Maya medicinal plant knowledge for respiratory diseases in Yucatán, Mexico: toward an adaptive biocultural framework of pharmacopoeia organization

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Traditional Maya medicine remains a key component of local healthcare and biocultural heritage in Yucatán, Mexico, yet it is increasingly affected by socio-environmental change. While ethnobotanical studies have documented plant use, fewer have examined the underlying organization of medicinal systems. This study integrates ethnographic fieldwork with all six recognized traditional healers in two Maya communities (Tibolón and Yaxcabá) and a systematic literature review following PRISMA 2020. A consolidated database of 268 use-reports was analyzed using descriptive statistics, Informant Consensus Factor, co-occurrence network analysis, null model comparisons, and core–periphery analysis. The respiratory pharmacopoeia comprised 139 taxa across 54 families. Plant use was concentrated in a limited set of therapeutic categories, with leaves, decoction, and oral administration predominating. The flora included native (55.2%), exotic (42.2%), and regionally endemic taxa (2.6%). Network analyses revealed a structured pattern of associations among plant families and therapeutic uses. Null model comparisons showed that observed networks deviated from random expectations, with elevated clustering and reduced modularity. Core–periphery analysis identified a recurrent core of eight highly connected respiratory categories. Network and null-model analyses indicate a non-random organization of the Maya respiratory pharmacopoeia. The concentration of taxa, therapeutic categories, and use patterns, together with network and null model analyses, suggests an interconnected system shaped by ecological accessibility, sensory perception, cultural transmission, and historical incorporation of new taxa. These findings provide the basis for a preliminary theoretical framework for interpreting the Maya respiratory pharmacopoeia as an adaptive biocultural system.