The cultural-bound disease "empacho" in Argentina. A comprehensive botanico-historical and ethnopharmacological review.

ETHNOPHARMACOLOGICAL RELEVANCE: Empacho is one of the most recognized cultural-bound syndromes in Argentina. It is a digestive disorder with many causes, being excessive food intake the most frequent. It is easily diagnosed in household medicine and there are different treatments applied for releasing the obstruction of the gastrointestinal tract. Therapeutics includes the use of medicinal plants and abdominal maneuvers, as well as rituals of magical and/or religious nature. The aim of this work is to analyze the compiled literature, considering documents from the XVIIIth century up to present, related to the employed plant species for the treatment of empacho. MATERIAL AND METHODS: The bibliographic and journal collections of several Argentinean and foreign libraries and bookstores were consulted, in addition to the comprehensive review of the specific information found online. RESULTS: Ninety (90) primary sources, spanning three hundred years (from 1710 to 2010) were found; most of them included ethnobotanical studies besides others of medical botany, pharmacobotanical and anthropological origin. A total of 152 plant species used to treat empacho were found in 360 total quotations, being Dysphania ambrosioides (L.) Mosyakin and Clemants; Alternanthera pungens Kunth; Ruta chalepensis L.; Clinopodium gilliesii (Benth.) Kuntze; Aloysia polystachya (Griseb.) Moldenke; Lippia turbinata Griseb., and Pluchea sagittalis (Lam.) Cabrera, the most frequently mentioned. The main therapeutic properties of the medicinal plants cited against empacho are stomachic, purgative, antispasmodic, bitter-tonic, carminative, and cholagogue-choleretic. CONCLUSIONS: The variety of regions - spanning most of the country - from which the information comes, as well as the great variety of therapeutic strategies used, diversity of plant species and knowledge related to the treatment of empacho, is directly associated with the great significance that this disorder has within the system of medical-nosologic representations of the Argentinean popular medicine.

[Giant hydatid of the left lung]. / Idatide gigante del polmone sinistro.

A case of giant hydatid cyst of the left lung submitted to conservative surgery is reported. The postoperative period was complicated by the appearance of a bronchopleural fistula and a residual cavity. The complication was treated with targeted double lumen drainage which enabled pleuroclysis with saline solution and betadine. The closure of the fistula, the elision of the cavity and recovery were accomplished after 95 days. These results demonstrate that conservative surgery is possible even in the presence of giant lung hydatid cyst. Major resections constitute an extreme measure.