Ethnobotanical Remedies for Acute Diarrhea in Central Anatolian Villages1 JANNA L. ROSE*,2, EVRIM ÖLÇER ÖZÜNEL3,

AND

BRADLEY C. BENNETT4

2

People, Organizations, and Society, Grenoble Ecole de Management, Grenoble, France Faculty of Literature (Edebiyat Fakültesi), Department of Turkish Folklore (Türk Halk Bilimi Bölümü), Gazi University (Gazi Üniversitesi), Ankara, Turkey 4 Department of Biological Sciences, Florida International University, Miami, FL, USA *Corresponding author; e-mail: [email protected]@grenoble-em.com 3

Ethnobotanical Remedies for Acute Diarrhea in Central Anatolian Villages. Acute gastrointestinal illness is a common, life–threatening complication for rural villagers in developing countries such as Turkey. Our study identifies and describes the classification schemes surrounding acute gastrointestinal illness, or diarrhea, and its folk treatments among Central Anatolian villagers. We conducted informal interviews with small groups of rural Turkish villagers in the spring of 2009, using scenarios, recall, free–listing, and ranked saliency techniques to amass information on knowledge and beliefs about diarrhea and its treatments. We also compared treatments from published ethnobotanical studies with 8 of 44 plants still used today. Foods available in the home as well as nearby wild plants were used by 96% of villagers to treat diarrhea. Species in the Rosaceae, Lamiaceae, and Asteraceae families were used most frequently. Villagers blended folk and biomedical concepts to explain their preferences for botanical remedies and to explain the perceived treatment efficacy. Orta Anadolu Köylerinde Akut İshal için Etnobotanik Tedaviler. Akut gastrointestinal hastalık Türkiye gibi gelişmekte olan ülkelerde kırsal alanda yaşayan köylüler için yaygın ve hayatı tehdit eden bir komplikasyonudur. Çalışmamızda akut gastrointestinal hastalık ya da ishalin Orta Anadolu köylüleri arasında geleneksel tıbbi yöntemler kullanılarak yapılan tedavi biçimleri sınıflandırılmış ve tanımlanmıştır. Çalışma kapsamında 2009 yılı baharında, ishal ve ishal tedavileri hakkında inanç ve bilgileri toplamak için anımsatma, yeniden yapılandırma, serbest listeleme, yöntemleriyle gayriresmi sınırlı grup görüşmeler yürütülmüştür. Ayrıca etnobotonikal çalışmalarda basılı olan ve bugün halıhazırda kullanılan 44 bitkiden sekiz tanesi de karşılaştırılmıştır. Evde kullanılan yiyeceklerin yanı sıra civardaki yabani otlar da köylülerin %96’sı tarafından ishali tedavi amaçlı kullanılmaktadır. En sık kullanılan türler arasında gülgiller, ballıbabagiller, papatyagiller bulunmaktadır. Köylüler uyguladıkları bitkisel tedavinin iyileştirici etkisini açıklamak için geleneksel ve biyomedikal tedavi türlerini harmanlamaktadırlar. Key Words: Medicinal plants, ranked saliency, diarrhea, ethnobotanical knowledge, Central Anatolia, Turkey.

Introduction As in the rest of the world, diarrheal disease in Turkey is common and, at times, life–threaten1

Received 6 September 2012; accepted 17 May 2013; published online 5 June 2013. Electronic supplementary material The online version of this article (doi:10.1007/s12231-013-9233-8) contains supplementary material, which is available to authorized users.

ing (WHO and UNICEF 2004). In Turkey, 10% of infant mortality is caused by diarrhea (Ergener 2002), and uncounted others fall ill yet recover. Diarrhea in children leads to malnutrition, stunted development, and susceptibility to other pathogens (Simeon and Grantham– McGregor 1990), and it decreases students’ performance measures (Ulukanlığıl and Seyrek 2004). In some regions of Turkey, the Ministry of Health (2004) provides medicines, iron supplements, and nutritious foods in school lunches to

Economic Botany, 67(2), 2013, pp. 137–146 © 2013, by The New York Botanical Garden Press, Bronx, NY 10458-5126 U.S.A.

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combat malnutrition and helminthic diarrhea (PCD 2000). Ethnobotanists have surveyed plant–based remedies for gastrointestinal disease in Mexico (Berlin and Berlin 1996; Heinrich et al. 1992), India (Tetali et al. 2009), Nigeria (Agunua et al. 2005), South Africa (Fawole et al. 2009; Mathabe et al. 2006), and other locales. Plants are commonly used for treating infectious diarrhea and other gastrointestinal illnesses in these regions, as travel to distant biomedical clinics and pharmacies is impractical during acute episodes of gastrointestinal distress. This holds true in rural Turkey, although more national healthcare clinics are anticipated in all regions of the country. Clinics are one of many places Turkish villagers can seek health advice, but because of political and religious tensions, non–biomedical healers are increasingly difficult to locate. There are several healing specialties. Koranic healers are gifted at holy prayers and blessings, either spoken or written (Eyüboğlu 1987). The cinci hoca (genie master) or üfürükçü (anger man) employ spiritual therapies to resolve problems resulting from cin (jinn, genie, or spirit) possession or harassment. Others included the ocaklı (miracle worker), the kurşuncu (lead pourer), the evliya (saint–like person), and the aktar (herbalist) (Dole 2004). Today, aktarlar (herbalists) own shops or market stalls and supply herbs, tonics, powders, prepared remedies, pastes, and healing balms. Some import European botanicals. However, the national government requires herbal shops to obtain pharmaceutical licenses if they give advice on remedies and administer drugs. Nonetheless, plant–based remedies are common in halk ilaçları or kocakarı ilacı (folk remedies) throughout Turkey. Generally, Turks are ambivalent about herbal remedies. On one side, biomedical practitioners belittle botanical remedies and question their validity while government officials push for more biomedical empiricism. They equate traditional herbal remedies with religious doctrines. To the other extreme, devout Muslims view traditional healers as sacrilegious and blasphemous. Between the two extremes, most people associate herbs with past great philosophers, medical schools, and herbaria, so plant–based remedies are tenuously accepted in Turkey. This view of traditional medicine mixes Mediterranean, European, and Arabic traditions from ancient to current times and homogenizes them. Worried that villagers would opt for biomedical treatments in lieu of traditional ones (Yeşilada et al.

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1999), several pharmaceutical professors in Turkey and Japan began collaborative research on traditional Turkish medicines in the 1980s. They identified and vouchered plants, their preparations, and their treatment procedures and published these studies in Turkish and international journals as a way to salvage some of the invaluable traditional knowledge of villagers. Tabata et al. (1988) stated: Villagers are the only source of correct and practical information on folk medicine. Other knowledge is generally based on Islamic medicine or European books of phytotherapy. There have been few studies that disclosed the accumulation of folk medicine in villages, and no analytical investigation on such knowledge has yet been carried out (Tabata et al. 1988: 11).

For this study, we aimed to analyze how folk knowledge is accumulated and shared in villages. We worked with Central Anatolian villagers to gather information on folk etiologies of disease and treatment preferences. We analyzed our results using saliency techniques, evaluation of plant families and bioactive plant species, and comparison with previous ethnobotanical studies in Anatolia. We realize that villagers and their traditional knowledge are not isolated from national and global actors and concepts; rather, they are influenced by external sources of knowledge. Villagers are connecting, changing, and often mixing ideas.

Turkey Turkey comprises the eastern borders of the Mediterranean and Aegean Seas and the southern border of the Black Sea. While a small portion of Turkey lies in Europe (Thrace, 24,378 km2), the rest lies within Asia (Anatolia, 790,200 km2). Situated in the northern temperate region between 35o to 43o N latitude and 26o to 45o E longitude, Turkey has more estimated plant species than all of Europe combined (Sezik et al. 1991), with more than 300 new species identified in the last three decades (Güner et al. 2000). High endemism and species numbers result from numerous mountain ranges adding elevation niches, refugia during the Pleistocene, and the conjunction of Mediterranean, Russo–Ural Mountains, and Syrian–Iraqi Desert ecosystems (Davis 1965; Kaya and Raynal 2001).

CENTRAL ANATOLIA Anatolia is a high plateau bounded on all sides by mountain ranges, with elevations ranging from sea level in the west to 1,700 m in the east. The region

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is divided into six phytogeographic regions (Davis 1965), including Central Anatolia. The WWF Terrestrial Ecoregion is a steppe interspersed with mixed conifer (pine or juniper) and deciduous (oak) forests or solely deciduous forests (Olson et al. 2001). The Köppen–Geiger climate classification (Peel et al. 2007) is semi–arid steppe (BSk) with a middle latitude temperature range. From July to September, the climate is hot (average 25°C) and dry (