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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