Ethnomedicinal survey in two villages of Cumilla district, Bangladesh

Introduction: Folk medicines play an important part among the village people in Bangladesh. The main objective of the present study was to carry out a randomized ethnomedicinal survey among the folk medicine practitioners (Kavirajes) of two villages, Parati and Panjab, located in Cumilla Sadar south sub-district of Cumilla district in Bangladesh. Methods: Informed consent was obtained from the Kavirajes and surveys were conducted with the help of a semi-structured questionnaire and the guided field-walk method. Interviews were carried on in the Kaviraje’s native language – Bengali. After completing the survey, voucher specimens were deposited into the Bangladesh National Herbarium for complete identification. Results: It was observed that the Kavirajes of the two villages used 16 plant species which were distributed into 16 distinct families. Plants belonging to these 16 families were used for the treatment of various ailments such as jaundice, blood dysentery, asthma in infants, leukorrhea, dysentery, abdominal pain, lower abdominal fat, lower back pain, tachycardia, and painful abscess. The major plant part used were leaves (50%), followed by bark and gum (13.2% each), and young shoot, whole plant, pith, and bulb (6% each). Kavirajes, once plentiful are becoming scarce both as to numbers and to their medicinal knowledge. The present survey points to possible plants that need to be pharmacologically assessed as to their traditional uses. Conclusion: The plant information collected in the present survey is suggestive of significant prospects for further scientific research towards discovery of lead compounds and possibly better drugs.


Introduction
Folk medicines, independent of more established traditional medicines like Ayurveda and Unani system have existed as a substantial part of primary health care services since time immemorial in Indian sub-continent countries. In developing countries like Bangladesh, folk medicine practiced by folk medicine practitioners, locally known as 'Kavirajes' are largely considered among rural communities as well as remote areas due to their availability, cost-effectiveness, and traditional belief in the positive outcome of the medicine (WHO 2013; Haque et al. 2018). Folk medicine is not only practiced by regular rural people but also elderly men and women, irrespectively. Folk medicine varies on historical, ecological, ethnic and social background to a great extent (Payyappallimana 2010  be an important resource for scientists to identify potential drug component(s); therefore proper documentation of this knowledge is imperative to protect the medicinal plants from extinction, more so, because Kavirajes with every passing year are noticeably getting rarer in Bangladesh. Therefore, the present study was aimed to carry out a randomized survey among folk medicine practitioners in two villages, 'Parati' and 'Panjab' of Cumilla district in Bangladesh.

Study area
The present study was conducted in the two villages namely 'Parati' and 'Panjab' within Cumilla Sadar south sub-district of Cumilla district in the division of Chittagong, Bangladesh. Cumilla district covers the south-eastern region of Bangladesh. Its area is 3,087.33 km 2 (1,192.02 sq mi), and is situated roughly in between 23°02' and 24°47' north latitudes and in between 92°39' and 91°22' east longitudes. It is surrounded by Tripura state of India on the east, Munshiganj and Chandpur districts on the west, Noakhali and Feni districts on the south, and Brahmanbaria and Narayanganj districts on the north. Cumilla Sadar south sub-district has 10 union councils, and 459 villages. The present study area 'Parati' and 'Panjab' villages are under Bholain south union council of Cumilla Sadar south sub-district ( Figure 1). The total population of Parati and Panjab villages is 3088 and 954, respectively according to information in the Bangladesh Statistics Bureau.

Data collection and sampling techniques
To record the practical application of medicinal plants, a survey was carried out among the folk medicine practitioners ('Kavirajes') in Parati and Panjab villages to collect the ethnomedicinal data. The purpose of the survey was made clear to the Kavirajes and permission obtained to present survey results verbally and in writing. The survey was conducted with the help of a semi-structured questionnaire and the guided field-walk method as described by Martin (1995) and Maundu (1995). A guide was managed initially (Mr. Masud Rana, Age: 26, Student-Cumilla Victoria College) and local people were asked about the details of practicing 'Kavirajes' and three 'Kavirajes' were convened for interviews, namely Mst. Saleha Begum, Mohammed Shahjahan (belong to Panjab village) and Mst. Tahera Begum (belong to Parati village). Interviews were organized after receiving permission from the 'Kavirajes' to initiate the survey and subsequently a focused group discussion was conducted. Interviews were carried on in the native language (Bengali) of Kavirajes and the authors (interviewers). The Kavirajes discussed about medicinal plants and gave explanations of their local names and uses to treat various ailments. All information obtained was cross-checked with the 'Kavirajes' after completion of the day's work, when there was more free time for free discussions. The English names of

Plants and their distribution into distinct families
The result of the present study showed that 16 species of plants were used for the treatment purposes by three Kavirajes from Parati and Panjab villages of Cumilla district, Bangladesh ( Figure 1).   It was reported earlier that the plant parts mostly used by folk medicine practitioners are leaves and roots (Wondimu et al., 2007;Giday et al., 2003). Our ethno-medicinal survey result showed a similar profile of plant parts used in Parati and Panjab villages. Leaves were the major plant parts used solely or mixed with other parts forming 50% of total uses. This was followed by bark and gum (12.5%), and the lowest parts used were young shoot, whole plant, pith, and bulb (6%) (Figure 3). The folk medicine was applied either through oral or topical administration for the treatment of simple to complicated diseases.

Discussion
Rural people, by themselves generally use different parts of plants as medicine (as prescribed by Kavirajes) due to limited access to modern heath facilities, poverty, and shyness to urban doctor. Women in rural Bangladesh are reluctant to mention their ailments, particularly gynecological ailments even to a female physician, who is unknown to them because properly trained physicians with a doctor's degree rarely practice in villages. They even practice rarely in the small towns, and to a village woman appear to be totally alien. Therefore, village people visit neighborhood folk medicine practitioners (Kavirajes) who have indigenous knowledge on these medicinal plants, transmitted orally from their ancestors or gained through long time experience (Rahman 2013 Terminalia arjuna. Lower back pain, lower abdominal fat, asthma, abdominal pain, dysentery were other important diseases, which were also treated by five plants each (Table 1). Kavirajes reported to treat jaundice with the leaves of Stephania japonica, Litsea glutinosa and Eclipta prostrata, and bark of Oroxylum indicum. Allium cepa and Alstonia scholaris were processed and applied in the treatment of abscess.
Reported scientific studies supported the use of these medicinal plants by the Kavirajes. Lawsonia inermis commonly known as Henna leaves or mehendi gach, which contain active compounds such as lawsone, gallic acid, glucose, mannitol, fats, resin, mucilage, and alkaloid showed antifungal and antibacterial effect (Dixit, 1980;Rahmoun, 2013;Mohiuddin, 2019). Crude extracts of Eclipta prostrata and Litsea glutinosa also demonstrated antibacterial activity, and previous ethnomedicinal reports mentioned that the powder of Eclipta prostrata was used to cure hepatitis and jaundice (Khan, 2008;Mandal, 2000). Hossan et al., (2010) reported earlier the traditional use of Streblus asper Lour. and Litsea glutinosa by Kavirajes in the treatment of infectious diseases in reproductive systems such as syphilis, gonorrhea, and painful burning during urination, respectively. Moreover, its leaf extract acted as an anti-inflammatory agent and showed potent antimicrobial activity reducing plaque formation (Sripanidkulchai, 2009;Pradeepa, 2011;Kumar, 2020). Rahmatullah et al., (2010a) in their survey stated the traditional use of the bark of Terminalia arjuna by Kavirajes for heart diseases. The bark extracts of Terminalia arjuna have been reported to contain major constituents such as flavonoids, polyphenols, saponins, tannins, triterpenoids, sterols and minerals. These phytochemicals were experimentally proved to have antioxidant and antihypertensive effects relevant to the therapeutic potential in cardiovascular diseases (Maulik, 2012;Amalraj, 2017). Furthermore, the leaf and fruit extract of Mangifera indica, Aegle marmelos, and Ananus comosus, respectively showed significant cardioprotective roles (Saxena, 2014;Bhatt, 2017;Vishwakarma, 2018). The leaf extract of Mangifera indica was also reported to have potential to reduce serum cholesterol level (Gururaja, 2017).

Conclusion
Overall it can be said from the survey that a large number of medicinal or herbal plants used in Parati and Panjab villages of Cumilla Sadar south sub-district of Cumilla district has been validated by previous as well as current scientific research. Besides, the Kavirajes interviewed or their rural patients did not mention any toxic effects of the medications prepared with the plants. Recently scientists are showing renewed interest in medicinal plants because of the emergence of new diseases. These plants can provide effective roles in new treatments. Therefore, it is important to research more on these medicinal plants to identify potential compounds as therapeutic agents so that the plants may be validated as remedies against various diseases in a more rational and scientific manner.