Zootherapy as traditional therapeutic strategy in the Cholistan desert of Bahawalpur‐Pakistan

Abstract The use of traditional medicines has tremendously increased over the past few decades. Approximately 80% of the world's population relies on traditional medicines for their primary healthcare needs because of their cost effectiveness and efficiency with no or minimal side effects. Zootherapy refers to the use of medicines that are prepared or derived from animals or from their products. The current study documented the folk knowledge related to the practice of various animal‐derived products and ethnozoological based drugs used as medicines by the residents of the Cholistan desert of Bahawalpur (Pakistan). In this regard 46 knowledgeable and reliable elderly people, hakims and spiritual healers ranging from 35–60 years of age having knowledge related to zootherapy were included in the current study. A field survey from February 2006 to November 2007 was conducted by interviewing the selected respondents through a structured questionnaire. They provided knowledge regarding the use of animals and their derived products in traditional medicine. The zootherapeutic knowledge was based on both domestic animals as well as wild animals. A total of 20 animal species were included in the study, among which nine animals were domestic while 11 were wild animals. Among selected animals, nine were mammals, four birds, four reptiles and three insects. It was reported that camel was the most commonly used (n = 32 respondents) among mammals while Pigeon (n = 39 respondents), Spiny‐tailed lizard (n = 41 respondents) and Indian honey bee (n = 27 respondents) among birds, reptiles and insects, respectively, have significant use for the treatment of different diseases. Based on this communication we could recommend that this type of abandoned knowledge should be considered for the management and conservation of faunistic resources. However, the advantageous role of animals and their products was reported but more extensive research is required to explore the bioactive constituents in the raw material of these animals responsible for their beneficial effects.


| INTRODUC TI ON
World Health Organization (WHO) estimates that the majority (approximately 80%) of the world's population rely mainly on plant and animal-based medicine. Literature reports indicated that traditional medicine accounts for around 40% of all health care medicines in China while 65% of Indian population living in rural areas uses traditional medicines to meet their primary health care needs. Traditional medicines are becoming more popular in underdeveloped and developed countries as well and being used by 48% population in Australia, 49% in France, 70% in Canada and 42% in the United States of America (Mahawar & Jaroli, 2007;Rakhmanina and Anker, 2011).
Since ancient time, in different cultures of the world, animals and their products obtained from various parts are used for medicinal purposes (Lev, 2003) and such practices still exist in folk medicine.
In modern civilizations, among many other well-known therapies practiced worldwide, zootherapy constitutes a significant substitute. Body parts of domestic and wild animals (e.g., tusks, feathers, skins, bones and hooves) and their by-products (e.g., fat) form the principal constituents in the formulation of curative, protective and preventive medicine (Adeola, 1992;Angeletti et al., 1992;Solavan et al., 2004). In Traditional Chinese Medicine more than 1,500 animal species have been documented for their medicinal uses. Of the 252 essential chemicals that have been recorded by the WHO, 11.1% from plants, while 8.7% come from animals. In the United States of America (USA) among 150 prescriptions medicine that is currently in use, 27 drugs have an animal origin. In India, approximately 15%-20% of the Ayurvedic medicines are obtained from animals. In Unani system of medicines nearly 200 drugs derived from the animal source are documented which are claimed to be useful for the management of different diseases. In Pakistan, 31 substances (constituting 9% of all the medicinal substances) were recorded in the inventory of folk medicines (Mahawar & Jaroli, 2007).
Cholistan desert is uniquely located wild land of its own kind with the scarcity of endemic flora and fauna. The Cholistan desert is situated in the south-west of Punjab (Pakistan) occupies an area of 16,000 km 2 with highly saline soils and brackish subsoil aquifer ( Figure 1). A human population of 110,000 herders depends exclusively upon livestock for their livelihood including sheep, goats, cattle, camels and rarely donkeys. Life sustainability revolves around annual precipitation ranging from 100 to 250 mm per annum. The water harvested from run-off is collected in low-lying areas called 'Toba' which is the only source of potable water. The water is consumed from the same 'Toba' both by inhabitants and animals until it is exhausted, a situation which compels them to migrate to another water source 'Toba', 'kund' (well or canal area) a basic reason for their nomadic way of life (Akbar et al., 1996;Arshad et al.,2006Arshad et al., , 2007. In Cholistan desert summer is extremely harsh and punishing. It experiences soaring temperature touching 52°C or more with periodical long droughts (Mughal, 1997  The treatments are given by these local practitioners throughout the Cholistan desert and its adjoining areas who cure the diseases with various drugs of animal origin. Arshad et al. (2002) has given comprehensive knowledge about the use of medicinal plants in the Cholistan desert (Arshad et al., 2002). However, animals which are being put to therapeutic practice in the area yet to be emphasized.
So, the current survey-based study was planned to investigate the zootherapeutic aspects of Cholistan desert used for the treatment and survival of the local population with limited resources.

| Selection of study sites and respondents
The Cholistan desert is situated in the south-west of Punjab The selection of respondents was made on their recognition as knowledgeable members concerning traditional medicine. Informed consent was taken from the respondents whether they know the use of animals in the healing practices. Generally, they have information regarding plant-based remedies, but they also know some use of animals in therapeutics.

| Sampling and data collection
We asked the method of formulation, its administration or application, and the proper dose of the remedy. According to them, they acquired the knowledge of traditional medicines primarily through parental heritage, or because they have practiced about the medicinal significance of animal to treat themselves or their relatives.
The ethnozoological data was collected through questionnaires, interviews and focus group discussion with selected residents of different areas of Cholistan and purposively, 46 key respondents were selected.

| Informant consensus
During the study, each informant visited three times in order to confirm the reliability of the ethnozoological information. Consequently, the responses of an informant that was not in harmony with each other were rejected since they were considered as unreliable information.

| Animal identifications
A total of 20 different medicinal animal species were documented that are used for various ethno-medicinal purposes. Among the selected medicinal animals, 9 were domestic animals while 11 were wild animals. All the nine domestic animals were mammals while wild animals included four birds, four reptiles and three insects ( Figure 2 and Table 1). Animal species and their scientific names were identified and confirmed by Local University in Bahawalpur-Pakistan. In spite of their significance, as compared to plants, studies on the therapeutic usages of animals and their body parts have been neglected.
It is important to highlight that some folk medicinal systems, like the Traditional Chinese Medicine, is approved by WHO and accepted by one fourth of the world human population.

| RE SULTS
Collected data from indigenous people practicing traditional medicine for many decades explored that oral route, massaged and direct applying to wounds were the major routes of administration.
F I G U R E 2 Percentage of major four animal groups used as a zootherapeutic treatment for different ailments in the Cholistan desert of Bahawalpur-Pakistan No injectable route is being practiced till now in selected areas. The most commonly mentioned species were spiny-tailed lizard (n = 41), pigeon (n = 39), camel (n = 32), buffalo (n = 29), honeybee (n = 27), goat (n = 21) and sheep (n = 19). The most important parts or products of animals used as folk medicine are milk, meat, wool, fat, egg, fresh blood, gall bladder, butter, nector, horns, liver, flesh and whole animal. There are different methods for preparation of different dosage forms and the summary is presented in Table 2. Further, the respondents informed that animal-based traditional medicines have therapeutic potential to treat different diseased conditions like general weakness, asthma, epilepsy, skin disease, jaundice, rickets, tuberculosis, conjunctivitis, sexual debility, paralysis, cough, meningitis, piles, impotency, leucoderma, diabetes, leprosyand arthritis.
Further, it was reported from 29 informants that zebu is used for weakness, asthma, epilepsy and skin diseases, 32 informants reported that camels are used for jaundice, skin diseases and rickets, 21 informants reported the use of goats for tuberculosis and conjunctivitis, 19 informants reported the use of sheep for general and sexual debility and skin wounds. Given to newborn babies in diluted form, 21 informants reported that buffalos are used for general weakness and paralysis, 15 informants reported the use of chicken for weakness and cough, 24 informants reported the use of donkey for asthma and tuberculosis, 39 informants reported that pigeon is used for paralysis, tuberculosis and asthma. Whereas 14 informants reported that milk of women is used for meningitis, 27 informants reported the use of honey for weakness and eye diseases. A total of 17 informants reported the use of black buck for asthma, tuberculosis, weakness, and piles; 26 informants reported that rabbits are used for asthma and tuberculosis while 25 informants reported the use of sand lizard for impotency and sexual debility, 3 informants reported the use of house crow for leucoderma, 17 informants reported the use of crow pheasant for asthma and diabetes, 22 informants reported that Indian or spectacled cobra is used for leprosy, leucoderma and arthritis, 19 informants reported that geyr's spinytailed lizards are used for sexual organ debility in males and breast weakness in females, arthritis and paralysis. Twenty-seven informants reported the use of ant for muscular weakness, 27 informants reported the use of desert monitor for arthritis and muscular weakness. This zootherapeutic knowledge was based on both domestic as well as wild animals and the detailed information is presented in Table 2.

| D ISCUSS I ON
In the present study, the data collected from nomadic pastoralists of Cholistan desert was examined critically and thoroughly, and only the information advocated, averred and asserted by the native people, quacks and practitioners of alternative medicines are presented.
All the relevant information regarding the animal's local name, parts or products used to cure the different diseases has been provided by respondents and also the methods of preparation of these products.
This study revealed 20 animal species that are utilized for medicinal purposes indicating very rich ethnomedicinal knowledge of the study area i-e Cholistan desert of Bahawalpur. We found that among 20 animals nine animals are domestic while 11 are wild animals, from which nine are mammals, four birds, four reptiles and three insects.
According to the survey, six animals and their products are used for the management of asthma, six are used for general weakness, five for sexual debility, five for tuberculosis, three for skin problems, three for paralysis, three for arthritis, two for cough, two for leucoderma, one for meningitis, one for impotency, one for piles, one for leprosy, one for diabetes, one for rickets, one for dropsy and one animal is used for the treatment of epilepsy. The study concerning with the parts of animals used by the people, milk of 6 animals, butter and ghee of two animals, wool of two animals, flesh/ meat of eight animals, fat of five animals is being used while three animals are used and horns of one animal is used as medicine. It was well reported in previous studies that animals including wild and domestic, and their organs/by-products such as bones, hooves, feathers, skin and tusks are important components for the preparation of curative, protective, and preventive medicine in zootherapy (Anyinam, 1995;Kang, 2003;Kushwah et al., 2017;Soewu et al., 2012). Meyer-Rochow (2017) and Jaroli et al. (2010) described that the nature of animal-derived medicinal substances depends upon the ailment and disease to treat which included squeezing, direct use, crushing/ grinding, burning, cooking, wrapping, powdering, and drying (Jaroli et al., 2010;Meyer-Rochow, 2017). An egg is the product of animals and ostrich's egg (Struthio camelus) is used to cure muscle strain, broken bone, and paralysis (Kendie et al., 2018). It was further investigated that different types of human diseases like cough, asthma, paralysis, tuberculosis, earache, erectile dysfunction, herpes, weakness and muscular problems are treated with animals or by body parts or by-products like organs, milk, flesh, blood, antler and feathers (Haileselasie, 2012).
Many of these animals are also used in another traditional system of medicine in Middle Eastern countries. Hooper and Field (1937) described that twelve different animals including cow, camel, sea sponge, honey, fish, sheep, silkworm and squid in Iraq are used as traditional medicine (Hooper & Field, 1937). A published study conducted in Egypt by a physician revealed that 41 drugs of animal origin out of 640 are present in the Cairo market (Meyerhof, 1918). During the 1970s, one study conducted in Pakistan stated that 31 organic substances were listed as animal parts and products that is 9% of all medicinal substances in the catalog of traditional medicines (Lev, 2003). It was reported in TA B L E 1 Age and gender-wise distribution of the questionnaires to local informants Ethiopia that the majority of human population (70%) and livestock (90%) uses traditional medicine to treat various ailments (Birhanu, 2013). Kendie et al. (2018) investigated the application of 51 animal species and their products to treat or to prevent about 36 different diseases (Kendie et al., 2018). Furthermore, it was revealed in a study in Degu tribes in Tigray region of Ethiopia that traditional medicine containing animals (23 animals) showed potential to cure ailments (Haileselasie, 2012) and about 16 animal species were identified and used for the cure of 18 different human ailments in the Kafta-Humera District, Northern Ethiopia (Yirga et al., 2011). Whiting et al. (2010)

| CON CLUS ION
As current investigations are majorly based on the deep discussions with nomads of Cholistan desert and their knowledge in the treatment of various diseases and maintain general well-being.
The results of this study explored that parts of animals, raw material and or their products occupied key positions in the traditional medicine and medical practices for the treatment of a vast range of different ailments. It could be concluded from the current investigations that traditional people mostly depend on spiritual as well as zootherapy due to the absence of modern medical facilities, lack of awareness, expensive drugs and unavailability of proper transportation. Based on this communication, we could recommend that neglected knowledge of this type should be included in conservation strategies and management of faunistic assets.
However, it was also found that some people from local areas of Cholistan now refrained to sacrificing animals due to strong material and spiritual ties with their animals. Furthermore, to overcome the diseases in these areas more research is needed for experimental confirmation. Moreover, significantly vital indigenous knowledge is getting lost together with the experts and elders due to scarce efforts to conserve, manage and proper documentation of indigenous knowledge and skills in the field of zootherapy. So, along with proper documentation and management of the indigenous knowledge regarding ethnozoological, more research should be done to test the animal's products to explore their bio-active components in the raw material of these animals scientifically for product development.

ACK N OWLED G EM ENT
We acknowledge Dr. Naveed Akhtar for allowing us to conduct this research work. No funding is obtained from any source.

CO N FLI C T O F I NTE R E S T
Authors declare that there is no conflict of interest. Validation.

PE E R R E V I E W
The peer review history for this article is available at https://publo ns.com/publo n/10.1002/vms3.491.