Ethnobotanical Study of Medicinal Plants Used in Central Macedonia, Greece … · 2019. 7. 30. ·...

Research ArticleEthnobotanical Study of Medicinal Plants Used inCentral Macedonia, Greece

Efthymia Eleni Tsioutsiou,1 Paolo Giordani ,2 Effie Hanlidou,3 Marco Biagi,4

Vincenzo De Feo ,5 and Laura Cornara 6

1Department of Pharmacognosy and Natural Products Chemistry, Faculty of Pharmacy,National and Kapodistrian University of Athens, Athens, Greece

2Department of Pharmacy, University of Genoa, Viale Cembrano, 4, 16148 Genoa, Italy3Laboratory of Systematic Botany and Phytogeography, School of Biology,Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece

4Department of Physical Sciences, Earth and Environment, University of Siena, Via Laterina, 8,53100 Siena, Italy

5Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132, 84084 Fisciano (Selerno), Italy6Department of Earth, Environment and Life Sciences, University of Genoa, Corso Europa 26,16132 Genoa, Italy

Correspondence should be addressed to Vincenzo De Feo; [email protected]

Received 14 December 2018; Accepted 19 February 2019; Published 1 April 2019

Guest Editor: Jose Carlos Tavares Carvalho

Copyright © 2019 Efthymia Eleni Tsioutsiou et al. This is an open access article distributed under the Creative CommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work isproperly cited.

This work provides the ethnobotanical data concerning the traditional use of medicinal plants in Macedonia region (NorthernGreece), which has, up to now, been poorly investigated. The aim of the present study was to collect, analyze, and evaluateinformation on the use of medicinal plants among different population groups living in Central Macedonia.The study was carriedout in the area of two small cities, Edessa and Naoussa, and nearby villages. The ethnobotanical data were gathered throughextensive and semistructured interviews. The informants belonged to different population groups living in the study areas andwere involved, at least partially, in agriculture. Together with detailed reports on each species, data were also summarized bysome indices, such as Fidelity Level (FL) and Informant Consensus Factor (Fic). A group of 96 informants was interviewedand 87 plant taxa with medicinal uses were cited. Medicinal plants are used to treat a wide range of diseases, in particularailments of the respiratory tract and skin disorders. The importance of the traditional use of plants to cure and prevent commonand some uncommon diseases had been highlighted. About 55% of medicinal plants mentioned by the informants had beenpreviously reported to be sold in Thessaloniki herbal market as traditional remedies. Medicinal uses of some endemic taxa hadbeen reported, e.g., Satureja montana subsp.macedonica, amember of the S. montana group restricted toNorthern Central Greece,Origanum dictamnus, an endemic species of Crete, and six Balkan endemics, i.e., Achillea holosericea, Digitalis lanata, Helleborusodorus subsp. cyclophyllus, Sideritis scardica, Thymus sibthorpii, and Verbascum longifolium. Several differences in TraditionalEthnobotanical Knowledge (TEK) were observed in relation to social and cultural components of the population. Only 7 species(Crataegus monogyna, Hypericum perforatum, Matricaria chamomilla, Rosa canina, Sambucus nigra, Sideritis scardica, and Tiliaplatyphyllos) were commonly reported by all population groups, whereas 30 out of 87 taxa (34%) were exclusively mentioned bya single group. All groups are incorporated in the local society and do not identify themselves as members of different ethnicgroups, although they try to preserve their distinctiveness by keeping their traditions and dialects. Nevertheless, our data showthat the knowledge regarding the medicinal plant use was rarely accompanied by preservation of linguistic diversity concerningthe plant names. This work contributes to improve the knowledge on the traditional use of plants in the folk medicine of aregion like Central Macedonia where different population groups live together, partially maintaining their traditions. A part ofdata of this paper has been presented as posted at 112∘ Congress of Italian Botanical Society (IPSC), Parma 20-23 September2017.

HindawiEvidence-Based Complementary and Alternative MedicineVolume 2019, Article ID 4513792, 22 pageshttps://doi.org/10.1155/2019/4513792

http://orcid.org/0000-0003-0087-7315

http://orcid.org/0000-0002-1070-3207

http://orcid.org/0000-0001-9154-7789

https://creativecommons.org/licenses/by/4.0/

https://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1155/2019/4513792

2 Evidence-Based Complementary and Alternative Medicine

1. Introduction

The rural regions of southeastern Europe represent a uniquesocial and environmental context for ethnobotanical studies,owing to the occurrence of a large mountainous area thatis recognized as a hotspot for both biodiversity and cul-tural/ethnic/religious diversities. Medicinal plants have rep-resented, for thousands of years, the only remedy for variousdiseases. Phytotherapy still maintains an important role inthe treatment of many diseases in Greece. Despite this fact,only a few studies have explored the use of plants in Greekfolk medicine while, on the contrary, in the neighboringregion of the Balkan Peninsula very intensive and highlyeffective ethnobotanical studies were carried out in the lastdecade ([1–5] and references therein). Ethnobotanical studieson traditional uses of plants and their products in Greeceare relatively scarce. An old study concerning the knowledgeof medicinal plants of Greece (Lawrendiadis, 1961) reportedsome data about most important plants used in folk medicinethroughout Greece. More recent works have been mainlyfocused on the regions of Zagori [6, 7], Thessaloniki [8–10], Crete [11], Mt. Pelion [12], and more recently on theGreek Islands of North Aegean Region [13]. In contrast, theregions of Edessa and Naoussa (Central Macedonia), wherethis study was carried out, remain poorly explored from anethnobotanical point of view, despite their high floristic andvegetation diversity.

Our study area, Central Macedonia, lies in the core of theancient Macedonian state (500-168B.C.) and is the homelandof Alexander the Great. It was conquered by the Romans(168-284 B.C.), then was a part of the Byzantine Empire,and subsequently became a part of Ottoman Empire (from1430), and, finally, it was incorporated into the Greek state in1917 [14]. Centuries of foreign dominance andmigrations hadshaped the area into a cultural and linguistic mosaic. Until thebeginning of 20th century, Greeks, Slavs, Bulgarians, Turks,and Vlachs were living together. The current populationcomposition was formed after the Neuilly Treaty (1919) andmainly after the Greek-Turkish War in Asia Minor (1919-1922) and the Lausanne Treaty (1923), when much of theSlav-speaking and all the Muslim populations left, and Greekpopulations from Asia Minor and Pontus moved in andsettled [15]. Nowadays, the population consists mainly of fivegroups: (a) the Dopioi, i.e., the local people that remainedafter the migrations of the first quarter of 20th century. Manyof them (Slavophones or Slavo-Macedonians) speak a localSlavic-based dialect while others are Greek-speaking; (b) thePontians, which come from the Greek population lived in theshores of the Black Sea since antiquity. Under the subsequentOttoman rule, they survived relatively intact, preserving theircustoms and dialect (Pontian Greek), which is related toancient Greek, until they were forced to leave their homeland(Day et al., 2002); (c) the Mikrasiates or prosfyges (meaningrefugees), descendants of the Greeks of Asia Minor (MikraAsia in Greek); (d) the Vlachs or Aromanians, people mostlyliving in montane region and occupied in animal husbandry,who speak a Latin-based language, having a long history ofsettlement in the study area. According to some historians,they are Latinized indigenous populations (Greeks, Illyrians,

Thracians or Dardanias), due to the historical presence ofthe Roman military in the territory [16]. Many Romanianhistorians claim that the Aromanians were part of a Daco-Romanian migration from the north of the Danube [17, 18];(e) others, who recently moved to the region from variousparts of Greece.

One of the most prominent differences of above pop-ulations groups is in their dialects, which are still used,particularly by the older people, as a second language aftercontemporary Greek. All groups are incorporated in the localsociety and do not identify themselves as members of dif-ferent ethnic groups (REF). However, they define themselvesbased on their origin and try to preserve their distinctivenessby keeping, in a large degree, their customs, music, dances,dialects, and cuisine [19–23], (Winnfrith, 2001). Taking intoaccount the lack of any published ethnobotanical informationas well as the great cultural diversity of Central Macedonia,our aim is to survey medicinal plants and their uses and tofind if significant differences concerning the use of medicinalplants still persist among the groups of inhabitants of the area.

2. Materials and Methods

2.1. Study Area. Our survey was conducted in two cities,Edessa and Naousa, each with a population of c. 18.000inhabitants and their nearby rural small villages (Figure 1).The inhabitants are mostly occupied in agriculture and stockraising. The area is located at the foothills of Mt Vermio andMt Voras. The two mountains, which are part of the Natura2000Network (GR1210001 and GR1240008, respectively), arecharacterized by a rich and diverse flora (> 1000 taxa wererecorded on Vermio, and > 1500 on Voras), including severalGreek and Balkan endemic species [24, 25].

2.2. Methods. The fieldwork was conducted during springand summer in 2016 and 2017. The ethnobotanical data weregathered through extensive interviews, aimed to create openinformal and semistructured interviews. Snowball samplingtechniques were used to recruit 96 informants (37 men,59 women). In snowball sampling, the first contact withthe community is selected as a well-known expert; in asubsequent phase, the expert indicates another expert, andso on, until all the specialists in the community are covered[26]. The informants were selected proportionally to theoccurrence of five groups within the local population: (a)Dopioi (28 persons), DO (b) Pontians (22 persons), PO (c)Mikrasiates (17 persons), MI (d) Vlachs (10 persons), VL (e)others (19 persons), OTH.

In particular, in the Naoussa municipality a total of 24informants were selected (8 OTH, 3 MI, 9 PO; 2 DO and 4VL), 20 coming from the town and 4 from the villages. In theEdessamunicipality, therewere a total of 72 (11OTH; 14MI; 13PO; 26DO and 6VL), 15 of which come from the town and 57from 16 villages. The subdivision of the inhabitants of the areain various groups was mainly based on the different dialectsthat are still spoken in the two municipalities. In addition, itis worth mentioning that the various groups are diversifiedfrom each other due to different cultural characteristics such

Evidence-Based Complementary and Alternative Medicine 3

0

Central Macedonia

Western Macedonia

NAOUSAGiannakochori

Agia Fotini

KallipoliPlatani

Rizari

Profitis Ilias

EDESSA

SotiraAgios Athanasios

Republic of North Macedonia

Panagitsa

AmissaFlamouria

Ano Grammatiko

km10

21∘36

40∘24

40∘36

40∘48

41∘00

41∘12

21∘48

22

∘00

22

∘12

22

∘24

Paint X Lite

Figure 1: Map of Edessa, Naoussa, and the nearby villages in Central Macedonia (Greece).

as traditional costumes, music, and folk dances. Starting fromSeventies the modern way of living has prevailed. However,at the same time, there was a turning towards folklore inevery county town of Greece, including Central Macedonia.Cultural societies are formed with folklore dance groupsand a recovery of the traditional music is still in progress[27]. Also in the study area several different folk traditionsstill persist among the group population, as shown by thepresence of many Folklore Museums spreading in CentralMacedonia (e.g., Vlach Folklore Museum, Folklore Museumof Edessa, History and Folklore Museum of Naoussa).

For every informant we recorded personal informationabout age, gender, education level, profession, and popula-tion group. This distinction helped to note differences andsimilarities between citations based on different factors. Theinformants had personal experience in self-medication usingherbs and had ethnobotanical knowledge because of familytradition or personal interest. Their age ranged between 24and 94 years (mean = 59 years), educational levels includedprimary (30%), secondary (41%), and higher education(29%), jobs included employees (e.g., public employees, civilengineers), farmers, workers, and people involved in human-istic occupations (e.g., painter, teachers). All information wasobtained after receiving an oral prior informed consent fromthe participants, according to the ISE (International Societyof Ethnobiology) Code of Ethics. During the interviews, theinformants were requested to indicate vernacular names ofplants, parts of the plant used, association with other plants,folk uses, and preparation procedures. In many cases, dataon specific recipes and their sources were included. Quiteoften the interviews took place in the village square or in thehouses of the informants (Figure 2) where they also showed

us traditional remedies that are currently used. Specimensof the plants were either given to us by the informants orcollected from the wild, according to their instructions. Theinformation collected refers to wild and cultivated species.The taxa were identified using standard Floras [24, 25, 28,29]. Nomenclature is according to Dimopoulos et al. [30].Voucher specimens are deposited at the Herbarium of theAristotle University of Thessaloniki (TAU).

The data gathered on plant uses were organized incitations and each citation coincided with a single row in adatabase created using Microsoft Excel. Then data were ana-lyzed and compared with several ethnobotanical references,primarily based on a search in Scopus database, using thesearch string “ethnobotany and Greece”. Following recentrecommendations for reporting ethnobotanical field studies,primary data are presented in an unaltered form, allowingdirect comparison between other similar researches [31]. Inorder to compare our resultswith the list of themost commonmedicinal plants used in Central Macedonia, in Table 1 wereported the species sold in the herbal market of the regionalcapital Thessaloniki [8]. Several ethnobotanical indices wereadopted for interpreting the large quantity of information.

2.3. Quantitative Indices and Statistical Analysis. To estimatethe use variability of the species, we adopted the InformantConsensus Factor [32], which was calculated for each medic-inal category. This index was calculated as follows: numberof citations in a subcategory (nur) minus the number of taxaused in the same subcategory (nt), divided by the number ofcitations minus one [33, 34]:

Fic =(nur − nt)(nur − 1) (1)


Figure 2: Informant interviewed during the ethnobotanical study.

The value of this factor ranges from 0 to 1. A high Ficvalue indicates an agreement among the informants onthe use of taxa within a medicinal subcategory. The Ficreflects homogeneity of information provided by differentinformants.

The Fidelity Level index (FL) was also considered toindicate the informants’ choice for a potential plant speciesto treat a given disease. It was calculated by the followingformula [35]:

FL (%) = (NpN) ∗ 100 (2)

where Np is number of use reports for a given speciesreported to be used for a particular ailment category and Nis total number of use reports cited for any given species.

Descriptive statistical analyses were carried out in Renvironment (vers. 3.4.0, R Core Team 2017) adopting acirclize package (vers. 0.4-2, [36]) andVennDiagrampackage(vers. 1.6-19, [37]).

3. Results and Discussion

3.1. Medicinal Plants. Our results showed that 87 medicinalplant species belonging to 48 families are used in the studyarea to treat several ailments. The surveyed species are listedin Table 1, where plant families and species within each familyare cited in alphabetical order. In this table, for each taxonreported, data on scientific name, family, local name, part ofplant used, medicinal use, and number of citations and if theyarewild or cultivated are included. In the last column, it is alsoreported if the species has been previously cited in the study

of Hanlidou et al. [8] on the herbal market in Thessaloniki(representing ca. 55% of the taxa cited in our work).

Noteworthy, the knowledge regarding themedicinal plantuse was rarely accompanied by preservation of linguisticdiversity concerning the plant names. In fact, only 6 out of 87taxa were cited also under their dialect names. Accordingly,also in previous works on ethnobotanical use of plants in folkmedicine in Greece, dialect names were seldomly reported[6]. Lawrendiadis (1961), speaking about common names ofmedicinal plants in Greece, referred that they are usuallyrelated to the part of the body on which they have curativeeffects or to the disease against which they can be used.For example, Tussilago farfara was called “vychion” from theGreek word “vyx” (cough) or Origanum dictamnus “stoma-chochorton” from the Greek words “stomachos” (stomach)and “chorton” (herb). More recently, Hanlidou et al. [8],referring tomedicinal plants sold in theThessaloniki market,reported for most taxa both commercial names and names inDioscurides.

3.1.1.Most Cited Species. Data show that Lamiaceae (21%) andAsteraceae (13%) are the most represented families, followedby Rosaceae (6%). Among the taxa (species and subspecies)recorded, 23 are cultivated, either grown in the study area orpurchased from the local market. However, most of the taxa(64) were collected from the wild. Among them, there is aGreek endemic taxon, Satureja montana subsp. macedonica,a member of the S. montana group restricted to NorthernCentral Greece, and six Balkan endemics (some of themextending to Italy or Anatolia), i.e., Achillea holosericea, Dig-italis lanata, Helleborus odorus subsp. cyclophyllus, Sideritisscardica, Thymus sibthorpii, and Verbascum longifolium. The


Table1:Ethn

obotanicaluses

ofplantsin

ther

egions

ofEd

essa

andNaoussa

(CentralMacedon

ia,G

reece).

Families/Species

Localn

ames

Partsu

sed

Use

categorie

s,preparation,

andailm

enttreated

No.citations

per

popu

latio

ngrou

pNo.of

totalreports

WS/CS

Soldin

Thessalonikimarket

[8]∗

OTH

MI

PODO

VL

Adoxaceae

Sambu

cusn

igra

L.(TAU

60500)

Zampo

uko

Inf

MED

-RES

:decoctio

nagainstinfl

ammationof

ther

espiratory

tract,cou

ghor

asexpectorant,(also

combinedwith

Le.ofA

lcearoseaor

with

Seof

Linu

musita

tissim

um,A

pof

Verbascum

longifoliu

man

dTh

ymus

vulga

ris)

51

37

221

W+

MED

-SKI

:stems’bark

with

wax

andoliveo

ilappliedon

cuts,

bruises,bu

rns,and

wou

nds

10

21

0Amaryllid

aceae

Allium

cepa

L.Kr

emidi

BuMED

-SKI

:usedas

cataplasm

with

saltor

wineo

roliveo

ilagainstskinbu

rns,bruises,

andedem

as0

20

10

3C

+Allium

sativ

umL.

Skordo

BuMED

-CAR:

eatenrawor

cook

edto

preventand

treathypertensio

n0

01

30

4C

+Ana

cardiaceae

Pista

cialen

tiscusL

.var.chia

Masticha

ReMED

-GAS:chew

edagainstgastricu

lcersa

ndailm

entsof

thed

igestiv

esystem

00

10

01

C+

Apiaceae

Apium

graveolen

sL.

Selin

oLe

MED

-CAR:

decoctionagainsth

ypertension

10

00

02

CMED

-RES

:boiledwith

milk

totre

atthes

ymptom

sofcom

mon

cold

10

00

0Aq

uifolia

ceae

Ilexaquifoliu

mL.

(TAU

60501)

Ou

LeMED

-MUS:decoctionto

treatjointand

muscularp

ains

00

01

01

WAraceae

Arum

italicum

Mill.(TA

U60

502)

Drako

ntia/

Smiin

abilk

a(D

O)

Le,R

oMED

-RES

:decoctio

nagainstcou

gh,bronchialcatarrh,andsore

throat

00

11

02

W

Arum

maculatum

L.(TAU

60503)

Drako

ntia

Le,R

oMED

-RES

:decoctio

nagainstcou

gh,bronchialcatarrh,an

dsore

throat

00

11

02

WAralia

ceae

Hederahelix

L.(TAU

60504)

Kissos

LeMED

-RES

:decoctio

nagainstcou

gh2

00

10

3W

+


Table1:Con

tinued.

Families/Species

Localn

ames

Partsu

sed

Use

categorie

s,preparation,

andailm

enttreated

No.citations

per

popu

latio

ngrou

pNo.of

totalreports

WS/CS

Soldin

Thessalonikimarket

[8]∗

OTH

MI

PODO

VL

Aspa

ragaceae

Ruscus

aculeatusL

.(TA

U60

505)

Agathi

ApMED

-GEN

:decoctio

nforthe

treatmenta

ndpreventio

nof

prostatitisan

das

diuretic

(com

binedin

thed

ecoctio

nwith

Fr.ofP

aliurusspina

-christi)

00

03

03

W+

Asph

odelaceae

Aloe

vera

(L.)Bu

rm.f.

Aloi

LeMED

-SKI

:parenchym

aticgelu

sedas

poulticeappliedon

wou

nds,sunb

urns,and

insectbites

00

01

01

CAs

teraceae

Achilleaholoseric

eaSm

.(TA

U60

506)

Kitrini

Achillia

Inf

MED

-RES

:decoctio

nagainstinfl

ammationof

ther

espiratory

tractan

dcoug

hor

asexpectorant

00

00

24

WMED

-GEN

:decoctio

nagainstcystitis

00

00

1MED

-SKI

:water

ofmacerationas

cataplasm

againsth

emorrhoids

10

00

0

Achilleamillefo

lium

L.(TAU

60507)

LefkiA

chillia

Inf

MED

-RES

:decoctio

nagainstinfl

ammationof

ther

espiratory

tractan

dcoug

h0

03

02

17W

+MED

-GEN

:decoctio

nagainstcystitis,

urogenitalinfl

ammation,

andregulatio

nof

menstr

ualcycle(w

ithCa

psellabursa-pasto

ris,cinna

mon

bark

andoran

gepeel)

40

50

1MED

-SKI

:water

ofmacerationas

cataplasm

againsth

emorrhoids;usedfre

shas

cataplasm

againstacne

10

10

0

ArctiumlappaL.(TAU

60508)

Arktio

RoFO

OD:eaten

rawas

depu

rativ

e1

02

00

11W

+Le

MED

-MUS:decoctionforjoint

pain

andinflammation

21

20

0Le

MED

-SKI

:decoctio

nused

aspo

ulticeappliedon

wou

ndsa

ndfuruncles

10

20

0Cirsium

eriophorum

(L.)Scop.(TA

U60

509)

Kirsio

FlMED

-MET

:decoctio

nford

etoxificatio

nan

dtre

atmento

fliver

diseases

02

00

02

WHelianthus

tuberosusL

.(TA

U60

510)

Kolokasi

TuFO

OD:eaten

boiledas

saladto

improveintestin

alfunctio

n0

03

00

6C

MED

-GAS:decoctionagainstcon

stipatio

n0

03

00

Lactucas

errio

laL.(TAU

60511)

Agrio

marulo

Le,Fl

MED

-MET

:decoctio

nagainsth

ypercholesterolemia

20

01

03

W

Matric

ariacham

omillaL.(TAU

60512)

Cham

omili

Inf

MED

-NER

:decoctio

nor

infusio

nagainstinsom

niaa

ndotitis

16

15

1

33W

+MED

-GAS:decoctionagainstabd

ominalpain

33

41

0MED

-GEN

:washing

totre

atvaginitis

30

10

0MED

-RES

:oily

extra

ctor

decoctionagainstcou

gh1

MED

-SKI

:oily

extra

ctappliedforw

ound

healing

30

00

0Pu

licariadysenterica

(L.)Be

rnh.

Pulicaria

Ap,F

lMED

-GAS:decoctionforc

onstipatio

nandintestina

lproblem

s1

00

00

1W

Silyb

ummarianu

m(L.)Gaertn.(TAU

60513)

Gaidu

ragatho

Fl,Fr

MED

-MET

:decoctio

nford

etoxificatio

nan

dtre

atmento

fliver

diseases

30

02

05

W+

Taraxacum

sp.(TA

U60514)

Taraxaco

ApMED

-NER

:decoctio

nagainsth

eadachea

ndinsomnia

10

10

14

W+

MED

-MET

:todecrease

triglycerideandcholesterollevels

10

00

0Tu

ssilago

farfa

raL.

(TAU

60515)

Vihio/

Flom

osAp

MED

-RES

:decoctio

nagainstcou

ghan

dinflammationof

ther

espiratory

tract

20

01

03

W+


Table1:Con

tinued.

Families/Species

Localn

ames

Partsu

sed

Use

categorie

s,preparation,

andailm

enttreated

No.citations

per

popu

latio

ngrou

pNo.of

totalreports

WS/CS

Soldin

Thessalonikimarket

[8]∗

OTH

MI

PODO

VL

Boragina

ceae

Cyno

glossu

mcreticu

mMill.

Kyno

glosso/

FrMED

-SKI:eaten

trituratedforthe

treatmento

fwarts

40

00

04

WAritsovotano

Caprifo

liaceae

Valer

iana

officin

alisL.(TAU

60516)

Valeria

naRo

MED

-NER

:tincturea

gainstinsomniaa

ndas

calm

ative(

combinedwith

Capsella

bursa-pasto

ris)

10

40

05

W+

Caryop

hylla

ceae

Sapona

riaoffi

cinalisL.(TAU

60517)

Sapu

nochorto

FlMED

-SKI

:cataplasm

appliedon

skin

againsteczem

aand

derm

atitis

20

01

03

W+

Conv

olvu

laceae

CuscutacampestrisYu

nck.(TAU

60518)

Kitrino

parasito

ApMED

-SKI:stemso

fthe

aeria

lpartrub

bedon

beesting

s0

00

30

3W

Cornaceae

Cornus

spp.

Krana

FrMED

-GAS:alcoho

licextra

ctdrun

kagainstabd

ominalpain

11

WCu

curbita

ceae

Cucurbita

pepo

L.Ko

lokithi

SeMED

-GEN

:oily

extra

ctdrun

kto

cure

andpreventp

rosta

titis

00

01

02

CMED

-MUS:oilyextra

cttopically

appliedagainstjoint

pain

00

01

0Mom

ordica

charantia

L.(TAU

60519)

Kanturi

FrMED

-SKI

:oily

extra

ctagainstw

ound

s,bu

rns,callu

ses;drun

kagainstgastricu

lcers.

52

06

130

CVET

:oily

extra

ctused

ongoatsa

ndpigs

tocicatrize

wou

nds

52

06

0Cu

pressaceae

Juniperuscom

mun

isL.

(TAU

60520)

MavrosK

edros

Ga

MED

-CAR:

eatenrawor

used

asflavorin

gfor

meattopreventcardiovasculard

iseases

00

20

02

WJuniperuso

xycedrus

L.(TAU

60521)

Kedros

Ga

FOOD-M

ED:flavoringfor

meatand

digestive

00

11

02

W+

Den

nstaed

tiaceae

Pteridium

aquilin

um(L.)Ku

hn(TAU

60522)

Fteri

LeDOM:w

rapup

rawmeattokeep

itfre

sh0

10

40

7W

MED

-GEN

:decoctio

nas

diuretican

dto

removek

idneysto

nes

11

Dioscoreaceae

Tamus

commun

isL.

Riza

touAd

amRo

MED

-MUS:alcoho

licextra

ctof

slicedroot

(form

sacream)a

gainstmuscularp

ain

andinflammation

10

20

03

W

Equisetaceae


Table1:Con

tinued.

Families/Species

Localn

ames

Partsu

sed

Use

categorie

s,preparation,

andailm

enttreated

No.citations

per

popu

latio

ngrou

pNo.of

totalreports

WS/CS

Soldin

Thessalonikimarket

[8]∗

OTH

MI

PODO

VL

Equisetum

arvenseL

.(TA

U60

523)

Ekuiseto/

Polik

ombi/U

ratu

alogu

ApMED

-GEN

:decoctio

nagainstu

rogenitald

iseases

andforthe

treatmento

fprosta

titis

asdiuretic

00

010

010

W+

Ericaceae

Vaccinium

myrtillusL

.(TA

U60524)

Mirtillo

FrMED

-NER

:eaten

rawto

improvev

ision

00

20

03

W+

MED

-SKI

:pulpedagainstgum

s’inflammation

1Fa

baceae

RobiniapseudoacaciaL.

(TAU

60525)

Akakia

FlMED

-MUS:decoctionagainstjoint

painsa

ndrheumatism

s(also

combinedwith

Fl.

ofCe

rcissiliqua

strum

)0

00

50

5W

Cercissiliqua

strum

L.(TAU

60526)

Kutsu

pia

FlMED

-MUS:decoctionagainstjoint

painsa

ndrheumatism

s(also

combinedwith

Fl.

ofRo

biniapseudacacia

andLe.ofA

lcearosea)

00

07

07

WFa

gaceae

Casta

neasativ

aMill.(TA

U60

527)

Kasta

nia

FlMED

-GAS:decoctionagainstd

iarrhea

60

00

06

C+

Grossulariaceae

Ribesu

va-crispa

L.(TAU

60528)

Fragostaph

iloAp

MED

-MET

:decoctio

nor

tinctureto

increase

ironlevelsan

das

tonic

10

20

03

WHyp

ericaceae

Hypericu

mperfo

ratum

L.(TAU

60529)

Valsa

mocho

rto/

Ruman

a/Spatho

chorto

Inf

MED

-SKI:oily

oralcoho

licextra

ctappliedon

wou

nds,bu

rns;mixed

with

wax

and

Re.ofP

istacia

lentiscusvar.chiaandappliedon

deep

sores

87

146

965

W+

MED

-MUS:as

massage

toalleviatea

rthritissym

ptom

sand

jointp

ain

01

30

0MED

-GAS:drun

kto

treatgastr

iculcersan

dgastr

ointestin

aldistu

rbs(1spo

on/day)

14

61

3MED

-NER

:decoctio

nagainstinsom

niaa

ndas

antid

epressant

00

11

0Iridaceae

Crocus

sativ

usL.

Krok

osFl

MED

-MET

:water

ofmacerationof

stigm

asas

immun

ostim

ulanto

rfor

the

preventio

nof

common

coldsa

ndflu

00

10

01

C+


Table1:Con

tinued.

Families/Species

Localn

ames

Partsu

sed

Use

categorie

s,preparation,

andailm

enttreated

No.citations

per

popu

latio

ngrou

pNo.of

totalreports

WS/CS

Soldin

Thessalonikimarket

[8]∗

OTH

MI

PODO

VL

Lamiaceae

Hyssopu

sofficin

alisL.(TAU

60530)

Issopo

sAp

MED

-NER

:decoctio

nagainsth

eadache

10

20

03

CLa

vand

ulaangustifolia

Mill.(TA

U60

531)

Levanta

Inf

MED

-NER

:decoctio

nas

blandsedativ

e1

11

00

6C

+MED

-CAR:

againsth

ypertensionifcombinedwith

Le.ofM

enthas

picata

11

10

0Melissa

officin

alis

Melissocho

rto

LeMED

-NER

:decoctio

nor

infusio

nas

sedativ

e;used

asdecoctionin

combinatio

nwith

Ap.ofC

rataegus

monogyn

aJacq.for

thep

reventionof

cardiovascular

diseases

40

02

06

W+

subsp.altissim

a(Sm.)Arcang.(TAU

60532)

Menthas

picata

L.(TAU

60533)

Menta

Le,A

pMED

-MET

:decoctio

nor

infusio

nagainsth

ypercholesterolemia

10

04

018

W+

MED

-CAR:

cardiovascular

prob

lemsa

ndhypertensio

n1

00

40

MED

-GAS:decoctionin

combinatio

nwith

Inf.of

Hypericu

mperfo

ratum

forthe

treatmento

fgastricu

lcers,nausea

andflatulence

12

14

0

Menthas

pp.

Menta/D

yosm

osLe

MED

-GAS:decoctionagainstn

auseaa

ndflatulence

21

6W

MED

-RES

:decoctio

nagainstinfl

ammationof

ther

espiratory

tractan

dcoug

h2 1

Micr

omeriajuliana

(L.)Rc

hb.(TA

U60534)

Kiparis

saki

ApMED

-GEN

:decoctio

nas

diuretican

dforthe

preventio

nan

dtre

atmento

fprosta

titis

(also

incombinatio

nwith

Seof

Rosa

canina

andAp

.ofE

quise

tum

arvense)

11

60

08

W+

Ocim

umbasilicu

mL.(TAU

60535)

Vasilikos

LeMED

-NER

:usedfre

shas

decoctionor

infusio

nagainstinsom

niaa

ndto

improve

mem

oryan

dconcentra

tion

01

02

03

C+

Orig

anum

dictam

nusL

.Diktamo

ApMED

-RES

:decoctio

nagainstcou

ghandsymptom

sofcom

mon

cold

11

C+

Orig

anum

majoran

aL.(TAU

60536)

Matzurana

ApMED

-GAS:decoctionas

digestive,againstnausea

andgastr

icdistu

rbs

12

31

08

C+

MED

-GEN

:decoctio

nagainstm

enstr

ualpain

1Orig

anum

vulga

reRigani

ApMED

-MET

:decoctio

nor

water

ofmacerationas

bloo

ddepu

rativ

e0

00

20

3W

+subsp.hirtum

(Link)

Ietsw

aart(TAU

60537)

MED

-GAS:eatenrawto

improved

igestio

n1

Orig

anum

vulga

reTo

urkiko

tsai

Inf

MED

-RES

:decoctio

nwith

honeya

ndbu

ttera

gainstallergiccoug

h2

00

00

2W

subsp.virid

ulum

(Martrin-Don

os)N

yman

(TAU

60538)

Rosm

arinus

officin

alisL.

(TAU

60539)

Dentro

livan

oAp

MED

-MET

:decoctio

nagainsth

ypercholesterolemia

04

00

04

C+


Table1:Con

tinued.

Families/Species

Localn

ames

Partsu

sed

Use

categorie

s,preparation,

andailm

enttreated

No.citations

per

popu

latio

ngrou

pNo.of

totalreports

WS/CS

Soldin

Thessalonikimarket

[8]∗

OTH

MI

PODO

VL

Salvia

officin

alisL.

(TAU

60540)

Faskom

iloLe

MED

-NER

:decoctio

nor

water

ofmacerationagainstinsom

niaa

ndan

xiety(in

combinatio

nwith

Inf.of

Aloysia

citrodora)

21

03

06

W

Saturejamontana

subsp.macedonica

(Formanek)B

aden

(TAU

60541)

Thym

ari/

Thym

piron(PO)

Inf

MED

-RES

:decoctio

nagainstinfl

ammationof

ther

espiratory

tractan

dforc

ough

00

40

08

WMED

-MET

:decoctio

nagainsth

ypercholesterolemia

01

00

0MED

-NER

:decoctio

nto

alleviates

ymptom

softinnitus

00

30

0Sideritismontana

Asprotsa

iInf,Ap

MED

-RES

:decoctio

nagainstinfl

ammationof

ther

espiratory

tractan

dcoug

h2

01

02

5W

subsp.remota(d’Uvr.)P.W

.Ball(TA

U60

542)

Sideritisscardica

Gris

eb.(TA

U60

543)

Tsaitu

vunu

Inf,Ap

MED

-RES

:decoctio

nagainstinfl

ammationof

ther

espiratory

tractan

dcoug

h6

117

24

30W

+Teucriu

mcapitatum

L.(TAU

60544)

Tefkrio

FlMED


ominalpain

00

12

03

WTh

ymus

sibthorpiiB

enth.(TA

U60545)

Materina

Inf,Le

MED


ominalpain

orgastr

ointestin

aldistu

rbs

30

00

14

WLina

ceae

Linu

musita

tissim

umL.

Lina

riSe

MED

-GAS,decoctionagainstcon

stipatio

n0

03

00

13C

+MED

-RES

:decoctio

nor

infusio

nas

expectoranto

rtoalleviatec

ough

(also

incombinatio

nwith

Inf.of

Sambu

cusn

igra

andAp

.ofV

erbascum

longifoliu

m.and

Thym

usvu

lgaris)

13

50

0

MED

-SKI

:asc

ataplasm

totre

atwou

ndsa

ndfuruncles

1Lo

rantha

ceae

Loranthu

seuropaeus

Jacq.(TA

U60546)

Parasito

ApMED

-CAR:

decoctionof

twigstotre

athypertensio

n,varic

osev

eins

andto

improve

bloo

dcirculation

20

05

07

WMalvaceae

AlcearoseaL.

(TAU

60547)

Alth

eaLe

MED

-RES

:decoctio

nor

infusio

nagainstcou

ghin

combinatio

nwith

Inf.of

Sambu

cusn

igra;decoctio

nagainstrheum

atism

sand

musculoskeletalpain

incombinatio

nwith

Fl.ofR

obinia

pseudacacia

andof

Cercissiliqua

strum

10

03

04

W

Malva

sylve

strisL.

(TAU

60548)

Molocha

FlMED

-RES

:decoctio

nor

infusio

nas

expectorantand

againstcou

gh6

42

10

14W

+


Table1:Con

tinued.

Families/Species

Localn

ames

Partsu

sed

Use

categorie

s,preparation,

andailm

enttreated

No.citations

per

popu

latio

ngrou

pNo.of

totalreports

WS/CS

Soldin

Thessalonikimarket

[8]∗

OTH

MI

PODO

VL

Tilia

platyphyllosS

cop.(TAU

60549)

Tilio

s/Flam

uri

Inf

MED

-GAS:decoctionagainstintestin

alpain

02

21

026

W+

MED

-RES

:decoctio

nforc

ough

andbron

chialcatarrh

35

66

1MED

-NER

:decoctio

nas

sedativ

e0

00

10

Oleaceae

Fraxinus

ornu

sL.(TA

U60

550)

Fraksos

ApVET

:barkof

stemsintochickens’w

ater

topreventtheirillnesses

00

11

02

W+

Ona

graceae

Epilobium

angustifoliu

mL.(TAU

60551)

Epilo

vio

LeMED

-GEN

:decoctio

nto

treatan

dpreventp

rosta

titisor

asdiuretic

31

01

16

WEpilobium

parviflorum

Schreb.

Epilo

vio

LeMED

-GEN

:decoctio

nto

treatan

dpreventp

rosta

titisan

dcystitis

oras

diuretic

10

00

01

WOrchida

ceae

Dactylorhizasambu

cina(L.)So

o(TAU

60552)

Salepi

BuMED

-RES

:decoctio

nas

expectorantagainstcoug

han

dcommon

cold

50

20

18

WPa

paveraceae

PapaverrhoeasL

.(TA

U60

553)

Paparuna

SeMED

-NER

:infusionor

decoctionas

sedativ

e0

02

00

2W

Passifloraceae

Passiflora

sp.(TA

U60554)

Passiflora

FlMED

-NER

:decoctio

nas

sedativ

e0

00

20

2C

+Pipe

raceae

Pipern

igrum

L.Piperi

SeMED

-RES

:alcoh

olicextra

ctused

ascataplasm

againstcou

gh1

1W

+Plan

tagina

ceae

Plantago

mediaL.

(TAU

60555)

Pentan

evro/

Tigavits(D

O)

LeMED

-SKI

:usedfre

sh,rub

bedon

wou

nds,furunclesa

ndhemorrhoids

31

13

010

WMED

-GEN

:decoctio

nor

eatenas

saladto

treator

preventu

rogenitalailm

ents

(prosta

titis)

andim

provek

idneys’fun

ction

20

00

0

Digita

lislana

taEh

rh.(TA

U60

556)

Digitalis

LeMED

-CAR:

decoctionto

improveb

lood

circulationandpreventcardiovascular

diseases

10

00

01

WPo

aceae

Elytrig

iarepens

(L.)Nevski(syn.Ag

ropyron

repens

(L.)P.Be

auv.)

Agria

daAp

MED

-MUS:decoctionor

infusio

nagainstjoint

andmuscularp

ains

11

00

02

W

ZeamaysL

.Ka

lampo

kiStyF

lMED

-NER

:decoctio

nor

water

ofmacerationas

sedativ

e1

10

10

6W

+MED

-GEN

:decoctio

nin

combinatio

nwith

fruitstalksofP

runu

savium

asdiureticor

forthe

preventio

nandtre

atmento

furogenitald

isturbs

21

00

0Po

rtulacaceae

Portulacaoleracea

L.(TAU

60557)

Glistrida/

Adrakla

ApMED

-MET

:eaten

rawor

boiledagainsth

ypercholesterolemia

00

11

06

WMED

-NER

:eaten

rawagainsttoo

thache

andto

removetartar

00

01

0MED

-CAR:

eatenrawto

preventcardiovasculard

iseases,hypertension,ob

structed

arterie

s0

01

20

Ranu

nculaceae

Helleborus

odorus

subsp.cyclo

phyllus(A.

Braun)

Maire

&Petitm.(TA

U60

558)

Elevoros/S

pres

(DO)

RoMED

-MUS:decoctionof

fragmentedroot

(1partof

root

in2literso

fwater)totre

atjointp

ain;

toxicp

lant

00

02

04

WVET

:decoctio

nof

fragmentedroot

with

saltto

treatjointp

ainin

goats,cowsa

ndpigs

00

02

0Rh

amna

ceae


Table1:Con

tinued.

Families/Species

Localn

ames

Partsu

sed

Use

categorie

s,preparation,

andailm

enttreated

No.citations

per

popu

latio

ngrou

pNo.of

totalreports

WS/CS

Soldin

Thessalonikimarket

[8]∗

OTH

MI

PODO

VL

Paliurusspina

-christiM

ill.(TA

U60

559)

Paliu

ri/Fluri

FrMED

-GEN

,:decoctio

nforu

rinarytractan

durogenitald

iseases

andthetreatmento

fprostatitisas

diuretic

30

16

011

W+

MED

-MET

:decoctio

nagainsth

ypercholesterolemia

01

00

0Ro

saceae

Agrim

onia

eupatoria

L.(TAU

60560)

Agrim

onio

ApMED

-SKI

:infusionappliedas

cataplasm

forthe

cicatrizatio

nof

wou

nds

10

20

03

W+

Crataegusm

onogyn

aJacq.(TA

U60

561)

Krategos

Ap,(Fl,Fr,

LeSh

)MED

-CAR:

decoction(A

p)or

alcoho

licextra

ct(Fr)forthe

preventio

nof

cardiovascular

diseases

andforthe

treatmento

fhypertension

14

23

313

W+

Prun

usavium

L.(L.)(TAU

60562)

Kerasia

FrPed,

SeMED

-MUS:decoctionagainstarthritisa

ndjointp

ain(in

combinatio

nwith

StyF

l.of

Zeamays);asd

iuretic

10

01

13

C+

Rosa

canina

L.(TAU

60563)

Agrio

triantafilia/

Kyno

rodo

/Masura(

PO)

Fl,

FOOD:m

armalade;tonicliquo

r(madeo

fpetals)

00

02

0

24W

+Fr Se

MED

-MUS:againstrheum

atism

sincombinatio

nwith

Fl.ofC

ercis

siliqua

strum

;to

treatosteoarthritis;eatenpu

lverized

againstarthritisp

ain

01

01

0Fr Fr

MED

-GEN

:decoctio

nhelpstoremovek

idneysto

nes,againstprosta

titisin

combinatio

nwith

StyF

l.of

Zeamaysa

ndAp

.ofM

icrom

eriajuliana

00

10

0

Fl,Fr

MED

-MET

:eaten

rawas

antio

xidant,for

thep

reventionof

cardiovascular

diseases;

decoction,

syrup,marmaladeo

rliquo

rasimmun

ostim

ulant(to

preventcoldandflu

)3

34

72

Rosa

xdamascena

Herrm

.(TA

U60

564)

Palia

triantafyllia

FlMED

-MUS:oilyextra

ctof

petalsappliedto

treatmusculoskeletalpain/also

used

totre

atchild

ren’s

jointp

ainwhilethey

grow

up0

00

20

2C


Table1:Con

tinued.

Families/Species

Localn

ames

Partsu

sed

Use

categorie

s,preparation,

andailm

enttreated

No.citations

per

popu

latio

ngrou

pNo.of

totalreports

WS/CS

Soldin

Thessalonikimarket

[8]∗

OTH

MI

PODO

VL

Rutaceae

Citrus

limon

(L.)Osbeck

Lemon

iLe

MED

-MET

:decoctio

nagainsth

ypercholesterolemia

00

20

02

CScroph

ulariaceae

Verbascum

longifoliu

mTen.

(TAU

60565)

Verbasco/

Lupu

siou(V

L)Ap

MED

-RES

:decoctio

nto

treatcough

30

31

010

WAp

MED

-GEN

:decoctio

nto

treatan

dpreventp

rosta

titis

00

20

0Le

MED


ominalpain

00

20

0So

lana

ceae

Alkekengiofficin

arum

Moench.(syn

.Physalis

alkekengiL

.)(TAU

60566)

Fana

raki

FrMED

-MET

:eaten

rawas

immun

ostim

ulantand

tonic

10

01

02

WNicotia

natabacum

L.(TAU

60567)

Kapn

osLe

MED

-SKI

:usedfre

sh,app

liedon

wou

ndsa

scicatriz

ing,hemostatic,disinfectant

00

20

02

CUr

ticaceae

Urticad

ioica

L.(TAU

60568)

Tsou

knida

LeMED

-SKI

:decoctio

nforg

reasyhair

00

20

019

W+

MED

-MUS:infusio

nor

decoctionagainstrheum

atism

s3

00

10

MED

-GEN

:decoctio

nagainstprosta

titisan

das

diuretic

30

20

0MED

-MET

:decoctio

nor

eatenrawas

saladas

bloo

ddepu

rativ

eand

againstanemia

30

23

0

Legend

s:OTH

=others;M

I=Mikrasia

tes;PO

=Po

ntians;D

O=Dop

ioi;VL=

Vlachs.CS

=cultiv

ated

species;WS=

wild

species;Ap

=aerialp

art;Bu

=bu

lb;G

a=galbula;Fl=fl

owers;Fr=fruits;FrPed=fruitp

edicels;Inf=

inflo

rescences;Le=leaves;LeSh=

leafshoo

ts;Re

=resin;R

o=roots;Se=seeds;StFl=sty

leso

ffem

alefl

owers;Tu

=tub

ers.DOM=d

omestic;FOOD=for

human

nutrition

andhealth;M

ED-CAR

=cardiovasculard

iseases;

MED

-GAS

=gastro

intestinald

iseases;M

ED-G

EN=g

enito

urinarydiseases;M

ED-M

ET=m

etabolicdiseases;M

ED-M

US=

muscular-skeletal

diseases;M

ED-N

ER=n

ervous-sensoria

ldise

ases;M

ED-RES

=respira

tory

diseases;M

ED-SKI

=skindiseases.∗

Repo

rted

inHanlid

ouetal.[8]

fora

tleaston

eofthe

uses

citedin

thep

resent

study.


Table 2: Informant consensus factor.

Disease categories Citations Taxa FICRespiratory diseases 154 24 0,85Skin diseases 104 19 0,83Cardiovascular diseases 39 9 0,79Gastrointestinal diseases 75 18 0,77Genitourinary diseases 65 17 0,75Nervous-sensorial diseases 58 16 0,74Metabolic diseases 59 18 0,71Muscular-skeletal diseases 42 15 0,66Total 596 136

remaining are more widespread plants, with a European (14taxa), Mediterranean (16), Eurasiatic, or Cosmopolitan (23)distribution [30].

As shown in Table 2, the highest number of plants wasused to treat respiratory and skin diseases followed by cardio-vascular, gastrointestinal, genitourinary, nervous-sensorial,metabolic, and muscular-skeletal diseases. The most usedparts of the plants were flowers and inflorescences (40%),followed by aerial parts (22%), leaves (16%), fruits and seeds(15%), and underground parts (8%). Principal methods ofherbal preparations included infusion or decoction (76%),maceration in alcohol or oil (12%), used raw (7%), poultice(3%), and other (2%).Themost cited species wereHypericumperforatum, Matricaria chamomilla, the endemic Sideritisscardica, Tilia platyphyllos, and Sambucus nigra.

About 48% of the medicinal plants mentioned by theinformants had been previously reported to be sold inThessaloniki market as traditional remedies [8]. Seventeenof the 22 most relevant species, with at least 8 citations andhigh Fidelity Level (Table 3), are among them.The traditionalshops and the street markets of this city include interestinginformation mainly derived from the inherited knowledge ofthe herbal sellers. Lamiaceae, the most frequently recordedfamily both in our study area and in the market of Thessa-loniki, includes the greatest number of species mentioned fortreating digestive, nervous, and respiratory diseases [10].

In many cases, the most common species reported forCentral Macedonia for medicinal purposes are in agreementwith those cited from other regions of Balkan Peninsula. Forexample,H. perforatum,M. chamomilla, S. nigra,R. canina,U.dioica, and C. monogyna were frequently cited by informantsfrom Bosnia-Herzegovina [1] and from south Kosovo [4].In Northern Macedonia Albanian informants reported H.tuberosum as a remedy for improving heart contractility,in addition to the use as human food [3]. In the samearea, Sideritis scardica was reported mainly for treatment ofrespiratory diseases.

3.1.2. Plants Used for Respiratory Diseases. In our study S.scardica is one of the most important (FL = 100%) plants citedfor respiratory diseases, followed by Tilia platyphyllos, Sam-bucus nigra, Malva sylvestris, and Dactylorhiza sambucina.S. scardica is an aromatic plant very popular in Greece,Bulgaria, Albania, and North Macedonia where it is largely

used in local cuisines. The species, together with severalrelated Sideritis species, is known as “mountain tea”, andin folk medicine of the Balkan countries, it is used for thepreparation of decoctions mainly indicated to aid digestion,strengthen the immune system, and treat cold, flu, and aller-gies [6, 38]. It is also employed against shortness of breath,sinus congestion, and evenpain andmild anxiety [5, 38, 39]. Itis worth noting that tubers ofDactylorhiza sambucina (as wellas other Orchidaceae species) are collected from the wild andused to prepare a beverage, called “salepi”, used as a coughremedy popular in several eastern Mediterranean countries[40]. Similar uses were reported for another Orchidacea,Orchis morio L., in south Kosovo where the tuber infusion isindicated as a remedy for influenza, stomach disorders, andwound healing [4].

3.1.3. Plants Used for Skin Diseases. Among plants used totreat skin diseases Momordica charantia shows the highestFL (94%), while Hypericum perforatum (Figure 3(a)) reachesthe highest number of citations (44). M. charantia or bittermelon is a tropical vegetable extensively used in Indian folkmedicine as a remedy for diabetes. In Ayurveda, the fruit isconsidered as tonic, stomachic, stimulant, emetic, antibilious,and laxative. In addition, the fruit juice and/or a leaf tea isemployed for malaria, colic, sores, wounds, and other skindiseases [41]. M. charantia fruit powder, in the form of anointment (10%w/w dried powder in a simple ointment base),showed a statically significant response in terms of woundhealing in rats [42]. In addition, recent studies showed thata M. charantia extract improves and accelerates the processof wound healing in rabbits in comparison with conventionalcreams used therapeutically [43]. It is a surprising fact thatthis tropical species has been incorporated in the traditionalherbal medicine of the study area. In Macedonia we havepreviously reported the traditional preparation of an oint-ment made from the fragmented fruits of the plant that areimmersed in olive oil and placed in the sun for 30–40 days.This ointment is indicated for the treatment of human andanimal wounds [44]. The same use was referred by Turksliving in south Kosovo, but in this case internal uses were alsocited, including antidiabetic and anticancer [4].

A particular use of Cuscuta campestris (Figure 3(b)) wasreported as a topic remedy against bee sting. Some of thearomatic plants used for the treatment of gastrointestinal


Table3:Re

sults

ofqu

antitativea

nalysis

forthe

mostrelevantspecies

(≥8citatio

ns).Dise

asec

ategoriesw

ithmax

FLarer

eportedin

bold.

Ninform

ants

citin

gTo

talN

citatio

nsCardiovascular

diseases

Gastro

intestinal

diseases

Genito

urinary

diseases

Metabolic

diseases

Muscular-

skeletal

diseases

Nervous-

sensorial

diseases

Respira

tory

diseases

Skin

diseases

Max FL

Hypericu

mperfo

ratum

L.47

6615

42

144

67

Matric

aria

cham

omillaL.

2934

114

142

341

Sideritisscardica

Gris

eb.

3030

30100

Tilia

platyphyllos

Scop.

2327

41

2281

Sambu

cusn

igraL.

2424

204

83Ro

sacanina

L.16

201

172

85Ur

ticadioica

L.11

195

84

242

Menthaspica

taL.

1318

58

544

Achilleam

illefo

lium

L.12

1710

52

59Mom

ordica

charantia

L.16

171

1694

Malva

silvestrisL.

1416

11

1488

Crataegusm

onogyna

Jacq.

1213

13100

Dactylorhizasp.

1313

13100

Linu

musita

tissim

umL.

913

39

169

Paliu

russpina

-christi

Mill.

1111

101

91

Equisetum

arvenseL

.7

105

550

Plantago

mediaL.

910

28

80Verbascum

longifoliu

mTen.

810

22

660

Arctium

lappaL.

58

53

63Micr

omeriajuliana

(L.)Rc

hb.

78

8100

Orig

anum

majoran

aL.

88

71

88

Saturejamontana

L.s ubsp.macedonica

(Formanek)B

aden

88

13

450


(a) (b)

(c) (d)

Figure 3: Plant species used to treat various ailments in the regions of Edessa andNaoussa: (a)Hypericum perforatum, (b)Cuscuta campestris,(c) Origanum majorana, and (d) Paliurus spina-christi.

problems are Origanum majorana (Figure 3(c)), Matricariachamomilla, and Mentha spicata. It is interesting to notethat this latter species is included within plant taxa soldas “mint” in the market of Thessaloniki, where it is mostlyrecommended for common cold and cough [9].O. majoranais widely used to treat colds and rhinitis [45, 46], but it isalso quoted for its antiulcer effect [47]. In addition, Castaneasativa catkins are widely used as a decoction for the treatmentof diarrhea.

3.1.4. Plants Used for Cardiovascular Diseases. Two specieswere found to be the most quoted (FL = 100%) for thetreatment of cardiovascular diseases: Crataegus monogynaand Loranthus europaeus. C. monogyna is popularly knownfor its cardioprotective action reducing cardiovascular riskfactors, such as hypertension and hypercholesterolemia [48,49]. InMacedonia this species is used as an infusion preparedwith flowers, fruits, or leaves, but also as an alcoholic extractprepared from the fruits. L. europaeus (yellow-berried mistle-toe) is a hemiparasite plant usually found on the branchesof trees. The popular use of this plant for the treatment ofcardiovascular problems has also been reported in Bosniaand Herzegovina [1]. In addition, a recent study on the

ethnobotany of mistletoes species also cited the frequent useof this plant to treat cardiovascular disorders [50].

3.1.5. Plants Used for Nervous Diseases. The use of Melissaofficinalis and Valeriana officinalis to cure nervous systemproblems is well known [51, 52], while that of Salvia offic-inalis is less common. In the traditional medicine of manyEuropean countries this species has been used mainly totreat mild dyspepsia, excessive sweating, and throat and skininflammations [53], but the use in age-related brain disordershas also been reported [54]. In addition, some informantsreported an uncommon use of Taraxacum officinale fortreating nervous diseases, i.e., headache and insomnia. Thisuse has been previously reported in an ethnobotanical surveyof Zagori, Epirus, Greece [6].

3.1.6. Plants Used for Genitourinary Diseases. Different plantparts of a large variety of species are used for genitourinarydiseases, as diuretic and in prevention and treatment of pro-statitis, mainly in the form of a decoction. Among them, themost quoted areMicromeria juliana (8 citations, FL.= 100%),Paliurus spina-christi (10 citations, FL= 91%; Figure 3(d)), andAchillea spp.


3.1.7. Plants Used for Musculoskeletal Diseases. A large num-ber of species are used for musculoskeletal diseases, inparticular against joint pains and rheumatism, such as Equi-setum arvense (aerial parts), Arctium lappa (root), Cercissiliquastrum and Robinia pseudoacacia (flowers). The alco-holic extract of the sliced root of Tamus communis is alsoemployed to treat muscular pain and inflammation. Thisspecies shows toxicity due to its content of calcium oxalates,saponins, tannins, and other substances; nevertheless, itsanti-inflammatory and analgesic properties are well known[55] and its use in the treatment of rheumatisms has alsobeen reported in the traditional medicine of Turkey [56] andPortugal [57].

3.1.8. Plants Used for Metabolic Diseases. The most quotedplant for the treatment of metabolic diseases is Rosa canina(17 citations, FL= 85%), followed byUrtica dioica and Silybummarianum. In particular, R. canina is used as a decoction offruits and flowers, syrup of boiled fresh fruits but also eatenraw as an immunostimulant, and for the prevention of thecardiovascular diseases.

3.2. Plants with Unusual Medicinal Uses or Used Only by aSingle Population Group. Somemedicinal uses of plants seemto be particularly interesting because they have been infre-quently or never reported. In addition, some of these usesconcern toxic plants and rare or endemic species. Cuscutacampestris stems (Figure 3(b)) are applied topically againstbee stings; Dopioi informants have exclusively reported thisuse. There are only a few ethnobotanical uses that have beendetailed for this species: as purgative and against constipationin Saudi Arabia [58] and for its analgesic effect in thetreatment of rheumatisms and headaches in Nepal [59].

In the present study, the use of a toxic species, Cynoglos-sum creticum, which contains pyrrolizidine alkaloids, hasbeen cited [60]. The fruits of this plant have been reportedto be eaten to treat a skin disease called “myrmecia” (Greek“myrmigkia”= ant), a word used allover Greece for thecommon skin warts caused by HPV (Human PapillomaVirus). The disease is characterized by the presence of smallskin warts apparently similar to anthills. In the traditionalmedicine of India the aerial portion of Cynoglossum spp.is used against wounds, burns, ear infections, and coughfor its antibacterial properties [61] and against fungal skininfections [62]. In Sardinia the root is used to prepare anemollient cream against burns [63], while leaves are directlyapplied as a cicatrizant or as a poultice to treat eczema [64].In this study only informants from the group “others” havecited this particular use of C. creticum for the treatment ofmyrmecia.

Satureja montana subsp. macedonica, in addition to thecommon use of the flower infusion for the treatment offlu and cough, is also used in the study area by Pontiansinformants to relieve tinnitus and improve hearing. Gen-erally, Satureja spp. have been used since ancient times asflavorings for food and for the treatment of various diseases;their essential oils have been documented for antimicro-bial, antidiarrheal, fungicidal, and antioxidant activities [65].

However, the specific use for tinnitus treatment and forhearing improvement is particularly unusual and, to ourknowledge, has never been previously reported.

Hyssopus officinalis is an aromatic plant commonly usedin the traditional medicine of the Balkan Peninsula for itsantiseptic, carminative, and spasmolytic properties [66]. Theaerial parts of the species are used against chronic bronchitisand asthma [67, 68]. Notably, the use of the decoction fromthe aerial parts as an analgesic to treat headache, cited in thepresent study, has never been previously reported.

Helianthus tuberosus is a naturalized species, native toNorth America, which was introduced in Europe duringthe XVII century. It was used at first as animal feed andsubsequently as human food. Its tuber contains inulin asits main polysaccharide and is therefore indicated in thediet of diabetics. In the Carpathian basin it is also used inthe treatment of asthma and heart problems [69]. Althoughit had not been highly reported in traditional medicineof the Mediterranean region, in the present survey, thedecoction of the fragmented tuber was indicated againstconstipation. Similar uses have been described in Aus-tria [70]. Also in south Kosovo the use of fresh tubersof H. tuberosum as human food was recently reported[4].

Finally, Equisetum arvensis (10 citations) and Robiniapseudoacacia (4 citations) were used by Dopioi only, whileCastanea sativa (6 citations) by the group “others”. Moreover7 out of 8 citations concerning Satureja montana came fromPontians.

3.3. Quantitative Analyses

3.3.1. Traditional Ethnobotanical Knowledge among DifferentPopulation Groups. The group “others” (i.e., informants whocome from various parts of Greece) and Dopioi reported thehighest number of species (53), followed by Pontians (42)and Mikrasiates (23 species). Vlach informants only cited10 species. Only 7 species (Crataegus monogyna, Hypericumperforatum, Matricaria chamomilla, Rosa canina, Sambucusnigra, Sideritis scardica, and Tilia platyphyllos) were com-monly reported by all population groups (Figure 4), whereas30 out of 87 taxa (34%) were exclusively mentioned by asingle group: 11 by Dopioi, 8 by Pontians, 7 by the group“others”, and 4 by Mikrasiates. The species reported byMikrasiates and Vlachs were mostly or fully shared withone or more of the groups. Notably, only 12% of taxawere referred with more than one name and only 6% wereknown with different dialectal names by different populationgroups (Table 1). It was demonstrated that in different Balkanareas that share similar flora but have different culturalor linguistic heritage, medicinal plants are used in verydistinct ways [71–73]. For example, Mustafa et al. [4] foundthat Albanian, Bosniak/Gorani, and Turkish communities ofKosovan villages shared 22% of the taxa used for food andmedicine, suggesting a hybrid character of the Kosovar plantknowledge. However, 42% of the plant species were only citedby a single ethnic group.


7

4

811

00

291

2

2

6 5

2

1

0

315

0

0

3

1

0

00

11

0

5

7

Others

Mikrasiates

PontiansDopioi

Vlachs

Figure 4: Venn diagram representing an overlap of Traditional Ethnobotanical Knowledge of the 5 population groups. Numbers are thespecies in common for each combination of overlapping (including nonoverlapping subsets, i.e., species reported by a single populationgroup).

3.3.2. Plant Knowledge according to Sociologic Variables. Thediagrams in Figure 5 report the most important remedies-informant groups associations (> 20% of the total infor-mation reported for each disease category) observed, as afunction of the main social categorizations of informantsinterviewed in our survey. When analyzing the distributionof disease categories in relation to population groups, somesignificant differences have been observed (Figure 5(a)). Theknowledge of less numerous groups (Vlachs andMikrasiates)was equally distributed among disease categories, but lessrelevant with respect to that provided by the other groups.Plant species used against skin and respiratory diseases werehighly cited by other informant groups, such as Pontians,Dopioi, and “others”. For these latter about 50% of theinformation is related to these diseases. Dopioi showedimportant contribution in four remedy categories, beinghighly prevalent in the citations of treatments for musculardisorders. Similarly, the information delivered by Pontiansrepresented nearly half of the total knowledge about thetreatments for gastrointestinal diseases.

Although both male and female informants cited speciesthat are used for different healing purposes, the ethnobotan-ical knowledge of females was more equally distributed in alluse categories, whereas men mainly reported information onrespiratory, genitourinary, and skin diseases (Figure 5(b)).

Remedies for respiratory diseases were highly citedby informants, independently from their educational level,whereas the knowledge of medicinal plants used for treat-ing nervous, skin, and gastrointestinal diseases was mainlyreported by informants with a secondary level of education.Graduate informants had a major degree of knowledge aboutthe treatment of metabolic disorders (Figure 5(c)).

Independently from their job, many informants reportedtreatments of respiratory diseases (Figure 5(d)). Moreover, incontrast with other job groups, the information reported by

farmers was largely distributed among nearly all disease cate-gories. Unexpectedly, no relevant differences were observedin relation to the age of the informants: both younger andolder groups equally cited plant remedies for most of thediseases (data not shown). However, some associations wereobserved: persons< 40 years old frequently cited remedies forskin diseases, whereas plants used for treating genitourinarydisorders were mainly cited by informants between 60 and 70years old.

4. Conclusions

Our study highlights the importance of reporting the TEKtypical of areas of Europe that have until now been poorlyinvestigated. In fact, despite the large number of papersdealing with ethnobotany in the Balkans and southeasternEurope [74, 75], Greece is still scarcely explored from anethnobotanical point of view although it is characterizedby a high floristic diversity. This is particularly true forregions like Central Macedonia where different populationgroups live together, maintaining most of their traditions.Information on species used in folk medicine of this regionshowed that most of them were wild and cultivated plantswell known in the European ethnobotany for their healthcareand curative properties. Nevertheless some unusual useswere found, in particular concerning several toxic plants andrare or endemic species. Despite growing erosion of existingEuropean tradition ethnobotanical knowledge, populationgroups in this region maintain some exclusive folk remediessuch as the use of Cuscuta campestris against bee stingsreported only by Dopioi informants and that of Saturejamontana subsp. macedonica cited by Pontians to relieve tin-nitus and improve hearing. Such local knowledge is culturallysignificant and can provide information for developing future


Dop

ioi

Mikrasiates

Others

Pontians

VlachsCA

RD

GAS

TGENU

METAMUSC NERV

RESP

SKIN

040

80

120

040

800

40801200

40

80

120

040

0

040

040

040

040 0 40 0

4080

120

040

80

(a)

FEMALESMALES

CARD

GA

STGEN

U

METAMUSC NERV

RESPSKIN

040

80

120

160

200

240

2803203600

40

80

120160

2000

040

040

0

400

40 0 40 040

80120

040

80

(b)

High

er

SecondaryPrimary

CARD

GAS

TGEN

U

METAMUSC NERV

RESP

SKIN

040

80

120

160

2000

4080120160

200

240

040

80

1200

040

040

0

400

40 0 40 040

80120

040

80

(c)

Empl

oyee

Farmer

Humanistic

Workm

an

CARD

GAS

TGENU

METAMUSC NERV

RESP

SKIN

040

80

120

0

40

80120

1602000

40

80

0

4080

0

040

040

0

400

40 0 40 040

80

120

040

80

(d)

Figure 5: Circular plots showing the relationships among referred disease categories and the informants grouped on the basis of differentsocial factors: (a) origin; (b) gender; (c) education; (d) job. Color bands summarize main relationships (> 20% of the total information)between each disease category and population groups. Numbers below the external segments in the graphs represent the total numbers ofcitations for each disease category and population group (e.g., in Figure 5(a), 40 citations were overall reported for plants used as a remedyfor muscular-skeletal diseases, whereas a total of 132 citations were provided by Dopioi).

researches and promoting ethnopharmacological advances.When taking in account differences among the studiedpopulation groups, only 7 plant species were commonlyreported by all groups, whereas 34%of plants were exclusivelymentioned by a single group. This observation supports theidea that some differences are maintained among populationgroups, although the knowledge on the medicinal plant useis not accompanied by preservation of linguistic diversityconcerning the plant names. Furthermore our analysis ofplant knowledge according to sociologic variables contributes

to a better understanding of factors that affect changes inplant uses and perceptions in different sociocultural contexts.

Data Availability

The ethnobotanical data used to support the findings of thisstudy have been deposited in the Department of Pharmacog-nosy and Natural Products Chemistry, Faculty of Pharmacy,National and Kapodistrian University of Athens, Athens.


Conflicts of Interest

The authors declare that they have no conflicts of interest.

Acknowledgments

Special thanks are due to all informants, who generouslyshared their knowledge regarding local plants and their usesand especially to Aikaterini Tsitsi for her contribution, help,and passion about traditional medicine. We thank SiFit Labof Italian Society of Phytotherapy for the partial economicsupport to this study.

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