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The practice of ethnomedicine in the Northern and Southern provinces of Oman.

In Oman, the information on traditional ethnomedicine practice is not transferred from generation to generation in written form but is verbally inherited from the elder members of the family. Traditional medicine is still widely used to treat minor illnesses like colds, fevers, stomach problems, and headaches, even with the availability of primary and secondary healthcare. The elders or trained traditional healers have the right to administer traditional medicines in the society.

The Unani tibb is the base of traditional Islamic medicine and depends on the humoral system, a Graeco-Arab style of medicine. (1,2) It is believed to be derived from the ancient Greek medicinal system where the four elements (earth, water, air, and fire) correspond to blood, phlegm, yellow bile, and black bile in the body. A healthy body is considered to have an equilibrium between the four humors and any imbalance may result in sickness. The Greek physician Hippocrates linked the four humors to four basic temperaments and evolved the ancient medical concept of humorism. (3,4) These temperaments were sanguine (element: air, people: social type), choleric (element: fire, people: short tempered and extroverts), melancholic (element: earth, people: serious and introverts), and phlegmatic (element: water, people: relaxed and peaceful)

In some Omani villages, when doctors are rare, a hakim (wiseman) dispenses herbal and other forms of medication. The practice is based on practical, common-sense cures derived from some empiric knowledge. Traditional Omani healers base their diagnosis and treatment on the ancient Greek ideas of health and illness as described by Aristotle (5) and adapted by medieval Arab medical practitioners. The West used the Greek model for centuries too.

The Oman Animal and Plant Genetic Resource Center (OAPGRC) (6) was established in 2012 and has been involved in making action plans for the conservation and maintenance of Oman's genetic resources like animals, medicinal plants, marine species, and microorganisms. The first Indian Ocean Rim Association's meeting on medicinal plants was conducted in July 2014, during which the participating countries signed the Salalah Declaration on Applied Research, Technology Transfer and Commercialization of Medicinal Plants and Traditional Medicine.

The hilly ranges at Jebel Akdhar and Dhofar are rich with remarkable flora and fauna and comprise of migratory birds and valuable medicinal plants. The Jebel Akdhar area in Oman, from which medicinal plant data was gathered, is situated at latitude 23.3[degrees] 19.8' N and longitude 57.88[degrees] 52.8'E and 2000 m above sea level. It is one of the highest points in Oman and surrounded by the Al-Hajar mountain range. Dhofar occupies the southernmost province of Oman, famous for its frankincense (luban) trade. Salalah is the capital of Dhofar governorate. Dhofar is situated at latitude 18[degrees], 23.8' N and longitude 54[degrees], 26.1'E and 1200 m above sea level.

[FIGURE 1 OMITTED]

Survey methodology

We conducted this review between September 2013 and August 2014. Relevant information (6-9) was collected through a literature survey of the published ethnobotanical and biodiversity books, monographs or papers on herbal medicines found in the Jebel Akdhar and Dhofar regions of Oman

Additionally, interviews were conducted in villages with the traditional medicine people, folklore groups, and native informants to gather information on the inherited knowledge and empiric experiences about the healing properties of local plants. Each herbal traditional use/evidence was considered authentic only after validation through three or more informants from village localities and cross checking the information at different times. Samples of all medicinal plants were identified and authenticated by experts on plants' taxonomy at the Department of Science, Higher College of Technology, Muscat.

The mode of preparation of the crude drugs and the methods of their administration were recorded. Most plants are used as infusions, decoctions, pastes, or inhalants.

The Dhofar plains form a wide coastal belt between the mountain ridges and the Arabian sea and stretches around 20-25 km. They are composed of marine and aeolian sand and alluvial limestone gravels and are navigated by a network of several wadis that drain out from the mountains. The soils in such areas are shallow and support vegetation of xerophytic shrubs. The genus, species, and families of the identified herbs are arranged in alphabetical order [Table 1].

[FIGURE 2 OMITTED]

The majority of Omani traditional treatments include lime, honey, and garlic (10) as herbal additives for treating wounds, the common cold, throat infections, diabetes, and obesity.

Aqueous decoctions of the herbs like cinnamon bark, (11) cloves, (12) true myrtles, (13) frankincense, (14) and ginger (15) are used to treat infections of the respiratory tract and stomach disorders. Leaf and stem decoctions of the plant Teucrium mascatense are used in traditional Omani medicine as a febrifuge [Figure 1]. (16,17)

The traditional wisdom accumulated over generations of trial and error may result in fatal errors due to ignorance of the toxicities of plant chemical compounds. For example, certain plant chemical compounds are more concentrated at particular times of day, due to diurnal variations, so preparing the correct concentration or dilution of natural herbal treatment is essential.

Rose water (18) is used in folk medicine mainly for eye disorders as well as an astringent and cardiac and cephalic tonic. Thyme (19) and juniper (20) are utilized for their carminative, digestive, diuretic, and spasmolytic properties. Hemp (21) or al keefis used in traditional medicine as an astringent, sedative, anesthetic, and retentive. Solanum incarnum (22) or bitter apple is used for earache and hemorrhoids. Myrtle or Myrtus communis (22) which is calledyas in Arabic, grows on the banks of the wadis (valleys that are dry except following rains), and is used for the cure of ulcers, burns, and scorpion stings. Senna leaves (Sana makki) (24) are used widely as a laxative. Ocimum basilicum, (25) otherwise known as sweet basil, is an important plant rich in its thymol content. The sweet basil is used widely in Oman by local healers as a cure for the common cold, eye infections, and sore throat. The oil is made by boiling the leaves of juniper and wild olives with fixed oils are used effectively by the local hakims for the treatment of pain from mountain climbing. The aqueous leaf extract of Euryops arabicus (26) or kabouv is used as an analgesic.

[FIGURE 3 OMITTED]

Cumin seeds (kimoon) are used to improve the appetite. (27) Papaya fruit juice is used to treat diarrhea and walnut leaf juice is applied topically for calm skin conditions like eczema. The leaves and seeds of papaya are used to treat diarrhea. (28)

Frankincense, otherwise known as Boswellia carteri (14) [Figure 2] is a useful Omani traditional remedy for bronchitis, and can be used as a tonic for cleansing the digestive system, a mouth cleanser, for asthma and ulcers, and as a diuretic. The plant is found largely in the Dhofar region. Solanum incanum (29,30) is known as sharinjiban or mazi and used to treat hemorrhoids and eye and ear infections.

[FIGURE 4 OMITTED]

[FIGURE 5 OMITTED]

A decoction made from ginger roots (15) is used mainly to relieve stomach ailments in the traditional practices. Datura seed decoction (31,32) is used as a sedative or sometimes to treat asthma and the tree sap of Ficus cordata (Tha'ab) (36) is used in bites, boils, and burns.

Acridocarpus orientalis (23) is used by the locals of the Jebel Akdhar mountain range and also in the sandy plains of western Gulf countries like Oman, Yemen, and the UAE, for headaches. A poultice or paste is made from the crushed seeds and applied to the forehead to relieve headache. In Oman, villagers use the seeds of this plant as a source of yellow dye. Citrullus colocynth (22,34) is found scattered in the sandy soil of desert plains bearing green and yellow round gourd included in Cucurbitaceae family. The fruits have astringent and laxative properties. Traditional healers used the fruit juice as a remedy for insect and dog bites. The leaf juice of the walnut plant (Joz or nakash) (35,36) is used to treat skin infections and eczema.

In traditional practices, the smoke from the dried leaves of harmal (Rhazya stricta) (37) are inhaled to treat bronchial infections. Harmal is also used for treating eye infections, skin rashes, worm infestations, and in diabetes.

Moringaperegrina, (38) otherwise known as miracle tree or shu, is mainly used for nutrition, and the crushed seeds are used to cure constipation and other stomach ailments. The shu oil is used traditionally for bone setting by applying it to the skin. The milky sap extract from the Calotropisprocera plant is used in folk medicine for arthritis [Figure 3]. (39)

[FIGURE 6 OMITTED]

[FIGURE 7 OMITTED]

The dried Isqal juice obtained from the common garden aloe plants (Aloe barbedensis) (40) is used for its cleansing, antimicrobial and wound healing properties. The fresh juice obtained from the plant is useful for eye infections. A decoction of the stem of the plant Lycium shawii, (41) known asgharqad, is used to purify and detoxify the digestive and circulatory systems.

The folk medicine men of Oman frequently use resins, latex, and tree saps to dress wounds arising from burns, bites, and boils. The commonly used plants are Acacia gerardii [Figure 4],42 Euphorbia larica [Figure 5] (43) and Ficus cordata. (36)

Prosopis cineraria (44) is a very popular plant, the gum and resins of which are useful as an astringent and demulcent. Also, date palms (Phoenix dactylifera) (45,46) are considered a general tonic, rejuvenator, and cooling agent in traditional medicine practice. A xerophytic plant which can be found abundantly in the Al Fazayeh region of Dhofar is Carallumaflava. (47) Natives use these cactus varieties to suppress hunger, stomach ailments and as a general tonic.

[FIGURE 8 OMITTED]

Summary

This review focused on the folklore information available on medicinal plants in Oman. We identified 33 medicinal plants routinely used in the folk medicine practice. These plants are included in 22 plant families and 18 traditional treatment groups. Most of the plants are used as infusions, pastes, or inhalants.

Aloes and Senna are the most common laxatives used to relieve constipation in folklore medicine. Rose water, clove, Teucrium plants, and Ocimum herbs and shrubs are the major antimicrobial agents. Plants like garlic, cat thyme, arabicum, and Lycium are used for their antipyretic and antiinflammatory properties. Acidocarpus, Euryops and Teucrium are utilized for their analgesic activity, and the plant Teucrium is a good bitter tonic. Datura seeds, Boswellia, cinnamon, and garlic are utilized for respiratory tract infections. Plants like Calotropis, cinnamon, garlic and true myrtle are used as antiarthritic and antirheumatic agents.

[FIGURE 9 OMITTED]

Acacia gerardii, Ficus cordata [Figure 6], Euphorbia larica, and Ocimum basillicum, are used for bites, boils, and burns, and Juglans cinerea (walnut) for skin infections and eczema. Datura seeds and cannabis are used as sedatives. The smoke from the dried leaves of Rhazya stricta [Figure 7] is inhaled from a pipe for chest ailments. Citrullus colocynthis [Figure 8] are used for dog and insect bites, while Myrtus communis is used for scorpion stings. Solanum incanum [Figure 9] is utilized for its antihemorrhagic activity, and Lycium shawii is a traditional detoxifying agent.

CONCLUSIONS

The paper provides a report on ethnomedicinal uses of some important plants locally available for curing various ailments found in the Jebel Akdhar and Dhofar regions of Oman. The medicinal plants present in these areas are still not fully explored. The curative and palliative effects of some herbs, minerals, and animal parts are well acknowledged among the rural or tribal populations throughout the world, and this information is typically passed on from one generation to another in the folklore community.

In most instances, the traditional medicine acts as the basic level of contact for rural people when they require medical attention. It is important for governments to take urgent steps to introduce the use of traditional medicine to supplement primary health care. Deforestation at the scrub jungles may result in an added damage to the vegetation of the hilly areas and the valleys along with other environmental hazards. The valuable endangered medicinal plants present over these areas will be extinct in the near future if they are not conserved.

Ethnomedicine is considered the origin of all traditional and complementary systems of medicine and even for modern medicine. Ethnomedicine surveys are considered to be useful for the scientific community to provide basic evidence for the therapeutic value and safety of herbal medication.

ARTICLE INFO

Article history:

Received: 4 February 2016

Accepted: 22 May 2016

Online:

DOI 10.5001/omj.2016.49

Disclosure

The authors declared no conflicts of interest. No funding was received for this study.

Acknowledgements

The authors are thankful to all the native medicine men who provided valuable information on herbs and their use.

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Madhu. C. Divakar *, Amani Al-Siyabi, Shirley. S. Varghese and Mohammed Al-Rubaie

Herbal Drug Division, Directorate of Pharmaceutical Affairs and Drug Control, Ministry of Health, Muscat, Oman
Table 1: Traditional medicines of Oman

Name of the          Local name            Botanical name
herb                  (Arabic)              (family name)

Rose water              Ward               Rosa damascena
                                             (Rosaceae)

Garlic                  Thom,              Allium sativum
                       kurath               (Tilliaceae)

Thyme                  Zaater              Thymus vulgaris
                                             (Tabiatae)

Acridocarpus            Qafas          Acridocarpus orientalis
                                           (Malpighiaceae)

Cinnamon                Qurfa           Cinnamomum zeylanicum
                                             (Taraceae)

Clove                  Qurnfel          Eugenia caryophyllus
                                             (Myrtaceae)

Hemp                   Al-keef             Cannabis sativa
                                           (Cannabinaceae)

True myrde               Yas               Myrtus communis
                                             (Myrtaceae)

Senna leaves         Sana makki           Cassia acutifolia
                                            (Teguminosae)

Juniper                 Arar               Juniper excelsa
                                           (Cupressaceae)

Frankincense           Mohor,       Boswellia carteri or B.sacra
                       Sheehaz              (Burseraceae)
                        mogar

Mountain/felty       Kalpooreh,          Teucrium mascatense
germander               qasba                (Lamiaceae)
or Cat thyme

Bitter apple        Sharinjiban,          Solatium incanum
                        mazi                (Solanaceae)

St Joseph's wort,     Theemran            Ocimum basilicum
sweet basil             zawab                (Tamiaceae)

Jacobeastrum           Kabouv             Euryops arabicus
arabicum                                    (Compositae)

Cumin                 Kimoon or            Cuminum cyminum
                       Sanoot              (Umbelliferae)

Papaya fruits         Pawpaw or             Carica papaya
                        fifay               (Caricaceae)

Walnuts             Joz or nakash          Juglans cinerea
                                           (Juglandaceae)

Rhazya                 Harmal              Rhazya stricta
                                            (Apocynaceae)

Miracle tree             Shu              Moringa peregrina
                                            (Moringaceae)

Aloe plant           Isqafsabbar          Aloe barbedensis
                                      A.clhofarensis,A.innermis
                                            (Lilliaceae)

Lycium                 gharqad              Lycium shawii
                                             (Solanaceae

Bitter apple           handal           Citrullus colocynthis
                                           (Cucurbitaceae)

Spurge tree             Labna             Euphorbia larica
                                           (Tuphorbiaceae)

Rubber bush             shakr            Calotropis procera
Camel weed                                (Asclepicfaceae)

Thorn apple/            Mazi              Solatium incanum
N ight shade                                (Solanaceae)

Ginger                Zanjabil           Zingiber officinale
                                           (Zingiberaceae)

Angels trumpet         Tatorah              Datura metel
                                            (Solanaceae)

Namaqua fig            Tha'ab               Ficus cordata
                                             (Moraceae)

Red thorn              Thbeean             Acacia gerardii
                                             (Fabaceae)

Khejri                  Ghaf             Prosopis cineraria
                                             (Fabaceae)

Dates                  Nakhleh           Phoenix dactylifera
                                             (Arecaceae)

Caralluma           Qahr al-luhum          Carallumaflava
                                           (Asclepidaceae)

Name of the               Major chemical                 Uses
herb                       constituents

Rose water            Citronellal, geraniol,      Astringent, cardiac
                    methyl euginol, linalool,     and cephalic tonic.
                    vitamin C, kaempferol, and    Used as eye drops.
                            quercetin

Garlic               Aliin, allicin, diallyl       Fever, pulmonary
                       trisulfide, S-allyl            infections,
                     cysteine, ajoene S-allyl         rheumatism,
                        mercapto cysteine            hypoglycemic,
                                                      purgative.

Thyme               [alpha]-pinene, camphene,        Carminative,
                          [beta]-pinene,             spasmolytic.
                    [alpha]-terpinene, thymol

Acridocarpus            Flavonoids morin,        Headaches and muscle
                      polyphenols, phenolics             pain.

Cinnamon            eugenol, eugenol acetate,      Infection of the
                      cinnamic aldehyde and       respiratory tract,
                         benzyl benzoate              rheumatism,
                                                  arthritis, general
                                                        pains.

Clove               euginol, euginol acetate,    Acne, bruises, burns
                         iso-eugenol and             and cuts, for
                          caryophyllene            toothache, mouth
                                                        sores.

Hemp                    Teaf: tetra hydro             Retentive,
                     cannabinol Oil: rich in          anesthetic,
                      proteins and vitamins      astringent, sedative.

True myrde           myrtenyl acetate, 1, 8-       Used in scorpion
                        cineole, limonene,        sting, burns, sores
                    linalool, methyl eugenol,         and ulcers.
                        terpineole, trans-            Antiseptic,
                        carveole, geraniol          antirheumatic.

Senna leaves            Sennocides A,B,C,D             Taxative.

Juniper             [alpha]-pinene, camphene,    Aromatic, stimulant,
                       [beta] pinene, 1,4-       digestive, diuretic.
                    cineole limonene, camphor,
                             linalool

Frankincense           Timonene, verbenone,         Asthma, wounds,
                             incensol             ulcers, bronchitis,
                                                  diuretic, tonic for
                                                     cleansing the
                                                 digestive system and
                                                  for deodorizing the
                                                        mouth.

Mountain/felty              Flavonoids              Antibacterial,
germander                                          antinociceptive,
or Cat thyme                                       antinflammatory,
                                                     bitter tonic
                                                      febrifuge.

Bitter apple            Steroid alkaloid,        Hemorrhoids, earache.
                       solanin, solasonine

St Joseph's wort,      Thymol, euginol, 1,8          Colds and eye
sweet basil                  cineole               problems, insect
                                                        bites.

Jacobeastrum              Volatile oil,               Analgesic.
arabicum                 secoeurabicanal

Cumin                 Cuminaldehyde, cymene       Enhancing appetite,
                                                  boiling the ground
                                                  seeds with lime and
                                                    then drunk as a
                                                        colic.

Papaya fruits        Papain enzyme, lycopene,          Diarrhea.
                           polyphenols

Walnuts                   Nutrient-dense                Eczema.

Rhazya                      Alkaloids            Smoke from its dried
                                                   leaves is inhaled
                                                 from a pipe for chest
                                                       ailments.

Miracle tree            Flavonoids rutin,        Seed oil is used for
                        quercetin [beta]-            bone setting.
                    sitosterol, [beta]-amyrin

Aloe plant            Anthracene glycosides         Purgative, eye
                                                   infections, wound
                                                       healing.

Lycium                 Alkaloids, steroids,      Detoxification, anti-
                            flavonoids             inflammatory, for
                                                       sore eyes

Bitter apple         Flavonoids, unsaturated     Dog and insect bites.
                      fatty acids, alkaloids

Spurge tree                 Flavonoids           Bites, boils, burns.

Rubber bush             Cardiac glycosides            Arthritis.
Camel weed

Thorn apple/          Steroidal glycosides,      Hemorrhoids, eye and
N ight shade           steroidal alkaloids          ear infections.

Ginger                      Oleoresins             Stomach ailments.

Angels trumpet          Tropane alkaloids          Sedative, used to
                                                     treat asthma.

Namaqua fig          Polyphenols, flavonoids     Bites, boils, burns.

Red thorn             Polyphenols, catechins     Bites, boils, burns.

Khejri               Polyphenols, catechins,          Astringent,
                         Flavonoids, 5HT              demulcent.

Dates                  Flavonoids, tannins,         General tonic,
                       vitamins, minerals,       cooling, aphrodisiac,
                             sterols                  bronchitis.

Caralluma              Pregnane glycosides,         Tonic, stomach
                        flavone glycosides        ailments, suppress
                                                        hunger.

Name of the         Reference   Herbarium      Extraction methods/
herb                            accession        decoctions used
                                 number

Rose water             10        DCHM/23    Aqueous water distillate.

Garlic                 11       DC/HM/24       Water distillation.

Thyme                  12       DC/HM/25     Extracted from the fresh
                                            or partly dried flowering
                                              tops and leaves of the
                                                  plant by water
                                                  distillation.

Acridocarpus           13       DC/HM/26       Decoction made from
                                                  crushed seeds.

Cinnamon               14       DC/HM/27      The water distillate/
                                             decoctions of the leaves
                                             and twigs or inner dried
                                                      bark.

Clove                  15       DC/HM/28    Water distillate of clove
                                                      buds.

Hemp                   16       DC/HM/29     The oil is expressed by
                                                applying pressure.

True myrde             17       DC/HM/30     Myrtle oil is extracted
                                            from the leaves, branches,
                                            fruits and flowers through
                                               water distillation.

Senna leaves           18       DC/HM/31     Teaf and root decoction.

Juniper                19       DC/HM/32     Juniper oil is extracted
                                              from dried, crushed or
                                            slightly dried ripe fruit
                                                or leaves by water
                                                  distillation.

Frankincense           20       DC/HM/33      Oleoresin is collected
                                            from cut made in the bark
                                                   of the tree.

Mountain/felty        21,22     DC/HM/34       Water extract of the
germander                                        leaves and stem.
or Cat thyme

Bitter apple           23       DC/HM/35       Water extract of the
                                                      roots.

St Joseph's wort,      24       DC/HM/36          Teaf extract.
sweet basil

Jacobeastrum           25       DC/HM/37      Aqueous Leaf extract.
arabicum

Cumin                  26       DC/HM/38     Decoction of the seeds.

Papaya fruits          27       DC/HM/39        Leaves and seeds.

Walnuts               28,29     DC/HM/40           Leaf juice.

Rhazya                 30       DC/HM/41      Dried leaf smoke, leaf
                                                      juice.

Miracle tree           31       DC/HM /42       Crushed seed oil.

Aloe plant             32       DC/HM/43    Dried or fresh leaf juice.

Lycium                 33       DC/HM/44        Decoction of stem.

Bitter apple          34,35     DC/HM/45    Decoction of the berries,
                                                   whole plant.

Spurge tree            36       DC/HM/46    Latex from the tree stem.

Rubber bush            37       DC/HM/47     Plant milky sap extract.
Camel weed

Thorn apple/           38       DC/HM/48       Leaves, whole plant.
N ight shade

Ginger                 39       DC/HM/49            Rhizomes.

Angels trumpet        40,41     DC/HM/50       Decoction of seeds.

Namaqua fig            42       DC/HM/51            Tree sap.

Red thorn              43       DC/HM/52          Plant resins.

Khejri                 44       DC/HM/53         Gum and resins.

Dates                 45,46     DC/HM/54      Fruits, leaves, seeds.

Caralluma              47       DC/HM/55    Aerial part, whole plant.
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Article Details
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Author:Divakar, Madhu. C.; Siyabi, Amani Al-; Varghese, Shirley. S.; Rubaie, Mohammed Al-
Publication:Oman Medical Journal
Article Type:Report
Geographic Code:7OMAN
Date:Jul 1, 2016
Words:4533
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