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Traditional use of non-wood forest products in Ayurvedic medicine in Sri Lanka

Upali Pilipitiya
Director, Bandaranaike Memorial Ayurvedic Research Institute

Sri Lanka's forests cover about 20 percent of its land area. The Forest Department has planted small areas with jackfruit trees in Kurunegala District, teak trees in Anuradhapura District and pine trees in Nuwara Eliya District. The rest of the forest cover is natural jungle with a thick undergrowth, and a large primary rain forest called "Sinha Raja." These natural forests are veritable storehouses of Ayurvedic medicines.

Sri Lanka has a recorded history of 2,589 years, chronicled in the Mahawamsa and the Culavamsa. During the country's long history, there were many instances where traditional medicines were highlighted. The Mahawamsa mentions that King Dutugemunu built hospitals for the clergy and for pregnant women as early as 173 B.C. King Buddhadasa (388 to 416 A.D.) was a great surgeon and physician himself, who was well-versed in medicine and veterinary science. In 1153, King Parakramabahu I built a hospital with hundreds of rooms. Both male and female nurses served the sick day and night. The King visited the hospital once a week and distributed clothes to discharged patients. Anuradhapura and Pollonnaruwa, the ancient capitals of Sri Lanka, have many ruins of hospitals and teaching institutes, where traditional medicine was taught and practiced.

The medical system practiced in Sri Lanka is called "Ayurveda." The word Ayurveda is derived from Sanskrit ("Ayu" means life, and "Veda" means science). This science was developed in India and spread to almost all the Asian and south Asian countries like Sri Lanka, Bangladesh, Burma, Bhutan, Tibet, Sikkim etc. In Sri Lanka, it intermingled with the indigenous siddha medicine of South India which was in use in northern Sri Lanka, the Unani or Greko-Arabic system, and some aspects of acupuncture from China. At present, Ayurveda serves a large proportion of Sri Lanka's people, providing them with religious, cultural and social values. Just as modern medicine is based on chemistry, physics, biology and mathematics, Ayurveda is built on Indian philosophy and pragmatism. This philosophical background has a great bearing on the beliefs of the people. There is one Ayurvedic physician practicing today for every 3000 people.

Until the introduction of modern medicine by the British in the 19th century, the health of the nation was looked after by traditional physicians. In the beginning of the 20th century, there was a big demand by the intelligentsia of Sri Lanka for the traditional system of medicine in the Health Care Service. The British could not resist this uproar and as a result, a government-run College of Indigenous Medicine was established in 1929. In addition, two private institutions were also set up. Up to this time, medical knowledge had been passed on from father to son.

There are many factors which contribute to the popularity of traditional medicine in Sri Lanka. Some of these are:

· The expressions of the common people and their symptoms are easily understood by the native physicians.

· There is a very close consonance between the beliefs of the physician and the patient.

· Both the physician and the system of medicine suit the cultural and spiritual values of the people.

· The traditional system adopts a holistic approach to the patient and the disease.

· Treatment is based on the regulation of diet, exercise, behavioral patterns and medicine.

· The drugs used are more of a herbal nature and can be obtained from the environment.

· There is a general belief that traditional medicine has minimal or no side effects at all.

· Traditional medicine acts wholesomely by strengthening the system, especially the immune system.

· There are specialists who treat fractures and dislocations, mental disorders and eye diseases.

· Many people prefer traditional medicine because of its cost effectiveness for chronic conditions like arthritis, diabetes mellitus, chronic bowel diseases, lung disorders and skin diseases.

· In the village areas, the patient and his or her family are personally known to the physician and hence there is a close bond of understanding.

· Of the 17.5 million people who live in Sri Lanka, 72 percent live in rural areas.

Taking the above factors into consideration, all post-independence governments took an interest in promoting the traditional system of medicine in Sri Lanka. In 1956, a separate government department under the Health Ministry was established to strengthen and promote Ayurveda. Today, the government has accepted the traditional system of medicine to be parallel with modern medicine. In 1977, the government upgraded the Government College of Ayurveda, by affiliating it with the University of Colombo. The existing traditional physicians were registered by a team of physicians who evaluated the knowledge and practical experience of the traditional healers.

There are now 47 government hospitals in different districts and 307 central dispensaries which provide Ayurvedic treatment free of charge. The Bandaranaike Memorial Ayurvedic Research Institute was established in 1962 and declared open by the Prime Minister of India, Sri Jawahar Lal Nehru. An Ayurvedic Drug Cooperative was formed in 1965 to provide medicines for government hospitals and dispensaries. The annual budget for the drugs used in these hospitals and central dispensaries is approximately US$ 2 million. Apart from the Government Health Care system, there is a large community of about 10,000 physicians who practice in the villages as private practitioners after obtaining a licence from the government, or a degree from the university.

It is the normal custom of the traditional physicians to prepare their own medicines. However, due to requirements of space, labour and technical know-how, many physicians of the younger generation prefer to buy prepared medicines from the manufacturers. Hence, a new industry has developed to produce local pharmaceutical herbal products. These manufacturing units or small companies have to be registered under the Department of Ayurveda, and there are provisions for the quality of drugs with G.M.P. (good manufacture practices) etc. There are about 75 of these manufacturing units in the country.

The raw material for the manufacture of Ayurvedic drugs is obtained from natural sources. There is no systematic large-scale cultivation of medicinal plants as yet. Many persons are involved in the collection, processing and storage of raw materials. The cultivation, collection and processing of Ayurvedic herbs have great potential for creating new job opportunities. As there is a great demand for traditional medicine, the Department of Ayurveda and the Research Institute have started to popularise the cultivation of medicinal plants. Four herbal nurseries have been established in three different zones of Sri Lanka. Ten species which are currently imported from India in large quantities, but could be grown in Sri Lanka, were selected and studied in great depth and are now under cultivation. These species are:

1. Acorus calamus
2. Woodfordia fruticosa
3. Plumbago indica
4. Cassia angustifolia
5. Withania somnifera
6. Abelmoschus muscatus
7. Justicia adhatoda
8. Rubia cordifolia
9. Piper longum
10. Vetiver zizanioidus

Apart from these 10 species, there are about 150 herbs commonly used by traditional physicians. About 2,700 plants are mentioned in Ayurvedic books. Cultivation of these herbs is also encouraged. Extension officers involved in cultivation are utilised to educate villagers in the growing and harvesting of these plant species. These extension officers are given training by state agencies in all aspects of cultivation and processing of Ayurvedic herbs

The common medicinal preparations used in traditional practice are herbal teas, powders, pills, oils, herbal wines, decoctions and pastes. A large proportion of herbs are imported from India, Nepal, Bangladesh and Pakistan at a cost of over 20 million U.S. dollars. Some of these raw materials have to be imported as they grow only in the Himalayan region. There are many non-wood forest products which are being collected from the jungle. These include neem (Azadiractha indica), Cassia fistula, Adhathoda vasica, Maduca indica, Messua ferra, Santalum album, Tinospora condifolia, Vitex negundo, etc.

The ancient kings grew large herbal gardens, some of which still survive. There are large gardens of the three myrobalans, (i.e., Terminalia chebula, Terminalia belerica, and Phylanthus emblica). Their fruits are extensively used in Ayurvedic medicine and there are jungles of these trees which cover thousands of acres. The villagers go to the jungles and collect the fruits when they are in season. In the case of Phyllanthus emblica, the fruits should be processed and dried before use. This involves labour and knowledge of processing.

Traditionally, knowledge was transferred by word of mouth through compositions of easily remembered verses. The ancients documented this medical poetry on processed palmyrah leaves called "Ola" manuscripts. These ancient books were restricted to certain families. They are now being collected, transcribed and protected by the Department of Ayurveda. UNDP/WHO support has been received for this venture and 100 books have been published. There are many more Ola books to be read and published, and still more Ola manuscripts to be unearthed from old temples and ancient houses. This massive task will take years.

The Bandaranaike Memorial Ayurvedic Research Institute (BMARI) conducts research in three major fields, (i.e., clinical, literary and drug research), and the following diseases have been selected for clinical research with traditional medicine: Rheumatoid arthritis, diabetes mellitus, bronchial asthma, leucoderma, psoriasis, hydrocephales, obstinate and chronic headaches, epilepsy, urolithiasia, fistula in ano, malaria, haemorrhoids, eczemas and drug addiction. From this research, very promising results have been obtained in rheumatoid arthritis, haemorrhoids, and fistula in ano. WHO assistance was available for research on rheumatoid arthritis, diabetes, urolithiasia and epilepsy.

In the literary research section of BMARI, the transcription of Ola manuscripts and translation of ancient Sanskrit books is being undertaken. Leaflets and pamphlets on common ailments, their prevention, and suitable diets are being published. A pharmacopoeia of Ayurveda with selected prescriptions and formulae of indigenous medicaments has been published. A materia medica of about 400 medicinal species which are included in the pharmacopoeia has been published in a series of volumes. National seminars are being conducted regularly to educate the public and school children about the value of traditional medicinal plants and their uses. The mass media is also used for this publicity campaign.

Drug research highlights cultivation, processing and storage. Another important aspect is the quality control of traditional medicine. Strict quality control was not needed in the early days because the physicians themselves were manufacturing their own drugs. The necessity for quality control arose as private enterprise started manufacturing drugs on a large scale. Developing specific standards for each and every drug is a tedious task because many traditional drugs are compound preparations which sometimes include hundreds of herbs. Different methods are being followed to ensure quality by controlling processing methods. However, there is long way to go in this field. Quality control of any product involves extreme vigilance. With regard to the systematic cultivation of plants, zonal nurseries are maintained at Nawinna (wet zone), Haldummulla (intermediate zone), Girandurakotte (dry zone) and Pattipola (wet zone over 3000 feet.).

Jeevaka, the Indian physician who treated Lord Buddha, could not find a single plant in the jungle that could not be used in an Ayurvedic medicine. In Sri Lankan villages, the people know a large number of the common medicinal herbs used in snake bites, fractures, etc. Sheer necessity was the motivation for the acquisition of this knowledge. Therefore, when the need arose, in addition to picking up a few herbs from the garden, they visited the jungle to obtain the required herbs. All of the Sri Lankan jungles are storehouses of Ayurvedic herbal medicines. The exploitation of wood in a jungle must be undertaken with the written approval of the government, but non-wood forest products are obtained by villagers as a matter of traditional right, at any time. The cultivation, collection and processing of NWFPs can provide opportunities of employment, especially because herbal products that can be grown locally are still being imported. With the increasing use of herbal products, even in the West, the demand for Ayurvedic herbal products will increase; therefore, the cultivation, collection and processing of Ayurvedic herbs will have to be organised and undertaken on large scale.

Apart from their medicinal value, many forest products have food value as well. Sri Lanka has an extensive system of "home gardens." Different species are cultivated in home gardens to achieve different objectives. From a home garden or a forest, the villagers gather firewood, leaves, fruits, and medicinal plants. They also enjoy watching birds, and listening to their music. There are important food items which the villagers prepare with plants and leaves as part of the rituals of daily life. These include the taking of herbal gruel in the morning and herbal tea between meals. This traditional habit is said to have ensured the health of Sri Lanka's people in ancient times. At present, a campaign has been started by western-qualified doctors to encourage people to resurrect the ancient practice of having a cup of herbal gruel each day. Many restaurants in Colombo have begun providing herbal gruel for sale on a regular basis. It augurs well for the future health of our people, when even western-qualified doctors see the wisdom in Ayurevedic practices.

Annex 1

Plants used for the preparation of herbal tea

Sinhala name

Botanical name

Polpala

Aerva lanata (L) ex Schult

Neeramulliya

Asteracantha longifolia (L) Nees

Maduruthala

Ocimum sanctum L.

Gotukola

Centella asiatica (L) Urban
Hydrocotyle javanica Thunb

Eramusu

Hemitesmus indicus Br

Beli

Aegle marmelos (L) Correa

Ranawara

Cassia auriculata L.

Adhathoda

Justisia adhatoda L. Syn. Adhatoda vasica L.

Annex 2

Plants used in making herbal gruel (the same leaves are also used in salads and curries)

Sinhala name

Botanical name

Rasakinda

Tinospora cordifolia (Wilid) Miers ex. Hook F & Tho

Mathawariya

Asparagus gonoclados Baker

Wel Penela

Cardiospermum halicacabum L.

Elabatu

Solanum melongena L. Syn

Batu

Solanum xanthocarpum Schrad

Wel Tibbotu

Solanum trilobatum L.

Monarakudumbiya

Vernonia cinerea (L) Less

Pitawakka

Phylanths debilis Klein ex Willd
Phyllantus urinaria L.

Mussanda

Mussaenda frondosa L.

Polpala

Aerva lanata (L) Juss ex. Schult

Gotukola

Centella asiatica (L) Urban

Mukunuwenna

Alternanthera sessilis (L) DC

Koora Thampala

Amaranthus viridia L.

Thampala

Amaranthus tricolor L.
Amaranthus hybridus L.

Nivithi

Basella alba L.

Akkapana

Kalanchoe laciniata DC

Karapincha

Murraya koenigii (L) spreng

Sudu Handun

Santalum album L.

Sarana

Trianthema monogyna L.

Kan Kun

Ipomoea aqutica Forsk

Kuringgan

Gymnema lactiferum (L) R. Br. ex Schult

Katuru Murunga

Sesbania grandiflora (L) Poir

Murunga

Moringa olerfera Lam


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