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(n =49), Crotalus durissus (Linnaeus, 1758) (Viperidae)ratt-
lesnake (49), Cayman crocodilus (Linnaeus, 1758) (Alliga-
toridae)cayman (39), Boa constrictor Linnaeus, 1758
(Boidae)boa (37) and Paleosuchus palpebrosus (Cuvier,
1807) (Alligatoridae)cayman (31). These species are also
used as remedies in more remote areas in Brazil (e.g., Branch and
Silva, 1983; Alves and Rosa, 2006, 2007; Begossi and Braga,
1992), reinforcing the view that medical traditions accompany
people as leave their native surroundings and migrate to urban
centers (see Baca, 1978; Gordon, 1994; OConnor, 1998).
The use of similar resources as medicines in more remote
and urban areas suggest that zootherapeutic practices may func-
tion as a social conduit which, in conjunction with other factors,
helps to maintain the connections between rural and peasant
people living in cities and their own traditional culture and val-
ues. More specically, it indicates the potential for exchange of
materials and information on illnesses and treatments between
more remote and urban communities.
Brazil congregates rapidly growing urban populations, where
people originated mainly fromruralpeasant communities. Over
the last fewdecades, the countryhas undergone a process of rapid
urbanization: in 1970, 44% of the population lived in rural areas
and 56% in urban areas. By year 2000, the population living
in urban areas represented 81% of the total (Barros and Porto,
2002).
However, despite the exposure to an urbanized setting,
where increasedwesternizationandthe presence of conventional
medicine are apparent, zootherapeutic practices perseveres in
all the surveyed localities, as well as in cities such as Salvador,
Porto Alegre, Recife, Macei o, Aracaju, Goi ania, Vit oria, Natal,
Fortaleza and Florian opolis (Ierec e Rosa, personal observation).
The notable use and commercialization of medicinal animals
to alleviate and cure health problems and ailments in the cities
surveyed points out the resilience of that resource in the folk
medicine in Brazil. Animals with magic and superstitious con-
notations were also sold in the markets, being used for protection
against evil spirits or evil eye, for good luck, and to attract money
or partners. Some non-natural diseases are treated through
chants or rituals involving animals, by pais and m aes-de-
santo (fathers and mothers of saints), Afro-Brazilian priests
and priestesses of the yorub a religion know as candombl e, a
testimony of the signicance and value animals have for urban
communities either for utilitarian or cultural functions.
In a sense, Afro-Brazilian cults and zootherapeutic practices
have developed a mutualistic relationship, in which the use of
ritualistic of animals to treat ailments and to aid in recovery has
helped to the perpetuate zootherapy in urban areas in Brazil,
and the zootherapeutic component of umbanda, as remarked
by Moura (1988), has helped to spread the religion throughout
the country.
Migration from more remote/rural areas to cities has also
played a signicant role in knowledge transmission. The
importance of the more remote-urban connections has been
highlighted by Belluck (1996) and OConnor (1998) who found
that within urban centers, members of immigrant and ethnic
minority groups typically use a variety of traditional healing
resources in conjunction with conventional medicine care. Fur-
thermore, as remarked by Cocks (2006), even people who have
migrated to (peri) urban areas and have become involved in mod-
ern economic sectors still perform certain cultural practices for
maintaining a sense of well-being and expressing their iden-
tity. In our study, such connection was revealed by the fact that
70% of the medicinal animal traders interviewed informed that
the knowledge about medicinal animals was mainly acquired
through people of the rural areas, previous herbalists, or relatives
(parents and grandparents).
Zootherapeutic resources were used to treat 82 different dis-
eases, and most of them (62%, n =60) had multiple therapeutic
uses. For instance, the products of the rattlesnake (Crotalus
durissus), and boa (Boa constrictor) were indicated to treat
13 and 11 conditions, respectively. Conversely, a single illness
could be treated by various animal species (e.g., 47 animal
species were used in the treatment of asthma and 30 in the
treatment of rheumatism). In popular Brazilian medicine, the
presumed multiple therapeutic actions of plants and the simul-
taneous use of various plants for the same condition are locally
justied by the different medical properties either of parts used
or of modes of preparation (Ngokwey, 1995). Additionally, the
possibility of using various animal remedies for the same ail-
ment renders an adaptation to the availability/accessibility of
materials possible (Alves and Rosa, 2006).
In our study we recorded 1320 use-citations of medicinal
animals (Table 4). The most frequently quoted treatments con-
cern the respiratory system (58 species; 407 use-citations), the
osteomuscular system and conjunctive tissue (46 species; 384
use-citations), and circulatory system (34 species; 124 use-
citations). Less frequently, the following categories of illnesses
were mentioned: oftalmological diseases (2 species, 2 use-
citations), blood and hematopoeitic organs, and some disorders
of the immune system (3 species; 3 use-citations) and preg-
nancy, parturition and puerperium (1 species; 5 use-citations).
Similarly to the results obtained in previous studies (e.g., Branch
and Silva, 1983; Alves and Rosa, 2006, 2007), the data we ana-
lyzed revealed the use of a high proportion of species (59.8%) to
treat respiratory system diseases, mainly asthma, u, cough and
sore throat, and to treat osteomuscular system and conjunctive
tissue diseases, such as rheumatism, osteoporosis, arthritis and
arthrosis (46 species, 47.4%).
Some similarities were found between more remote (Alves
and Rosa, 2007) and urban areas in Brazil, such as the high
ICF valuesa reection of the dissemination of knowledge,
mostly via migration from rural to urban areas, and acceptance
of such practices in those regions of the country. Nonetheless,
in the surveyed metropolitan areas, animal-based remedies have
become part of a regular business that may involve advertising,
the use of books describing, for example, the posology of the
remedy, and pre-packaged medicines. Such practices generally
are looked down upon by traditional traders of folk medicine,
who feel proud of their knowledge of the raw materials and
remedies.
Medicines were prescribed as a single drug or in mixed
ingredient form; in the latter case, different medicinal animals
were mixed together, with or without the addition of medicinal
plants. For instance, the penis of the Coati, Nasua nasua (Lin-
naeus, 1766Procyonidae) and plants such as marapuama
(Ptychopetalum olacoides BenthOlacaceae) and guaran a
(Paullinia cupana KunthSapindaceae), make up the remedy
locally known natural viagra, a mix used for treatment of
male impotence which represents a good example of informa-
tion exchange between conventional medicine and TM. The
inuence of westernization was also reected in the presen-
tation of some zootherapeutic products, which were either
manufactured or pre-packaged. Examples are the fat extracted
from the manatee (Trichecus sp.), sold as tablets, and the
fat of Amazon River turtle (Podocnemis expansa (Schweiger,
1812)Podocnemididae) sold as manufactured soap.
In relation to users, 53% of the traders interviewed informed
that zootherapeuticals resources were sought after by people
from all social classes, while 47% stated that low income peo-
ple were the main buyers. Despite the existence of allophatic
pharmacies in all surveyed sites (their number ranging from
115 in Campina Grande to 331 in Bel em), there was consensus
among interviewees that one of the reasons why users resorted
to zootherapeuticals resources was the perception that animal-
based remedies were cheaper than allopathic remedies, and
therefore more affordable by the poor. In other words, socioeco-
nomic status was viewed by traders as one of the most pervasive
determinants of the use of animal-based remedies among the
study population.
The use of medicinal animals in the surveyed areas, however,
was not related to socio-demographic factors alone, but also to
the availability, quality and accessibility of other health care
resources.
According to IBGE (2006), the North and the Northeast
regions have the lowest socioeconomic development of the
Brazil, and the economic and social inequalities are reected
in the health area. In fact, Schramm and Szwarcwald (2000)
considered the limited offer and access to public health care as
relevant impediments to the population resident in those regions.
For low income families in the surveyed areas (to whom
health insurance is out of reach), medical-hospital care gen-
erally means getting access to facilities available within the
public sector, or to private hospitals authorized by the Ministry
of Health. In all surveyed cities but S ao Lus, private hospitals
were numerically dominant.
The existence of socioeconomic inequalities in health, how-
ever, has been evidenced as much in industrialized countries
(Macintyre, 1997; Mackenbach et al., 1997) as in developing
countries (Victora et al., 2000; Braveman and Tarimo, 2002;
Schneider et al., 2002), and the results of worldwide investiga-
tions generally show that health indicators vary according to a
social gradient unfavorable to groups of lower socioeconomic
levels, whether this be measured by income, education, occupa-
tion, or social class (Marmot et al., 1997; Chandola, 2000).
In addition to socioeconomic aspects, traders highlighted
that traditional remedies generally are perceived as being more
effective than allopathic remedies, and informed that it is not
uncommon that users resort to traditional medicines after being
treated with allopathic remedies, which in their view did not
cure them. This result is in line with the information provided
by Brown (1992) that while in the rural areas herbalists are
Table 4
Informant consensus factor (ICF) by corporal systems or diseases
Category
A B C D E F G H I J L M N O P Q R S
All cities combined
Species 58 46 11 34 10 34 8 1 9 5 3 15 3 18 26 11 5 2
All species (%) 59.79 47.42 11.34 35.05 10.31 35.05 8.25 1.03 9.28 5.15 3.09 15.46 3.09 18.56 26.80 11.34 5.15 2.06
Use-citations 407 384 20 124 24 84 15 5 9 8 12 19 3 33 96 60 15 2
All use (%) 30.83 29.09 1.52 9.39 1.82 6.36 1.14 0.38 0.68 0.61 0.91 1.44 0.23 2.50 7.27 4.55 1.14 0.15
ICF 0.86 0.88 0.47 0.73 0.61 0.60 0.50 1.00 0.00 0.43 0.82 0.22 0.00 0.47 0.74 0.83 0.71 0.00
Bel em, PA
Species 31 29 3 11 2 6 2 1 3 3 4 1 2 1
All species (%) 63.27 59.18 6.12 22.45 4.08 12.24 4.08 2.04 6.12 6.12 8.16 2.04 4.08 2.04
Use-citations 135 206 7 43 2 23 6 4 5 11 15 36 12 1
All use (%) 26.68 40.71 1.38 8.50 0.40 4.55 1.19 0.79 0.99 2.17 2.96 7.11 2.37 0.20
ICF 0.78 0.86 0.67 0.76 0.00 0.77 0.80 1.00 0.50 0.80 0.79 1.00 0.91 0.00
S ao Lus, MA
Species 32 25 6 28 4 21 1 6 1 2 11 1 10 22 9 1 1
All species (%) 50.79 39.68 9.52 44.44 6.35 33.33 1.59 9.52 1.59 3.17 17.46 1.59 15.87 34.92 14.29 1.59 1.59
Use-citations 87 79 10 56 7 39 1 6 1 3 14 1 10 52 14 1 1
All use (%) 22.77 20.68 2.62 14.66 1.83 10.21 0.26 1.57 0.26 0.79 3.66 0.26 2.62 13.61 3.66 0.26 0.26
ICF 0.64 0.69 0.44 0.51 0.50 0.47 0.00 0.00 0.00 0.50 0.23 0.00 0.00 0.59 0.38 0.00 0.00
Teresina, PI
Species 19 12 2 8 4 6 6 2 1 3 1 2 6 8
All species (%) 67.86 42.86 7.14 28.57 14.29 21.43 21.43 7.14 3.57 10.71 3.57 7.14 21.43 28.57
Use-citations 100 78 2 23 13 13 9 2 1 9 1 2 11 16
All use (%) 35.71 27.86 0.71 8.21 4.64 4.64 3.21 0.71 0.36 3.21 0.36 0.71 3.93 5.71
ICF 0.82 0.86 0.00 0.68 0.75 0.58 0.38 0.00 0.00 0.75 0.00 0.00 0.50 0.53
Jo ao Pessoa, PB
Species 17 4 5 1 1 6 3
All species (%) 62.96 14.81 18.52 3.70 3.70 22.22 11.11
Use-citations 52 9 8 1 1 9 7
All use (%) 59.77 10.34 9.20 1.15 1.15 10.34 8.05
ICF 0.69 0.63 0.43 0.00 0.00 0.38 0.67
Campina Grande, PB
Species 16 10 1 2 2 1 4 1 4 2 2
All species (%) 61.54 38.46 3.85 7.69 7.69 3.85 15.38 3.85 15.38 7.69 7.69
Use-citations 33 12 1 2 2 1 4 1 4 3 2
All use (%) 50.77 18.46 1.54 3.08 3.08 1.54 6.15 1.54 6.15 4.62 3.08
ICF 0.53 0.18 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 0.00
generally consulted at the early stages of disease and for acute
complaints, oftenbefore a biomedical practitioner, inurbanareas
neo-herbalists are consulted for persistent problems for which
patients cannot nd a cure from modern medicine.
Simultaneous and serial utilization of multiple healing
resources has been documented among populations world-
wide for some time (Janzen, 1978; Crandon-Malamud, 1991;
Waldram, 2000), an aspect that was also observed in this study
and also among some shing communities in Brazil (Alves and
Rosa, 2006, 2007).
Sanitary conditions of the products generally were poor, a
result consistent with the data obtained by Amaral et al. (2003)
for medicinal plants sold in S ao Lus city, where 81.5% of the
material analyzed were contaminated by bacteria.
Schnurrenberger and Hubbert (1981) drew attention to the
possibility of transmission of other serious and widespread
zoonoses such as tuberculosis or rabies, an aspect that should
be considered whenever animal tissues from unknown sources
are handled and used as remedies. Although the need for imple-
mentation of sanitary measures to the trade of animal or their
parts for medicinal purposes is evident, adoption of regulatory
measures faces considerable challenges, among them ensuring
adequate participation of all stakeholders involved, monitoring
of the activity, and combating illegal, unreported and unregu-
lated trade (Alves and Rosa, 2005).
Other relevant aspects that need to be addressed are the poten-
tial interactions among various ingredients (plants and animals)
used to prepare a concoction locally known as garrafada, the
potential interactions of folk medicines with allopathic reme-
dies, the effects of overdose, and the possibility of toxic or
allergic reactions. Concerns about herbdrug interactions are
frequently expressed by conventional physicians as well (Fugh-
Berman, 2000).
In 1983, Branch and Silva noted the absence of records of
folk cures concocted from animal parts, and pointed out that
the reason for the inexistence of records was not clear. In our
study it became apparent that the semi-clandestine or clandestine
nature of the trade, and the links between some zootherapeutic
resources and Afro-Brazilian religious rituals, generally result
in informants being more resistant to provide information. Most
animals traded as medicine are wild caught, and protected by
law. Equally important (see Prandi, 2004), until recently Afro-
Brazilian religious manifestations were severely repressed, and
still face strong prejudice.
Traditional drugs and traditional medicine in general rep-
resent a still poorly explored eld of research in terms of
therapeutic potential or clinical evaluation. There is a current
preoccupation about this, since it is well-established that all sorts
of vegetable, animal and mineral remedies used in a traditional
setting are capable of producing serious adverse reactions. As
remarked by De Smet (1991), traditional drug therapies should
be submitted to an appropriate benet/risk analysis.
Urban zootherapy is often supported by herbalists and by
the community, because it maintains and gives value to cultural
ties. These ndings add support to the notion put forward by
Cocks (2006) that the concept of culture must be understood as
a dynamic process of trans-cultural exchange with constant re-
articulations of tradition resulting in the persistence of certain
cultural practices amongst groups of people. In that sense, the
dynamic environment and complex interactions in an urban set-
ting offer a challenging opportunity for expanding the frontiers
of research on the relationship between animals and people.
One nal point: this study pointed out that 33 species of the
medicinal animals quoted by informants are endangered. In view
of this, there is an urgent need to (1) increase our understand-
ing of the harvesting and trade of those species; (2) assess the
impacts caused by the commercial exploitation; (3) adopt con-
servation measures as necessary, so that over-collection of such
species will not lead to the loss of source medicinal material.
Acknowledgments
To PROBIO/MMA/IBRD/GEF/CNPq and PADI Foundation
for nancial support. ToConselhoNacional de Desenvolvimento
Cientco e Tecnol ogico (CNPq) for providing a Ph.D. fellow-
ship to the rst author, and a research scholarship to the second
author. Thanks are also due to the Universidade Estadual da
Paraba, for all the support.
We are indebted to researchers who assisted in species iden-
tication: Gentil Alves P. Filho (reptiles), Ana Carolina Martins
Queiroz (echinoderms), Cl audio Lus Sampaio (shes), Isabel
Feitoza (aquatic mammals), Alberto Kioharu Nishida and Jef-
ferson de B. Batista (mollusks and crustaceans), and Maxwell S.
Silveira (bees). Field assistance was provided by Dario Manoel
B. Soares in S ao Lus (State of Maranh ao), Patrcia Charvet-
Almeida and Maurcio Almeida in Bel em(State of Par a). Special
thanks are due to the interviewees, whose generosity made our
research possible, and to the Regional Pharmaceutical Council
in the states of Paraba, Par a and Maranh ao, for providing infor-
mation on the number of allopathic pharmacies in the surveyed
cities.
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