Tropical forests represent repositories of medicinal plant species and indigenous ethnomedical knowledge. These biotic and cognitive resources are threatened by forest removal and culture change. It has, however, yet to be demonstrated quantitatively that tropical pharmacopoeias are concentrated in primary as opposed to disturbed forests, nor that folk ethnomedical knowledge is disappearing. I examined these questions by means of a useful species enumeration of 1-hectare primary and secondary forest plots, and a survey of the regional plant pharmacopoeia of the Atlantic forests of Bahia, Brazil, a region that has witnessed significant human and biological modification. Healers demonstrated a strong preference for disturbed over primary forest. Second growth forest plots yielded 2.7 times the number of medicinal species identified in primary forest plots. The regional survey likewise elicited an ethnoflora characterized by herbaceous, weedy, cultivated, and exotic taxa. These results may reflect the availability and intrinsic medicinal value of disturbance species, as well as the increasing rarity of the region’s primary forests. They may also represent the long term outcome of culture change, cognitive erosion, and reformulation of the region’s perceived healing flora.