REVIEW Open Access Historical ethnobotanical review of … · 2020. 3. 24. · REVIEW Open Access...

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REVIEW Open Access Historical ethnobotanical review of medicinal plants used to treat children diseases in Romania (1860s1970s) Madalina Petran 1 , Dorin Dragos 2,3 and Marilena Gilca 1* Abstract Background: Romanian ethnopediatrics has a long history of medicinal plant use. The main objective of the present review was to identify, collect, systematize, and prioritize the available bibliographical data related to medicinal plants traditionally used to treat various pediatric diseases in Romania during the 1860s1970s. Methods: Information was mainly obtained by manual systematic search in various relevant historical works focused on the traditional use of medicinal plants in Romania (1860s1970s), found in the Archives of Romanian Academy Library and National Romanian Library. Results: A total of 153 medicinal plants belonging to 52 families were identified as having ethnopediatric significance. The plant traditional indications, targeted body systems, parts used, and way of administration were provided. We have also proposed one index (expressed as percentage) in order to assess the ethnopediatric applicability area of species: ethnopediatric relative therapeutic versatility (ERTV), which was calculated on the basis of the number of distinct uses mentioned for a species. The species identified to have the highest ERTV scores were Dryopteris filix-mas (100%), Gratiola officinalis (85.71%), Allium sativum (71.42%), Eryngium planum (71.42%), Juglans regia (71.42%), Matricaria chamomilla (71.42%), Plantago major (71.42%). Conclusions: The present study exposed for the first time to the international scientific community important ethnopediatric information contained in several local Romanian bibliographical resources that could guide the local and international researchers towards new directions of plant valorization. Keywords: Medicinal plants, Ethnopharmacology, Pediatry, Ethnopediatry, Children, Romania Introduction Romanian ethnomedicine and ethnopediatry in the European contextpast and present The majority of the European ethnopharmacological knowledge has its roots in the Greek and Roman cultures, being essentially influenced by works of Dioscorides, Pliny the Elder, Galen, Theophrastus, and Hippocrates [13]. Scientists revealed a remarkably consistency between Dioscoridess De materia medica and later European pharmacopeia, Dioscoridean trad- ition lasting through the nineteenth century with only insignificant variation [4], or even up to the birth of modern pharmacology [2, 3]. While in the Western and Central Europe, herbalism played an important role in drug discovery beginning with the nineteenth century [5]; in Eastern Europe, the exploitation of the ethnophar- macological tradition was hindered by several challenges: (a) Vicissitudes related to the social-political-economic environment in those countries belonging to the © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. * Correspondence: [email protected] 1 Department of Functional Sciences I- Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania Full list of author information is available at the end of the article Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 https://doi.org/10.1186/s13002-020-00364-6

Transcript of REVIEW Open Access Historical ethnobotanical review of … · 2020. 3. 24. · REVIEW Open Access...

  • REVIEW Open Access

    Historical ethnobotanical review ofmedicinal plants used to treat childrendiseases in Romania (1860s–1970s)Madalina Petran1, Dorin Dragos2,3 and Marilena Gilca1*

    Abstract

    Background: Romanian ethnopediatrics has a long history of medicinal plant use. The main objective of thepresent review was to identify, collect, systematize, and prioritize the available bibliographical data related tomedicinal plants traditionally used to treat various pediatric diseases in Romania during the 1860s–1970s.

    Methods: Information was mainly obtained by manual systematic search in various relevant historical worksfocused on the traditional use of medicinal plants in Romania (1860s–1970s), found in the Archives of RomanianAcademy Library and National Romanian Library.

    Results: A total of 153 medicinal plants belonging to 52 families were identified as having ethnopediatricsignificance. The plant traditional indications, targeted body systems, parts used, and way of administration wereprovided. We have also proposed one index (expressed as percentage) in order to assess the ethnopediatricapplicability area of species: ethnopediatric relative therapeutic versatility (ERTV), which was calculated on the basisof the number of distinct uses mentioned for a species. The species identified to have the highest ERTV scoreswere Dryopteris filix-mas (100%), Gratiola officinalis (85.71%), Allium sativum (71.42%), Eryngium planum (71.42%),Juglans regia (71.42%), Matricaria chamomilla (71.42%), Plantago major (71.42%).

    Conclusions: The present study exposed for the first time to the international scientific community importantethnopediatric information contained in several local Romanian bibliographical resources that could guide the localand international researchers towards new directions of plant valorization.

    Keywords: Medicinal plants, Ethnopharmacology, Pediatry, Ethnopediatry, Children, Romania

    IntroductionRomanian ethnomedicine and ethnopediatry in theEuropean context—past and presentThe majority of the European ethnopharmacologicalknowledge has its roots in the Greek and Romancultures, being essentially influenced by works ofDioscorides, Pliny the Elder, Galen, Theophrastus, andHippocrates [1–3]. Scientists revealed a remarkably

    consistency between Dioscorides’s De materia medicaand later European pharmacopeia, Dioscoridean trad-ition lasting through the nineteenth century with onlyinsignificant variation [4], or even up to the birth ofmodern pharmacology [2, 3]. While in the Western andCentral Europe, herbalism played an important role indrug discovery beginning with the nineteenth century[5]; in Eastern Europe, the exploitation of the ethnophar-macological tradition was hindered by several challenges:

    (a) Vicissitudes related to the social-political-economicenvironment in those countries belonging to the

    © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you giveappropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate ifchanges were made. The images or other third party material in this article are included in the article's Creative Commonslicence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commonslicence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtainpermission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to thedata made available in this article, unless otherwise stated in a credit line to the data.

    * Correspondence: [email protected] of Functional Sciences I- Biochemistry, Faculty of Medicine,Carol Davila University of Medicine and Pharmacy, Bucharest, RomaniaFull list of author information is available at the end of the article

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 https://doi.org/10.1186/s13002-020-00364-6

    http://crossmark.crossref.org/dialog/?doi=10.1186/s13002-020-00364-6&domain=pdfhttp://creativecommons.org/licenses/by/4.0/http://creativecommons.org/publicdomain/zero/1.0/mailto:[email protected]

  • previous communist bloc, including Romania (e.g.,marginalization of experts originating from bour-geois families, and therefore considered “enemies ofthe regimen,” informational censorship, lack ofinterest in supporting scientific research andpreservation of national cultural heritage, lack offinancial support for libraries—Romanian AcademyLibrary was considered too “bourgeois” by thecommunist regimen, and therefore was replaced in1955 by State Central Library) [6].

    (b) Other types of challenges: inaccessibility of many ofthe texts on medicinal plants preserved in locationswith limited access to the public (e.g., monasterieswith a strict daily schedule, archives not open forthe public), reduced legibility of certain manuscripts(lost parts, deterioration in time, low quality ofprint or indecipherable handwriting), some texts arewritten in old languages and are not yet translated(e.g., many Romanian manuscripts found in theNational Archives are written in old Slavoniclanguage) or investigated by an interdisciplinaryteam (historians, linguists, anthropologists,botanists, etc.), old terminology with obscuremeaning for the contemporary scientist, lack ofcertainty about the identity of taxa (e.g., onlyvernacular names or obsolete Latin names),difficulties of communication with informants(e.g., monks who are not allowed to take in face-to-face interviews, suspiciousness of informantscaused by superstitions, or desire of therespondents to protect the “secrets” of theirmedical knowledge, sometimes transmitted onlywithin the families) [4, 7–11].

    Some of these aspects might have contributed to thefact that the ethnomedical knowledge of EasternEuropean countries remained in a certain degree local-ized, and isolated from the rest of the world [5, 12]. Onthe other side, due to this isolation and other factors aswell (e.g., slower economical development, preservationof small-scale agro-pastoral activities as main econom-ical subsistence tool in rural area [13], continuity oftraditional practices in monastic communities, knownfor their principles of living in harmony with the envir-onment), this part of Europe may still possess a tremen-dous reservoir of traditional ethnomedical knowledge[13, 14]. For instance, many Romanian ChristianOrthodox monasteries are located in the forests, or far-away from inhabited areas, and cultivate principles simi-lar to those of environmentalist sustainability (e.g.,respect for Creation/Nature as a manifestation of God,protection of natural resources (gifts of Creation) forfuture generations, vegetarianism, stability and discip-line, etc.) [15]. The monastic community from the

    Vânători-Neamţ Natural Park, which is recognized asthe second largest in Europe, after that of Mt. Athos inGreece, is such an example [15, 16].It is also known that prior to the twentieth century,

    European medicine was based mainly on Mediterraneanplant-derived drugs (with some additions from theMiddle East, Asia, and the Americas) [4], the ethnophar-macological tradition originating in the rest of Europe,such as Eastern European countries including Romania,being underexploited at that time, as well as nowadays.Many scientists claim that exploring historical texts

    in a systematic manner may represent a valuablesource of knowledge for the rediscovery of forgottenremedies and the development of modern ethnophar-macology [2, 4, 17, 18].While in some of the Eastern European countries,

    such as Poland [19–22], Estonia [12, 23, 24], Bosnia andHerzegovina [25, 26], and Russia [27, 28], the existingethnobotanical resources are already thoroughly studiedor actualized in several ethnobotanical surveys; a differ-ent situation exists in Romania. The content of the avail-able Romanian ethnographic resources is still unknownby the rest of the world as they are not yet published(e.g., manuscripts found in various museums or librar-ies), or published only in the national language (e.g.,“Botanica Poporana Romana” by Simion Florea Marian).These written resources cover mainly the period until demid twentieth century.Romania has a rich ethnomedical and ethnobotanical

    heritage. According to various antique texts authored byDioscoride (Codex Constantinopolitanus, De MateriaMedica) and Pseudo Apuleius (De Herbarum Virtuti-bus), many plants (e.g., Thymus vulgaris, Urtica dioica,Achillea millefolium, Mentha piperita) have been usedas remedies on this territory since millennia, and are stillused for similar therapeutic purposes in nowaday ethno-medical practices [29, 30]. Local historical documentsmention the art of healing through herbs practiced byindigenous population beginning with the fourteenthcentury. Several manuscripts originating from variousregions of the present day Romania or interwarRomania, dating from the fourteenth–seventeenth cen-turies, contain elements of medical botany. Some arekept in the Archives of the Library of RomanianAcademy (e.g., manuscripts 740, 498, 573, 312) [8],others are found today outside Romania (e.g., theSlavonic manuscript from Hodros-Bodrog monastery,Banat, Romania, written in the fourteenth or fifteenthcentury, known as Hodoski sbornic or Miscelaneul de laPraga, is found now in Prague) [31]. The sixteenth cen-tury manuscript no.740 in the Romanian AcademyLibrary is considered the oldest text of medical folklorepresently existing in Romania. The initial section is enti-tled “The use of healing plants” and contains 12 pages

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 2 of 33

  • with descriptions of indications of several medicinalplants (the section was longer, but some pages were lost)(e.g., small and great plantain, angelica, mint, burdock,gentian, etc.). In order to understand the cultural con-text of our country during the Middle Ages, it should bereminded that the territories of the present day Romanialie within the !!influence area of the Byzantino-Slavicculture; therefore, several of these manuscripts havemixed influences. For instance, despite the fact thatmanuscript no. 740 is written in Ukrainean Slavic lan-guage, it contains influences from Western and CentralEurope (probably Dioscoride’s Materia Medica orMatthiolus’s commentaries to Dioscoride’s work), as wellas elements of local medical folklore [32].More systematic documentation of local traditions of

    plant use in Romania, based on field studies, began inthe nineteenth century, with the work of various ethnog-raphers. Simion Florea Marian (1847–1907) initiated thistype of work, and he was followed by Nicolae Leon(1862–1931), Charles Laugier (1875–1930), AlexandruBorza (1887–1971), George Bujorean (1893–1971), ValerButura (1910–1989), and others.The Romanian ethnopharmacological knowledge and

    practices were kept alive through oral tradition, withinfamilies of healers, midwives, medicinal plant collectors,and monastic communities in a form almost institution-alized until the XXth century [11, 30].The ethnomedical Romanian practices are also

    attested by the lexical background. The manuscript Dic-tiones latinae cum valachica interpretatione by TeodorCorbea, the first encyclopedic lexicographic work cre-ated in the Romanian space, dating around 1701 andpublished only recently [33], contains approximately 400names of plants, including medicinal plants [34]. In1783, the calvinist priest József Benkő (1740–1814) fromTransylvania, published the botanical dictionary “Nom-ina vegetabilium,” which contains 429 species with 612popular Romanian plants names, some also from thearea of !! Muntenia [35]. In other important botanicalwork, Transsilvania Generalis, József Benkő stated that“the Romanian women use efficiently weeds neglectedby others, to cure various diseases” [35].Despite this valuable biocultural heritage, only a few

    local teams of researchers focused their attention onRomanian ethnopharmacological practices in the last de-cades [36–41]. The data collected by Romanian scientistsin field studies after 1970s have been reflected in only afew reliable scientific publications [38, 39, 41]. We havealso noticed a recently increasing international interestin traditional uses of medicinal plants on Romanian ter-ritory, especially by ethnic minorities [42–48].Concerning the European ethnopediatry research,

    there is a relative scarcity of studies. Moreover, the ma-jority of the available European ethnopharmacological

    field studies only contain isolated references to the me-dicinal plant use in children diseases, as they are not ex-clusively focused on traditional ethnopediatry, but ratheron adult ethnomedicine. There are such isolated men-tions on the traditional indications of medicinal plantsin children in various European countries, in cases of di-gestive diseases [26, 49–59], bedwetting [25], respiratorydiseases [55, 60–64], insomnia [52, 63], and growth delay[46, 65]. Nevertheless, more and more scientists try togather and systematize the available world clinical dataon the safety and efficacy of various herbal medicines inchildren [66–71].

    Romania—a country with rich biodiversityRomanian flora has unique diversity, being recently esti-mated to 3700 species of higher plants [72], including 57endemic and 171 subendemic species [73]. One of theexplanations of this biodiversity lies in the fact thatRomania is a biological confluence point, located equallydistant from both the North Pole and the Equator andfrom the Atlantic Ocean and the Ural Mountains. Thus,Romania is the most biogeographically diverse countryof the European Union, possessing five of the ten offi-cially recognized geographic regions: alpine, continental,pannonic, pontic, steppic. Moreover, no other EuropeanUnion country possesses steppe region [72]. Its floraconsists of Western and Central European, as well asMediterranean spontaneous vegetal species, representingmore than half of the European flora [30]. More than700 species were identified as being traditional medicinalplants [74, 75]. A recent evaluation concluded that thereare 756 spontaneous medicinal plants in Romania, outof which 126 species are on the Red List, and 122 spe-cies are completely forbidden to be collected [76]. Sug-gestive for the ethnobotanical potential of Romania, isthe fact that Romania is on the list of the most import-ant European source regions of medicinal plants col-lected today from the wild, following behind otherSoutheastern European countries, such as Bulgaria andAlbania [77].Despite the richness of this biocultural heritage, the

    studies focused on ethnopediatrics in Romania, as wellas in the rest of Europe, are absent. Therefore, we con-sidered that filling this gap represents a priority for sci-entists. In order to spur the use of Romanian (andEuropean) medicinal plants for the treatment of childrendiseases, we need first to review the historical use ofplants in ethnopediatrics.The main objective of the present review was to iden-

    tify, collect, systematize, and prioritize the available bib-liographical data related to the medicinal plantstraditionally used to treat various pediatric diseases inRomania during the 1860s–1970s.

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 3 of 33

  • Materials and methodsWe have obtained ethnobotanical information by man-ual systematic search in various resources which are notcovered in the main electronic databases, such as journalpapers, reports, books and PhD works written inRomanian language. All of them, excepting one [11], areavailable in the Romanian Academy Library (https://biblacad.ro//eng_index.html) and/or in the RomanianNational Library (http://www.bibnat.ro/). Depending onthe methodology used by the authors of these publica-tions, the resources could be classified into four categor-ies: (A) original publications (based on field study-typemethodology) [9–11, 78–84]. Inclusion criterion wasthat the field work and observations had been performedbefore 1980, even if some of these studies where pub-lished after that date [85, 86] (or the studies included in-formants who were old enough, at the date of thefieldwork, to report plant use during the target period1860s–1970s [10, 11, 87]); (B) review publications (basedon documentation and synthesis of previous ethno-graphic or ethnobotanical works) [75]; (C) mixed publi-cations (compilation of original field study and review ofliterature) [74, 85, 86]; (D) other types of document pa-pers which report use of medicinal plants in children byRomanian people during the 1860s–1970s period [88].Table 1 contains a brief critical overview of all re-

    sources used in this paper. In the following paragraphs,details are provided regarding the seven most represen-tative sources, ordered chronologically according to thedate ethnobotanical data were collected or published[whenever the collection date was not available or notapplicable (e.g., review work)]:

    1. “Botanica Poporană Română” (engl. Romanian FolkBotany) by Simion Florea Marian (1847–1907), aRomanian folklorist, ethnographer, hystorian, andnaturalist, active member of the RomanianAcademy, one of the greatest collectors ofinformation and writers on the Romanian legacy ofmedicinal plants. Although he was a priest and forthe most of his life a schoolteacher, he is the onewho layed the foundations of scientific folkloreresearch in Romania. “Botanica Poporană Română”represents a monumental work of therapeuticalindications and folklore on medicinal plants inRomanian territory, collected by the author himselffrom hundreds of informants (whose names andresiding villages are mentioned in the book), during1867–1907. His correspondence attested the factthat he collaborated with specialists from theBotanical Institute in Bucharest to identify (i.e.,correctly establish the scientific names of) the plantvoucher specimens in his herbarium. Unfortunately,his work was published only recently, one century

    after his death—this sorrowfully delayed publicationwas due to the huge efforts of an enthusiasticRomanian ethnographer, Aura Brădăţan [85, 86].This masterpiece was awarded a distinction byRomanian Science Academy, being considered atreasure of national culture.

    2. Istoria naturală medicală a poporului român" (engl.Natural medical history of Romanian people) byNicolae Leon (1862–1931), a Romanian biologist,professor at the Faculty of Medicine, AlexandruIoan Cuza University, Iasi, published in 1903, inRomanian Academy Annals [84]. He had a veryrigurous approach in his fieldwork, in terms ofcriteria used for plants inclusion in his study. Hestated in the Foreword of the publication: “I havenot mentioned the vegetal remedies quoted bysome authors if I had not the possibility to makesure that the people use them indeed.(…)even ifthey were counted by Czihak and Szabo as folkmedicinal plants(…) Even if they were counted byCzihak and Szabo as folk medicinal plants, theplants that I could not identify because of the lackof voucher specimens are all gathered in Notes, atthe end of the Chapter I, and only their use isindicating, without the scientific name.” Thepublication contains a special chapter entitled“Numiri vulgare cu cari poporul cunoşte bolele”(engl. Folk names by which people know thediseases), where the author offers the clinicalpicture of the diseases treated by Romanian folkmedicine and also provides the scientific medicalterms corresponding to a series of folk terms.

    3. “Monografia comunei Răşinariu” (engl. Monographyof Răşinariu village), by Victor Păcală (1874–1955)[9], awarded a distinction by Romanian Academy in1916, is considered the best monography of aRomanian village written before the First WorldWar [89], and represents even today a model forhow a comprehensive descriptive ethnographicmonography should be written.

    4. “Contribuţiuni la etnografia medicală a Olteniei”(engl. Contribution to the medical ethnography ofOltenia) [82], by Charles Laugier (1875–1930)was granted Botez Prize by Romanian Academyin 1927. Charles Laugier was a physician whograduated from Carol Davila Faculty of Medicinein Bucharest in 1898. Latter he became Directorand Sanitary Inspector for Oltenia region. Duringhis regular inspections, he collected a lot ofethnographic information, includingethnobotanical and ethnomedical data which iscited even today by specialists. Laugier offers atthe end of his publication a list withcorrespondences between folk terms designating

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 4 of 33

    https://biblacad.ro/eng_index.htmlhttps://biblacad.ro/eng_index.htmlhttp://www.bibnat.ro/

  • Table

    1Resourcesused

    forthehistoricalreview

    onmed

    icinalplantsused

    inRo

    manianethn

    oped

    iatryin

    1860s–1970s

    Title

    Autho

    rYear

    ofpu

    blication

    Sources(and

    metho

    dology)

    Trustlevelinterm

    sof

    plant(criterion1+

    criterio

    n2)a

    nddisease

    iden

    tification

    Reference

    1)“BotanicaPo

    porană

    Română”

    (eng

    l.Roman

    ianFolk

    Botany)

    SimionFlorea

    Marian

    2008,2010(post-mortem

    publication;data

    collected

    durin

    g1867-

    1907)

    Fieldw

    ork(observatio

    nalm

    etho

    d,collectionof

    plantvouche

    rspecim

    ens);literature

    (review

    )5(2+3)

    (plants)

    3(diseases)

    [85,86]

    2)“Istoria

    naturalămed

    icalăapo

    poruluirom

    ân”

    (eng

    l.Naturalmedicalhistoryof

    Roman

    ianpeople)

    Nicolae

    Leon

    1903

    Fieldw

    ork(observatio

    nalm

    etho

    d,iden

    tification

    ofplantsbasedon

    collectionof

    vouche

    rspecim

    ens)

    6(3+3)

    (plants)

    4(diseases)

    [84]

    3)“M

    onog

    rafia

    comun

    eiRăşin

    ariu”(eng

    l.Mon

    ograph

    yof

    Răşin

    ariuvillage)

    Victor

    Păcală

    1915

    Fieldw

    ork(ethno

    graphicmetho

    d-participant

    observation,keyinform

    antinterviewing;

    completeinventoryof

    localflora)

    4(1+3)

    (plants)

    2(diseases)

    [9]

    4)“Con

    tribuţiuni

    laetno

    grafiamed

    icalăaOlteniei”

    (eng

    l.Co

    ntributionto

    themedicalethn

    ograph

    yof

    Oltenia)

    CharlesLaug

    ier

    1925

    Fieldw

    ork(observatio

    nalm

    etho

    d)4(1+3)

    (plants)

    4(diseases)

    [82]

    5)“Boli,leacurişip

    lantede

    leac

    cuno

    scutede

    ţărănimea

    română”

    (eng

    l.Diseases,folkremedies

    andplan

    tsknow

    nby

    Roman

    ianvillagers)

    Geo

    rgeBu

    jorean

    1936

    Fieldw

    ork(observatio

    nalm

    etho

    d);literature

    (review

    )6(3+3)

    (plants)

    4(diseases)

    [74]

    6)“Plantelemed

    icinaleşimed

    icinapo

    pulară

    laNiscani”(Eng

    l.Medicinalplan

    tsan

    dfolkmedicineat

    Niscan

    i)

    AlexeiA

    .Arvat

    (1890-

    ?),

    1937

    Fieldw

    ork(observatio

    nalm

    etho

    d,keyinform

    ant

    interviewing,

    inventoryof

    ethn

    obotanicaland

    ethn

    ograph

    icdata,collectionof

    plantvouche

    rspecim

    ens)

    6(3+

    3)(plants)

    4(diseases)

    [80]

    7)“Enciclope

    diade

    Etno

    botanică

    Românească”

    (eng

    l.Encyclopediaof

    Roman

    ianEthn

    obotan

    y)ValerBu

    tura

    1979

    Literature

    (review

    )6(3+3)

    (plants)

    4(diseases)

    [75]

    8)“Plantecuno

    scuteşiîntreb

    uinţatede

    românii

    dinArdeal.Noteetno

    botanice”(eng

    l.Plan

    tsknow

    nan

    dused

    byRoman

    ians

    inArdeal.Ethno

    botanicaln

    otes)

    ValerBu

    tura

    1935

    Fieldw

    ork(observatio

    nalm

    etho

    d)6(3+3)

    (plants)

    3(diseases)

    [83]

    9)“Plantecuno

    scuteşiîntreb

    uinţatede

    româniidin

    Transilvania”(eng

    l.Plan

    tsknow

    nan

    dused

    byRoman

    ians

    inTran

    silvania)

    ValerBu

    tura

    1936

    Fieldw

    ork(observatio

    nalm

    etho

    d)6(3+3)

    (plants)

    4(diseases)

    [79]

    10)“Plantecuno

    scuteşiîntreb

    uinţatede

    locuito

    riicâtorvasate

    româneşti(Ethno

    botanische

    mitteilung

    enausRu

    manien)”(eng

    l.Plan

    tsknow

    nan

    dused

    byinha

    bitans

    offewRoman

    ianvillages)

    ValerBu

    tura

    1938

    Fieldw

    ork(observatio

    nalm

    etho

    d)6(3+

    3)(plants)

    4(diseases)

    [78]

    8)“Florilebu

    nede

    leac”(eng

    l.Flow

    ersgood

    forhealing)

    Geo

    rgeUlieru

    1929

    Med

    icalliteratureessay

    2(1+1)

    (plants)

    4(diseases)

    [88]

    9)“Nou

    tatietno

    botanice

    româneşti”

    (eng

    l.Roman

    ian

    ethn

    obotan

    icalno

    velties)

    Alexand

    ruBo

    rza

    1936

    Fieldw

    ork(observatio

    nalm

    etho

    d,collectionof

    plantvouche

    rspecim

    ens)

    6(3+3)

    (plants)

    3(diseases)

    [81]

    10)“Studiid

    eetno

    botanică

    încomun

    aPo

    iana

    Cristei,

    jud.

    Vrancea”

    (eng

    l.Ethn

    obotan

    icalstudiesin

    Poiana

    Cristeivillage,Vrancea

    coun

    ty)

    Ana

    Con

    drea

    1991

    Fieldw

    ork(observatio

    nalm

    etho

    d,oldinform

    ant

    interviewing)

    6(3+3)

    (plants)

    4(diseases)

    [87]

    11)“Valea

    Sebe

    şului.Mon

    ografie

    Etno

    folclorică,vol.II.

    Folclor”(eng

    l.Sebeşv

    alley.Ethn

    ofolkloricalmon

    ograph

    y,Ghe

    orgh

    ePavelescu

    2004

    (datacollected

    in1934-1939,anden

    riche

    dFieldw

    ork(observatio

    nalm

    etho

    d,inform

    ant

    interviewing)

    5(3+2)

    (plants)

    2(diseases)

    [10]

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 5 of 33

  • Table

    1Resourcesused

    forthehistoricalreview

    onmed

    icinalplantsused

    inRo

    manianethn

    oped

    iatryin

    1860s–1970s(Con

    tinued)

    Title

    Autho

    rYear

    ofpu

    blication

    Sources(and

    metho

    dology)

    Trustlevelinterm

    sof

    plant(criterion1+

    criterio

    n2)a

    nddisease

    iden

    tification

    Reference

    vol.II,Folklor)

    in1971)

    12)“M

    edicinapo

    pulară

    dinBasarabiade

    lasfârșitul

    secoluluialX

    IX-lea–începu

    tulsecolului

    alXX

    -lea.

    Aspecte

    istorico-etno

    grafice”

    (eng

    l.Folkmedicinefro

    mBasarabiaat

    theendof

    the19th

    -beginn

    ingof

    the20th

    centuries.Historical-ethno

    graphicalaspects)

    NataliaGradinaru

    2015

    (datacollected

    durin

    g2003-2014;average

    ageof

    inform

    ants71.5

    years)

    Fieldw

    ork(observatio

    nalm

    etho

    d,qu

    estio

    nnaires,

    simulation-

    toreveal“professionalsecrets”,case

    stud

    y);literature

    (review

    offield

    stud

    iesavailable

    intheArchivesof

    theInstitu

    teof

    theCultural

    Heritage

    ,Chişin

    ău)

    6(3+

    3)(plants)

    4(diseases)

    [11]

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 6 of 33

  • plants/diseases and scientific botanical/medicalterms.

    5. “Boli, leacuri şi plante de leac cunoscute deţărănimea română” (engl. Diseases, folk remediesand plants known by Romanian villagers) publishedin 1936 by another important figure in Romanianethnobotany, George Bujorean (1893–1971),botanist and founder of Romanian experimentalecology and geobiology [74]. This publicationbecame a national reference work for its period.Bujorean discovered several new plants withmedicinal properties, which were used in Romanianfolk medicine, but were not mentioned inDragendorff’s publication, which was recognized atthat time as the world’s ethnopharmacologicalreference list of medicinal plants [90] (e.g.,Trifolium campestre L, Sempervivum marmoreumGriseb., known at that time by its synonym,Sempervivum assimile Schott).

    6. “Plantele medicinale si medicina populara laNişcani” (Engl. Medicinal plants and folk medicineat Nişcani) by Alexei A. Arvat (1890-?), a botanistwell known in Romanian ethnographic world. Hegraduated Natural Sciences at Iassy University andpublished several valuable ethnobotanical worksduring his life. The one relevant for our presentreview is a comprehensive field study performed inthe Nişcani village, Basarabia, during which hefound 140 medicinal species traditionally usedagainst 137 diseases. One of his conclusions issignificant for the value of the local ethnobotanicalknowledge: the number of medicinal species knownto the population of Nişcani was close to the totalnumber of species in that area, his informantsclaiming that “all the weeds have healing properties,only the people do not know” [80]. He alsoidentified during this study new vernacular namesfor 41 Romanian medicinal plants. Anotherinteresting conclusion of this work was thatmedicinal plants were used in folk medicine inNişcani in a much higher proportion (85%) thanother remedies (e.g., incantations- descântece,organic or inorganic substances, etc.).

    7. “Enciclopedia de Etnobotanică Românească” (engl.Encyclopedia of Romanian Ethnobotany) by ValeriuButura (1910–1989) is a remarkable synthesis workwhich reveals more than 100 years of traditionalRomanian medicine practice [75]. He was abotanist, student of another great Romanianethnographer Alexandru Borza (1887–1971). ValerButura started his ethnobotanical studies in 1930–1940 [78, 79, 83]. His encyclopedia containing morethan 700 medicinal plants with traditional uses waspublished in 1979, 10 years after his professor

    published another reference work Ethnobotanicaldictionary (containing 2095 species with over 11000Romanian names of plants) in 1968 [91].

    We estimated for each source used the trust level interms of plant identification, using two graded criteria,as follows:Criterion 1 (author’s background): 3—author was bot-

    anist, biologist, or anthopologist; 2—the author was nota botanist, biologist, or anthropologist, but collaboratedwith botanists for the identification of plants; 1—authorwas a physician or self-educated in terms of botanicaland anthropological studies; 0—author was none of theprevious.Criterion 2 (plant identification): 3—if the author was

    able to differentiate between medicinal plants withclaimed clear botanical identity and plants with unre-solved botanical identity, and all the plants with claimedclear botanical identity had Latin names which were ei-ther accepted names or synonyms of the accepted namesin The Euro+Med PlantBase (http://ww2.bgbm.org/EuroPlusMed) [92] and/or The Plant List (www.theplantlist.org) [93]; 2—if the Latin names of the majorityof medicinal plants claimed to have a clear botanicalidentity were either accepted names or synonyms of theaccepted names in The Euro+Med PlantBase (http://ww2.bgbm.org/EuroPlusMed) [92] and/or The Plant List(www.theplantlist.org )[93]; 1—if the Latin names of themedicinal plants were available for a small percentage oftaxa, or a significant number of plant had unresolvednames in The Euro+Med PlantBase (http://ww2.bgbm.org/EuroPlusMed) [92] and/or The Plant List (www.theplantlist.org) [93], or Latin names were not available(and plant identification was based on the vernacularname).The sum of grades for the two criteria represented the

    trust level in terms of plant identification. The highestpossible grade was 6 (3 + 3), and the lowest possiblegrade was 1 (0 + 1).Whatever the trust level of the source, we did not

    include plants with unclear botanical identity in ourwork.We estimated for each source also the trust level in

    terms of disease identification, as follows: 4—in thesource, the diseases are identified by their scientificnames or by both their folk and scientific names; 3—some diseases are identified by their scientific names,others only by their folk names; 2—diseases are identi-fied only by their folk names, whose modern medicalequivalents could be determined nonetheless by meansof dictionaries or other resources [74, 84, 94]; 1—dis-eases are designated only by folk terms whose signifi-cance in modern medical terms could not be establishedwith the help of dictionaries or other resources. The

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 7 of 33

    http://ww2.bgbm.org/EuroPlusMed/http://ww2.bgbm.org/EuroPlusMed/http://www.theplantlist.org/http://www.theplantlist.org/http://ww2.bgbm.org/EuroPlusMed/http://ww2.bgbm.org/EuroPlusMed/http://www.theplantlist.org/http://ww2.bgbm.org/EuroPlusMed/http://ww2.bgbm.org/EuroPlusMed/http://www.theplantlist.org/http://www.theplantlist.org/

  • higher the grade, the higher the trust level. The high-est possible grade was 4, and the lowest possiblegrade was 1.A medicinal plant was included in our database if its

    traditional use was mentioned by at least one author.Despite the fact that the majority of the dietary plants

    may be used for children, those species where pediatricindications were implicit (due to their dietary value)were excluded from our study, while only the specieswith explicit pediatric indications (mentioned in theethnographic text as such) were included. For instance,plants like Urtica dioica, Malus domesticus, Vitis vinif-era, Persica vulgaris, Petroselinum sativum, Raphanussativum, etc. were excluded, despite their ethnopediatricpotential. Beside the objective restrictions imposed bythe limited availability of written resources, this ap-proach was adopted in order to (1) reduce to zero/nullifythe risk of selecting a wrong plant, (2) avoid overloadingthe paper with too many common plants with universaldietary value, and (3) identify local non-nutritional medi-cinal plants with pediatric indications, which might beless known to the scientific community.Regarding the name of the plants—in our sources a

    perimated Latin term was sometimes used for speciesidentification. In all these cases, the perimated Latinterm was changed to the presently accepted one (e.g.,Galium odoratum (L.) Scop. instead of Asperula odorataL.). More often than not, a given species had several ver-nacular names—in such cases, all the various vernacularnames encountered in our sources were gathered as aunique entry under the accepted Latin name (e.g., “sân-ziene de pădure,” “vinariţă,” and “mama pădurii” are puttogether under the accepted latin name Galium odora-tum (L.) Scop.).Data analysis and extraction were performed by med-

    ical professionals involved in clinical and scientific re-search at academic level. All data were cross examinedby a second author.Concerning the indigenous classification of diseases in

    Romanian traditional medicine, to the best of our know-ledge, no systematic classification is provided by theavailable historical resources. In order to avoid suppress-ing the cultural traits, we have adapted the InternationalClassification of Primary Care (ICPC) [95] to our set ofdata. ICPC was reported to be a closer approximation toethnomedical reality and emic perspective, than othermodern classifications such as International StatisticalClassification of Diseases and Related Health Problems(ICD) or the Economic Botany Data Collection Standard(EBDCS) [96].Preliminary data concerning traditional pediatric indi-

    cations and the parts used were organized in a tabularform. Afterwards, we performed a second systematicsearch in PubMed for all the medicinal plants recorded

    for ethnopediatric use which were included in our data-base, in order to identify whether their therapeutic po-tential was evaluated or not in clinical pediatric studies.

    Data analysisWe divided the collected bibliographic material into usecategories such as various types of diseases, based on theInternational Classification of Primary Care (ICPC)(WHO | International Classification of Primary Care,Second edition (ICPC-2), 2012).In order to compare the utility of medicinal plants in

    Romanian ethnopediatry, we proposed one index: Ethno-pediatric Relative Therapeutic Versatility (ETRV).In our analysis, all ethnopedriatic uses included under

    the umbrella of a certain targeted body system werecounted as one. For each medicinal plant, we summedup all the targeted body systems and obtained a valuedesignated as BS. Phylogenetically closely related medi-cinal plants (the single case of Populus spp.), which hadsimilar ethnomedical uses, were counted together, as asingle phytotherapic entity. The formula used for thecalculation of ERTV expressed as percentage was:

    ERTV% ¼ BSiBS max

    � 100

    where BSi—number of body systems targeted by theplant i; BSmax—maximum number of body systems tar-geted by a single plant obtained in our bibliographicstudy (which is seven). For example, Gratiola officinalisis traditionally used to treat six body systems, one lessthan 7, corresponding to Dryopteris filix-mas (L.) Schott,the most versatile of all species. Therefore, it has ERTVof 85.71% (6:7 ×100).Altogether, more than 30 local publications were used

    for this historical review to collect information aboutmedicinal plants used in Romania (1860s–1970s), butonly in 15 publications we have found relevant data forethnopediatrics. Since some of the publications rely onidentical sources (e.g., George Bujorean [74] is cited byother ethnographers, such Valer Butura [75]), we consid-ered that the number of citations did not express therelative importance of the species in Romanianethnopediatrics.

    ResultsWe have identified in the available literature several oldRomanian terms comprising children-specific diseases(acrum—newborn aphthous stomatitis, babiţi—digestivetroubles in children caused by tooth eruption, boalacânească/socote/sohote/zilizit—athrepsia, severe nutri-tional disturbance in small children, boala copiilor/răulcopiilor/răutatea copiilor/ceas rău/samca/sanca—con-vulsions, epilepsy, coriu/coriu adevărat/bubatu al mic—

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 8 of 33

  • measles, coriu negru—scarlet fever, focușor—red papulareruptions on face or chest in children, lamoste—childdysentery, mătrice—cramps in newborns due to abdom-inal gas accumulation, muma pădurii—nightmares/in-somnia/weeping during night in small children, oase moi(“soft bones”)/oase strâmbe (“curved bones”)—rickets,opăreală—diaper/napkin dermatitis, rahnă—cold,pleasnă/plesne—irritation of lingual and palatal mucosaor aphtous stomatitis, especially in small children,rodimcic—nervous spasms, convulsions, cramps in new-borns, strâns—diarrhea of children, suldumaș or surdu-maș—small red papular eruption on the newborn scalp,tuse măgărească—whooping cough) or disorders com-mon in both adults and children (apucătură- colic,arâne/fudulie- scabies, boli lipicioase- contagious dis-eases, bubă- abscess/pustule/purulent subcutaneous col-lection, bube dulci/rofii/rohii—impetigo, cufureală/treapăd—diarrhea, gîlci—tonsillitis, izdat/surdumaci—abdominal pains, mărgăritărel—stomatitis, scrofuri—tu-berculosis of the lymph nodes, trecătură—gastro-enter-itis) [74, 75, 85, 94, 97]. Some of them are still used inthe modern language (e.g., tuse măgărească, bube dulci,cufureală, gîlci).After adaptation of the International Classification of

    Primary Care (ICPC) [95] to our set of data, we had 12categories of body system-related pediatric diseases(Table 1).A total of 153 medicinal plants belonging to 52 fam-

    ilies were identified as having ethnopediatric relevance—

    they are presented in the alphabetical order of theirLatin name in Table 3, which also includes the medicalindications, targeted body systems, parts used, way ofadministration (where available), and ERTV. Half of thespecies (49.67%) used in Romanian traditional medicineto treat children diseases belong to seven families: Aster-aceae (21), Lamiaceae (15), Apiaceae (12), Rosaceae(ten), Fabaceae (seven), Ranunculaceae (six), Brassica-ceae (five).The plant indications, targeted body systems, parts

    used, way of administration (where available), ERTV,and available scientific evidence are provided in Table 2.The distribution of the plants with respect to their

    medical indications is as follows: blood, lymph andspleen diseases (five species), cardiovascular (one), di-gestive (53), ear (two), endocrine, metabolic, and nutri-tional (28), general (45), musculoskeletal (11),neurological (22), psychological (26), respiratory (14),skin (44), urological diseases/conditions (one).The top of the seven most versatile plants in Roma-

    nian ethnopediatry is represented in Fig. 1.Only 15 medicinal plants were scientifically evaluated

    in pediatric clinical studies, or at least in human clinicalstudies with mixed groups of subjects (adults and chil-dren). For six plants, we found some positive evidencefor few indications mentioned in Romanian ethnopedia-trics; for ten medicinal plants, some positive evidencefor certain indications not mentioned in Romanian eth-nopediatrics, and for one plant some negative evidence.

    Table 2 Classification of ethnopediatric indications in the present study, adapted after the International Classification ofPrimary Care (ICPC)

    Category Examples of diseases

    General and unspecified Asthenia, Chicken pox/Varicella, Scarlet fever, Colic, Cramps, Fever, Measles/Rubeola,German measles/Rubella, Spasms, Tuberculosis, Weakness, Physical debility

    Blood, blood forming organs, lymphatics and spleen Anemia, Enlarged lymph nodes, Scrophulosis

    Cardiovascular Tachycardia

    Digestive Abdominal cramps, Abdominal pain, Acute digestive infections, Colitis, Constipation,Dental abscesses, Dental cavities, Dental eruption, Diarrhea, Digestive cramps, Dysentery,Enteritis, Flatulence, Intestinal cramps, Intestinal parasites, Intestinal worms, Stomatitis,Tape worms, Teeth ache/pain, Ulcerative stomatitis, Vomiting

    Ear Ear discharge, Ear pain

    Musculoskeletal Bone diseases, Bone deformities, Disability/Weakness of the extremities Rickets, Trauma

    Neurological Convulsions, Epilepsy, Paralysis

    Psychological Agitation, Anxiety/Fright, Enuresis, Irritability, Sleep disturbances/Insomnia/ Nightmares/weeping during sleep, Psychosis

    Respiratory Acute respiratory diseases, Asthma, Bronchitis, Phlegm in the throat, Cold, Cough, Coughwith sputa and puss, Whooping cough, Respiratory infections, Tonsillitis

    Skin Acne, Burn wounds/Burns, Dermatitis, Diaper (napkin) dermatitis, Eczema, Hair complaint,Skin inflammation, Skin infections, Impetigo, Scabies, Skin lesions, Subcutaneous tumors,Verruca, Wounds

    Endocrine, metabolic and nutritional Anorexia/Loss of appetite, Athrepsia, Cashexia, Growth dysfunctions/Growth delay,Underweight, Nutritional dysbalances

    Urology Anuria, Oliguria

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 9 of 33

  • DiscussionEthnopediatrics in Europe, as well as in Romania,represents a neglected field of research. Many potentialreasons could explain this fact. Regarding clinical trials(not only with herbal medicines, but also with syntheticdrugs) in this vulnerable population, we should take intoaccount, first of all, that The European PediatricRegulation was adopted only recently, in 2006, and en-tered into force in 2007 [120]. Moreover, scientists facemultiple challenges related to small subjects’ population,economical burdens, pharmacological issues (extra-tox-icity test required, higher risks of unpredictable severeadverse reactions in children than in adults), ethical con-cerns, necessity of additional parental consent, multipleage groups with specific needs and dramatic differencesbetween them, difficulties in communication with chil-dren, high percentage (60%) of children who do notassent to take part in research studies, high rate ofwithdrawal, etc. [121, 122]. Owing to all these con-straints, it was suggested to use all available knowledge(e.g., clinical pharmacology data generated by usingmany therapeutic agents with no approved dosing labelsand guidance), as well as modeling and simulation ap-proaches in drug development [123]. We have proposedhere a complementary solution to fill the actual gap inthe pediatric research: to use all available, but neglectedethnopediatric knowledge, starting with systematic ana-lysis of historical resources, and following with fieldstudies. The present paper follows this direction, focus-ing on the review of medicinal plants used in Romanianethnopediatrics in the 1860s–1970s.More than 700 common species of medicinal plants

    are listed in various resources as being used inRomanian traditional medicine [74, 75, 124]. According

    to the present study, around one-fifth of them arehighlighted as having ethnopediatric indications. Wehave also noticed that a great part of the indications ofphytoremedies in children are for acute diseases: from atotal of approximately 80 different types of illnesses,about two-thirds were acute (e.g., acute respiratory dis-eases, acute digestive disorders with vomiting and diar-rhea, intestinal colic and other types of pains, spasms,wounds, chicken pox, scarlet fever, dental eruption, etc.)(see Table 1). This fact is expected since children oftenhave acute, short-term illnesses [125]. Also, some of themost common adult diseases that are chronic (e.g.,cardiovascular, central nervous system and oncologicaldiseases) are less frequent in children [126].Some of these plants have been cultivated and have

    been part of everyday Romanian diet for many cen-turies: aromatic plants (e.g., Foeniculum vulgare,Mentha piperita, Levisticum officinale), fruits andseeds (e.g., Pyrus communis, Rosa canina, Juglansregia, Cucurbita pepo), vegetables (e.g., Zea mays,Phaseolus vulgaris, Vicia faba, etc.), various recipesbeing preserved during the centuries, especially in therural communities [30, 127]. Some particular Roma-nian plant-based dishes, which are also consumed bychildren, are pumpkin pie (from Muntenia area), beansoup (from Transylvania), home-made noodles (“iofca”)prepared with cabbage, nuts, poppy (from Banat)[127]. Interestingly, the experts in food sciences sug-gested that the traditional cooking methods andhabits seem to selectively preserve the specific beneficactivities of different phytochemicals [128, 129]; there-fore, we suggest that studying the traditional recipesmay inspire new extraction methods of bioactiveconstituents.

    Fig. 1 Top 7 of the most versatile plants in Romanian ethnopediatry (Ethnopediatric Relative Therapeutic Versatility- ERTV- expressed as percentage)

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 10 of 33

  • Concerning the fact that only some of the plants werespecifically marked for use in children in the studiedbook and papers, a question arises: what is the reason orreasons behind this specification? We can onlyhypothesize. Potential explanations are the following:these plants might have been more frequently used orconsidered to be more efficient in their therapeutic ac-tivity by the informants or ethnographers, the informantmight had a special direct experience with that plant, acertain plant or plant use might had a special value for alocal community or for a family of healers, transmittedinformation might have been uncomplete due to weakmemory of the informant. It was also suggested that thetraditional ethnopharmacological knowledge is unevenlydistributed (e.g., women, as managers of householdhealth and mothers, might know more about ethnope-diatric remedies than men; differential acces to the land-scapes, such as forests, and therefore to certainmedicinal plants; increased amount of knowledge withage of informant, etc.) [130–133].

    Ways of medicinal plant administration in ethnopediatryin RomaniaIn Romanian ethnopediatry, medicinal plants are pre-pared in various ways, which are intended for internaluse (infusions, decoctions, syrups), external use (baths,ointments, cataplasms, fumigations, inhalations), orboth (infusions, decoctions). Alcoholic preparationsare in general not recommended in Romanian (eth-no)pediatry [85]. The reason is obvious, since alcoholis known to be toxic when administered to children[134, 135]. WHO proposed the limitation in the etha-nol content of pediatric products to less than 0.5%[136]. We noticed that the most frequently cited wayof administration for small children in Romanian eth-nopediatry was by bath, not only for skin diseases,but also for internal diseases, such as digestive orneurological ones, due to the fact that the quantitiesof phytochemicals absorbed through the skin, albeitsmall, are sufficient to be active in young children,particularly because phytochemicals can reach thebloodstream easier through the skin in small childrenthan by internal administration in adults [137–139].

    Use of toxic plants in Romanian ethnopediatryIn our bibliographic study, we have noticed that inRomanian ethnopediatry some of the toxic alkaloid-richspecies (Aconitum napellus, Dryopteris filix-mas, andTanacetum vulgare) have been traditionally prescribedunder rigorous dosing, with the specification of in-creased toxicity [75, 86, 124], some of them even forinternal use (e.g., Acontium napellus for epilepsy, Dryop-teris filix-mas for scrophulosis)! We have noticed insome of these cases that the traditional recipe is usually

    a polyherbal multimineral formula, with a complicatedway of preparation. The rationale behind this may be thereduction of plant/mineral toxicity, similarly to theherbo-mineral ayurvedic preparations called rasa ousha-dies [140]. We give one such example from Romanianethnomedicine. In Bucovina, the peasants used to pre-pare a decoction of wolfsbane (Aconitus napellus L.) andsilver thistle (Carlina acaulis L.), over which they addedsineala (syn. ultramarine), a blue mineral dyestuff usedin the past to bleach the laundry, obtained by melting amixture of kaolin, sodium carbonate, wood ash, and sul-fur. This complex liquid preparation was administeredto the child suffering from epilepsy (Rom. raul copiilor),both internally (a very small amount) and externally (asa whole body washing) [86].

    Comparison of relative therapeutic versatility of topmedicinal plants in Romanian ethnopediatryConcerning the ERTV index, we discovered several in-teresting facts. Surprisingly, the versatility hierarchy istopped by two less commonly used medicinal plantswith toxic potential: fern (Dryopteris filix-mas) withERTV 100% and gratiole (Gratiola officinalis) withERTV 85.71%. Not unexpectedly, next to these two spe-cies were four common medicinal species, used in manyparts of the globe in ethnopediatry [garlic (Allium sati-vum), nut tree (Juglans regia), chamomile (Matricariachamomilla), and broadleaf plantain (Plantago major)],and another one less known for its ethnopediatric use,blue eryngo (Eryngium planum), all having equal scores(ERTV 71.42%). Dryopteris filix-mas’ biological activitiesare not yet scientifically studied, except for its antiin-flammatory potential (one animal study) [141]. Gratiolaofficinalis’ therapeutic activity is more evidence based;its anti-inflammatory (correlated with its ethnopediatricuse in eczema, see Table 3) and sedative (correlated withits ethnopediatric indication in fright during sleep, seeTable 3) potential being partially supported by animal orin vitro studies [142, 143]. Nevertheless, its ethnopedia-tric use in physical debility, epilepsy, paralysis, andtachycardia has no scientific support yet.Garlic (Allium sativum) (ERTV 71.42%) was used for

    centuries in different cultures for the treatment of manydiseases and is also one of the best studied herbal rem-edies [144]. Several recent studies raised the possibilityof revival of some of its ethnopharmacological uses(mentioned also in Romanian folk medicine), which maybe beneficial in child infections [99, 100], respiratory dis-eases [101]. In vitro experiments revealed some furthertherapeutic properties (benefits in alopecia areata [102],anticancer activity [145]).Walnut tree (Juglans regia, Juglandaceae) (ERTV

    71.42% ) is a tree known to humankind since prehistorictimes, its fruits representing an important source of

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 11 of 33

  • Table

    3Med

    icinalplantsused

    inethn

    oped

    iatricsin

    Romania(1860s–1970s)

    No.

    Species

    Family

    Englishname

    Romanian

    name

    Orig

    inTradition

    alindicatio

    nsandtargeted

    body

    system

    sPartsused

    ERTV

    (%)

    References

    fortradition

    alindicatio

    ns

    Scientificeviden

    cein

    pediatric

    clinicalstud

    ies

    1.Acercampestre

    L.Sapind

    aceae

    Fieldmaple

    Jugastru

    Native

    1.Gen

    eral:W

    eakness(fo

    rge

    neral

    streng

    then

    ing;

    ext-bath,int-sap)

    Bark,Sap

    14.28

    [75,86]

    n.y.s.

    2.Acon

    itum

    napellusL.

    Ranu

    nculaceae

    Wolfsbane

    Omag,

    toaie

    Native

    1.Neurological:Epilepsy(int.,ext-bath)

    2.Skin

    (ext):Wou

    nds

    Leaves,

    Root

    28.57

    [75,86]

    n.y.s

    3.Allium

    ascalonicum

    L.Amaryllidaceae

    Shallot

    Haşmă,

    hajm

    e,hagima

    Non

    -native

    1.Skin:Eczem

    a,Im

    petig

    o(ext),scalpred

    erup

    tions

    ofne

    wbo

    rnBu

    lb,

    leaves

    14.28

    [75,84,86]

    n.y.s.

    4.Allium

    cepa

    L.Amaryllidaceae

    Onion

    Ceapă

    Non

    -native

    1.Respiratory:A

    sthm

    a,Bron

    chitis,

    Cou

    gh;2.D

    igestive:Stom

    achpain,

    intestinalcolic

    (ext

    +int),Tapeworms,

    Cramps

    inne

    wbo

    rnsdu

    eto

    accumulationof

    gas(int-1drop

    juiceof

    onion),U

    lcerativestom

    atitis,Den

    tal

    erup

    tion;3.Ear:pain;4.Skin:ne

    wbo

    rnscalperup

    tions

    (ext)

    Bulb,

    leaves

    57.14

    [9,75,84–86

    ]p.e.Skin:alope

    ciaareata-effectivetopical

    therapy(Note.mixed

    grou

    pof

    adultand

    child

    subjects)[98]

    5.Allium

    sativum

    L.Amaryllidaceae

    Garlic

    Usturoi

    Non

    -native

    1.Digestive:Intestinalworms,Diarrhe

    a,Gastro-en

    teritis,C

    olic

    2.Respiratory:C

    ough

    with

    sputaand

    puss

    3.Skin

    (ext):Verruca,Skin

    infections,

    Impe

    tigo

    4.Psycho

    logical:nigh

    tmares

    5.Neurological::epilepsy(ext-polyherbal

    ointmen

    t,in

    combinatio

    nwith

    lovage

    ,elecam

    pane

    ,and

    othe

    rplantswith

    unresolved

    botanicalide

    ntity)

    Bulb,

    leaves

    71.42

    [74,75,82,

    84,86]

    p.e.antib

    acterialn

    .e.antifung

    al-as

    polyhe

    rbalmou

    thrin

    se[99];p

    .e.

    antiverruca

    [100];p.e.respiratory

    diseases

    (improved

    oxygen

    ationanddyspne

    ain

    childrenwith

    hepatopu

    lmon

    ary

    synd

    rome)

    [101];n.e.topicaln

    on-effective

    therapyin

    alop

    eciaareata[102]

    6.Althaea

    officinalisL.

    Malvaceae

    Marsh

    mallow

    Nalbă

    mare

    Native

    1.Digestive:Diarrhe

    a2.Skin:d

    iape

    r(napkin)

    derm

    atitis

    Flow

    ers,

    leaves,

    roots

    28.57

    [75,88]

    n.y.s

    7.Am

    ygdalus

    commun

    isL.

    Rosaceae

    Alm

    ondtree

    Migdal

    Non

    -native

    1.Ear:Earpain,Ear

    discharge

    Buds,

    seed

    s,flowers,

    bark

    14.28

    [86]

    *p.e.-↓

    symptom

    sin

    attention-de

    ficit/

    hype

    ractivity

    disorder

    [103]

    8.An

    emon

    epulsa

    tillaL.

    Ranu

    nculaceae

    Pasque

    flower

    Ded

    iţel,

    sisine

    lNative

    1.Psycho

    logical:Insomnia(ext-

    fumigations)

    Flow

    ers

    14.28

    [75]

    n.y.s.

    9.An

    ethu

    mgraveolens

    L.Apiaceae

    Dill

    Mărar

    Native

    1.Digestive:Abd

    ominalcram

    ps,C

    olic,

    Intestinalworms(ro

    undw

    orms)

    Aerial

    parts,

    Seed

    s

    14.28

    [75,84,86]

    p.e.antip

    arasitic(↓incide

    nceof

    Giardia

    lambliaafter5days

    oftreatm

    ent)[104]

    10.

    Anthyllis

    vulnerariaL.

    Fabaceae

    Wou

    ndwort

    Vătămătoare

    Native

    1.Skin:Eczem

    a,Wou

    nds(ext);

    2.Psycho

    logical:Fear,Frig

    ht(int)

    Flow

    ering

    tips

    28.57

    [75,83]

    n.y.s.

    11.

    Aquilegia

    vulgarisL.

    Ranu

    nculaceae

    Colum

    bine

    Căldăruşă

    Native

    1.Respiratory:W

    hoop

    ingcoug

    h(ext)

    Aerial

    parts

    14.28

    [75]

    n.y.s.

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 12 of 33

  • Table

    3Med

    icinalplantsused

    inethn

    oped

    iatricsin

    Romania(1860s–1970s)(Con

    tinued)

    No.

    Species

    Family

    Englishname

    Romanian

    name

    Orig

    inTradition

    alindicatio

    nsandtargeted

    body

    system

    sPartsused

    ERTV

    (%)

    References

    fortradition

    alindicatio

    ns

    Scientificeviden

    cein

    pediatric

    clinicalstud

    ies

    12.

    Arctium

    lappa

    L.Asteraceae

    Greater

    burdock

    Brusture

    Native

    1.Skin:W

    ound

    s;infections;Eczem

    a;2.

    Digestive:cram

    ps(ext)

    Leaves

    14.28

    [75,86]

    n.y.s.

    13.

    Arnica

    mon

    tana

    L.Asteraceae

    Mou

    ntain

    arnica

    Arnică

    Native

    1.Musculoskeletal:Traum

    a(ext);2.

    Psycho

    logical:Anxiety/frigh

    t(onlythe

    plantcollected

    ontheCross

    Day)(ext-

    fumigations)

    Leaves

    28.57

    [75,85]

    n.y.s.

    14.

    Artemisia

    abrotanu

    mL.

    Asteraceae

    Sage

    brush

    Lemnu

    ldo

    mnu

    lui,

    lemnu

    ş

    Native

    1.Gen

    eral:w

    eakness(ext-w

    eeklybath,

    floweringtip

    s)2.Digestive:Stom

    atitis(ext-leaves

    inho

    ney,chew

    ingtw

    igs),colic(int-milk

    decoctionof

    bark)

    3.Musculoskeletal:riketts(ext-bath

    weekly,floweringtip

    s)

    Leaves,

    Flow

    ering

    tips,Bark

    42.85

    [75,84,86]

    n.y.s.

    15.

    Artemisia

    absin

    thium

    L.Asteraceae

    Wormwoo

    dPelin

    Native

    1.Nutritional:Athrepsia(ext-crushe

    dfre

    shleaves)

    2.Neurological:Epilepsy(ext-bath)

    Leaves

    28.57

    [74,75,84]

    n.y.s.

    16.

    Arun

    cusdioicus

    (Walter)

    Fernald

    Rosaceae

    Goat's

    beard,

    bride'sfeathe

    rsCoada

    priculicilor,

    barbapo

    pii

    Native

    1.Neurological:Epilepsy(ext-bath,

    fumigation)

    2.Psycho

    logical:Insomnia(ext-bath,

    fumigation)

    Aerial

    parts

    28.57

    [85]

    n.y.s.

    17.

    Astragalus

    glycyphyllosL.

    Fabaceae

    Wild

    liquo

    rice

    Ung

    hiagăii,

    ungh

    iacăţelei,iarba

    limbricilor

    Native

    1.Skin

    (ext):Eczema,Diape

    r(napkin)

    derm

    atitis(washing

    with

    decoctionin

    milk),Necrotic

    wou

    nds(Rom

    .“colţde

    lup”-cutane

    oustube

    rculosisor

    cutane

    ouslesion

    sin

    syph

    ilis),Infectio

    ns,

    Panaris

    Aerial

    parts

    14.28

    [75,78,80,84

    ]n.y.s.

    18.

    Ballota

    nigraL.

    Lamiaceae

    Black

    horeho

    und

    Urzică

    moartă,

    cătuşe

    Non

    -native

    1.Gen

    eral:for

    sufferin

    gchildren(ext-

    bath)

    Aerial

    parts

    14.28

    [80]

    n.y.s.

    19Berteroa

    incana

    (L.)DC.

    Brassicaceae

    Hoary

    alyssum

    Ciucuşoară,

    păsatul

    vraghiei

    Native

    1.Skin:infectio

    ns(ext

    ),eczema(ext-

    bath)

    Aerial

    parts

    14.28

    [75,80]

    n.y.s.

    20.

    Betulapend

    ula

    Roth

    Betulaceae

    Silver

    birch

    Mesteacăn

    Native

    1.Nutritional:Athrepsia,N

    utritional

    dysbalances,grow

    thde

    lay(ext-sapor

    bath

    with

    decoctionof

    bark

    from

    ayoun

    gtree)

    Sapof

    the

    youn

    gtree,b

    ark

    ofa

    youn

    gtree

    14.28

    [9,74]

    n.y.s.

    21.

    Betula

    pubescens

    Ehrh.

    Betulaceae

    White

    birch

    Mesteacăn

    alb

    Native

    1.Nutritional:Athrepsia,N

    utritional

    dysbalances,Growth

    delay(ext-bath)

    Sapof

    the

    youn

    gtree

    14.28

    [74]

    n.y.s.

    22.

    Bidens

    tripartitus

    L.Asteraceae

    Three-lobe

    begg

    articks

    Den

    tiţă,

    cîrlige

    i,Native

    1.Gen

    eral:W

    eakness(fo

    rge

    neral

    tonification/streng

    then

    ing)

    Stem

    s,leaves,

    42.85

    [75]

    n.y.s.

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 13 of 33

  • Table

    3Med

    icinalplantsused

    inethn

    oped

    iatricsin

    Romania(1860s–1970s)(Con

    tinued)

    No.

    Species

    Family

    Englishname

    Romanian

    name

    Orig

    inTradition

    alindicatio

    nsandtargeted

    body

    system

    sPartsused

    ERTV

    (%)

    References

    fortradition

    alindicatio

    ns

    Scientificeviden

    cein

    pediatric

    clinicalstud

    ies

    turiţă

    flowers

    23.

    Brassica

    oleracea

    L.Brassicaceae

    Cabbage

    Varză

    Non

    -native

    1.Skin:W

    ound

    s,Im

    petig

    o(ash

    ofbu

    rnt

    cob)

    2.Gen

    eral:M

    easles

    Leaves

    28.57

    [84,86]

    n.y.s.

    24.

    Butomus

    umbellatusL.

    Butomaceae

    Flow

    eringrush

    Crin

    debaltă,

    roşăţea

    Native

    1.Neurological:Con

    vulsions,Epilepsy

    (ext-bath)

    Aerial

    parts

    14.28

    [75]

    n.y.s.

    25.

    Calend

    ula

    officinalisL.

    Asteraceae

    Com

    mon

    marigold

    Filim

    ină,

    Gălbine

    leNative

    1.Psycho

    logical:Insomnia(ext-bath)

    Flow

    ers

    14.28

    [75]

    p.e.*↓severityof

    diaper

    derm

    atitis

    [105–107];p.e.*↓clinicalsign

    sof

    chronic

    blep

    haritisanddryeyesynd

    rome(Note.

    Mixed

    grou

    pof

    subjects-adu

    ltsandchil

    dren

    [108];

    26.

    Cann

    abissativa

    L.Cannabaceae

    Hem

    pCânep

    ăNative

    1.Skin

    (ext):Infections,Impe

    tigo

    Seed

    s14.28

    [74]

    p.e.*ben

    efits

    inep

    ilepsy[109];p.e.*m

    otor

    disorders

    (improved

    spasticity

    anddyston

    ia,sleep

    disturbances,p

    ainseverity)[110]

    27.

    Carduusnu

    tans

    L.Asteraceae

    Muskthirstle

    Scăiete,

    Ciulin

    Native

    1.Gen

    eral:W

    eakness(fo

    rge

    neral

    tonification/streng

    then

    ing)

    Aerial

    parts

    14.28

    [75]

    n.y.s.

    28.

    Carlina

    acaulis

    L.Asteraceae

    Silver

    thirstle

    Ciurul

    zâne

    lor,sita

    ielelor

    Native

    1.Neurological:Epilepsy(ext-bath,int);2.

    Psycho

    logical:Fright

    (ext-fu

    migations)

    Flow

    ers

    28.57

    [84,86]

    n.y.s.

    29.

    Carum

    carviL.

    Apiaceae

    Caraw

    ayChimen

    Native

    1.Digestive:Cramps,C

    olic,D

    iarrhe

    a,Flatulen

    ceSeed

    s14.28

    [74,84]

    n.y.s.

    30.

    Centaurium

    erythraeaRafn

    Gen

    tianaceae

    Europe

    ancentaury

    Ţintaură

    Native

    1.Gen

    eral:W

    eakness

    2.Endo

    crine/MetabolicandNutritional:

    Ano

    rexia(int-syrup)

    3.Neurological:Epilepsy(ext-bath)

    Stem

    s,leaves,

    flowers

    42.85

    [75,84]

    n.y.s.

    31.

    Ceratoceph

    alus

    falcatus

    (L.)

    Pers.#

    Ranu

    nculaceae

    -Ploşnicar

    Native

    1.Skin

    (ext):Infections

    Aerial

    parts

    14.28

    [75]

    n.y.s.

    32.

    Chaeroph

    yllum

    arom

    aticum

    L.Apiaceae

    -Anton

    ică

    Native

    1.Digestive:Toothpain

    2.Neurological:Headache

    3.Psycho

    logical:Psycho

    sis

    Leaves

    42.85

    [85]

    n.y.s.

    33.

    Chelidon

    ium

    majus

    L.Papaveraceae

    Celandine

    Rostop

    ască

    Native

    1.Gen

    eral(ro

    ot,ext-bath

    forge

    neral

    tonification/streng

    then

    ing)

    Root

    14.28

    [75]

    p.e.*chronictonsillitis(im

    proved

    cellular

    andhu

    moralim

    mun

    ity,non

    specific

    resistance,red

    uced

    thenu

    mbe

    rof

    recurren

    ces)[111]

    34.

    Cichorium

    intybusL.

    Asteraceae

    Com

    mom

    chicory

    Cicoare

    Native

    1.Neurological:Epilepsy(ext-bath)

    Leaves,

    roots,

    rhizom

    e

    14.28

    [85,86]

    p.e.*acutegastroen

    teritis-related

    diarrhea

    (redu

    ceddu

    ratio

    nof

    acutediarrhea)

    [112]

    35.

    Cirsium

    arvense(L.)

    Asteraceae

    Creep

    ing

    thirstle

    Pălămidă,

    pălămidă

    Native

    1.Nutritional:Athrepsia(ext-bath)

    Aerial

    parts,

    14.28

    [74]

    n.y.s.

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 14 of 33

  • Table

    3Med

    icinalplantsused

    inethn

    oped

    iatricsin

    Romania(1860s–1970s)(Con

    tinued)

    No.

    Species

    Family

    Englishname

    Romanian

    name

    Orig

    inTradition

    alindicatio

    nsandtargeted

    body

    system

    sPartsused

    ERTV

    (%)

    References

    fortradition

    alindicatio

    ns

    Scientificeviden

    cein

    pediatric

    clinicalstud

    ies

    Scop

    .seacă

    roots

    36.

    Cirsium

    oleraceum

    (L.)

    Scop

    .

    Asteraceae

    Cabbage

    thirstle

    Crăpu

    şnic

    Native

    1.Gen

    eral:for

    gene

    ralstren

    gthe

    ning

    /tonification(ext-bath)

    Roots,

    stem

    s14.28

    [85]

    n.y.s.

    37.

    Clem

    atisvitalba

    L.Ranu

    nculaceae

    Old

    man’s

    beard

    Curpe

    nNative

    1.Gen

    eral:W

    eakness(ext)

    Aerial

    parts

    14.28

    [75,84,85]

    n.y.s.

    38.

    Cochlearia

    officinalisL.

    Brassicaceae

    Com

    mom

    scurvygrass

    Ling

    urea

    Native

    1.Gen

    eral:Tub

    erculosis

    2.Digestive:Indige

    stion/Dyspe

    psia

    3.Endo

    crine,metabolic,nutritional:Lack

    ofappe

    tite

    Leaves

    42.85

    [75]

    n.y.s.

    39.

    Conium

    maculatum

    L.Apiaceae

    Hem

    lock

    Cucută

    Native

    1.Skin

    (ext):Dermatosis

    2.Neurological:Paralysis(ext-bath)

    Leaves

    28.57

    [75]

    n.y.s.

    40.

    Consolida

    regalis

    Gray

    Ranu

    nculaceae

    Forking

    larkspur

    Somno

    roasă,

    creasta

    cucului

    Native

    1.Psycho

    logical:insomnia(int-

    decoction)

    Flow

    ers

    14.28

    [80]

    n.y.s.

    41.

    Cornus

    mas

    L.Cornaceae

    Europe

    ancornel

    Corn

    Native

    1.Digestive:Diarrhe

    a2.Psycho

    logical:Agitatio

    nwith

    scream

    ing

    3.Gen

    eral:Typho

    idfever

    4.Nutritional:Und

    erweigh

    t

    Fruits

    57.14

    [75,84–86]

    p.e.*im

    provem

    entof

    lipid

    profile

    and

    vascular

    inflammation[113]

    42.

    Corylus

    avellana

    L.Betulaceae

    Com

    mon

    hazel

    Alun

    Native

    1.Gen

    eral:W

    eakness(ext-bathfor

    gene

    ralton

    ificatio

    n/streng

    hten

    ing)

    Leaves,

    buds,

    fruits,

    male

    flowers

    14.28

    [74,75]

    n.y.s.

    43.

    Cucurbita

    pepo

    L.Cucurbitaceae

    Pumpkin

    Bostan

    Non

    -native

    1.Endo

    crine,metabolic,nutritional:

    Und

    erweigh

    tPu

    lp28.57

    [75]

    n.y.s.

    44.

    Daucuscarota

    L.Apiaceae

    Carrot

    Morcov

    Non

    -native

    1.Musculoskeletal:Rickets

    2.Digestive:Stom

    atitis

    3.Skin:W

    ound

    s,Im

    petig

    o(ext)

    Roots,

    leaves,

    seed

    s

    42.85

    [75,84,86]

    p.e.*gastroe

    nteritis(stoolsreturningto

    norm

    alconsistencyandfre

    quen

    cyin

    6days)[114]

    45.

    Dryopteris

    filix-

    mas

    (L.)Scho

    ttDryop

    terid

    aceae

    Malefern

    Ferig

    ăNative

    1.Digestive:Intestinalworms

    2.Skin

    (ext):Wou

    nds

    3.Neurological:Epilepsy;4.Endo

    crine,

    metabolicandnu

    trition

    al(ext-bath):

    Delayed

    grow

    th5.Psycho

    logical(ext):

    insomnia

    6.Musculoskeletal(ext):Rickets,Bo

    nediseases,Bon

    ede

    form

    ities

    7.Bloo

    dandlymph

    node

    s:Scroph

    ulosis

    (ext-cataplasm

    +int-milk

    decoction)

    Rhizom

    e,leaves

    100

    [75,84]

    n.y.s.

    46.

    Equisetum

    arvenseL.

    Equisetaceae

    Com

    mon

    horsetail

    Coada

    calului

    Native

    1.Digestive:Diarrhe

    aSterile

    aerial

    28.57

    [75]

    n.y.s.

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 15 of 33

  • Table

    3Med

    icinalplantsused

    inethn

    oped

    iatricsin

    Romania(1860s–1970s)(Con

    tinued)

    No.

    Species

    Family

    Englishname

    Romanian

    name

    Orig

    inTradition

    alindicatio

    nsandtargeted

    body

    system

    sPartsused

    ERTV

    (%)

    References

    fortradition

    alindicatio

    ns

    Scientificeviden

    cein

    pediatric

    clinicalstud

    ies

    parts

    47.

    Equisetum

    fluviatile

    L.Equisetaceae

    Water

    horsetail

    Pipirig

    Native

    1.Musculoskeletal:w

    alking

    difficulties

    (bathforbo

    nestreng

    then

    ing,

    incombinatio

    nwith

    Jacobaea

    erratica

    (Bertol.)Fourr.))

    Not

    specified

    (probably

    aerial

    parts)

    14.28

    [75,79]

    n.y.s.

    48.

    Eryngium

    plan

    umL.

    Apiaceae

    Blue

    eryngo

    Scaivânăt,

    spinul

    albastru

    Native

    1.Endo

    crine,metabolic,nutritional:

    Und

    erweigh

    t2.Skin

    (ext):Scalpfung

    alinfections,

    Impe

    tigo,Eczema

    3.Gen

    eral:W

    eakness(ext-bathfor

    gene

    ralton

    ificatio

    n/streng

    then

    ing)

    4.Digestive:Colic(ext-bath)

    5.Neurological:ep

    ilepsy(ext-bath)

    Roots

    rhizom

    e,flowers

    71.42

    [74,75,84,86

    ]n.y.s.

    49.

    FicuscaricaL.

    Moraceae

    Figtree

    Smochin

    Non

    -native

    1.Bloo

    dandlymph

    node

    s:Scroph

    ulosis

    (ext-cataplasm

    +int-milk

    decoction)

    Fruits

    14.28

    [84]

    p.e.*atopicde

    rmatitis(safety,efficacy,

    tolerability,andsymptom

    relief

    considerablein

    comparison

    with

    hydrocortison

    e1.0%

    )[115]

    50.

    Filipendula

    ulmaria(L.)

    Maxim

    .

    Rosaceae

    Meadwort

    Creţuşcă

    Native

    1.Gen

    eral:W

    eakness(ext-bathfor

    gene

    ralton

    ificatio

    n/streng

    then

    ing)

    Aerial

    parts

    14.28

    [75]

    n.y.s.

    51.

    Foeniculum

    vulgareMill.

    Apiaceae

    Fenn

    elFenicul

    Non

    -native

    1.Digestive:Intestinalcram

    ps,Flatulence

    Fruits

    28.57

    [75,84,86]

    p.e.infantile

    colic

    (decreased

    intensity

    ofcolic,d

    ecreased

    averagedaily

    crying

    time[116])

    52.

    Fraxinus

    ornu

    sL.

    Oleaceae

    South

    Europe

    anfloweringash

    Mojdrean

    Native

    1.Digestive:Con

    stipation

    Sap

    14.28

    [75]

    n.y.s.

    53.

    Galium

    odoratum

    (L.)

    Scop

    .

    Rubiaceae

    Sweetscented

    bedstraw

    ,woo

    druff

    Sânziene

    depădu

    re,

    vinariţă,

    mum

    apădu

    rii

    Native

    1.Psycho

    logical(ext-bath):Fright,

    Bedw

    ettin

    g/Enuresis,W

    eeping

    durin

    gsleep

    2.Gen

    eral:W

    eakness(ext-bathfor

    gene

    ralstren

    gthe

    ning

    )

    Aerial

    parts

    28.57

    [75,84,86]

    n.y.s.

    54.

    Galium

    interm

    edium

    Schu

    lt.

    Rubiaceae

    -Samca,

    sămcuţa,

    cucută

    depădu

    re

    Native

    1.Neurological:ep

    ilepsy(ext-bath,int-

    smallamou

    ntof

    decoction)

    Not

    specified

    (probably

    aerial

    parts)

    14.28

    [86]

    n.y.s

    55.

    Galium

    verum

    L.Ru

    biaceae

    Lady’s

    bedstraw

    Sânziene

    ,drăgaică

    Native

    1.Gen

    eral:A

    sthe

    nia,Weakness

    Aerial

    parts

    14.28

    [75,84]

    n.y.s.

    56.

    Geran

    ium

    macrorrhizum

    L.

    Geraniaceae

    Bigroo

    tge

    ranium

    Priboi

    Native

    1.Neurological:Epilepsy(ext-bath)

    Aerial

    parts,

    leaves

    14.28

    [75]

    n.y.s.

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 16 of 33

  • Table

    3Med

    icinalplantsused

    inethn

    oped

    iatricsin

    Romania(1860s–1970s)(Con

    tinued)

    No.

    Species

    Family

    Englishname

    Romanian

    name

    Orig

    inTradition

    alindicatio

    nsandtargeted

    body

    system

    sPartsused

    ERTV

    (%)

    References

    fortradition

    alindicatio

    ns

    Scientificeviden

    cein

    pediatric

    clinicalstud

    ies

    57.

    Gratiola

    officinalisL.

    Plantaginaceae

    Gratio

    leVeninariţă,

    avramească

    Native

    1.Skin:Eczem

    a2.Nutritional:Ph

    ysicalde

    bility(ext.)

    3.Gen

    eral(fu

    migations):ge

    neral

    streng

    then

    ingagainstdiseases

    4.Psycho

    logical(fumigations):Fright

    durin

    gsleep

    5.Neurological(fumigations):Epilepsy,

    Paralysis

    6.Cardiovascular:Tahicardia

    Aerial

    parts

    85.71

    [75,85]

    n.y.s.

    58.

    Helianthu

    san

    nuus

    L.Asteraceae

    Com

    mon

    sunflower

    Floarea

    soarelui

    Non

    -native

    1.Digestive:Stom

    achpain

    Flow

    ers,

    Seed

    soil

    14.28

    [81]

    n.y.s.

    59.

    Heracleum

    spho

    ndylium

    L.Apiaceae

    Hog

    weed

    Brânca

    ursului

    Native

    1.Psycho

    logical(ext-de

    coctionpo

    ured

    onthehe

    ad):Fright

    2.Neurological(ext-bath):Paralysis

    (inability

    towalk)

    Leaves,

    stem

    s28.57

    [75]

    n.y.s.

    60.

    1.1.1.Elaeagnu

    srham

    noides

    (L.)

    A.N

    elson

    1.1.2.

    Elaeagnaceae

    Seabu

    ckthorn

    Cătinăalbă

    Native

    1.Gen

    eral:W

    eakness

    Fruits

    14.28

    [11]

    n.y.s.

    61.

    1.1.3.Hordeum

    vulgareL.

    1.1.4.Po

    aceae

    Barley

    Ovăz

    Non

    -native

    1.Gen

    eral:W

    eakness(ext-bath)

    Seed

    s14.28

    [84]

    n.y.s.

    62.

    Hum

    ulus

    lupulusL.

    Cannabaceae

    Com

    mon

    hop

    Ham

    eiNative

    1.Skin:Infectio

    ns,W

    ound

    s(ext-bath)

    2.Nutritional:Ph

    ysicalde

    bility,

    Und

    erweigh

    t(ext-bath)

    Flow

    ers,

    leaves

    28.57

    [75,84,86]

    n.y.s.

    63.

    Hyoscyamus

    nigerL.

    Solanaceae

    Hen

    bane

    Măselariţă

    Native

    1.Psycho

    logical:Insomnia(ext-bath)

    Seed

    s14.28

    [75]

    n.y.s.

    64.

    Hypericum

    perfo

    ratum

    L.Hypericaceae

    Perfo

    rate

    StJohn

    ’swort

    Sunătoare,

    pojarniţă

    Native

    1.Skin

    (ext):Eczema,Wou

    nds,Im

    petig

    o/Skin

    infections,Burns

    Aerial

    parts

    14.28

    [75]

    n.y.s.

    65.

    Impatiens

    noli-

    tang

    ereL.

    Balsam

    inaceae

    Touch-me-no

    tbalsam

    Slăbănog

    Native

    1.Gen

    eral:w

    eakness(ext-bathfor

    gene

    ralton

    ificatio

    n/streng

    then

    ing)

    2.Musculoskeletal:D

    isability/W

    eakness

    oftheextrem

    ities

    (ext-bathforbo

    nestreng

    then

    ing)

    Aerial

    parts

    28.57

    [75,84,86]

    n.y.s.

    66.

    Inulahelenium

    L.Asteraceae

    Elecam

    pane

    Iarbămare

    Native

    1.Psycho

    logical:Weeping

    durin

    gnigh

    t(ext-fu

    migation)

    2.Neurological:ep

    ilepsy(ext-polyherbal

    ointmen

    t,in

    combinatio

    nwith

    lovage

    ,garlic,andothe

    rplantswith

    unresolved

    botanicalide

    ntity)

    Root

    28.57

    [74,82,86]

    n.y.s.

    67.

    Iris×

    germ

    anicaL.#

    Iridaceae

    Iris

    Stânjene

    lalbastru

    Native

    1.Digestive:Tootherup

    tionpain

    Rhizom

    e14.28

    [75]

    n.y.s.

    68.

    Jacobaea

    erratica(Bertol.)

    Asteraceae

    -Iarbacarelor

    Native

    1.Musculoskeletal:D

    isability/w

    eaknessof

    theextrem

    ities

    (ext-bathforbo

    neNot

    specified

    14.28

    [75,79]

    n.y.s.

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 17 of 33

  • Table

    3Med

    icinalplantsused

    inethn

    oped

    iatricsin

    Romania(1860s–1970s)(Con

    tinued)

    No.

    Species

    Family

    Englishname

    Romanian

    name

    Orig

    inTradition

    alindicatio

    nsandtargeted

    body

    system

    sPartsused

    ERTV

    (%)

    References

    fortradition

    alindicatio

    ns

    Scientificeviden

    cein

    pediatric

    clinicalstud

    ies

    Fourr.

    streng

    then

    ing,

    incombinatio

    nwith

    water

    horsetail)

    69.

    Juglan

    sregiaL.

    Juglandaceae

    Walnu

    ttree

    Nuc

    Native

    1.Gen

    eral:W

    eakness(intandext-

    bath—forge

    neralton

    ificatio

    n/streng

    then

    ing)

    2.Skin

    (ext):Eczema,Wou

    nds,Skin

    infections

    (im

    petig

    o,scabies)

    3.Digestive(int-teaof

    shells):Diarrhe

    a,Vo

    miting

    ,Intestin

    alpain,Stomatitis,

    Intestinalparasites

    4.Bloo

    dandlymph

    node

    s:Scroph

    ulosis

    (ext-bathandint),ane

    mia

    5.Nutritional:un

    derw

    eigh

    t(asfood

    ,in

    combinatio

    nwith

    bread)

    Seed

    s,leaves,

    youn

    gseed

    shells,

    buds

    71.42

    [74,75,80,

    84,86,88]

    n.y.s.

    70.

    Laserpitium

    prutenicum

    L.Apiaceae

    -Prussian

    serm

    ountain

    Somno

    roasă

    Native

    1.Psycho

    logical:Insomnia(ext-bath)

    2.Respiratory

    (ext-bath):C

    old,

    Coryza

    Flow

    ery

    stem

    s28.57

    [75]

    n.y.s.

    71.

    Leon

    urus

    cardiaca

    L.Lamiaceae

    Mothe

    rwort

    Talpagâştei,

    alion,

    somnişor

    Native

    1.Psycho

    logical:Insomnia(ext.b

    ath).

    Aerial

    parts

    14.28

    [85]

    n.y.s.

    72.

    Lepidium

    ruderaleL.

    Brassicaceae

    Pepp

    ergrass

    Pădu

    chelniţă,

    buruiană

    deroşte

    Native

    1.Skin:Scalp

    eczema,ne

    wbo

    rnscalp

    eczema

    Aerial

    parts

    14.28

    [75,80]

    n.y.s.

    73.

    Levisticum

    officinale

    W.D.J.Ko

    ch

    Apiaceae

    Lovage

    Leuştean

    Non

    -native

    1.Neurological:Epilepsy(ext-po

    lyhe

    rbal

    ointmen

    t,in

    combinatio

    nwith

    Inula

    helenium

    L.,and

    othe

    rplantswith

    unresolved

    botanicalide

    ntity)

    Not

    specified

    (probably

    Leaves

    orRo

    ot)

    14.28

    [86]

    n.y.s.

    74.

    Ligustrum

    vulgareL.

    Oleaceae

    Wild

    privet

    Lemncâinesc

    Native

    1.Skin:Scabies

    Bark

    14.28

    [74]

    n.y.s.

    75.

    Lina

    riavulgaris

    Mill.

    Plantaginaceae

    Com

    mon

    toadflax

    Linariţă,colţu

    llupu

    lui

    Native

    1.Skin:Sub

    cutane

    oustumors(ext)

    Aerial

    parts

    14.28

    [74]

    n.y.s.

    76.

    Linu

    mhirsutum

    L.Linaceae

    Dow

    nyflax

    Inişo

    rde

    deal

    Native

    1.Digestive:Intestinalcolics

    Not

    specified

    14.28

    [75]

    n.y.s.

    77.

    Lycium

    barbarum

    L.Solanaceae

    Europe

    ango

    jiLiţio

    n,cătin

    ăde

    garduri,

    licia

    Native

    1.Psycho

    logical(ext-bath):Fright/Anxiety

    2.Neurological(ext-bath):Epilepsy,

    Spam

    s

    Aerial

    parts,

    twigs,

    leaves

    28.57

    [75,86]

    n.y.s.

    78.

    Lycopodium

    clavatum

    L.Lycopo

    diaceae

    Com

    mom

    club

    moss

    Brădişo

    r,pe

    dicuţă,

    coada-celor-

    din-vânt

    Native

    1.Skin

    (ext):Dermatitis,Eczema

    Spores

    14.28

    [75,84]

    n.y.s.

    79.

    Lysim

    achia

    Prim

    ulaceae

    Mon

    eywort

    Dreţe

    Native

    1.Gen

    eral:W

    eakness(ext-bathfor

    Aerial

    42.85

    [75,79]

    n.y.s.

    Petran et al. Journal of Ethnobiology and Ethnomedicine (2020) 16:15 Page 18 of 33

  • Table

    3Med

    icinalplantsused

    inethn

    oped

    iatricsin

    Romania(1860s–1970s)(Con

    tinued)

    No.

    Species

    Family

    Englishname

    Romanian

    name

    Orig

    inTradition

    alindicatio

    nsandtargeted

    body

    system

    sPartsused

    ERTV

    (%)

    References

    fortradition

    alindicatio

    ns

    Scientificeviden

    cein

    pediatric

    clinicalstud

    ies

    nummulariaL.

    gene

    ralton

    ificatio

    n/streng

    then

    ing)

    2.Endo

    crine,metabolic,nutritional:

    Growth

    delay

    3.Musculoskeletal:D

    isability/W

    eakness

    oftheextrem

    ities

    (ext-bathforbo

    nestreng

    then

    ing)

    parts

    80.

    Lythrum

    salicariaL.

    Lythraceae

    Purple

    loosestrife

    Răchitan

    Native

    1.Endo

    crine,metabolic,nutritional:

    unde

    rweigh

    t(ext-bath)

    2.Psycho

    logical:Insomnia(int)

    3.Bloo

    dandlymph

    node

    s:anem

    ia(int)

    Aerial

    parts

    42.85

    [75]

    n.y.s.

    81.

    Malva

    sylvestris

    L.Malvaceae

    Com

    mon

    mallow

    Nalbă

    depădu

    reNative

    1.Skin:Impe

    tigo

    2.Respiratory:Ton

    sillitis,D

    iphthe

    rictonsillitis(intandext),cou

    gh

    Leaves,

    Flow

    ers

    28.57

    [74,86]

    n.y.s.

    82.

    Matricaria

    cham

    omillaL.

    Asteraceae

    Chamom

    ille

    Museţel,

    Romaniță

    Native

    1.Digestive(int):A

    bdom

    inalcram

    ps/

    pains,cram

    psin

    newbo

    rnsdu

    eto

    accumulationof

    gas

    2.Respiratory

    (int):cold

    3.Skin

    (ext):Wou

    nds,Im

    petig

    o4.Gen

    eral:p

    ain(unspe

    cified),b

    athfor

    gene

    ralstren

    gthe

    ning

    ofne

    wbo

    rns,tea

    forinternalpu

    rification(int)

    5.Neurological:Epilepsy(int)

    Flow

    ers

    71.42

    [9,74,75,86]

    p.e.infantile

    colic

    (significantly

    more

    effectivethan

    simethicone

    [117],

    decreasedaveragedaily

    crying

    time

    [116])

    83.

    Melissa

    officinalisL.

    Lamiaceae

    Lemon

    balm

    Roiniţă,

    matocină

    Native

    1.Neurological:Epilepsy(ext-bath)

    Leaves