Usadha Kacacar: Traditional Chickenpox Treatment Guidelines in Balinese Culture

Usadha Bali is a collection of knowledge in the field of health that has been used as a traditional guide by the people in Bali. This knowledge has developed long before the advancement of modern medical science as we know it today. It is derived from the local knowledge of the community and is believed to be influenced by other traditional health systems, particularly Ayurveda. The term "Usadha" originates from the Sanskrit word "Ausadhi", which means medicinal plants.

The medical knowledge is documented on palm leaves, now known as Lontar Usadha Bali. This manuscript contains information about the healthcare system, medicinal ingredients, and their usage methods. There are various branches of this medical knowledge documented in "lontar", such as Usadha Dalem, Usadha Rare, Usadha Buduh, Usadha Taru Pramana, and also Usadha Kacacar, which will be further discussed in this article.

Lontar Usadha Kacacar is a manuscript that serves as a guide in traditional chickenpox treatment in Bali. This manuscript is associated with the concepts of "sekala" and "niskala". In the "sekala" concept, the treatment involves the use of herbal ingredients made from plants. On the other hand, in the "niskala" concept, the treatment involves a ritual such as a ceremony. The manuscript contains information about various aspects related to chickenpox, including symptoms, medicinal plants that can be used, how to prepare herbal remedies for chickenpox treatment, and the necessary preparations if a ceremony is needed.

Chickenpox, or Varicella, is a disease caused by the Varicella zoster virus. This disease is highly contagious through saliva droplets or direct contact with the fluid from the rashes. The age group most susceptible to infection are children under 12 years old. Other factors that can increase the risk of infection include never had chickenpox before. The symptoms of chickenpox typically appear within a range of about 10 to 21 days after exposure to the virus, with the main sign being red fluid-filled spots on the face, chest, or back that can spread throughout the body. Other possible symptoms include fever, headache, sore throat, weakness, and loss of appetite.

In a study published in "Jurnal Riset Kefarmasian Indonesia", after an analysis and translation of Lontar Usadha Kacacar from Sanskrit to Indonesian, the research results revealed that there are 100 medicinal herbs utilizing 107 different types of plants. These plants can be used either individually or in a combination. It is also known that there are various ways of using the herbs, reaching up to 10 different methods.

The plants contained in Lontar Usadha Kacacar have been believed for generations to possess healing properties that can help relieve chickenpox symptoms and speed up the recovery process. Despite the existence of 107 types of plants, not all of them can be easily found in our local areas. This article will focus on discussing several plants that can be found around the house or readily purchased at traditional markets. The aim is to facilitate people who want to try this treatment in finding the necessary ingredients. The mentioned plants are betel leaves, galangal, gamongan, and kencur.

Ingredients for the Herbal Remedy (Source: Author's Collection)

Betel (Sirih) is a climbing plant scientifically known as Piper betle. The commonly utilized part of this plant is its leaves, which contain essential oils comprising betlephenol, sesquiterpenes, starch, diatase, tannins, and chavicol. The essential oil content in betel leaves possesses antibacterial, antifungal, and fungicidal properties that can address the potential skin infections arising from wounds caused by chickenpox. These also aid in speed up the recovery and preventing infection complications.

Galangal (Lengkuas), scientifically known as Alpinia galanga, is a rhizomatous plant that thrives in both highland and lowland areas. It is commonly used by the community as an ingredient in various dishes. Aside from its role as a culinary spice, galangal also holds health benefits. The rhizome of galangal contains about 1% essential oil and compounds such as flavonoids, phenols, and terpenoids, which possess anti-inflammatory properties. These properties can help reduce inflammation and swelling on the skin that occurs during a chickenpox infection and help to relief from discomfort.

Gamongan, also known as Lempuyang, is a rhizomatous plant scientifically named Zingiber zerumbet. This plant typically grows in tropical regions and resembles ginger but is larger and longer. Some of the contents found in it include essential oil, saponins, flavonoids, tannins, acetic acid, amino acids, terpenes, heulene, zingiberene, zerumbone, monoterpenes, phenolics, polyphenols, sesquiterpenes, caryophyllene, vitamin C, calcium, and potassium. Lempuyang contains antioxidant compounds that can help protect skin cells from damage caused by chickenpox-induced wounds. This enables better skin regeneration during the chickenpox healing process.

Kencur, scientifically known as Kaempferia galanga, is a rhizomatous plant that has long been popular due to its health benefits. This plant has been used in traditional medicine since ancient times due to its contents which include saponins, flavonoids, phenols, and essential oils. These constituents can help reduce inflammation and alleviate itching on the skin caused by chickenpox.

After understanding the contents and benefits provided by each plant, it's time to make these ingredients into a herb that can help treat chickenpox. The first step is to prepare the tools and ingredients. Some equipment that needs to be prepared includes containers like plates, cutting boards, graters, and knives. Meanwhile, the ingredients that need to be prepared are betel leaves, galangal rhizomes, gamongan, and kencur.

The way to make it is quite simple. After preparing all the necessary tools and ingredients, the first step is clean all the ingredients and place them in the prepared container. The second step is to grind the ingredients by grating the galangal rhizomes, gamongan, kencur, and finely chopping the betel leaves. The final step is to mix the ingredients with water while squeezing it. Repeat the final step until all the ingredients are mixed well. Once done, this herb can be applied to the areas of the body affected by chickenpox wounds.

The Result of Herbal Remedy (Source: Author's Collection)

However, in severe cases of chickenpox that are potentially fatal, treatment must be accompanied by a ceremony. The ceremony becomes a necessity, considering the severity of this disease and the belief that its end may result in death. The implementation of this ceremony is considered a fairly complex process as it involves many means, one of which is the "kepeng". The use of "kepeng" or "pis bolong" is considered an important tool because it is needed in a significant quantity during this ceremony.

"Kepeng" as One of the Means in the Ceremony (Source: Author's Collection)

In the Usadha Kacacar manuscript, pages 2a-2b state: "This is a sacrifice for someone afflicted with chickenpox. If the illness is severe and it is believed that death is imminent, the offering consists of 1 brumbun-shaped cone of rice, placed on red andong leaves, with a sengkwi at its base, filled with a whole raw chicken cut open from the back, with the gizzard still intact and raw. Additionally, it is accompanied by sidapurna rice cakes, 1 bakasem egg, and 11 pieces kwangen. Three of the kwangen are filled with Japanese "kepeng" coins, 1 "kepeng" each, and the remaining 8 are filled with regular "kepeng" coins. Other items include canang gantal, canang, cigarettes, canang lengawangi buratwangi, panyeneng, tulung, peras, and one daksina. The sacrificial offering is filled with 175 "kepeng" coins, the rice cake with 33 "kepeng" coins, and the canang with 11 "kepeng" coins. The daksina is filled with 225 "kepeng" coins. This offering is presented to the guardian spirit of the cemetery, seeking safety and well-being. After the ceremony is complete, the daksina is placed on the sick person's bed, and the other offerings are discarded at the intersection of the main road".

When conducting this ceremony, it is advisable to ask for help from experts such as serati or ritual specialists during the process due to the involvement of numerous means and the complexity of the procedure. The goal is to ensure that the ceremony aligns with the guidelines outlined in the Usadha Kacacar manuscript. That concludes the explanation regarding Usadha Kacacar, which has been strongly upheld by the Balinese community. This treatment can be an intriguing alternative to modern medical approaches in dealing with chickenpox.