Ancient respiratory healing traditions in Nepal

Ethnobotanical practices, herbal pharmacology, and their relevance for global respiratory health

Abstract

Respiratory diseases remain a major global health burden, disproportionately affecting low- and middle-income countries. Nepal, home to more than 1,700 medicinal plant species, possesses a deep reservoir of ethnobotanical knowledge used for treating cough, asthma, bronchitis, pneumonia, sinusitis, and other respiratory disorders. Across Ayurvedic, Tibetan (Amchi), and diverse Indigenous healing traditions, respiratory care relies on a pharmacopeia of herbs including Terminalia chebula, Terminalia bellirica, Phyllanthus emblica, Acorus calamus, Ocimum basilicum, Mentha arvensis, Glycyrrhiza glabra, and Swertia chirayita. Evidence from contemporary studies confirms the strong anti-inflammatory, antimicrobial, antioxidant, bronchodilatory, and immunomodulatory activities of these medicinal plants. These properties have been documented across Nepal’s rural districts, including Kaski, Kavrepalanchok, Bardiya, and the Terai Plains. For example, Terminalia bellirica is widely used for cough and cold, and Acorus calamus for respiratory congestion. Several herbs traditionally used for respiratory infections also featured prominently during Nepal’s COVID-19 response, including Tulsi, Aloe vera, Cinnamomum zeylanicum, and Mentha species. For Nepal’s global diaspora now widespread in the United States, Europe, the Middle East, and Australia, traditional respiratory remedies remain a culturally meaningful and cost-effective adjunct to biomedical care, supporting intergenerational knowledge transfer and community health. Yet rapid biodiversity loss, climate change, commercialization pressures, and declining ethnobotanical transmission threaten these practices. This article uses an integrative review approach to synthesize ancient respiratory healing traditions of Nepal with contemporary pharmacological evidence, identify priority areas for clinical research, and outline pathways for culturally grounded integration of herbal medicine into public health systems.