A preliminary survey of plants used in traditional medicine in the Grahamstown area

Most tribes in South Africa still use prescriptions from herbs and shrubs and other materials in their traditional medicine. The medicinal plants used in Grahamstown are no exception and are a constituent of traditional culture. Unfortunately much of the traditional culture and knowledge is in danger of being lost with the increasing modernisation of society, especially by the development of roads, communication, the migration of people from villages to cities and the influx of modern medicine. Furthermore, ethnobotanical information is not always passed down by word of mouth from one generation to the next, so the need to record and uti lise the current wealth of ethnobotanical knowledge remains important for ethnopharmacological, cuftural and historical purposes. Higher plants, some of which are threatened with extinction, are also used as sources of pharmaceuticals and as ingredients of tradi tional medicine. Furthermore, the compounds they contain may serve as templates for new synthetic drugs (Omulokoli et al. 1997). Herbalism is not only practised as an alternate health option and source of employment but also to meet the growing urban demand for traditional medicine. However, the increase of human population, increase in the need for certain plants, the incorrect way of harvesting the plants and the compet ition with other forms of land use has led to a decrease in the availability of wi ld plant resources (Martin 1995). Due to urbanisation and the increased commercialisation of the herbal trade in South Africa, the activity of harvesting medicinal plants, formerly the speCialist domain of traditional healers, has also become the domain of untrained commercial gatherers who supply the urban areas with plants (Wi ll iams 1997). An increase in the demand of traditional medicine has resulted in t ions of these plants were discovered. This also suggests that there are gaps in recorded knowledge of medicinal plant usage, therefore more research on traditional practice still needs to be undertaken before the knowledge is lost. The curative properties of these plants appear to be well known to the healers who use them but many of them still have to be chemically tested.


Introduction
Most tribes in South Africa still use prescriptions from herbs and shrubs and other materials in their traditional medicine. The medicinal plants used in Grahamstown are no exception and are a constituent of traditional culture. Unfortunately much of the traditional cu lture and knowledge is in danger of being lost with the increasing modernisation of society, especially by the development of roads, comm unication, the migration of people from villages to cities and the influx of modern medicine. Furthermore, ethnobotanical information is not always passed down by word of mouth from one generation to the next, so the need to record and utilise the current wealth of ethnobo tanical knowledge remains important for ethn opharmacological, cuftural and historical purposes. Higher plants, some of which are threatened with extinction, are also used as sources of pharmaceuticals and as ingredients of tradi ti onal medicine. Furthermore, the compounds they co ntain may serve as templates for new synthetic drugs (Omulokoli et al. 1997).
Herbalism is not only practised as an alternate health option and source of employment but also to meet the growing urban demand for traditional medicine. However, the increase of human population, increase in the need for certain plants, the incorrect way of harvesting the plants and the compet ition with other forms of land use has led to a decrease in the availability of wi ld plant resources (Marti n 1995). Due to urbanisation and the increased commercialisation of the herbal trade in South Africa, the activity of harvesting medicinal plants, formerly the speCialist domain of traditional healers, has also become the domain of untrained commercial gatherers who supply the urban areas with plants (Williams 1997). An increase in the demand of traditional medicine has resulted in t ions of these plants were discovered. This also suggests that there are gaps in recorded knowledge of medicinal plant usage, therefore more research on traditional practice still needs to be undertaken before the knowledge is lost. The curative properties of these plants appear to be well known to the healers who use them but many of them still have to be chemically tested.
other plants being used to substitute indigenous plants that are becoming scarce (Williams 1996).
Ethnobotanical studies have been done in many areas in South Africa (Bhal and Jacobs 1995, Ellis 1986, Metelerkamp and Sealy 1983. The inform ation gathered from these studi es can be used to identify the important medicinal plants, those in great demand as well as those th reaten ed with over utilisation. A few studies have been done in the Eastern Cape (Bhat and Jacobs 1995, Dold and Cocks 1996, Hirst 1990, Broster 1982, Smith 1895), but until recently not much in small er centres such as Grahamstown. Stud ies in neighbouring areas show that traditional medicine is still in great demand, especially in rural areas (Bhat andJacobs 1995, Dold andCocks 1996). The present study aims to rescue the disappearing knowledge of medicinal plants by combining the collection of voucher specimens with information gathered from interviews with traditional healers, diviners, herbalis ts and other people who know and use the plants for medicinal purposes. The information gathered wil l be documented and stored in the Selmar Schonland Herbarium (G RA) and will probably be used in the proposed construclion 01 a nursery and garden dedicated to ethnobotanical species in the National Arboretum for Peace and Reconciliation. It is hoped that by making people aware of the importance of these plants and many others, they will learn to appreciate indigenous plants. Also by making them aware of the problems some other parts of South Africa already have in terms of scarcity or some of the important plants, they wi ll see the need to conserve them. It is hoped that all th is will help to reinforce [inks between the com munity and the environment, which is essential if sustainable utilisation is to be realised.

Study Area
Grahamstown is situated approximately 50 kilometres inland from the Indian ocean and lies on the arterial axis of the old national road between the larger coastal cities of Port Elizabeth and East London. It is situated in a transitional zone between the summer rainfall region to the east and the all year rainfall area of the Sou th Coast. Various vegetation types ranging from karroid vegetation to evergreen woodland, acacia grassland and heathland (Daniel et al. 1985) surround the town. The area consis ts of the commercial centre (the town ) with a large residential area almost surrounding the central business district, the townsh ips (mostly Xhosa speaking people) and the farms in Albany and Bathurst dis tri cts. The population of the area has increased substantially, from approximately 45 530 in 1980 to 110 000 in 1996 (Grahamstown Health Department). This increase is due to both a high rate of natural increase and an influx from surrounding areas like King William's Town and the former Ciskei.

Information on the utilisation of plants in the Grahamstown area was collected through direct contact and interviews with herbalists, diviners, traditional heale rs and other people who know and use the plants fo r medicinal purposes. This was done over a period of six months, between March and
August 1997. Interviews were conducted in the informants' houses , where they do most of their work, and in the field. These interviews we re conducted in Xhosa. Informants were asked for the source of th eir knowledge to eliminate in formation of secondary nature. Efforts were made to doublecheck any information provided by asking the opinion of older people or other herbalists .
Three approaches to information gathering were used: Information was gathered by 1) asking what plants in the locality were used in traditional medicine; 2) asking what a particular plant was used for; or 3) on observing an activity (such as preparing medicine fo r a patient) and enquiring as to the plants used. The first of the th ree approaches was used as an icebreaker in most cases. The second approach was used in order to cross check the information received. The most rewarding approach was the third one, since the informant was thoroughly fami liar with the plants' use.
For collection of plant materials, informants were asked to guide us to the places where the plants grow. An attempt was made to cover as much of the study area as possible. The fresh or dried medicinal plant material was collected and kept for botanical identification. Information on what plants they use, what plant parts they use, what they use them for and how they use the plants was recorded. Informants also provided us with vernacular (Xhosa) names that they use for these plants. All the informants used the same vernacu lar names. Plants collected as vouchers were identified with the help of the Selmar Schonland Herbarium (GRA) curator, Mr AP Dold. All vouchers were deposited in the Selmar Schonland Herbarium (G RA) .

Informants Background and Practice
The informants described below were all interviewed on more than one occasion and provided much of the information on plant usage. All the informants consented to having the ir information made public. It is diHicult to assess how representative this small group is of the ancient traditional practice. However, some of the plants they use and customs they referred to have been previously reco rded (Hirst 1990, Lamia 1981, Bhat and Jacobs 1995, Broster 1982) and can thus be considered reliable. 1. Mrs Lindani is a 62-year-old housewife, whose grandfather and aunt had bo th been diviners. She acquired her expertise from them and she has practised since she was 14 years old. She also trained as a Prophet in the Zion church. As a diviner, she keeps contact with the ancestors, divines the causes of misfortune and illness and sometimes treats the patients. 2. Mr Bonisile Dipi is an 87-year-old traditional healer. His fa the r was a traditional healer. He started practising at the age of 37, after training for three years. He diagnoses, prescribes and sells the medicines for various ailments .
He has a certificate from the African He rbalist Dingaka Association (in Zwelitsha, Eastern Cape), giving him the right to work as a traditional doctor anywhere in South Africa. He does most of his work at home and sometimes visits patien ts in their homes. 3. Miss Fihlani is a middle-aged woman and is the daughter of Mr Dipi (above). She trained as a diviner fo r three years and has started working, although she is still under her fathe r's supervision . 4. Adolphus is a 49-year-old herbalist who was trained by his father. He considers the use of remedies to be a family secret handed down from one generation to the other. He works in the only herbal shop in Grahamstown. He prescrib es and sells medicine to patients and customers. He also works with another man, who is Indian, who uses his trad itional (Indian) methods in healing. Sometimes the patients were treated by both (e.g. the Indian man wou ld use his methods in trying to find the cause of the illness and then refer the patient to Adolphus who would give the patient the prescription he/she needs). 5. Zizi (not his real name) is 50 years old. He did not receive any formal training about medicine, but acquired his knowledge by helping the herbalis ts.
Other people interviewed were the customers (people who went to the shop to buy medicine fo r themselves or for someone else) and patients who went to see Mr Fihlani. The interviews with the customers were made as informal as possible, e.g. no name taken and no pen and paper. This was done to avoid making customers uncomfortable as most of those we talked to were not happy to tal k about why they were the re or what they had bought, and wanted their visit to the shop to be kept secret. The interviews with the patients were fo rmal (e.g. What she/he was suffering from and then observed what the informant was preparing for the patient) and notes were taken in some cases with the patients permission. Seven customers and four patients were interviewed. The in formation gathered from patients and customers was used to double check information that was pre-vi au sly obtained from the informan ts and to ascertain that these plants were actually used by other peopte. The infor-

mation obta ined from these interviews is acknowledged in
Tab te 1.

Medicinal Plant Usage
Twenty· four medicinal plants were identified during the investigation. These plants are listed in alphabetical order according to family and then accord ing to genus and species within the family. This data is presented in Table 1.
The informants claim that all the information they know and that they have provided was obtained through proper training by thei r counterparts or by consulting their ances· tors , in the case of diviners and traditional healers.

Discussion
Some difficulty was experienced during the study in extracting information about the plants from these people. Studies done by Hirst (1990) have shown that appeasing the ancestral sp irits is an integral part of the Xhosa medicine. The knowledge of herbal medicines for complex diseases is sti ll confined to mainly practi sing herbalists or to certain family members of the traditional healers who inherit the knowledge from their forefathers . The knowledge and use of traditional plants is also associated with the supernatural powers , hence rituals follow some of the preparations.
Six of the 24 herbal remedies recorded here are used for pain relief, two for treatment of stomach complaints, five for skin diseases, th ree to treat infertility, three to treat ear infection , one for heart problems , one for diabetes, one for nose blockage and two to treat respiratory problems . The most commonly used remedies are those used for pain relief and skin diseases. These plants also have various other functions as indicated in the previously recorded uses of these plants, but not by our informants. Th e diseases that are mostly treated through external applications are inflammations , skin diseases and wounds. Most of the surveyed medicinal plant uses involved using only one plant species.
Except for Hermannia althaeoides and Senecio carnosus, twenty-two of the plants documented here have been previously reco rded in ethnobotanical publications (Hutchings 1996, Watt and Breyer-Brandwijk 1962, Smith 1895, Broster 1982. However, it is important to note that many of the uses recorded here were new except for that of Sanseviera hyacinthoides (L.) Druce. This is in part because of the diversity of the tribal groups in South Africa. Eight uses recorded during this study are related to those previously recorded . However, this does not necessarily mean that they are used for the same ailment de scribed by the informants in this study. Thirteen of the plants recorded have previously been chem ically screened and some found to have antibiotic, anti-inliammatory and other types of effects (Hutchings 1996, Watt andBreyer-Brandwijk 1962). Certain plants are used fo r treating men only, (e.g.

Herman;a althaeoides Link , used for treating impotence)
whi le others are used exclusively for women (e.g. Knipholia uvaria (L.) Oken, used to treat infertility) , revealing the speci- Three of the species, namely Haemanthus albillos, Bu/bine alooides and Hypoxis hemerocallidea are known to at least four of the five informants while some of them are known to Mr Dipi and his daughter (who wo rk together) and others are known only to one informant, Mrs Lindani. Six of the plants recorded in this study were also known to cus · tamers and patients, who had used them before or bought them for someone else. The customers and patients had no difficulty in identifying these plants but they knew the uses of a lew other plants only when they were to ld their names. It is interesting to note that the species known by Mrs Li ndani are mainly used to treat women and fo r minor ailments in babies and sometimes adu lts.

Conservation
The conservation status of the plants recorded was investi· gated and it was found that none of the plants are included in the list of threatened plants of the Eastern Cape (Everard 1988)

or in the Red Data book (H ilton-Taylor 1996). This
gives the impression that these plants are not threatened . Traditional healers use certa in methods to sustai n the use of their flora. Adolphus, who works in the herbal shop, som etimes collects the plants and other times buys the plants from people com ing from other parts of the country, such as KwaZulu-Natal. The informants interviewed (except Zizi and Adolphus) in Grahamstown still prefer to collect plants them-

selves and they follow certain rituals when collectin g. Th is is
done in a way to protect the plants. For example, they do not collect from a plant whe re one of the traditional doctors has just collected. When collecting bark, they do not ring bark the trees, but only lake bark from one side of the tree. When collecting roots, not al l roots are removed from a tree , but a few a re left so that the tree can continue to grow. After col· lecting at each point, bead s are thrown at the plant to than k the ancestors and so that they can find other cures. Failu re to follow these rituals is believed to anger the ancestors and make the medicine ineffective.
Although the traditional healers stress that they follow

Conclusion
There seems to be a comprehen sive knowledge about the curati ve properties of many plan ts among the Grahamstown population and healers , and the list of taxa presented here is by no means exhaustive. During the course of the study, 24 plants were found to be used by both healers and customers or patients of the healers. In spite of the development and spread of modern medicine in Grahamstown, traditional medicine is a popular alternative to address health problems in the area. Although th e current importance and potential importance of medicina l plants has been locally and internationally recognised, there is still a need for further scientific and experimental studies to evaluate these crude extracts for their medicinal and pharmacodynamic properties, cl inical usefulness and toxicological potential. These studies may result in the utilisation of these plants as crude drugs or as raw material in the manufacture of pharmaceutical products requ ired in the promotion of primary health care. This cou ld contribute towards increasing the availability of essential drugs at a muchreduced cost. In addition, populations of medicinal plants must be monitored in order to conserve them and aid in pl anning sustainable utilisation.

82: 11-14
Williams VL (1997) Muti traders on the Witwatersrand, South Africa -an urban mosaic. South African Journal of Botany 63 : 378-381 Previously recorded medicinal uses, chemistry and biological properties Leaves are used for rash and sores. Tuber decoctions a re used as an anhspasmodic to quell vomiting and diarrhoea.
Crushed rhizomes are used In enemas lor painful menstruation and lor Itchiness during menstruation. Screening tests gave positive antibiotic resuUs with Neurospora erassa Roots are used In enemas for stomach complaints. Root decoctions are used for chrOniC coughs. to clean nostnls and for snakeb!le Roots and lubers were fou nd to have a very acnd resinous body Hoi Jeaf and root mfuslons are taken for stomach complaints Burnt seeds are rubbed into scarifications on Sides of the body to relieve pam. Polyacetylene isolated from leaves has reported to show antimicrobial activity and antifungal action on wounds and ulcers. Leaf Infusions are used to promote conception by the Vhavenda.
Oned rooLs are reported to have been used effectively for bots in horses (Watt and Breyer-Brandwljk 1962).
Root bark is used as a charm lor harming an enemy. Combre lastanln. an antineoplastic and antimitotiC agent has been isolated.
The runner and roots have been found to be pOisonous to sheep and rabbits. Hydrocyanic aCid has been found 10 th e tuber (Wall and Breyer-Brandwijk 1962).
Warmed leal sap is used for earache Sap has been used for tuberculosis and other respiratory conditions, and also applied to rin gworm (Watt and Breyer-Brandwijk 1962).
Used tor gonorrhoea, diarrhoea and dysentery. Used to treal prolapsed rectum. Root decoctions are laken for severe diarrhoea and for babies With stomach ailment known as 'intsila'. Coumarins have been found In roots.
Corm IOtuslons are administered as emetics for diZZiness and mental disorders. Juice from the root is applied to burns.
Other Leucas species are used lor feverish conditions In Children. The root IS used to trealln Lernallhroal wounds and th e s tem (wood) to trea l external wounds The rooL is cooked In waler. A spoon 10 hall a cup 01 lhe decoction is taken. A dry slem is grated and the powder is applied 10 the wound Used lor sleamlng and treatment of ear inlectlon. For steaming. the leaves are bOiled. For the ear. the leaves are crushed and mixed with a drop 01 warm water. A drop IS put into the ear 2&3 2&3 2 &3

MESEMBRYANTHEMACEAE
To treat impotence In men. The rools 2 & 3 are crushed and boiled in water An decoction IS taken orally.
Used to treal gonorrhoea. The fre sh p l ant is crushed and mixed with water The Inlusion is taken orally. The plant IS also dried over fire and crushed The powder is applied to the wound's mfected area.

Matslhza and Barker
Previously recorded medicinal uses, chemistry and biological propert ies Used to make enema for children. Used to treat aUergles. diabetes and sore throats JUice from leaves is used lor diphtheria and thrush and digestive troubles, diarrhoea and dysen lery. Calchecol tannins, Malic and Cline aCids and their calcium salts have been found In the sap of leaves and siems. Red-violet belalalns and leucoanthocyanlns have also been isolated Bark is used for rheumatism and arlhntlS . Sapomns . volatile 0115. lannlnS. resin. lat. glycosldes and an alkalOid wi th antidepressant properties have been Isolated from bark.
Hot In fuSions are taken as emetics for chronic coughs. Leal and bark infuSions are taken for respiral ory ailmen ts. Steam balhs from the bark are used to pUrify complexion. Peptide alkalOids have been lsotated from the bark and leaves. Plant extracts have been reported to shOw antifungal acilvily agamst Candida alb/callS.
Sap is used lor toothaches (Inserted into the wound after tooth removal). as a disinlectant and lor snakebite. Four dimeflc piperidine alkalOids and various other compounds. including tarpenolds. glutinol friedalin lupeol and beta-Si tosterol have been isolated from bark Usnlc aCid has been found in unspecified lichens. and has antibiotiC activities (Watt and Breyer-Brandwirk 1962)