History of Salvia divinorum       Review of Literature        Mazatec healing   Virgin Mary Association     Divination    Prayer used for Protection and Holy Mother Mary     



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Salvia divinorum - Diviner's Sage
- Labiatae - Oaxaca, Mexico
 
salvia_divinorum.jpg
 

Ethnopharmacology of Ska María Pastora
by Leander J. Valdés III, José Luis Díaz* and Ara G. Paul


Summary

Salvia divinorum
is a perennial labiate used for curing and divination by the Mazatec Indians of Oaxaca, Mexico. The psychotropic effects the plant produces are compared to those of the other hallucinogens employed by the Mazatecs, the morning glory, Rivea corymbosa L., Hallier F. and the psilocybin-containing mushrooms. A discussion of the role of ska María Pastora in the "native pharmacopoeia" is based on previous reports and fieldwork by the authors with a Mazatec shaman. S. divinorum is the first of three plants to be employed in shamanic training for spiritual and healing uses and sacred to and named for the holy Mother Mary.

Introduction

Salvia divinorum (Epling and Játiva-M.) is a perennial herb in the Labiatae (mint family) native to certain areas in the Sierra Mazateca of Oaxaca, Mexico (Fig. 1). It is one of about 500 species of Salvia in the New World subgenus Calosphace (Epling and Játiva-M.. 1962). The plant grows in large clones to well over 1 m in height and its large green leaves, hollow square stems and white flowers with purple calyces are characteristic taxonomic features. This sage has been found only in forest ravines and other moist humid areas of the Sierra Mazateca between 750 m and 1500 m altitude (Díaz, 1975a). Carl Epling, who first described S. divinorum, reported the flower as having a blue corolla, and it has been illustrated this way in the literature (Epling and Játiva-M, 1962; Schultes, 1976). However, this description has been shown to be an error, as all living specimens of the plant have had blossoms with white corollas and purple calyces (Díaz, 1975a; Emboden, 1979).

S. divinorum
is one of several vision-inducing plants employed by the Mazatec Indians, one of the native peoples living in the mountains and upland valleys of northeastern Oaxaca. Unlike other Mexican tribes, there is little information concerning their existence before the arrival of the conquering Spanish, who reduced the Mazatecan population through exploitation and disease (Weitlaner and Hoppe, 1964). The 1970 census estimated their number at 92,540 (Córtes, 1979) and the language, of the Mazatec-Popoloca family, is one of the many non-Spanish dialects spoken throughout Mexico (Weitlaner and Hoppe, 1964). The Mazatecan ritual use of hallucinogens, such as mushroom containing psilocybin and morning glory seeds containing lysergic acid amide, has been widely publicized through the investigations of R. Gordon Wasson and Albert Hofmann, among others (Wasson and Wasson, 1957; Wasson, 1963; Hoffman, 1964; Hoffman, 1980).

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Review of literature

Although the use of the mushrooms and morning glories was documented by the Spanish conquistadores and chroniclers who arrived in Mexico during the Sixteenth Century (Wasson, 1963), the literature on S. divinorum is relatively recent. Wasson originally proposed that this Salvia was the plant known to the Spanish by the Nahuatl (Aztec) name of pipiltzintzintli, but new investigations suggest that the Mexican name probably refers to Cannabis sativa L. (Díaz, 1979).

There are a number of common names for S. divinorum and nearly all are related to the plant's association with the Virgin Mary. It is known to the Mazatecs as ska María or ska Pastora and the sage is also known by a number of Spanish names including hojas de María, hojas de la Pastora, hierba (yerba) María or la María. The Mazatecs believe this Salvia to be an incarnation of the Virgin Mary, and care is taken to avoid trampling on or damaging it when picking the leaves, which are used both for curing and in divination (Fig. 2).

Attempts at the identification of ska María Pastora were carried out in conjunction with anthropological expeditions led by one of Mexico's leading anthropologists, the former Austrian engineer, Roberto G. Weitlaner, who rediscovered native use of hallucinogenic mushrooms among the Mazatecs in 1936 (Wasson, 1963). On a field trip in 1938, Weitlaner's future son-in-law, the American anthropologist, Jean B. Johnson learned that the Mazatecs employed a "tea" made from the beaten leaves of a "hierba Maria" for divination. The preparation was used in a manner similar to the "narcotic" mushrooms and the semillas de la Virgen, which were later identified as morning glory seeds (Johnson, 1939). Blas P. Reko, who knew Weitlaner well, referred to a "magic plant" employed by the Cuicatec and Mazatec Indians to produce visions. It was known as the hoja de adivinación (leaf of prophecy) and although Reko could not identify the plant, it was probably S. divinorum (Reko, 1945).

In 1952 Weitlaner reported the use of a yerba (hierba) de María by the Mazatecs in Jalapa de Díaz, a small Oaxacan village. According to his informant the leaves of this plant were gathered by curanderos (shamans or healers), who went up into the mountains and harvested them after a session of kneeling and prayer. For use in "curing" the foliage was rubbed between the hands and an infusion of from 50 to 100 leaves was prepared, the higher dose being used for alcohol "addicts". Around midnight the curandero, the patient and another person went to a dark quiet place (perhaps a house) where the patient ingested the potion. After about 15 min the effects became noticeable. The subject would go into a semi-delirious trance and from his speech the curandero made a diagnosis and then ended the session by bathing the patient in a portion of the infusion that had been set aside. The bath supposedly ended the intoxicated state. In addition to such "curing", the yerba María also served for divination of robbery or loss (Weitlaner, 1952).

Five years later the Mexican botanist, A. Gómez Pompa, collected specimens of a Salvia known as "xka (sic) Pastora". He noted that the plant was used as an hallucinogen (alucinante) and a dose was prepared from 8 to 12 pairs of leaves. Since flowering material was not available, the sage could not be identified past the generic level (Gómez Pompa, 1957). The holotype specimen of S. divinorum was acquired by Wasson and Hofmann in 1962 while they were traveling with Weitlaner. Flowering plants were brought to them in the village of San José Tenango, as they were not permitted to visit the locality in which ska María Pastora grew. This collection was sent to Epling and Játiva-M. who described it as a new species of Salvia, S. divinorum (Wasson, 1962; Epling and Játiva-M., 1962).

Wasson was the first to personally describe the effects of ska Pastora, relating the experiences he and member of his party had on ingestion of different doses of a beverage prepared from the plant's foliage. At a session in July 1961 in which he participated, a curandera (female shamans are very common among the Mazatecs and other Mexican peoples) squeezed the juice of 34 pairs of leaves by hand into a glass and added water. Wasson drank the dark fluid and wrote that although the effects came on much faster than those of the mushrooms, they lasted a much shorter time. He saw only "dancing colors in elaborate, three-dimensional designs" (Wasson, 1962). Summing up the experience, he later stated (pers. comm):

 

A number of us (including me) had tried the infusion of the leaves and we thought we experienced something, though much weaker than the Psilocybe species of mushroom.

Hofmann and his wife, Anita, who accompanied Wasson on an expedition the following year, took an infusion prepared from five and three pairs of S. divinorum leaves, respectively. Mrs. Hofmann "saw striking, brightly bordered images" while Hofmann found himself "in a state of mental sensitivity and intense experience, which, however, was not accompanied by hallucinations" (Hofmann, 1980).

María Sabina, the Mazatec shaman made famous by Wasson, and who lives in the Mazatec highland town of Huautla, in Oaxaca, briefly mentioned her use of the plant in her autobiography (Estrada, 1977):

If I have a sick person during the season when the mushrooms are not available, I resort to the hojas de la Pastora. Crushed (molido) and taken, they work like the "children" (i.e., the mushrooms). Of course, the Pastora doesn't have as much strength.

Roquet and Ganc reported that the Mazatecs prepared a dose of S. divinorum from 120 pairs of crushed leaves and used the plant only when the mushrooms and morning-glory seeds were not available. Roquet and his associates used the plant twice in their psychiatric investigations of Mexican hallucinogenic plants and stated that they had difficulties in working with it (Roquet, 1972).

José Luis Díaz and his coworkers studied the use of ska María Pastora in the Mazatec highlands during the 1970's. Díaz himself took the Salvia infusion under the supervision of a shaman, Doña J., on six different occasions, noting an increased awareness of the plant's effects each time. The first changes he perceived were a series of complex and slowly changing visual patterns that occurred only in complete quiet with closed eyes. There were no colored geometric patterns which characteristically occur with ingestion of other hallucinogens nor were there auditory images. After a short time he noticed peripheral phenomena, such as a feeling of lightness in the extremities and odd sensations in the joints. The climax of effects, accompanied by dizziness or nausea (mareo), lasted about 10 min and disappeared about 0.5 h after ingestion of the infusion. Other, more subtle, effects seemed to persist for a few hours (Díaz, 1975a).

Hofmann (Hofmann, 1964) and Díaz (Díaz, 1975a) each investigated S. divinorum chemically without isolating and identifying any active principle. As noted above, the descriptions in the literature emphasize the mildness of the plant's effects. There are many ways to achieve visions other than by ingestion of classically defined "hallucinogens" such as mescaline, LSD and psilocybin. Among these are meditation, prayer, mental illness, disease (especially when accompanied by fever), poisoning, experiences of dying, and suggestion (placebo effect). Therefore, prior to conduction chemical and animal studies, we decided to attempt to clarify the role of S. divinorum as a vision inducer among the Mazatec Indians.

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Mazatec healing

The following report is based on fieldwork with a Mazatec curandero, or healer, living near the Alemán Reservoir in the Mexican state of Oaxaca, about 100 km from the port of Veracruz. Although a study based on information from a single source is open to criticism, the jealous and secretive nature of native shamans works against statistical methods of survey. Visiting many shamans in a single are can actually lessen the amount of information gathered, as each curandero may fear the visitor is telling their secrets and giving their "power" to a rival. To them magic can hurt or kill. Wasson and Richard E. Schultes have both commented on the difficulty of making contacts with the curanderos of this region (Wasson and Wasson, 1957; Schultes, 1941).

Don Alejandro, the informant, spoke only a Mazatecan dialect. One of his sons served as an interpreter, translating from the native tongue to Spanish. The information they provided the authors was gathered in fragments over many visits during the summer of 1979 and spring of 1980.

Mazatec healing and religion are united in a manner common to traditional cultures. This is somewhat foreign to western scientific medicine which is isolated from religion except for the times when it no longer serves to cure. A brief description of Mazatec healing, based mainly on the work with Don Alejandro should help to explain the use of ska María Pastora and its relationships to other healing plants. The Mazatecs (the name, taken from the city of Mazatlan was actually imposed on the natives by the Spanish) are nominally Catholic Christians, but they have incorporated many features of their traditional beliefs into their conceptions of God and the Saints, whom they consider to have been the first healers. The most prominent among them is San Pedro, or Saint Peter, who is said to have cured a sick and crying infant Jesus through the ritual use of tobacco (Nicotiana spp.). Tobacco is considered to be a health problem in the United States and many other countries, and its acute pharmacological effects are due to the alkaloid nicotine (Larsen et al, 1961). Yet for the Mazatecs, as well as for almost all Mesoamerican Indians, it is the most important curing tool in the "pharmacopeia". The fresh tobacco leaf is dried, ground and mixed with line to form a powder known to the Mazatecs as San Pedro (Saint Peter); the "best" is prepared on the Saint's day, June 29th (Incháustegui, 1977). The preparation is more familiarly known by its Nahuatl name picietl (piciete). It is worn in charms and amulets as a protection against various "diseases" and witchcraft, but its most important use is in limpias, or ritual cleansings. It may be used alone with a prayer and copal (an incense prepared from the resin of Bursera spp.) (Díaz, 1975b), or in conjunction with such herbs as basil (Ocimum spp.) or marijuana (Cannabis sativa)*, eggs, or various other substances. Anyone who comes to Don Alejandro to be treated usually gets a limpia. This ritual cleansing may be the cure itself, or it may be accompanied by other "medicines". The patient is given a pinch of the San Pedro powder (wrapped in paper) to carry with them and use during the healing period.
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*Don Alejandro does not use marijuana, as it is illegal.

One learns to become a shaman through an informal apprenticeship, although the Mazatecs will insist they are taught by a progression of visions from and of heaven, rather than by people. Psychotropic plants are intimately associated with this training, which can last up to two years or longer. In this area of Oaxaca, as well as the highland region visited by Díaz, the vision inducers are taken systematically at intervals of a week to a month. Once one becomes a healer the hallucinogenic plants are ingested much less frequently. The process begins by taking successively increasing doses of S. divinorum for a number of times to become acquainted with the "way to heaven". Next comes mastery of the morning glory (Rivea corymbosa (L.), Hallier, f.) seeds and finally one learns to use the sacred mushrooms. There is a rigid dieta, or diet, to follow during this time. "Hot" foods such as garlic and chili peppers are restricted and there must be abstinence from sex and alcohol for extended periods. However, many Mazatec shamans incorporate alcohol into their training and drink during their ceremonies (Wasson and Wasson, 1957). Breaking from this dieta, or ritual diet, could make one crazy according to Don Alejandro and since such obligations require maturity, one should be at least 30 years old before becoming a curandero.

Remedial uses of S. divinorum

From the shaman the investigators learned that the plant could be used as a "medicine" as well as for the induction of visions. A low dose serves as what the investigators interpreted to be a "tonic " or "panacea" as well as for "magical" healing (Don Alejandro did not use such terms). An infusion prepared from 4 or 5 pairs of fresh or dry leaves may be taken by the glass (vaso) or tablespoonful (cucharada) as needed. It is used to cure the following "illnesses", although there may be other possible uses:

  1. It helps one defecate and urinate. It stops diarrhea (the plant apparently is believed to regulate eliminatory functions).
     
  2. It is given to the sick, old or dying to revive them oralleviate their illness. People who are pale, white and almost ready to die (they have "anemia") may recuperate on taking la María.
     
  3. It may be taken to relieve headaches and rheumatism (however, when taken in the high doses that induce visions, it often leaves one with a headache the following morning, according to the curandero).
     
  4. There is a semi-magical disease known as panzon de barrego (sic), or a swollen belly, which is supposedly caused by a curse from a brujo, or evil sorcerer. The victim's midsection swell up due to a "stone" that has been put inside them. Taking the Salvia causes elimination of this "stone" and the belly shrinks down to size. The researchers met an old shaman who showed them his wrinkled middle and said he had cured himself of the "disease" by the use of "la María". Don Alejandro confirmed the "illness" and the "cure".
     
  5. Other documented and undocumented uses have included: Depression, Sleep Anxiety, PMS and Menopause, Alzheimer's and improvement of concentration, and drug Rehabilitation.  More studies are need to define the medicinal applications of this herb. (*Addition 2008)

Divination with S. divinorum

S. divinorum may be prepared as an infusion from 20 (about 50 g) to 80 (about 200 g) or more pairs of fresh leaves to induce visions and may be taken by the curandero, the patient (or apprentice) or both, depending on the situation. Only fresh foliage will serve for divination. At this dosage level, the Salvia is used to foretell the future, find the causes and cures of illnesses and obtain answers to questions about friends, enemies and relatives. In shamanic training, the future healer takes la María to learn the ways of healing and the identification and use of medicinal plants (there is supposedly a tree in Heaven with all such herbs in it and one talks to God and the Saints about them under the influence of the hallucinogens). After preliminary sessions in the company of the master, who takes the infusion along with the apprentice to watch him on the journey, the future healer may continue to study on his own until it is time for the next plant in the series. Don Alejandro told the investigators that the Salvia, the morning glory seeds and the mushroom each told their own historia (story or history) and ska María was the best teacher of the ways of curing, as one learned the most from it. During the course of the visits, the researchers were able to participate in two sessions under the shaman's guidance. As the hallucinogens are never taken without a valid purpose and since the researchers were from "the University", the ceremonies were oriented to teach them about healing and especially the uses of the María and other medicinal plants. Don Alejandro said they would have to follow the dieta, or ritual diet for 16 days, although they could bathe and drink beer (after the first time, the dieta for S. divinorum is only 4 days in length).

The preparations for the two ceremonies were essentially the same. As Dark came (about 19:30 to 20:00 h) the curandero began making the Salvia infusion. The leaves were first counted out in pairs to arrive at each person's dose and put neatly into piles with their petioles aligned. Then Don Alejandro picked up part of a pile and crushed it by hand into a small bowl partially filled with water (Fig. 3). As more foliage was squeezed and added, the liquid turned dark green from the chlorophylls. After the potion was prepared, it was poured through a sieve into a glass which was topped off with water (Fig. 4). During the preparations for the second session a head of foam formed on the glasses and the curandero laughed. He explained through his son that the foam (espuma) was an indication of strength and the María would be very potent that evening. The glasses were covered with inverted cups to "prevent the escape of the humor (que no salga el humor)". Although the foliage of S. divinorum could reportedly be kept fresh for a week or longer when wrapped in the large leaves of Xanthosoma robustum Schoff, the prepared infusion was said to be stable for a day. The spent leaves were set aside to be discarded in an out of the way location where they wouldn't be defiled by people or animals. However, Don Alejandro said they could still be used by putting them on a subject's head to refresh them after the session. The curandero picked up a glass of the María and began an oration.

The Holy Trinity, Saint Peter, the Virgin Mary and other Saints were called on to watch over the participants and teach the visitors the ways of curing:

 

In nomine Spiritu Santo (this "Latin" phrase was always
translated into the vernacular as:
In the name of the Father, the Son and the Holy Ghost) Most
Holy Lord Saint Peter
In the name of Leandros (the subject)

In nomine Spiritu Santo
María
, show Leandros,
that he may see what there is in the world
For he wishes to study all the classes of medicines
Lord Jesus Christ, show him
May he learn
May he see all the classes of medicinal plants
You, who know all, show him
I want you to show him all the different kinds
of illnesses and remedies that exist in the world
In a short time he must learn your story

In nomine Spiritu Santo
Most Holy sainted Rosary
Set him free, that he may see it
Show him as you have shown me
May he recognize all that is the Universe
All that is your History
He wishes to learn out of love and sincerity
I want you to show him, as I am asking your favor
You, María and Lord Jesus Christ, amen
If there is bad or good, save him
Help him out of sincerity or love

In nomine Spiritu Santo

Most Holy Lord Saint Peter
You, too, María, show him
Set him free that he may see it
Do not be deceptive
This day, on this very date
he is going to take it (the Salvia infusion)

In nomine Spiritu Santo
Most Holy Lord Saint Peter
Help this Leandros
May he grow more
May he learn things
Show him all that there is in the world
All that is good
All that is medicinal

In nomine Spiritu Santo
Most Holy Lord Saint Peter
Lord Saint Anthony, Lord Saint Peter, Jesus Christ
You are the only three who know about la María
You must show him all that is medicinal
All that is the Universe
All that is your History
Show him, do not be bad

In nomine Spiritu Santo
Holy Sanctuary, Lord Santa Ana
You who are good, You must help him
so that he becomes acquainted with our Universe
You must teach him what I ask
so that it will be to the Lord Saint Peter's pleasure
Let Leandros take it (la María)
In nomine Spiritu Santo
Most Holy Lord Saint Peter
 

Two to four hours passed in conversation and telling of stories. The shaman repeatedly emphasized that it was important to describe one's visions, "If you are going to learn or if you are going to understand what it is all about, you must speak." Finally it was time for ingestion of the infusions (between 21:00 and 23:00 h). Following Mazatec custom, at least one person didn't participate, in order to watch over the rest (Wasson et al., 1974). As a last protection against any dangers during the visionary "travels", Don Alejandro performed limpias, or ritual cleansings on the visitors (Fig. 5),

 

In nomine Spiritu Santo
Most Holy Lord Saint Peter
This is a limpia for Leandros (subject)
Arise, listen, as it is now the time

In nomine Spiritu Santo
Most Holy Lord Saint Peter
I ask Your favor for Leandros
Heal him, care for him
For I am going to cleanse him now
Help him at this moment that he may be cleansed
Strike out the bad illnesses that he may have
Lord (Saint Peter) attend him
That he may see the Universe
What there is in the world
Everything
Help him, raise him
May he see what there is
All that he wishes to know
Save him, care for him

In nomine Spiritu Santo
Most Holy Lord Saint Peter
Reclaim this man
That he live well, live better
For this man is known by all the children of God
Heal him, as you will
Heed his messages the moment you heal him
Take care of him, help him
That is what I am saying

In nomine Spiritu Santo
Most Holy Lord Saint Peter
Lord Jesus Christ
You know how to save him, how to cleanse him
Cure him, no matter what badness has fallen on him
Heal him, care for him
I want You to heal him and save him from all bad things
Being in my hands, I can help him,
having faith and will.

In nomine Spiritu Santo
Most Holy Lord Saint Peter
Sainted trinity, care for him
Help him, let no evil befall him
 

As the oration was being recited, Don Alejandro anointed the subject with a piece of copal dipped in the San Pedro. The Curandero then gave him a pinch of the San Pedro to carry for protection if he felt danger during or after the session. After a final benediction (Fig. 6), the potions were drunk and the light was turned out.

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Use in Divination
During the two sessions with S. divinorum, the investigators noted the following:

  1. Various sensations were reported by the subjects while lying or sitting down in quiet darkness. These included flying or floating and traveling through "space," twisting and spinning, heaviness and lightness of the body and "soreness."
     
  2. Physical effects also accompanied the experience. There was an intoxication that produced dizziness and a lack of coordination on trying to move about. The recording of the second session revealed slurred speech and awkward sentence patterns. Díaz had a decrease in heart rate accompanied by a chill. Both subjects had a normal pupillary response to a light shined into their eyes.
     
  3. Even though the subjects were aware of the sensations and the physical incoordination produced by the Salvia infusion, they claimed there minds seemed to be in a state of acute awareness. The experience was not like intoxication from alcoholic beverages.
     
  4. Previous reports of S. divinorum ingestion emphasized the mildness of the effects, and the shortness of their duration. It has been shown, however, that under the appropriate conditions of quiet and darkness it was possible to experience effects which lasted for hours. The visions produced were readily terminated by light or noise.
     
  5. There is apparently an aspect of the Salvia intoxication that leaves the subject's mind in a receptive state. This was well documented in the second session when both subjects spoke out fairly continuously. Díaz began by describing plants and flowers. After he finished speaking Valdés began with a similar vision. When Díaz lamented his inability to see the religious figures as described by the curandero, he apparently triggered off Valdés, who saw such imagery for the rest of the session and during the ride in the car. As Valdés described a castle, Díaz began to see one also.

Don Alejandro's son translated the shaman's explanation of how S. divinorum worked in humans,

What happens to the i-nyi-ma-no (the soul, the heart, or life, all three concepts are contained in a single Mazatec word) when one drinks the María is that the María has so much liquor (licor) that one is left as in a faint. For this reason a person becomes intoxicated (borracho) when they have been entered by the María, the oration my father prays and the words of Christ, also. But it really isn't liquor, I tell you, you go into a "delicate" state (delicado vayas). Do not worry, do not be afraid of what is happening to the i-nyi-ma-no; something does happen, but it is small and unimportant. At times one who takes the María becomes half-drunk, but with the result that what they are taking will be engraved on their mind.

Among Mazatec healers who use the three divinatory plants (the mushrooms, the morning glory seeds and the Salvia), S. divinorum is the first to be employed in shamanic training. Leary and Alpert have been credited with being the first to discover the importance of what they called set("a person's expectation of what a drug will do to him") and setting ("the environment, both physical and social, in which a drug is taken") to an individual's experiences under the influences of an hallucinogen (Weil, 1972). In traditional cultures, like that of the Mazatecs, the purpose of plants like ska María Pastora is to induce visions, and shamans, such as Don Alejandro, are masters at the manipulation of set and setting to such ends. Although reportedly only weakly psychotropic, the Salvia infusion will induce powerful visions under the appropriate conditions. Two ritual orations, which heighten the mystery of what is to follow, are performed on the subject or apprentice, who then takes la María with the curandero himself. As the shaman reveals his visions in the silent darkness, the subject (whose mind has been into a receptive state by the María and the ceremonial settings) is able to "see" it also. By having a sober person monitor the session any difficulties that arise will be observed, and if the experience becomes too terrifying, it can readily be terminated by a few words or producing a light. Mastering S. divinorum and learning to use the morning glory seeds before employing the mushrooms probably makes an apprenticeship much less traumatic than it would be by use of the fungi alone, in addition to giving the future shaman wider insights into the varieties of hallucinogenic experiences.

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References

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ORIGINAL ARTICLE: College of Pharmacy, The University of Michigan, Ann Arbor, MI 48109 (U.S.A.) and *Departamento de Neurobiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de Mexico, Apartado Postal 70228, Ciudad Universitaria 20, D.F. (México).

(Accepted July 10, 1982) [J. Ethnopharmacology, 7 (1983) 287-312]

*Addition 2008, more information has become available through scientific and cultural studies and possible uses of herb in medicine and holistic healing.  Further research is necessary and needed.

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