Xki yoma' (our medicine) and xki tienda (patent medicine)--interface between traditional and modern medicine among the Mazatecs of Oaxaca, Mexico.

Objectives: Little is known about the interface of traditional (generally plant based) medicines and of commercially available pharmaceutical (and related) products. Here we provide a case study to understand how and to what extent traditional and modern medicine have been integrated in an indigenous community and whether these two categories offer a meaningful model for understanding medicine selection. Consequently, this paper explores the use and knowledge of medicinal plants and patent medicines among laypeople living in a rural Mazatec indigenous community in Oaxaca, Mexico.

Methods: This paper is based on field study over a period of approximately 20 months using participant observation, unstructured and structured interviews including freelisting. The medicinal plant species and commercially available pharmaceuticals were assessed using published biomedical information.

Main Outcomes: The local ethnopharmacopoeias, emic concepts of illness, epidemiology, and case studies on therapeutic choice were documented. We found that self-treatment is the most common first therapeutic choice. Many of the plant species used by Mazatecs have recognized therapeutic properties, in some cases in vivo and in vitro studies point to well defined pharmacological effects, and in a few cases clinical evidence is available. Likewise, people commonly use patent medicines that are effective in the treatment of the most common health conditions. However, we also documented the medicinal use of some toxic plant species (Aristolochia spp.) and of some patent medicines that are held to be unsafe in developed countries (sodium metamizole).

Conclusions: When looking at a complex pluralistic medical system an approach that goes beyond the externally imposed dichotomic categories of traditional and modern medicine can be very useful to shed light on other dimensions that underlie the local use of medicines. With the increasing integration of the Mazatecs with the outside world, the concomitant use of both types of resources is constantly changing and helps the Mazatecs in their struggle for health.