Giovannini Peter, Heinrich Michael
Centre for Pharmacognosy and Phytotherapy, The School of Pharmacy, University of London, 29-39 Brunswick Sq., London WC1N 1AX, UK.
J Ethnopharmacol. 2009 Jan 30;121(3):383-99. doi: 10.1016/j.jep.2008.11.003. Epub 2008 Nov 8.
Little is known about the interface of traditional (generally plant based) medicines and of commercially available pharmaceutical (and related) products. Here we provide a case study to understand how and to what extent traditional and modern medicine have been integrated in an indigenous community and whether these two categories offer a meaningful model for understanding medicine selection. Consequently, this paper explores the use and knowledge of medicinal plants and patent medicines among laypeople living in a rural Mazatec indigenous community in Oaxaca, Mexico.
This paper is based on field study over a period of approximately 20 months using participant observation, unstructured and structured interviews including freelisting. The medicinal plant species and commercially available pharmaceuticals were assessed using published biomedical information.
The local ethnopharmacopoeias, emic concepts of illness, epidemiology, and case studies on therapeutic choice were documented. We found that self-treatment is the most common first therapeutic choice. Many of the plant species used by Mazatecs have recognized therapeutic properties, in some cases in vivo and in vitro studies point to well defined pharmacological effects, and in a few cases clinical evidence is available. Likewise, people commonly use patent medicines that are effective in the treatment of the most common health conditions. However, we also documented the medicinal use of some toxic plant species (Aristolochia spp.) and of some patent medicines that are held to be unsafe in developed countries (sodium metamizole).
When looking at a complex pluralistic medical system an approach that goes beyond the externally imposed dichotomic categories of traditional and modern medicine can be very useful to shed light on other dimensions that underlie the local use of medicines. With the increasing integration of the Mazatecs with the outside world, the concomitant use of both types of resources is constantly changing and helps the Mazatecs in their struggle for health.
对于传统（通常以植物为基础）药物与市售药品（及相关产品）之间的界面了解甚少。在此，我们提供一个案例研究，以了解传统医学与现代医学在一个土著社区中是如何整合以及整合到何种程度，以及这两类药物是否为理解药物选择提供了一个有意义的模式。因此，本文探讨了墨西哥瓦哈卡州一个农村马萨特克土著社区居民对药用植物和专利药的使用及相关知识。
本文基于约20个月的实地研究，采用参与观察、包括自由列举法在内的非结构化和结构化访谈。利用已发表的生物医学信息对药用植物种类和市售药品进行评估。
记录了当地的民族药典、疾病的主位概念、流行病学以及治疗选择的案例研究。我们发现自我治疗是最常见的首要治疗选择。马萨特克人使用的许多植物种类具有公认的治疗特性，在某些情况下，体内和体外研究表明其具有明确的药理作用，少数情况下还有临床证据。同样，人们普遍使用对最常见健康状况有效的专利药。然而，我们也记录了一些有毒植物种类（马兜铃属植物）以及一些在发达国家被认为不安全的专利药（安乃近）的药用情况。
在审视一个复杂的多元医疗体系时，一种超越传统和现代医学这种外部强加的二分法分类的方法，对于揭示当地药物使用背后的其他层面可能非常有用。随着马萨特克人与外部世界的融合日益增加，这两类资源的同时使用也在不断变化，并有助于马萨特克人维护自身健康。
