Ethnomedicinal List of Plants Treating Fever in Ahmednagar District of Maharashtra, India

A search of ethno-botanical literature revealed that 62 plant species belonging to 32 families are used as ethnomedicines under various preparations in the treatment of fever by ethnic groups residing in Ahmednagar district of Maharashtra, India. A coordinated field study however recorded 71 plant species from 35 families that were explained to deal with fever by the countryside dwellers. Out of these two lists, 23 plant species belonging to 17 families are found common. The total identified families containing all plant species (n=109) are arranged as per the latest edition of Angiosperm Phylogeny Group (APG) Classification System (APG IV, 2016) with indications of newly recorded ones for a future interests.


Introduction
Fever, also known as pyrexia in modern medical terminology and Jvara in vernacular language, is a common medical symptom and a sign of an increased internal body temperature to the levels above normal temperature i.e. 37 o C (98.6 o F). Body temperature varies with time of the day, being at lower levels in the morning and higher levels in the evening. Body temperature greater than 41.67 o C (107 o F), can result in brain damage and possibly death.
[1] Fever is commonly associated with many other diseases and thus treated individually and along with other disorders. The febrile response, therefore, remains a significant contributor to the pathogenesis, clinical presentation and outcome of many illnesses and diseases. Consequently, understanding fever and febrile response is vital in the diagnosis, treatment and follow-up of various ailments and diseases. [2] Ethnic groups and countryside people are still depending on ethnomedicinal practices pursued mostly by seniors and experienced individuals among them to heal/cure most of the health related ailments in their periphery. Ethnomedicinal traditions or therapies are having natural potential but have not been adequately and clinically documented to claim equal status of modern medicine. Several ethno-botanical/ ethnomedicinal surveys have been carried out in all parts of forest dominated areas during last hundred years including Ahmednagar district of India. There are different objectives attached to these surveys such as studying the floristic and bio-diversity of the region, documenting ethno-botanical, ethno-medico-botanical and ethno medicinal practices being carried out against different diseases and disorders from different tehsils of the district. [3][4][5][6][7][8][9][10][11][12] . Present study was focused to enlist the specific plants used to treat patients during fever under ethnomedicine by the locals in Ahmednagar district of India. This will add more information to the database of ethnomedicinal plants for future endeavours.

Study Area
Ahmednagar district of Maharashtra state, India lies between 18°2' and 19°9'N latitudes and 73°9' and 75°5' E longitudes. The district has 14 tehsils/talukas. Akole and Sangamner tehsils of the district are mostly tribal populated due to forest covers. Therefore, the present study of ethnomedicinal data collection was based at these two Tehsils. The field study was carried out by arranging Botanical excursions for documenting local ethnomedicinal knowledge at different times. Surveys were conducted during the period of July 2016 to June 2018 (covering all the seasons) in tribal areas of the district. The tribal communities namely, Mahadev Koli, Katkari, Bhill and Thakar are found in Akole and Sangamner Tehsils. Gegraphically, this part of the district is the foothill zone of the end part of Western Ghats mountain ranges. [27] The assistance of local experts (key informants) belonging to these tribal groups was taken during the survey visits.

Methods
The methods followed for the survey were i) Interview methods: Informal/qualitative methods (Open ended or semi-structured interviews); ii) Formal/quantitative methods (Systematic or structured interactions through Questionnaires), and iii) Participant Observation method. This was to find and assess how do the local informants use medicinal plants, parts used to make formulations and serve dosage, etc. Random sampling method was used in selecting the study area, sub-areas as well as the informants. Each plant specimen was botanically identified, dried and was made in to herbarium. The voucher specimens are deposited in the herbarium of Swami Ramanand Teerth Marathwada University's Sub-Centre, Latur, for the purpose of documenting the presence of that particular species of the study area and for future reference. The identified species are arranged family-wise and presented in a Table form. The families in turn are sequenced according to the latest APG-IV (Angiosperm Phylogeny Group -Fourth Version) system of classification (2016). [28,29] An attempt was also made to use Roman Unicode font with diacritical marks to write the Sanskrit/Marathi/Vernacular words for universal correct pronunciation and understanding.

Results
The analysis of Ethnomedicinal data from this piece of work reveals -A. 62 species belonging to 32 families were recorded from literature studies. B. 71 species belonging to 35 families were recorded during field studies. C. Out of 62 species, 37 species belonging to 21 families were found exclusively in literature studies.
D. Out of 71 species, 48 species belonging to 26 families were found exclusively in field studies. E. Thus a total 109 species belonging to 43 families are recorded for ethnomedicinal way of treatment for fever/jvara. F. 23 species belonging to 17 families were recorded as the species common to both the literature records as well as the field studies enumerations. G. The families Asteraceae, Fabaceae, Apocynaceae and Acanthaceae are the abundant families with respect to utilization of ethnomedicines from those. H. Table 3 reveals that Herbs constitute the major portion with respect to the habit-wise distribution of plant species followed by Trees, Climbers, Shrubs and Under-shrubs which are used in the treatment of fever.

Discussion
The ethnomedicinal literature survey on Ahmednagar district enlisted a total of 62 medicinal plant species belonging to 32 families and the present field survey made in the tribal regions revealed 71 ethnomedicinal plants which are ascertained to 35 families (all angiosperms) used for the treatments of fever / Jvara by the locals. There are 23 plant species of 17 families found common in both studies and remaining are different. The details of the total plants, families and ethnomedicinal characteristics, etc. are presented in table 1. Specific marks are given in the table to recognize the differential species in the list. Some of the photographs of plant species and parts used as collected while conducting field visits are also presented here. It has been further observed as per the data that a maximum of 10 species belong to family Asteraceae followed by Fabaceae, Apocynaceae and Acanthaceae, which have medicinal effect on fever/jvara ( Table 2). It is found that the most common plant species from this combined list of literature and field studies is Tinospora cordifolia (Willd.) Hook F. & Thoms (with the maximum score of 12 references). The other common plants are Azadirachta indica A. Juss. and Andrographis paniculata Nees. with 10 references each, followed by Alstonia scholaris (L.) R. Br. (09) and Nyctanthes arbor-tristis L. (09) whereas Santalum album L. (08), Adhatoda vasica Nees. (08) and Vitex negundo L. (08) together are comfortable with the fourth position that they gained. While all other species belong to the common list of 23 plants mentioned earlier. Alstonia scholaris (L.) R. Br. is the only species among these common plants reported from the present field studies and not found in earlier reports of the district. All these plants reported here in the context of treatment of fever would definitely get the attention of investigators for further studies and pharmaceutical research.  [7,14,16,18 ,19,23,26] 7 The decoction of rhizome 25 g -with a glass of milk twice a day.
The milky latex 5-10 drops mixed in half teaspoon of honey -given orally.

Shrub
Leaves Y [14,19] 2 The decoction of the boiled leaves (to minimize toxicity) 5-10 ml -along with the lime juice.

Śevagā
Tree Seeds Y [17,19,21, 24] 4 Decoction of seeds made in 100 ml of water -to be drunk at a time.
$ Score = The total number of references in which plant is reported.

Conclusions
Fever is mostly an indication of infection. According to Modern sciences, antipyretic medicines are NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) that usually act by inhibiting prostaglandin synthesis within the hypothalamus region that acts as temperature regulator in our body. [30] But as per Ayurveda, the ancient traditional medicinal system of India, plant substances which have dominance of bitter taste (Tikta Rasa) like, Cirāta (Andrographis paniculata Nees.), Guḍūci (Tinospora cordifolia (Willd.) Hook F. & Thoms or Nima (Azadirachta indica A. Juss.) contain the property of reducing fever (Jwara Hara). Tikta Rasa reduces toxins / poisons and checks fever. [31] Such plants are commonly found in this list made in this study.
The objective behind preparing this list is to attract the attention of those researchers who have interest in folk medicines. The research workers will find the list as a new starting point for further investigation because the newly documented plants have potential for use as source of new drugs for the treatment of fever. Further Pharmacognostic, phytochemical, pharmacological, biotechnological and clinical studies will enable the validity of the present inquired information.