The forest remedies: How bone fractures are treated in Tripura

Agartala: The knowledge does not begin in a laboratory. It begins with traditional practitioners who have learnt, preserved and passed on ways of treating bone fractures using plants found in Tripura. Some of that knowledge is held by older healers, many of whom have spent years practising a form of medicine rooted in the biological resources around them.

The study, titled “Traditional Healing Practices in Tripura: Exploring Ethnomedicinal Plants Employed by Local Healers for Bone Fractures”, has been published in the book Ecorestoration and Biodiversity Conservation, edited by Dr Debabrata Das and Dr Pampi Ghosh. The research-oriented volume was published by Bharati Publication.

Between July 2022 and October 2023, researchers travelled through eight districts of Tripura to document this knowledge.

The exercise, carried out under the Regional Ayurveda Research Centre in Agartala and supported by the Tripura Forest Department, was originally undertaken as a project of the National Medicinal Plants Board.

The result is a detailed record of 67 plant species used in 34 traditional treatment methods for bone fractures.

But the significance of the research extends beyond the number of plants recorded. It captures a body of knowledge that the researchers say remains actively practised in Tripura, while also showing how much of that knowledge is concentrated among older practitioners.

The Healers Behind the Record

The study involved 122 traditional healers, of whom 32 were identified as specialists in bone-fracture treatment. The researchers recorded their age, place of practice, experience, methods of learning, diagnostic approaches and the ways in which plants were stored and used. Plant specimens were collected after interviews and subsequently identified and preserved.

The eight researchers (Prasenjit Patari, Niral Hansrajbhai Sojeetra, Sanjoy Das, Rohit Kumar Ravte, Nikhil Krishna, Deepika Tewari, Vimal Tewari and Devanjal Bora) describe the exercise as an attempt to document traditional medicinal practices across communities in the state.

Patari, Sojeetra, Das, Ravte, Krishna, Tewari and Tewari are associated with the Regional Ayurveda Research Centre, Agartala, while Bora is with the Central Ayurveda Research Institute in Guwahati.

Among the 32 practitioners who formed the focus of the study, 29 were men and three were women. Twenty-two belonged to Scheduled Tribe communities, seven were categorised by the researchers as Forward caste and three as belonging to a Minority community.

Their ages ranged from 30 to 90. The largest group had primary-level education, while nine respondents were recorded as illiterate and only two were graduates.

The age pattern produced one of the study’s most striking findings.

The researchers found a very strong correlation between the age of practitioners and their ethnobotanical knowledge. In other words, the older practitioners in the survey tended to possess more knowledge of medicinal plants than younger respondents.

That finding gives the botanical inventory a human dimension. The plants may be recorded in a scientific paper, but the knowledge of how they are traditionally used remains dependent on people who have acquired it through experience and transmission.

The researchers took steps to document that process. They say the healers were informed about the research before information was recorded. Those willing to participate signed consent forms, and their geographical locations were recorded using GPS. Interviews were conducted through open-ended questionnaires, with project staff discussing the completed questionnaires with healers in local languages.

The resulting list is extensive.

Of the 67 recorded plants, 40 were identified as wild, eight as cultivated and 19 as both cultivated and wild. Trees accounted for the largest group, with 25 species, followed by herbs, climbers and shrubs. Leaves were the most commonly used plant part, appearing in the treatment records for 41 species.

One plant stands out in the survey: Antidesma roxburghii.

It recorded the highest relative frequency of citation among the plants documented, at 0.406, or 40.6 per cent. The researchers found that it was used in 13 different ways in connection with bone-fracture treatment. Litsea glutinosafollowed with a relative frequency of 0.218, while Cassia fistula and Cissus quadrangularis each recorded 0.156.

Evidence, Ecology and Ownership

The study does not, however, establish that any of these plants can be used as clinically proven treatments for fractures.

Instead, the researchers point towards the next stage of scientific investigation. They argue that the phytoconstituents and pharmacological activities of plants used by traditional practitioners need to be explored to assess their ethnomedicinal applications. In their conclusion, they specifically call for phytochemical screening of Antidesma roxburghii, followed by pharmacological and clinical assessment of the remedies.

That distinction matters.

Traditional use and modern clinical evidence are not the same thing. The study documents what practitioners use and how frequently particular plants were cited; it does not present clinical trials demonstrating the safety or efficacy of these remedies for treating fractures.

Its importance, therefore, lies partly in establishing a baseline.

The authors write that such documentation can provide baseline data for traditional medicine and contemporary drug discovery. Their argument is rooted in the possibility that scientific investigation may eventually identify useful compounds, while recognising that the knowledge itself belongs to a longer cultural history of plant use.

That history is closely tied to Tripura’s ecology.

The researchers place the state within the Indo-Burman biodiversity hotspot and point to its tropical geography, high rainfall and forest reserves as factors contributing to its abundance of medicinal and aromatic plants. They note that rural and tribal communities have longstanding relationships with forest resources, including medicinal plants used for treating ailments.

The relationship is not one-way.

The researchers observed a gradual decline in some of the plants used by traditional healers. They also found practitioners showing interest in cultivating medicinal plants in home gardens. The paper describes this as a practice that can contribute to the preservation of ecological biodiversity.

Here, the story of traditional medicine intersects with the story of conservation.

The plants are resources for treatment, but they are also part of the ecological environment on which communities depend. If the plants disappear, the loss is not simply botanical. It can also mean the disappearance of a component of a knowledge system that has been transmitted across generations.

The researchers therefore place ethics alongside scientific investigation. They argue that applying scientific knowledge to biological resources requires attention to socioeconomic factors, environmental effects and biodiversity conservation. They also state that ethical practice requires preservation of knowledge structures, development of indigenous capacities and equitable distribution of gains arising from commercial use of indigenous knowledge.

This is where the study opens a wider conversation about ownership and benefit-sharing.

If future research identifies pharmacologically useful compounds in plants documented through traditional knowledge, questions will inevitably arise over recognition, consent, access and the distribution of any commercial benefits. The paper raises the principle of equitable distribution, but it does not itself determine ownership rights, establish a patent or make a finding of bio-piracy.

That distinction is particularly important because the study is fundamentally a documentation exercise.

Its researchers did not simply compile a list of plants. They recorded the names used by different communities, the plant parts employed and the frequency with which particular plants were cited. The list includes vernacular names from Tripuri, Bengali, Jamatia and Noatia usage, reflecting the multiple cultural contexts in which the plants are known.

The research also acknowledges the people whose knowledge made the work possible.

In their acknowledgement, the authors thank traditional practitioners from diverse communities for sharing information on the practical use of medicinal herbs. They also acknowledge the National Medicinal Plants Board, Ministry of AYUSH, the Tripura Forest Department and researchers at Tripura University’s Plant Taxonomy and Biodiversity Laboratory.

The fieldwork itself depended on a chain of participation. Forest rangers, van mitra and local people helped researchers identify practitioners and reach remote and inaccessible areas.

For the researchers, the urgency is not only about preserving the past.

The study notes that traditional bone-setting remains actively practised in many parts of Tripura. It also links the continuing relevance of fracture treatment to the changing circumstances of the state, citing previous research that associated fractures in Agartala with road traffic accidents and rapid urbanisation.

At the same time, the knowledge base appears unevenly distributed across generations.

The survey’s strongest statistical association was between age and ethnobotanical knowledge. Because older practitioners hold greater knowledge than younger respondents, the documentation of what they know becomes a record not only of medicinal plants but of a body of practical knowledge that could otherwise become harder to transmit.

There is another layer to that finding: gender.

Only three of the 32 specialised practitioners surveyed were women. The researchers say female practitioners were fewer than male practitioners in their sample, consistent with findings reported in some earlier studies.

The researchers’ final argument is therefore cautious but consequential. They call for conservation of the plant species and for further phytochemical, pharmacological and clinical assessment of the remedies.

For Tripura’s traditional healers, the significance of that next step may extend beyond whether a particular plant eventually produces a medically useful compound. It may also determine how a body of knowledge, carried through generations by people living close to the forests, is treated when it enters the formal worlds of science, medicine and commerce.

The plants may be rooted in the forests of Tripura. The knowledge of their use is rooted in people.

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