"Abish" for a procedural pain control in bone-setting

Blogger's Note: This is a reprint of an article written by Dr. Fekadu Fullas and was originally posted to Ethiopian electronic discussion forum. It is republished here with kind permission of the author.

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 FeFuBal@aol.com, and wishes to acknowledge Dr. Tsehai [Berhane Selassie} 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