Increasing numbers of Americans are drawn to natural medical therapies such as Chinese herbology and the Ayurvedic medical traditions of the Indian subcontinent. Borrowing from and contributing to both these systems of medicinal plant use is a close relative, jamu, the traditional plant medicines of Indonesia. Woefully unexplored by students of herbal wisdom, jamu offers many plants and methodologies which are worthy of in -depth study and new to the ethnomedical literature. Rich in flora and tradition, the potential contributions Indonesia's "Apotik Hidup" ("Living Apothecary") could make to world medical knowledge and public healthcare are great.

Derived from the leaves, roots, bark, flowers, and stems of higher plants as well as the minerals and fungi of Indonesia's abundant tropical forests,jamu come in the form of nonprescription pills, powders, teas, tonics, topical oils, and creams. About 1,000 indigenous plants, from Acacia to Zingiber, are grown or gathered to make jamu. Remedies usually consist of about three to a dozen ingredients and are used to treat just about every malady imaginable, from urinary tract infections to infertility, to cancer, to depression. Jamu to promote general health and beauty are also very popular. There are herbs to: "stay young," "keep breasts firm," "improve male virility" (sometimes called "He-Man Jamu"), "improve married life," as well as a myriad of herbs to aid a mother before and after she gives birth. It is estimated that 80% of all Indonesians take some form of jamu daily. (A noteworthy consensus for a diverse population -- the world's fourth largest -- of about 191 million peop le spread over 13,667 islands, sharing 500 language groups). Bought in pharmacies, department stores, street stalls, from door to door vendors, grown in backyard garden plots, or foraged in the forest, jamu use spans ethnic and economic barriers.

From Behind the Kraton Wall

The origin and development of jamu is not completely known. The earliest evidence of internal and external use of herbs dates back to the eighth century. In Central Java, on the walls of the Borobudur temple (the largest ancient monument in the Southern hemisphere and the world's largest stupa -- a dome-shaped Buddhist shrine), there is a relief of a kalpataru tree: a mythological tree that lives forever. Beneath the tree, people crush ingredients for the preparation of jamu. Ancient scripts handwritten in Javanese, such as "Serat Primpon Jampi," ("Handbook of Magic Formulas") and "Serat Racikan Boreh Wulang nDalem" ("Handbook for Mixing Medicinal Ingredients") contain recipes recorded for the exclusive use of Javanese royalty. In the earliest surveys of flora of the Indonesian archipelago, botanists noted the curative properties of jamu. The Dutch botanist, Rumphius (Georg Eberhard Rumpf) (1628-1702), the "Pliny of the Indies," covered medicinal uses of plants in his classic wo rk on the Indonesian island of Ambon, Herbarium Amboinense (published in 1741), as did Karel Heyne in his 1927 De Nuttige Planten Van Indonesie, and Issac Henry Burkill in his 1935 Dictionary Of The Economic Products Of The Malay Peninsula.

The popular practice of jamu today, especially beauty products, owes much to the once secret herbal pharmacopoeia of the kingdoms based in Solo and Yogyakarta, Central Java. While villagers employed a simpler form of jamu, the heavily guarded Kraton (Palace) recipes included mare ingredients, some of which came from India and China. Good health and beauty was considered evidence of a leader's divine right to rule. Also, jamu was required for the many wives of the king to maintain their youth, fertility, and their strength during child birth; it was also needed for the king to maintain his virility. Solo, once the seat of the former great Mataram dynasty, is now a center for the marketing and large-scale production of packaged jamu. Some of the major manufacturers claim that their herbals are based on the original Solo court recipes. (How these recipes jumped the Kraton walls to become standard home remedies is still a matter of conjecture.)

At the heart of the Javanese tradition of jamu use is a cultural icon known as jamu gendong (jamu -- herbal remedies, gendong -- meaning to carry on one's back). Jamu gendong is usually carried and sold by young, attractive women who reportedly hail from Solo, Central Java. Their generally youthful appearance and beauty is believed to be evidence of the salubrious benefits of regular jamu use. Instantly recognizable in traditional dress, the jamu vendors peddle door to door, their backs laden with recycled Johnny Walker and other beverage bottles full of ocher and khaki-colored potions swaddled in batik cloth.

The Healing Elixir

Among her tonics, a jamu gendong will normally include at least one general health restorative. Cabe Puyang -- a jamu taken to relieve fatigue and muscle pain -- contains many of the ingredients common to concoctions found in Java. Cabe Puyang usually includes: Java pepper, two types of ginger (Zingiber aromaticum Val. and Zingiber officinale Roscoe), turmeric, greater galangal, cardamom, clove, cinnamon, tamarind, and sugar made from sap of sugar palm flowers (Tilaar, et al; 1991). As a culinary compliment to a tonic that can taste like barn floor spiked with chili peppers, most jamu drinks are followed by a sweet chaser such as orange juice or honey-ginger tea. Jamu devotees who lack the intestinal fortitude to follow up with the chaser may add honey, chocolate syrup, or rice wine to the drink itself.

Simply stated, jamu are applied according to a notion of "balance" similar to the way in which Chinese traditional medicine is said to bring the body's yin and yang back into balance or how Ayurvedic medicine balances the three constitutional types, roughly translated as air, fire, and water (the doshas). There are many influences, external and internal, that determine one's health and general well-being. Emotional stress, climate, diet, etc., can upset personal balance and thus lead to illness. Many of these influences are assigned a "hot" or "cold" property. Emotional upset may be deemed "hot," while infertility is considered a "cold" condition. Almost all foods and plant medicines are assigned a temperature (though these hot-cold classifications can vary from area to area). Acidic fruits, coffee, greasy foods, and chili peppers are often considered "hot." Foods like banana, lettuce, cucumber are "cold." Generally, jamu is used to correct imbalances. A person suffering from pa nas perut ("hot stomach," i.e., heartburn or indigestion) may eat papaya, which is cooling. A woman who is unable to bear children is considered "cold." She may therefore take a potion based on the turmeric root which is believed to be warming when taken internally. Conversely, turmeric is considered cooling when used topically as a poultice to bring down fever or cosmetically to relieve itching or other common skin complaints.

The healing properties of many of the ingredients found in jamu are recognized in other cultures as well. Two very common ingredients of jamu, also found in Chinese and Indian herbology, are turmeric and ginger. Turmeric is found in the greater part of internally and topically applied jamu. Taken internally its action is carminative, dispelling gas from the gastrointestinal tract. A NAPRALERT database search, conducted courtesy of Mary Lou Quinn, University of Illinois at Chicago, identified several recent studies which also confirm antibacterial, antifungal, and antiviral properties of turmeric. The NAPRALERT survey cites research done in countries such as India, Taiwan, and Japan which may reveal possible serendipitous and unclaimed benefits of the turmeric used in jamu. Curcumin, the active principle of turmeric, has been shown in preliminary laboratory (non-human) experiments to have anticarcinogenic and antimutagenic activity, inhibiting free radical reactions much in the s ame way as do nutrient antioxidants, such as vitamins C and E.

Ginger, one of the world's oldest and most popular medicinal spices, runs a close second to turmeric in the preparation of jamu. Both these plants belong to the ginger family, as do many of the herbs found in jamu. (The above recipe for Cabe Puyang, in fact, contains five members of Zingiberaceae: Zingiber aromaticum Val., Zingiber officinale Roscoe, both identified as "ginger" in standard English, Curcuma domestica Val. or "turmeric," Kaempferia galanga L. or"galangal," and Ammomum compactum Soland. ex Maton or "cardamom.") Ginger is a rubefacient, stimulating the flow of blood when applied to a particular area of the body. This accounts for its topical use to ease muscle soreness. Like turmeric, it is a carminative. HerbalGram readers should be familiar with recent evidence that ginger can be used to aid in the prevention of motion sickness and vertigo (see HerbalGram No. 26).

Renewed Western interest in herbal therapies means that many Americans are more familiar with jamu than they realize. Known to most health store patrons and practitioners of traditional herbology are Lidah buaya ("crocodile tongue," also known as Aloe vera) used for skin rashes and hair care; papaya enzymes used to aid the digestive process; Minyak Kayu Putih ("white wood oil," also known as eucalyptus) used for muscle ache and bronchial congestion; clove oil used to ease toothaches, and more.

Given the long history of wade between various Eastern and Middle Eastern nations, and the paucity of specific data on Indonesian plant medicinals, it is often difficult to determine the exact origins of a particular herbal usage and which plant remedies are unique to Indonesia. The current ethnomedical literature yields a few instances of plant medicines primarily common to Indonesia. The bark of Alyxia spp. (or Pulosari in Indonesian) is popularly used to treat coughs, fever, stomach ache, diarrhea and catarrh of the bladder (Departamen Kesehatan Republik Indonesia, 1989). Scientific studies on the efficacy of various species of Alyxia, however, are few and inconclusive. The flowers and leaves of Nicolaia speciosa Horan., used to alleviate body odor, and the twigs of Gymnopetalum leucostictum Miq. (Departamen Kesehatan Republik Indonesia, 1989), used to encourage appetite, also appear to he favored by Indonesian jamu practitioners with rare references to their use in other cul tures. Ascertaining past contributions and divining future possibilities of the Indonesian system of medicinal plant use are dependent upon more intensive investigation of the available literature and additional field studies.

Madison Avenue Meets Grandma's Home Remedies

The marketing of jamu has blossomed into an annual multi-million dollar business. There are over 450 commercial manufacturers, most of which belong to the Jamu Manufacturers Association. Production of jamu cakes for the skin, oil for the hair, topical rubs for sore muscles, and packets (containing about seven grams of fine powder to be mixed with warm water for tonics) is expanding dramatically. According to government statistics, production in 1984 alone increased by 43% (Financial Times, 1985). This may reflect what the industry has dubbed a "back to nature" trend. Export business is booming, with traditional medicines and raw materials being sent to about thirty-three countries throughout Asia, the Middle East, and recently Europe. The largest manufacturers, Nyonya Meneer (named after its founding mother, Mrs. Meneer), Air Mancur ("Fountain" as in a "fountain of life"), Djamu Djago ("Rooster" or "Champion" brand jamu), and Mustika Ratu ("Magic jewel of the Queen/King") are so me of Indonesia's leading companies. Slick packaging, pop idol pitchmen on radio and television, omnipresent billboards and glitzy fast food style jamu bars are more reminiscent of Madison Avenue marketing than grandma's home remedies.

With the boom in commercial sales of herbal remedies over the past two decades, the Indonesian government has sought to regulate the jamu industry. In 1975, the Traditional Medicine Administration was established under the Ministry of Health. Commercial manufacturers are now required to file with the government a list of all the ingredients in each of its products (this goal is still hindered by commercial producers' desire to retain their secret recipes). The Traditional Medicine Administration makes sure that there are no potentially dangerous ingredients in the jamu. Inspectors test random samples for unwanted bacteria or mold (sometimes found in jamu because of the high level of humidity in Indonesia). For example, laboratory tests have turned up spores of the mold Aspergillus flavus in random samplings of commercial jamu. The spores are generally found in many stored agricultural crops (such as peanuts) and are themselves harmless. However, if the spores germinate, aflato xins -- powerful liver carcinogens -- are produced (Eiseman, 1981). Quality control laboratories equipped with fully modem pharmaceutical instruments are found in all jamu factories. As in the West, laboratory mice and rabbits are usually the first to sample new formulas Research and development departments search for new remedies, such as for baldness. Traditional potions are constantly being refined for better taste, absorption, etc. Standardization of products is a constant challenge, as plant potency varies greatly according to soil, climate, and season.

In addition to overseeing large scale sales of jamu, the Traditional Medicine Administration oversees home industry. The government recognizes that in a low income and primarily rural country such as Indonesia where 80% of the population live outside cities, access to modem pharmaceuticals is not always easy. Jamu is often the first line of defense against illness. In the capital city of Jakarta, the Administration, working in conjunction with the private Jamu Manufacturers' Association, holds one-day seminars for jamu gendong peddlers to teach hygienic preparation of herbal remedies. The door to door vendors are compensated one day's income, about 5,000 rupiah or $2.50 (twice the daily income of a factory worker or domestic servant) for their attendance. Herbal medicine formularies are made available to the public; public health cadres are dispatched to work with village healers; and neighborhood medicinal gardens axe sponsored by the government.

Forest Jamu and the Search for New Medicines

Though Central Javanese jamu dominates the commercial market and perhaps the cultural imagination of the Indonesian public, almost every village throughout Indonesia has its own variety of "jamu."

While the jamu industry is a well organized machine primed to make major contributions to the world phytotherapeutic market, it is the noncommercial plant remedies, a far larger and lesser documented herbal pharmacopeia, which may hold more surprises for medical science.

There is now a small, but growing, body of ethnomedical literature on the folk uses of plants of the Indonesian archipelago beyond Java. In 1989 a team of botanists and ethnobotanists, under the guidance of indigenous healers, conducted field work in Seberida, Sumatra. Supported by the World Wildlife Fund and partly by the National Cancer Institute, the scientists collected plants to be screened for potential anticancer and anti-HIV properties. Their research revealed several plant species with no previous record of medicinal use, such as Asystasia nemorum Nees, Ervatamia sphaerocarpa (B1.) Berk, and Homalomena pendula (B1.) Bakh f. In their report, "Medicinal Plants of Seberida (Riau Province, Sumatra, Indonesia)," the authors concluded that further investigation of the rich pharmacopeia of the Seberida people may lead modem medicine to new thug entities. The World Wildlife Fund has also sponsored research on the medicinal plants of Siberut island (Ave, et al. 1990), and of Eas t Kalimantan (Leaman, et al. 1991).

Conservation of Medicinal Plant Species

It will come as no surprise to informed readers that this vast reservoir of novel uses of plants and their compounds is threatened by deforestation. Indonesia has one of the richest flora on earth. Nearly 10% of the world's forest and nearly 40% of all the forest in Asia is contained in Indonesia. This immense potential source of new medicines and jamu is being eliminated by the extensive logging of Indonesia's tropical forests. According to Indonesian Ministry of Forestry estimates, deforestation in Indonesia is occurring at the rate of about 11,550 square kilometers a year (Myers, 1989).

Possible relief for Indonesia's dwindling forests may come from the development of economic and ecological alternatives to logging, such as planned and controlled harvest of wild medicinals. Management of non-timber resources in a sustainable way may save forests from further destruction, as well as provide a sustainable source of income for local people. As Steven King reported in HerbalGram No. 27, there has been a swell in research and development of nontimber or nonwood forest products by the Food and Agriculture Organization of the United Nations and numerous independent organizations working throughout the world's tropical regions. A 1991 report, "Forest to Market," produced by Project Borneo, a group of MBA candidates at Harvard Business School, provides one example of work being done in this area. "Forest to Market" presents a practical assessment of the difficulties and opportunities involved in the development of sources and markets for the medicinal plants and prepack aged jamu products of Borneo (the island that includes, Kalimantan, the Indonesian portion, East Malaysia -- Sabah and Sarawak -- and Brunei). The report also considers natural cosmetics, honey, mushrooms, and other nontimber forest products.

On Java, medicinal plant collection for commercial jamu does not provide a good model for success for the rest of Indonesia. The traditional medicinal industry, barely cognizant of the need to protect botanical sources, moves towards sustainable cultivation at a snail's pace. In the glossy literature of one major manufacturer, the source of the raw materials of jamu is refered to as "inexhaustible." Scientists at Indonesian universities and herbaria, in cataloging threatened plant species, have discovered otherwise. Many plants of medicinal value, such as Alyxia reinwardtii B1. (sometimes used in the tonic, Cabe Puyang, mentioned above), Cassia tora L. (used as eye tonic, purgative, laxative), and Stelechocarpus burahol Hook.f. & Th. (used as fragrance, diuretic) are being rapidly depleted (Sangat-Roemantyo, 1987). As businesses scramble to meet consumer demand and forest dwellers take advantage of the easy and immediate source of income provided by plant collection, a free-for- all in "Java's forests is taking place. Cultivation of medicinal plants in a way that will genuinely benefit local people is hampered by the lack of guaranteed markets and price stability for jamu farmers and traders.

Embryonic efforts are now under way to develop sound environmental and economic alternatives to the current system of medicinal plant exploitation.

Research institutions, large and small scale vendors of jamu, government, and farmers are starting to communicate on issues of mutual concern. The National Working Group on Traditional Medicines (P.O.K.J.A.), a consortium of government and private sector interests, plans to conduct field research and community economic development in forested regions of Java and Kalimantan; launch a national campaign to heighten consumer "green" awareness; improve marketing systems; and generate supportive national policies (Fricke, 1991).

World utilization of plants and plant knowledge is at a critical juncture as both face the threat of extinction. Experts now recognize the value of traditional systems of plant use -- when carried out in a sustainable way -- to the environment, to local peoples who still depend on plant cures for the majority of their primary and routine health care, and to the global market in phytotherapeutic and pharmacological products. While European, Japanese, and, increasingly, United States researchers and corporations race to investigate and invest in the natural therapies and medicinal folk wisdom of China, India, and tropical America, understanding of jamu -- the traditional remedies of Indonesia -- remains incomplete. Clearly the traditional plant medicinals of Indonesia offer fertile ground for ethnopharmocological and ethnobotanical study.

References

Anonymous. Financial Times. (1985) "Indonesians Put Their Trust in Folk Potions." September 6, 1985, pp 2.

Ave, Wanda and Satyawan Sunito. (1990) "Medicinal Plants of Siberut" a report for Worldwide Fund for Nature, Indonesia Program.

Departemen Kesehatan Republik Indonesia. (1989) Pemanfaatan Tanaman Obat. Third edition, Jakarta, Indonesia.

Dixon, Anthony; Hannah Roditi, and Lee Silverman. (1991) From Forest to Market: A Feasibility Study of the Development of Selected Non-Timber Forest Products from Borneo for the U.S. Market. Vols. I & II. Cambridge, MA: Project Borneo.

Eiseman, Fred B. (1981) "Indonesia's Billion-Dollar Herbal Tonic." Asia. Nov.-Dec. Asia Society, Inc.

Fricke, Thomas B., International Environmental Consultant, Personal Communication.

Leaman, Danna J., Razali Yusuf, and Harini Sangat-Roemantyo. (1991) "Kenyah Dayak Forest Medicines: Prospects for Development and Implications for Conservation," a report for Worldwide Fund for Nature, Indonesia Program.

Mahyar, Uway W., John S. Burley, C. Gyllenhaal, and Djaja D Soejarto. (1991) "Medicinal Plants of Seberida (Riau Province, Sumatra, Indonesia)." Journal of Ethnopharmacology, 31, pp. 217-237, Ireland: Elsevier Scientific Publishers, Ireland, Ltd.

Myers, Norman. (1989) "Deforestation Rates in Tropical Forests and their Climatic Implications," a report for Friends of the Earth.

Sangat-Roemantyo, Harini. (1987) "Some Ethnobotanical Aspects and Conservation Strategy of Several Medicinal Plants." BIOTROP Special Publication No. 30. Bogor, Indonesia.

Tilaar, Marta, Harini Sangat-Roemantyo, and Soedarsono Riswan. (1991) "Tumeric, the Queen of Jamu." Paper presented at the Regional Conference on Medicinal Products from the Tropical Rain Forest, Kuala Lumpur, Malaysia.

Article copyright American Botanical Council.

~~~~~~~~

By Lisa X. Gollin