|Year : 2012 | Volume
| Issue : 3 | Page : 212-222
An ethnomedicinal survey of cucurbitaceae family plants used in the folk medicinal practices of Bangladesh 1
Mohammed Rahmatullah, Anup Biswas, Wahid Mozammel Haq, Syeda Seraj, Rownak Jahan
Department of Biotechnology & Genetic Engineering, University of Development Alternative, Dhanmondi, Dhaka, Bangladesh
|Date of Web Publication||10-Aug-2012|
Pro-Vice Chancellor, University of Development Alternative, House No. 78, Road 11A, Dhanmondi, Dhaka - 1205
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: The Cucurbitaceae family comprising about 125 genera and 960 species is a family that is further characterized by commonly having five-angled stems and coiled tendrils and is also known as gourd family of flowering plants. Plant species belonging to this family have a worldwide distribution, but most species can be found in tropical and subtropical countries. A number of the plants belonging to this family have reported important pharmacological activities. Cucurbitaceae family plants are also in use in the folk medicinal system of Bangladesh-a traditional medicinal system, which mainly relies on medicinal plants for treatment of diverse ailments. Aims: Since folk medicinal practitioners form the first tier of primary health care in Bangladesh, the objective of this study was to conduct ethnomedicinal surveys among 75 folk medicinal practitioners (Kavirajes) practicing among the mainstream Bengali-speaking population of randomly selected 75 villages in 64 districts of Bangladesh and 8 tribal practitioners (1 each from 8 major indigenous communities or tribes, namely, Bede, Chakma, Garo, Khasia, Marma, Murong, Santal, and Tripura) of the country. Materials and Methods: Surveys were carried out with the help of a semi-structured questionnaire and the guided field-walk method. Results: It was observed that the folk and tribal medicinal practitioners use a total of 19 Cucurbitaceae family species for treatment of ailments such as dysentery, diabetes, edema, skin disorders, leukoderma, hypertension, jaundice, typhoid, spleen disorders, respiratory problems, leprosy, rheumatoid arthritis, chicken pox, and cancer. The 19 species of Cucurbitaceae family plants in use were Benincasa hispida, Bryonopsis laciniosa, Citrullus colocynthis, Citrullus lanatu, Coccinia grandis, Cucumis melo, Cucumis sativus, Cucurbita maxima, Cucurbita pepo, Hodgsonia macrocarpa, Lagenaria vulgaris, Luffa acutangula, Luffa cylindrica, Momordica charantia, Momordica cochinchinensis, Trichosanthes anguina, Trichosanthes cordata, Trichosanthes dioica, and Trichosanthes kirilowii. The review of the available scientific literature showed that the use of a number of the above-mentioned plants in folk medicine can be validated based on their reported pharmacological activity studies. Conclusion: Taken together, the plants present excellent potential for further scientific studies, which may result in discovery of novel compounds of therapeutic interest.
Keywords: Bangladesh, cucurbitaceae, folk medicine
|How to cite this article:|
Rahmatullah M, Biswas A, Haq WM, Seraj S, Jahan R. An ethnomedicinal survey of cucurbitaceae family plants used in the folk medicinal practices of Bangladesh 1. Chron Young Sci 2012;3:212-22
|How to cite this URL:|
Rahmatullah M, Biswas A, Haq WM, Seraj S, Jahan R. An ethnomedicinal survey of cucurbitaceae family plants used in the folk medicinal practices of Bangladesh 1. Chron Young Sci [serial online] 2012 [cited 2019 Jul 16];3:212-22. Available from: http://www.cysonline.org/text.asp?2012/3/3/212/99583
| Introduction|| |
Bangladesh has more than 86,000 villages spread throughout the various regions of the country.  The population is predominantly rural with agriculture and agricultural laborer forming the major occupations of the rural people. Although modern allopathic medicine is available in the country, it has yet to reach the rural people, who for the most part lack access to good allopathic doctors and modern medical facilities. Since the rural people have to travel considerable distances, they often turn to folk medicinal practitioners who offer a cheaper mode of treatment for the various ailments suffered by the people. This practice has gone on for centuries. Practically, every village in Bangladesh has one or more folk medicinal practitioners, depending on the population of the village. The folk medicinal practitioners, locally known as Kavirajes or Vaidyas, practice a simplistic form of treatment with medicinal plants. Folk medicinal practitioners are possibly the most ancient practitioners of traditional medicine in Bangladesh and in general are the primary health care providers to a majority of the rural and a substantial segment of the urban poor population in the country. 
Virtually every indigenous culture in the world uses medicinal plants in some form or other for treatment of ailments. The actual knowledge of medicinal plants is possessed by a select group of practitioners, who determine the nature of the ailments and then prescribe remedies. Although indigenous cultures possess a holistic view of ailments and their cure, medicinal plants do form a major part of indigenous medicinal or traditional medicinal practices. Since the advent of modern or allopathic medicine, traditional medicine lost quite a bit of ground, being determined to be somewhat akin to superstitious beliefs or even quackery by allopathic doctors. However, in recent periods, traditional medicine has made a major comeback. It has been realized that a number of important modern pharmaceuticals have been derived from or are plants used by indigenous people.  A number of modern drugs such as aspirin, atropine, ephedrine, digoxin, morphine, quinine, reserpine, and tubocurarine are examples, which were originally discovered through observations of traditional cure methods of indigenous peoples. 
The Indian subcontinent comprising the countries India, Pakistan, and Bangladesh form one of the richest sources of traditional medicinal practices in the whole world. Overall, the alternative medicinal systems of India use more than 7500 plant species.  Bangladesh also has a number of traditional medicinal systems including Ayurveda, Unani, homeopathy, and the folk medicinal system. In addition, Bangladesh has a number of tribes, and the tribal medicinal practitioner's practices can be considered as a variant of the folk medicinal system of the mainstream population with similar emphasis on medicinal plants. In our ethnomedicinal surveys among the various Kavirajes spread throughout the country and the tribal medicinal practitioners of various tribes, we have observed considerable variations about the plant species selected by any individual Kaviraj for treatment of a specific ailment. ,,,,,,,,,, Quite naturally, this variation extended to families of plants.
Cucurbitaceae family, worldwide, comprises about 960 species distributed into 125 genera. Some of these species are quite common in Bangladesh. Considerable scientific literature is present on pharmacological activity studies and the traditional uses of plant species belonging to this family. ,,, The objective of this study was to conduct surveys among the Kavirajes and tribal medicinal practitioners in randomly chosen areas and major tribes of the country to determine the species of Cucurbitaceae family plants used in the folk and tribal medicinal system of Bangladesh. A further objective was to review the scientific literature for available pharmacological studies on the Cucurbitaceae family plants used in Bangladesh to determine the scientific validation of their folk and tribal medicinal uses.
| Materials and Methods|| |
A total of 75 village Kavirajes were interviewed from 75 randomly selected villages scattered throughout the 64 districts of the country. Care was taken that at least one village was from every district of the various districts of Bangladesh. In more densely populated districts of the country such as Dhaka, Netrakona, Mymensingh, Chittagong, Rajshahi, Rangpur, Bogra, Khulna, Kushtia, Jessore, and Sylhet, two Kavirajes were chosen from those districts. These Kavirajes practiced among the mainstream Bengali-speaking population. In addition, eight tribal medicinal practitioners (TMPs) were chosen from eight major tribes of Bangladesh, namely, the Bede, Chakma, Garo, Khasia, Marma, Murong, Santal and Tripura tribe. TMPs belonged to the respective indigenous community or tribe from where they were chosen, practiced among their communities, and could speak the Bengali language in addition to their tribal language.
Informed consent was initially obtained from the Kavirajes and the TMPs. The practitioners were informed in details as to the nature and purpose of our visits, and consent was obtained for disseminating any information obtained, both nationally and internationally. Where tribes were concerned, informed consent was also obtained from the Headman of the particular tribal community. Interviews were carried out in Bengali language. Where any TMP was concerned, interviews were carried out in presence of the Headman, who was in all the tribes surveyed, fluent in the Bengali language, the language spoken by the interviewers.
Interviews were conducted with the help of a semi-structured questionnaire and the guided field-walk method of Martin  and Maundu.  In this method, the practitioners took the interviewers on guided day time field-walks through places from where they usually collected their medicinal plants, pointed out the plants, and described their uses. Interviews were open-ended where the Kavirajes and the TMPs were allowed to speak at length on medicinal plants with only occasional interruption from the interviewers. Plant specimens as pointed out by the practitioners were photographed and collected on the spot, field-dried, and brought back to Dhaka for identification by Mr. Manjur-Ul-Kadir Mia, ex-Curator and Scientific Officer of the Bangladesh National Herbarium. Voucher specimens were deposited at the Medicinal Plant Collection Wing of the University of Development Alternative. All information was double-checked with Kavirajes and TMPs in later evening sessions. It is to be noted that although formulations and dosages were asked from every practitioner, very few chose to give them on grounds that such information may destroy their practices through the dissemination of such knowledge among other people. Also to be noted that data were collected for various plant species belonging to a number of families; information on plants belonging only to the Cucurbitaceae family is presented in this study.
| Results|| |
Results obtained in the present survey indicated that 19 Cucurbitaceae family plant species were used by the Kavirajes and TMPs of various regions and tribes of Bangladesh. The diseases for which these plants were used included alopecia, bed wetting in children, bleeding from external cuts and wounds, burns, cancer, cholera, diabetes, debility, dizziness, ear disorders, edema, eye disorders, fever, gastrointestinal disorders, goiter, heart disorders, helminthiasis, hematemesis, hemorrhoids, hepatic disorders, infections, infertility, inflammation, insanity, lesions, leucorrhea, malaria, menstrual disorders, mumps, pain, paralysis, pox, respiratory tract disorders, rheumatoid arthritis, skin disorders, sexual disorders, sexually transmitted diseases, sun stroke, tetanus, tuberculosis, typhoid, and vomiting. Additionally, some plants were used to keep whole body or body parts cool. The summer months are hot in Bangladesh, and rural people have to work whole day in the sun tending to the fields for cultivation and harvesting of crops. As a result, people visit Kavirajes or TMPs for use of medications (plants), which can keep the whole body or exposed body parts cool while working in the summer heat. Some plants also had ethnoveterinary uses. The results are shown in [Table 1].
|Table 1: Cucurbitaceae plant species and ailments treated as reported by folk and tribal medicinal practitioners from various regions in Bangladesh|
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Whole plants, a single plant part, or a combination of plant parts were mentioned by the Kavirajes and TMPs to be used in their treatments. The same plant part or combination of plant parts could be used for treatment of ailments, which were diverse in nature. For instance, a combination of roots, seeds, and fruits of the plant Benincasa hispida was used for treatment of diverse ailments such as infertility, tumor, gonorrhea, mucus, and helminthiasis. Seeds of the same plant were used for treatment of helminthiasis and colic. The formulation prescribed was a little different for the above two ailments; while pulp of seeds was macerated and taken in the morning on an empty stomach for helminthiasis, pulp of seeds was dried, burnt, and taken with warm water to relieve colic pain.
The plant which was used for treatment of the maximum number of diseases was Coccinia grandis. Consistent with the maximum number of ailments treated with this plant species was the observation that this plant had the most number of its parts used in the treatments. In fact, whole plant, leaves, roots, stems, flowers, fruits, and meristems from the plant were used in the treatment singly or in combination. Merely, the leaves alone were used by different Kavirajes and TMPs for treatment of stomach pain, diabetes, fever, dizziness, coughs, jaundice, increased temperature of hands or head, hypertension, flatulence, blood disorders, sun stroke, eczema, leucoderma, burning sensations in hands or feet, whitish discharge in urine of men, oral lesions, scabies, bed wetting in children, head ache, and insanity. 73 of the 83 Kavirajes and TMPs surveyed reported using this plant for treatment of one or other diseases. Apart from the Murong TMP, the other seven TMPs from various tribes reported using the plant in their treatments, of which the most common ailment being treated is diabetes. Diabetes was also one of the major ailments being treated with this plant by the mainstream Kavirajes.
In several cases, Cucurbitaceae family plants were used in combination with plants from other family species. For treatment of lesions on the tongue, skin of young fruits of B. hispida was applied topically following maceration with skin of fruits of Elettaria cardamomum and young whole plants of Ricinus communis. It is to be noted that during the treatment period, the Santal TMP advised not to eat any of the four fish species, namely, Wallago attu, Puntius puntius, Channa marulias, and Cirrhenus mrigala. For treatment of excessive bleeding during menstruation and lower abdominal pain, the Bede TMP used juice obtained from squeezed fruits of Bryonopsis laciniosa with juice from leaves of Eclipta alba, fruit of Musa sapientum, and ash of any metal. The mix was to be taken in a wet cup and with wet hair. While it would be difficult to say without performing the requisite scientific experiments about the efficacy of the procedure, it is very much possible that wet cup and wet hair may be part of a psychological healing process by the TMP, who is trying to induce a strong belief in the patient that such process can lead to healing. Such strengthening of a belief in the patient can lead to a much quicker recovery through built-up of a patient's confidence, and forms a part of the treatment method, even with modern allopathic medicine. The Bede TMP seemed to apply more often this form of psychological healing, while at the same time using plant-based materials. For treatment of edema by the Bede TMP, macerated skins of old fruits of Lagenaria vulgaris were mixed with rotten leaves of Mangifera indica, ashes of burnt roots of Corchorus olitorius, and indigo and then applied to the whole body. It is to be noted that rotten leaves were to be collected from sides of ponds or tube wells; it is possible that such leaves will fall on top of any collected water (in case of tube well) or damp soil (ponds) where they will end up rotting and not drying up, as will be the case if they fall on dry ground. The use of rotten leaves can be of therapeutic efficiency (needs to be proved scientifically), but the use of indigo and the use of whole plants of C. olitorius collected in the Bengali calendar month of Bhadra (mid-August to mid-September) again suggests a psychological form of healing on top of plant components. Indigo is a dye obtained from the plant, Indigofera tinctoria L. (Fabaceae), and is of dubious value in treatment of edema, except for any psychological effect that the dye may produce when a patient's whole body is thus colored. Also, the use of C. olitorius collected only in the month of Bhadra may have a psychological impact on the patient, that in this month the particular plant may have special healing effects.
Gastrointestinal disorders appeared to be the most common ailment treated by the practitioners. Altogether, 12 plants were used for treatment. Cancer and respiratory tract disorders were treated with nine different Cucurbitaceae family plant species each, diabetes and fever with six plants, helminthiasis with seven plants, and hepatic disorders and skin disorders with eight plants each. The results are shown in [Table 2]. Gastrointestinal disorders, helminthiasis, skin, and respiratory tract disorders are common in Bangladesh, partly due to the unhygienic conditions of living by the rural and urban poor population and partly because of the hot and humid weather during summer, especially during the monsoon months from May till around October.
|Table 2: Types of ailments and their treatment with Cucurbitaceae family plants by Kavirajes and TMPs in Bangladesh|
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Two diseases treated by the practitioners are difficult to treat by modern allopathic medicine. These diseases are cancer and diabetes. The Kavirajes and TMPs did not use any clinical diagnostic procedures for diagnosis of these two diseases. Cancer was when a patient had visible but unexplained swellings or tumors, or when a patient wasted away without any discernible cause, or had continuous loss of appetite and loss in weight. Diabetes was diagnosed by sweet taste of urine, frequent thirsts, and frequent urinary urges. Quite often, a patient would be asked to urinate near an ant nest, followed by closely observing whether ants hover near the urination site after the urine has soaked in to the soil.
| Discussion|| |
It was of interest to review the scientific literature and evaluate whether the use of any Cucurbitaceae family plant species for treatment of a given ailment could be validated through existing scientific studies. Such evaluation would lend credence to the belief that folk medicine is at least not quackery, but to some extent may have evolved through trials with the plant species by the practitioners. Accordingly, a search was made of the established scientific databases for relevant data. The scientific data search clearly indicated that the use of a number of Cucurbitaceae family plant species by the Kavirajes and the TMPs can be validated by existing scientific studies.
B. hispida was observed to be used, among other ailments, for treatment of heart and gastrointestinal disorders. The hypotensive effects and antiangiogenic effects of fruits and seeds, respectively, have been reported. , Gastroprotective effects against gastric ulcers have also been reported. ,, Various plant parts of C. colocynthis were reported by the Kavirajes to be used for treatment of cancer, rheumatoid arthritis, and as an abortifacient. In vitro and in vivo studies have demonstrated the efficacy of cucurbitacins-type triterpene glucoside obtained from this plant against hepatocellular carcinoma.  The anti-inflammatory and analgesic effects of the plant have been reported, which suggests that the plant may prove useful in the treatment of rheumatoid arthritis. , Additionally, the plant reportedly has abortifacient effects. 
C. grandis was found to be used extensively by the Kavirajes and the TMPs for treatment of diabetes. Blood sugar lowering effect of the plant has been reported.  Potent α-amylase inhibitory activity has also been reported for the plant, suggestive of its antidiabetic potential.  In addition, antidyslipidemic activity of polyprenol obtained from the plant has been shown in high-fat diet-fed hamster model.  In vitro antioxidant activities of leaf extract have further been reported.  Cumulatively, the results suggest that the plant can prove efficacious in ameliorating various diabetic symptoms or diabetes-induced complications. Diabetes, over time, can lead to neurological, cardiovascular, and nephropathic disorders, and diabetic patients have an increased risk for developing heart-related complications with time, especially if they also suffer from obesity. From that view point, use of the plant, Cucumis melo by Kavirajes for treatment of diabetes can be significant, for the plant has been shown to ameliorate atherogenic diet-induced dyslipidemia, hypothyroidism, and hyperglycemia. 
Luffa acutangula, which is used by the Kavirajes for treatment of jaundice, has been found to have hepatoprotective effects against carbon tetrachloride and rifampicin-induced liver toxicity in rats.  Luffa cylindrica was observed to be used for treatment of diarrhea and dysentery by the Kavirajes. Fruit and seed extracts of the plant have been demonstrated to be effective for disinfecting waterborne coliform bacteria.  The antidiabetic and anticancer potentials of Momordica charantia have been quite extensively documented. ,,,,, Notably, the plant is used for treatment of diabetes, as well as cancer, by the folk medicinal practitioners and TMPs of Bangladesh. The anticancer potential of Momordica cochinchinensis has been shown through the ability of water extract of its fruit in inhibiting tumor growth and angiogenesis.  The fruits of this plant are also used by the Kavirajes for treatment of cancer.
Trichosanthes dioica is used by the Kavirajes to treat, among other ailments, cancer, constipation, and bleeding from external cuts and wounds. Roots of the plant have been shown to have stimulant laxative activity in mice.  Roots have also been shown to possess antitumor efficacy and ameliorated oxidative stress against Ehrlich ascites carcinoma in mice models.  Additionally, roots reportedly demonstrated in vitro cytotoxic effects.  The wound healing potential of fruits of the plant has been reported.  Trichosanthes kirilowii was observed to be used by the folk medicinal practitioners for treatment of diabetes and cancer. Several glycans, namely, trichosans A-E, have been reported from the roots of this plant with hypoglycemic properties.  Anticancer activities have been reported for trichosanthin and cucurbitacin D, isolated from the plant. ,,,
Taken together, a review of relevant scientific literature indicated that a number of medicinal plants used by the Kavirajes and TMPs of Bangladesh for treatment of various ailments can be validated scientifically. Among such ailments are two difficult to cure diseases with allopathic medicine like cancer and diabetes. Only some forms of cancer can be cured through allopathic medicines and then if only the cancer is at the early to midstages of the disease. Moreover, the forms of treatment of cancer are costly and can have many deleterious side-effects. Diabetes cannot be totally cured at all with allopathic medicine. It is expected that the formulations of the Kavirajes can become the subject of scientific studies leading to discovery of novel and efficacious drugs at affordable prices to the poor.
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[Table 1], [Table 2]