**3.2 Some emic perspectives on the ethnobiology of** *C. spinarum*

Anthropology has historically been an integral part of ethnobotanical investigations dating to the colonial era. The emic approach in anthropology came to the fore in the 1960s whereby the researcher attempted to experience and interpret the culture from the insider's perspective. In ethnobiological research, techniques to gain the insider perspective are used in order to understand and interpret the relationship of people and plants. In ethnomedical research, this can take the form of understanding local illness aetiologies, concepts of health and healing, the meaning of different elements of the healing process and the meaning attached to different plants and habitats. In Hunn's four phases, the emic aspect becomes significant in Phase II from the 1950's through to the 1970's though Frazão-Moreira illustrates clearly the ongoing centrality of ethnographic research in ethnobiology [35]. An anthropological perspective in ethnobotanical and ethnomedical studies has been considered vital for decades [31, 32, 36, 37]. This view can give valuable context for the medicinal use of plants and can help direct further study and practice in many fields such as health care provision, sustainable plant use, environmental protection and bioprospecting. There is very little of the insider's understanding available in this analysis on *C. spinarum*. Of all primary ethnomedical studies involving *C. spinarum*, 75% have no contextual information at all including no information on local morbidity, mortality or availability of biomedical healthcare. Some 25% of studies, provide some emic information with short descriptions of selected aspects of local traditional medicine such as causation and diagnosis, specific illness understandings and descriptions, knowledge distribution and transmission, information on the place of plants in healing and biomedical health context [38–53]. However, a view on how this species has a role in health and healing in some communities is presented in research from Australia and Eastern Africa.

#### *3.2.1 Australia: "Boonyja Bardag Gorna—All trees are good for something"*

The phrase "*Boonyja Bardag Gorna*—All trees are good for something" is the title of the book authored by Esther and Sandy Paddy and Moya Smith [54] and is an illustration of the centrality of biocultural knowledge to life for the authors. Attempts to record that knowledge are ongoing in parts of Australia.

There are elements of Aboriginal biocultural knowledge that makes Australian ethnobiological research different to that conducted in other cultural contexts. These elements relate to the historical context and cultural norms relating to biocultural knowledge, knowledge transmission and plant usage. *C. spinarum* is a widely distributed species in northern Australia [55]. However, there is relatively little ethnobotanical data in comparison to the high level of botanical sampling. This might be explained by the fact that significant ethnobiological research in the area is relatively recent, being concentrated in the past 35 years with the greater part of that local ecological knowledge already lost (Glenn Wightmann, Ethnobiologist, Northern Territory Government pers. comm 2020). Most of the research analysed in relation to Australian Aboriginal ethnobiology is not published in online academic journals but is mostly in the form of Botanical Bulletins. The research is collaborative with community members as primary authors and is published for the purposes of transmission of biocultural knowledge, a cultural requirement for Aboriginal Elders [56]. Research with the Wik peoples in Queensland, has illustrated how ethnobotanical research methods need to be culturally appropriate [57]. They stated that for Aboriginal Communities with whom they have conducted research, widely used ethnobotanical methods such as those described by Cotton [58] and Martin [37] are not appropriate in this environment. Factors contributing to this include: categories of public and secret biocultural knowledge, inappropriate questions and inappropriate questioning. Researchers need to be aware that only selected people may speak on behalf of "country" by law. In this analysis of the ethnobotany of *C. spinarum*, the reality of public and secret knowledge is described by several authors [56, 59–62]. These studies highlight the fact there is a vast amount of knowledge of Aboriginal medicines including gendered knowledge, which is secret, culturally sensitive and cannot be shared in publications.

In a large study of Australian Aboriginal medicinal plant usage, Latz [63] found that, in contrast to western medicines, fewer than 10% are taken internally and that about 70% are used as a wash or an ointment. The use of fumes from heated plant parts is also common in Australia especially for children in a process known as "smoking" [63–65]. These general findings are reflected in the research on *C. spinarum* in Australia. The most common routes of administration are fumigation and external application. Latz stated that most important species have several uses. Connelly and Wallis [64] added that there is knowledge of all of the different elements of a plant

Carissa spinarum *L.: A Case Study in Ethnobotany and Bioprospecting Research DOI: http://dx.doi.org/10.5772/intechopen.104665*

and how they may each be used in different ways. In these Australian studies, *C. spinarum* is used medicinally and ritually but is also included in diet, as an insect repellent, for carving and for firewood. This multifunctionality of plant species is reflected across the global range of *C. spinarum*. The possibility of multifunctionality of species recorded in ethnobotanical research may be important to bear in mind when asking why a particular species may be chosen by local people. It's very multifunctionality may be a central reason for its choice as a medicinal species. While emic description of Australian aboriginal EM is provided in some documents, as elsewhere, detailed anthropological information in relation to *C. spinarum* in particular is limited. McDonald [66], in an anthropological study in the East Kimberley region researching concepts of health and illness, described the "smoking" process: Aboriginal peoples "smoke" the bodies of children and adults with medicinal plants in order to clear the body of "rubbish"—debris that can clog the flow of *birlirr*, the body's life-force. In the study community, *C. spinarum* is an excellent smoking medicine [60, 66]. Aromatic leaves are believed to be strong medicinally as the smoke can be felt entering the body through the senses and the skin:

*You can feel the jiluwa working, feel the blood flowing [during a smoking treatment]. I was heavy before, just like sin. I'm fresh and light now. We can feel the medicine going into us. Feel cold coming through the body. When we take gardiya tablets, we don't feel anything. Gija woman, [66] p. 90. [Note: Jiluwa are body channels, gardiya tablets are whitefella medicine or pharmaceuticals. Coldness is a healthy state].*

For Aboriginal peoples, bush medicine is considered to have been in the ground from *ngarrangkarni—*the Dreaming time, placed there by the ancestors [66]. This elicits trust in users of bush medicine. *C. spinarum* is included in some Dreaming stories and thus is part of Aboriginal cosmology, which links plants, animals, humans, and places, past and present [67]. The inclusion of this and other aspects of the social and natural environment in these stories indicate a cultural importance that extends beyond the utilitarian realm.

The loss of biocultural knowledge is a well-established phenomenon in the ethnobotanical literature in general [68, 69]. Latz [63] and Wightmann (2020 pers. commun.) described the loss of many aspects of traditional Aboriginal knowledge due to changes in the way of life and the influx of new diseases. Other authors describe how many of the plant species and the practices involving them are still in use by many adults as "domestic" medicine and need to be documented [61]. The value of the publication of the Dalabon biocultural knowledge from North Australia was asserted in [56]. Given that traditional modes of transmission of knowledge relating to native species from elders to the next generation are being interrupted through the lack of access to sacred sites and ceremonial practices, some elders feel that the transmission of knowledge through publication is a way of fulfilling their duty.

#### *3.2.2 Buda (Evil Eye) in Ethiopia*

Spirit-Related Illness, usually *Buda* (Evil Eye) is commonly reported to be treated with *C. spinarum* in Ethiopian studies. Treatment often involves *C. spinarum* in combination with other species in the form of fumigation. Literature shows that there is a wide geographical and historical spread of Evil Eye. It is referenced in Classical Greek literature, the Bible, Islamic literature and is reported among some Asian peoples and in most European, African and American countries [70]. However, there is no description of the presentation of *Buda* or other spirit-related illness in any of the Ethiopian documents on *C. spinarum*. In other Ethiopian research with a sociological rather than ethnobiological focus, *Buda* has been studied. The ability to inflict Evil Eye/*Buda* is described as being innate and that the identity of people who can inflict *Buda* is secretly known within a community [71]. Abbink [72] wrote that the Amhara people of Ethiopia believe *Buda* to be held by people outside of the Amhara group, perhaps landless or with no permanent home or people of certain professions such as blacksmiths or potters. They have a hereditary, malevolent power which is used, perhaps involuntarily, to cause harm. He wrote that the victims of *Buda* become weakened with a sense of being drawn to their death. *Buda* is described as causing many animal and human health problems as well as damage to property and is commonly treated by ritual [71–74]. Jacobsson [75] wrote that it can cause any kind of illness including neuroses and psychosomatic illness, though it often manifests as gastrointestinal disorders. Jacobsson argues that there is no clear distinction between physical and mental disorders, and consequently there is none between associated healing methods. Thus, physical and spiritual means may be used as part of the healing process. The treatment with medicinal plants can have ritual and physical components, and the burning of *C. spinarum* in the treatment of *Buda* disorders could be interpreted in this light. The most common method of preparation of *C. spinarum* for treatment of *Buda* is the administration of root smoke by fumigation (for example see [51]). In a few cases, the root is mixed in water alone and inhaled or taken orally or the root may be tied around the neck as protection [76–78]. Ritual and physical effects may combine in the use of *C. spinarum* to treat *Buda*. In an examination of ritual plant use in Benin and Gabon from a biomedical (BM) (conventional medicine) perspective, Quiroz et al [79] illustrated that ritual use does not imply a lack of pharmacological activity. Pharmacological activity of the smoke of *C. spinarum* may augment the socio-cultural healing benefits of the ritual components of healing.

The example of spirit-related illnesses illustrates that an understanding of the context of healing, can help to situate the use of plants in the healing process and to interpret it from a cross cultural perspective.

#### *3.2.3 Kenya: Pokot and Luo health-seeking behaviour*

There are two anthropological studies from Kenya, whereby the context of *C. spinarum* use is provided through in-depth emic information in relation to health and illness in the study areas. These studies are conducted with the Pokot people in north western Kenya [80] and the Luo of Western Kenya [81] with some emic information from some other studies [41, 82–90].

The 1982 study of Pokot health-seeking behaviour illustrated the dynamic nature of this behaviour in the context of the availability of traditional and BM forms of health care [80]. The Pokot understanding of illness causation is detailed as having naturalistic/biological, interpersonal and/or spiritual basis. Treatment and prevention can involve addressing each of these planes of causation with the treatment for biological cause being more specific to the symptomatology and treatments for interpersonal and spiritual cause being more diffuse. Some ailments such as infertility and mental illness are considered to have an interpersonal or spiritual basis while others such as malaria are thought to have a more naturalistic causation. Treatments usually involve administration of medicinal plants, ritual and instructions on foods to eat or avoid. The use of purgatives and emetics by the Pokot in the study area to prevent and treat illness is understood in the context of illnesses residing in the gut. The process is

#### Carissa spinarum *L.: A Case Study in Ethnobotany and Bioprospecting Research DOI: http://dx.doi.org/10.5772/intechopen.104665*

thought to "clean up the system". The treatment for malaria, for instance, may involve the use of pharmaceuticals complemented by the subsequent use of purgatives and emetics to ensure the complete expulsion of the illness. The use of emetics and laxatives was likewise discussed elsewhere in the context of Pokot ethnobotany [89] and among the Luo [81].

Ethnobotanical research with Luo mothers was conducted with reference to the authors' earlier extensive anthropological research with the Luo of western Kenya [81]. It is an instance of rich emic understandings presented in this analysis of *C. spinarum.* As with the Australian example above, there is an amount of secret knowledge among the Luo mothers, especially in the treatment of more complex ailments resulting in lacunae in the recorded knowledge. Their research found that gastrointestinal illnesses are the most commonly treated with medicinal plants while fever and headache are rarely treated using plant medicines despite the high prevalence of malaria in the study area. The authors attribute this to the availability of pharmaceuticals in local shops to treat these symptoms. The extent of secret knowledge and the availability of effective pharmaceuticals could result in an overall skewing of the ethnobotanical findings towards gastrointestinal use. Illness itself is considered to be a constant element of life and plant remedies are used, not to eliminate illness but rather to find a balance in a constant process. In the case of helminth infections, worms are considered to live permanently in the gut and it is important to maintain worms in a healthy equilibrium in the gut for the health of the individual. Treatment of other illnesses, such as diarrhoea, require the illness to be removed from the body with purgatives. This concept of healing also finds the BM healing by suppression of illness to be unhealthy such that sometimes the use of BM is prohibited in the pursuit of health:

#### *Luo medicine makes the illness come out; injections push it back inside. If you inject, it moves through the body and you swell and may die. (Luo mother [81] p. 44).*

Many illnesses including diarrhoea may be thought to be caused by *Yamo*, an overarching illness concept that can manifest in many ways but is treated through eliminating it from the body. The constant presence of illness in the body, even when it is healthy, requires that a child be constantly treated to make illness emerge from the body and as such keep the forces of *Yamo* and other forces of illness at bay:

#### *'a (young) child ought to be ill regularly' (nyathi onego otuore) lest it would die, once the illness (i.e., Yamo) finally 'comes out'. (Luo saying, [81] p. 44).*

In their research with Luo mothers, the authors report the use of *C. spinarum* (*Ochuoga*) in the treatment of diarrhoea and *Ang'iew* (a childhood febrile illness with rash) [81]. While no individual species is singled out as culturally important, the presentation of in-depth emic understandings of health and illness described in brief here gives valuable context to the listing of 91 medicinal species. From a BM perspective such as researching health-seeking behaviour or bioprospecting, it is important to understand the socio-cultural understandings of health and illness as a backdrop to the choice of treatments. The use of *C. spinarum* as a purgative to treat malaria, for instance, does not imply that it is ineffective as an anti-malarial but the knowledge could modify the perspective of the bioprospecting ethnopharmacologists. For BM healthcare workers, the knowledge of local purgative and emetic practices is important in providing care to the communities served.
