ARTICLE 6: ANIMALS IN HEALTHCARE AND TRADITIONAL & COMPLEMENTARY MEDICINE

ARTICLE 6: ANIMALS IN HEALTHCARE AND TRADITIONAL & COMPLEMENTARY MEDICINE

INTRODUCTION

Malaysia is a mega-biodiversity country. Although no exact figure could be obtained for the rich plant and animal diversity, the most recent assessment showed that its flora diversity could be as many as 17,000 species to include vascular plants, ferns, algae, gymnosperm, monocots, dicots and bryophytes. [1] A more detail figures are summarised in Table 1. In terms of people living in the country, there are 3 major ethnics – Malays accounting for 60%, Chinese 30%, Indian 5% and the other more than 70 ethnics comprises of 5% of the populations [2]. Chinese and Indians are non-indigenous as they were brought into this country during the colonial period to provide for the man-power needed for industries, such as railway, tin mining, and rubber. Table 2 shows a list of some major ethnics of Malaysia

Table 1: Fauna species number in Malaysia and the world and percentage of global diversity [3][4].

            Taxon Malaysia World

% global fauna

diversity in Malaysia

Mammals 286 4630 6
Birds 736 9950 7.4
Reptiles 268 7400 3.6
Amphibians 158 4950 3
Marine fishes 4000 13321 30
Freshwater fishes 449 8411 5
Invertebrates 150000 1000000 15

Table 2: List of some ethnics in Malaysia [2].

Region Ethnics
Sabah Dusun, Kadazan, Rungus, Bisayah, Murut, Tidong, Bajau, Orang sungai, Bongi, Kedayan, Bajau Sulug, Pelauk, Bugis, Chinese, Brunei Malay, Malay, Indian, Iranun, Punjabi.
Sarawak Iban, Melanau, Murut, Penan, Orang ulu, Dayak, Malay, Indian, Chinese, Punjabi, Kayan, Kenyah, Kenyah-badang, Kajang, Bidayuh
Peninsular Malaysia Malay, Indian, Chinese, Protomalay, Negroid, Bateq, Temiar, Senoi, Semai, Temiang, Jakun, Javanese, Banjar, Peranakan, Jah hut, Ma’betisek, Mah meri, Temuan, Orang hulu, Orang laut, Sakai, Semag beri, Semelai.

The largest percentage of the population, that is the Malays, do not practice animal use in healthcare as they are mostly muslims. In the Islamic religion some animals are prohibited to be consumed and that influence the Malays culture. Interestingly, the Indian too being basically Hindu (some are Muslims) are not in the habit of using animals in their healthcare. Unlike the Malay and Indian, the Chinese uses animals freely in their healthcare. This will be elaborated using examples listed in a reference. [5]

As for the other ethnics in Malaysia, in-depth study on what animals they use in healthcare had not been done intensively for all except a preliminary study on the Orang Sungai of the lower Kinabatangan river of which are also mainly Muslim. [6] The list of animals used by the Orang Sungai of Kinabatangan will also be listed out in Table 3.

In this article, we will focus on some animal groups that are known to be commonly used in Malaysia. Research on these animals had been, and some are still carried out. For each animal group, the taxonomic identification will be inferred together with its biology and ecology. Information on chemical bioactive compounds will also be included if indicated in referred publications.

Table 3: A summarised table to show commonly used animals in healthcare, and traditional and complementary medicine by several ethnic groups in Malaysia [6].

Animal group Animal Used in Malaysia
Annelida Leeches
Arthropoda Weevil, termites, ants, bees, flies (maggots), stink bugs
Echinodermata Starfish, sea cucumber, sea urchin
Pisces Snakehead, mudskipper
Amphibia Frog, toad
Reptilia Snake, turtle, lizard, crocodile
Aves Ayam kampong, burung but-but, burung walit
Mammals Bear, rhino, porcupine, anteater, bats, elephant

 

THE COMMONLY USED ANIMALS FOR TRADITIONAL CHINESE MEDICATION IN MALAYSIA

Most ethnics in Malaysia do not use animals extensively in their healthcare and as medication. In Traditional Chinese Medicine (TCM) however, comparatively a variety of animals have been used. To illustrate the whole array of animals used in TCM, the list of animals is excised as below:

List of animal species used in Traditional Chinese Medicine [5][6][7][8][9]

Groups Species
Sponges Eunapius fragilis
Annelids Hirudo nipponica
Earthworm Pheretima aspergillum
Diplopods Kronopolites svenhedini
Centipede Scolopendra subspinipes mutilans
Scorpion Buthus martensii
Isopods Armadillum vulgare, Porcellio scaber
Insects Cryptotympana pustulata, Vespertilio superans, Laccifer lacca, Bombyx mori, Gryllotalpa africana, Scapipedus aspersus, Lepisma saccharina, Aspongopus chinensis, Trogopterus xanthipes, Trogopterus xanthipes, Eupolyphaga sinensis, Tabanus bivittatus, Mylabris phalerata, Huechys philaemata / Huechys sanguinea, Lytta caragana, Apis cerana, Apis mellifera, Tenodera sinensis, Statilia maculate, Hierodula patellifera
Mollusks Meretrix meretrix, Cyclina sinensis, Arca subcrenata, Arca inflata, Haliotis asinina, Haliotis ovina, Haliotis discus hannai, Haliotis diversicolor, Cristaria plicata, Hyriopsis cumingii, Pteria martensii, Ostrea gigas, Ostrea talienwhanensis, Ostrea rivularis, Mauritia arabica, Pteria martensii, Hyriopsis cumingii, Mauritia arabica, Pteria martensii, Hyriopsis cumingii, Cristaria plicata, Sepiella maindroni, Sepia esculenta
Fish Hippocampus histrix, Hippocampus kelloggi
Amphibian Rana temporaria chensinensis, Bufo melanostictus, Bufo bufo gargarizans
Reptiles Deinagkistrodon acutus, Zaocys dhumnades, Manis pentadactyla, Eretmochelys imbricata, Gekko gecko, Trionyx sinensis, Chinemys reevesii,
Birds Gallus gallus domesticus
Mammals Sus scrofa domestica, Ursus arctos, Bubalus bubalis, Macaca mulatta, Moschus berezovskii, Saiga tatarica, Naemorhedus goral, Bos taurus domesticus, Cervus nippon, Phoca vitulina, Callorhinus ursinus, Equus asinus, Erinaceus europaeus, Hemiechianus dauricus.

 

ANIMALS USED BY THE ORANG SUNGAI OF LOWER KINABATANGAN IN TRADITIONAL MEDICATION AND HEALTHCARE

A study was undertaken in 2000 to evaluate animals used by an ethnic in Sabah. For this study the Orang Sungai of Lower Kinabatangan was chosen. They are mainly Muslim, and as such do not use many species of animals. Nonetheless, due to their traditional knowledge and practices, some species of animals were recorded to be useful in treating several ailments and also for healthcare. Table 5 lists the animal groups used by Orang Sungai of Kinabatangan in treating some ailments. [9]

Table 5: List of animals used by Orang Sungai of Kinabatangan, Sabah. [9]

Animal groups  Animal used 
 Annelids  Leeches, earthworms
 Insects  Honey bee, gasshopper, termites, American cockroach, cicada, sago grub, Sukarno beetle
 Fish  Common snakehead, catfish, eel
 Amphibian  Large river frog
 Reptiles  Softshell turtle, Malayan box turtle, saltwater crocodile, common water monitor, black rough monitor, reticulated phyton
 Birds  Storms stork, great eagle, eagle, white-breasted waterhen, lesser coucal, greater coucal, black nest swiftlets, rhinoceros hornbills, magpie robin, blue-eared kingfisher
 Mammals

 Large flying fox, long tongue nectar bird, slow loris, proboscis monkey, long tailed monkey, orang utan, pangolin, plantan squirrel, house rat, thick spined porcupine, domestic dog, sun bear, flat headed cat, Asian elephant, Sumatran rhinocerous, lesser mouse deer, red muntjack, sambar deer, tembadau, domestic cattle, water buffalo, domestic goat

COMMONLY USED ANIMALS IN TRADITIONAL AND COMPLEMENTARY MEDICINE IN MALAYSIA

LEECHES

Leeches, belong to a group of segmented worms (Annelida) and is commonly found in a damp forest, or in freshwater water bodies such as paddy fields, lakes, or slow flowing rivers. They breathe through their skin and as such require a moist environment to facilitate oxygen intake. In Malaysia, leeches can be clustered into two groups – the thin leech and the fat leech. In the Malay vocabulary there are two words for leeches: pacat is slimmer with two distinct ends – the mouth end and the foot end. The mouth end has teeth that hook on to the skin, puncture it, and sucks blood; the slightly thicker foot end has a sucker pad that helps the leech to loop. [8]

Another group is the lintah. These are fatter and more robust leeches. They are somewhat flattened and bigger in size. In Malaysia the best way to encounter with pacat is in moist animal-rich (especially mammals) forests. As you walk along the trail, you may chance upon a pacat standing on its foot end waving around ready to latch on to the passing by people or animals. They are opportunistic feeders. Lintah prefer slow running or static water body such as lakes, rivers or paddy fields. It is not difficult to see a blackish soft lintah flattened and fastened itself to the skin of the buffaloes in wet paddy field, feeding off their blood. Lintah also feed on aquatic animals such as fish. Leeches used in medication, Hirudo medicinalis are the lintah and not the pacat. [8]

The taxonomic classification of the medicinal leech, Hirudo medicinalis. [8]

Phylum: Annelida (earthworms, marine polychaetes, leech)

Order: Hirudinea

Genus: Hirudo

Species: Hirudo medicinalis

Annelids are segmented worms. Their body is comprised of many segments, and movement is facilitated by the expansion and contraction of these segments. These worms comprise of three orders: Oligochaeta  are earthworms, Polychaeta are marine worms, and Hirudinea, leeches. Earthworms have stiff bristles called setae for anchoring themselves to surfaces to assist in locomotion. Polycheates have feathery parapods that helps movement in watery ecosystem. Leeches do not have any of these structures, and movement are facilitated two ways: swimming and hurtling. About 600 species of leeches identified in the world, only 15 are used in healthcare and thus classified as the medicinal leeches. [9]

The general colouration of leeches is black although some maybe gray. There are those that have orange stripes and thus called tiger leech. Before feeding on blood, most leeches are thin and slender. When fully fed they are fat, engorged with blood. This animal since ancient times had been relieving many people off of all sorts of diseases. [10]

In Malaysia, during the olden days, people had been practicing bloodletting. Bloodletting was divided into a generalised method done by venesection and arteriotomy, and a localised method done by scarification with cupping and leeches [11]. Bloodletting by wet- cupping involves scarification of the skin and applying the cupping glass. The protocol for performing cupping requires the puncturing of the skin repeatedly with microlancet, and applying vacuum cups where the air within the cup was rarefied by manual mechanical suction. The cupping glass will then be removed after they became partially filled with capillary blood. [12] This is a messy way of blood-letting. The other cleaner and simpler way to bloodlet is to release a hungry leech to do the job more efficiently. The leech or lintah in Malay will hook onto the skin with their sharp rows of teeth. This bite will cause blood to flow which will be sucked by the muscle present around its mouth. Clotting of blood is prevented by the presence of enzymes and other chemicals found in the saliva of the leech. As they suck blood from mammals, birds or people, they release their saliva into the cut. The pacat or lintah will not let go of the bite until their hunger is satiated. Engorged with blood they are now fat and release their bite and will fall off from the prey. [13]

Leeches have been used in various treatment such as glaucoma, myasthenia, inflammatory reactions, heart disease, rheumatic disorders, tendovaginitis, varicose veins or venous disease, arthritis, muscle stiffness, thrombosis and embolisms, passive congestion and spastic conditions, vertebrogenic pain syndrome and blood purification. [14]

Table 8: Effect of leech therapy and chemicals responsible for it were represented in table below [15]:

Bioactive substance Mode of action
Hirudin Inhibits blood coagulation by binding to thrombin.
Calin Inhibits blood coagulation by blocking the binding of von.
Willebrand factor to collagen Inhibits collagen-mediated platelet aggregation.
Destabilase Monomerizing activity Dissolves fibrin. Thrombolytic effects.
Hirustasin Inhibits kallikrein, trypsin, chymotrypsin, neutropholic cathepsin G.
Bdellins Act as an anti-inflammatory. Inhibits trypsin, plasmin, acrosin.
Hyaluronidase Increase interstitial viscosity. Antibiotic.
Tryptase inhibitor Inhibits proteolytic enzymes of host mast cells.
Eglins Anti-inflammatory and inhibit the activity of α-chymotrypsin, chymase, substilisin, elastase, cathepsin G.
Factor Xa inhibitor Inhibits the activity of coagulation factor xa by forming equimolar complexes.
Complement inhibitors May possibly replace natural complement inhibtors if they are deficient.
Carboxypeptidase A inhibitors increases the inflow of blood at the bite site.
Histaminelike substances vasodilator Increases the inflow of blood at the bite site.
Acetylcholine Vasodilator.
Anesthetics substance Causing loss of sensation (anesthetic effect).
 LEECH FIG1
Fig. 1: Leeches are reared in Malaysia to be used traditionally in treating certain ailments such as hypertension and gout. 
 LEECH FIG 2
Fig. 2: Two leeches released on the foot of a gout patient.  

 

INSECTS

MAGGOTS

Among the well documented insects used in Malaysia is the fly. Although the species used, Lucilia sericata is locally not found, it belongs to a family of well-known fly in Malaysia, called Calliphoridae. Flies in this family are generally known as the blue or green bottle fly due to its bluish green colouration. In Malay, calliphorids are called langau. Taxonomic classification of Lucilia sericata is shown below [16]:

Phylum : Arthropoda

Subphylum : Uniramia (Mandibulata)

Class : Insecta (Hexapoda)

Order : Diptera

Family : Calliphoridae

Genus : Calliphora

Species : Lucilia sericata

Synonym : Phaenicia sericata

Flies exhibit a complete life cycle. Eggs will hatch into larvae or maggot and feed to moult several times and increase in size. Later the maggot will stop feeding and enter a resting stage called the pupal stage. The maggot develops a thick outer skin to form the puparium. While the larvae do not have legs and wings, these structures will develop during the pupal stage. After a period of time, the adults will emerge from the puparium and fly off to look for food, to mate, and lay eggs. For flies, it is the larvae or maggots stage that are being used in medication. [7]

An open wound is normally treated with antibiotic to kill bacteria that could infect the wound. Occasionally due to the rapid growth of the bacteria colony, or the bacteria acquiring resistance to the antibiotic, the wound persisted and pus accumulated. Dead (necrotic) tissues accumulate and darken and is now known as gangrene. This requires alternative measures such as operation to remove the gangrene. Another alternative is maggot therapy. [11]

Sterile maggots of the species Phaenicia sericata at the size of 2mm are released into the wound. The wound is covered with sterilized gauze loosely to allow for ventilation required by the maggots. The maggot will release digestive enzymes that will decompose necrotic tissues to a liquid form. Maggots will then ingest to feed on the liquid. Maggots of this species will only feed on dead tissues and pus if present, thus no damage will be done on the living tissue of the patient. After a period of about three to four days, the gauze and maggots will be removed. It also found that these maggots will also excrete antibiotic enzymes from their body perhaps to protect themselves. By doing so they are also promoting    disinfection of the wound, promoting healing [17].

SEA CUCUMBER

The sea cucumber belongs to phylum Echinodermata, under class Holothuroidea. As the name implies sea cucumber looks like cucumber, being cylindrical and elongated. Different from other echinoderms such as sea star, holothuroid or sea cucumber is soft in texture, and body wall leathery [19]. In Malaysia sea cucumber is generally called timun laut, but those used in traditional medication is called gamat. Some species are consumed as food, and are commonly used in Chinese dishes; and these are commercially known as trepan [19].Table 10 shows the taxonomic classification of the gamat.

Table 10: Taxonomic classification of gamat. [19]

Phylum: Echinodermata

Class : Holothuria

Genus (examples) : Holothuria

Species: Holothuria atra

In the northern state of Kedah, fishermen collected sea cucumbers and extract oil from them. This oil is known as minyak gamat (gamat oil), used to treat wounds and also other skin problems. Another product obtained from sea cucumber is the tonic (water) which is drunk for internal wounds. Medical properties of gamat has been recognised by indigenous people since time immemorial. Some research done in Malaysia as well as from outside Malaysia are quoted here. A correlative study on lectin involved in the immune system in sea cucumber, Holothuria scabra in India, indicated that the expression of this defensive lectin is induced by bacterial challenge, wherein cell wall glycoconjugates of bacteria are involved in lectin induction [21]. Human seminal lectin (HSL) showed strong broad spectrum antibacterial activity against gram-positive and gram-negative bacteria. Under in vitro conditions, purified HSL mediate agglutination of the test bacteria, thereby indicating a possible mode of action in physiological situation. [21]

Several scientists from Tunisia and France investigated the antifungal activity of aqueous and methanolic extracts of the Mediterranean sea cucumber, Holothuria polii). Determined in vitro, using well diffusion test in the casitone agar medium, both extracts were found to produce, in a concentration-related manner, a significant antifungal activity. A semipurified fractions for both extracts also showed a significant antifungal activity in a concentration-related manner. However, different species of fungi react differently, with Aspergillus fumigatus showing the highest susceptibility, followed by Tiichophyton rubrum. Candida albicans showed no activity. [22]

From China, sea cucumber were hydrolysed sequentially with bromelain and alcase and the hydrolysate gelatin from the sea cucumber Acaudina molpadioidea which is then fractionated into three ranges of molecular weight using ultrafiltation membrane bioreactor system. They found that one of the fractions, GH-III with <1kDa brought about a high angiotensin-I-converting enzymes (ACE) inhibitory activity, with IC50 value of 0.35mg/ml. In the same study an ACE inhibitory peptide was isolated from GH-III, and purified. It has a molecular weight of 840Da and consisted of 5 main amino acids (Glu, Asp, Pro, Gly and Ala) and its IC50 value was 0.0142mg/ml. This sea cucumber gelatin hydrolysate (GH-III)was used as drink administered to renal hypertensive rats (RHR) for 1 month. The systolic blood pressure and diastolic blood pressure of RHR were significantly reduced, indicating an antihypertensive effect by oral administration. [20]

Although in Malaysia, one could see sea cucumber being sun-dried, a study has stated that freeze-drying yields the best quality (but most expensive), dried sea cucumber, and air dried give the poorest. To achieve faster drying along with a high quality product, a microwave freeze-drying (MFD) technique was developed, at various pressures and initial moisture content to avoid the possibility of corona discharge during MFD. According to the drying characteristics of MFD, a control strategy for MFD process as also developed. MFD reduced the drying time by about half of the conventional FD process, and provided a similar good product quality. [23]

A few studies had described the use of sea cucumber extracts as an anticoagulant and thrombotic compounds [13][25], cholesterol and lipid reducing compounds [24], anticancer and antitumour compounds [23], and antibacterial compounds [25]. Russian researchers showed that cucumarioside derived from the species Cucumaria japonica has potent immunomodulatory properties, exhibiting high efficacy against Eschericia coli, Proteus mirabilis, Neisseria meningitidis BT-2, Salmonella minnesota, Pertussis meningoencephalitis and Salmonella typhimurium [25].

 

SNAKEHEAD FISH

Among the freshwater fish species found in Malaysia, the snakehead Channa striatus or ikan haruan in Malay has been widely used as medicine since ancient times by various ethnics of Malaysia.  There are about 30 species of snakeheads (family Channidae) worldwide and distributed in tropical Africa and southern Asia. There are eight species found in Malaysia [27]. In Borneo, this group of fish is also known as Ophiocephalus striatus and most specimens  were collected in turbid water in secondary growth close to coast and possibly do not invade streams in primary forest. In Sarawak it was also observed to prefer stagnant water [27]. Besides ikan haruan two other species are also favourite among fishermen and sport anglers, they are Channa micropeltis (the toman) and Channa lucius(the bujuk). [27]

 

SWIFTLETS

Taxonomy

Birds belong to Class Aves. Most (about 60%) are perching and singing birds belonging to order Passeriformes. Swifts however, is non-perching and belongs to the order Apodiformes. They are small with short legs and rapid wingbeat [29] and the term ‘swift’ are given to European swift because of the fast flying ability of these birds [30]. In Malay, this bird is known as burung layang-layang, and those that produce nests that can be consumed as walit (origin Javanese, Indonesia). 

There are two families in Apodiformes: Apodidae and Hemiprocnidae. In Borneo there are 14 species as seen in Table 11 [30].

Table 11: List of swift species found in Malaysia [30] :

Family 1 : Apodidae

  1. Aerodromus maxima Hume,1878 – Black nest swiftlet
  2. Hydrochous gigas Hartert & Butler,1901 – Giant swiftlet
  3. Aerodramus salangana Streubel,1848 – Mossy nest swiftlet
  4. Aerodramus fuciphagus Thunberg,1821 – Grey rumped swiftlet (Edible nest)
  5. Aerodramus vestitus  Lesson,1843 – Brown rumped swiftlet (Edible nest)
  6. Collocalia esculenta Linneaus,1758 – White bellied swiftlet
  7. Hirundapus giganteus Temminck,1825 - Brown spinetailed swift (Needletail)
  8. Hirundapus caudacutus Latham,1801 - White throated spinetailed swift (Needletail)
  9. Rhaphidura leucopygialis Blyth,1849 - Siler-rumped swift
  10. Apus pacificus Latham,1801 - Fork-tailed swift
  11. Apus affinis JE Gray,1830 - House swift
  12. Cypsiurus balasiensis Gray,1829 - Asian palm swift

Family 2 : Hemiprocnidae (Tree Swift)

  1. Hemiprocne comate Temminck,1824 – Whiskered tree swift
  2. Hemiprocne longipennis Rafinesque,1802 – Crested (Grey-rumped) tree swift

It has been reported that, five species are cave dwelling, seven non-cave dwelling and two are tree swifts. The cave dwellers are: Aerodromus maxima (Black nest swiftlet), Aerodramus salangana (Mossy nest swiftlet), Aerodramus fuciphaga (Grey rumped (Edible nest) swiftlet), Aerodramus vestita (Brown rumped (Edible nest) swiftlet) and Collocalia esculenta (White bellied swiftlet). [30]

Eight species of swifts in South East Asia are listed including in Borneo and the Phillipines and they are: Aerodromus fuciphagus (Edible nest swiftlet, Aerodromus maximus (Black nest swiftlet), Collocasia esculenta (White bellied swiftlet), Hirundapus giganteus (Brown needletail), Raphidura leucopygialis (Silver runped swift), Apus affinis (House swift), Cypsiurus balasiensis (Asian palm swift), and Hemiprocne longipennis (Grey rumped tree swift). [30]

 

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