Traditional Medicine and Medicinal Plants
It was in September 2000 when I wrote to Rex Botengan, my former English teacher in senior year high school, and mentioned my interest to attend the Igorot International Consultation-4 (IIC-4) in London on June 28-July 1, 2002. With the topic on “Traditional Medicine and Medicinal Plants” in the tentative program, I volunteered to share what I know. I would like to thank the 4th IIC organizers for inviting me to present a subject that is close to my heart, even if my experience is about 20 years ago. When I read about the rush to document medicinal plants in areas where indigenous peoples live, I believe the research and documentation of Cordillera medicinal plants, which we did in our NGO health program, is a pioneering endeavor.
My experience with the use of medicinal plants is from my mother, Ana Belen nee Kay-an. She was a nurse at the Bontoc Hospital in Bontoc, Mountain Province from 1952 until 1970. She used to say that when their supply of antiseptic solution in the dispensary is nearly finished, she or the nursing aide would get leaves from guava trees in the hospital compound. They would make a decoction and use it as antiseptic.
I continued to be interested in medicinal plants even after I finished my medical studies. When I was a school physician at the Ministry of Education, Culture and Sports (MECS) in Benguet, I had an experience with guava. One day, the school nurse and I went to an elementary school, which we reached by hiking for about two hours from the main road. Along the way, I noticed several guava trees. During physical examination of the school children, I saw that very few had dental caries. There was only one village store. I learned that the owner bought his supplies weekly. It meant less candies and biscuits, and more fruits, especially guava.
Afterwards, I chose public health, specifically community medicine. As founder of an NGO health program, CHESTCORE (Community Health Education, Services and Training in the Cordillera Region), based in Baguio City in 1981 and its first program director from 1981 until 1985, there were many opportunities to learn about medicinal plants. Since it is not included as a subject in our medical school curriculum, we had much to learn from traditional healers. During community health worker’s training, I shared my knowledge and skills on western medicine and what I learned about medicinal plants, their uses, preparation and dosages. The members of the staff and I gave lectures on the rationale and use of medicinal plants to teachers, health professionals, church groups and community health workers in several provinces of the Cordillera. Everyone welcomed and liked these lectures but what interested them most were the cooking sessions.
Through generations, traditional healers in indigenous peoples’ communities would research medicinal plants and use these as medicine. We, medical doctors who chose community medicine, studied these medicinal plants and their uses, systematized the preparations and dosages. I would like to acknowledge what we have learned from the traditional healers. They are the true bearers of our knowledge on medicinal plants.
In 1981, two of our projects in CHESTCORE were research on medicinal plants in the Cordillera region and publishing a book after three years. Leonardo (Leonard) L. Co, our botanist, made a compendium of 122 medicinal plants with their scientific and common names. Each plant had a description and included: habitat, distribution, parts utilized, indications, directions for use, dosage, and precautionary notes on toxicity and contraindications. The illustrations were made such that anyone, who sees the drawing, would be able to identify the plant. This compendium of medicinal plants was published in 1984. Leonard would continue updating the book. In 1989, CHESTCORE published a more comprehensive book, “Common Medicinal Plants of the Cordillera Region: A Trainor’s Manual for Community-Based Health Programs,” with Leonard as the author. The book is composed of three parts: (1) A compendium of the common medicinal plants of the Cordillera region with 122 species entries, (2) Collection, Storage, Preparation and Usage of Herbal Drugs and (3) Major constituents, Pharmacological and Clinical Research. Although the book may have its shortcomings, it is still the only book of its kind in the Philippine Cordillera.
The original paper I intended to deliver at the British Museum had the introduction above. However, each speaker was given only 15 minutes for the lecture, so I opted for a powerpoint presentation.
My lecture includes the following topics:
(1) Traditional medicine as practiced among the Ifugaos in Mayoyao, a town in Ifugao, and among the Kankanaeys in the far-flung village of Badeo, Kibungan, Benguet.
(2) Traditional healers and a profile of a traditional healer.
(3) On Medicinal plants.
(4) Drawbacks of Traditional Medicine.
(5) Traditional Medicine and the Future.
There are various terms used for traditional medicine and one of these is local health tradition. Hafeel et al. (2001) defines local health traditions as:
“…Practices, beliefs and customs related to health, that are specific to each locality and community. Diverse and informal health care systems are passed on from generation to generation by word of mouth. These time-tested local health traditions are an integral part of community life and focus on
prevention and cures for human and animals. Knowledge of specific plants
and health-related customs are living expressions of these traditions.”
Other terms used for traditional medicine are:
Indigenous health knowledge and practices (Castro-Palaganas et al. 2001)
Traditional health procedures (Garcia et al.1996)
The Cordillera: Its Land and People
The Gran Cordillera Central is a mountain range, which forms about 1/6 of the land area Luzon in the northern Philippines. The people are collectively called Igorots, totaling about 1.8 million. There are seven major ethnolinguistic groups in the Cordillera: Ibaloi in southern Benguet, Kankanaey in northern Benguet to western Mountain Province, Bontok in central Mountain Province, Ifugao in Ifugao, Kalinga in Kalinga, Isneg in Apayao and Tingguian (or Itneg) in Abra.
People live in clusters of houses, which form a village. Or, they live in houses that are about one kilometer or more away from each other. Most villages have a water source for drinking and cooking purposes. If it is a spring, the village people go there to bathe and launder their clothes. Sometimes, water is piped from the source or reservoir to the houses.
Majority of the people are poor. They grow rice as a staple food, which they harvest once or twice a year. They also grow sweet potatoes (kamote) after the rice harvest. When their supply of rice is low, the residents eat kamote. Their source of protein is mostly beans. During feasts, the community people get their animal protein from meat of chicken, or pigs that are butchered.
Health facilities are found in town centers, which could be a hospital or a Rural Health Unit (RHU). The personnel would consist of a physician, two or three nurses and five or six midwives. Midwives, who are assigned to villages, visit on a specific day of the week.
In some cases, the nearest hospital is an hour or two-hours walk from the village. If a person gets sick, the traditional healer is the most available to consult. The healer uses his herbal preparation and performs healing rituals. If the patient becomes worse, it is time to bring the patient to the hospital. Bringing the patient to the hospital is a family activity. Some family members usually accompany the patient and they bring along rice and a live chicken. My mother used to say that while the physicians are treating the patient in the hospital, the relatives would camp on the hospital grounds. They would perform their healing rituals, which culminates in butchering the chicken. The village people want to make sure that all means of healing are exhausted, so the patient gets well.Thus, we see two systems of healing complementing each other.
Health, Disease and Healing
The concepts of health, disease and healing are within the framework of the people’s belief system. They believe in a supernatural being and deities called anitos. Some spirits live in the mountains, rocks, caves, stones, trees and rivers. It is believed that any person who goes into or steps in the home of the anitos would get sick. Some deities are:
female deity of the underworld or goddess of earthquake or hell;
male deity of the skyworld or god of lightning, thunder and heaven;
male sun deity;
female moon deity;
a constellation deity or god of the stars;
deity of wild animals;
deity of war;
god of the farming system;
a creator god and
the evil spirit.
Health is encompassing. It means physical, mental and spiritual well being. There are terms in the vernacular that people use to describe health---happy, alert, sound body, free from disease and well-being.
People eat health-giving foods like rice, kamote (sweet potatoes), legumes and vegetables. Legumes are mostly in the form of dried beans---white, red or black or mung beans (munggo). In some villages, boiled dried beans and rice would be for breakfast, lunch and dinner. Most of the time, women cook newly-pounded rice for their meals. The resulting brown rice is an excellent source of Vitamin B1 or , which prevents “Beriberi,” a disease that could affect the nervous, cardiovascular and digestive system. The food combination of brown rice and beans forms a complete protein and is a substitute for meat. This food combination is a dietary strategy called mutual supplementation.
In traditional medicine, the healer looks for the cause of the disease, how it is contracted and who causes the disease. The last item is important since people believe that when an illness occurs in the family, a supernatural being and deities cause the illness. The spirit of ancestors or dead relatives is also implicated in the cause of illnesses. When children have no appetite to eat, it is thought that this might be due to a dead relative’s visit. When a person is ill, they attribute it to spirits that are angry or homesick or that may have been displeased. Ancestors and deities could also cause illness when the ecosystem is disturbed. For example, it is a belief that when rice fields are left uncultivated, someone would get sick.
Other causes of illness are:
(1) Environment, e.g., allergy could be due to the pollen of plants that flower during the summer season;
(2) Diet, e.g., high blood pressure has been attributed to a diet of meat and drinking liquor and
(3) Hot and cold temperatures, e.g., people could get sick from exposure to the rain.
Healing is holistic---the healing process considers the person’s physical, mental and spiritual dimensions. The departed ones are part of the healing process.
Rituals are essential in the healing process and appease the dead relatives’ spirits that might have inflicted the illness. Rituals come in many forms such as a prayer or an offering to deities like butchering a pig or dressing a chicken.
In a study of Besao traditional knowledge, Fiar-od (2001) says:
“The 54 traditional prayers verbally passed from generation to generation have specific purposes as healing, … Of the 54 prayers, 26 were said for their healing effect on sicknesses either physical, spiritual or psychological in nature or as preventive measure.”
In Ifugao, the ritual includes reciting a ritual myth and use of paraphernalia. According to Enkiwe-Abayao (2001), “The ritual myths contain an elaboration of how the illness originated, why it was inflicted, and conditions of the social as well as environmental resources of the people to their fellow citizens and to their environment.”
They are persons in the community who are gifted with healing and are taught the healing rituals. Traditional healers diagnose the disease, prescribe the treatment and perform healing rituals. The traditional healer may be a man or woman. They usually live in the community and share the people’s beliefs on causes of illnesses and on healing rituals.
Traditional healers have their lines of specialization. Among the Ibalois of Benguet, there are specialists in muscular and bone ailments, child delivery, eye ailments and tooth extraction.
Prayer is an essential part of the healing ritual so the religious figures also perform these. The mambunong (one who recites the prayers) is held in high regard during feasts. The mambunong must know the different ceremonies and which prayer is needed for each ceremony. One learns to be a mambunong. For others, it’s a calling. One starts as an apprentice, observes ceremonies and learns the prayer or is taught. The apprentice becomes a full-fledged mambunong when his prayer is granted. He is then given the right to perform during ceremonies.
In our health program, we were fortunate to have known a traditional healer, the late Lakay (old man) Domin-eng, who lived in Aguid, Sagada, Mountain Province. While earning his living as a farmer, he is a traditional healer during his free time. As a healer, he was known in the village where he lived and in other villages. People respected and trusted him, so they would walk for hours just to see him.
Beside his house is a one-room hut, which is his kitchen and storage room for his healing paraphernalia. Among other things, he stores roots, barks, leaves, flowers, oils and bottles. In the summer (April through May), he goes to the forest and gathers herbs. For each plant, he knows its habitat, characteristics, and its flowering and fruiting season. Fortunately, Leonard was able to interview Lakay Domin-eng about his expertise and recorded 350 plant species.
Lakay Domin-eng knew how to get the person’s temperature, and carried with him a thermometer. He also knew when to refer sick persons to the hospital. For persons with a fever of more than three days, he advised them to go to the hospital. When a person has a fall, he would first feel if s/he has a broken bone before he does any massage. He would refer a person with a bone fracture to the hospital. He was an expert on the use of medicinal plants and on massage. People went to him when they were sprained. According to Leonard, the plant that Lakay Domin-eng used most was lubigan (Acorus calamus L,) also known as dalaw or sweet flag. He would chop the rhizomes and cook these in coconut oil. This became the base of his medicinal preparations, which he used as a carminative and for general massage.
Massage, which is the equivalent of touching, is a skill that is frequently used by traditional healers. Among healers, whether in traditional or western medicine, touching is an old and effective act. Sick people need and want to be touched. The act of touching, the laying on of hands, could make the sick person well. And the traditional healer knows this.
Thomas (1983) explains the essence of touching among traditional healers when he says:
“The shaman learned his profession the hardest way… He had epileptic fits, saw visions, and heard voices, lost himself in the wilderness on end, and fell into long stretches of coma, and when he came back to life he was licensed to practice, dancing around the bedside, making smoke, chanting incomprehensibilities, and touching the patient everywhere. The touching was the real professional secret, never acknowledged as the central essential skill, always obscured by the dancing and chanting, but always busily there, the laying on of hands.”
The other skill of the traditional healer is listening. The traditional healer would listen to the sick person’s complaints, feelings and other woes. Sometimes, the complaints may not be disease-related but the traditional healer listens. The patient may even talk about his family, his work in the rice fields and probably the water buffalo (carabao), pigs or dog. When it is time to give advice, they would both discuss the healing rituals that need to be done. The traditional healer only suggests which healing ritual is needed and the family of the sick person would decide what to do.
Time is an element that the traditional healer has. There is time to listen; there is time to talk and the traditional healer makes time for both.
On Medicinal Plants
Village people in the Cordillera have long been using medicinal plants even before western pharmaceutical companies manufactured drugs from plants. They used medicinal plants for several reasons:
(1) Availability. The forest is their pharmacy and those who know the plant’s medicinal uses could easily get roots, barks, stems or leaves and make their preparation.
(2) Effectivity. Various preparations made from these plants work for certain illnesses.
(3) Low or no cost. Since the plants grow in the forest, anyone could get them. One doesn’t have to buy them.
(4) Holistic. Medicinal plants have become part of the healing process where cure does not only come from the plant, but also from rituals associated with their healing properties.
Medicinal plants are prepared in various ways before they are used.
A decoction is a preparation where the herbal material is boiled and strained or filtered. The liquid part is used.
An infusion is a preparation where boiling water is poured on the herbal material, covered, left to stand for a few minutes and strained.
Covering prevents the escape of volatile oils. A poultice (tapal) is a mass of wet and crushed or powdered herbal material, which is applied directly on the skin. It could also be wrapped in a gauze or thin cloth material before being applied on the affected part.
A tonic is a medicinal preparation that improves the body’s functioning or well-being.
I have selected a few weeds from the book: Common Medicinal Plants of the Cordillera Region…” and described some of their uses. These weeds also grow in other provinces of the Philippines. Some medicinal plants like dandelions and purslane are food plants.
1. Bulak manok
Pagpagey(Bontok), Billy goat weed (English).
The poultice from the fresh plant is applied over wounds.
The sap from the fresh plant is used for burns and stiff joints. Dandelion, as an herbal tea, is a tonic. It also helps in food digestion. The young dandelion shoots, although bitter, can be added to salads. These should be blanched before eating.
Keskesteng (Bontok), Milkweed (English)
The juice from the fresh plant is used to clean wounds.
Botonis (Ilocano), Australian asthma weed (English).
As a decoction, the fresh plant is used to wash wounds. And as a poultice, it’s applied over wounds.
Ngalug(Ilocano), Purslane (English)
A leaf decoction is used for washing wounds. Young leaves can be mixed in salads and young shoots cooked as a vegetable or added to broths.
Plantago major L.
Tabtabako (Bangnin-Kankanai), Plantain (English).
Slightly crushed fresh leaves can be placed over minor cuts and abrasions.
A poultice from the fresh plant is applied over skin sores.
A poultice from the fresh plant is applied over wounds.
Other common useful medicinal plants are sabila (Aloe barbadensis Mill.) or aloe and heart-leaved mint (Mentha x cordifolia opiz ex Fresen.), the common variety of peppermint plant in the Cordillera. The sap of the sabila is used for burns. Pounded fresh leaves from the heart-leaved mint are rubbed over insect bites. Mint is useful in digestion and can be drunk as a decoction or infusion two hours after meals.
There are some examples of medicinal plants that are used in a remote mountain village of Badeo in Kibungan, Benguet. One is guava (Psidium guajava L.) The leaves are boiled in water and the lukewarm decoction is used to wash the navel of a newborn or a decoction of guava leaves and salt is used to clean skin diseases. Another plant is ginger (Zingiber officinale Rosc.) For cough, ginger is cooked in coconut oil and wrapped in cloth. As a poultice, it is placed over the chest and back.
Drawbacks of Traditional Medicine
While traditional medicine has some positive aspects, it also has its drawbacks These include “… incorrect diagnosis, imprecise dosage, low hygiene standards, the secrecy of some healing methods and absence of written records about the patients.” (Shankar and Haverkort 2000)
Some practices need the attention of health professionals. One is the practice of colostrum being suctioned and thrown away because it is thought to be dirty. It is important to teach that colostrum contains antibodies needed by the newborn. Other practices are: (1) the mother, father or grandmother chew the food and feed it to the child and (2) the person chews the herb, makes a poultice and applies it on an open wound. These are inadvisable because some diseases, e.g., tuberculosis, could be transmitted through these practices.
Traditional Medicine and the Future
Over the years, practice of traditional medicine in the Cordillera has decreased due to:
(1) Availability of western medicine in town centers and cities. There are hospitals or rural health clinics, which are staffed by health professionals trained in western medicine, and people prefer to go to these facilities.
(2) Introduction of Christian religion, which has affected the practice of healing rituals. Village people, who have been converted to Christianity, see no need to do healing rituals.
(3) Expenses incurred. Some families couldn’t afford to buy a pig or a carabao (water buffalo) as an offering during a healing ritual.
Traditional medicine continues to exist in many villages of the Cordillera. Some reasons are:
(1) Traditional medicine has been practiced for generations and it works. Although the traditional healer may not know it, many illnesses are due to viral infection that only needs supportive care at home. The patient is brought to the hospital when the sickness becomes worse and is the last resort.
(2) Traditional medicine is holistic. It considers the whole person so healing is all-sided: physical, mental and spiritual. Praying to a Supreme Being and deities, which is part of the healing ritual and their belief system, has a great influence on the patient’s recovery.
(3) People prefer traditional medicine since health facilities are geographically inaccessible in some villages. At times, the nearest hospital could only be reached by walking two hours or more.
(4) People make use of traditional medicine because of poor economic conditions. The healer charges nothing or if he does, would only ask for “what the family can afford to give.”
(5) Traditional healers live in the community. They are accessible and give time to listen to the sick person and his family. They do not only talk about the person’s illness, but also about other aspects of his life. This has a therapeutic effect on the sick person.
(6) Medicinal plants continue to be an essential component of traditional medicine in the remote villages although they are used less in town centers and cities. There is ongoing research on medicinal plants in various areas in the Cordillera. Some of this research has been published. Herbal gardens are also being set up in schools. However, medicinal plants are disappearing, especially in deforested areas.
Traditional medicine and the use of medicinal plants are still very much a part of community life among Igorots in the Cordillera. People trust the traditional healer and they believe in healing rituals. Trust and belief are components of a sick person’s speedy recovery. Traditional medicine will continue to exist because the concepts of health, disease and healing are integrated in people’s belief systems.
(Yvonne Kay-an Belen, July 2021)
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This is an edited version of the paper presented on June 28, 2002 during the 4th Igorot International Consultation (IIC-4) held in London, United Kingdom from June 28 - July 1, 2002. Igorot-UK hosted the event.