The Determination and Fidelity Level of Medicinal Plants Used to Make Traditional Turkish Salves

Abstract

Objective:

This study has been done in order to identify plants that were used to make traditional Turkish salves between 2007 and 2008.

Materials and methods:

During the step of identification of plants, the informants from different cities of Turkey were asked questions about the salves they have made and which plants and materials they have used. In this study, a total of 105 people from 21 provinces (N = 5 each province) were interviewed. Information was gathered through scientifically guided questionnaires, interviews, and general conversations, and fidelity level (FL) of species was determined.

Results:

According to the results of the identification, 68 plants are being used to make Traditional Turkish Salves for medicinal purposes in Turkey. Among them, 61 plants are wild and 7 plants are cultivated plants. Most used families were Asteraceae, Apiaceae, Lamiaceae, Liliaceae, and Rosaceae. Urtica dioica (100%) has the highest FL and Lawsonia inermis (33%) has the lowest.

Conclusions:

The data provided from our informants and analyzed in the present article clearly show that folk knowledge on medicinal plants and plant uses is still alive in the studied region.

Introduction

E thnobotanical knowledge is one of the precious cultural heritage parts of an area that depicts the lifestyle and relationship of a local community with their environment, and their mutual interaction has profound importance for long-term survival of people and biodiversity in an ecosystem.¹ Ethnobotany investigates the relationship between humans and plants in all its complexity, and is generally based on a detailed observation and study of the use a society makes of plants, including all the beliefs and cultural practices associated with this use.² There are many important sectors in developing ethnobotany, such as cultivation of medicinal, horticultural, and timber-yielding plant species for commercial use as well as for maintaining their healthy population and reducing pressure on the wild stock.^3
–5

Traditional ethnobotanical knowledge, pharmacopoeia, and prevalence of medicinal plants has been investigated in different areas of Turkey.^6

–12 Furthermore, intensive research by Ertuğ¹³ and Baytop¹⁴ provided considerable information not only on medicinal plants, but also on edible plants, fodder, fuel, dyes, and gums. However, many more detailed studies are needed to obtain a comprehensive picture of plant-human interactions in Turkey.

Medicinal preparations of plant origin for external use such as salves, gels, creams, and liniments (liquid ointments) contain biologically active substances that are for the most part nontoxic, produce no irritation, and induce no allergic reactions. At the same time, these preparations provide highly effective treatment of many strains of microbes and viruses, including those having acquired resistance to many antibiotics and synthetic drugs.¹⁵

Phytopreparations (salves, gels, creams) are widely used for the treatment of various diseases of skin and mucous membranes. This treatment is especially effective in the case of chronic disorders, since phytotherapy can be carried out over a long period of time without risk of inducing side-effects (which is especially important in dermatology and gynecology).¹⁵ The search for new forms of medicinal plant preparations requires more detailed characterization of the components of such mixtures. The therapeutic and antiviral effects of many phytopreparations are related to the presence of biologically active substances such as alkaloids, cardenolides, flavonoids, triterpene and steroidal saponins, anthraquinones, polysaccharides, coumarins, chromones, carotenoids, fatty and ethereal oils, organic acids, etc.¹⁶

This study aimed to look into traditional salves that are used by Turkish people for curing various ailments. Objectives of the study were (1) to identify and document traditional Turkish salves, (2) to identify medicinal plant species used to make traditional Turkish salves and use by Turkish people, and (3) to record traditional knowledge of the use of these salves.

Materials and Methods

The study area

Turkey is a country that has a wide variety of topographical and climatic conditions, which form the basis of seven different regions: Marmara, Aegean, Mediterranean, Central Anatolian, Black Sea, Eastern Anatolian, and Southern Anatolian. The study was carried out by interviewing resource persons in three provinces from every region of Turkey. The provinces chosen are showed Table 1.

Table 1.

The Plants That Are Used to Make Traditional Turkish Salves

Salves	Plants in salve	Local names of the plants	Families of the plants	Plant part used	Other substances in salve	Preparation of salve
Moisturizer salve	Papaver rhoeas L. (1) (DEBB. 493) Petroselinum crispum (Miller) A. W. Hill (2) (DEBB. 509) Cucumis sativum L. (3) (DEBB. 471) Tulipa sp. L. (4) (DEBB. 524)	Gelincik Maydanoz Salatalık Lale	Papaveraceae Apiaceae Cucurbitaceae Liliaceae	Leaves Seeds Seeds Bulbs	Rye flour (5) Cream (6) Violet oil (7)	• 1, 2, 3, and 4 are crushed. • The crushed material is boiled. • The boiled mixture is strained. • The filtrate is kneaded with 5 and 6. • The mixture is softened with 7.
Moisturizer salve	Fritillaria sp. L. (1) (DEBB. 518) Ranunculus arvensis L. (2) (DEBB. 486) Rosa damescena L. (3) (DEBB. 541) Rubus canescens DC. (4) (DEBB. 501) Althaea officinalis L. (5) (DEBB. 531)	Gelin çiçeği Sarı düğün çiçeği Gül Böğürtlen Hatmi	Liliaceae Ranunculaceae Rosaceae Rosaceae Malvaceae	Leaves Leaves Leaves Leaves Fruits	Butter (6) Yolk (7) Milk (8)	• 1, 2, 3, 4, and 5 are boiled. • The boiled mixture is strained. • The filtrate is kneaded with 6 and 7. • The mixture is softened with 8.
Salve for burns and miliarias	Myristica fragrans Houtt. (1) (DEBB. 479) Urtica dioica L. (2) (DEBB. 542) Salix alba L. (3) (DEBB. 535) Allium sativum L. (4) (DEBB. 502) Citrus limon (L.) Burm. f. (5) (DEBB. 523)	Besbase, Muskat Isırgan otu Söğüt Sarmısak Limon	Myristicaceae Urticaceae Salicaceae Liliaceae Rutaceae	Fruit bark Seeds Leaves Leaves Fruit bark	Soybean oil (6)	• 1 is crushed. • The crushed material is boiled with 2, 3, and 4. • The boiled mixture is strained. • The filtrate is mixed with 5. • The mixture is softened with 6.
Salve for chaps and burns	Betula pendula Roth. (1) (DEBB. 547) Urtica dioica L. (2) (DEBB. 505)	Akhuş Isırgan otu	Betulaceae Urticaceae	Buds Aerial parts	Beeswax (3) Milk (4) Olive oil (5) Linen flour (6) Almond oil (7)	• 1, 2, 3, 4, and 5 are boiled. • The boiled mixture is strained. • The filtrate is kneaded with 6 and 7.
Salve for chaps and panniculitis	Centaurea sp. L. (1) (DEBB. 517) Salix alba L. (2) (DEBB. 472)	Peygamber çiçeği Söğüt	Asteraceae Salicaceae	Flowers Seeds	Resin (3) Vetch flour (4) Egg white (5) Soybean oil (6)	• 1 and 2 are crushed. • The crushed material is boiled with 3. • The boiled mixture is strained. • The filtrate is kneaded with 4 and 5. • The mixture is softened with 6.
Salve for chaps and rheumatism	Rosmarinus officinalis L. (1) (DEBB. 499) Sinapis arvensis L. (2) (DEBB. 469) Hamamelis virginiana L. (3) (DEBB. 548) Gundelia tournefortii L. (4) (DEBB. 519)	Biberiye Çalgıcı otu Hamame otu Kenger otu	Lamiaceae Brassicaceae Hamamelidaceae Asteraceae	Flowers Leaves Leaves Leaves	Tomato paste (5) Broad bean flour (6) Egg (7) Cottonseed oil (8)	• 1, 2, 3, and 4 are boiled with 5. • The boiled mixture is strained. • The filtrate is kneaded with 6 and 7. • The mixture is softened with 8.
Salve for eczema and itches	Anacardium occidentale L. (1) (DEBB. 540) Juniperus oxycedrus L. (2) (DEBB. 485) Phlomis grandiflora H.S. Thomson (3) (DEBB. 500) Capsicum annuum L. (4) (DEBB. 549) Allium cepa L. (5) (DEBB. 529)	Baladur Ardıç Ayıkulağı otu Yeşil biber Soğan	Anacardiaceae Cupressaceae Lamiaceae Solanaceae Liliaceae	Leaves Leaves Leaves Fruits Leaves	Milk (6) Honey (7) Corn oil (8)	• 1, 2, 3, and 4 are boiled with 6. • The boiled mixture is strained. • The filtrate is mixed with 5 and 7. • The mixture is softened with 8.
Salve for furuncles	Lamium amplexicaule L. (1) (DEBB. 550) Urtica dioica L. (2) (DEBB. 530) Achillea millefolium L. Subsp. millefolium (3) (DEBB. 473)	Ballıbaba Isırgan otu Civanperçemi	Lamiaceae Urticaceae Asteraceae	Leaves Seeds Flowers	Resin (4) Olive oil (5) Mushroom flour (6) Almond oil (7)	• 1, 2, and 3 are boiled with 4. • The boiled mixture is strained. • The filtrate is kneaded with 5 and 6. • The mixture is softened with 7.
Salve for headache	Convolvulus scammonia L. (1) (DEBB. 522) Lactuca sativa L. (2) (DEBB. 480) Petroselinum crispum (Miller) A. W. Hill (3) (DEBB. 543)	Mahmude otu Marul Maydanoz	Convolvulaceae Asteraceae Apiaceae	Leaves Leaves Leaves	Vetch flour (4) Vinegar (5) Rose oil (6)	• 1, 2, and 3 are crushed. • The crushed material is boiled. • The boiled mixture is strained. • The filtrate is kneaded with 4 and 5. • The mixture is softened with 6.
Salve for hemorrhoids and furuncles	Artemisia campestris L. (1) (DEBB. 516) Morus nigra L. (2) (DEBB. 492) Anacardium occidentale L. (3) (DEBB. 483) Armeniaca vulgaris Lam. (4) (DEBB. 520) Rosmarinus officinalis L. (5) (DEBB. 510) Juglans regia L. (6) (DEBB. 498)	Kara Pelin Karadut Baladur Kayısı Biberiye Ceviz	Asteraceae Moraceae Anacardiaceae Rosaceae Lamiaceae Juglandaceae	Flowers Fruits Fruits Fruits Flowers Leaves	Beeswax (7) Black pepper oil (8)	• 1, 2, 3, 4, and 5 are boiled with 7. • The boiled mixture is strained. • The filtrate is kneaded with ash of walnut trees. • The mixture is softened with 8.
Salve for inflamed wounds	Achillea millefolium L. Subsp. millefolium (1) (DEBB. 528) Conium maculatum L. (2) (DEBB. 503) Apium graveolens L. (3) (DEBB. 484) Papaver somniferum L. (4) (DEBB. 470)	Civanperçemi Baldıran otu Kereviz Haşhaş	Asteraceae Apiaceae Apiaceae Papaveraceae	Flowers Leaves Leaves Seeds	Almond flour (5) Chickpea flour (6) Yolk (7) Terebinth tree oil (8)	• 1, 2, 3 and 4 are boiled. • The boiled mixture is strained. • The filtrate is kneaded with 5, 6 and 7. • The mixture is softened with 8.
Salve for insect bites and inflamed wounds	Vicia faba L. (1) (DEBB. 532) Crataegus monogyna Jacq. (2) (DEBB. 508) Gundelia tournefortii L. (3) (DEBB. 551) Spinacia oleraceae L. (4) (DEBB. 468) Punica granatum L. (5) (DEBB. 525) Ficus carica L. (6) (DEBB. 552)	Bakla Geyik dikeni Kenger otu Ispanak Nar Incir	Fabaceae Rosaceae Asteraceae Chenopodiaceae Punicaceae Moraceae	Leaves Leaves Leaves Leaves Fruit bark Latex	Henna (7) Yogurt (8)	• 1, 2, 3, and 4 are boiled. • The boiled mixture is strained. • The filtrate is kneaded with 5, 7 and 8. • The mixture is softened with 6.
Salve for itches	Agrimonia eupatoria L. (1) (DEBB. 539) Papaver somniferum L. subsp. anatolicum (2) (DEBB. 494) Origanum majorata L. (3) (DEBB. 487)	Kasık otu Kara haşhaş otu Mercan köşk	Rosaceae Papaveraceae Lamiaceae	Leaves Leaves Roots	Potato flour (4) Pea flour (5) Yolk (6) Milk (7)	• 1, 2, and 3 are boiled with 4. • The boiled mixture is strained. • The filtrate is kneaded with 5 and 6. • The mixture is softened with 7.
Salve for joint aches	Glycyrrhiza glabra L. (1) (DEBB. 474) Rosa damescena L. (2) (DEBB. 511) Urtica dioica L. (3) (DEBB. 504)	Meyan Gül Isırgan otu	Fabaceae Rosaceae Urticaceae	Roots Leaves Aerial Parts	Vinegar (4) Rye flour (5) Soybean oil (6)	• 1, 2 and 3 are boiled with 4. • The boiled mixture is strained. • The filtrate is kneaded with 5. • The mixture is softened with 6.
Salve for lumbago	Narcissus tazetta L. (1) (DEBB. 497)	Nergis	Liliaceae	Bulbus	Milk (2) Soybean flour (3) Garlic powder (4) Egg white (5)	• 1 is soaked in milk approximately 1 day and the aged things are crushed. • The crushed material is kneaded with 3 and 4. • The mixture is softened with 5.
Salve for lumbago and backache	Urtica dioica L. (1) (DEBB. 467) Narcissus tazetta L. (2) (DEBB. 482)	Isırgan otu Nergis	Urticaceae Liliaceae	Aerial Parts Flowers	Beeswax (3) Bean flour (4) Egg white (5) Lavender oil (6)	• 1 and 2 are boiled with 3. • The boiled mixture is strained. • The filtrate is kneaded with 4 and 5. • The mixture is softened with 6.
Salve for mouth wounds and burns	Agrostemma githago L. (1) (DEBB. 491) Convolvulus arvensis L. (2) (DEBB. 533) Alnus orientalis Decne. (3) (DEBB. 475) Sinapis arvensis L. (4) (DEBB. 515) Celtis australis L. (5) (DEBB. 553)	Amberbaris Tarla sarmaşığı Kızılağaç Çalgıcı otu Çitlembik	Caryophyllaceae Convolvulaceae Betulaceae Brassicaceae Ulmaceae	Roots, Leaves Leaves Flowers Flowers Seeds	Beeswax (6) Lily oil (7)	• 1, 2, 3, 4, and 5 are boiled with 6. • The boiled mixture is strained. • The filtrate is kneaded with 1. • The mixture is softened with 7.
Salve for muscle aches and rheumatism	Dianthus caryophyllus L. (1) (DEBB. 506) Rosmarinus officinalis L. (2) (DEBB. 526) Tanacetum cinerariifolium (Trevir.) Sch.Bip. (3) (DEBB. 554) Glycyrrhiza glabra L. (4) (DEBB. 514) Platanus orientalis L. (5) (DEBB. 521)	Karanfil Biberiye Akır-I Karha Meyan Çınar	Caryophyllaceae Lamiaceae Asteraceae Fabaceae Platanaceae	Flowers Leaves Flowers Roots Leaves	Broad bean flour (6) Olive oil (7) Hyacinth oil (8)	• 1, 2, 3, and 4 are boiled with 6. • The boiled mixture is strained. • The filtrate is kneaded with ash of plane trees and 7. • The mixture is softened with 8.
Salve for whitlow and goiter	Lawsonia inermis L. (1) (DEBB. 495) Quercus coccifera L. (2) (DEBB. 555) Coriandrum sativum L. (3) (DEBB. 512) Allium sativum L. (4) (DEBB. 544)	Kına Meşe Kişniş Sarmısak	Lythraceae Fagaceae Apiaceae Liliaceae	Leaves Leaves Seeds Juice	Tomato paste (5) Yeasted dough (6) Almond oil (7)	• 1, 2, 5, and 6 are boiled. • The boiled mixture is strained. • The filtrate is kneaded with 3 and 4. • The mixture is softened with 7.
Salve for panniculitis and skin wrınkles	Malus sylvestris Miller (1) (DEBB. 536) Capsicum annuum L. (2) (DEBB. 476) Brassica oleraceae L. (3) (DEBB. 488)	Elma Yeşilbiber Lahana	Rosaceae Solanaceae Brassicaceae	Fruits Fruits Leaves	Beeswax (4) Linseed (5) Olive oil (6)	• 1, 2, 3, and 4 are crushed. • The crushed material is boiled. • The boiled mixture is strained. • The filtrate is kneaded with 5. • The mixture is softened with 6.
Salve for scabies, itches, and inflamed wounds	Peganum harmala L. (1) (DEBB. 534) Lycopersicum esculentum Miller (2) (DEBB. 556) Urtica dioica L. (3) (DEBB. 557) Gundelia tournefortii L. (4) (DEBB. 507) Linum usitatissimum L. (5) (DEBB. 478)	Üzerlik otu Domates Isırgan otu Kenger otu Keten	Nitrariaceae Solanaceae Urticaceae Asteraceae Linaceae	Leaves Leaves Leaves Roots Seeds	Milk (6)	• 1, 2, 3, 4, and 5 are boiled. • The boiled mixture is strained. • The filtrate is kneaded with ash of poplar trees. • The mixture is softened with 6.
Salve for sciatic aches and rheumatism	Iris pseudocorus L. (1) (DEBB. 538) Ficus carica L. (2) (DEBB. 490) Sinapis alba L. (3) (DEBB. 558)	Süsen Incir Hardal	Iridaceae Moraceae Brassicaceae	Leaves Leaves Leaves	Corn flour (4) Vinegar (5) Sunflower oil (6)	• 1, 2, and 3 are boiled. • The boiled mixture is strained. • The filtrate is kneaded with 4 and 5. • The mixture is softened with 6.
Salve for skin blots	Gentiana lulutea L. (1) (DEBB. 559) Ranunculus asiaticus L. (2) (DEBB. 481) Quercus coccifera L. (3) (DEBB. 545) Allium cepa L. (4) (DEBB. 513) Psoralea bituminosa L. (5) (DEBB. 537)	Centiyane Düğün otu Meşe Soğan Katran	Gentianaceae Ranunculaceae Fagaceae Liliaceae Fagaceae	Roots Leaves Acorns Leaves Leaves	Rice flour (6) Yolk (7) Rose oil (8)	• 1, 2, and 3 are crushed with 4. • The crushed material is boiled with 5. • The boiled mixture is strained. • The filtrate is kneaded with 6 and 7. • The mixture is softened with 8.
Salve for skin wrınkles (beauty salve)	Achillea millefolium L. Subsp. millefolium (1) (DEBB. 527) Lavandula angustifolia Miller (2) (DEBB. 560) Viola tricolor L. (3) (DEBB. 546) Rosa damescena L. (4) (DEBB. 489)	Civanperçemi Lavanta Hercai menekşe Gül	Asteraceae Lamiaceae Violaceae Rosaceae	Leaves Flowers Flowers Flowers	Egg (5) Soybean oil (6) Thyme powder (7)	• 1, 2, 3, and 4 are boiled. • The boiled mixture is strained. • The filtrate is kneaded with 5 and 7. • The mixture is softened with 6.
Salve for swollen testicles	Cumium cyminum L. (1) (DEBB. 477) Sinapis arvensis L. (2) (DEBB. 496)	Kimyon Çalgıcı otu	Apiaceae Brassicaceae	Seeds Leaves	Broad bean flour (3) Hyacinth oil (4)	• 1 and 2 are crushed. • The crushed material is boiled. • The boiled mixture is strained. • The filtrate is kneaded with 3. • The mixture is softened with 4.

DEBB, Herbarium of Dokuz Eylul University.

Data collection

The information collected included various data such as salve names and therapeutic effects of salves, plants in salves and local names of plants, parts of plants used, and methods of preparation. Interviews were done of elderly people of the provinces and districts, experienced adults and patients in various places between the periods 2007 and 2008. Five (5) inhabitants were selected from applications in each of the provinces based on one of the following criteria: that they had been living in the region for more than 10 years, that they used plants as the main medicine, or identified using medicinal plant extractors or traditional healers. The information was checked with other areas, neighboring provinces, and districts, to verify the accuracy. During the step of identifying of plants, the preparers of salves from different cities of Turkey have been asked questions about the salves they have prepared and which plants they have used. Information was gathered through scientifically guided questionnaires, interviews, and general conversations.

After doing interviews with preparers, it is shown in Table 2 which plant is used in which salve. The taxonomic determination of the plants was carried out according to Davis¹⁷ and Guner et al.¹⁸ and compared to the specimens kept in the Herbarium of Buca Educational Faculty, Dokuz Eylul University (DEBB). Voucher herbarium specimens were prepared and deposited in the DEBB Herbarium. The specific names of the identified plants are also shown in the table.

Table 2.

The Families of Plants That Are Used to Make Traditional Turkish Salves

Family	Number of species	Family	Number of species
Anacardiaceae	1	Linaceae	1
Apiaceae	5	Lythraceae	1
Asteraceae	7	Malvaceae	1
Betulaceae	2	Moraceae	2
Brassicaceae	3	Myristicaceae	1
Caryophyllaceae	2	Nitrariaceae	1
Convolvulaceae	2	Papaveraceae	3
Cucurbitaceae	1	Platanaceae	1
Cupressaceae	1	Punicaceae	1
Fabaceae	2	Ranunculaceae	2
Fagaceae	2	Rosaceae	5
Gentianaceae	1	Rutaceae	1
Hamamelidaceae	1	Salicaceae	1
Iridaceae	1	Solanaceae	2
Juglandaceae	1	Ulmaceae	1
Lamiaceae	5	Urticaceae	1
Liliaceae	5	Violaceae	1

Data analysis

The fidelity level (FL), the percentage of informants claiming the use of a certain plant for the same major purpose, was calculated for the most frequently reported diseases or ailments as: \documentclass{aastex}\usepackage{amsbsy}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{bm}\usepackage{mathrsfs}\usepackage{pifont}\usepackage{stmaryrd}\usepackage{textcomp}\usepackage{portland,xspace}\usepackage{amsmath,amsxtra}\pagestyle{empty}\DeclareMathSizes{10}{9}{7}{6} \begin{document} \begin{align*} FL ( \% ) = (N_p / N) \times 100 \end{align*} \end{document} where N _p is the number of informants that claim a use of a plant species to treat a particular disease, and N is the number of informants who use the plants as a medicine to treat any given disease.¹⁹

Results

The plants that are used to make traditional Turkish salves are presented in Table 2, arranged in alphabetical order of the names of salves, with relevant information. According to the results of the identification, 68 plants are being used to make traditional Turkish salves for medicinal purposes in Turkey (Table 3). Among them 61 plants are wild and 7 plants are cultivated plants.

Table 3.

The Provinces Chosen for Study

Regions of Turkey	Marmara	Aegean	Mediterranean	Central Anatolian	Black Sea	Eastern Anatolian	Southern Anatolian
Provinces	İstanbul<	İzmir	Antalya	Ankara	Trabzon	Erzurum	Gaziantep
	Bursa	Denizli	Isparta	Konya	Zonguldak	Malatya	Diyarbakır
	Edirne	Muğla	Adana	Kayseri	Sinop	Ağrı	Adıyaman

Further analysis on the families has shown that family Asteraceae is represented by the highest number of species (seven species). Apiaceae, Lamiaceae, Liliaceae, and Rosaceae are represented by five species, respectively. These are followed by Brassicaceae and Papaveraceae, each represented by three species. The rest are represented by two species each (8 families) and one species each (19 families). These are shown in Table 3.

Among the recorded species, Rosmarinus officinalis, Urtica dioica, Sinapis arvensis, Gundelia tournefortii, and Rosa damescena are the most popular plants used to make traditional Turkish salves in the treatment of many ailments (e.g., Urtica dioica [six different uses], Rosmarinus officinalis [three different uses], Rosa damescena [three different uses]).

The category that has the highest FL value is Urtica dioica and Cucumis sativum (100%) followed by Rosa damescena (95%). The lowest is Lawsonia inermis (33%). The FL calculated for medicinal plants is shown in Table 4.

Table 4.

Most Commonly Used Medicinal Plants and Their Major Uses With Their Fidelity Level (FL) (0 = The Least, 100 = The Highest Efficiency)

Species and family	Local name	Uses	FL
Urtica dioica L. Urticaceae	Isırgan, Dalagan, Gidişken	Burns, miliarias, chaps, furuncles, joint aches, lumbago, backaches, scabies, itches, inflamed wounds	100%
Cucumis sativum L. Cucurbitaceae	Salatalık	Moisturizer	100%
Rosmarinus officinalis L. Lamiaceae	Biberiye	Muscle aches, hemorrhoids, furuncles, rheumatism	97%
Rosa damescena L. Rosaceae	Gül	Moisturizer, joint aches, skin wrinkles	95%
Achillea millefolium L. Subsp. millefolium Asteraceae	Civanperçemi	Skin wrinkles, inflamed wounds	83%
Sinapis arvensis L. Brassicaceae	Çalgıcı otu	Chaps, rheumatism, mouth wounds, burns, swollen testicles	75%
Peganum harmala L. Nitrariaceae	Üzerlik out	Scabies, itches, inflamed wounds	72%
Glycyrrhiza glabra L. Fabaceae	Meyan	Joint aches, muscle aches, rheumatism	68%
Allium cepa L. Liliaceae	Soğan	Skin blots	57%
Juglans regia L. Juglandaceae	Ceviz	Hemorrhoids, furuncles	45%
Juniperus oxycedrus L. Cupressaceae	Ardıç	Eczema, itches	41%
Origanum majorata L. Lamiaceae	Mercanköşk	Itches	40%
Petroselinum crispum (Miller) A. W. Hill Apiaceae	Maydanoz	Moisturizer	38%
Lawsonia inermis L. Lythraceae	Kına	Whitlow, goiter	33%

All parts of various plants are used in the traditional medication of different diseases; however, the most frequently used parts are leaves. The local people also used other ingredients, such as flour, honey, and oil to prepare the remedies.

It is revealed that some of the plants are collected for commercial purposes by local people: Dianthus caryophyllus, Rosmarinus officinalis, Morus nigra, Armeniaca vulgaris, Juglans regia, Urtica dioica, Lawsonia inermis, Allium sativum, Capsicum annuum, Allium cepa, Vicia faba, Spinacia oleraceae, Punica granatum, Ficus carica, Apium graveolens, Rosa damescena, Lactuca sativa, Petroselinum crispum, Cucumis sativum, Rubus canescens, Sinapis alba, Cumium cyminum, Malus sylvestris, Brassica oleraceae, Lycopersicum esculentum, and Citrus limon.

Discussion

The salves reported by the informants usually contain a range of pharmacologically active compounds; in some cases, it is not known which ingredients are important for the therapeutic effect.²⁰ For example, salve for inflamed wounds in this study consists of four medicinal plants: Achillea millefolium, Conium maculatum, Apium graveolens, and Papaver somniferum. One of these four medicinal plants may be the remedy for evil eye and the rest are for masking and keeping the knowledge secret. On the other hand, many herbalists believe that the polyherbal treatment healing power is increased over that of a single medicinal plant, although each medicinal plant is used as a remedy.²¹

The rational combination of phytopreparations with appropriate auxiliary substances and the use of optimal technological schemes in the production of medicinal forms for external use (salves, gels, creams, and liniments) provide for a significant increase in the quality and therapeutic efficacy of phytopreparations intended for the treatment and prophylaxis of various disorders in dermatology, gynecology, dentistry, and cosmetology.¹⁵

Increasing requirements for the quality of drugs, including those based on plant raw materials, lead to the need for developing methods of standardization of phytopreparations. This task can be solved using the main classes of active substances contained both in ready-to-use medicinal forms and in the initial raw materials. These principal classes include polyphenols, tocopherols, flavonoids, ubiquinones, vitamins, and others.²²

The category that has the highest FL value is Urtica dioica and Cucumis sativum (100%), followed by Rosa damescena (95%). The lowest is Lawsonia inermis (33%). Obviously, the remedies for frequently reported ailments have the highest FL value and those with low number of reports have lowest FL values. Remedies such as Lawsonia inermis (33%) have low FL value because the majority of the informants do not know the dosage and the methods of preparation of the remedies.

The data provided from our informants and analyzed in the present article clearly show that folk knowledge on medicinal plants and plant uses is still alive in the studied region. In the present study, it was found that most people (68%) continue to use traditional systems of health care including medicinal plants alone or in combination with other ingredients, such as flour, honey, and oil. This indicates that ethnobotanical studies constitute a valuable first step in the bioprospection process, which may lead to the development of new plant-based medicines. However, phytopreparations such as salves, gels, creams, and liniments are complex mixtures. In addition to the pharmacologically active components, they contain other chemical compounds that can influence their activity (for example, by modulating either their bioavailability or stability), as well as inactive or inert materials, and sometimes allergenic or toxic compounds.²³

The rational use of herbal medicinal products requires that adverse events and potential interactions be recorded. The establishment of pharmacovigilance programs for herbal products is the main tool to reach this objective, and the World Health Organization has issued a guideline addressing this topic.²⁴ The pharmacovigilance of herbal products faces specific challenges, including those related to the incorrect or missing description of ingredients in herbal preparations and to how herbal medicines are perceived, sourced, and utilized.²⁵

Interest in herbal remedies has gained momentum in recent years, and a great deal of effort is being made to prove the efficacy of plant extracts in a rigorous clinical trial setting. In the United States, large government-funded trials are presently in preparation or ongoing to assess the efficacy and safety of a number of herbal medicinal products. Between 2001 and 2008, approximately 90 such trials have been registered on clinicaltrials.gov²⁶ It is hoped that the present study conducted in Turkey will provide new ideas for future work in this field.

Footnotes

Acknowledgments

The authors are very grateful to all the informants of the research area for sharing their precious knowledge. We would like to acknowledge the contribution of TUBITAK (The Scientific and Technological Research Council of Turkey) in providing financial support.

Disclosure Statement

No competing financial interests exist.

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