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1 March 2010 A Comparative Assessment of Zootherapeutic Remedies from Selected Areas in Albania, Italy, Spain and Nepal
Cassandra Leah Quave, Usha Lohani, Alonso Verde, José Fajardo, Diego Rivera, Concepción Obón, Arturo Valdes, Andrea Pieroni
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Abstract

Zootherapy is the treatment of human ailments with remedies derived from animals and their products. Despite its prevalence in traditional medical practices worldwide, research on this phenomenon has often been neglected in comparison to medicinal plant research. Interviews regarding zootherapeutic traditions were conducted with informants from Albania, Italy, Nepal and Spain. We identified 80 species used in zootherapeutic remedies, representing 4 phyla in the animal kingdom: Annelida, Arthropoda, Chordata, and Mollusca. Remedies were ranked by consensus indices. Our studies show that the selection of medicinal fauna is mediated by human subsistence patterns. Concepts of health and disease differ among our study sites in the Mediterranean and Asia, and these differences also play a substantive role in the selection and use of animal-based remedies.

Introduction

The treatment of ailments with remedies made from animals and their products is known as zootherapy (Alves and Rosa 2005). Animal-based medicines are generally derived from three sources: the whole or parts of the animal body, metabolic products of the animal (secretions or excrement), and other things created by animals such as nests, cocoons, honey, and eggs (Costa-Neto 2005). Since ancient times, zootherapy has been integral to the traditional pharmacopoeias of many cultures (Alves and Rosa 2006; Costa-Neto 1999; Lev 2003; Mahawar and Jaroli 2007) and has comprised a fundamental element to well-known traditional medical systems, such as Ayurvedic medicine, Traditional Chinese Medicine, and ancient Egyptian medicine. Records of the medicinal use of animals and their by-products date back to the invention of writing (Lev 2003, 2006). Today, animal products make up an important portion of modern pharmaceuticals; approximately 18% of prescription drugs used in the USA have animal origins (WRI 2000). Yet, despite its continued prevalence in traditional medical practices around the globe and importance as a potential source of novel pharmaceutical agents, zootherapy appears in the literature much less than studies of medicinal plant therapies.

Zootherapy is a vital component of traditional medicine (Alves and Rosa 2007a, 2007b, 2007c). This is especially evident in rural communities where access to modern healthcare is limited. Over centuries, the close interactions of rural populations with the environment, often associated with an economic dependence on local natural resources, has fostered the accumulation of a wealth of knowledge in this field. This knowledge of animal-based medicines, much like that of medicinal plants, is usually passed down through the oral traditions typical of many societies.

Loss of this traditional knowledge (TK) in the wake of rampant urbanization in cultures across the globe instills a sense of urgency for ethnobiologists to record and interpret this data before it is lost forever. In an effort to better understand the role of zootherapy in traditional medicine today and to record TK of endangered medicinal practices, we have taken a cross-cultural approach to examine data from our field sites located in four countries. We identify, describe, and compare zootherapeutic remedies used in the traditional pharmacopoeias of rural communities in Albania, Italy, Spain, and Nepal (Figure 1). These four regions were selected specifically for their disparate cultural and geographic domains. We use data from the Mediterranean field sites in Albania, Italy, and Spain to compare zootherapeutic practices in locations that are characterized by different cultures, but similar terrain and fauna. The Nepal data provide zootherapeutic practices from a region with a different culture, environment, and native fauna than that of the Mediterranean sites.

Figure 1

Map of the study area: Spain, Italy, Albania and Nepal.

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Cross-cultural studies of zootherapeutic practices are uncommon, yet they can offer valuable insight into the dynamic relationship that we share with our environment. In this paper, we aim to address the following questions: How does culture mediate human-environment interactions as they relate to zootherapies? How do subsistence patterns and economic models influence human health and access to medicines? How can we use our understanding of traditional lifeways and ethnomedical systems to promote biodiversity conservation?

Study Area

Albania

Albania has a predominantly mountainous terrain. Although a relatively small country, it has a high level of biodiversity, and 5.8% of the country is protected as national parks and reserves (Hoda and Zotaj 2007). The nation's economy is based on agriculture and forestry. According to the Albanian National Institute of Statistics, 58% of Albanians live in rural areas and approximately 20% of the population live in very poor conditions, 10% on less than US $2 per day (World Bank 2003). Albania is one of the poorest countries in Europe with an estimated Gross National Product of US $930 per capita.

Recent ethnobiological studies have been conducted in two remote villages–Lepushe and Theth–both located in the Shala Valley in the northern Albanian Alps (Pieroni 2008; Pieroni et al. 2005). The terrain in this area is mountainous and is characterized by alpine pastures and beech forests. The average temperature in the summer is 16°C, and winter brings heavy snowfalls and an average temperature of −3°C. Members of these communities survive on an economy of self-sufficiency; households care for a few livestock (usually one or two cows, pigs, and a few sheep) and cultivate staple crops like potatoes and corn along with some additional vegetables. Thus, due to the economic environment and physical isolation from other populations, these communities maintain strong ties with their environment and are actively involved in the collection of plant materials and animal products from both wild and cultivated sources for food and medicine.

Italy

Italy's Basilicata province lies in the south-central region of the country and is dominated by a rugged, mountainous terrain. This 9,992 km2 region has a population of about 600,000 people. The local economy is based on small-scale agriculture and agro-pastoral activities, although in the past decade it has shifted toward factory labor for both men and women. One prominent geographical feature of Basilicata is the dormant volcano, Monte Vulture (1,330 m a.s.l.). The Monte Vulture area is home to both autochthonous (native) Italians and ethnic Arbëreshë Albanian communities who have been included in extensive ethnobiological studies (Pieroni et al. 2002; Quave and Pieroni 2005).

In addition to the Vulture area, ethnobiological field studies have been conducted in the Lucanian Dolomite area –an isolated mountainous region near the province capital city of Potenza. The population is autochthonous Italian, with the exception of some eastern European migrants employed as household helpers. The remote location of these communities combined with their close proximity to forests fosters a close relationship between people and their environment. The tradition of collecting wild plants for food and medicine (both for human and animal consumption or use) still thrives, as does the similar use of wild and domestic animals and their products (Pieroni et al. 2004). Some of the domestic animals common to Basilicata include poultry, swine, cattle, goats, and sheep. Those who regularly participate in pastoral labor often use horses or donkeys for transportation while herding the livestock. Thus, the health of their animals is of primary importance, and a rich tradition of ethnoveterinary practices has been documented (Pieroni et al. 2004).

Spain

Castilla-La Mancha lies in the center (C-SE) of Spain, near Madrid. This 79,463 km2 region has a population of almost 2 million people (Instituto Nacional de Estadística 2009). The flat plains of La Mancha are almost entirely devoid of natural vegetation and are instead occupied by crops, mainly grape vines and cereals like barley, wheat, oat, and rye. Groves of olive and almond trees are common in the warmer climes.

From an ethnobiological point of view, the most interesting areas are the peripheral mountains, where the Mediterranean forests are filled with Quercus spp. and Pinus spp. in the highest mountains. There, people live in small villages still close to nature and the traditional way of life. The elders living in this region remember old healing practices, now in disuse, but which were an important part of their lives in the past (Verde et al. 2008). A review of the Spanish literature confirms the importance of traditional remedies in the Spanish medical heritage (Blázquez 1989, 1991; Iniesta and Jordán 1991; Sánchez-Mínguez 1995). Zootherapy was commonplace in Spain in the second half of the 20th century, particularly in mountainous areas. In the Pyrenees (Alto Aragón), 48 animal species were used to treat up to 197 different ailments (Palacín-Latorre 1994; Palacín-Rodríguez 1985). In the Cantabrian mountains Orense and Asturias, 12 and 13 animal species respectively, were reported as medicinal resources (Rico-Avelló 1974; Taboada 1948).

Like other Mediterranean countries, Spain has a rich diversity of reptiles and amphibians and many species of birds. Big mammals, however, are rare, and wolves are almost extinct in the region. Some game like deer and wild boar are still common, and foxes are also easy to find, even near villages and towns. Hunting is an important source of income, and the focus is mostly on small game like partridges, rabbits and hares and big game in some mountainous areas like the Toledo Mountains, Morena Range, and Cuenca Range.

Livestock, particularly sheep and goats used for their milk and meat, are also very important in La Mancha. Some areas are dedicated to breeding bulls for corridas (bull-fighting). Cattle are frequently found in the mountains. Swine and rabbits are bred for meat, and poultry are raised as a source of meat and eggs. Horses and donkeys were very common in the past, but are now rare in the countryside, although some remain in the mountain villages.

Nepal

Nepal has a distinctive topography that contributes to its rich biological and cultural diversity. Rugged terrain forms specific niches harboring unique assemblages of flora and fauna. Further, because of its location, the country encompasses two zoogeographical regions: the Palearctic in the north and the Oriental in the south. The country, though small, is rich in fauna of both the realms. The narrow middle strip of the country from east to the west is the main region of faunal mixing. Historic and current economic factors have promoted human interaction with biological resources in Nepal resulting in a rich body of traditional knowledge concerning resource utilization, management and conservation (for example Nanhoe and Ouboter 1987; Rajbhandari 2001; Shah and Giri 1992; Shrestha 2003), but Lohani et al. (2008) emphasize a strong need for comprehensive ethnozoological studies.

In this study we document ethnozoological knowledge in Majhi communities from the central mountainous region of Nepal. Majhi communities are usually scattered along the river banks in the Inner Terai and lower mountainous regions. These are river people who constitute about 0.32% of the total population of the country (CBS 2001). The nearby ancient Tharu people depended only upon wild forest products for their livelihood while ancient Majhi were engaged in fishing and farming (Bista 2000). In the wake of modern development efforts, modern Majhi are now engaged in other economic activities such as wage labor and business.

Materials and Methods

Our research methods included participant observation, semi-structured interviews, and focus groups. Although field research was conducted in each of the four study sites by different ethnobiologists, similar interview techniques and data collection methods were employed. Prior informed consent was obtained before conducting interviews, and ethical guidelines adopted by the International Congress of Ethnobiology/International Society of Ethnobiology (ISE 2007) were followed. Interviewees were questioned in their native language about the medicinal uses of the local fauna. Study participants were asked to free-list any known zootherapeutic remedies. Informants were prompted by asking about remedies for different common health problems, such as remedies for respiratory ailments, skin infections, diarrhea, women's health, stomach problems, pain, and wounds. When possible, informants were also interviewed using a focus group format, and dialogue between the participants was encouraged while the researcher(s) recorded references to zootherapeutic remedies. Details regarding the local names of animals and the use and collection of animal products are presented in Table 1. The consensus index uses how often a certain remedy was cited to provide a relative measure of the knowledge of remedies within each study location.

Table 1

Popular uses of animals as zootherapeutic remedies in Albania, Italy, Nepal and Spain.

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For Albania, Pieroni conducted field research in the upper Shala Valley in the northern Albanian Alps from 2004 to 2007. Snowball sampling methods (Bernard 2002) were used to recruit 38 study participants, primarily among elderly members of the community who had lived in the area for all or most of their lives. Albanian fauna were identified using the Libri i kuq i faunës shqiptare [Red Book of Albanian Fauna] (Misja 2006).

Field research was conducted in the Basilicata Province of southern Italy by Quave and Pieroni from 2000 to 2008. Random sampling techniques were employed to recruit 112 interview subjects. Interviewees were equally stratified by gender and four age groups (21–35, 36–50, 51–70, 71+ years). Italian fauna were identified using the Checklist of Italian Fauna (Stoch 2009).

Fajardo, Verde, Rivera, and Obón conducted field research in Castilla-La Mancha Spain from 2000 to 2008. More than 600 study participants were interviewed, 170 of which were knowledgeable of local ethnobiological applications of fauna. Fauna were identified using the Fauna Iberica (Ramos 2009).

Field research was conducted in the Inner Terai and Lower Mountainous regions of Nepal by Lohani from 2004 to 2006. A total of 38 informants were interviewed, 17 of whom were 18–29 years old, 10 were 30–49, and 11 were older than 50. Nepali fauna were identified using several taxonomic keys (Grimmet et al. 2003; Shah and Tiwari 2004; Shrestha 1981; Shrestha 2003).

Results

Our research in three countries in the Mediterranean (Albania, Italy, and Spain) and one in Asia (Nepal) gathered information on 80 animal species used in 232 traditional zootherapeutic remedies for either human or animal health (Figure 1). A detailed description of these remedies is provided in Table 1, including popular use, preparation and application, and. a consensus index system.

Animals from 4 phyla (Annelida, Arthropoda, Chordata, and Mollusca) were reported as sources of medicinal remedies, with the majority (62 species, 77.5%) Chordata, followed by Arthropoda (13 species, 16.3%), Mollusca (4 species, 5%) and Annelida (1 species, 1.3%). Of the animal classes, most reported species come from the Mammalia (27 species, 33.8%), followed by the Aves (12 species, 15%) – both in the phylum Chordata. As to orders, the Artiodactyla from the class Mammalia had the most species represented (8 species, 10%), followed by the Carnivora of class Mammalia and order Squamata of class Reptilia, both of which had 7 species (8.8%) represented (Table 2).

Table 2

Distribution of fauna and corresponding remedies by country. Numbers in columns for each specific country indicate the number of different species or remedies cited for the respective country. Totals in bold indicate the total number of different species or remedies cited in all countries. If the same species or remedy was cited in more than one country, this is counted only once in the total column. For example, in the order Hirudinea, three countries reported the use of the European Medicinal Leech. Since the number 1 assigned to each country represents the same species, only 1 goes into the total column in bold. However, this species is used in different ways in the different countries, so each remedy will be counted once and the total number of remedies is 3.

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Correlation of Remedies to Fauna

A total of 232 zootherapeutic remedies were reported. More remedies were reported from species belonging to certain orders. There were 52 remedies (22.4%) reported using animals from the order Artiodactyla. Other important orders included Squamata (24 remedies, 10.3%), Primates (20, 8.6%), Galliformes (19, 8.2%), Carnivora (18, 7.8%), and Hymenoptera (13, 5.6%). The distribution of fauna and remedies is reported by country in Table 2. The greatest number of remedies was reported in Spain, with 77 remedies coming from 34 species. This is closely followed by Italy, where 71 remedies were reported from 21 species. Nepal reported the most species used–37 species used in 56 remedies, and Albania reported 11 species used in 31 remedies.

Etic Categories of Use

Our research found over 50 categories of medicinal remedies, including applications for the treatment of various forms of infection and illness, as well as magical or spiritual protection from illness or misfortune (Figure 2). Vulnerary agents were most numerous (20 remedies), followed closely by protective amulets and blessings (15 remedies). Each study site had a concentration of certain types of remedies. In Spain, the majority of remedies were for vulnerary (9) and anti-rhinitic (6) applications, and ethnoveterinary remedies for the treatment of sick livestock (7). In Italy, the majority of remedies were for anti-dermatitic (6), vulnerary (5), and emollient (5) applications. In Nepal, most remedies were for protective amulets and blessings (9), followed by vulnerary (5), and reconstituent or nutraceuctical (5) purposes. In Albania, the most commonly reported remedies were for treating animal bites (3)–such as wolf, dog or snake-bites and for nutraceutical or reconstituent purposes (3).

Figure 2

Distribution of remedies by etic category. Remedies reported only once are not included: fertility aid, anti-hydrocele, anti-blister, anti-dysenteric, anti-wrinkle, diaphoretic, heal inguinal hernia, treatment for difficulty passing urine, anti-enuresis, anti-erysipelas, anti-chillbains and anti-leucoderma.

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Animal Parts Used in Remedies

There were 36 source categories reported for remedies (Figure 3). The most common sources included the whole animal (33 remedies), milk and milk products (21), meat/animal flesh (16), fat (15), honey (12), and eggs (11). Some of the more unusual remedies come from animal excrements, including feces (10), urine (3), and seminal fluid (1). Figure 4 illustrates the use of some of these different remedies in traditional Spanish medical applications.

Figure 3

Animal parts used in traditional zootherapeutic remedies. Animal parts quoted in only one remedy are not illustrated: bees wax, cerumen, claws, heart, horns, saliva, milt, musk, silk, spines, sweat and teeth.

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Figure 4

Zootherapeutic remedies from Spain. (A) Feeding a mule bread and a snake skin to cure general sickness. (B) Applying a spider web to seal a skin laceration and promote healing. (C) Puncturing the skin with a tip of a deer horn to release the poison from a snake bite. (D) Preparing an oleolite by soaking several newborn mice in a jar of olive oil. The oil is instilled in the ears to treat earache.

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Only two species were used as remedies in all four study sites–the domestic chicken (Gallus gallus) and domestic goat (Capra aegagrus hircus). Other than these two, Nepal shared no common species with the Mediterranean study sites. People in Albania, Italy, and Spain used 7 of the same species for their zootherapeutic pharmacopoeias. These were mainly common livestock such as donkeys, sheep, and swine and the honey bee, medicinal leech, and dog.

Discussion

It is not surprising that the fauna used in traditional zootherapeutic remedies in Nepal differ significantly from those in the Mediterranean study sites (Figure 5). While Albania, Italy, and Spain vary somewhat in their respective wild fauna, their domestic livestock are similar, typical of the agro-pastoral economies of the Mediterranean. The study area in Nepal, on the other hand, is home to a much different wild fauna, and the ethnic populations living in this region demonstrate a strong reliance on wild resources rather than livestock. The native fauna in the Nepali environment includes monkeys, rhinoceroses, tigers, and elephants–none of which are indigenous to the Mediterranean.

Figure 5

Intercultural correlation of fauna reported in zootherapeutic remedies. The fauna reported in Nepal (a) are very different from those in the other countries. Other than Gallus gallus (chicken) and Capra aegagrus hircus (goat) - reported in all study sites - Nepal shares no other common species with the other study sites. Albania, Italy, and Spain (b) share 7 species as zootherapeutics: sheep, swine, donkeys, honey bees, medicinal leeches, and dogs.

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It is interesting to note that even when the same or similar species are used in the different study sites, the actual part of the animal and the application often diverge. The only exception we found is that in all study sites honey, from various species of bees, is reported as a popular remedy for colds and sore throat and is typically added to a hot tea and drunk or eaten alone.

To better describe this divergence in preparation and use of similar species, we discuss the example of pigeons. Various species of pigeon are used in three of the study sites, but different parts or products of the pigeon are used depending on the country. In Spain, pigeon feces are used to treat ingrown toenails and acne, whereas in Italy the meat is eaten as a soup for galactagogue, reconstituent, and post-partum healing purposes. On the other hand, in Nepal, a live pigeon is set free as an augury and magical protection against misfortune (Table 1).

The medicinal use of the domestic chicken also differs based on the study site: in Italy it is used to heal broken bones, to treat general sickness, for post-partum healing, as well as to treat abscess and furuncle; in Spain it is used as an amulet, an anti-anemic, and treatment for ingrown toenail; in Albania it is used to treat kidney stones and stomachache, as a poison antidote and analgesic; in Nepal it is used for magical blessings, as a vulnerary, and to heal broken bones. While some applications are similar in more than one country, the animal part used differs. For example, people in both Spain and Nepal use the chicken as a vulnerary, but the egg white is used in Spain while fat is used in Nepal. Only in Italy and Albania, where eating boiled eggs is a diarrhea remedy, do we find a similar preparation and application of chicken.

Besides chickens, other domestic animals commonly used as a source of traditional medicine include cattle, goats, sheep, pigs, dogs, donkeys, and horses. In fact, the largest portion of animal-based remedies reported in this study come from domestic animals, and this is likely due to their role in local subsistence practices and the consequential ease of access and availability of these species to humans. This is particularly evident in the Mediterranean study sites. While the medicinal use of these species was reported in several sites, once again, we note that the actual animal part(s), application, and preparation of the remedies differ between locations.

The use of wild fauna for traditional medicine is, of course, highly dependent on local availability and accessibility to wild resources. We would expect the close proximity of communities to natural resource reservoirs such as forests or water sources to be correlated with a greater use of wild fauna. Communities in the Spanish study site are located near game preserves and hunting is a popular sport. The time spent in the forests perhaps gives this population a greater level of access to wild fauna like snakes, foxes, badgers, and lizards–all of which were reported as popular zootherapeutic remedies. In Nepal, on the other hand, the emphasis on water creatures–such as fish, eels and turtles, as well as snakes–perhaps relates to the Nepalese economy, which is based in large part on fishing. In Italy and Albania the heavier reliance on domestic, rather than wild fauna is likely associated with the agro-pastoral economy of these study sites.

In addition to looking to other species for medical remedies, certain ethnomedical solutions come from humans themselves. These human-based remedies are not derived from essential organs, but instead from human excrements and secretions, including breast milk, cerumen, sweat, menstrual blood, urine, and feces. Some of these remedies, such as the use of breast milk as an anti-conjunctivitic, may have a biomedical basis to them. For example, breast milk has antibacterial properties that could be useful in treating an eye infection (De Souza, et al. 2002; Stevens et al. 2000). While all of the human-based remedies were reported in the Mediterranean study sites, this does not necessarily exclude the use of such products in Nepal. It is probable that many more zootherapeutic remedies are still practiced (or were used in recent years), but were simply not reported by informants in these particular field studies.

Other studies conducted in countries like Brazil (Alves 2009) and India (Mahawar and Jaroli 2008) have documented the zootherapeutic use of 250 and 109 animal species, respectively. In comparison with these studies, our documentation of 34 medicinal species in Spain, 21 in Italy, 11 in Albania, and 37 in Nepal, reflects a rather small number of species. This may be a consequence of one or more of several possible factors: 1) our study documents the zootherapeutic practices of isolated communities in distinct regions of each country, and the data do not reflect the TK of zootherapy for the entire country; 2) the conversion of wildland habitats (especially forests and wetlands) to accommodate grazing animals and crops has been detrimental to the faunal populations of these regions and also reduces community access to these wild resources; 3) modernization efforts and economic shifts in each study region have contributed to a decline in human daily interaction with the environment and a general abandonment of traditional lifeways; and 4) especially in contrast to NE Brazil (Alves and Rosa, 2006, 2007a, 2007b, 2007c), the biodiversity of our field sites is relatively low, and this is reflected in the diversity of resources used by the communities we studied.

Local Perceptions of Animals as They Relate to Human Health

Local economies doubtlessly play an important role in the relationship between human health and the environment. We have established that communities with an agro-pastoral economy, like that of the Mediterranean study sites, utilize more domestic animals (especially ungulates such as sheep, cattle, swine, donkeys, and goats) in the management of human health, whereas ethnic communities in Nepal that subsist on a fishing economy utilize more animals associated with a riverine or wetland environment for their medical care. These trends underline the implicit link between human subsistence behaviors and the traditional healing praxis. While this general correlation is likely associated with ease of access to certain species, other distinct sociocultural factors, such as religion, should also be taken into consideration.

Like other Nepalese ethnic groups, the Majhi believe in animism. The Majhi worship a family deity called Kulkulayan and sacrifice animals to appease the deity. The Majhi also worship a forest goddess called Ban Devi, who protects the forest, an area essential for Majhi survival. This devotion to the forest goddess explains the group's attention to resource conservation. The forest is believed to be governed by the deity and thus is considered sacred. The Mahji believe that life is influenced by the attitude of forest spirits, and many of the zootherapeutic remedies prepared by this group are utilized as protective amulets against bad spirits and as tokens of good fortune. In this sense, religion influences the Majhi perceptions of health and illness and guides the selection of remedies for particular disease states. This health epistemology where a preoccupation with illnesses of magico-spiritual or supernatural origin predominates greatly differs from that of the Mediterranean.

The people in the Mediterranean study sites are Catholic and overall have a more naturalistic perception of health and illness. In other words, the Mediterranean informants believe that many illnesses are caused by exposure to natural elements such as changing temperatures, humidity, rain, wind, and other seasonal weather events. In addition, our informants in Italy and Spain have greater access to allopathic medical care and, as a consequence, also demonstrate a greater understanding of biomedical principles of health and illness. Here, zootherapeutic remedies are selected to treat distinct symptoms of disease–such as the use of animal fat as an emollient for burns and wounds or dairy products in the treatment of intestinal disorders (diarrhea and constipation). In some cases, however, spiritual or magical elements are thought to be the causative factor in disease or misfortune (Quave and Pieroni 2005), and there are some zootherapeutic remedies, such as evil-eye amulets made from dog hide, which are used as a mode of spiritual protection.

Threats to these Medicinal Fauna

Eleven of the species documented in these field studies are included on the IUCN Red List of Threatened Species. Many of these species are threatened as a consequence of human development and the associated loss of natural habitats. In the Mediterranean sites, medicinal reptiles are most at risk–the European pond turtle is listed as lower risk/near threatened (Tortoise & Freshwater Turtle Specialist Group 1996), the four-lined snake is listed as near threatened (Romano and Jelić 2008), and Lataste's viper is listed as vulnerable (Mateo et al. 2008) In addition to the threat from loss of habitat, these two snakes are also subjected to human attack throughout their respective ranges. The European medicinal leech, whose use for phlebotomy has been documented over the centuries, is listed as lower risk/near threatened (World Conservation Monitoring Centre 1996). The major threats to this species are over-collection for medicinal purposes and the loss of their primary habitat from the conversion of grazing marshes to arable land.

In Nepal, four of the medicinal species documented in our study are listed under endangered status: elongated tortoise (Asian Turtle Trade Working Group 2000), Asian elephant (Choudhury et al. 2008), Himalayan musk deer (Wang and Harris 2008), and Bengal tiger (Ahmad et al. 2008). The sloth bear (Garshelis et al. 2008) and Indian rhinoceros (Talukdar et al. 2008) are listed as vulnerable species. The Assam macaque is listed as a near threatened species (Boonratana et al. 2008). Populations of the listed species above are declining due to a combination of habitat loss and poaching/hunting. Moreover, obtaining medicinal products from these species oftentimes requires killing the animal, which also contributes to the population decline.

Loss of habitat is not the only negative environmental factor instigated by people; reduced habitat quality also severely impacts these threatened species. The conversion of land for agriculture leads to the invasion of nonnative plant species and grazing by domestic livestock. Indian rhinoceros populations, in particular, have been affected by such a reduction in habitat quality (Talukdar et al. 2008). Likewise, the Assam macaque is threatened by both a loss of habitat and decline in the quality of habitat as a result of selective logging. They are also trapped for sport, food, medicine, and the pet trade (Boonratana et al. 2008).

Conclusion

We have found that while animal-based remedies constitute an important facet of traditional medicine in each study site, the actual application and preparation of animal products differs noticeably among sites. In addition, the popularity, or consensus of use, is dependent to a large degree on the accessibility or availability of the animals to these communities. Moreover, our studies show that the selection of medicinal fauna is mediated by human subsistence patterns. In other words, people are more likely to utilize medicinal products from animals with which they are in regular contact. This is why the most popular zootherapeutic remedies in the Mediterranean come from domestic animals (especially ungulates), whereas in Nepal, communities rely more heavily on wild fauna. In this sense, economic models play an important role in traditional healthcare practices by influencing the selection of particular medicines.

Concepts of health and disease differ among our study sites in the Mediterranean and Asia, and these differences play a substantive role in the selection and use of animal-based remedies. In Nepal, where a magical or spiritual medical epistemology is predominant, amulets are popularly used to ward off bad spirits and to bring good fortune. Powerful and even feared animals such as the Bengal tiger provide a “strong” medicine. The same is true in Spain with the medicinal use of venomous snakes. The difficulty of obtaining products from rare (vulnerable and endangered) species is often associated with the “potency” of the particular remedy. The sociocultural value assigned to threatened species that are considered to be “powerful” due to their rarity or the peril associated with their collection should be taken into consideration when designing biodiversity conservation measures.

In both the Mediterranean and Asia, populations of wild fauna are in a state of decline due to over-hunting, habitat loss, and reduced habitat quality. Threats posed to endangered and vulnerable wild fauna by poaching, which is also driven by their use in traditional medicine, must be acknowledged and addressed. The resulting loss of biodiversity is detrimental not only to the immediate wildlife affected, but also to local ecosystems and humans in general. Depletion of the variety of natural resources in our environment diminishes the potential for the discovery of new and much needed drugs. Thus, biodiversity is critical to current and future human health. A thorough understanding of human cognition of animal utility in folk medical systems is necessary for the creation and implementation of appropriate biodiversity conservation measures.

Acknowledgments

This project was supported by grant numbers F31AT004288 and F32AT005040 from the National Center for Complementary and Alternative Medicine. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the National Center for Complementary and Alternative Medicine or the National Institutes of Health. Additional support for C. Quave was provided by Botany in Action and the Anne Chatham Fellowship in Medicinal Botany. Financial support for U. Lohani was provided by the University Grant Commission, Nepal. Support for A. Verde, D. Rivera, C. Obón, and A. Valdes was provided by the Junta de Comunidades de Castilla La Mancha (PBC-05-011-2. Estudio etnobiológico de las áreas de montaña y humedales de Castilla-La Mancha and PAC-08-173-4838. Etnobiología de la Flora Medicinal De Castilla La Mancha). Support for A. Pieroni's fieldwork in northern Albania was provided by EU Commission (RUBIA project, ICA3-2002-10023,  http://www.rubiaproject.net/, 01.01.2003-31.12.2005).

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Cassandra Leah Quave, Usha Lohani, Alonso Verde, José Fajardo, Diego Rivera, Concepción Obón, Arturo Valdes, and Andrea Pieroni "A Comparative Assessment of Zootherapeutic Remedies from Selected Areas in Albania, Italy, Spain and Nepal," Journal of Ethnobiology 30(1), 92-125, (1 March 2010). https://doi.org/10.2993/0278-0771-30.1.92
Published: 1 March 2010
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