“Abish” for a procedural pain control in bone-setting

            The present article
grew out of a lively exchange of views in the Ethiopian Electronic Distribution
Network (EEDN) discussion forum on the merits of fenugreek (vernacular Amargna name: abish) in
traditional medicine. Useful data, literature citations, testimonials and
opinions were exchanged to amplify the medicinal importance of the plant. The
purpose of this write-up is to distill that discussion into a summary, followed
by a close examination, in particular, of one aspect of the use of this
important plant—its utility in decreasing pain
level during bone-setting procedure in Ethiopian traditional medicine. It will
be preceded, however, by a general discussion of the background of the plant.

            The
botanical name of abish is Trigonella foenum-graecum (family: Lguminosae [Fabaceae]). It is
also known as Greek hay seed. The generic Latin name “Trigonella” stands for
“little triangle” to depict the triangular shape of the small white-yellowish
flowers of the plant, while the specific epithet ‘foenum-graecum’ literally
means “hay from Greece.” Historically, the Romans obtained the
plant from Greece, and hence named it “fenugreek.” Due to the
horn-shaped seed pods, fenugreek is also called “goat’s horn”
or “cow’s horn.” The 2^nd century B.C. Roman
authority on animal husbandry Porcius Cato is said to
have ordered fenugreek be sown as oxen feed, possibly because of the rich
protein content of the former. The great medieval emperor Charlemagne
encouraged its cultivation in central Europe in A.D. 812.

            Fenugreek
is an important ingredient of spice blends. It has the typical taste and odor
of maple syrup. Since biblical times, the seed was reported to have been used
to increase milk production in women. In addition, it has a long list of
folkloric medicinal uses, including for the treatment of boils, cellulites, tuberculosis,
mouth ulcers, and topically for inflammation and myalgia (muscular pain). It is
possibly effective when used to reduce blood sugar in diabetics, to improve
appetite, and topically when used as a poultice for local inflammation. There
is also some evidence that fenugreek might lower cholesterol levels. It has
been proposed that saponins and the fiber-rich gum
portion of the seeds might contribute to the cholesterol lowering effect, while
the galactomannan ingredient may be responsible for
the antidiabetic activity. Animal data show that
fenugreek inhibits inflammatory swelling. Fenugreek is also a source of diosgenin, a precursor used in commercial steroid
synthesis.

Fenugreek grows
predominantly in the Mediterranean regions of Africa—Egypt, northern
Sudan, Lybia and Tunisia. In northern Africa, it is
known by the local Arabic name helba. It is also
cultivated in the Rift valley of east Africa.  As one of the oldest cultivated plants
known to humans, it has been grown in the Nile Valley since as far back as 1000
B.C.

Abish is grown in all
parts of Ethiopia. It is a popular spice used in the preparation of bread. In
traditional medicine, it is used as a tonic for stomach problems, to expel gas,
for leprosy and wound dressing. Dawit Abebe & Ahadu Ayehu (1993) claim that fenugreek is used for urinary
retention and joint immobility (vitality of ligaments). For the latter effect,
the remedy is taken orally (by mouth). This writer is not aware of any
documented use of abish in Ethiopia to enhance
milk production in women, although such use was mentioned in the discussion in
EEDN as ascertained by a participant. Considering the established folkloric use
of fenugreek in other countries outside of Ethiopia as a galactogogue
(milk production stimulant), it is not surprising to find such parallel use in
Ethiopia.

To revert back to the
subject of this article, I will start with a testimonial by Dr. Tsehai Berhane-Selassie in EEDN
which went like this:

I wanted to share a little bit of
information on the ‘medicinal’ use of abish
(fenugreek). In the late 1960’s, I saw a traditional physician from Gurage (Eza) using thickly boiled
(powdered) abish as padding on dislocated shoulder
and broken collar bone that he wanted to fix. He left that on for a few days
(can’t recall exactly how long). He then fixed the socket and the broken collar
bone very easily. The patient had dislocated her shoulder and broken the
collar bone while riding a horse in janmeda; Ras Desta Hospital had used their
system and left it, but nothing was mended. The traditional bone-setter said
the fenugreek he applied externally made the bone malleable. His name was Hakim
Bayesa, and he had an office in Merkato]…..”

The above
testimonial appears to have scientific backing. As indicated earlier, abish has been reported to have anti-inflammatory and
anti-muscular pain (myalgia) properties. In this “case testimonial,”
it seems the healer prepped the patient for a bone-setting procedure by
applying topically a good dose of abish. This can be
likened to “procedural pain control” or a notch higher
“conscious procedural sedation” which is used in modern medicine
prior to light and non-invasive procedures. Abish
has not, of course, been reported to have sedative properties. A dislocated and
broken bone is nonetheless bound to produce inflammatory response and pain. The
latter is where our good old traditional remedy abish
comes in.

The author can be reached at [email protected], and wishes to acknowledge Dr. Tsehai for sharing her observation.

Selected References (and references therein)

1. Dawit Abebe and Ahadu Ayehu, 1993. Medicinal and Enigmatic Health Practices of Northern Ethiopia, B.S.P.E. Addis Ababa.
2. Fekadu Fullas, 2003. Spice Plants in Ethiopia: Their Culinary and Medicinal Applications. Sioux City, Iowa, USA
3. Fekadu Fullas, 2006. Interactions of Ethiopian Herbal Medicines and Spices with Conventional Drugs: A Practical Guide. A.J. Phillips Publishing Co., South City, Nebraska, USA