Animal-derived natural products of Sowa Rigpa medicine: Their pharmacopoeial description, current utilization and zoological identification

Karma Yeshi, Paolo Morisco, Phurpa Wangchuk

Bhutan has two traditional healing systems: a folklore medicine and the Bhutanese Sowa Rigpa medicine (BSM). Three different types of ingredients namely plants, animals (and their derived products) and minerals are used for the preparation of various formulations in combined form. Animals and their derived products are vital ingredients in the preparation of numerous traditional remedies. Unlike medicinal plants, research on medicinal animals has remained largely untouched. This study is aimed to investigate the animal-derived natural products used in BSM as a zootherapeutic agents, taxonomically identify the medicinal animals, and shed lights on their positive as well as undesired implications. A five stage process was conducted which consisted of: (1) a survey of specialized ancient ethnomedical texts (Pharmacopoeias and formularies) to list animal products used as ingredients; (2) identify the natural products from animals used as ingredients by consulting Traditional Physicians (Drungtshos) and other experts at Menjong Sorig Pharmaceutical (MSP); (3) collect information about number and types of diseases treated by each animal ingredient; (4) confirm the list of animal ingredients separately as currently used, total medicinal animals described in the traditional text books, and those which are substituted by plants; (5) ethno-pharmacological uses of each animal ingredients were translated with the help of Traditional Physicians, clinical assistants and experts at MSP. The nomenclature of identified animal ingredients was confirmed by crosschecking the descriptions with the series of translated books of vernacular literature, scientific papers on animal ingredients, and the animal databases. The study reported 73 natural products belonging to 29 categories derived from 45 medicinal animals (36 vertebrates and 9 invertebrates) which are used as ingredients in Bhutanese Sowa Rigpa medicine system to prepare various formulations. The identified species comprise 9 taxonomic categories and belong to 30 zoological families. The groups with highest number of species were mammals (n = 26; 19 - wild and 7 - domestic), birds (n = 5), reptiles (n = 3), gastropods (n = 3) and insects (n = 3). Out of 116 formulations currently produced, 87 of them contain one or more extracts and products obtained from 13 medicinal animals to treat more than 124 illnesses. This demonstrates the importance of zootherapy as alternative therapy in Bhutan. Only five (5) animal ingredients namely Bear's bile (dom-m.khris), male musk deer's naval musk gland (gla-rtsi), pig's blood (phag-khrag), red deer's horn (śa-rwa) and red deer's immature horn (śa'i-khrag-rwa) were found available in Bhutan, the rest being imported from neighbouring countries like India. There is an increasing demand for animals and their parts in the traditional medicines (TMs) but MSP prefers plant substitutes due to difficulties in obtaining the animal parts. In this study, we identified 73 natural products belonging to 29 categories derived from 45 medicinal animals (36 vertebrates and 9 invertebrates) in the Sowa Rigpa medicine. 13 medicinal animals were currently included in formulating 87 essential multi-ingredient prescription medicines in BSM to cure multiple diseases. This demonstrates the importance of zootherapy as alternative therapy in Bhutan. The Bhutanese Sowa Rigpa medicinal fauna is largely based on wild animals (n = 38; 84.4%), including some endangered species. Only 2 of the medicinal animals were substituted by plants.