Research ArticleEthnobotanical Study of Indigenous Medicinal Plants ofJazan Region, Saudi Arabia

Taieb Tounekti , Mosbah Mahdhi, and Habib Khemira

Centre for Environmental Research and Studies, Jazan University, Jazan, Saudi Arabia

Correspondence should be addressed to Taieb Tounekti; tounekti taiebb@yahoo.com

Received 27 January 2019; Revised 18 April 2019; Accepted 9 May 2019; Published 2 June 2019

Academic Editor: Mohammed S. Ali-Shtayeh

Copyright © 2019 Taieb Tounekti et al. This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

For a long time, the people of Saudi Arabia have been using medicinal plants (MPs) as conventional medicine to heal diversehuman and livestock diseases. The present work is the first study on ethnobotanical uses of 124 MPs species used by the localtribal communities of Jazan province in the Southwest of Saudi Arabia. Ethnobotanical data were collected by interviewing 174local informants using semistructured interviews. Informants of different ages, from several settlements belonging to severaltribal communities, were interviewed. It is worth noticing that the age of informants and their knowledge of MPs were positivelycorrelated, whereas the educational level and MP knowledge of participants were negatively correlated. To find out if there wasagreement in the use of certain plants in the treatment of given ailments, we used Informant Consensus Factor (ICF). To determinethe most frequently used plant species for treating a particular ailment category by local people we used the fidelity level (FL%).TheRelative Frequency of Citation (RFC) was used to indicate the local importance of a species and the relative importance (RI) levelwas used to check the therapeutic potentials of the cited plants. A total of 124 MPs belonging to 103 genera and 48 families werecollected and identified.Themajority of these plants were shrubs (45%), perennial herbs (21%), annual herbs (19%), or trees (18%).The Asteraceae (10.48%), Fabaceae (7.25%), and Apocynaceae (7.25%) families were the most represented. Leaves, fruits, and wholeplant (24%, 18%, and 16%, respectively) were the most used plant parts in formulating traditional medicines. Ziziphus spina-christiandCalotropis procerawith the highest RI level (2.0) were found to have the highest range of therapeutic uses.Theywere followed byDatura stramonium (1.86),Withania somnifera, andAloe vera (1.81).The ICF ranged from 0.02 to 0.42 covering 12 disease categorieswith a prevalence of disease categories related to skin and hair problems (ICF=0.42) having 75 species cited, while 73 species werecited for gastrointestinal tract (GIT) disorders (ICF = 0.40). Senna alexandrina (67%), Tribulus terrestris (64%), Pulicaria undulata(60%), Leptadenia pyrotechnica (55%), and Rumex nervosus (55%) had the highest FL which indicates their good healing potentialagainst specific diseases. The high-FL species are the most promising candidate plants for in-depth pharmacological screeningand merit further consideration. Accordingly, Jazan flora has good ethnobotanical potential. Unfortunately, many MP speciesare endangered by drought, overgrazing, and overexploitation. Some protection measures should be undertaken to prevent thesespecies from becoming extinct. Natural reserves and wild nurseries are typical settings to retain medically important plants in theirnatural habitats, while botanic gardens and seed banks are important paradigms for ex situ conservation.

1. Introduction

Since ancient times, people of Saudi Arabia and the ArabianPeninsula, in general, have been using medicinal plants(MPs) to heal various human and livestock diseases. Thisspecial relationship with the flora continues to this day aspeople still rely heavily on traditional medicine to meettheir healthcare needs [1, 2]. In fact, traditional Arab andIslamic medicine is a well-known system of healing inmany Arab and Islamic countries going back to ancient

times. This traditional medicine refers to healing practices,beliefs, and philosophy integrating herbal medicines, spir-itual therapies, dietary practices, mind-body practices, andmanual techniques, applied singularly or in combinationto treat, diagnose, and prevent illnesses and/or maintainwell-being [3]. Furthermore, this healing system reflects apermanent interconnectivity between Islamic medical prac-tice and Prophetic guidance (Hadith), as well as regionalhealing practices emerging from specific geographical andcultural origins [3]. For instance the healing practices vary

HindawiEvidence-Based Complementary and Alternative MedicineVolume 2019, Article ID 3190670, 45 pageshttps://doi.org/10.1155/2019/3190670

2 Evidence-Based Complementary and Alternative Medicine

considerably from country to country and region to region,as they are influenced by factors such as local flora diversity,culture/ subcultures, history, personal attitudes, and philoso-phy [3].

Saudi Arabia occupies the largest part of the ArabPeninsula which is dominated by desert. Geographically, itis characterized by a variety of habitats including mountains,valleys, lava fields, meadows, and rocky deserts. It is madeup of two zones: the rain fed zones of the western andsouthwestern highlands and the arid region of the interiorarea [50, 52]. The eastern part comprises large swaths of landcovered with sand dunes and lower mountains and plains(deserts). The Asir highlands as well as the southwesternhighlands that stretch parallel to the Red Sea constitute aflowing series of cliffs extending far in to Yemen. Most of theforests (about 2.7 million hectares) are found in the south-western highlands [2, 13] where vegetation is closely related tothat of Yemen andEastAfrican countries such as Ethiopia andEritrea [52]. These forests remained under a system of tribalprotection since ancient times, when they were an importantsource of timber used in the manufacture of ceilings of thebuildings, doors, and windows and agriculture tools. Theywere also the main source of firewood and charcoal andgrazing surface for the herds. Most of the population ofthe region is ethnically Arab and is made mainly of tribalcommunities; therefore the use of MPs is the central part ofthe diversity of cultures in the country which resulted in theheterogeneity of the conventional healing system. Traditionalhealers are the primary providers of traditional therapiesbut professional practitioners were recently licensed in SaudiArabia to practice cupping therapy [53].

The flora of Saudi Arabia offers a rich reserve of MPspecies for folk medicine and some of them are endemic[2, 20]. Such flora of the desert, semidesert, andmountainousecosystems has several elements of the Palaearctic (Europeand Asia), Afrotropical (Africa south of the Sahara), andIndo-Malayan terrestrial realms [1, 2]. Hence, the region hasbeen considered as a natural reservoir for the collection ofwild MPs; about 600 species (27% of the flora) are actuallyused in traditional healing systems or were reported tohave medicinal value [2, 20]. The southwestern region isthe richest in terms of species diversity and also holds thelargest number of endemic species [4]. Most of the speciesare found in the mountains chains highly occupied withhuman settlements from ancient times [2, 13]. The use ofMPs by the local tribal communities and traditional healers(Hakim or Tib Arabi) in these regions goes back thousandsof years and still plays a major role in people’s cultureand therefore accounts for the accumulation of outstandingtraditional knowledge (TK) in the region [4, 54]. In spite ofthe presence of modern hospitals and well-trained medicalstaff, local communities still use MPs as an alternative toallopathic medicine to deal with several routine maladies andchronic diseases including skin-related diseases, rheumatism,bone fracture, asthma, diabetes, stomach problems, consti-pation, respiratory tract infections, eye and ear problems,colds, fever, measles, bladder and urinary diseases, liver andspleen disorders, typhoid, toothache, epilepsy, tuberculosis,hypertension, anaemia, nervous problems, scorpion stings,

and snake bites as well as several tropical diseases such asleishmaniosis, malaria, rift valley fever, and schistosomiasis.In particular, tropical diseases and scorpion stings and snakebites are a health and socioeconomic problems in SaudiArabia and many other tropical and subtropical countries[55, 56].

Gathering and processing MPs for domestic use or forselling is common in Saudi Arabia [2, 20]. Unfortunately,overexploitation of these MPs and the conversion of naturalhabitats to cropland have critically reduced the size ofcommonMPs communities and their economic contributionto local communities [2, 21]. Furthermore, the number ofresource persons with knowledge on the use of local MPsis fast decreasing among rural communities whose veryexistence is now under the threat of rapid urbanization takingplace in the Arabian Peninsula like inmuch of the developingworld. Therefore, scientific ethnobotanical studies have to beundertaken on the largest scale possible as recommendedby the WHO [57] to preserve this fast vanishing knowledge.In Saudi Arabia, most of the studies on herbal medicineswere partial and fragmentary [4, 7, 10, 21, 23]. Still, verylittle are the documents that detailed the folk medicinein southwestern regions of the country. Documenting theTK on MPs of Jazan region in particular still needs morework to avoid losing this knowledge. The present work,being the first collection and listing of all existing data onMPs used by the local tribal communities of Jazan region,provides the first ethnomedicinal and cultural assessment ofthese species. The study area is ethnobotanically unexploredand rich in plants resources. The aim of the study was to(i) document the knowledge and the uses of wild plantsin folk system of Arab and Islamic medicine for treatinghuman health related ailments, including plant local names,method of preparation, plant part(s) used, and application;(ii) analyse the outstanding traditional knowledge of localtribal communities of Jazan region specifically with regardto gender, age and geographical origin of the informants;(iii) determine the most common ailment categories andplant species used for treating different ailments in the studyarea; (iv) find out the highest diversity of medicinal uses ofa plant using relative importance (RI) value. We addressedour aims by documenting various uses of MPs from Jazanregion and then analysing the data using indices such asInformant consensus factor (ICF), relative frequency citation(RFC), fidelity level (FL%), and RI level to check the levelof consensus within a community and the potential uses ofthe cited plants. Our findings may help for future researchto investigate new derivative used as medicines and alsomanufacture natural health products. We hope it will helpin preserving TK and contribute to the conservation ofbiodiversity.

2. Materials and Methods

2.1. Study Area. Jazan province is located in the southwestcorner of Saudi Arabia and directly north of the border withYemen between 16∘20’ N to 17∘40’N and 41∘55’E to 43∘20’E(Figure 1). It is one of the smallest administrative districts

Evidence-Based Complementary and Alternative Medicine 3

Figure 1: Map of Saudi Arabia and the study area (Jazan region).

of the country; the total area of the region is estimated to11,670 km2 in addition to around 80 islands in the Red Sea,of which the largest is Farasan, covering around 752 km2.The study area is bordered from the south by the north-western frontier regions of Yemen (120 km border) and fromthe north by the town of Ash-Shuqaiq and from the eastby the eastern slopes of Fyfa Mountains (part of Al-Sarawatmountain range that runs parallel to the western coast ofthe Arabian Peninsula). The region has about 260-km-longcoastal area on the western side. Farasan islands, 40 km offthe coast of Jazan, were also included the study area. Themain cities of Jazan region are Jazan, Sabya, Abou-arish, Al-darb, Ash-Shuqaiq, Haroub, Al-rayth, Samitah, Farasan, Al-Aridha, and Al-Idabi. The population, according to the 2010census, was about 1.37 million. It is made up of ethnic Arabsand divided into several tribal communities. All people speakArabic and they have old cultural traditions and festivals. Themain occupations of these communities have been livestockrearing and traditional agriculture. Jazan region has a hotdesert climate with an average annual temperature above30∘C.

The plants considered in this study were collected fromareas ranging in altitude between sea level and 3,000 m. Thearea is characterized by considerable cultural, topographic,and climatic diversity. The area can be divided roughly intothree different regions: Tihama coastal plains, the escarp-ments (highlands), and the islands. It represents variantlandforms such as marshland, coastal plains, alluvial plains,and valleys. Based on annual rainfall, the area of Tihamawas classified as arid while the high mountains as semiarid[58]. Data of 25 years obtained from Jeddah Regional ClimateCenter [58] show that the climate in the lowlands (Tihamacoastal plains and islands) is characterized by hot summers(33.6∘C in June and July) andmildwinters (26.1∘C in January),with the mean annual temperature is 30.4∘C and the meanannual rainfall is 139.7 mm.The rainy season in these regionsoccur between August (26.2 mm) and October (18.5 mm).Humidity ranges from60% in July to 73% in thewinter periodwith an average relative humidity about 68%. On the other

hand, data of five years obtained from the meteorologicalstation of FayfaDevelopment Authority show that the climatein the high mountains (Jabal Fyfa, Jabal Tallan, Bani-Malek,Jabal Hasher, Habess, Khacher, wadi Dafa, Maadi, JabalQahar, etc.) is characterized by rainy cold winters, rainycool summers, and a mean annual rainfall of ca. 373 mm.The hottest and the coolest months are June (41.2∘C) andNovember (16∘C), respectively.

From a biogeographical point of view, the vegetationof this region is closely related to that of Yemen and EastAfrican countries such as Ethiopia and Eritrea [52]. Tihamacoastal area is characterized by a sparse vegetation coverwith eight major community types dominated by nine peren-nials: Ziziphus spina-christi, Calotropis procera, Leptadeniapyrotechnica, Suaeda monoica, Panicum turgidum, Salvadorapersica, Acacia tortilis, Tamarix mannifera, and Cyperusconglomeratus. This area is noted for production of high-quality tropical fruits like mango, figs, and papaya.The regionhas been considered a natural reservoir for the collectionof wild MPs [2]. Still most of the species are found inthe mountain chains to the east highly occupied by humansettlements from ancient times [2, 13]. The west facing slopesof these mountains, which profit from frequent moisture-laden winds from the Red Sea, boost a plant cover withseveral endemic and endangered species. Terrace cultivationhas been practiced in these mountains for centuries andArabica coffee, khat (Catha edulis), maize, vegetables, andfruits are widely cultivated here.The natural vegetation of theescarpments is dominated byAcacia asak, Otostegia fruticose,Olea europaea, Dodonaea viscosa, Rhus retinorrhaea, andPennisetum setaceum. The higher elevations (above 2000m)are home to a Juniperus procera forest along with Acaciaorigena and O. europaea subsp. cuspidata and many othershrubs such as Clutia myricoides, Maytenus arbutifolia, andseveral annual and perennial ground cover species.

2.2. Consent and Ethical Approval. This ethnomedicinalstudy was duly approved by the Standing Committee forScientific Research Ethics of Jazan University, Saudi Arabia

4 Evidence-Based Complementary and Alternative Medicine

(Registration number HAPO-10-Z-001). Prior to conductingthe interviews, the objectives of the study were well explainedto the participants and a written consent was obtained fromeach individual.

2.3. Collection of Ethnobotanical Data. Semistructured inter-views following standard ethnobotanical methods of Martin[59] and group conversation with local peoples were led inArabic (spoken by both participants and the interviewers)in a relaxed, informal discussion, with the interviewee andinterviewer sitting face-to-face, normally in the healer’shouse. A copy of the survey questionnaire is provided assupplementary information (Additional file 1). The researchwas carried out over a period of approximately 2 years(2015–2016) in Tihama coastal plains comprising the biggesttowns of Jazan province, e.g., Jazan, Abou-arish, Al-darb,Ash-Shuqaiq, Sabya, Haroub, Al-rayth, and Farasan, as wellin the mountains regions of Fyfa, Al-Aridha, Al-Idabi, Beni-Malek, Tallan, Dafa, Habess, Sala, Khacher, Qahar, Hashar,andMaadi (Figure 1). Despite the good public health facilitiesexisting in the mountain villages, peoples have to travel insome cases about 100 km to find a modern hospital withwell-trained medical staff which is mostly in Jazan city,Abu-Arish, and Sabya (Tihama coastal plains). Moreoverin several rural areas modern health facilities were onlybuilt recently and they generally provide care for simpleconditions [10]. Therefore, we compared the knowledge ofMPs between the two collection regions and between fourage brackets (35–45, 46-55, 56-65, and above 65 years of age).Further comparisons were made between educational levelcategories of informants. In total 174 informants with 93%male, 7% female and traditional healers were interviewed.Half of informants (87) were from Tihama coastal plainsand the other half from the mountain villages. Most of theinformants (88%) were from the rural areas. Informationregarding the local vernacular plant names, plant parts used,and preparation techniques of the recipes were documented.The participants were requested to indicate the wild MPsmost often used in the past and now. First, they mentionedthe plants to the interviewers and later took the interviewersto spots from where they collected the plants. Wheneveravailable, plant samples of the MPs mentioned were col-lected or obtained from the participants, then dry pressedin the field using a plant press, and later brought backto the university for complete identification. The scientificnames of the plants were determined by the authors whocross-checked their vernacular names and photographs withavailable literature. The dry pressed plants were identified byusing flora of Saudi Arabia [50] literature and botanists fromJazan University Herbarium. Later, they were compared withdeposited herbarium specimen at Jazan University, Jazan.The nomenclature was followed as given in the Interna-tional Plant Name Index (http://www.ipni.org) and the plantlist (www.theplantlist.org). For the families, A.P.G. system(Angiosperm Phylogeny Group system) was followed [60].A set of voucher specimens was deposited in the herbariumof the Centre for Environmental Research and Studies, JazanUniversity, Jazan. Instances of endemism and risk categories

(www.plantdiversityofsaudiarabia.info/Biodiversity-Saudi-Arabia/Flora) were also specified for some species. Theinformation given on localMPswas comparedwith data fromthe literature.

2.4. Data Presentation and Analysis. The collected data wasanalysed both qualitatively and quantitatively using diverseindices such as Informant consensus factor (ICF), relativefrequency citation (RFC), fidelity level (FL%), and relativeimportance (RI) level to check the level of consensus withina community and the curative potentials of the cited plants.Before calculating the ICF index, diseases are mostly classi-fied into twelve categories based on the information gatheredfrom the informants. ICF index specifies the homogeneity ofthe ethnobotanical data and the degree of overall agreementabout a specific plant use to treat a specific category of ailmentand, then, the degree of shared knowledge for the treatment ofthat ailment.The ICFwas calculated by the formula describedearlier [61, 62] as follows:

IFC = 𝑛𝑢𝑟 − 𝑛𝑡𝑛𝑢𝑟 − 1 , (1)

where 𝑛ur is number of use reports for each disease categoryand 𝑛t indicates the number of species used in said category.

The ICF value ranges from 0 to 1. A value close to oneindicates that only one or a few plant species are reported tobe used by a large fraction of informants to treat a particularcategory of ailments. Yet, lower values (close to 0) indicatethat informants disagree over which plant to use [62].The useof the ICF allows the degree of consensus about the treatmentof different ailments within a community to be assessed aswell as the identification of themost importantMP species. Inother words, by using the ICF it was possible to detect speciesof specific importance for a given community and to comparethat to how they are used in other cultures.

Ethnomedicinal data were quantitatively analysed usingRelative Frequency of Citation (RFC) which indicates thelocal importance of a species. RFC is calculated as follows[63]:

RFC = 𝐹𝐶𝑁 , (0 < RFC < 1) (2)

where FC is the number of informants citing a usefulspecies andN is the total number of informants in the survey.A highest RFC value (RFC close to 1) indicates that theinformants report the particular species as useful, whereasa lower RFC value (RFC close to 0) indicates that nobodymentioned the use of that plant species.

The fidelity level (FL%) was calculated to rank therecorded plant species based on their claimed relative efficacy.It indicates the proportion of informants who cited the uses ofcertain plant species to cure a specific disease in a study area.FL was calculated for the most regularly reported diseases orailments. It was given by the following formula [64]:

FL (%) = (𝐼𝑝𝐼𝑢) × 100 (3)

Evidence-Based Complementary and Alternative Medicine 5

where ‘Ip’ is the number of informants that claimed a useof certain plant species for a particular disease and ‘Iu’ is thetotal number of informants citing the species for any diseaseor ailment. The high value of FL (%) shows the reputation ofcertain species over other plants to cure a particular diseaseas high value approves the high rate of plant usage againsta definite ailment. MPs that are not regularly used have lowFL and the informants commonly disagree on their potential.The MPs that were cited only by one informant to curea precise ailment were not considered in the FL ranking.Relative importance (RI) of MP species mentioned by theinformants was calculated as follows [65]:

RI = NP +NCS (4)

where NP is obtained by dividing the number of specificailments ascribed to a plant species by the total number ofailments ascribed to the species with the highest number ofpharmacological properties. NCS is the number of ailmentcategories ascribed to a species divided by the total numberof ailment categories ascribed to the most versatile species.The highest value for RI (RI=2) indicates the most versatilespecies with the maximum number of uses.

3. Results and Discussion

3.1. Demographic Characteristics of the Study Participants.Demographic characteristics of the informants were docu-mented through semistructured interviews and group con-versation with local inhabitants. A total of 174 local partici-pants with 162 males (93%) and 12 females (7%) were ques-tioned. Informants, with diverse ages (35–45, 46-55, 56-65,and above 65 years of age), from several settlements belongingto several local tribal communities were interviewed. Thecommunities living inmountain villages and those of Tihamacoastal plains were considered in the present study.The studyrevealed that only 12 informants, most of them from Tihamaplains (75%), did not have knowledge of MPs (Table 1).Accordingly, most inhabitants (about 93%) mainly from themountain settlements still use conventional medicine aloneor in combination with modern drugs. Surveys conducted inother countries had reported values ranging from42% to 98%depending on the region and country of the study [66, 67].Still, the high percentage of TK of MPs identified in Jazanprovince may be due to factors such as lower influence ofthe modern and urban lifestyle and the strength of culturaltraditions in the rural communities. Still the transmission andconservation of TK are more evident in the mountain villagesdue to the high plant biodiversity and the modesty of publichealth facilities compared to the big cities. Furthermore, thesemodern health facilities found presently in the mountainvillages were built only recently and they are generallyproviding care for simple conditions [10]. Therefore peoplesfrom themountain villages have to travel about 100 km tofinda modern hospital which is mostly in Jazan city, Abu-Arish,and Sabya (Tihama coastal plains). As far the dominance ofmale participants, it is due to the fact that women in the studyarea were reluctant to talk to male strangers (the researchteam). All females interviewed were from Tihama plains and

were old women; meanwhile it was not possible to interviewany women from the mountainous regions. Previous studiesshowed that women from Saudi Arabia combine biomedicaland MP health care and learn about MPs from their socialnetwork, mass media, and written sources [14].

One of the most important aspects of this research is thedocumentation of a high number of taxa mentioned by theinformants as medicinal, whereas in several other regions ofSaudiArabia folkmedicine is still practiced among local com-munities but on a limited scale [1, 4, 7, 13, 21, 68]. For instance,inAl-Bahah region, with comparable climate and biodiversityto Jazan region, only 39 plant species were recorded by theinformants for theirmedicinal benefits [4].Moreover, TK losshas been reported in local communities and Bedouins livingin the desert area in the central region of Saudi Arabia [13].In general, TK erosion has been observed in the Middle Eastboth among herbalists and the general population [69]. Stillrural communities havemore knowledge about themedicinaland therapeutic properties of plants and have contributed tothe conservation and transmission of the TK.

3.2. Knowledge of Study Participants. The study revealed thatinformants have rich TK about the distribution, harvesting,and uses of MPs. The present results show that the fewwomen (7%) questioned has comparable knowledge to menon conventional medicine. The average MP reported by afemale is 4.36 ± 0.76 and by male is 3.98 ± 1.17.The differencebetween the two genders was not significant. Moreover,the TK is mostly held by old males (41% of the reportedplants). This is different from some societies in Africa, SouthAmerica, and Asia where experts in MPs and their use aremostly women [70, 71]. In fact most of the medicinal healers(Hakim or Tib Arabi) in these tribal communities are oldmen. Ten men (among the 174 respondents) are known ashealers of which seven are from the mountain villages andthree from Tihama coastal plains settlements. These localexpert healers account for a significant number of citations(155) in this study. The number of ailments reported bythe informants ranged from 1 to 18. The highest numberof MPs reported by a healer is 19 (Tihama plains). Theyalso stated mixture of many MPs to treat an ailment whilemost of the informants (45%) told of single or two MPs(Table 1). Only 25 informants (14%) told above six MPs.The number of MPs reported by the participants increasedas the distance from modern hospitals increased. In fact,the number of MPs reported in the mountain villages (420use reports) was much more important than those reportedin Tihama plains settlements (277 use reports) where mostmodern hospitals are located. Moreover, the average numberof MPs reported by participants of 35–45 years of age is0.75 ± 0.27 in Tihama plains and 1.75±0.49 in the mountainvillages. Besides, the more aged informants (above 65 years)were the more knowledgeable about MPs uses. The averagenumber of MPs reported by informants above 65 years ofage is 5.62 ± 1.59 and 6.29 ± 1.18 for Tihama coastal plainssettlements and themountain villages, respectively. We foundthat illiterate informants hold more information on herbalmedicine (average number of MPs reported is 5.98 ± 1.41)

6 Evidence-Based Complementary and Alternative Medicine

Table1:Num

bero

fMPs

repo

rted

byinform

antsfro

mTihamac

oasta

lplains(n=

87)and

them

ountainvillages(n=

87)o

fJazan

region

aswe

llas

then

umbero

fMPs

repo

rted

byinform

ants

with

varyingeducationallevel(n=174).

Num

bero

fMPs

repo

rted

Inform

antsages

bracketinTihama

coastalplain

(years)

Inform

antsages

bracketinthe

mou

ntainvillages(years)

Inform

ants’

educationallevelcategory

35-45

46-55

56-65

above

65To

tal

35-45

46-55

56-65

above

65To

tal

Illiterate

Prim

ary

scho

olSecond

ary

scho

olHigh

scho

olUniversity

Total

02

52

09

12

00

30

52

41

121

19

92

211

73

213

410

125

334

21

48

619

14

62

1310

116

41

323

01

65

120

45

211

76

64

023

40

25

310

11

83

136

69

11

235

00

63

90

37

616

913

03

025

≥60

02

57

00

99

1815

100

00

25

Evidence-Based Complementary and Alternative Medicine 7

than educated participants (2.23 ± 0.38 reported for thosewhich had a secondary school education). This may bedue to the shifting to the use of allopathic medicine andurbanization as reported earlier for several other developingcountries [65, 72, 73]. Less educated persons tend to be lessacculturated and knowmoreMPs, but educated persons tendto be more acculturated, know few MPs, and seek modernhealthcare services. It appears that this TK is not easily passedfrom the old persons to the younger generation and it maybe lost soon. Likewise, most of the informants were usingwild plants without attempting to apply any conservationmeasures to prevent the extinction of species.

3.3. Vernacular and Scientific Plant Names. Most of thevernacular names of plant were found to be derived fromArabic. As shown in Table 2, MPs reported in Jazan regionoften have one, two, or three names. For some MPs welldistributed throughout the Middle East and well known intraditional Arab medicine, generally only one name wasgiven. For example, Alar’ar, Hundhal, Kharwah, Al-Arfaj,and Sabar are the names for Juniperus procera, Citrulluscolocynthis, Ricinus communis, Rhanterium epapposum, andAloe vera, respectively, in all Arab countries. Still for someplants, people of Jazan have additional regional/local namesas in the case of A. vera which is also called “Al-Maguar” inJazan region. Additionally, for some species, a third name isgiven which is generally the local name of the plant.

The people of Jazan were capable of naming and classi-fying the plants that they have been using for generations.For example,Om-laben and Lubbana are names used, respec-tively, for Euphorbia retusa and Euphorbia schimperiana.Thepeople gave related local names to two species belonging notonly to the same plant family (Euphorbiaceae) but also tothe same genus (Euphorbia). The meaning in Arabic of bothvernacular names is “plant with milk”. Another example isthe names ofAlsomer andAssalam given toAcacia tortilis andAcacia ehrenbergiana, respectively. The scientific basis of thelocal nomenclatural systems can be noted from this example.For some other species, the Latin name was derived from thelocal name such as the case with Sayel, Al-orfot, and Adnahwhich are the local names ofAcacia seyal,Acacia oerfota, andAdenium obesum, respectively. The last species is endemic tothe south of Saudi Arabia and Yemen [8, 48].

3.4. MPs Used and Taxonomic Identification. Despite thepresence of modern hospitals and well-trained medical staffespecially in the largest towns, Jazan communities still useherbs as an alternative to allopathic medicine for dealingwith routine maladies and chronic diseases. A total of 124MP are commonly used for curative purposes (Table 2). Itis worth mentioning that during the survey some MPs werecited by local peoples to have certain medicinal uses but arenot native to Saudi Arabia so they were not considered inthe present study.Thementioned plants belong to 48 familiesof angiosperms and 103 genera and most of them are wild(91%); only a few are cultivated mainly in home gardens (8%).This confirmed the existence of great diversity of plants usedfor therapeutic purposes and preserved traditional culture,

as reported previously [1, 68]. A recent literature surveyshowed that a total of 309 genera containing 471 species in89 families are used in ethnomedicine in Saudi Arabia [68].Moreover, our findings indicate that most of the participantsdepend on wild sources to get the MPs, since the practice ofdomestication and cultivation ofMPs is not common. In fact,this would be a very difficult task on the mountain terraceswhereas in Tihama coastal plains most of farmers grow highvalue cash crop as well as other subsistence crops insteadof MPs. Some species which showed promising results fordomestication in home gardens suffer from lack of properagronomic techniques. Furthermore, there is a convictionshared between all informants that wild MPs have bettermedicinal values than those domesticated in home gardenswhich may explain the lack of interest in cultivating MPs.The above notes further argue for the need to conserve thenatural flora in Saudi Arabia in order to realize the dual aimsof protecting the species used by people as well the flora ingeneral and avoid the loss of the TK.

The family, scientific name, endemism, vernacular name,preparation and administration methods, and use categoriesof the MP used in Jazan region are given in Table 2. Thetable shows a substantial number of MP used for severalroutine maladies and chronic diseases related to skin andGIT disorders, urogenital diseases, liver and spleen disorders,SMproblems, general health conditions (GHC), and scorpionstings and snake bites and somewhat fewer for respira-tory tract and throat problems, ear, nose, eyes, and mouth(ENEM) diseases, diabetes, cardiovascular diseases, andnervous system problems. The families with greater worthbecause of the number of species are Asteraceae (13 plants),Fabaceae and Apocynaceae (9 plants each), Lamiaceae andEuphorbiaceae (7 plants each), Zygophyllaceae (6), Ama-ranthaceae (5), Acanthaceae (4), Apiaceae, Capparidaceae,Cleomaceae, Solanaceae (4 plants each), and Moraceae andPolygonaceae (3 plants each), while the remaining 34 familieshad one species each (Figure 2). In agreement with this,a recent literature survey on MPs of Saudi Arabia showedthe most mentioned MP families were Asteraceae, Fabaceae,Lamiaceae, Euphorbiaceae, Solanaceae, Apiaceae, Brassi-caceae, Chenopodiaceae, Poaceae, Amaranthaceae, Bor-aginaceae, Apocynaceae, Convolvoulaceae, Asclepiadaceae,Capparaceae, Polygonaceae, and Zygophyllaceae [68]. How-ever, it was reported that the families of medicinal valuein the southwestern Saudi Arabia are Fabaceae, Lamiaceae,Asteraceae, and Euphorbiaceae [1, 4]. The dominance ofthe utilization of MP species belonging to Asteraceae andFabaceae families in our study was reported for several com-munities in other countries especially in the neighbouringcountries such as Ethiopia [65, 71]. This may be due totheir wide distribution and their traditional uses known bythese local communities too. Asteraceae is one of the mainfamilies of the desert flora and the second most importantplant family of therapeutic value in the Mediterranean region[74]. All these families as well as other families cited in thepresent study are described in Saudi Arabia flora [50, 52].Thetherapeutic virtues of some plant species belonging to thesefamilies were also reported while their bioactive compoundsand mode of action have not yet been defined accurately and

8 Evidence-Based Complementary and Alternative Medicine

Table2:Listof

theM

Psrecorded

from

Jazanregion

,dise

ases

they

were

claimed

tocureandwayso

futilisa

tion.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

ACANTH

ACEA

E

1Blepharis

ciliaris

(L.)B.

L.Bu

rtt

(CER

SH-022)

Perenn

ial

herb

Sand

dunesand

plains

Al-Z

aghaf

Lea,Ro

o,See

Pow,

Dec

Decoctio

nof

leaves,

rootsa

ndseedsis

takenorally.

The

rootsare

grou

ndto

makea

powder

appliedtopically

;eye

drop

s

Fever,astringents,

appetizer,cou

gh,

asthma,wou

nds,

sores,pruritic,

injurie

s,liverand

GIT

diseases,

diuretic,urin

ary

diseases,m

enstr

ual

pain,spleendisorder,

eyep

ain

0.05

Vitiligo,sores,

wou

nds,fever,

coug

h,asthma,

anti-inflammatory,

cataracts,astringents,

eyeinfl

ammation,

appetizer,antito

xic,

diuretic,lu

ngdiseases,liverand

spleen

disorder

[4–6

]

2An

isotestrisulcus(Fo

rssk.)Nees

(end

emic)

(CER

SH-044

)Sh

rub

FyfaMou

ntains

Math

Lea,flo

wDec

Boiling

crushedfre

shleavesandflo

wersin

waterandthew

ater

istakenorally

Fever,malaria,

diabetes,fo

otinflammation,

oedema,

hepatoprotectiv

e,neurological

disorder,hepatitis

0.06

Diabetes,malaria,

hepatitis,

oedema,

epilepsy,anaesth

etic,

hepatoprotectiv

e,jaun

dice,

antib

acteria

l,cytotoxicity[7–9

]

3Av

icenn

iamarinaFo

rssk

(CER

SH-108)

Sub-shrub

Along

the

shore-lin

eSh

oura

Bar

Inf

Soakingc

rushed

bark

inwaterandthe

wateristakenorally

Smallpox,sores,

pruritic,indu

cewom

eninfertility,

diabetes

0.04

Smallpox,diabetes

[10,11]

4Peristro

phep

anicu

lata

(Forssk.)

Brum

mitt

(CER

SH-076)

Ann

ual

Herb

Tihamap

lains

Madhiafa,thou

emWho

Inf

Soakingc

rushed

plantinwaterand

thew

ateristaken

orally

Anti-snake

veno

m0.02

Anti-snake

poiso

n[5]

AGAV

ACEA

E

5Dracaenaom

betK

ot.&

Peyr.

(rare)

(CER

SH-109)

T ree

Fyfamou

ntains

Azef,Meqr

Aer,Re

sEx

t,Pas,Po

w

Paste

isapplied

topically

forskin

prob

lems;thep

lant

extractistaken

orally

form

alaria,

powderedresin

isappliedtopically

Skin

infections,

wou

nds,bu

rns,

injurie

s,haem

orrhage,

smoo

ththeh

air,

allergy,malaria,

spasm

0.03

Wou

nds,bu

rns,hair,

spasm,

strengthening

,allergy,malaria[10]

Evidence-Based Complementary and Alternative Medicine 9

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

AMARA

NTH

ACEA

E

6Achyranthesa

speraL.

(CER

SH-107)

Perenn

ial

herb

Fyfamou

ntains

Mahwat

Who

Pas,Ex

t

Leafpaste

isapplied

locally

forskin

diseases;roo

tpasteis

appliedon

snakeb

itearea,the

plant

extractisu

sedfor

fever,abortio

nand

labo

urpainsand

GIT

diseases;garglefor

toothache

Fever,astringent,

colds,sto

machache,

diuretic,skin

diseases,acne,

anti-inflammatory,

pruritic,snakea

ndscorpion

sting

s,abortio

nandlabo

urpains,toothache

0.06

Pruritic,fever,snake

bites,jaun

dice,

stomach-ache,

toothache,colds

[5,12]

7Suaeda

aegyptiaca

Hasselq

(CER

SH-114)

Perenn

ial

herb

Tihamap

lain

andFarasan

Island

sSuwwad

Lea

Pas

Leafpaste

isapplied

topically

Con

tagiou

sskin

diseases,blisters,

sores,pruritic

0.02

Blistersand

sores[4]

8Ae

rvajavanica

(Burm.f.)Juss.

exSchu

ltes

(CER

SH-046

)

Perenn

ial

herb

Com

mon

inTihamap

lains

Al-R

aaRo

o,lea,flo

w,See

Pow,

Pas,Inf

Leafpaste

isapplied

topically

forskin

diseases;soaking

the

crushedfre

shplant

inwaterandthe

wateristakenorally

Headaches,w

ound

s,injurie

s,bruises,

toothache,snakea

ndinsectsting

s,malaria,

kidn

eysto

nes,bo

nefractures,

rheumatism

,neurological

disorders

0.09

Headaches,

toothache,

haem

ostatic

,wou

nds,ulcers,

anti-inflammatory,

neurological

disorder,

rheumatism

,GIT

diseases,bon

eprob

lems,

haem

orrhage,kidn

eyprob

lems[6,7,12–15]

9Ae

rvalanata

(L.)Juss.exSchu

lt(C

ERSH

-115)

Perenn

ial

herb

Nearthe

stagn

antw

aters

ofthew

adis

Al-A

thlab

Who

Ext,Pas

Root

paste

isapplied

onscorpion

sting

are a

Di uretic

,GIT

diseases;scorpion

sting

s0.02

Antim

icrobial,

scorpion

sting

[16]

10Am

aranthus

virid

isL.

(CER

SH-075)

Ann

ual

herb

Fyfamou

ntains

KafA

lmehana,

Qutaifa

Who

Pas,Dec

Leafused

asem

ollient

inscorpion

sting

s

Bloo

dpu

rifier,piles,

GIT

diseases,

abortifacient,

scorpion

sting

s

0.04

Scorpion

sting

s[17]

10 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

APIAC

EAE

11An

ethu

mgraveolen

sL.

(CER

SH-045)

Ann

ual

herb

Cultivatedin

gardens

Shibt/snou

tLea,fru,Ro

oInf

Soakingc

rushed

plantand

thew

ateris

takenorally

Postn

atalprob

lems,

GIT

prob

lems

0.03

GIT

diseases

[14]

12Foenicu

lum

vulga

reMill.

(CER

SH-116)

Perenn

ial

herb

Mou

ntains

Sham

rRo

o,See

Pow,

Dec

Boiling

crushedfre

shrootsinwaterand

thew

ateristaken

orally

Body

energizer,

tonic,GIT

diseases,

spasm,blood

purifi

er,m

alaria

0.04

GIT

diseases,

urological,

neurological,

gynaecological,

bloo

dandim

mun

esyste

m,cou

gh,

spasm

[14,18]

13Cu

minum

cyminum

L.(C

ERSH

-023)

Ann

ual

herb

Cultivatedin

gardens

Cumin

See

Info

rDec,Pow

Seedsp

owder

appliedexternally;

boiling

crushedseeds

inwaterandthe

wateristakenorally

GIT

prob

lems,

urinaryd

iseases,

scorpion

sting

s,diabetes

0.03

GIT

diseases,

gynaecological,

endo

crinea

ndnu

trition

alprob

lems,

respira

tory

prob

lems

[14]

14Trachyspermum

ammi(L.)

Sprague(CE

RSH-001)

Shrub

Cultivatedin

gardens

Ajwain

Who

,See,oil

Pow,

Dec

Boiling

crushed

seedsinwaterand

thew

ateristaken

orally;Seeds

powder

appliedexternally;

oilisg

iven

toexpel

hook

worms.

GIT

diseases,

hook

worms,

diarrhoea,asthma,

coughs,infl

uenza,

cholera,kidn

eysto

nes,urinary

diseases,scorpion

sting

s,SM

disorders

0.04

GIT

diseases,SM

disorders,

gynaecological,

scorpion

sting

s[14]

APO

CYNAC

EAE

15Ca

rallumaedulis(Edgew

.)Be

nth.&Hoo

k.f.

(CER

SH-074)

Perenn

ial

herb

Along

watercourses

Gh lotha

See,Ste

Pas,Po

w

Powderm

ixed

with

milk

andapplied

externally,

leafpaste

isappliedtopically

Malaria,respiratory

andthroatdiseases,

lung

pains,scorpion

sting

sand

snake

bites,chickenp

ox,

smallpox,m

easle

s,pruritic

0.04

Chickenp

ox,

smallpox,diabetes,

measle

s,breast

cancer[10,19]

Evidence-Based Complementary and Alternative Medicine 11

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

16Monollumaquadrangula

(Forssk.)P

lowes

(CER

SH-106)

Perenn

ial

herb

Mou

ntains

Ghalaf

Lea

Coo

k/heated

Heatedon

coalthen

cooked

with

spices

andeaten;thefresh

plantise

aten

totre

atgastr

iculcersand

diabetes

Influ

enza,diabetes,

spasm,gastriculcers

0.03

Influ

enza,diabetes,

spasm,gastriculcers

[10,20]

17Ce

ropegiavarie

gata

Forssk.

Decne.(endangered)

(CER

SH-047)

Perenn

ial

herb

Along

watercourses

Meyabesa

Aer

Pas

Leafpaste

isapplied

externallyin

the

abdo

minalarea

Expeltapew

orms

0.02

Taeniafuge

[10]

18Ca

lotro

pisp

rocera

(Aito

n.)W

.T.Aito

n(C

ERSH

-024)

Smalltree

Distrib

uted

inTihamap

alin

Ushar

Flow

,lea,Ste,

lat

Ext,Pas,lin

i,Po

u

Leafpaste

isused

tocleanpain

area.Leaf

extractisa

pplied

directlyagainsth

air

loss;Leafp

asteand

latexa

reused

for

locally

forskin

prob

lems;po

ultic

eis

appliedon

rheumatic

pain

Body

energizer,fever,

asthma,headaches,

indigestion

,cou

gh,

diarrhoea,toothache,

leprosy,wou

nds,

musclesprob

lems,

skin

infections,boils,

psoriasis,hairloss,

scorpion

sting

s,malaria,diabetes

0.08

Skin

infections,

psoriasis,hairloss,

diabetes,

leish

maniosis,

analgesic

,respiratory

prob

lems,scorpion

sting

s,str

engthening

muscles,rheum

atism

[5,6,10,13,14,21]

19Leptadeniapyrotechnica

(Forssk.)D

ecne

(CER

SH-002)

Shrub

Sand

dunesand

plains

Markh

Who

Inf,Pas,Ex

t

Soakingc

rushed

bark

inwaterandthe

wateristakenorally;

crushedste

msare

appliedto

wou

nds;

infusio

nof

thew

hole

plantm

ixed

with

butte

rmilk

isgiven

forstomach

disorders.

Headaches,diuretic

,sto

machdisorders,

wou

nds,sto

pbleeding

,kidney

disorders,urinary

retention,SM

and

gynaecological

disorders

0.06

diuretic,smallpox,

pso riasis,eczem

a,derm

atitis,diabetes,

carm

inative,

purgative,antitum

or,

hypo

lipidem

ic,

anti-atherosclerotic

[6]

20Ne

rium

oleand

erL.

(CER

SH-093)

Smalltree

Cultivatedin

gardens

Difla

Lea,Ro

oPas,Ex

t,Po

u

Extractsfro

mleaves

androotsare

used

internally;pou

ltice

isappliedforskin

prob

lems.

Skin

diseases,

scabies,pruritic,

bron

chitis,coughs,

diuretic,anti-snake

veno

m

0.06

Diuretic

,emetic,

bron

chitis,coughs,

scabies[6,18]

12 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

21Rh

azya

strictaDecne.

(CER

SH-119)

Shrub

Tihamap

lains

Harmal

Lea,flo

wPo

w,Pas

Leafpaste

isapplied

topically

Rheumatism

,allergy,

improvingb

adbreath,skinrash,

pruritic

0.06

Tonic,stimulant,

syph

ilis,allergy,GIT

disease,

anti-microbial,colon

cancer,

anti-inflammatory,

rheumatism

[4,6,13,14,19]

22Ca

rissa

edulisVa

hl(Forssk.)

CERS

H-073

Shrubor

smalltree

FyfaMou

ntains

A'rm

,Airo

onLea,Fru

Pow,

Pas

Berriesa

reeatenraw;

leafpaste

isapplied

topically

Anti-snake

veno

m,

parasiticworms,

colic,too

thache,

menstr

ualpain

0.03

Anthelm

intic

,sto

machdisorders,

antiscorbutic,

toothache,astringent

[22]

23Ad

eniumobesum

(Forssk.)

Roem

&Schu

lt.(rare,endemic)

(CER

SH-124)

Shrub

Rockys

lopesa

tinterm

ediate

elevations

Adnah

Aer,lat

Pow,

Pas,Jui

Powderedplantis

appliedexternallyon

theh

ead;thep

lant

juiceisd

ropp

eddirectlyin

the

mou

th;the

useo

fplantm

ilkylatex

isappliedtopically

toskin

diseases

(lotio

n)

Headache,GIT

diseases,skin

infections,rashes,

pruritic,lice,muscle

pain,dislocations,

excitesthe

sexual

desireinwom

en,

venerealdiseases,

scorpion

sting

s,teeth

cleaning

,pestic

ide

0.07

Headache,muscle

pain,joint

pain,kill

lice,tonsillitis,skin

diseases,cleaningthe

teeth,aphrod

isiac,

antiv

iral,

antib

acteria

l,venerealdiseases

[7,10,15,23–26]

ASPARA

GAC

EAE

24Sansevier

iaehrenbergii

Schw

einf.exBa

ker.

(CER

SH-078)

Shrub

Tihamap

lains

Salb

Aer

Pow

Powderisa

pplied

topically

onskin

affectedareas

Wou

nds,pruritic,

injurie

s,insectbites,

malaria

0.03

Wou

nds,insectbites

[10]

ASP

HODEL

ACEA

E

25Aloe

vera

(L.)Bu

rm.f.

(CER

SH-105)

Shrub

FyfaMou

ntains

Al-M

aguar,Sabar

Lea,Ro

oJui,Ex

t,Pas

Leafjuiceisg

iven

orallyform

enstr

ual

tr oub

le,treating

gono

rrho

ea,liver

andspleen

disorders;

leafgelisapp

lied

topically

forskin

prob

lems;paste

isappliedlocally

for

rheumatism

Fever,laxativ

e,sunstro

ke,m

alaria,

eczema,psoriasis,

hairloss,gastric

ulcer,liverpain,

diabetes,m

enstr

ual

troub

les,

gono

rrho

ea,spleen

disorders,nerve

pain,rheum

atism

0.08

Skin

diseases,

eczema,psoriasis,

laxativ

e,sunstro

ke,

stomachulcer,pain

ofnerves,

gono

rrho

ea,

menstr

ualtroub

le,

liverandspleen

disorders,

rheumatism

[5,14,15,27]

Evidence-Based Complementary and Alternative Medicine 13

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

26Asphodelu

stenuifoliu

sCav.

(CER

SH-025)

Perenn

ial

herb

Along

watercourses

Broq

ueSee,Ro

oPas,Po

uPo

ultic

eisa

pplied

forskinprob

lems

andrheumatism

Skin

diseases,

wou

nds,

anti-inflammatory,

pruritic,

rheumatism

,colds

0.02

Eczema,alop

ecia,

paralysis,earache

[28]

AST

ERAC

EAE

27Pu

licariaun

dulata

(L.)Ko

stel.

(CER

SH-090)

Perenn

ial

herb

FyfaMou

ntains

Gathgath

Who

Pas,Inf

Leafpaste

isapplied

topically,infusionis

takenorallyfor

internaldiseases

Skin

diseases,

wou

nds,central

nervou

ssystem

depressio

n

0.06

Centralnervou

ssyste

mdepressio

n,antim

icrobial,breast

cancer,livercancer,

leuk

aemia,diuretic

[6,19,23]

28Pu

licariajaubertii

Gam

alEd

Din

(CER

SH-048)

Perenn

ial

herb

Tihamap

lains

andFarasan

Island

Al-A

rar/

EterElraee

Who

Dec

Soakingc

rushed

leavesin

boiledwater

andthew

ateris

takenorally

Carminative,

intestinalw

orms,

digestive

disorders,

malaria

0.03

Anthelm

intic

,antim

icrobial,

antifun

gal,

antim

alarial,

insecticidal[29]

29Pu

licariaschimperiDC.

(CER

SH-072)

Ann

ualor

biennial

herb

FyfaMou

ntains

Sakab

Lea

Pas

Leafpaste

isapplied

topically

tocure

wou

ndsand

forh

air

Hairstre

ngthening,

wou

ndsinfectio

n0.03

Wou

nds[30]

30Rh

anteriu

mepapposum

Oliv.

(CER

SH-003)

Shrub

Desertlands

Al-A

rfaj

Lea

Pas,Dec

Leafpaste

isapplied

topically

;decoctio

nisused

orallyto

treat

diabetesand

digestive

troub

les

Respira

tory

and

throatdiseases,

diabetes,allergy,

oedema,digestive

troub

les,toothache,

insectrepellent

0.06

Diabetes,allergy,

oed ema,toothache,

GIT

disorders,

antim

icrobial[6,10]

14 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

31Ar

temisiaabyssin

icaSchu

ltz-Bip(C

ERSH

-121)

Shrub

Mou

ntains

Beith

ran,Al-o

bal

Who

Dec

orInf

Decoctio

nisused

orallyto

treat

diabetes,cou

gh,cold,

irritatio

nof

the

throatandmenstr

ual

pain

Appetizer,digestiv

etro

ubles,parasitic

worms,spasm,

rheumatism

,menstr

ualpain,

diabetes,m

alaria,

coug

h,cold,

irritatio

nof

the

throat

0.07

Appetizer,headache,

diabetes,m

ellitus,

cold,spasm

,ph

aryn

gitis,insect

repellent,

anthelmintic

,rheumatism

,antib

acteria

l,indigestion

[5,7,10,23]

32Ar

temisiasieberiBe

sser

(CER

SH-092)

Shrub

Mou

ntains

Shih

Who

Dec,B

ur

Thew

holeplantis

used

asas

moke

inhalant

totre

atvario

usdiseases;

decoctionfro

mleavesareu

sedorally

asan

anthelmintic

GIT

diseases,

intestinalw

orms

0.04

Breastandliv

ercancer[19

]

33Ch

rysanthemum

coronariu

mL.

(CER

SH-071)

Ann

ual

herb

Tihamap

alin

Ouk

houan

Who

Pas

Leafpaste

isapplied

topically

;fresh

roots

arec

hewed

Laxativ

e,anti-inflammatory

0.03

Purgative,syph

ilis.

Anti-infl

ammation

[5]

34Achilleabieberste

iniiAfan.

(CER

SH-079)

Perenn

ial

herb

Mou

ntains

Kaysou

m/A

ldefera/

thafra'a

Who

Pas,Inf

Leafpaste

isapplied

topically

;aninfusio

nform

itsleavesis

used

orally;chewing

offre

shleaves

relievestoo

thache

Carminative,itching

,insectrepellent,

urinaryd

iseases,

toothache,kidn

eyinflammation,

menstr

uatio

ntro

ubles,

leish

maniosis

0.05

Leish

maniosis,insect

repellent,too

thache

[7,23]

35Co

nyza

incana

(Vahl)Willd.

(CER

SH-026)

Perenn

ial

herb

FyfaMou

ntains

Baith

ran,arfaj

Lea

Bur

Thes

mokeo

fburned

leavesisused

torepel

insectsand

isinhaled

nasally

forrelieving

mu scularp

ains

Centralnervou

ssyste

mdepressio

n,cardiacstim

ulation,

muscularp

ains,

insectsrepellent,

malaria,

leish

maniosis

0.03

Antifu

ngalactiv

ity[23]

Evidence-Based Complementary and Alternative Medicine 15

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

36Xa

nthium

strum

arium

L.(C

ERSH

-081)

Ann

ual

herb

Along

watercourses

Who

Dec,C

ook

Soakingc

rushed

who

leplantinbo

iled

waterandthew

ater

istakenorally

Malaria,G

ITdisorders,sto

mach

ache

0.02

Leuk

oderma,biteso

finsects,epilepsy,

allergy,saliv

ation,

malaria,leprosy,

rheumatism

,tuberculosis,

rheumatoidarthritis,

diarrhoea,

constip

ation,

lumbago,pruritus,

bacterialand

fung

alinfections

[31]

37Oste

osperm

umvaillantii

Decne

(CER

SH-110)

Shrub

Mou

tains

Ann

akad,H

echm

atEl-th

ore

Who

Inf

Soakingc

rushed

who

leplantinwater

andthew

ateris

takenorally

GIT

diseases,liver

disorders

0.02

Fever,sto

mach

ailm

entsandliver

disorders

38Picriscyanocarpa

Boiss.

(CER

SH-094)

Ann

ual

herb

Tihamap

lains

Hozan

Who

Dec

Soakingc

rushed

who

leplantinwater

andthew

ateris

takenorally

Lower

bloo

dpressure,cardiac

stimulation,central

nervou

ssystem

stimulation,

0.02

Antioxidant

prop

ertie

s[23]

39Sonchu

soleraceusL

(CER

SH-004

)Ann

ual

herb

FyfaMou

ntains

Udd

aid

Lea,flo

wPas,Dec

Leafpaste

isapplied

topically

;decoctio

nappliedorallyto

indu

cemenstr

uatio

n

Indu

cemenstr

uatio

n,skin

infection,sores,

pruritic,scorpion

sting

s

0.03

Skin

diseases,sores

[4,13]

ASPARA

GAC

EAE

40Asparagusa

fricanu

sLam

.(C

ERSH

-111)

Shrub

FyfaMou

ntains

Smin,khu

rustheeb

Aer

Pas

Leafpaste

isapplied

topically,chewingo

fleavesrelieves

breathingp

roblem

s

Paralysis,skin

diseases,pruritic,

swellin

g,malaria,

breathingp

roblem

s

0.03

Malaria,

leish

maniosis,

ana lgesic

and

anti-inflammatory

activ

ities[32]

16 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

BORA

GIN

ACEA

E

41Heliotropium

digynu

mFo

rssk.

(CER

SH-070)

Shrub

Sand

ysoilin

Tiham

plains

Hettan,Ra

ghel,

Atana,Dafra

Who

Pas,Inf

Leafpaste

isapplied

topically

;soaking

crushedleavesin

waterandthew

ater

istakenorally

Skin

diseases,liver

pain,diuretic

0.03

Skin

diseases

[4]

42Heliotropium

bacciferum

Forssk.

(CER

SH-027)

Perenn

ial

herb

Tihamap

alin

Ramram

Who

,lea

Dec,Pas

Leafpaste

isapplied

topically

forsnake

bites;decoction

appliedorallyisused

foru

rinaryp

roblem

s

Urin

aryd

iseases,

snakeb

ites,skin

infections

0.04

Scorpion

sting

s,skin

diseases,ton

sillitis

[21]

BURS

ERAC

EAE

43Co

mmiphora

gilea

densis(L.)

Chris

t.(rare)

(CER

SH-049)

Shrub

Tihamap

lains

andFarasan

Island

Al-b

isham

Bran,gum

,Re

sDec,Pas,Pou

Poultic

eisa

pplied

forskinprob

lems

andbo

nefracture

(topically);soaking

crushedresin

inwaterandthew

ater

istakenorally

Toothache,

respira

tory

diseases,

anti-snakev

enom

,bo

nefracture,

leish

maniosis,

nervou

ssystem

disorders

0.05

Anti-snake

poiso

n,pepticulcer,

leish

maniosis,

gynaecological

diseases,respiratory

diseases,

neurologicaltro

ubles

[7,14]

44Co

mmiphora

myrrha(

Nees)

Engl.(rare)(CE

RSH-005)

Shrub

Tihamap

lains

Myrrha

Orouq

AlA

qaRe

s,gum,B

arInf,Pas

Oilleafpaste

isappliedtopically

;soakingcrushed

resin

orbark

inwater

andthew

ateris

takenorally

Carminative,bo

nefractures,wou

nds,

burns,pruritic,

stomachpain,

urinarytract

infection,scorpion

sting

s

0.05

Laxativ

e,wou

nds,

stomachpain,

diarrhoea,urinary

tractinfectio

n,scorpion

sting

s,respira

tory

diseases,

gynaecological

infections,

haem

orrhage

[10,12,14,21]

BRASSIC

ACEA

E

45MatthiolaArabica

Boiss.

(CER

SH-080)

Ann

ual

herb

Tihamap

lains

alon

gwatercourses

Soqar

See

Inf

Soakingc

rushed

seedsinwaterand

thew

ateristaken

orally;the

seedsa

reeatenraw

Anaem

ia0.02

Anaem

ia[10]

Evidence-Based Complementary and Alternative Medicine 17

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

CACT

ACEA

E

46Opuntia

ficus-in

dica

Mill

(CER

SH-006)

Shrub

Cultivatedin

gardens

Barsho

umSte,Fru

Dec

Soakingc

rushed

stemsinbo

iledwater

andthew

ateris

takenorally

Diabetes

0.03

Diabetes[21].

CAPP

ARI

DAC

EAE

47Ca

pparisspinosaL.

(CER

SH-028)

Shrub

Tihamap

lains

Shafallah

Lea,Ro

oDec,Pas

Leafpaste

isapplied

topically

;soaking

crushedleavesand

rootsinbo

iledwater

andthew

ateris

takenorally

Urin

aryd

iseases,

kidn

eysto

nes,GIT

prob

lems,parasitic

worms,diuretic,skin

diseases,

anti-inflammatory,

rheumatism

,diabetes,

spleno

megaly,indu

cemenstr

uatio

n

0.06

Dermatitis,

diarrhoea,diabetes

[5,7]

48Ca

pparisdecid

ua(Forssk.)

Edgew(rare)(C

ERSH

-051)

Shrub

Tihamap

lains

andFarasan

Island

sTand

hab

Who

Pas,Inf

Leafpaste

isapplied

topically

;soaking

crushedfre

shleaves

inwaterandthe

wateristakenorally

Carminative,

laxativ

e,fever,

intestinalw

orms,

leprosy,sores,ear

pain,diabetes,

rheumatism

,aphrod

isiac,in

duce

menstr

uatio

n

0.05

Cou

ghs,appetizer,

asthma,fever,bo

ils,

anti-inflammatory;

cardiactroub

les,

analgesic

,bilio

usness,

alveolaris,

pyorrhoea,

purgative,diabetes,

anthelmintic

,hyper-

cholesterolemia,

antim

icrobial[33]

49Ca

daba

rotund

ifolia

Forssk.

(CER

SH-069)

Shrub

Tihamap

lains

Kathab

Lea

Inf

Soakingc

rushed

fresh

leavesin

water

andthew

ateris

takenorally

Rheumatism

,urin

ary

diseases

0.02

Antibiotic

[12]

50Ca

daba

farin

osaFo

rssk

(CER

SH-050)

Shrub

Abu-Aris

hTihamap

lains

Asaf,Q

usaia,

Azan-al-arnab

Lea

Pas,Dec

Leafpaste

isapplied

topically

ontheh

ead;

decoctionfro

mleavesistakenorally

Parasiticworms,liver

pains,dysentery,

indu

cemenstr

uatio

n,cough,lung

sprob

lems,nervou

ssyste

mdisorders

0.04

Hepatoprotective,

sores,wou

nds,

hydrocephalus,

haem

orrhage

antio

xidant

activ

ities

[12]

18 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

CARY

OPH

YLLA

CEAE

51Minuartiafilifolia

(Forssk.).

Mattf.

(CER

SH-095)

Perenn

ial

herb

Mou

ntains

Oud

Al-H

alaba

Bar

Pas,Dec

Leafpaste

isapplied

topically,decoctio

nfro

mbark

istaken

orally

Prom

otew

omen

fertility,snakesb

ites

0.02

CLEO

MAC

EAE

52Cleomev

iscosaL.

(CER

SH-007)

Ann

ual

herb

FyfaMou

ntains

Om

-Hanif

Who

Pas,Dec

Leafpaste

isapplied

topically

;decoctio

nfro

mcrushedfre

shleavesistakenorally

Intestinalw

orms,

stomachache,

anti-inflammatory,

skin

diseases,

wou

nds,leprosy,

malaria,ear

pain,

snakeb

ites

0.05

Anthelm

intic

,wou

nds,analgesic

,carm

inative,

antic

onvulsa

nt,

antitum

or,

antid

iarrheal,

antie

metic,

antim

icrobial,

hepatoprotectiv

e[12]

53Cleomea

mblyocarpaBa

rratte&

Murb.(C

ERSH

-104

)Ann

ual

herb

Tihamap

lains

Khun

ayzah/

ouffina

Who

Dec

Decoctio

nfro

mcrushedplantis

takenorally

Insecticide,scabies,

rheumatism

,kidney

prob

lems,sexual

stimulator

0.03

Rheumatism

,rheum

,scabies,rheumatic

fever,

anti-inflammatory

[6]

54Cleomeg

ynandraL.

(CER

SH-117)

Ann

ual

herb

Along

watercourses

andmou

ntains

Oyfiqan

Roo,lea,See

Dec

Boiling

crushedfre

shleavesandrootsin

waterandthew

ater

istakenorally

Appetiser,

carm

inative,ear

pain,splenom

egaly,

musclesprob

lems,

scorpion

sting

s

0.04

Musclew

eakn

ess,

diabetes,

anti-inflammatory,

antic

ancer,

antio

xidant,

immun

omod

ulatory,

cardiovascular

diseases

[10,34]

55Cleomeb

rachycarpa

Vahl

exDC

(CER

SH-068)

Perenn

ial

herb

Tihamap

lains

andFarasan

Island

sBirbran

lea

Pas,Inf

Leafpaste

isapplied

topically

;soaking

crushedfre

shleaves

inwaterandthe

wateristakenorally

Appetizer,

carm

inative,sto

mach

irritant,skin

diseases,scabies,

leprosy

0.03

Diuretic

and

astringent,narcotic

andsto

machirr

itant,

foot

prob

lems[6,12]

Evidence-Based Complementary and Alternative Medicine 19

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

COMBR

ETAC

EAE

56Co

mbretum

molleR.Br.exG.

Don

.(CE

RSH-029)

Shrubor

smalltree

FyfaMou

ntains

Alth

u’ab

Gum

-Th

egum

iseatenraw

Causewom

eninfertility,digestiv

edisorders,sto

mach

ache,m

alaria

0.03

anti-inflammatory,

infections,diabetes,

malaria,bleeding,

diarrhoea,digestive

disorders,diuretic,

anti-Trypanosom

a,anthelmintic

[7,35]

CUCU

RBITAC

EAE

57Citru

lluscolocynthis(L.)Schrad.

(CER

SH-008)

Perenn

ial

herb

Along

watercourses

Hun

dhal

Fru,See,lea

Dec

Halfthe

fresh

fruitis

appliedtopically

;decoctionof

leaves

andseedsisu

sed

orally.

Laxativ

e,scorpion

sting

sand

snakes

bites,insectbites,

leish

maniosis,

vitiligo,skin

infections,rabies,

GIT

diseases,

rheumatism

0.08

Laxativ

e,analgesic

,skin

infection,

hair

dye,scorpion

,dog

,insectandsnake

bites,vitiligo,GIT

diseases,laryn

xcancer,leukaem

ia[4,6,13,14,19,21]

CUPR

ESSA

CEAE

58Juniperusp

rocera

Hochst.Ex

.En

del.(C

ERSH

-052)

Tree

AlH

ashar

mou

ntains

Alar’ar

Lea,fru

Inf,Bu

r

Soakingc

rushed

fruitsin

wateris

takenorally;le

aves

area

ppliedon

burningc

harcoaland

smokeisinh

aled

nasally

Skin

infections,

warts,

toothache,

spasm,cold,flu

0.03

Spasm,gou

t,cold,

pharyn

gitis,

urologicaldisorder

[7,14]

EUPH

ORB

IACE

AE

59Ricin

uscommun

isL.

(CER

SH-009)

Shrub

Widely

distr

ibuted

inTihamap

lains

Kharwah

Who

,oils

Lini,Pow

,Ext,

Jui,Po

u

Leafandroot

powdersarea

pplied

topically

onwou

nds;

root

extractisg

iven

totre

atasthma,

bron

chitisand

rheumatism

;pou

ltice

ofleavesapplied

locally

;seedoilis

appliedtopically

Boils,sores,w

arts,

wou

nds,intestinal

worms,dysentery,

inhibitm

enstr

uatio

n,e nhancethe

lactation

process,rheumatism

,jointp

ain,

bad

breath,too

thache,

asthma,bron

chitis,

scorpion

sting

s

0.07

GIT

diseases,

dysentery,asthma,

warts,

wou

nd,skin

diseases,boils,

sores,

SM,bronchitis,Joint

pain,crackso

ffeet,

rheumatism

[4,5,14]

60Eu

phorbiaschimperia

naScheele

(CER

SH-123)

Smalltree

FyfaMou

ntains

Lubb

ana

Who

,lat

Ext,Dec,lini

Anextracto

fleaves

androotsisu

sed

topically

;soaking

crushedfre

shleaves

inwaterandthe

wateristakenorally

Laxativ

e,respira

tory

andthroatdiseases,

coughs,asthm

a,wou

nds,skin

infections,anti-snake

veno

m,ear

pains

0.04

Caverno

usstink

ing

wou

nds[7]

20 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

61Eu

phorbiaretusa

(Forssk.)

(CER

SH-053)

Perenn

ial

herb

Ghazalah/

Om-la

ben

Lat

Lini

Latexisu

sed

topically

Nervous

syste

mdepressio

n,asthma,

eczema,wou

nds,

warts,

leish

maniosis

0.03

Ano

rectaldiseases,

colondiseases,

fissures,cracks,

fistulas,abscesses,

haem

orrhoids,

inflammatoryb

owel

disease[36,37]

62Jatro

phagla

ucaVa

hl.

(CER

SH-030)

Shrub

FyfaMou

ntain

Kharat,O

rouq

Aobab

Lea,See,Ste

Pow,

Dec,Pas

Soakingc

rushed

fresh

leavesin

water

andthew

ateris

takenorally;the

paste

isused

topically

;pow

dero

fwhiteste

msisu

sed

topically

Chronicskin

diseases,enh

ance

the

lactationprocess,

asthma,allergy,

malaria

0.03

Asthma,

leuk

oderma,allergy,

haem

orrhoids

[10,12].

63Ac

alypha

fruticosa(Forssk).var.

fruticose

(CER

SH-082)

Shrubor

tree

Along

watercourses

and

Abadil

mou

ntains

Thefran,anam

aLea,Ro

oPas,Dec,Inf

Leafpaste

isapplied

topically

;soaking

the

crushedplantin

waterandthew

ater

istakenorallyor

used

asno

sedrop

s;a

root

decoction/infusio

nis

takenorallyforfever

andconstip

ation;

stemso

rroo

tsare

chew

edfortoo

thache

Fevers,too

thache,

eyeinfectio

ns,bee

sting

s,malaria,

typh

oid,liver

prob

lems,

constip

ation,

wou

nds,skin

infections,sores,

colds,coug

h,haem

orrhage

0.06

Malaise,fevers,colds,

coug

h,toothdecays,

eyeinfectio

ns,

haem

orrhage,

wou

nd,skin

infections,

diph

theria,m

alaria,

typh

oid,liver

prob

lems,sto

mach

ache,con

vulsion

s,constip

ation

[5,12,15]

64Ac

alypha

indica

L.(C

ERSH

-096)

Ann

ual

her b

Along

watercourses

andAb

adil

Mou

ntains

Who

Pas

Leafpaste

isapplied

topically

Bron

chitis,asthma,

pneumon

ia,scorpion

sting

s0.03

Ganglions

[12]

65Ch

rozophoraoblongifolia

(Delile)A

.Juss.ex

Spreng

.(C

ERSH

-112)

Sub-shrub

Along

watercourses

Tann

oum

Lea,Ste

Ext

Stem

orleafextractis

used

topically

GIT

prob

lems,

cathartic

andem

etic

0.02

Antim

icrobial,

antio

xidant

[38]

Evidence-Based Complementary and Alternative Medicine 21

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

FABA

CEAE

66Tamarindu

sind

icaL.

(CER

SH-010)

Tree

FyfaMou

ntains

Tamur

Hindi

Fru,See

Dec

Boiling

crushedfre

shfruitsin

waterand

thew

ateristaken

orally

Laxativ

e,headache,

earp

ain,

smallpox,

scabies,sores,

wou

nds;bloo

ddiseases,

antih

ypertensive,

liverpain,intestin

alworms,bo

nefractures,snakeb

ites

0.07

GIT

diseases,skin

diseases

[14,15]

67Alhagigraecorum

Boiss

(CER

SH-103)

Shrub

Tihamap

lains

Aqoo

lWho

Dec

Adecoctionmade

from

seedsisu

sed

orally

Anthelm

intic

,constip

ation,leprosy,

anti-inflammatory,

kidn

eysto

nes,bloo

ddiseases,blood

purifi

er;sexual

enhancem

ent,

rheumatism

0.04

Cataracts,

jaun

dice,

migraine,painful

joints,

aphrod

isiac,

bilharzias,

rheumatism

[6]

68Ac

aciaoerfo

ta(Forssk.)

Schw

einf.(CE

RSH-054)

Shrubor

tree

Fyfa,

mou

ntains

Al-o

rfet

Lea

Inf,Pas

Soakingc

rushed

leavesin

waterand

thew

ateristaken

orally;leafp

asteis

appliedtopically

Severefever,allergy,

skin

diseases,

scorpion

sting

s,hepatitis

0.04

Food

poiso

ning

,wou

ndinfections

[12]

69Ac

aciatortillis(Fo

rssk)

(CER

SH-031)

Shrubor

tree

Along

watercourses

andFyfa

Mou

ntains

Also

mer

Bran,R

oo,

honey

Dec,Pas,B

ur

Thes

hootsand

roots

areb

urnedand

smokeisinh

aled

nasally

;scorched

leaves/roo

tsare

appliedtopically

;toothb

rush

Ulcersand

deep

wou

nds,

anti-inflammatory,

teethcleaning

0.03

Teethcleaning

,ulcersandgang

rene,

wou

ndsd

rycoughs,

coughs,diphtheria

[7,12]

70Ac

aciaehrenbergianaHayne

(CER

SH-083)

Shrubor

tr ee

Along

watercourses

Assalam

Lea,Ba

rPas,Inf

Leafpaste

isapplied

topically

andgrinded

leavesin

wateris

used

towashthee

yes

GIT

diseases,eye

infections

0.03

Injurie

s,wou

ndinfections,eye

infections

[12]

22 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

71Ac

aciaseyalD

el.

(CER

SH-032)

Shrubor

Tree

FyfaMou

ntains

Talh,SanatSayel

Bar,Gum

,Ro

oInf

Soakingc

rushed

bark

orroot

inwater

andthew

ateris

takenorally

Burns,sto

pbleeding

,Leprosy,sto

mach

ache,afte

rabo

rtion

0.03

Stop

bleeding

,sto

machache,

dysentery,aft

erabortio

n[4,12]

72Astra

galusspinosusV

ahl.

(CER

SH-077)

Shrub

Mou

ntains

Katad

Who

Dec

Boiling

crushedplant

inwaterandthe

wateristakenorally

Leuk

aemia,skin

diseases,w

ound

s,scorpion

sting

s0.02

Scorpion

sting

s[21]

73Senn

aalexandrinaMill.

(CER

SH-055)

Shrub

Along

watercourses

Sana,Eshriq

Lea,See

Dec,Pas

Leafpaste

isapplied

topically

;soaking

crushedleavesin

waterandthew

ater

istakenorally

Laxativ

e,skin

diseases,G

ITdiseases,

constip

ation,

abdo

minalpain,

stomachcram

ps

0.07

Injurie

s,skin

diseases,

constip

ation,

stomachcram

ps,

abdo

minalpain,

gynaecological

[6,10,12,14]

74Tephrosia

apollin

ea(D

elile)

Link

(CER

SH-011)

Shrub

Mou

ntains

Who

Dec

Soakingc

rushed

plantinwaterand

thew

ateristaken

orally

Lower

bloo

dpressure,cardiac

stimulation,coug

h,bron

chitis,bo

nefractures,eara

che

0.03

Anti-b

acteria

l;ear

ache,bronchitis,

cough,

wou

nds

bleeding

,bon

efractures,dysentery,

diarrhoea[6,12,23]

LAMIA

CEAE

75Plectra

nthu

sasirensis

J.R.I

Woo

d(rare,endemic)

(CER

SH-084)

Shrub

Fyfa,

Mou

ntains

Shar

Elkroo

d,sana’ab

urWho

Dec,Pas

Boiling

crushedfre

shplantinwaterand

thew

ateristaken

orally;pasteof

fresh

leavesarep

laced

topically

onwou

nds

toavoidinfection

S orethroat,rash,

itching

,wou

nds,

malaria

0.03

Intestinal

distu

rbance,

respira

tory

disorders,

heartd

iseases,liver

fatig

ue,m

alaria,

centraln

ervous

syste

mdisorders,

antiseptic

,wou

nds

[39–41]

Evidence-Based Complementary and Alternative Medicine 23

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

76Orig

anum

majoranaL.

(CER

SH-056)

Sub-shrub

Cultivatedin

gardens

Bardakush

Who

Dec

Boiling

crushedfre

shplantinwaterand

thew

ateristaken

orally

Headaches,

analgesic

,asth

ma,

coug

h,rheumatism

0.04

Analgesicdu

ring

labo

ur-

inflammationof

the

uterus

[10]

77Lavand

uladentataL.

(CER

SH-067)

Shrub

common

onMou

ntains

Dhu

rum

Flow

Inf,tea

Infusio

nof

fresh

plantinwaterand

thew

ateristaken

orally;leafextractin

teaistaken

orally

Urin

eretentio

n,kidn

eysto

nes,ureter

stones,bo

weldisease

0.02

Wou

nds,diuretic,

carm

inative,

antiseptic

,rheumatism

,bron

chopulmon

ary

infections

[42]

78Ne

peta

deflersiana

Schw

einf.ex

Hedge

(CER

SH-118)

Perenn

ial

herb

Mou

ntains

Shaya’a

Who

Tea

Leafextractinteais

takenorally

Sedativ

eor

tranqu

illise

r,sto

machprob

lems

0.03

Anti-infl

ammatory,

carm

inative,

ant-r

heum

atic[43]

79Ocim

umbasilicu

mL.

(CER

SH-033)

Ann

ual

herb

Cultivatedin

gardens

Rayhan

Lea,Ro

o,See

Dec,Pas,Jui,Tea

Decoctio

ntaken

orallyforinternaluse

andas

spices;paste

ofleavesarep

laced

topically

onbruises

toavoidinfection;

leafpaste

isapplied

topically

onsnake

bites;leafandroot

juicea

regivenorally

tocuredysentery;

leavesmixed

with

tea

used

toallayu

pset

stomach,cold,and

fever.

Fever,cough,bruises,

ulcers,skindiseases,

GIT

diseases,

diarrhoea,

ringw

orms,eara

che,

spasm,urin

ary

diseases,kidney

disorders,internal

piles,anti-snake

veno

m

0.06

Spasm,stomach

ulcer,dysentery,

respira

tory,parasite

s,eara

che[5,10,12,14]

80Marrubium

vulga

reL.

(CER

SH-012)

P erenn

ial

herb

Mou

ntains

Zagome

Lea

Pow,

Dec

Leafpo

wderisu

sed

topically

totre

atwou

nds;decoctionis

used

orallyfor

treatingm

enstr

ual

pain

andurinary

diseases

Body

energizer,

intestinalw

orms,

hepatitis,

dyspepsia

,menstr

ualpain,

absenceo

famenstr

ualperiod,

urinaryd

iseases,

tuberculosis,

chronic

bron

chitis

0.04

Wou

nds,coughs

[15]

24 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

81Teucriu

myemenseDeflers

(end

emic)(CE

RSH-097)

Perenn

ial

herb

Al-A

badiland

FyfaMou

ntains

RechalFatim

aWho

Inf

Soakingc

rushed

plantinwaterand

thew

ateristaken

orally

Diabetes,kidn

eyprob

lems,

anthelmintic

,rheumatism

0.03

Insectrepellent,

spasm,kidney

disease,rheumatism

,diabetes[27]

LYTH

RACE

AE

82Laws

oniainermisL.

(CER

SH-085)

Shrub

Cultivatedor

wild

Henna

Lea

Inf,Po

w

Leafinfusio

nisused

orally;le

afpo

wderis

used

asad

yefor

wom

en

Urin

arytract

infection,

skin

protectio

n,diabetes,

scorpion

sting

s,nervep

ainand

nervou

ssystem

disorders

0.04

Antifu

ngal,urin

ary

tractinfectio

n,skin

protectio

n,neurologicalandSM

disorders[9,10,14]

MALV

ACEA

E

83Ab

utilonPa

nnosum

(Forest.)

Schlecht

(CER

SH-057)

Shrub

FarasanIsland

sandAlong

watercourses

Rayn

See,Ba

rEx

t,Inf

Thee

xtractsand

infusio

nof

seedsa

ndbark

inwaterare

appliedorallyto

treat

mosto

fthe

diseases

Sedativ

e,fever,

psoriasis,cleaning

wou

nd,skinulcer,

diabetes,anaem

ia,

GIT

diseases,

diuretic,diarrho

ea,

urinaryd

iseases,

pulm

onary

prob

lems,cough,

bron

chitis,vagina

linfection,

gono

rrho

eabladder

disorders

0.06

Diuretic

,dysentery,

fever,sedativ

e,diarrhoea,cough,

gono

rrho

ea,

bron

chitis,pile

grum

bles,

pulm

onary

prob

lems,cleaning

wou

ndandulcer,

vaginalinfectio

n,anaemia,diabetes,

bladderp

roblem

s,haem

orrhoids

[5,6,23]

84Malva

parvifloraL.

(CER

SH-034)

Ann

ual

herb

Tihamap

lains

Khob

aiza

Who

Inf.

Soakingc

rushed

plantinwaterand

thew

ateristaken

orally;fresh

leavesis

chew

edto

treat

respira

tory

and

throatdiseases

Laxativ

e,respira

tory

andthroatdiseases,

coug

h,bron

chitis,

diabetes,in

testinal

ulcers,hairg

rowth,

constip

ation,

scorpion

sting

s

0.06

Laxativ

e,hair

grow

th,cou

gh,

constip

ation,skin

burns,urinarytract

infection[13,14,18]

MEL

IACE

AE

85Az

adira

chta

indica

A.Juss.

(CER

SH-066

)Sm

alltree

Along

watercourses

Neem

Who

Dec,Pas

Soakingc

rushed

plantinwaterand

thew

ateristaken

orally,

plantp

astis

used

topically

for

scorpion

sting

s

GIT

diseases,gastric

ulcers,scorpion

sting

s,diabetes

0.04

GIT

diseases,

antifun

gal,

antip

yretic,

antib

acteria

l,anti-inflammatory,

diabetes,

anti-arthritic,gastric

ulcer[9,14]

Evidence-Based Complementary and Alternative Medicine 25

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

MORA

CEAE

86Dorste

niafoetidaSchw

einf.

(end

angered)

(CER

SH-098)

Sub-shrub

FyfaMou

ntains

Arkou

th,O

m-la

kef

Lat

Inf,Lat

Infusio

nandlatexis

used

topically

(lotio

n)

GIT

diseases,

Leish

maniosis

0.02

Leish

maniosis

[7]

87Ficusp

almataFo

rssk

(CER

SH-120)

Smalltree

FyfaMou

ntains

Al-H

amat

Who

,lat

Lat

Fruitsaree

aten;latex

isused

topically

kidn

eyandbladder

prob

lems,

gastr

o-intestinal

diseases,w

arts

0.03

Warts,

GIT

diseases

[7,14]

88Ficuscarica

L.(C

ERSH

-087)

Smalltree

Tihamap

lains

Teen

Lea,fru

Dec,Pas,Lat

Fruitsaree

aten

raw;

decoctionof

fruitin

wateristakenorally;

leafpaste

isapplied

onface

tolighten

freckles

Laxativ

e,kidn

eyinfections,kidney

stones,GIT

diseases,

scorpion

sting

s

0.03

Laxativ

e,cough;

lighten

freckles[5]

MORI

NGAC

EAE

89Moringa

peregrina(Forssk.)

Fiori(rare)(CE

RSH-013)

Tree

Tihamap

lains

Al-B

anLea,Seeo

il,gums

Dec,Pas,oil

Decoctio

nandoil

from

thes

eeds

istakenorally;grin

dtheleavesinwater

andwashthee

ye

Laxativ

e,headache,

incurablew

ound

s,bu

rns,abdo

minal

andcolonpains,

constip

ation,

diabetes,eyesp

ain,

anaemia,sciaticpain,

SMdisorders

0.07

Headaches,fe

ver,

burns,wou

nds,

colon,eyespain,

anaemia,jo

ints

pains,backache,

diabetes,sciaticpain,

conjun

ctivitis

[4,7,10]

MYR

TACE

AE

90Myrtuscom

mun

isL.

(CER

SH-035)

Shrub

Tihamap

lains

Al-A

’s/Hadass

Lea,Ba

rInf,Pas

Soakingc

rushed

leavesin

waterand

thew

ateristaken

orally(org

argle)to

cure

respira

tory

and

intestinalproblem

s;bark

ischew

ed;le

afpaste

isapplied

topically

forskin

prob

lems

Deepwou

nddiseases,G

ITdiseases,liver

disorder,asth

ma,

coug

h,mou

thulcers,

scorpion

sting

s,cardiovascular

prob

lems,

leish

maniosis

0.07

Ast hma,cough,

respira

tory

prob

lems,

gang

rene,

pharyn

gitis,

leish

maniosis,blood

andim

mun

esystem

[7,14]

26 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

91Eu

calyptus

camaldu

lensis

Dehnh

.(CE

RSH-058)

Tree

Tihamap

lains

Khafou

rLea

Bur

Theleafisroaste

don

theh

eatedtooland

thesmokeisinh

aled

Abortio

n0.02

Antim

icrobial,

spasmolytic[13]

NIT

RARI

ACEA

E

92Peganu

mharm

alaL.

(rare)(C

ERSH

-065)

Perenn

ial

herb

Tihamap

lains

Harmal

Who

Bur

Thew

holeplantis

used

asas

moke

inhalant

totre

atvario

usdiseases

Toothache,intestinal

worms,rheumatism

,skin

diseases

0.03

Sheepfertility[18]

OLE

ACEA

E

93Jasm

inum

sambacL

inn

(CER

SH-086)

Smallshrub

Cultivatedin

gardens

Al-F

illFru,flo

wDec,B

ur

Decoctio

nof

fruit

andflo

wersinwater

istakenorally;

inhalatio

nof

the

flowers

Intestinalw

orms,

skin

diseases,skin

rashes,leprosy,

ulcers,heighten

sexualdesire

0.03

Liverd

iseases,

cirrho

sis,diarrho

ea,

heighten

sexual

desir

e,skin

rashes,

sunbu

rn,analgesic,

antim

icrobial,

wou

ndhealing[

25]

94Olea

europaea

L.ssp.cuspidata

(Wall.ex

G.D

on)

Ciferri.(CE

RSH-059)

Tree

Mou

ntains

Al-e

tem

Oil,lea,Ba

rInf,Paslini

Soakingc

rushed

leavesin

waterand

thew

ateristaken

orally;fresh

leavesis

chew

ed,soaking

leavesin

waterand

waterisused

asmou

thwash,paste

andoilisu

sed

topically

Liverd

iseases,

oesoph

ageal

irritatio

n,ulcers,

oedemas,oral

thrush,dentalcaries,

warts,

skin

smoo

thing,leprosy,

smallpox,scabies,

diabetes,

leish

maniosis,

rheumatism

0.05

Rheumatism

,leish

maniosis,skin

diseases

ofcamels,

diabetes,m

ellitus

andhypertensio

n,gono

rrho

ea[7,12]

PAPA

VER

ACEA

E

95Fu

mariaparvifloraLam

(CER

SH-037)

Ann

ual

herb

Tihamap

lains

andMou

ntains

Shahtaraj

Aer

Inf,lin

i

Soakingc

rushed

aeria

lpartsin

water

andthew

ateris

takenorally

Intestinalw

orms,

diuretic,urin

ary

diseases,blood

purifi

er,spleen

disorder,leprosy,

scabies,eczema,

acne,lu

ngsd

iseases

0.05

Diuretic

,laxative,

bloo

dpu

rifier,

scabies,eczema,

acne,skindisorders

[5]

Evidence-Based Complementary and Alternative Medicine 27

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

PLAN

TAGIN

ACEA

E

96Plantago

major

L.(C

ERSH

-014)

Perenn

ial

herb

Tihamap

lains

Lissan

Jamal

Roo,lea

Dec,Pow

Decoctio

nof

fresh

plantinwateris

takenorally,

leaf

powderisu

sed

topically

forskin

diseases

Urin

aryd

iseases,

blisters,bo

il,wou

nds,malaria,

scorpion

sting

s

0.03

Blisters,bo

iland

wou

nds[4]

PLUMBA

GIN

ACEA

E

97Limonium

axillare(Fo

rssk.)O.

Kuntze

(CER

SH-099)

Shrub

Tihamap

lains

andFarasan

Island

sQattaf

Who

Dec

Decoctio

nof

fresh

plantinwateris

takenorally

Centralnervou

ssyste

mdepressio

n0.02

Diarrho

ea,astr

ingent

[6,23]

POAC

EAE

98Saccharum

spontaneum

L.(C

ERSH

-038)

Perenn

ial

grass

Along

watercourses

Half

Who

Jui

Juiceo

fwho

leplant

isused

orally

Urin

aryd

iseases,

skin

diseases,

tuberculosis

0.03

Anaem

ia,vom

iting

,abdo

minaldisorders,

obesity,astr

ingent,

emollient,diuretic

,tonic,dyspepsia

,bu

rnings

ensatio

n,piles,respira

tory

troub

les,

antid

iarrheal,

anti-urolith

iatic

activ

ity[44]

99Dactylocte

nium

aegyptium

(L.)

Willd.ex

Asch.&

Schw

einf.

(CER

SH-015)

Ann

ual

grass

Tihamap

lains

andMou

ntains

na’eem

el-saleeb,

riglA

l-harbaya

Roo,lea

Pas,Ex

t,Dec

Theleafp

astein

waterisapplied

topically

;Ext

ofthe

plantistaken

orally;

decoctions

ofseedsis

givenorallyfor

postn

atalprob

lems

GIT

diseases,gastric

ulcer,kidn

eydiseases,biliarya

ndurinarya

ilments,

skin

inflammation,

smallpox,lesion,

sores,po

stnatal

prob

lems

0.03

Astringent,bitter

tonic,

anti-anthelmintic

,wou

nds,sm

allpox,

GIT,biliarya

ndurinarya

ilments,

polyurea

fevers,

spasm

ofmaternity,

r enalinfectio

ns,

immun

e-deficiency,

gastr

iculcers[45,46]

POLY

GONAC

EAE

100

Rumex

nervosus

Vahl.

(CER

SH-100

)Sh

rub

FyfaMou

ntains

Al-a

thrub

Lea,Ro

o,See

Pow

Seedsroaste

dand

used

topically

forthe

treatmentof

dysenterya

ndsnake

bites;leavesand

seedsa

reeatenraw;

chew

ingo

fthe

leaves

Appetizer,astr

ingent,

diarrhoea,diuretic,

stoop

bleeding

,bu

rns,dentalpain,

diabetes,dysentery,

scorpion

andsnake

bites

0.06

Diabetes,asthma,

diarrhoea,diuretic,

dentalpain,w

ound

s,dysentery,scorpion

sting

sand

snake

bites,appetizing,

astringent

[5,7,47]

28 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

101

Rumex

vesicariusL

.(C

ERSH

-088)

Ann

ualor

perenn

ial,

rhizom

a-tous

herb

Al-H

ashar

Mou

ntains

Al-H

ommad

See,lea

-Th

eleavesand

seeds

arec

rushed

and

eatenraw

Wou

nds,spasm,

musclec

ramp,

diuretic,dysentery,

toothache,scorpion

sting

sand

snakeb

ites

0.07

Toothache,

antie

metic,

leuk

aemia,breast,

lung

,centralnervou

ssyste

mcancers,

scorpion

sting

s[6,7,13,19]

102

Emex

spinosa(L.)Cam

pd.

(CER

SH-060

)Ann

ual

herb

FyfaMou

ntains

Ham

baaz

Lea,Ro

o-

Theleavesand

roots

aree

dible(chew

ing)

Dyspepsia,G

ITdisorders

0.03

Appetizer,dyspepsia,

diuretic[13]

RANUNCU

LACE

AE

103

Clem

atiswigh

tiana

Wall.ex

Wight

&Arn.(CE

RSH-016)

Clim

ber

FyfaMou

ntains

Threeja,Alharya

Who

Pas

Theleafp

astein

waterisapplied

topically

Skin

diseases,

leprosy,cardiac

depressio

n,varic

ose

veins,bo

nefracture,

rheumatism

0.03

Rheumatism

,headaches,varic

ose

veins,syph

ilis,gout,

bone

prob

lems[23]

RHAMNAC

EAE

104

Zizip

husspina

-christi(L.)W

illd

(CER

SH-113)

Tree

Fyfamou

ntains

andalon

gwatercourses

Seder,Arq

Lea,Fru,See

Dec,Inf.

Decoctio

nof

the

plantisu

sedorally

forG

ITprob

lems;

crushedseed

kernels

aree

aten

raw;

chew

ingfresh

leaves

torelieve

mou

thprob

lems

Scabies,measle

s,sores,wou

nds,lice,

hairtonic,allergy,

rabies,antidandruff

;toothache,sto

mach

ache,liverp

roblem

s,headache,in

sect

bites,leish

maniosis,

spasm,rheum

atism

,urinarytroub

les,

diabetes,anaem

ia

0.08

Duo

denu

mand

stomachache,

allergy,chestp

ain;

scabies,itc

hing

,sores,wou

nds,

bruises;insectbites,

diabetes,spasm

,str

engthening

hairs

,antid

andruff

,mou

thprob

lems

[4,5,7,13,21,48]

RHI ZOPH

ORA

CEAE

105

Rhizophora

mucrona

taLam.

(CER

SH-039)

Smalltree

Tihamap

lains

Kind

ale

Bar,Ro

o,lea,

fru,flo

wDec,Pas

Soakingc

rushed

plantinwaterand

thew

ateristaken

orally

Diabetes,GIT

diseases

0.02

Diabetes,diarrhoea,

anti-inflammatory

hepatitis[11]

Evidence-Based Complementary and Alternative Medicine 29

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

RUTA

CEAE

106

Ruta

chalepensis

L.(C

ERSH

-061)

Perenn

ial

herb

Cultivatedin

gardenso

rwild

inFy

faMou

ntains

El-shathab

Lea,Ste

Dec

Soakingc

rushed

leavesin

waterand

thew

ateristaken

orally

Headache,fever,ear

pain,vitiligo,

measle

s,snakeb

ites,

menstr

ualpain,skin

diseases,

rheumatism

,GIT

diseases

0.08

Snakeb

ites,ear,

neurological,

diph

theria,

respira

tory

diseases

[7,12,14]

RUBIAC

EAE

107

Coffeaarabica

L(C

ERSH

-040

)Sm

alltree

Cultivatedon

Mou

ntains

Bone

See

Pow

Heatcrushed

seeds

andapplytopically

Fever,tonic,

headache,m

alaria,

kidn

eydisorders,

kidn

eyinflammation

0.03

Haemorrhage,

asthma,flu

,atropine-poisoning

,sores,stimulants

fever,headache,

jaun

dice,m

alaria,

vertigomigraine,

narcosis,

neph

ritis

[5]

SALV

ADORA

CEAE

108

Salva

dora

persica

L.(C

ERSH

-017)

Shrubor

Smalltree

Tihamap

lains

andfoothills

Al-A

rak

Fru,Ro

oCoo

k

Rootsare

used

astoothb

rush;fruits

are

eatenraw;coo

ked

leavesfork

idney

prob

lems

Teethcleaning

,kidn

eydiseases

and

stones,spleen

disorder,

rheumatism

,snake

bites

0.05

Snakeb

ites,epilepsy,

rheumatism

,skin

diseases,too

thbrush,

gono

rrho

ea,spleen

troub

les,sto

mach

ulcer[7]

SAPINDAC

EAE

109

DodonaeaviscosaJacq

(CER

SH-101)

Smalltree

FyfaMou

ntains

Shath

Lea

Pas,Po

w

Leafpo

wderisu

sed

fortreating

toothache;leafpaste

isappliedtopically

forskinprob

lem

Rheumatism

,toothache,wou

nds,

burns,malaria,

leish

maniosis

0.03

Toothache,bu

rns,

wou

nds

leish

maniosis

[4,6,7]

SOL A

NAC

EAE

110

Solanu

mincanu

mL

(CER

SH-063)

Shrub

Fyfa

Mou

ntains

And

foothills

Nagum

,Al-h

adak

Fru,Ro

o,lea

Pas,Dec,Pou

Leafpaste

isapplied

topically

aspo

ultic

eon

skin

diseases;

decoctionfro

mberries,leavesand

rootsistaken

orally;

berriesb

oiledin

oil

andtheo

ilisused

for

earache

Severfever,m

alaria,

leish

maniosis,

earache,wou

nds,

bruise,rashes,warts,

dyspepsia

,ulcers,

carbun

cles,

stomach-ache,

painfulm

enstr

uatio

n

0.07

Malaria,

leish

maniosis,

bruisedfin

gers,

wou

nds,

onchocerciasis,

earache,dyspepsia

,pleuris

y,rheumatism

,pn

eumon

ia,

haem

orrhoids

[5,7,12]

30 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

111

Daturastram

onium

L.(C

ERSH

-018)

Ann

ual

herb

Com

mon

alon

gwatercourses

Daturah,/ainel

bakar

Who

Pas

Leafpaste

isplaced

onbleeding

wou

nds

andskin

diseases;

leavesared

ried,

crushed,heated

and

appliedtopically

tothes

tingp

oint

Headaches,epilepsy,

rabies,asth

ma,

earache,sores,

vitiligo,pruritic,GIT

diseases,w

ound

s,scabies,hair-fall,

coug

h,skin

inflammation,

rheumatism

,bron

chitis,scorpion

sting

s

0.08

Dermatitis,soresa

ndvitiligo,wou

nds,

stomachache,

scorpion

sting

s[4,15,21,49]

112

Hyoscyamus

muticu

sL.

(CER

SH-089)

Shrub

Tihamap

lains

As-sakran

Lea,See

Pas,Po

u,Ex

t,Bu

r

Acrushedleavesis

appliedtopically

asa

poultic

etorelieve

pain;w

holeplantis

used

asas

moke

inhalant

totre

atvario

usdiseases,

grindtheleavesin

waterandwashthe

eye

Asthma,toothache,

eyes

prob

lems,

rheumatism

,spasm

0.03

Eyesprob

lems,

muscles,asth

ma

intoxicatin

geffect

[47]

113

With

aniasomnifera(L.)Dun

al(C

ERSH

-062)

Shrub

FyfaMou

ntains

Sem

Alfa’ar/A

lobeb

Lea,Fru,Ro

oPa

s,Inf,Ex

t,Po

u

Paste

from

berries

andleavesare

appliedas

apou

ltice

toulcers,skin

diseases

andeyes

pain;soaking

crushedroot

inwater

andthew

ateris

takenorally(gargle)

Tranqu

ilizer,

intestinalw

ormsand

ulcers,dyspepsia,

skin

chronic

inflammation,eye

pain,asth

ma,

bron

chitis,urinary

diseases,scorpion

sting

s,aphrod

isiac,

toning

uptheu

terus

ofwom

en

0.09

Ulcers,chronic

derm

atitis,psoriasis,

breast,

colonand

livercancers,asthma,

leuk

aemia,

aphrod

isiac,sexual

disorders,eyep

ains

bron

chitis,,

gynaecological

disorders

[5–7,12,13,19]

TAMARI

CACE

AE

114TamarixniloticaEh

renb

(CER

SH-041)

Shrubor

smalltree

T ihamap

lains

Tarfa

aLea,seed’soil

Pas,Po

uTo

pically

tocure

wou

ndsand

skin

prob

lems

Wou

nds,

anti-inflammatory,

varic

osev

eins

0.04

Dermatitis,leg

varic

es[7,13]

115

Tamarixaphylla

(L.)Ka

rst

(CER

SH-019)

Tree

Tihamap

lains

andFarasan

Island

sAl-Athl

Bran,lea,

Roo,Ba

rDec,B

ur,Pas,

Pou

Decoctio

nof

the

rootsand

branchesis

used

orally,

fumigationof

the

leavesisbeneficialin

flu;pasteform

bark

isused

topically

onwou

nds.

Astringent,cold,flu

,tuberculosis,

spleen

diseases,stomach

ache,hepatitis,

leprosy,wou

ndinfection,eczema,

smallpox,

aphrod

isiac,uterus

prob

lems

0.06

Astringent,w

ound

,eczema,leprosy,

smallpox

stomach-ache,

hepatitis,

tuberculosis,

cold,

flu,spleendiseases,

aphrod

isiac,

germ

icidaleffect,

tetanu

s[4,5,50]

Evidence-Based Complementary and Alternative Medicine 31

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

TILIAC

EAE

116

Grew

iatena

x(Forssk.)F

iori

(CER

SH-122)

shrub

Tihamap

lains

andFarasan

Island

sKh

adar

Who

Pas,Po

uTh

eroo

tsareu

sedto

makea

poultic

e.

Hairloss,skin

infection,

central

nervou

ssystem

depressio

n,liver

prob

lems,

rheumatism

,spasm

0.03

Stom

achaches,skin

andintestinal

infections,cou

gh,

fever,diarrhoea,

dysentery,jaun

dice,

rheumatism

,antib

iotic

prop

ertie

s[23]

URT

ICAC

EAE

117

UrticapiluliferaL.

(CER

SH-042)

Ann

ual

herb

Tihamap

lains

Hou

rrigua

Lea,Ste

Inf

Aninfusio

nof

the

plantistaken

orally

Scorpion

sting

s,sto

pbleeding

and

epistaxis,

diabetes,

uterine

haem

orrhage,

urinarytract

infection,

anaemia

0.05

Antidandruff

,anti-asthmatic,colic

diabetes,

rheumatism

,urin

ary

tractinfectio

n[18]

VITAC

EAE

118

Cissu

squa

drangularis

(CER

SH-102)

Clim

ber

Tihamap

lains

Salae

Lea,Ro

o,Ste

Ext

Leavesaree

xtracted

with

oliveo

iland

appliedtopically

;fre

shleavesare

softe

non

coaland

applieddirectlyto

skin

prob

lems

Earp

ain,

menstr

ual

pain,bon

efracture,

wou

nds,bu

rns,

snakeb

ites

0.05

Wou

nds,snakeb

ites,

circum

cisio

n[10]

ZYGOPH

YLLA

CEAE

119Tribulus

terrestrisL

.(C

ERSH

-036)

Ann

ual

herb

Tihamap

lains

andabadel

Mou

ntains

Kotbah

Lea

Dec,Pas,Pou

.

Soakingc

rushed

plantinwaterand

thew

ateristaken

orally;pou

ltice

for

externaluse

Kidn

eypain,kidney

stones,skin

diseases,

vitiligo

0.08

Renalcolic,kidney

stones,kidn

eydiseases,skinpain

[4,10,12,13]

120

Balanitesa

egyptia

ca(van

Tieghem)B

latte

r(C

ERSH

-020)

Shrubor

tree

Tihamap

lains

Hijlij/Seder

Al -k

adhib

Lea,Ro

oPas,Inf.

Leafpaste

isapplied

topically

;soaking

crushedrootsin

waterandthew

ater

istakenorallyor

insertthed

rops

inthen

ose

Intestinalw

orms,

liverandspleen

prob

lems,scorpion

sting

s,diabetes,

epilepsy,

schisto

somiasis

,tuberculosis

0.07

Wou

nds,

haem

orrhage,

tuberculosis[12]

32 Evidence-Based Complementary and Alternative Medicine

Table2:Con

tinued.

N∘

Family,Plant

species,

voucherspecimen,end

emism

Habit

Habitat

Vernacular

name

Plantp

art(s)

used

aPreparations

bUtilizationmetho

dPh

armacological

activ

ityRF

CRe

corded

literature

use

121

FagoniabruguieriD

CCE

RSH-091

Shrub

Tihamap

lains

Shika’a

Lea

Dec

Soakingthe

leavesin

boiledwaterandthe

waterisapplied

topically

Bloo

dandheart

tonic,skin

inflammation,

scabies,blisters,

vitiligo,allergy

0.03

Bloo

dandheart

tonic,scabies,

vitiligo,blisters

derm

atitis[4,13]

122

Zygophyllum

simplex

L.(C

ERSH

-064

)Ann

ual

herb

Tihamap

lains

Insalin

esoils

Al-D

hamran,

Kharmeel

Lea,Ste,fru

Jui,Pas,Po

u

Ajuicefrom

fresh

leavesandste

msis

orally,

poultic

efor

externalusea

ndwashthee

ye

Eyed

iseases,

hypertensio

n0.02

Oph

thalmia[13]

123

Zygophyllum

coccineum

L.(C

ERSH

-021)

Perenn

ial

lowshrub

orherb

Tihamap

lains

andFarasan

Island

sHarm

Lea,Ste,fru

Jui,Pas,Po

u

Ajuicefrom

fresh

leavesandste

msis

used

orally,

poultic

efore

xternaluse

Wou

nds,measle

s,sm

allpox,

rheumatism

,chickenp

ox,scorpion

sting

s,hypertensio

n,kidn

eysto

nes,

intestinalw

orms,

cholera

0.06

Anthelm

intic

,diuretic,

rheumatism

,gou

t,coug

h,asthma,

hypertensio

n,flatulent

colic,skin

diseases

[13]

124

Zygophyllum

album

L.(C

ERSH

-043)

Perenn

ial

lowshrub

Tihamap

lains

andFarasan

Island

sRitrit,

Herm

Lea,Ste,fru

Jui,Pas,Po

u

Ajuicefrom

fresh

leavesandste

msis

takenorally,

poultic

efore

xternaluse

Severefever,

cardiovascular

diseases,diabetes,

rheumatism

0.04

Diabetes,pu

rgative,

laxativ

e,anti-virus

andfung

i,indigestion

,asth

ma,

diuretic,skin

diseases,analgesic,

rheumatism

,antih

istam

inic[51]

aPlantp

art(s

)used:Ae

r,aeria

lparts;

Bra,branches;Flow,

flowe

rs;Fru,fruits;Lat,latex;R

es,resin;L

ea,leaves;Ro

o,roots;Ste,ste

ms;See,seeds;Ba

r,bark;and

Who

,who

leplant.

bPreparations:D

ec,decoctio

n;Inf,infusio

n;Po

w,po

wder;L

at,latex

isremoved;P

as,paste;Pou

,pou

ltice;E

xt,extract;Jui,juice;L

ini,lin

iment;andBu

r,bu

rned.

Evidence-Based Complementary and Alternative Medicine 33

0

1

2

3

4

5

6

7

8

9

10

11

12

13

14

�e most common plant families

Asterac

eae

Apocynace

ae

Fabaceae

Euphorbiaceae

Lamiac

eae

Zygophyll

aceae

Amaranthace

ae

Acanthace

ae

Apiaceae

Capparidace

ae

Cleomace

ae

Solanace

ae

Moraceae

Polygonace

ae

Asphodelacea

e

Boraginace

ae

Burserac

eae

Malvace

ae

Myrtace

ae

Oleacea

e

Poaceae

Tamari

caceae

�e n

umbe

r of s

peci

es p

er p

lant

fam

ily

Figure 2: Most representative botanical families.

need further studies [10]. Still, most of these species are nottraded in local markets in Saudi Arabia.

The majority of MP recorded in Jazan are shrubs (56plants representing 45% of the total), perennial herbs (26plants or 21%), annual herbs (24 plants or 19%), and trees(18 plants or 15%) (Figure 3). This may be explained by thefact that shrubs are the most plant form in the study area.The regular use of herbs (40%) by local people may be dueto their availability and high effectiveness against ailmentscompared to other plant forms [75]. Still, the perennial lifeform (herbs, shrubs, and trees, 81%) is more visible amongMP species than annuals. This could be explained by the factthat they are available throughout the year compared to theshort-lived herbs which is contrasting their efficacy as MPs.Grazing by livestock and the aridity of the medium, both ofwhich appear to increase over time, are also responsible forthe dominance of perennials.

3.5. Preparation and Administration Methods. Several prepa-ration and application methods are used to treat a varietyof ailments. Local inhabitants of Jazan province use diversemethods including decoction, juice, extract, cooked, lini-ment, powder, paste, infusion, poultice, and tea to prepareremedies (Figure 3). Paste and decoction were the two mostfrequently used methods of preparation (29% and 23%of applications, respectively), followed by infusion (16%),powder (8%), extract, poultice (7% each), juice (4% each),liniment, burned (3% each), cooked, and tea (1% each). Suchdiversity in preparation methods has also been described

earlier in other countries [65, 76]. Furthermore, the majorityof remedies were prepared from fresh wild plants, that is whyit fairy easier and faster to make them into decoction or pasteform. The infusion and decoction preparations are takenorally mainly for GIT and urogenital problems. In the case ofskin diseases, eye infection, and hair problems, the remedieswere applied topically or locally. Decoction is considered oneof most important methods to prepare drugs in conventionalmedicine because it is easy to make by mixing with water,honey, milk, tea, or soup [77]. Decoction also encouragesextraction of most of the active ingredients from the herband reduces or removes the toxic effect of certain compounds.Almost all healing recipes were prepared from a single plant.Still, when the treatment was done by a traditional healer,often several plants were used in combination apparently toguarantee the secrecy of the recipe by masking the key MPsused. Some plant preparations were mixed with honey, water,tea or milk to improve the palatability of the remedy.

As far as route of administration is concerned, about 45%of drug preparations were taken orally (Figure 3), followedby applied topically (38%), through vapour inhalation (5%),eaten raw (4%), as eye drops (2%) and chewed (2%), gargleor as toothbrush (2%). These findings were similar to earlierreports [65, 76]. Besides, some herbal drugs were usedfor washing and as nose drops or eardrops. For topicalapplications, people used either directly the paste, or thepoultice or oils often to treat skin-related diseases, scorpionstings, snake bites, rheumatism, headache, eye infections, andhair disorders. Some preparations were mixed with othermaterials such as honey and milk to treat asthma, cough,

34 Evidence-Based Complementary and Alternative Medicine

15%

21%

19%

45%

Life forms of medicinal plants

TreesPerennial herbs

Annual herbsShrubs

24%

9%

9%

3%3%

5%

1%

16%

5%

18%

2%1% 2% 2%

Plant part used in folk recipes

LeavesRootsSeedsFlowersAerial partsBarkResin

Whole plantStemsFruitsLatexBranchesGums

1% 1%

45%

38%

5%

3%4% 3%

Mode of administration of the folk recipes

GargleToothbrushOrallyTopically

InhalationEye dropsEaten rawChewed

8%

23%

16%

7%3%1%

3%1%

7%

28%

3%

Mode of preparation of folk recipes

PowderDecoctionInfusionExtractLinimentCooked

JuiceTeaPoulticePasteBurned

Figure 3: Life forms ofMPs, plant part used, andmode of administration and preparation of traditional recipes in Jazan region, Saudi Arabia.

Evidence-Based Complementary and Alternative Medicine 35

Table 3: Informant consensus factor (ICF) values of category of ailments.

Category of Diseases Species Percentage of all species (%) Use citation All use citation (%) ICF1 Skin and hair problems 75 60 128 18.4 0.422 Gastro-intestinal tract (GIT) disorders a 73 58 121 17.4 0.403 Urogenital diseases 53 42 81 11.6 0.354 Blood and cardiovascular disorders 28 22 38 5.5 0.275 Scorpion stings and snake bites 44 35 58 8.3 0.256 Skeletomuscular (SM) disorders 43 34 56 8.0 0.247 Diseases caused by protozoa 30 24 38 5.5 0.228 Diabetes 25 20 31 4.4 0.209 Respiratory and throat diseases 36 29 42 6.0 0.1510 Nervous disorders 17 14 19 2.7 0.1111 Ear, Nose, Eyes and Mouth (ENEM) diseases 37 30 40 5.7 0.0812 General health conditions (GHC)b 44 35 45 6.5 0.02a Gastrointestinal tract (GIT) disorders include diarrhoea, dysentery, dyspepsia, gallbladder, stomach pains, liver problems, pancreas problems, oedema, etc.bGeneral health conditions (GHC) include pains, headache, allergies, fevers, sun burns, flu, colds, astringents, appetizer, analgesic, body energizer, tranquilliser,and laxative.

and stomach ulcers. Lack of accuracy in dosages given byrespondents for several therapies was repeatedly noted.

3.6. Plant Part Used. Even though all plant parts were usedto cure divers ailments (Figure 3); still the participants, livingin Jazan region and in its villages used mostly leaves (24%)in their traditional healing system, followed by fruit (18%),whole plant (16%), roots (9%), seeds (9%), stem (5%), bark(5%), flowers (3%), aerial parts, latex, oil, and gum (2% each),branches (1%), and resin (1%). Previous reports also showedthat leaves are the most frequently used plant part in folkmedicine systems of the residents of islands, Italy, Punjab-Pakistan, and Ethiopia [75, 78]. This is a noteworthy resultsince collecting leaves does not have harmful effects on thesurvival of the MPs, whereas collecting roots or whole plantsmay cause severe threat to local flora [79]. Besides, leaves arethe site of photosynthesis and storage of several secondarymetabolites responsible for the biological activities of theherb. Even though some MPs including C. procera, Daturastramonium, Euphorbia spp., Peganum harmala, A. obesum,and Solanum incanum are known to be poisonous, they areused to deal with several human and livestock disorders bythe local communities. Plant species with effective bioactivecompounds are often considered either toxic or curativedepending on the ways they are prepared and administered[80].

3.7. Ailments Treated by MPs. All of the medicinal attribu-tions gathered from the interviewees were categorized into 12disease categories associated with different body functionalsystems based on the information provided (Table 3). Thistable also shows informant consensus factor (ICF) values andimportant plant species for each illness category. The ICFvalues specify the degree of knowledge shared about the useof MPs to deal with several diseases. A higher ICF valuesindicates that the MPs are effective in curing a given disease.Skin and hair problems had the highest ICF score (0.42).GIT disorders had the second highest ICF, while the fourth

level of ICF values (0.27) was for cardiovascular diseasescategory. Scorpion stings and snake bites were ranked asthe fifth ailment with ICF value of 0.25 while SM disordersreceived an ICF value of 0.24. The lower ranked diseases forMP use were protozoa (malaria and leishmaniosis), diabetes,respiratory and throat diseases, nervous disorders, ENEMdiseases, and GHC with ICF value of 0.22, 0.20, 0.15, 0.11,0.08, and 0.02, respectively. These low ICF value recorded inthe present study could be ascribed to the recent trends inevolution of the society [81]. Besides, the very low ICF valuesfor respiratory and throat diseases, nervous disorders, ENEMdiseases, and GHC could be explained by the fact that thesediseases were not important health problems at that time.Still, these types of diseases, mainly the nervous disordersandGHC (sunburns, allergies related to appetizers, analgesic,body energizers, tranquillisers, laxatives, etc.), are commonlyreferred to healers and generally treated with polyherbalmedicines; thus, a range of MPs are reported. Furthermore,our findings suggest that skin-related problems and GITdisorders are prevalent in Jazan region [4]. In general, theuse of MPs for the treatment of chronic, inflammatory,and infectious diseases is very common in communitiesdominated by farm laborers or nonskilled workers [68].In fact, cutaneous leishmaniosis still constitutes till nowone of the main skin diseases found in the study area[55]. Also, the visceral leishmaniosis type is restricted tosouthwest regions of the Kingdom including the study area.According to recent estimates, Saudi Arabia ranks the secondhighest country in the Middle East and North Africa forleishmaniosis infections, with more than 4,000 reportedcases [55]. Despite the availability of modern public healthfacilities, several plant species are still widely used by localcommunities as antileishmanial agents includingO. europaeassp. cuspidata, Myrtus communis, Achillea biebersteinii, andDodonaea viscosa. The in vitro antileishmanial activity ofthese MPs has been proven [55]. Other rare and endangeredspecies such asCommiphora gileadensis andDorstenia foetidawere reported to have good antileishmanial activity; thesespecies need to be protected against overexploitation.

36 Evidence-Based Complementary and Alternative Medicine

Malaria has been also recognized as a main health issuein some provinces of Saudi Arabia where about 1.4 millioninhabitants are considered at risk especially after heavy rains[55]. With the emergence of drug-resistant malaria-causingstrains, drug research efforts should be extended to severalMP species with good antimalarial activities as those adoptedby the local communities of Jazan. Twenty-two MPs werereported to be used againstmalaria.These species belong to 17botanical families of which Asteraceae was the most cited fol-lowed by Apocynaceae and Euphorbiaceae with two specieseach (Table 2).Acalypha fruticosa,Anisotes trisulcus, Plantagomajor, and S. incanum are commonly used by traditionalhealers in Jazan region to treatmalaria. Previous reports showthat A. fruticosa possesses significant antimalarial potentialin vitro [82] which explains their use in traditional medicine.The active constituents of the plant extract were cytotoxic forPlasmodium falciparum trophozoites, thereby inhibiting theirdevelopment to the schizont stage [82]. A. trisulcus is usedin folk medicine in the Arabian Peninsula as a treatment forall hepatic conditions including hepatitis, jaundice, gallstone,and other hepatic problems [8, 83, 84]. It is also used asan antidiabetic, bronchodilator, hypotensive, and local anes-thetic [48]. It is further used locally in several pharmaceuticalforms to limit tobacco consumption and to suppress appetite[84]. The methanolic, n-hexane, and chloroform extractsof A. trisulcus dried aerial parts showed mild antimalarialactivity against the tested P. falciparum (D6 clone) relative tochloroquine [83]. A literature survey revealed that the aerialparts of A. trisulcus are rich in alkaloids such as anisotine,peganine, vasicinone, 5-methoxypeganine, and trisulcusinethat are responsible for the biological activity of the plant[48, 83]. S. incanum is also an important MP in Jazan regionto treat malaria, leishmaniosis, and several skin infections.Similar medicinal uses were reported in Africa [85]. Otheruses include relieve of menstruation, pains, liver problems,and pain caused by onchocerciasis, pleurisy, pneumonia,and rheumatism. Phytochemical screening indicates that S.incanum holds several constituents with important medicinalvalues such as steroidal alkaloids, glycoalkaloids, antiox-idants, saponins, and carcinogenic constituents [85]. Theplant extract possesses antinociceptive, antipyretic, antispas-molytic, orexic, anorexic, hypoglycaemic, antimicrobial, anti-schistosoma, antifungal, and anticancer activities. Hence, thisplant is expected to be a key source of new active compoundsagainst several maladies distressing people worldwide [85].Still some species are not well studied for this purpose such asC. procera, Caralluma acutangula, Aerva javanica, Artemisiaabyssinica, Conyza incana, Cleome viscosa, Jatropha glauca, D.viscosa, Foeniculum vulgare, A. vera, and Sansevieria ehren-bergii. Hence Saudi Arabia is well positioned to significantlycontribute to the efforts to find new remedies for tropicaldiseases.

In Saudi Arabia, rheumatism, diabetes, colds, coughs,bronchi, allergies, asthma, cough, and flu are common healthproblems. However, most people tend to use the traditionalhealing system to deal with such illnesses; especially in ruralareas and among the elderly [68]. For instance, Capparisspinosa, C. decidua, Cadaba rotundifolia, C. colocynthis, Ori-ganum majorana, P. harmala, Z. spina-christi, R. chalepensis,

D. viscosa, D. stramonium, Hyoscyamusmuticus, andMoringaperegrina are widely used to treat rheumatic diseases inJazan region. Another example is diabetes which is a widespread problem in Saudi Arabia; several MPs were reportedin different communities to have hypoglycemic effect. Aloevera, M. peregrina, Lawsonia inermis, Malva parviflora, andB. aegyptiaca were the most commonly cited species [4, 86].However, the antidiabetic effect of Rumex nervosus reportedin the present study was not reported elsewhere.

Scorpion stings and snake bites are a severe medical andsocioeconomic concern in many countries in the tropicaland subtropical regions including Saudi Arabia [52, 56].They constitute an occupational danger for rural populations.Therefore, MPs showing antivenom properties were someof the most represented plants in the survey. Twenty-fiveplant species were recorded to be useful against scorpionstings; 14 species for snake bites and 5 species for bothscorpion stings and snake bites (Table 2). These speciesbelong to 26 botanical families of which Apocynaceae andAmaranthaceae with 5 and 4 species, respectively were themost represented. Families represented with three specieseach were Fabaceae and Euphorbiaceae, whereas the familiesCleomaceae, Zygophyllaceae, Sapindaceae, Apiaceae, Polyg-onaceae, and Burseraceae had 2 plants each. The remainingfamilies were represented with only a single MP. In total,92 MPs have been reviewed for their use for the treat-ment of scorpion stings in Saudi Arabia [56]. These speciesare distributed in 37 families among which Fabaceae andApocynaceae have a maximum representation with 11 and10 plants, respectively. The Amaranthaceae and Asteraceaefamilies accounted for 8 and 6 plants, respectively, while theEuphorbiaceae, Poaceae, and Solanaceae families had 5 plantseach [56]. The dominance of Apocynaceae, Fabaceae, andEuphorbiaceae as the families containing the most plant usedagainst snakebites and scorpion stings was also demonstratedin an extensive review of the literature by Felix-Silva et al.[87]. Likewise, in a cross-cultural comparison of MPs usedagainst snakebites, Molander et al. [88] identified some “hot”families including Apocynaceae, Lamiaceae, Rubiaceae, andZingiberaceae [88] which should be prioritized in studiessearching for plants with antivenom properties.

Most of the plant species represented here to be used forthe treatment of scorpion sting victims including D. stramo-nium, Astragalus spinosus, Heliotropium bacciferum, Cissusquadrangularis, C. gileadensis, Ruta chalepensis, C.myrrha, C.procera, C. viscosa, C. gynandra, C. colocynthis, R. communis,Tamarindus indica, M. parviflora, Azadirachta indica, M.communis, W. somnifera, and B. aegyptiaca were previouslyreported to have such antivenom potentials either in otherparts of Saudi Arabia or elsewhere [4, 21, 56, 87]. ThesesMPs contain various types of flavonoids, steroids, terpenoids,alkaloids, tannins, and coumarins that may account for theirantivenom potentials [89]. Still the antivenom activity ofa plant cannot be attributed to a single active ingredient;however the overall activity results from the synergistic effectof various constituents on various target structures suchas enzymes and receptors [90]. The fact that some of thereported plants have similar uses elsewhere can be takenas indication of their pharmacological potential [91]. Still,

Evidence-Based Complementary and Alternative Medicine 37

in vivo preclinical assays or, even better, clinical assays areessential for giving even stronger evidences of the effectivityof the use of theseMPs against snakebites and scorpion stings.On the other hand there is no report about the antivenompharmacological activities of some MPs, either endemic ornot, in Saudi Arabia including A. obesum, Acacia oerfota,Urtica pilulifera, C. acutangula, S. persica, Peristrophe panic-ulata, L. inermis, A. javanica, Sonchus oleraceus, Minuartiafilifolia, Acalypha fruticosa, Acalypha indica, Plantago major,and Zygophyllum coccineum. These plants can be a target forin-depth ethnomedicinal studies. For instance, the endemicspecies A. obesum is considered a very important speciesin the Saudi folk medicine. The local communities use theplant to treat venereal diseases and skin diseases as wellas to kill lice. The same traditional use was reported inOman and Kenya [24, 25]. Most importantly the plant isused by the local communities of Jazan for their antisnakevenom poison properties, which is not reported elsewhere.The phytochemical study showed that A. obesum containeddifferent biologically active groups of chemical compounds[26, 92].

Our results showed that leaves and the whole plant arethe most used parts for the treatment of scorpion stings orsnake bites victims (Table 2). The use of the whole plant witha particularly complex mixture may favor the neutralizationof a wide range of venom components [90]. Regarding themode of use, the most frequent one is the topical applicationof the plant products directly on the place of the bite. Thisis interesting mainly in snake venoms that cause severe localtissue damage. On the other hand, the use of some plantspecies is made by internal and external routes at the sametime, while for most of species the route of administrationcould be either internal or external. Regarding the mode ofpreparation, in general, paste (26 species) and decoction (18species) were the most recorded forms of use. It is importantto emphasize that these species, in addition to their use asantivenom agents, present a series of another popular usesmainly anti-inflammatory activity and against skin problems(30 species from the 44 species used for the treatment ofscorpion stings or snake bites victims).

3.8. Diversity Use ofMPs. Our 174 participants cited 124 plantspecies for 12 different disease categories. Most of these plantsensure more than a one medicinal use which indicates thatdifferent plant organs have different uses. Forty-one species(Table 4) received more consideration by informants (citedby nine or more informants); therefore included for furtherdiscussion. The high versatility of MPs could specify thelarger range of bioactive compounds enclosed by the differentparts of the plant. The data showed that some plants havemore varied therapeutic practices than others. Z. spina-christiand C. procera with the highest RI level (2.0) were found tohave the highest range of therapeutic uses (used to deal with18 different ailments). This was followed by D. stramonium(1.86), W. somnifera, and A. vera (RI=1.81 for each), whichare used to deal with 17 and 16 diseases, respectively, andA. javanica (RI = 1.72) and C. colocynthis (RI = 1.64), whichare used to deal with 13 diseases. The high RI value of

these MPs could partly be a reflection of its abundance.The lowest RI value was shown for six species (RI=0.14)which are used against one ailment (Table 4). The formerspecies cannot be considered as of lower pharmacologicalpotential or importance, because these may be species ofrecent introduction in the culture of the communities understudy but might have been confirmed by the habitual usein other social communities [93]. Some species with thehighest RIwill be considered further by highlighting themostimportant available literature on them.

3.9. Efficacy of the MPs. In order to find promising plantspecies for chemical and pharmacological screening, the FL(%) values of 41 MPs (Table 5), mentioned by more thannine informants, were used for the analysis of the efficacy ofthe MPs. Senna alexandrina (67%), Tribulus terrestris (64%),Pulicaria undulata (60%), L. pyrotechnica (55%), and R.nervosus (55%)with the highest FI values that evidenced theirgood medicinal potential to treat precise disease (Table 5).For the GIT disorders the species S. alexandrina (67%) wasthe most regularly used with FL values of 67% followed byL. pyrotechnica (55%), R. nervosus (55%), and C. spinosa(50%). The species P. undulata, Tamarix aphylla, A. vera, C.decidua, and Z. spina-christi recorded 60, 50, 36, 33, and 29FL% in treating skin-related diseases, respectively. A. verais well-known species all over the world in treating skin-related diseases; however the communities of Jazan use otherplants as P. undulata and T. aphylla for such purpose, mostlybecause of their ease accessibility. A. vera is found on the hillymountains and not easily accessible. S. incanum recorded50 FL % followed by A. trisulcus (45%) in treating malaria.Rhanterium epapposum with 50% FL is the most efficientin treating diabetes in Jazan communities. According toTrotter and Logan [61], plants which are used in some routinemanner are more expected to be biologically active [61]. Thespecies that gave the highest FL values are deliberated moreencouraging candidate plants for in-depth pharmacologicalstudies and merit more attention. This is the first baselinestudy on the TK of native Jazan communities about the usageof MP species for a specific disease.

3.10. Some MPs and Literature Review. The present studyrevealed that informants have rich TK about distribution,harvesting, and uses of MPs. The TK of the local tribalcommunities were documented and compared with dataobtained in previous studies. During the survey some MPswere cited by local peoples to have certain medicinal uses butare not native to Saudi Arabia so they were not considered inthe present study. Some species with the highest RI and rel-ative frequency citation (RFC) will be considered further byhighlighting the most important available literature on them.In general, the chemical composition, mode of action, andtoxicity of Saudi Arabian plants with medicinal propertieshave previously not been determined [13].

RFC is useful indexes to elect promising MP species forfurther pharmacological research and approval in pharma-ceutical progress. The RFC index verifies the frequency ofcitation of a MP used for several disorders. The RFC of the

38 Evidence-Based Complementary and Alternative Medicine

Table 4: Relative importance (RI) values for MPs used against specific ailments in Jazan region. RI=NP+NCS where NP is obtained bydividing the number of properties (reported specific ailments) attributed to a species divided by the total number of properties attributed tothe most versatile species (species with the highest number of properties). NCS is the number of body systems (ailment categories) treatedby a given species divided by the total number of body systems treated by the most versatile species.

Plant species NSC NSC RIZiziphus spina-christi, Calotropis procera 18/18 12/12 2.00Datura stramonium 17/18 11/12 1.86Withania somnifera, Aloe vera 16/18 11/12 1.81Aerva javanica 13/18 12/12 1.72Citrullus colocynthis. 13/18 11/12 1.64Blepharis ciliaris 18/18 7/12 1.58Tribulus terrestris 12/18 11/12 1.58Abutilon Pannosum, Ricinus communis 16/18 7/12 1.47Adenium obesum, Acalypha fruticosa 14/18 7/12 1.36Senna alexandrina 11/18 9/12 1.36Ocimum basilicum 14/18 7/12 1.36Tamarindus indica. 13/18 7/12 1.31Moringa peregrina 11/18 8/12 1.28Tamarix aphylla 14/18 6/12 1.28Capparis spinosa, Solanum incanum, Achyranthes aspera 13/18 6/12 1.22Artemisia abyssinica 11/18 7/12 1.19Olea europaea 14/18 5/12 1.19Capparis decidua 12/18 6/12 1.17Ruta chalepensis 10/18 7/12 1.14Commiphora gileadensis, Myrtus communis 9/18 7/12 1.08Fumaria parviflora, Rumex nervosus, Zygophyllum coccineum 10/18 6/12 1.06Trachyspermum ammi 11/18 5/12 1.03Anisotes trisulcus 7/18 7/12 0.97Commiphora myrrha, Malva parviflora, Balanites aegyptiaca 8/18 6/12 0.94Leptadenia pyrotechnica, Cleome viscosa, Alhagi graecorum 9/18 5/12 0.92Marrubium vulgare 10/18 4/12 0.89Achillea biebersteinii, Euphorbia schimperiana 8/18 5/12 0.86Salvadora persica 5/18 7/12 0.86Dracaena ombet 9/18 4/12 0.83Rhanterium epapposum, Lawsonia inermis, Rumex vesicarius 7/18 5/12 0.81Caralluma acutangula 8/18 4/12 0.78Cissus quadrangularis, Foeniculum vulgare, Cleome gynandra, Urticapilulifera 6/18 5/12 0.75

Dactyloctenium aegyptium 9/18 3/12 0.75Nerium oleander, Cadaba farinosa 7/18 4/12 0.72Conyza incana, Juniperus procera, Grewia tenax, Plantago major,Tephrosia apollinea 6/18 4/12 0.67

Rhazya stricta, Jatropha glauca, Amaranthus viridis, Acacia oerfota,Ficus carica 5/18 4/12 0.61

Cleome brachycarpa, Coffea arabica, Clematis wightiana, Euphorbiaretusa, Jasminum sambac 6/18 3/12 0.58

Teucrium yemense, Peganum harmala, Zygophyllum album 4/18 4/12 0.56Avicennia marina, Sansevieria ehrenbergii, Asparagus africanus,Cleome amblyocarpa Acacia seyal, Hyoscyamus muticus, Plectranthusasirensis, Origanum majorana, Dodonaea viscosa

5/18 3/12 0.53

Asphodelus tenuifolius, Fagonia bruguieri 6/18 2/12 0.50Pulicaria jaubertii, Azadirachta indica, Combretum molle 4/18 3/12 0.47

Evidence-Based Complementary and Alternative Medicine 39

Table 4: Continued.

Plant species NSC NSC RISonchus oleraceus 5/18 2/12 0.44Carissa edulis, Saccharum spontaneum, Pulicaria undulata, Cuminumcyminum, Monolluma quadrangular, Heliotropium bacciferum, Ficuspalmata

3/18 3/12 0.42

Acalypha indica, Lavandula dentate, Astragalus spinosus 4/18 2/12 0.39Aerva lanata, Xanthium strumarium., Picris cyanocarpa, Heliotropiumdigynum, Tamarix nilotica, Acacia tortillis, Emex spinosa 3/18 2/12 0.33

Suaeda aegyptiaca 4/18 1/12 0.31Anethum graveolens, Zygophyllum simplex, Chrysanthemumcoronarium, Cadaba rotundifolia, Minuartia filifolia, Acaciaehrenbergiana, Nepeta deflersiana, Dorstenia foetida, Rhizophoramucronata

2/18 2/12 0.28

Pulicaria schimperi, Chrozophora oblongifolia, Artemisia sieberi,Osteospermum vaillantii 2/18 1/12 0.19

Peristrophe paniculata, Ceropegia variegate, Matthiola Arabica,Opuntia ficus-indica, Eucalyptus camaldulensis, Limonium axillare 1/18 1/12 0.14

stated species went from 2 to 11% (Table 2). The highest RFCwas given for A. javanica and W. somnifera (0.09 for each)and Z. spina-christi, C. procera, C. colocynthis, R. chalepensis,D. stramonium, A. vera, and T. terrestris (0.08 for each),and Rumex vesicarius, A. obesum, A. abyssinica, T. indica, R.communis, and S. alexandrina (0.07 for each). The ranks oftheseMPsmatch to the fact that they were cited bymaximumnumber of participants, so they ensure the highest frequencyof citation (Table 2). The traditional use of these species isnot restricted to Jazan but most of them are well-knownelsewhere for their effect. In adjacent regions with similarclimate and biodiversity as Al-Baha, different species such asJ. procera, Z. spina-christi, and Rumex nervosus were the mostcommon [4]. However Commiphora myrrha was consideredto be the most popular MPs used traditionally by most ofthe Saudi population, which is not the case in our study area[10, 68].

Z. spina-christi and C. procera had the highest RI levels,being cited for 18 different ailments. In Jazan region the fruitsof Z. spina-christi are generally eaten fresh for nutritionalpurposes, and flowers are a source for honey. Besides, inSaudi folk medicine the plant has been used for the treatmentof several contagious skin diseases, stomach ache, urinarytroubles, diabetes, fever, headache, allergy, leishmaniosis,rabies, mouth problems, and anaemia. The plant extractare also used as antidandruff which is in agreement withprevious reports [94]. The decoction of the stem bark andfresh fruits is used by the Bedouins as a body wash, tocure fresh wounds and is also used for treating dysentery,bronchitis, coughs, and tuberculosis [95]. The plant holdsseveral compounds as flavonoids, alkaloids, triterpenoids,saponins, lipids, proteins, free sugar, and mucilage [96].Cyclic peptide alkaloids, franaganine, mauritine C, and sati-vanine A have been isolated from the stem bark and fullycharacterized [97]. The presence of these compounds couldin part explain the antifungal, antibacterial, antinociceptive,antioxidant, antidiabetic, antiplasmodia, antischistosomiasis,analgesic, and anticonvulsant activities of the plant [96, 98].

The aqueous and ethanolic extracts of stem bark of Z. spina-christi have been previously studied, and an anticholinergiceffect was observed, which may justify the traditional useof the plant as antispasmodic [99]. A cytotoxic effect wasobserved for the aerial part of the plant against cervical,breast, and colon cancers [100].

C. procera is characterized by themilky sap which, despitecausing blindness, has a strong uterotonic and cardiotonicactivities [74]. This plant is used in Jazan as body energizerand to treat common diseases such as fever, headaches,toothache, asthma, and cough, as well as treat skeletomus-cular (SM) problems, GIT disorders, skin infection, hairloss, and scorpion stings. Most importantly the plant isused for their ant-leishmaniosis and antimalarial proprietieswhich are not well-known use for this species. It wasshown that the latex of the plant is used as analgesic, anti-inflammatory, hepatoprotective, antidiarrhoeal, antidiabetic,antinociceptive, anthelmintic, anticonvulsant, antimicrobial,anticancer, antifertility, and antioxidant [101]. As well, W.somnifera is traditionally used in Jazan region mainly to expelintestinal worms and to cure several skin and urogenitaldiseases as well as for scorpion stings. Its proteins like W.somnifera glycoprotein and withania lectin like-protein wasshown to possess antimicrobial and antisnake venom poisonproperties [102]. Furthermore, constituents like withanolideA, withanolide D, withaferin A, and withaniamides wereshown to play an important role in its pharmacologicalproperties [102]. D. stramonium is also one of the widelywell-known MPs in the southwestern Saudi Arabia. Theplant has both toxic and medicinal properties and has longbeen known as a plant hallucinogen all over the world[103]. Consumption of any part of the plant may result in asevere anticholinergic reaction that may lead to toxicity andoccasionally causes diagnostic difficulties. Death may occurfrom heart failure after ingesting 125 seeds [103]. The peopleof Jazan use the plant for its anti-inflammatory propertyand to cure GIT disorders, epilepsy, and rabies, dental andskin infections, and scorpion stings as well as stimulate

40 Evidence-Based Complementary and Alternative MedicineTa

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Evidence-Based Complementary and Alternative Medicine 41

the central nervous system. The phytochemical screeningof D. stramonium indicated the existence of high amountsof saponins, tannins, steroids, alkaloids, flavonoids, phenols,and glycosides [103]. D. stramonium was investigated as asource for tropane alkaloids which contain a methylatednitrogen atom (N-CH3) and include the anticholinergicdrugs atropine, and scopolamine. It is, therefore, potentiallyuseful as an alternative to atropine for dealing with themuscarinic symptoms of organophosphate toxicity and someof central anticholinergic effects. We recorded that the localcommunities of Jazan region used T. terrestris for kidneyproblems and several skin diseases. This is in agreementwith previous experiments done on animal model [104].Despite his toxicity effects [81], the plant was shown tohave an antihypertensive effect in Turkey [73]. The differentplant organs enclose a range of chemical compounds whichare therapeutically significant, such as flavonoids, flavonolglycosides, steroidal saponins, and alkaloids. T. terrestris wasshown to have several biological activities mainly used asanti-inflammatory, diuretic, hepatoprotective, aphrodisiac,antidiabetic, hypolipidemic, cardiotonic, central nervous sys-tem, antispasmodic, anticancer, antibacterial, anthelmintic,and anticariogenic [104].

A. javanica (RI = 1.72) and C. colocynthis (RI = 1.64) areused in Jazan region to treat 13 diseases which may reflecttheir abundance. For instance, A. javanica is a very abundantplant with several uses. It was introduced in different areasof Saudi Arabia to assist the revegetation of degraded rangelands and for dune stabilization. Our results revealed thatthe densely woolly parts of the inflorescence were usedby Jazan people in earlier times for stuffing saddle padsand cushions. Its roots are used also for cleaning teethand cure toothache; while the seeds are used for relievingthe headaches and rheumatism. The leaf paste is applieddirectly against snakebites, insect stings and bone problemsas well as to cure scabies and skin diseases. Recently somereports showed that the methanolic extracts of A. javanicashowed potential antibacterial activities [105]. Furthermore,our results revealed that decoction of roots, flowers, or leavesis used orally against malaria, renal calculus, and kidneytroubles. In surrounding countries such as Bahrain andYemen the flowers are used for the treatment of wounds andto stop bleeding, and juice extracted from roots is used totreat eye diseases [106]. As well in Djibouti, the plant is usedto treat haemorrhage, bone problems, and kidney troubles[5]. Glycosides, tannins, saponins, alkaloids, unsaturatedsterols, triterpenes, and flavonoids have been demonstratedto be present in this species. Aqueous extracts of the speciesexhibited dose-dependent smooth muscle relaxant effectsand significant antispasmodic activity [107]. According to arecent study based on the analysis of LC-MS/MS and otherbiological activities A. javanica can be used as functional foodingredients and as well as for the pharmaceutical purposes inthe treatment ofmany oxidation based diseases such as aging,neural disorders, and genetic mutations such as cancer [108].It is also given to cancer patients and to the pregnant womenduring childbirth.

C. colocynthis is a promising MP with wide range ofuse in Jazan region. The plant is mainly used against insect

bites, leishmaniosis, and skin infections. The fruit and seedsare used against rabies and several GIT problems. A pasteof the leaf is applied externally for the inflammation ofthe breast, joints pain, urinary diseases, and rheumatism.Most importantly the plant is used to treat scorpion stingsand snakes bites. Previous results showed that injected C.colocynthis extract before envenomation is able to protectanimals against the toxicity of the venom [109]. The plantappeared to be a potential tool that can reduce pathophys-iological effects induced after envenomation (inflammationand oxidative stress) [109]. For example, it reduced someinflammatory markers. Previous reports showed that theplant possessed antioxidant, antidiabetic, antimicrobial, anti-cancer, anti-inflammatory, analgesic, gastrointestinal, repro-ductive, protective, and many other pharmacological effects.C. colocynthis contained carbohydrate, protein, separatedamino acid, tannins, saponins, phenolics, flavonoids, flavoneglucosides, terpenoids, alkaloids, anthranol, steroids, cucur-bitacins, saponarin, cardic glycoloids, trace elements, andmany other chemical groups.

The results showed that few are the reports dealing withthe phytochemical or pharmacological data of several MPspecies used by the local communities of Jazan in theirfolk medicine namely: M. filifolia, P. paniculata, Pulicariaschimperi, Picris cyanocarpa, Matthiola arabica, Osteosper-mum vaillantii, Chrozophora oblongifolia, C. acutangula, andJ. glauca. Most of these species are used by the local com-munities to cure particular ailments not reported elsewhere.Consequently, the selection of these species for pharmacog-nostical studies is a promising task based on the claim oftheir traditional medicine uses. Furthermore, some endemic(Teucrium yemense, Plectranthus asirensis, A. trisulcus, andA. obesum), rare (mainly Dracaena ombet), and endangered(mainly Dorstenia foetida and Ceropegia variegata) speciesused in Saudi folk medicine have received little attentionin relation to their phytochemical constituents and mostimportantly for their conservation actions.

4. Conclusions

The present study is the first documentation of ethnobotani-cal uses of 124 MPs by the local communities of Jazan regionof Saudi Arabia. Despite the presence of modern medicalfacilities in this region, local tribal communities still considerfolk medicine as an important alternative for curing certainhealth disorders. ManyMPs, particularly those in the vicinityof villages and hamlets, are used in emergencies and forroutine maladies. Younger people are less interested to know,share, and try conventional medicine practices and recipes.We found that paste, decoction, and infusion were the mostfrequently used types of drug formulations. Leaves and fruitsare the most used parts. The study revealed that skin andhair problems and GIT disorders had the highest ICF scoresand therefore are the most prevalent health concerns inthe study area. A. javanica, W. somnifera, Z. spina-christi,C. procera, C. colocynthis, R. chalepensis, D. stramonium, A.vera, and T. terrestris received the highest RFC, meaning thatthey were frequently cited by the informants. Furthermore

42 Evidence-Based Complementary and Alternative Medicine

Z. spina-christi and C. procera which had the widest rangeof therapeutic uses (used in the treatment of 18 differentdiseases). They were followed by D. stramonium, W. som-nifera, and A. vera. This reflects in a way their abundance,meaning that these relatively isolated communities tried tomake use of what is available to them to provide for theirhealthcare needs. S. alexandrina, T. terrestris, P. undulata,L. pyrotechnica, and R. nervosus had the highest healingpotential against specific diseases. These species should beconsidered for in-depth pharmacological screening in thefuture. The high versatility of some MPs suggests that maycontain a large number of bioactive compounds. Therefore,these species as well as other endemic species should beconsidered in future phytochemical and pharmacologicalstudies given their frequent use in traditional medicine.

Jazan province flora has good ethnobotanical potential.We are conscious that this study is by nomeans complete, butit constitutes a primer to the ethnobotany of this province,focusing on MPs. It is also the first field investigation of MPsto be carried out in Saudi Arabia with an ethnobotanicalmethodology. More studies are necessary to gather TK,including all kinds of useful plants, in other Saudi provinces.This should encourage better management, the cultivation(domestication), and trade ofMPs in Saudi Arabia in order tocreate new employment opportunities for rural populations.

Data Availability

The data used to support the findings of this study areavailable from the corresponding author upon request.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Acknowledgments

Theauthors wish to thank all the informants who contributedto this work with their information and friendship. Thisstudy was financially supported by the Deanship of ScientificResearch of Jazan University (project code 37/7/00087).

Supplementary Materials

Supplementary material file entitled “Questionnaire for col-lecting ethnomedicinal data during ethnobotanical study”.(Supplementary Materials)

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