together justify folk use of a recipe, it is grouped at the highest level of validity and would most likely be an effective remedy.

Results and discussion
Aboriginal medicinal knowledge (AMK) and the gender Despite men and women practice traditional healing in most healing communities AMK has gender dimensions. Among the 120 aboriginal healers interviewed each from dry and wet zones, 85 (75%) were males and 35 (25%) were females. Though males were predominant in aboriginal herbal therapy (AHT), most gynecological issues were attended by females [9]. Some of the females engaged in AHT were birth attendants experienced and proficient in aboriginal clinical gynecology has brave suggestions for gynecological healthcare including delivery at the squatting position. The profile of the study sites and the respondents are summarized in the table 1. years suggested a maximum 33.33 percent affinity to modern pharmacy. Among educated, the least percent supported modern pharmacy was 22.2, the percent was against the age group of 55-70. Among uneducated the least percent (20) opted modern pharmacy amid the age group of 40-45 years. Some of the respondents were of the opinion that the disease suggests the therapy among the educated, 15.38 percent of the age group ranging 45-55 years supported the same. Among educated, a least percent of 11.11 only supported the concept of disease and therapy and they were of the age group 55-70 years. Among uneducated a maximum of 13.04 percent suggested the diseasetherapy relation within the age group 55-70. Among uneducated only 11.11 percent supported disease-therapy relation and were of the age group of 45-55 years. The educated category between ages 70-80 years had no preferences, but uneducated category of all age group articulated their preferences. Table 2 shows age wise medicinal preference of the respondents. Aboriginal medicinal knowledge (AMK) and the rituals An aboriginal healer (AH) is the person authorized to diagnose the disease and to prescribe therapy [11]. To become a healer, pro aboriginal healer has to work years together under the guidance and supervision of a healer. During the training period a pro aboriginal healer learn to diagnose disease and recommend cure, learn sustained harvest of herbal medicinal parts, preparation of recipe and the dosage. Among the many attendants, healer appoints his descendant, pro aboriginal healer on the basis of proficiency or heir ship. The trained pro healer operates as first attendant till death of the healer. A pro aboriginal healer authorized to become healer when his teacher dies, his contemporaries operate as attendants in collecting and processing of herbs in to medicinal recipe. A male healer used to be in charge of the family temple and he is authorized to diagnose the disease and to recommend remedies ( Figure.7). Correct dose of medicinal recipes were dispensed on showering magical words on it. It is believed that during these prayers healer communicate with the souls of the passed away healer ancestors [12].
Aboriginal medicinal knowledge (AMK) and the diseases The aboriginal healing system in Wayanad, Kerala, India has demonstrated a rich practice so bright future in the therapy of many diseases [13]. 120 respondents reported the use of 68 herbal recipes against the management and cure of 15 urinary and reproductive remedies. The list of disease includes, less sperm count, premature ejaculation, urine block, kidney stone, white discharge (male), inflammation to penis and testes, white discharge (Female), Correction of menstrual cycle, birth control, to occur pregnancy, headache during pregnancy, constipation during pregnancy, easy delivery, inflammation on breast and to increase the mother milk. Figure. 3 represents the diseases and the percent of herbal recipes used.   4 pound together and 5 ml of stone bee honey was added to the mixture. 10 g. of the medicinal preparation was advised twice a day at morning in empty stomach and night before sleep.
2) Maranta arundinaceae L. (Koova, Marantaceae, Herb, Pith powder obtained from corm), Prunus amygdalus Batsch. (Badam, Rosaceae, Tree, Dried seeds). 10 g. each Maranta and Prunus were pound and was boiled in 100 ml. of cow milk for 5 minute. 50 ml. of the preparation was advised twice a day at morning in empty stomach and night before sleep.
3) Ipomoea mauritiana Jacq. (Palmuthakku, Convolvulaceae, Climber, dried tuber). 5 g. of dried powdered Ipomoea was added to 10 ml of honey and the preparation was advised twice a day early morning before food and night after food. THRI-19.

THRI-16
THRI-1.   To correct menstrual cycle 1) Vitex negundo Linn. (Karinochi, Verbenaceae, Tree, Dried root). 20 g. of dried powdered roots of Vitex was mixed in 50 ml. of boiled milk and was advised twice early morning before food and continued.
3) Tinospora cordifolia (Willd) Miers (Chittamruthu, Menispermaceae, Climber, Dried whole plant). 10 g. of Tinospora was boiled in 100 ml. of cow milk and the volume was reduced to 50 ml, finally 10 drops of honey was added to the preparation. The medicine was advised twice a day early morning before food and night after food.

Validation of aboriginal medical practices (AMP)
Validation and documentation of aboriginal herbal therapeutics (AHT) exercised for urinary and reproductive healthcare were done only when at least 5 respondents independently report the use of a preparation with specific herbal ingredients [14]. Validity stands maximum when FPVS is four and minimum when FPVS is two. Among the 67 medicinal recipes 59 has highest FPVS and the remaining 08 has mediocre FPVS. FPVS of the recipes are figured in table 1.

Documented aboriginal medicinal knowledge (AMK)
Aboriginal herbal therapy make use diverse herbs in the preparation of medicinal recipe, the practice of polypharmacy using more than one herbal extract in a recipe (Compound herbal recipe) is most common [15]. It is believed that 'elements' from different herb forms recuperative substance. A total of 60 species distributed in 56 genera belong to 38 families were identified being used in 67 different recipes meant for reproductive and urinary healthcare in Wayanad (Kerala), India. Figure. 4-6 represents habit and the percent use of medicinal species, percent use of medicinal herb ingredients in different recipes and the families with the number of medicinal species used. Table 3 summarizes the ailments and the AHT being in practice at Wayanad (Kerala), India.       Aboriginal healers in Wayanad (Kerala), India have been retained rich traditional knowledge concerning the medicinal utility of native flora trickled down over generations, which is supported by their vast intra-ethnic diversity. There are over 550 aboriginal communities that come within 227 ethnic groups. Population of scheduled tribes and scheduled caste are respectively 1.14,969 and 27,835. The aboriginal community includes Paniyar, Kurumar, Adiyar, Kurichiar, Ooralar, Kattunaikar, and Kadar [16].
Traditional knowledge developed over years of observation, trial and error, and inference has largely remained with the aboriginal people, many of these classical prescriptions and secret folk recipes with outstanding curative effects have been in use from great antiquity. Despite of miraculous recuperative power, none of this therapeutics has been developed so far with the advent of modern medical and pharmaceutical technology. However, these cultures and their associated botanical knowledge may be in peril and may even become extinct. Many aboriginals in India migrate to access emerging opportunities and industrialization. This widens the gap between traditional knowledge and modern knowledge associated with work place and social skill of the developed mainstream population. The study of Ethno botanical research is deeply rooted within India. There are many examples of ethno medico botanical surveys conducted in India in the past that have recorded many botanical remedies among aboriginal groups [17].

Conclusions
Traditional communities in Wayanad preserved many herbal remedies over generations for their community healthcare. Both males and females undertake traditional healing, but most gynecological issues were answered by females. 120 respondents including herbalists and medicine vendors reported the use of 68 herbal recipes towards cure and management of 15 urinary and reproductive complications. The diseases were included male and female urinary and reproductive diseases. The practice of polypharmacy using more than one herbal extract in a recipe was most common. They believe that the elements from different plant extracts together accomplish the recuperative substance (s). It was recorded that a total of 60 species distributed in 56 genera belongs to 38 families were identified being used in 67 different recipes.