Monday, June 22, 2009

Herbal Medicine: Herbal Tradition (Part I)

The Mercado Central, located in in the city of San Jose, the capital of Costa Rica, as its name implies, is the focal point of commerce in this Central American city. It is a tired, painted building on the main concourse in town, the Avenida Central, three blocks from the city's main square. The place is old and shows it. Inside the main passageway of the market is a stale smell, a commingling of the odors of old cardboard boxes, wet wood, fried rice, and animal fat. With the shops and stalls lined up along narrow alleyways, the market resembles a Middle Eastern bazaar. The floor is worn maroon tile over concrete, all with the accumulated grime from years, maybe decades, of feet of passing Ticas, as native Costa Ricans call themselves. A sheet metal roof is punctuated with an occasional skylight.

Since the market is enclosed, there is a constant drone that resembles that heard in New York's Grand Central Terminal. A waitress, looking bored and moving slowly among the tables of a marketplace restaurant, tries to entice passersby to stop.
"What will you have?" she said in Spanish over and over to no one in particular. "What will you have?"

Not far from the main entrance, down one of the alleyways, is Alfredo's business. He did not reveal his last name but had no problem talking about his livelihood. His job in San Jose is similar to that of Antonio Mora's in New York, selling medicinal herbs.

Alfredo's store is really just an open market stall without walls, known to the merchants as a tramo. It is covered with so many plants that it looks like a hut from the South Sea islands. Stems of aloe vera hang from the walls, looking with their serrated edges like trophies from a swordfish. Fresh flowering chamomile, its fragrant smell easily masking the odor of the marketplace, is stuffed into pails of water. Eucalyptus, with its own menthol-like aroma, adds to the scent that permeates the surroundings. Other plants are piled high along the shelves, some dry, some fresh. Stacks of bark from the cinchona tree, the source of quinine, used to fight malaria, sit next to chunks of sarsaparilla, which is used as a health tonic, and mozote, which is believed to help stomach ulcers.

Alfredo works six days a week at the business, one of about a half dozen competing tramos de hierbas in the market. One of twelve brothers in his family, the thirty-eight-year-old Alfredo has known only the way of life of the tramo, as did his father. Those who sell medicinal plants in Costa Rica tend to come from long lines of entrepreneurs who have carved out a family niche.

A few turns down another alley in the market is the tramo run by Carlos and Eugenia Asturias. Eugenia, who works as a schoolteacher, said that their business, Tramo de Hierbas Margarita, was passed down from Carlos's grandmother to his mother and, as far as anybody can remember, has always been in the Mercado Central. They have a product that is much in demand.

In a country that seems blessed with an eternally springlike climate, Costa Rican herbal merchants such as Alfredo and the Asturias family have a large, seemingly never-ending source of supply. What they do not grow themselves they buy from any number of itinerant herb and plant gatherers, men and women who round up bushels of plant material from the lush tropical rain forests and fertile plains that comprise so much of the countryside surrounding the capital city. Tying their products into large white bags, the herb gatherers make their way to San Jose's central market, where buyers await them.

Experts in Costa Rica say that the reliance of the population here on medicinal plants is strong, as it is in many Latin American countries. Part of the reason for that is the cost of medical care in a country where money is not plentiful. Some who monitor Central American economies say expensive drugs produced by the large pharmaceutical companies are scarce.

"Medical services are really expensive," explains Victor, who runs the fish counter next to Alfredo's herb stand, "so many more poor people do this." He gestures at the rich variety of medicinal plants piled around the stall.

Victor maintains that herbal remedies have always been used in Costa Rica and that they are more appealing now because medical care is so costly. Victor does not know if the plants are as effective as Western medicines. But as persuasive and correct as the economic argument might be for their use, the tradition of using medicinal plants is one that is deeply intertwined with the cultures of Latin America.

The ancient Maya, Aztec, and Inca cultures had developed their own sophisticated systems for using medicinal plants before the Spanish Conquest in the early part of the sixteenth century. These three Indian cultures were centered in three distinct areas. Mayans occupied what is now Guatemala, Belize, southern Mexico, Honduras, and the northern part of Costa Rica. The Incas had an empire that included a wide swath of territory stretching from Peru into what is now western Argentina and northern Chile. The empire of the Aztecs centered on an area where Mexico City stands today.
Though there is not a great deal of written material from those civilizations to rely on, historians agree that herbal medicines were an established part of the health systems in those societies. The Aztecs in particular are believed to have had a pharmacopoeia of about 1,500 medicinal plants. Historians say that botanical gardens flourished throughout the empire. The written record kept by the Aztecs of their history and culture was largely destroyed by the Spanish after Cort6s arrived in 1519. But around 1570, King Philip II of Spain sent Francisco Hernandez, a court physician, to Mexico to investigate medicinal plants and general medical practices in the area. The work took over seven years and what was for that time a substantial amount of money. Hernandez died before his task was completed and a large part of his compilation was destroyed in a fire, although a copy with information on 1,200 herbs and plants survived and was ultimately rediscovered in Europe. A similar medical text done earlier by Martin de la Cruz, a Christianized Aztec, also survived.
It was a Spaniard who was responsible for one of the most ambitious written works on the Aztecs. Father Bernardino de Sahagtin learned the Nahuatl language and, with help from Aztec nobles and scribes, wrote A General History of the Affairs of New Spain, which was a comprehensive look at much of the life in the newly conquered lands, including a large section on herbs and medicinal plants.

Mayan books did not fare well. Most were destroyed by the Spanish after the Conquest, with all that remains amounting to three codices written on bark paper, now housed in Europe. However, historians say that Mayan manuscripts from the seventeenth century listed many illnesses and the appropriate cures. Yucatan, where the Maya lived, had a large assortment of medicinal plants.

The Inca tradition of medicine was memorialized in an account written by Felipe Guaman Poma de Ayala, the offspring of a noble Peruvian family. In the fifteenth century he prepared a codex, Prima Nueva Curonica, that describes the medical practices and beliefs of the Incas. According to medical historian Helmut M. Boettcher, the codex described numerous plants, including species that have medicinal uses.

Historians agree that the ancient Indian cultures' medical traditions were tightly bound with elements of religion. The traditions survived, despite attempts at suppression, and though the Spanish did construct hospitals in the conquered areas, it appears that the Indians continued to rely mostly on their own traditional healers and medicinal plants for treatment.

Many of the healing plants familiar to Indians in one area of the Americas also grew in other areas. So as geographically separate as those three civilizations may have been, there was nothing to keep indigenous peoples throughout Latin America from sharing knowledge of plant pharmacology. It was also not long before European settlers and traders came to realize the benefits the New World botanicals could provide. Europe had been battered by virulent outbreaks of diseases such as the plague and syphilis, and the Americas, particularly the Caribbean, were looked to for new cures. In 1578, Nicholas Monardes of Seville wrote in his Joyful Newes out of the Newe Founde Worlde about a number of plant cures from the West Indies, such as China root and sarsaparilla, that were used as syphilis remedies. His interest sparked widespread interest in New World botanicals.

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