1. Ethnomedicine David Kiefer, MD Botany 474

2. Easy! 300000 (total) 300 (U.S.) 10 plants for 80- 90% of a clinical practice

4. Goals Ethno-medicine (11:00-11:30) –History –Phytochemistry (And Wed/Fri) –Cross-cultural Introduce the on-line case (11:31-11:50) –Groups of 4 –“Due” Monday (10/27)

5. David Kiefer, MD Clinical Faculty –UW Family Med –Arizona Center for Integrative Medicine Residency: Seattle UW-Madison –BS-Zoology –MD

6. Richard Evan Schultes Harvard, Oakes Ames advisor 1937, undergrad: peyote Lophophora williamsii (Cactaceae) –Kiowa Indians (OK) PhD thesis: Mexico, sacred mushroom of the Aztecs. Teonanacatl (Panaelous campanulatus)

7. Immersion-Interdisciplinary 1941-1954 in NW Amazon –Collected 25000 plants, 1500 medicines/poisons Rituals Lived in villages Profound respect for peoples Conservation

8. Nascent pharmacology Conspicuousness, morphology Ubiquity Color Aroma Taste Contact dermatitis Lack of insect predation Animal food Anthropomorphic qualities Ease of transplantation Proximity to dwellings Cultural taboos and spirits Efficaciousness Multi-purpose utility Dreams Intuition Shamanic journeying

11. Traditional healers Shamanes Curanderos Y’chas

12. Ichilla panga shia Toothache Drooling

13. Cat’s claw (uña de gato) Uncaria tomentosa (Rubiaceae) Asháninka Indians in Peru –“savéntaro”, or “powerful plant” Oxindole alkaloids –Pentacyclic (+) –Tetracyclic (-) Mur (2002), Piscoya (2001)

14. Uña de gato Alkaloids: immunostimulant, increased phagocytosis, anti-cancer, anti-oxidant, anti-inflammatory Clinical trials: RA, OA, with vaccines Chemotypes: –Botanically similar –Healer-priests able to tell the difference

15. Oregano (Calentura panga) and Chonta chiri Oregano (Origanum vulgare) –Uses: Childhood fever Diarrhea Chonta chiri –? species –Uses: Shampoo alopecia

17. Phytochemicals Geranial + neral = “citral” –Aroma –Anti-fungal –Anti-bacterial –Anti-spasmodic, sedative –“Honey Citral IPA” Limonene: rind of lemon

18. Satagossa Aristolochia spp Uses: –Bites from scorpians, conga ants, spiders, snakes; –Diarrhea –Cough –Stomach ache May not be safe

19. Foods Medicines? Opuntia spp. Nopal, nopalitos Diabetes Ajo Spices: cinnamon, turmeric

20. Conservationist IUCN Red List: 34,000 species (12.5%) facing extinction “Scientists have analyzed the chemistry of fewer than 1% of the known…plants for biologically active substances…”(Plotkin, 2000) CITES: goldenseal, hoodia

21. Sustainable harvesting Chonta chiri –Bark: strips from one side of plant

23. “Back” home PlantsCulture HEALTH

24. The Herbal Team Traditional healers Naturopathic physicians (NDs) Herbalists MD, NP, RN, RP (PharmD), PA

27. “I want to lose weight” Brazilian cocktail –Ephedra –Furosemide (lasix) –Bovine thyroid

29. How about you? Low-grade temps (99.0-100.0) Scratchy throat, aches, runny nose Write down 3 things you would do now Turn to your left and see if any overlap

30. Hoodia Finding information: –Traditional use? Yes –PubMed: one “hit” (2002) MacLean (2004) Now: 11 articles –Review articles: nothing –Databases “Insufficient data” –Internet/Retail: overwhelming

31. Hoodia Traditional –Hoodia gordonii (Asclepiadaceae) –San: Kalahari desert abdominal cramps, hemorrhoids, TB, diabetes appetite suppressant: long walks in desert when no food is available –P57AS3 steroidal glycoside: Phytopharm, Pfizer, Unilever (Slim Fast) CNS (rats): blunts ATP decreases in with low-calorie diet –Slow-growing, limited range: CITES Rader 2007, Lee 2007, van Heerden 2007, MacLean 2004

32. Hoodia Traditional use –Possibly relevant to current use –Fill gap between retail science

33. On-line case PlantsCulture HEALTH Herbal medicine use –Madison vs home country –Why? Many factors involved Two example plant species Personal interaction with plants

34. On-line case Today –Groups of 4 This week: work on the case –mediastreamer.doit.wisc.edu/ltde/cscr-ethno-spring2013/ –Slide 3: Word document: Notes

35. Grade Final Report –End 5 sections –Fill in one section –Email: david.kiefer@fammed.wi sc.edu –5 th : work together –Hard copy: Next Monday

36. On-line case

37. stay together learn the flowers go light -Gary Snyder