Title: Medicinal plants of the Achuar (Jivaro) of Amazonian

Ecuador: Ethnobotanical survey and comparison with other

Amazonian pharmacopoeias.

Published on: Journal of Ethnopharmacology

Cite as:

Giovannini, P., (2015). Medicinal plants of the Achuar (Jivaro) of Amazonian

Ecuador: Ethnobotanical survey and comparison with other Amazonian
pharmacopoeias. Journal of Ethnopharmacology 164(4), 78-88.

Author: Dr. Peter Giovanninia, b

a: Natural Capital and Plant Health Department, Royal Botanic Gardens Kew,
Wakehurst Place, Ardingly, West Sussex RH17 6TN, U.K.

b: Centre for Biocultural Diversity, School of Anthropology and Conservation,

Marlowe Building, University of Kent, Canterbury, Kent CT2 7NR, UK.

Tel. +44 (0) 1444 894116

Fax. +44 (0) 1444 894110

e-mail: peter.giovannini@gmail.com

Abstract
Aim of the Study and Ethnopharmacological relevance
This paper presents the first ethnobotanical survey conducted among the
Achuar (Jivaro), indigenous people living in Amazonian Ecuador and Peru.
The aims of this study are: (a) to present and discuss Achuar medicinal plant
knowledge in the context of the epidemiology of this population (b) to compare
the use of Achuar medicinal plants with the uses reported among the Shuar
Jivaro and other Amazonian peoples.

Materials and methods

The author conducted field research in 9 indigenous villages in the region of
Morona Santiago and Pastaza in Ecuador. Semi-structured interviews on local
illnesses and herbal remedies were carried out with 82 informants and plant
specimens were collected and later identified in Quito. A literature research
was conducted on the medicinal species reported by Achuar people during
this study.

Results
The most reported medicinal plants are species used by the Achuar to treat
diarrhoea, parasites infection, fractures, wounds, and snakebites. Informants
reported the use of 134 medicinal species for a total of 733 recorded use-
reports. Of these 134 species, 44 are reported at least 3 times for one or more
specific disease condition for a total of 56 uses. These species are considered
a core kit of medicinal plants of the Achuar of Ecuador. Most of these
medicinal species are widely used in the Amazon rainforest and in many other
parts of Latin America.

Conclusion
The author documented a core kit of 44 medicinal plants used among the
Achuar of Ecuador and found that this core set of medicinal plants reflects
local epidemiological concerns and the pharmacopoeias of the Shuar and
other Amazonian groups. These findings suggest that inter-group diffusion of
medicinal plant knowledge had a prominent role in the acquisition of current
Achuar knowledge of medicinal plants.

1. Introduction

The Achuar are indigenous people living in Amazonian Ecuador and Peru.
They belong to the Jivaroan linguistic family together with the Shuar, the
Aguaruna, and the Humabisa (Descola, 1996). To date no ethnobotanical and
ethnopharmacological survey has been conducted among the Achuar. Some
information on the plants used by the Achuar can be found as part of the
ethnographical work about the Achuar compiled by Descola but this
information has a limited ethnobotanical value as it is not backed by a
collection of voucher specimens (Descola, 1996; Descola, 1997). Two other
studies have described the ritualistic use of Ilex guayusa (Lewis et al., 1991)
and reported about the medicinal use of Cyperus spp. (Lewis and Elvin-Lewis,
1990) among Achuar people. Therefore, this paper presents the first
comprehensive ethnobotanical survey conducted among the Achuar.

The aims of this paper are: (a) to present and discuss the medicinal plants
known by the Achuar of Ecuador in the context of the epidemiology of this
population (b) to compare the use of Achuar medicinal plants with the uses
reported among the Shuar and other Amazonian peoples.

The author expects to find a large overlap between Achuar pharmacopeia and
Shuar pharmacopeia, as Achuar and Shuar have lived in contiguous areas for
a long time and many cultural traits such as language are very related to each
other (Descola, 1996).

2. Methods

2.1 Site description:

The Achuar are an Amazonian indigenous group inhabiting north-eastern
Peru and southern Ecuador in the basins of the Pastaza, Corriente and
Morona river. Differently from many other indigenous people in the Americas,
and facilitated by the fact that they inhabit a remote area of the Amazon
forest, the Achuar have been able to defend their land and, to a certain
degree, their lifestyle (Enfermeras para el mundo, 2009).
Before their contact with missionaries at the end of the 1960s, the Achuar
were semi-nomadic horticulturalist and hunters living in small and temporary
settlements scattered in a vast territory (Descola, 1996).
Although Achuar people living in Peru have traded with outsiders (white and
mestizos) for more than a century, facilitated by the fact that Achuar territory
in Peru can be accessed through the Maraon river (Descola, 1996), the
Achuar of Ecuador had almost no peaceful contact with foreigners until the
first contacts with missionaries (Salesians and American protestants) at the
end of the 1960s (Descola 1996). In this period missionaries of the Summer
Institute of Linguistics (SIL) started to work among the Achuar of Peru and
later with the Achuar of Ecuador. They initially promoted the formation of
permanent settlements (centros) around the landing strips that they used to
enter in the area (Descola 1996) and in 1975 they started a program of cattle
raising in Achuar settlements. Missionaries introduced also a formal education
system (Descola, 1996).
In the 1970s oil companies started petrol exploration in Achuar territory and
began extracting oil from some of the Achuar territory in Peru. In the area
where oil extraction took place, contamination of natural resources and their
overexploitation has severely damaged the ecosystem and the health of
Achuar people (Martnez et al., 2007).

2.2 Current population and lifestyle of the Achuar.

As of 2006 the total population of the Achuar in both Ecuador and Peru was
estimated to be 20000 (Ministerio de Salud del Peru, 2006). This population is
distributed in small communities scattered over a territory of about the size of
Belgium. Achuars subsistence economy is mostly based on horticulture and
hunting but it is complemented by other activities such as cattle-raising and in
few communities the cultivation of cash crops or the harvesting of wild plants.
Both of these are sold for cash to external actors, such as NGOs and
commercial companies, which use them as ingredients for herbal products
and cosmetics.
In Ecuador an estimated 6000 Achuar people live in 75 communities scattered
in a territory (Figure 1 and 2) of about 681218 Hectares in the Cuenca Alta del
Rio Pastaza in the Provinces of Morona Santiago and Pastaza (Enfermeras
para el mundo, 2009). From outside the territory, the Achuar communities
can be reached only by canoe or with small airplanes but these communities
are connected to each other through a network of forest paths maintained by
their inhabitants.
The Achuar of Ecuador are organized politically through the Nacionalidad
Achuar Ecuador (N.A.E.), an organization founded in the 1990s and formally
recognised by the Ecuadorian state.

Figure 1. The map shows the territory of the Achuar of Ecuador

Figure 2. The map shows the territory of the Achuar of Ecuador. Achuar
communities are grouped in several associations (associacines)
indicated on the map.

2.3 Health and healing among the Achuar

Information on the epidemiology and health system of the Achuar before their
sedentarisation, which started in the late 1960s, is scarce. Descola (1996)
reports that in the 1970s the Achuar considered witchcraft the major cause of
sickness and illness. Accordingly, Descola observed that, although Achuar
used many medicines, ill people mostly attended a Shaman (wishin).
Currently, the most common health problems among the Achuar population
are acute infectious diseases of the respiratory tract and of the
gastrointestinal system, intestinal parasitic infections, dermatophytosis,
bacterial infections of the skin, gastritis, malaria, leishmaniasis, urinary tract
infections, arthritis, and tuberculosis. Dental disorders, snakebites,
malnutrition, wounds and traumas are other frequent medical problems
(Ministerio de Salud Peru 2006; personal communication Dr. B.Rodrguez;
Enfermeras para el mundo 2009).
As of 2012 there is a main health post (subcentro de salud) in Wasakentsa,
the Salesian mission, and in five other Ecuadorian Achuar communities there
are other smaller health posts (puestos de salud) where patients can be
attended and medicines are dispensed at no cost. These health posts are
under the jurisdiction of the Ecuadorian Ministry of Health.
In several communities there are also Achuar health workers (promotores de
salud) mostly men, elected by the community to be trained by external actors
(a local NGO) on primary health care. They manage the botiquin, a place
where the medicines are stocked, and dispense medicines to patients that
visit them.
Achuar health workers also refer severe cases to the health personnel
(auxiliares de salud) based in the health posts who decide if it is necessary to
call by radio a flight to transfer the patient into an hospital outside of the
Achuar territory. While Achuar communities have received few times
medicines at no cost from the government and from other external actors,
several communities are now organised to buy collectively medicines, which
are considered essential, when the stocks are depleted. With an increasing
trust toward the efficacy of biomedicine, the abuse of pharmaceuticals, such
as lack of compliance with recommended mode of use and administration,
has become widespread in the last 20 years (Vanesa Mojena personal
communication). In many cases pharmaceuticals are used empirically and
local knowledge about their use is developing among Achuar people as it has
been observed elsewhere in Latin America (Giovannini and Heinrich, 2009).
2. 4 Field research
Field research was conducted by the author between July and October 2011
in the Salesian missionary centre of Wasakentsa and in 9 indigenous villages
in the region of Morona Santiago and Pastaza in Ecuador: Sewastian,
Kaiptach, Tsunkintsa, Mashumarentsa, Juyukamentsa, Saapapentsa,
Wichimi, Achuar, Yutsuntsa. Herbarium specimens were collected and dried
following standard ethnobotanical methods and identified and deposited in
Quito at the Herbario de la Universidad Central del Ecuador (QCA), Herbario
Nacional de Ecuador en Quito (QCNE) and Herbario de la Universidad
Central del Ecuador (QAP). Table 3 in Appendix A shows voucher numbers
and where these are deposited. Plant names were later checked with The
Plant List (www.ThePlantList.org).
The research was part of a larger EU-funded project1 that aimed to reduce
contamination in the Achuar territory and was motivated by the observation
that pharmaceuticals discarded in the environment are contributing
significantly to contaminate Achuar territory. Therefore, as part of a wider
strategy to reduce contamination, the project aimed to support the use of
medicinal plants among the Achuar as part of a health care system that
integrates the use of both traditional and western medicine and minimise
contamination caused by the misuse of pharmaceuticals.
Permits to conduct the research were obtained from both Ecuadorian (Ministry
of the Environment) and Achuar institutions (N.A.E.). According to Article 8(j)
of the Convention of Biological Diversity, the objectives, methodology and
expected outputs of this study, including the benefits shared with the Achuar
and the publication of a research paper, were agreed with the president and
the coordinator of the N.A.E. Before starting the research in each community,
the aims and outputs of the research were explained and discussed in Achuar
language during community meetings. As part of the benefit sharing outputs
that were agreed with Achuar leaders a deliverable of this project was a
manual on Achuar medicinal plants that was distributed to health promoters in

1
ACRA/EU -ECUMON Project-
Waste management and pollution reduction in the Municipality of Taisha and in the Achuar
territory - NSAPVD/2010/259-173
all 75 communities and to Achuar general population a few months after the
research took place. In total 1000 copies of the manual of Achuar medicinal
plants were also distributed among the population and 22 workshops were
conducted to disseminate the results of the research with the participation of
more than 330 individuals. The results were also used to design a nursery of
medicinal plants in Wasakentsa. In March 2013, the results of the research
were also shared at the annual assembly of the N.A.E. .

2.5 Data collection and data analysis

The author collected epidemiological data from both the perspective of the
medical personnel working in the area and from the perspective of the Achuar
people. More specifically, the author conducted open and semi-structured
interviews with the medical doctor (Dr. B. Rodrguez) who has worked for
about 30 years in the area and with two nurses.
This information, together with pilot interviews with 7 Achuar informants, were
used to select a list of common medical problems in the area (table 1) that
were used as the main focus of the semi-structured interviews on medicinal
plants carried out with 82 informants (49 males and 33 females). This sample
includes any adult (age18) respondent, in the 9 villages where the study was
conducted, that was willing to participate in the study.
Considering that 63% of Achuar population is under 18 (this figure was
estimated by calculating the average from 14 communities where
demographic data were available), the sample of this study represents 3.7%
of the estimated Achuar adult population in Ecuador (6000 individuals).
In the first part of each interviews the researcher asked the informant to list
the most common health problems in the area, this methodology is
commonly referred as freelisting (Borgatti, 1999). These data complemented
the epidemiological data collected at the beginning of the study. The second
part of the interview focused on the informants knowledge of medicinal plants
that can be used to cure the illnesses in table 1. Informants were asked which
medicinal plants they know to cure each of these illnesses and, for each use
report described, information on the preparation and administration of the
remedy was recorded.
In some case informants spontaneously reported the use of medicinal plants
for illnesses not in table 1 and the author recorded this information. Interviews
were tape recorded (verbal permission to record the interviews was asked at
the beginning of the interview). With the exception of few interviews
conducted with informants fluent in Spanish, interviews were conducted in
Achuar language and facilitated by a bilingual Achuar-Spanish translator.
Plant specimens were collected by means of walks in the woods with the
informants, walks in households gardens following interviews, or by asking
people to collect them and bring them to the researcher. Plant specimens
were conserved with alcohol (Schweinfurth method) during fieldwork and later
pressed and dried in Macas, Morona Santiago, Ecuador.

TABLE 1.

Medical problem (English) Medical problem (Spanish)

Diarrhoea Diarrea
Malaria Paludismo
Common cold Gripe
Leishmaniasis Leishmaniasis
Intestinal parasites Bichos
Snakebite Picadura de culebra
Wounds Heridas
Splints, sprains and broken bones Huesos quebrados
Rheumatism Dolor de huesos

Table 1. List of common medical problems in the area selected as focus of

the semi-structured interviews on medicinal plants carried out with 82
informants

Data analysis
Each use reported during an interview was entered in a database. To discern
plant uses that are idiosyncratic from plant uses that are shared and part of
the basic medical kit of the Achuar, plant uses that have been reported
independently by at least 3 informants were selected for further analysis.
3. Results and discussion

3. 1 Ethnoepidemiology:
The result of the free list on most common illness and medical problems is
shown in table 2. These ethno-epidemiological data match well with the
epidemiological data available in literature (Ministerio de Salud del Peru 2006)
and the epidemiological information given by the medical doctor working in
the area. The Achuar perceive acute infective disease of the gastrointestinal
system, acute respiratory infection and malaria as the most common illnesses
in the area. Rheumatism, tuberculosis, leishmaniasis, gastritis and snakebites
are also perceived as common health concerns in the area.
Only 9% of the respondents reported witchcraft as a common cause of health
problems. This is a relatively low percentage considering that previous
ethnographic work on the Achuar emphasizes the role of witchcraft in their
medical system (Descola, 1996). This low rate is likely due both to response
bias caused by the researcher and changes in medical beliefs that have
occurred in the last 40 years. According to the medical doctor that worked in
the area since 1980s, belief in witchcraft was predominant when she started
to work in the area. While Achuar beliefs in witchcraft has diminished (but not
disappeared) the Achuar have acquired new beliefs regarding the use and
efficacy of biomedicine and there is a growing concern for the misuse of
pharmaceuticals.
TABLE 2.
English Spanish Frequency Percentage Smith's S
index
1 Diarrhoea Diarrea 51 65 0.491
2 Fever Fiebre 38 49 0.359
3 Malaria Paludismo 36 46 0.346
4 Common cold Gripe 24 31 0.221
5 Headache Dolor de cabeza 18 23 0.144
6 Cough Tos 18 23 0.126
7 Rheumatism Reumatismo, Dolor de 15 19 0.111
huesos
8 Stomach ache Dolor de estomago 14 18 0.106
9 Tuberculosis Tubercolosis 12 15 0.083
10 Leishmaniasis Leishmaniasis 8 10 0.069
11 Hepatitis Hepatitis 7 9 0.064
12 Gastritis Gastritis 10 13 0.063
13 Whooping Tos ferina 5 6 0.054
cough
14 Intestinal Bichos 5 6 0.051
parasites
15 Snakebite Picadura de culebra 8 10 0.049
16 Abscess Absceso 8 10 0.049
17 Witchcraft Brujeria 7 9 0.045
18 Pneumonia Pneumonia 7 9 0.043
19 Vomiting Vomito 8 10 0.038
20 Wounds Herida 4 5 0.031
21 Measles Sarampion 3 4 0.024
22 Body aches Dolor de cuerpo 6 8 0.023
23 Urinary Problema de orina 4 5 0.022
infections
24 Toothache Dolor de muela 3 4 0.02
25 Dizziness Mareo 3 4 0.02
Table 2. The result of the freelist on most common illness problems.
Frequency: frequency of mention during freelisting. Percentage: percentage of
informants that mentioned the item (illness); Smiths S index: Smiths S index
(Smith, 1993) of salience varies between 0 (least salient) and 1 (most salient)
and it takes in accounts both frequency and rank order of the item in each list.

3. 2 Medicinal plants of the Achuar:

In total, informants reported the use of 134 medicinal species for a total of 733
recorded use-reports. Of this 134 species 44 are reported at least 3 times for
one or more specific disease condition for a total of 56 uses for which
consensus was found. These medicinal plants are shown in the Table 3 in
Appendix A.

The most represented botanical families are Solanaceae (3 species),

Leguminosae (3 species), Rubiaceae (2 Species), Cyperaceae (2 species),
Euphorbiaceae (2 species), Moraceae (2 species). These families are well
known for having a high percentage of medicinal species, which reflect their
phytochemistry. Cyperaceae are usually underrepresented as medicinal
species but several studies have already reported the wide medicinal use of
Cyperaceae among Amazonian peoples (Lewis and Elvin-Lewis, 1990;
Plowman et al., 1990).

Preparations of Achuar herbal remedies

The most common way of preparing remedies among the Achuar consists of
preparing decoctions by boiling plant parts in a large amount of water until this
is considerably reduced and coloured by plants phytochemicals. In some of
the decoctions sugarcane is added to prepare medicinal syrups.
These preparations are administered orally and in many cases the patient is
expected to vomit after having taken the medicine. Respondents explained
also that children that have not yet learnt how to vomit are not allowed to
take these remedies. Accordingly, Lewis (1990) described how Achuar
emesis after the consumption of a drink of Ilex guayusa is learned rather than
physiological.
Some of these remedies are prepared with several plant species and in few
cases respondents explained that they invented the mixtures. Achuar people
are also aware of the possible adverse effects that can arise from mixing
some plant species in medicinal preparations, as several respondents warned
that some species must not be used together. For example, using the leaves
of Ilex guayusa and Psidium guajava in the same decoction is said to produce
a poisonous beverage.
Some remedies are prepared without cooking the ingredients but rather by
crushing, grating and mashing plant parts in water and then filtering the water
with a sieve. For example, the rhizome of Cyperus spp. are chewed and then
mixed with water, which is finally filtered before administration. Oral
preparations (both decoctions and uncooked preparations) are often
administered three times a day in a dosage that is related to the age of the
individual treated.
In some preparations Achuar people grate part of the bark, or the seed, of
some species and then use the powder obtained either as ingredients for oral
preparations or for topical application. For example the bark of Ceiba
pentandra is applied to external lesions.
The raw latex of some plant species is used internally and/or externally such
as, for example, the latex of Croton lechleri and Ficus insipida. Another type
of preparation consists in reducing herbal mixtures to ashes and then apply
these on leshmaniasis lesions. A cloth may be used to hold the preparation on
the lesions.
Young tender leaves of some species, such as Jacaranda copaia, are rubbed
on the skin to treat skin mycosis and other dermatological problems.

3. 2.1 Medicinal uses

Musculoskeletal disorders and traumatic injuries

Brugmansia insignis (19 Use Reports or UR) is commonly used by the

Achuar to treat fractures and sprains. Other species with thick leaves or
stems, such as Hylocereus sp. (11 UR), Phthirusa pyrifolia (4 UR), Opuntia
ficus-indica (4 UR) are also used to treat fractures and sprains.
Hay et al. (2012) reported the same use of Brugmansia insignis Among the
Shuar and De Feo (2004) reports similar uses of this species in the Peruvian
Andes. P. pyrifolia is used similarly among the Quichua (Alarcn, 1988) .
Decoctions of the leaves of Mansoa alliaceae (4 UR) and Brunfelsia
grandiflora (4 UR) are warmed and applied externally with bandages to treat
the same condition. Previous studies reported the use of M. alliaceae to treat
arthritis among Quichua (Alarcn, 1988) and the use of B. grandiflora to treat
rheumatism and other ailments (Broseghini and Frucci, 1986; Schultes and
Raffauf, 1990).
To treat rheumatisms and body aches the Achuar use also the urticant leaves
of Urera baccifera (6 UR) and Urera laciniata (3 UR). Affected areas of the
body are hit with the leaves and are then massaged. U. baccifera is used
similarly among the Shuar of Ecuador (Bennett et al., 2002) and the Sionas of
the Columbian Putumayo uses U. baccifera and U. laciniata to treat muscular
pains (Schultes and Raffauf, 1990).

Gastrointestinal complaints
Psidium guajava (40 UR), Croton lechleri (14 UR), Crematosperma
cauliflorum (13 UR), Cyperus prolixus (12 UR), Musa x parisidiaca (18 UR),
Zingiber officinale (18 UR) and Citrus aurantifolia (19 UR) are the most
reported medicinal plants used to treat diarrhoea and dysentery. Croton
lechleri (3 UR) is also used to treat stomachache.
P. guajava is widely used in tropical regions to treat gastrointestinal conditions
(Gutirrez et al., 2008). Similarly there are many reports of the use of C.
lechleri to treat diarrhoea (Carlson and King, 2000; Odonne et al., 2009;
Ubillas et al., 1994). The Shuar and other Amazonian indigenous group use Z.
officinale to treat diarrhoea and other gastrointestinal conditions (Schultes and
Raffauf, 1990). Musa x paridisiaca is used similarly among the Shuar
(Bennett et al., 2002). The use of Cyperus prolixus to treat several illnesses
including diarrhoea has been already reported among indigenous Amazonian
people (Plowman et al., 1990).
C. aurantifolia is a widely used ingredient of herbal remedies and a similar use
was documented among the Chayahuita of the Peruvian Amazon (Odonne et
al., 2013). Citrus sinensis is used similarly by indigenous people living in the
Indigenous Territory and National Park Isiboro-Secure (Thomas and
Vandebroek, 2006) and in other parts of Latin America (Heinrich et al., 1998).
Carica papaya (22 UR) and Ficus insipida (16 UR) are the most commonly
reported species used to treat intestinal parasites. Bennett (2002) reported
the same use of C. papaya among the Shuar and the use of both species for
intestinal parasites have been widely documented in Amazonian societies
(Schultes and Raffauf, 1990).
Skin-disorders
Wounds are treated by applying directly on the lesions the latex of C. lechleri
(24 UR), a poultice made of leaves of Brugmansia insignis (UR 5), a powder
obtained from the bark of Parkia multijuga (UR 4), the chewed leaves of Ilex
guayasa (3 UR) or the chewed liverwort Plagiochila cf. subplana (UR 5).
The Shuar use C. lechleri (Bennett et al., 2002) and Brugmansia insignis
(Hay, Gottshcalk and Holguin 2012) similarly. Alarcon (Ros et al., 2007)
reported the use of Parkia sp as vulnerary among the Quichua.
Himathanthus sucuuba is used to treat abscess (3 UR). This species has
been reported as a remedy used for wound healing (Bourdy et al., 2000;
Villegas et al., 1997) and to treat leishmaniasis lesions in other parts of the
Amazon (Castillo et al., 2007; Odonne et al., 2009).

Snakebites
Adenostemma fosbergii (15 UR), Mucuna sloaneii (6 UR), and an
unidentified Leguminosae species are the most reported remedies to treat
snakebite. The use of the first has been reported also among the Shuar
(Bennet et al 2002) while several Mucuna species have been reported as
remedies for snakebites in different part of the world (Coe and Anderson,
2005; Molander et al., 2012).

Respiratory disorders
Decoctions made with the rhizome of Zingiber officinale (14 UR) or the leaves
of Cymbopogon citratus (6 UR) and Mansoa alliacea (5 UR) are the most
reported remedies used to treat common cold and cough.
Bennett et al. (2002) and Gerique-Zipfel (2011) reported the use of these
species to treat respiratory disorders among the Shuar. C. citratus and Z.
officinale are widely used worldwide to treat common cold and cough (Bennett
and Prance, 2000; Ross, 2005). Alarcon (1988) reported the use of M.
alliacea among Quichua to treat fever.
Parasitic diseases
To treat malaria the Achuar use several medicinal plants. The leaves of
Nicotiana tabacum (8 UR) are crushed in water and sometimes mixed with
Chicha (a drink based on fermented manioc).
A decoction of the roots of Urera baccifera (7 UR) is drunk and vomited. The
roots of Bactris gasipaes (UR 3), the internal part of the bark of Guarea
grandifolia (3UR), and the roots of Euterpe precatoria (3 UR) are prepared
and administered similarly.
A decoction made with the leaves of Hamelia patens (6 UR) is drunk to treat
malaria. Similarly a decoction of the leaves Banisteriopsis capii (5 UR) is
drunk and then vomited to treat the same condition. A decoction of the bark of
Grias neuberthii is used to treat malaria (UR 3).
Previous studies showed similar uses in Amazonia for Hamelia patens
(Valadeau et al., 2009), Grias neuberthii (Schultes and Raffauf, 1990), Bactris
gasipaes (Balslev et al., 2008) and Euterpe precatoria (Bertani et al., 2005;
Kvist et al., 2006; Ruiz et al., 2011). Valadeau et al. (2010) reported the use of
Urera laciniata to treat malaria among the Yanesha and Sans-biset el al.
(2009) reported the use of Guarea macrophilla to treat the same condition in
the Peruvian Amazon. Interestingly a bark infusion of Guarea grandifolia was
reported to cause vomiting and intoxication (Boom and Moestl, 1990) two of
the physiological reactions that Achuar expect when treating malaria.
Banisteriopsis capii is widely used throughout the Amazon to treat many
diseases (Schultes and Raffauf, 1990) but there are no reports of the use of
this species to treat malaria among the Shuar.

To treat mucosal leishmaniasis the Achuar use also the juice extracted from
the leaves and stem of Mansoa alliacea (UR 3). A powder obtained from the
bark of Minquartia guianensis (3 UR) is applied externally on lesions and
remedies from Cedrela odorata (3 UR) and Ceiba pentandra (3 UR) are
prepared and administered similarly. Finally, the Achuar use also a poultice
made with the leaves of Jacaranda copaia (3 UR) to treat leishmaniasis.
Previous studies reported the same use of M. guianensis (Gachet et al.,
2010), C.odorata (Kvist et al., 2006; Odonne, 2010), J. copaia (Gachet and
Schhly, 2009), and C. pentandra (Odonne et al., 2011) by other peoples
inhabiting the Amazon but there are no reports of the use of these species to
treat leishmaniasis among the Shuar.

Gynaecological or reproductive conditions

Cyperus articulatus (3 UR) and Zingiber officinale (4 UR) are used to limit pain
during childbirth. Zingiber officinale (5 UR) is also used after copious blood
loss during childbirth.

4. Discussion

The epidemiological profile of the population of the Achuar of Ecuador, with a

high incidence of acute infectious diseases, it is typical of societies that
transitioned from a nomadic, semi-nomadic lifestyle to a sedentary lifestyle
(Alexiades and Peluso, 2009; Dounias et al., 2004; Dounias and Froment,
2011; Freedman and Kroeger, 1984; Hern, 1991).
Accordingly, the most reported medicinal plants are species used by the
Achuar to treat diarrhoea, parasitic infection, fractures, wounds, and
snakebites, although the author of this paper recognises that this result may
have been biased by the focus of the interviews on the diseases in Table 1.
Interestingly, while wounds, fractures and snakebites are likely to have been
an important cause of illness and death in the pre-sedenterised Achuar
society, gastrointestinal infections and parasites are likely to have been minor
illnesses in the past as these are unlikely to spread in semi-nomadic societies
(Dunn, 1968; Polunin, 1967).
Most of these medicinal species are widely used in the Amazon and most of
them in many other parts of Latin America. 21 out of 56 (37%) uses on which
there is consensus at species level have been reported also among the Shuar
and 49 out of the 56 uses reported (i.e. 87%) at the species level have been
reported also among other Amazonian peoples. However, it is interesting to
note that the most reported medicinal plant, Zingiber officinale, is an
introduced species native of Asia (Ross, 2005).
Similarly to the observations of Descola (1996), a Salesian priest who has
spent considerable time in Achuar communities at the beginning of their
contact with western culture (Salesian priest personal communication) stated
that, while some medicinal plants were commonly used, pre-sedenterisation
Achuar medical system was mainly based on witchcraft and the consultation
of a wishin (Shaman) rather than the use of medicinal plants.
Although no baseline data is available as a benchmark of comparison, the
findings of this study suggest that todays Achuar pharmacopoeia is likely the
result of how local knowledge of medicinal plants has adapted to a relatively
recent epidemiological change and of the effect of the increasing contact with
other indigenous groups and outsiders rather than the results of the
accumulation of botanical lore during centuries of isolation.
The epidemiological shift and the arrival of new diseases likely fostered the
acquisition of new ethnobotanical knowledge through exchange of information
and experimentation. However, the introduction of western medicine by
missionaries during the process of sedenterisation may have diminished the
incentive for the acquisition of new ethnobotanical knowledge.
The findings of this study suggest that inter-group diffusion of knowledge
(exchange of information) had a prominent role in the acquisition of Achuar
botanical knowledge. For example, it is likely that contact with the Shuar,
facilitated by linguistic and geographic proximity, highly influenced Achuar
pharmacopeia. The Shuar have been in contact with western civilization long
before the Achuar (Descola, 1996; Rubenstein, 2001) and its possible that
also their pharmacopeia was highly influenced by the changes due to
sedenterization that took place later among the Achuar. If this occurred, than
the Achuar would have conveniently found in the ethnobotanical knowledge of
the Shuar remedies for the new diseases introduced through the
epidemiological shift.
The findings and observations of this study fit with Davis and Yost hypothesis
that the pharmacopeias of some Amazonian indigenous people reflect at
least in part the chaos of contact and the accelerated experimentation that
took place in post-contact times (Davis and Yost, 1983).
5. Conclusion

In conclusion, the author documented a core kit of 44 medicinal plants used

among the Achuar of Ecuador and found that this core kit of medicinal plants
reflects local epidemiological concerns and the pharmacopeia of the Shuar
and other Amazonian groups. Future studies on Achuar medicinal plants,
could use the findings of this first ethnobotanical study of the Achuar of
Ecuador as a baseline data to evaluate change in ethnobotanical knowledge
and practices among this Amazonian people.

Acknowledgements:
Thanks to all the Achuar people and communities that have participated in
this study. Thanks to Pietro Graziani and to Adriana Sousa for assistance in
organising the logistical aspects of the field research. Thanks to the staff of
the Herbario de la Universidad Central del Ecuador (QCA), Herbario Nacional
de Ecuador en Quito (QCNE) and Herbario de la Universidad Central del
Ecuador (QAP) for assisting with plant identification. Thanks to Dr. Sarah
Edwards and Dr. Melissa Ceuterick for useful feedback on this manuscript.
This research was funded by ACRA/EU -ECUMON Project-Waste
management and pollution reduction in the Municipality of Taisha and in the
Achuar territory - NSAPVD/2010/259-173.

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Appendix A
Species Family Specimens Local name PU Use Preparation Use reported in Use reported
(Achuar in the Amazon among the Shuar
italics) (Use Reports)
Adenostemma APG20, Leaves are crushed
2
fosbergii R.M.King & APG67 , and mixed with water, (Bennett et al.,
3
H.Rob. Asteraceae APG77 Araraats L Snakebite (15) used orally. - 2002)
Bactris gasipaes Uwi, R Decoction, used orally (Balslev et al.,
1
Kunth Arecaceae APG89 - Chonta or L Malaria(3) and then vomited 2008) -
Banisteriopsis caapi
(Spruce ex Griseb.) Decoction is drunk and
2
C.V. Morton Malpighiaceae APG23 - Nateem L Malaria (5) then vomited (Ruiz et al., 2011) -
Dysentery (5),
1
Brosimum sp. Moraceae APG62 - Kustanch Lx Diarrhea (4) raw latex used orally na na
The stem is scraped
Brugmansia insignis and squezed to extract
(Barb. Rodr.) juice, the juice is drunk
Lockwood ex R.E. Maikua, Fractures and and applied externally (Schultes and
1
Schultes Solanaceae APG10 - Floripondio S sprains (19) with bandage. Raffauf, 1990) (Hay et al., 2012)
The stem is scraped
and squezed to extract
juice and applied
externally with
Brugmansia insignis bandage. The leaf is
(Barb. Rodr.) roasted, grounded and
Lockwood ex R.E. Maikua, S& Wound healing then applied on the
1
Schultes Solanaceae APG10 Floripondio L (5) wound - (Hay et al., 2012)
1
APG60
1
Brunfelsia grandiflora APG74 Decoction is used (Schultes and (Broseghini and
2
D. Don Solanaceae APG78 Chirikiasip L Rheumatism (4) orally Raffauf, 1990) Frucci, 1986)
Seeds are crushed
and mixed with water, (Broseghini and
Carica papaya L. Caricaceae Papaya Se Parasites (22) used orally (Rutter, 1990) Frucci, 1986)
Kanu, Leishmaniasis Internal part of the (Kvist et al., 2006;
1
Cedrela odorata L. Meliaceae APG13 Cedro B (3) bark is scraped and Odonne, 2010) -
Species Family Specimens Local name PU Use Preparation Use reported in Use reported
(Achuar in the Amazon among the Shuar
italics) (Use Reports)
applied on the lesion
Ceiba pentandra (L.) Leishmaniasis Bark powder is applied (Odonne et al.,
1
Gaertn. Bombacaceae APG15 Mente' B (3) externally 2011) -
Fruit or juice is added
Citrus aurantifolia F& to preparations with (Odonne et al.,
(Christm. ) Swingle Rutaceae Limon J Diarrhea (19) other species 2013) -
(Thomas and
1
Citrus sinensis (L.) APG97 Vandebroek,
1
Osbeck Rutaceae APG128 Naranja L Diarrhea (4) Decoction, used orally 2006) -
3
APG107 , Diarrhea (10),
3
APG115 , Dysentery (3),
APG115b Colic (1),
2
Cremastosperma , Mantach, Stomach pain (Bennett et al.,
1
cauliflorum R. E. Fr. Annonaceae APG129 - Quinina B (1) Decoction - 2002)
Cremastosperma Mantach,
cauliflorum R. E. Fr. Annonaceae Quinina Malaria (4) Decoction - -
Uruch Wound healing (Bennett et al.,
numi, (24), 2002)
Croton lechleri Mll. Sangre de Leishmaniasis Latex is applied on the
1
Arg. Euphorbiaceae APG90 drago Lx (1) lesion (Maxwell, 1990)
(Carlson and (Bennett et al.,
Uruch King, 2000; 2002)
numi, Odonne et al.,
Croton lechleri Mll. Sangre de Diarrhea (13), Raw latex is used 2009; Ubillas et
1
Arg. Euphorbiaceae APG90 drago Lx Dysentery (1), orally al., 1994)
Uruch (Bennett et al.,
numi, 2002)
Croton lechleri Mll. Sangre de Stomach ache Raw or cooked, used
1
Arg. Euphorbiaceae APG90 drago Lx (3) orally (Vsquez, 1994)
Decoction is drunk or (Bennett et al.,
Cymbopogon citratus Common cold the water is used to (Grenand et al., 2002)
(DC.) Stapf. Poaceae Hierba luisa L (6), fever (2) bath 1987)
Species Family Specimens Local name PU Use Preparation Use reported in Use reported
(Achuar in the Amazon among the Shuar
italics) (Use Reports)
2
APG22 , To limit Root chewed with (Bennett et al.,
2
APG50 childbirth pain water and then the 2002)
2
Cyperus articulatus L. Cyperaceae APG51 Piripiri R (3) water is drunk (Duke, 2008)
3
APG24 , (Bennett et al.,
3
APG55 , Crushed with water or 2002)
1
Cyperus prolixus APG68 , chewed and then used (Plowman et al.,
3
Kunth Cyperaceae APG146 Piripiri R Diarrhea (12) orally 1990)
Wound healing
Sunkip (3), Snakebite Stem is scraped and
1
Dieffenbachia sp. Araceae APG121 (camacho) S (1) applied on lesion na na
(Bertani et al.,
APG101b 2005; Kvist et al.,
2
Euterpe precatoria , Decoction is used 2006; Ruiz et al.,
Mart. Arecaceae APG101 Sak R Malaria (3) orally 2011) -
Latex with water
1
APG19 , Seem, Intestinal (somtimes cooked) is
2
22 Ficus insipida Willd. Moraceae APG111 , Wampu' Lx parasites (16) used orally (Vsquez, 1994) -
Decoction sometimes
P.guayava leaves and (Rengifo-Salgado,
2
Gossypium APG45 , Uruch, bark and lemon fruits 2010)
1
barbadense L. Malvaceae APG117 Algodon L Diarrhea (5) are added -
Fruit is roasted and
then the tip is cut, the
fruit is squeezed and (Grenand et al.,
2
Gossypium APG45 , Uruch, drops are appliead 1987; Luziatelli et
1
barbadense L. Malvaceae APG117 Algodon uF Ear ache (8) inside the ear al., 2010) -
3
APG32 , scraped bark is mixed
2
APG12 , Apai, with water and boiled,
1
Grias neuberthii J. F. APG131 , Huevo de decoction is drunk and (Schultes and
1
Macbr. Lecythidaceae APG141 burro B Malaria (3) vomited Raffauf, 1990) -
Guarea grandifolia (L.) Powdered bark is
1
Sleumer Rubiaceae APG81 - Pamasuki B Malaria (3) mixed with water and - -
Species Family Specimens Local name PU Use Preparation Use reported in Use reported
(Achuar in the Amazon among the Shuar
italics) (Use Reports)
used orally and then
vomited
2
APG42 Decoction is used (Valadeau et al.,
1
Hamelia patens Jacq. Rubiaceae APG28 Tsapuk L Malaria (7) orally 2009) -
(Odonne et al.,
Himatanthus sucuuba 2013; Schultes
(Spruce ex Mll.Arg.) Bark is scraped and and Raffauf,
1
Woodson Apocynaceae APG4 Apach B Abscess (3), applied on the lesion 1990) -
Gel/Juice is extracted
and then both applied
Fractures and externally and used
Hylocereus sp. Cactaceae Ikiamanch S sprains (10) orally na na
Decoction is used (Schultes and
1
Ilex guayusa Loes. Aquifoliaceae APG93 Wayus L Diarrhea (3) orally Raffauf, 1990) -
Wound healing Chewed and applied antiseptic use in
1
Ilex guayusa Loes. Aquifoliaceae APG93 L (3) on lesion (De Feo, 1992) -
Decoction is used
Wampaa, Diarrhea (5), orally mixed with P. (Gerique-Zipfel,
1
Inga edulis Mart. Mimosaceae APG44 Guava B Dysentery (1), guayava - 2011)
Leishmaniasis
(3), (Gachet and
2
Jacaranda copaia APG109 Kuiniap Dermatological Leaves are crushed Schhly, 2009; (De la Torre et al
1
(Aubl.) D.Don Bignoniaceae APG14 (Kuiship) L (1) and applied externally Plotkin, 1993) 2007)
1
APG149 Scraped bark releases
1
Leguminosae Leguminosae APG152 Kuup B Snakebite (16) liquid, which is drunk na na
(Vsquez, 1994)
Peeled and cooked reported for
roots are fermented to Fever.
make chicha and then (In this case the plant
juice from leaves of is used to create the
administration drink
Manihot esculenta Nicotiana tabacum are while the active
Crantz Euphorbiaceae Yuca R Malaria (3) added, used orally ingredient is probably -
Species Family Specimens Local name PU Use Preparation Use reported in Use reported
(Achuar in the Amazon among the Shuar
italics) (Use Reports)
nicotiana tabacum)
Mansoa alliacea Kaip, Ajo Common cold Decoction used orally (Grenand et al.,
1
(Lam.) A.H. Gentry Bignoniaceae APG3 del monte L (6) and to bath 1987) -
Mansoa alliacea Kaip, Ajo Disease Fumigation by burning (Grenand et al.,
(Lam.) A.H. Gentry Bignoniaceae del monte L prevention (4) leaves on a fire 1987) -
Leaves are boiled in
water, which is used to (Grenand et al.,
bath. Root is boiled in 1987; Schultes
Mansoa alliacea Kaip, Ajo L or water and the and Raffauf,
(Lam.) A.H. Gentry Bignoniaceae del monte R Fever (3) decoction is drunk 1990) -
Crushed and
Mucosal squeezed to extract
Mansoa alliacea Kaip, Ajo L& leishmaniasis juice, which is applied (Odonne et al.,
(Lam.) A.H. Gentry Bignoniaceae del monte S (3) on lesion 2009) -
L,
Mansoa alliacea Kaip, Ajo S&
(Lam.) A.H. Gentry Bignoniaceae del monte R Rheumatism (4) Decoction is drunk (Vsquez, 1994) -
External layer of the
bark is reduced in (Gachet et al.,
2
Minquartia guianensis APG82 Paini, Leishmaniasis powder and applied on 2010; Odonne et
1
Aubl. Olacaceae APG63 Wambula B (3) lesion al., 2009)
Duke and
Vasquez (1994)
reports the use of
Mucuna
pruriensis in the
The seed is split and Amazon.
the internal part is Mucuna rostrata
3
APG76 scraped and mixed used elsewhere
2
Mucuna sloanei Fawc. APG76b with water. Used for snakebite
1
& Rendle Fabaceae APG72 Wapaa Se Snakebite (6) orally. (Soukup, 1970)
1
Musa x paridisiaca L. Musaceae APG94 Majench, Lx Diarrhea (18) Latex is used orally (Branch and (Bennett et al.,
Species Family Specimens Local name PU Use Preparation Use reported in Use reported
(Achuar in the Amazon among the Shuar
italics) (Use Reports)
Guineo, Silva, 1983; 2002)
Orito Odonne et al.,
2013)
[(Samy et al.,
Majench, 2008) reported
Guineo, Liquid from the stem is the use
Musa x paridisiaca L. Musaceae Orito S Snakebite (3) used to wash the bite elsewhere] -
Leaves are crushed in
water, sometimes (Schultes and
mixed with Chicha. Raffauf, 1990) [as
Tsaank, The remedy is drunk treatment for
1
Nicotiana tabacum L. Solanaceae APG95 Tabaco L Malaria (8) and then vomited chills] -
Decoction of the
leaves, Cymbopogon
citratus leaves may be
added. Administered (Rodrigues, 2006;
Ocimum micranthum Common cold orally or as a steam Schultes and
1
Willd. Lamiaceae APG1 Albahaca L (3) bath Raffauf, 1990) -
Cladode is split in two
and the internal gel is
Opuntia ficus-indica L. Ikiamanch, Fractures and drunk and applied on
Mill Cactaceae Tuna Cl sprains (4) the affected part - -
2
Parkia multijuga APG16 Wound healing Powdered bark is used
Benth. Mimosaceae APG127 Tankam B (4) externally (Alarcn, 1988) -
(Alarcn, 1988;
1
Phthirusa pyrifolia APG30 Fractures and Decoction is used Odonne et al.,
2
Kunth Eichler Loranthaceae APG30b Au arake L sprains (4) orally 2013) -
Plagiochila cf. Wound healing Chewed and applied
3
subplana Plagiochilaceae APG11 Juu All (5) on the lesion - -
L,
3
APG88 Kirim, F, (Duke and
1
Psidium guayava L. Myrtaceae APG88b Guayaba B Diarrhea (40) Decoction Vasquez, 1994)
Species Family Specimens Local name PU Use Preparation Use reported in Use reported
(Achuar in the Amazon among the Shuar
italics) (Use Reports)
APG35
2
Urera baccifera (L.) APG48 Tuntun Decoction is drunk and (Valadeau et al.,
2
Gaudich. Ex Wedd. Urticaceae APG138 nara, Ortiga R Malaria (7) then vomited 2010) -
APG35 leaf hit body parts,
2
Urera baccifera (L.) APG48 Tuntun Rheumatism (5), which are then (Cayon and
2
Gaudich. Ex Wedd. Urticaceae APG138 nara, Ortiga L body aches (1) massaged Aristizabal, 1980) -
Decoction or rhizome (Grenand et al.,
Zingiber officinale Ajej, crushed in water and 1987; Vickers and (Bennett et al.,
1
Roscoe Zingiberaceae APG98 Jengibre Rh Diarrhea (17) then used internally Plowman, 1984) 2002)
Zingiber officinale Common cold (Bennett et al.,
1
Roscoe Zingiberaceae APG98 Rh (9) Decoction or chewed 2002)
Zingiber officinale (Duke and (Bennett et al.,
1
Roscoe Zingiberaceae APG98 Rh Cough (5), Decoction or chewed Vasquez, 1994) 2002)
Blood loss
Zingiber officinale during childbirth (Bennett et al.,
1
Roscoe Zingiberaceae APG98 Rh (5) Decoction, used orally. - 2002)
Zingiber officinale Pain during (Branch and (Bennett et al.,
1
Roscoe Zingiberaceae APG98 Rh childbirth (4) Decoction, used orally. Silva, 1983) 2002)
Zingiber officinale Chewed together with (Bennett et al.,
1
Roscoe Zingiberaceae APG98 Rh Snakebite (3) roots of Cyperus sp. - 2002)
Internal part of the cob
is reduced to ahses,
Colics (3) these are mixed with
Zea mays L. Poaceae IC Diarrhea (2) water, which is drunk - -

Table 3. Plants with medicinal uses reported during this study

Specimens: 1= Herbario de la Universidad Central del Ecuador , Quito (QCA); 2= Herbario Nacional de Ecuador en Quito (QCNE);
3= Herbario de la Universidad Central del Ecuador (QAP).
PU: Part used, L=leaves;R=root; Rh=Rhyzome; Lx=Latex; S=stem; B=Bark; Se=Seeds; F=Fruit; J=Fruit juice; uF=unripe fruit;
Cl=cladodes; IC=internal part of the corn cob.
Use reports: Number of independent reports of the same use is shown within parentheses.
Plant names were checked with www.theplantlist.org (accessed on May 2014); na=not applicable