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Iranian Journal of Pharmaceutical Research (2014), 13 (1): 157-162 
Received: September 2012 
Accepted: December 2013 



Copyright © 2014 by School of Pharmacy 
Shaheed Beheshti University of Medical Sciences and Health Services 



Original Article 

Ethno-Medicinal Plants Used to Cure Jaundice by 
Traditional Healers of Mashhad, Iran 

Mohammad Sadegh Amiri a *, Mohammad Reza JoharchP and Mohammad Ehsan TaghavizadehYazdi c 

"Department of Biology, Payame Noor University, Tehran, Iran. b Ferdowsi University 
of Mashhad, Mashhad. Iran, department of Plant Sciences, Eram Biotechnology Research 
Center, Technical and Vocational Training Organization, Mashad, Iran. 



Abstract 

Jaundice is the commonest ailments affecting the citizens of both developed and poor Asians 
countries including Iran. An ethnobotanical survey of plants used by the traditional healers 
for the treatment of jaundice was conducted in the Mashhad city, Northeastern Iran. A total of 
37 plants belonging to 32 genera and 26 families have been documented for their therapeutic 
use against jaundice. The plant families which contained the most commonly used species for 
their effects are: Fabaceae (5 species), Polygonaceae (4 sp.), Asteraceae (3 sp.), Plantaginaceae 
(2 sp.) and Salicaceae (2 sp.). The plants were arranged with correct nomenclature along with their 
common name, family, the part used and their medicinal value. The use of decoction is the most 
preferred method of herbal preparation. In all cases, the treatment involved oral administration 
of the extracts 2 to 3 times daily from a week to month till the problem disappears. Cichorium 
intybus, Salix alba, Cotoneaster nummularius, Descurainia sophia, Malva sylvestris, Berberis 
integrrima, Rumex acetosella, Phyllanthus emblica and Alhagi maurorum were repeatedly 
mentioned by the traditional healers as the most widely used for the treatment of jaundice in the 
study area. The study indicates that the local inhabitants rely on medicinal plants for treatment. 
This paper suggested that further clinical experimentation is needed to scientifically evaluate 
these widely used herbal remedies for possible bioactive effects. 

Keywords: Ethnomedicinal; Jaundice; Traditional healers; Mashhad, Iran. 



Introduction 

During the last few decades there has been 
an increasing interest in the study of medicinal 
plants and their traditional use in different 
parts of the world (1). Documenting the 
indigenous knowledge through ethnobotanical 
studies is not only useful for conservation of 
cultural traditions and biodiversity but also for 
community healthcare and drug development 
in the present and future (2). Ethnobotanical 



Corresponding author: 
E-mail: M.S._Amiri@pnu.ac.ir 



data supply clues for materials to be tested by 
clinical and pharmacological researches, provide 
new distribution areas for raw drugs and a 
broad base for interaction with other systems of 
medicines. However, of the estimated 350,000 
plant species worldwide only a small percentage 
has been investigated phytochemically and 
an even smaller percentage has been properly 
studied in terms of their pharmacological 
properties (3). Today according to the World 
Health Organization (WHO), as many as 80% 
of the world's people depend on traditional 
medicine for their primary healthcare needs. 
There are considerable economic benefits in the 



SadeghAmiriMefa/. /IJPR(2014), 13 (1): 157-162 



development of indigenous medicines and in 
the use of medicinal plants for the treatment of 
various diseases (4). Among different ailments, 
jaundice is the commonest ailments affecting the 
citizens of the world countries including Iran. 
Jaundice is the yellowish staining of the skin and 
sclera (the whites of the eyes) that is caused by 
high levels in blood of the chemical bilirubin. 
The color of the skin and sclera vary depending 
on the level of bilirubin. When the bilirubin level 
is mildly elevated, they are yellowish. When the 
bilirubin level is high, they tend to be brown. 
Jaundice may result from various diseases or 
conditions that affect the liver, like Hepatitis A, 
Hepatitis B, Hepatitis C, Hepatitis D, Hepatitis 
E, Autoimmune hepatitis, Liver cirrhosis, liver 
cancer, Hemolytic anaemia and Malaria (5). 
Our precedential study among the traditional 
healers (named Attar) of Mashhad city indicated 
that jaundice was one of the major problems 
among them and they used herbal remedies to 
heal it. Although some ethnobotanical studies 
have been accomplished among Iranian people 
by some earlier researchers, including Hooper 
(6), Ghorbani (7), Amiri (8) and Rajaei (9); 
no-systematic ethnotherapeutic studies have 
been conducted to evaluate of the traditional 
remedies of jaundice. The present investigation 
was undertaken with the aim of producing 
an inventory of the plants used by traditional 
healers to document ethnomedical information 
on potentially valuable medicinal plants for the 
development of new pharmaceuticals and also 
to emphasize the role of ethnomedicine to cure 
icterus. 

Experimental 

Study area and ethnic people 

The study was conducted during 2011-12 
under the project "Assessment of traditional 
medicinal plants commercialized in the 
markets of Mashhad, Iran", to elicit data on 
medicinal plants used by traditional healers of 
this metropolis for the treatment of jaundice. 
Mashhad is situated at the northeast of Iran. 
It is the second largest city in Iran and one of 
the holiest cities in the world. Its approximate 
geographic location is 35°43' to 37°8' north 
latitude and 59° 15' to 60°36' east longitude, in 



the valley of the Kashaf River near Turkmenistan, 
between the two mountain ranges of Binalood 
and Hezar-masjed. It is located in the center 
of the Razavi Khorasan province close to the 
borders of Afghanistan and Turkmenistan. The 
total area of the Mashhad is 270 km 2 and the 
population of the city is about 3 million people. 
There are also over 20 million pilgrims who 
visit the city every year. The vast majority of the 
Mashhad people are ethnic Persians who form 
over 95% of the city's population. Other ethnic 
groups include Kurdish and Turkmen people 
who have immigrated recently to the city from 
the North Khorasan province. 

Data collection 

During the course of exploration of 
ethnomedicinal plants the information 
including the various data such as name and 
age of informants, local names, purpose of 
usage, preparation procedure and duration of 
the treatment were obtained from traditional 
healers through discussions and questionnaires 
were used to gather their knowledge. A totally 
more than 100 informants with in the age group 
of 37 to 82 were interviewed, these included 
males and females. Subsequently, scientific 
identification and authentication was made 
with the help of Flora Iranica (10), Flora of 
Iran (11) and consulting with different herbal 
literature (12, 13). After correct identification, 
the specimens were deposited at the Ferdowsi 
University of Mashhad Herbarium (FUMH) for 
future references. For data analysis, plant species 
were tabulated and grouped into their respective 
families along with the relevant information. In 
this paper, all of data were updated on the base 
of latest changes of plant molecular systematic 
according to the rules of the International Code 
of Botanical Nomenclature (www.theplantlist. 
org website). 

Results and Discussion 

The present study demonstrated that 
traditional healers used 37 species of 
ethnomedicinal plants (distributed in 32 genera 
belonging to 26 families) to cure jaundice. 
From the point of view of Taxonomy, plants that 
are being used for therapeutic purpose in this 



158 



Ethno-Medicinal Plants Used to Cure Jaundice by Traditional Healers of 




Others flower Root Manna Aerial Seed fruiU 

parts 



Figure 1. Distribution of medicinal plants parts used in the 
treatment of jaundice. 



region belong to divisions of Pteridophyta (one 
species from Polypodiaceae and Pteridaceae) 
and Magnoliophyta (with two classes 
Magnoliopsida and Liliopsida, including 24 
families all together). According to Table 1, 
Maximum number of medicinal plant species 
belongs to family Fabaceae (5 species) followed 
by Polygonaceae (4 sp.), Asteraceae (3 sp.), 
Plantaginaceae (2 sp.) and Salicaceae (2 sp.). 
The rest of the families are represented by one 
species only. Data obtained from this survey is 
compiled in Table 1 and the folklore medicinal 
plants are arranged in alphabetic order. For each 
plant species botanical name, family, vernacular 
name, parts used, preparation and application 
are provided. Different plant parts were used 
to cure jaundice. Among these fruits were 
reported to be the most used part of the plants, 
constituting 35% of the herbal preparations. 
This was followed by the seed (16%), aerial 
parts (16%), manna (11%), root (8%) and flower 
(6%) (Figure 1). 

The methods of preparation are divided into 
four categories, among which the commonest 
method was decoction. Plant parts are used in 
the form of decoction (47%), infusion (26%), 
soak (19%) and extracts (8%) from the various 
parts of the plant (Figure 2). 

In all the cases mode of application was 
oral. In regard to the patient conditions, the 
preparation is usually administered two to 
three times per day from a week to month 
till the problem disappears. Icterus among 
Asians, especially Iranians is common. Some 
of the plant species include Adiantum capillus- 
veneris, Rheum ribes, Salix alba, Cotoneaster 



■ Decoct inn 

■ Infusion 

■ Soak 

■ Extracts 




Figure 2. Preparation method of medicinal plants and their 
percentages. 

nummularius, Tribulus terrestris, Descurainia 
sophia, Malva Phyllanthus emblica, Plantago 
ovata, Rhus coriaria, Tamarandus indica, 
Fumaria vaillantii and Alhagi maurorum were 
repeatedly mentioned by the traditional healers 
as the most widely used for the treatment of 
adults jaundice in the study area. Jaundice 
is one of the most common problems found 
in a neonate which appears during the first 
week of life. Hyperbilirubinemia may develop 
serious complications like kernicterus and 
lifelong disability (14). There are two usual 
methods of treatment for neonatal jaundice 
in the literatures: light therapy and blood 
exchange (15). Blood exchange is the last way 
for decreasing the serum bilirubin levels (16). 
Furthermore, practical management by giving 
traditional remedies like Alhagi graecorum, 
Cotoneaster nummularius and Descurainia 
sophia extracts to breast-fed babies for reducing 
jaundice is popular in Iranian culture (17). This 
problem was obviously easily diagnosed by 
the old herbalists. General physical condition 
and tongue or eyes color of the patient are 
used as indicators of the patient's problem. 
Six plants were frequently recommended by 
the traditional healers of the study area which 
demonstrated excellent results for the treatment 
of newborn jaundice. The most efficient are: 
Rumex acetosella, Cichorium intybus, Alhagi 
graecorum, Cotoneaster nummularius, Cassia 
fistula and Alhagi maurorum. This study 
determined that phytotherapy is the most 
common form of treatment for jaundice which 
showed significant results based on their use of 
traditional medicine in this area. 



159 



SadeghAmiriMefa/. /IJPR(2014), 13 (1): 157-162 



Table 1. Medicinal plants used for the treatment of jaundice by local inhabitants. 



NO 


Family Name 


Botanical Name 


Vernacular Name 


Part 
used 


Preparation 


Ethnomedicinal Uses 


Remarks 














Jaundice, Cholesterol Lowering, 




1 


Anacardiaceae 


Rhus coriaria L. 


Somagh 


Fruit 


Infusion 


Diabetes, Antihypertensive, 
Anti-hemorrhage, Flavoring 


Indigenous 














Jaundice, Acne, Appetizer, 




2 


Apiaceae 


Coriandrum sativum L. 


Geshniz 


Fruit 


Infusion 


Treat of Flatulence, 
Calmative, Antiseptic, Aromatic 


Indigenous 










Aerial 
parts 




Jaundice, Treat of Palpitation, 




3 


/\SIC1 aCCaC 


Cichorium intybus L. 






/\ppCUZ,Cl, L-'CpUIallVC, 


11 lUlg CI 1U U a 












Treat of Febrifuge, Antiallergic 




4 


Asteraceae 


Cynara scolymus L. 


Kangar Farangi 


Aerial 
parts 


Decoction 


Jaundice, Liver Tonic, Digestive 


Imported 


5 


Asteraceae 


Silybum marianum (L.) 
Gaertn. 


Khare Maryam 


Seed 


Decoction 


Jaundice, Liver Tonic, Antihepatit, 
Febrifuge 


Indigenous 


6 


Beberidaceae 


Berberis integrrima 
Bunge 


Zereshk Kuhi 


Fruit 


Extracts 


Jaundice, Hypoglycemic, 
Antihypertensive, Blood and Liver 


Indigenous 












Cleanser, Febrifuge 




7 


Brassicaceae 


Descurainia sophia (L.) 
Webb ex Prantl 


Khakshir 


Seed 


Soak 


Jaundice, Blood and Liver Cleanser, 
Febrifuge, Laxative, Treat of 


Indigenous 












Furuncles, Anti-thirst 
















Jaundice, Liver Tonic, Hepatitis, 




8 


Capparaceae 


Capparis spinosa L. 


Kavar 


Fruit 


Decoction 


Appetizer, Anthelmintic, 
Emmenagogue, Antigout 


Indigenous 


9 




It// 1 1 lit ILlliLl Lx/ Iv^U VllLl Xvt^LZj. 


Halileh Siah 




T~)ppnptinn 

l-V^CV/^ l IV. /1 1 


Jaundice, Purgative, Treat of 
Constipation, Liver Tonic 


TmnnrtpH 


10 


Cyperaceae 


Cyperus rotundus L. 


Soade Kufi 


Root 


Decoction 


Jaundice, Strengthening of Memory 


Indigenous 


11 


Fabaceae 


Alhagi graecorum Boiss. 


Taranjabin 


Manna 


Soak 


Jaundice, Laxative, Febrifuge, 
Thirst, Aphthous Ulcers 


Indigenous 


12 


Fabaceae 


Alhagi maurorum Medik. 


Khar Shotor- 
Taranjabin 


Aerial 
parts - 
Manna 


Decoction- 
Soak 


Jaundice, Appetite Suppressant, 
Diuretic, Febrifuge 


Indigenous 


13 


Fabaceae 


Astragalus fasciculifolius 
subsp. arbusculinus 
(Bornm. & Gauba)Tietz 


Anzerut 


Gum 


Decoction 


Jaundice, Antitussive, 
Laxative, Anthelmintic 


Indigenous 


14 


Fabaceae 


Cassia fistula L. 


Folus 


Fruit 


Extracts 


Jaundice, Treat of Leishmaniasis, 
Infant Colic, Febrifuge, Purgative 


Imported 


15 


Fabaceae 


Tamarindus indica L. 


Tamr Hendi 


Fruit 


Decoction 


Jaundice, Depurative, Pimples 


Imported 


16 


Lamiaceae 


Salvia macrosiphon Boiss. 


Kenocheh 


Seed 


Infusion 


Jaundice, Gastric ulcer, Pharyngitis, 
Antitussive 


Indigenous 


17 


Malvaceae 


Mfl/va sylvestris L. 


Panirak 


Rower 


Infusion 


Jaundice, Pharyngitis, Furuncles, 
Aphthous Ulcers, Antitussive 


Indigenous 



160 



Ethno-Medicinal Plants Used to Cure Jaundice by Traditional Healers of 



Table 1. (Continued). 



NO 


Family Name 


Botanical Name 


Vernacular Name 


Part 
used 


Preparation 


Ethnomedicinal Uses 


Remarks 


18 


Papaveraceae 


Fumaria vaillantii Loisel. 


Shatareh 


Aerial 
parts 


Infusion 


Jaundice, Psoriasis, Appetizer, 
Antiacid, Febrifuge 


Indigenous 


19 


Phyllanthaceae 


Phyllanthus emblica L. 


Agheleh 
Moghashar 


Fruit 


Decoction 


Jaundice, Diabetes, Febrifuge, Blood 
flux 


Imported 




Plantaginaceae 


Plantago major L. 


Barhang 


Seed 


Soak 


Jaundice, Eczema, Antiallergic, 
Febrifuge, Antitussive 


Indigenous 


21 


Plantaginaceae 


Plantago ovata Forssk. 


Esfarzeh 


Seed 


Soak 


Jaundice, Obesity, Depilator, 
Tonsillitis, Antacid, Antitussive 


Indigenous 


22 


Polygonaceae 


Rheum palmatum L. 


Rivand Chini 


Root 


Decoction 


Jaundice, Liver Diseases, Cardiac 
Tonic, Antilithiasis 


Imported 


23 


Polygonaceae 


Rheum ribes L. 


Rivas 


Fruit 


Infusion 


Jaundice, Urinary Antiseptic, 
Diuretic, Depurative, Liver Tonic 


Indigenous 


24 


Polygonaceae 


Rheum turkestanicum 
Janisch. 


Eshghan 


Root 


Extracts 


Jaundice, Diabetes, 
Antihypertensive, Depurative 


Indigenous 


25 


Polygonaceae 


Rumex acetosella L. 


Sagh Torshak 


Aerial 
parts 


Decoction 


Jaundice, Febrifuge 


Indigenous 


26 


Polypodiaceae 


Polypodium vulgare L. 


Baspayak 


Rhizome 


Infusion 


Jaundice, Expectorant 


Indigenous 


27 


Portulacaceae 


Portulaca oleracea L. 


Khorfeh 


Seed 


Soak 


Jaundice, Antitussive, Febrifuge, 
Anti-Thirst, Depurative 


Indigenous 


28 


Primulaceae 


Embelia ribes Burm.f. 


Barang Kaboli 


Fruit 


Decoction 


Jaundice, Anthelmintic, Antidiarrhea 


Imported 


29 


Pteridaceae 


Adiantum capillus-veneris 
L. 


Parsiavashan 


Frond 


Infusion 


Jaundice, Antitussive, 
Antihemorrhoid, Febrifuge 


Indigenous 




Rhamnaceae 


Ziziphus jujuba Miller 


Annab 


Fruit 


Decoction 


Jaundice, Depurative, Febrifuge 


Indigenous 


31 


Rosaceae 


Cotoneaster nummularius 
Fisch. & CAMey. 


ShirKhesht 


Manna 


Soak 


Jaundice, Febrifuge 


Indigenous 


32 


Rutaceae 


Toddalia asiatica (L.) 
Lam. 


Dahanbaz-Dahan 
basteh 


Fruit 


Decoction 


Jaundice, Diabetes, Febrifuge 


Imported 


33 


Salicaceae 


Salix alba L. 


Bid 


Leaves 


Decoction 


Jaundice, Menstrual Pains, Anodyne, 

/\11111USS1VC 


Indigenous 


34 


Salicaceae 


Salix excelsa J.F.Gniel. 


Bidkhesht 


Manna 


Soak 


Jaundice, Febrifuge, Laxative 


Indigenous 


35 


Solanaceae 


Physalis alkekengi L. 


Arusak Posht 
Pardeh 


Fruit 


Decoction 


Jaundice, Emmenagogue, 
Treat of Kidney Stones 


Indigenous 


36 


Violaceae 


Viola odorata L L 


Banafsheh 


Flower 


Infusion 


Jaundice, Eczema, Febrifuge, 
Antiallergic, Blood Cleansing 


Indigenous 










Aerial 
parts 




Jaundice, Duretic, Kidney Stone, 




37 


Zygophyllaceae 


Tribulus terrestris L. 


Kharkhasak 


Decoction 


Tonic, Treatment of Prostate 


Indigenous 












Hypertrophy, Anthelmintic 





161 



SadeghAmiriMefa/. /IJPR(2014), 13 (1): 157-162 



Conclusion 

The present investigation revealed that the 
study area have a variety of medicinal plants 
which are used by the local inhabitants for 
their primary healthcare. The results depicts 
that traditional healers used 37 species of 
ethnomedicinal plants to cure jaundice. Among 
them, 29 species were indigenous of Iran and 
8 species were imported from other countries. 
By comparing these plant species recorded 
for the treatment of icterus with available 
pharmacological literature reported from other 
regions of the world, it appears that there are many 
medicinal plant species in the area that were not 
reported in other locations. To our knowledge the 
use of Rheum turkestanicum, Physalis alkekengi, 
Toddalia asiatica, Salvia macrosiphon and Salix 
excels to cure jaundice, have never been reported 
before. These ethnomedicinal data may provide 
a baseline to start the search the new compounds 
related to pharmacology, pharmacognosy and 
phytochemistry. Therefore, the survey ascertains 
the value of a great number of medicinal plants 
used in traditional remedies against icterus 
which could be of considerable interest in the 
development of new drugs in the future. 

Acknowledgments 

The authors are cordially grateful to the 
traditional healers of Mashhad city because of 
their kind support and cooperation in sharing 
their knowledge during the field surveys. 

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