Ethnomedicines of Highly Utilized Plants in the Temperate Himalayan Region

Abstract

Background

Himalayan region of Pakistan has been known as a rich source for valuable medicinal plants. The present work is the documentation of indigenous knowledge of highly utilized plants as natural remedy by the local inhabitants of the northwest part of the country.

Methodology

Data on highly utilized medicinal plants were collected during May–September 2012 using semi-structured questionnaire from the elders, local herbalists and medicinal plants collectors.

Results

In total about 53, plants belonging to 38, families were highly utilized in the study area, of which majority of those (43), were medicinal plants. The most frequent part used in preparation of different medicinal remedies is leaves (53%). Most of the medicinal plant species (14) were used as antipyretic. The inhabitants of the study area were producing ethno-medicines mostly in crushed form (26%). Most of the remedies (74%), were taken orally within the study area. Ten species were found most valuable from the local's perspective such as Bergenia ciliata, Hedera nepalensis and Viola canescens.

Conclusion

In conclusion, traditional healers depend largely on naturally growing medicinal plant species, which are under severe threat. This study can provide a basis for further phyto-chemical and pharmacological studies on the region's medicinal plants. Moreover, documentation of indigenous recipes would serve as preservation of the knowledge for the generations to come.

Introduction

Medicinal plants have served as major sources for drugs for centuries. About half of the pharmaceuticals in use today are derived from medicinal plants (Fransworth and Soejarto, 1991). Most of the modern day drugs were invented by studying the traditional use of medicinal plants, which led to the development of very important and valuable drugs like Codeine, Digoxin, Vinblastine, Vincristine and Phytol (Lozoya, 1994). Traditional knowledge on plants used by humans is based on thousands of years' experience and by “trial and error” (Ahmed et al., 2013). The World Health Organization (WHO), estimated about 80% of the developing world dependence on medicinal plants for their primary health care due to socioeconomic conditions (Adnan et al., 2012). The global market for medicinal and aromatic plants was $62 billion in 2002, and may reach $5 trillion by 2050 (Shinwari, 2010). Medicinal plants contain synergistic neutralizing combinations of active compounds (Gilani and Rahman, 2005). The primary benefits of using plant-derived medicines are: relatively safer than synthetic alternatives, offering profound therapeutic benefits and more affordable treatment (Boye, 1985). In the last 100 years, the science of ethno-botany has progressed and the trend is shifting from mere documentation process to a more practical one, which lays emphasis on the conservation and sustainable use of plant resources.

Pakistan is one of the few places on earth with a distinctive biodiversity, comprising of diverse climatic zones with a wide range of plant species. Approximately 600 plant species with medicinal properties are found in Pakistan (Shinwari, 2010). Traditional Unani medicine is popularly practiced among the large segment of its population (Hussain et al., 2008). Pakistan has about 50,000 registered practitioners of traditional medicines (Jabeen et al., 2009). Local communities of different regions in the country have century's old knowledge and traditional practices. Indigenous knowledge on plants has been transferred from generation to generation through oral communication and personal experience (Shinwari, 2010). In early 1950s, up to 84% of Pakistani population was dependent on indigenous medicines for traditional health practices (Hocking, 1958), but now this is practiced only in the remote rural areas (Ibrar et al., 2007). Due to modernization peoples' attention has shifted from this treasure and knowledge is eroding at a much faster rate (Mahmood et al., 2011). Hence, there is need for the preservation of such knowledge particularly within the Himalayan region of the country that consisted diverse plant species. It is evident from the available literature that such studies can constitute the starting point for the development of new drugs and useful substances (Cox and Balick, 1994).

In Nathiagali, north-west Pakistan, medicinal plants have been used as traditional medicine in treating different human ailments by the local people from time immemorial. The study area consisted over 150 medicinal plants and richest sources of ethno-medicines (Adnan et al., 2012). The area is designated as rural having low literacy rate and lack of modern health facilities. Therefore, the locals are more dependent upon natural resources especially on plants for variety of uses including healthcare. However, information is less on the extensively used medicinal plants and their recipes in the study area. Therefore, the present study was carried out to document and preserve the indigenous knowledge on the uses and recipes making at local level for the treatment of human ailments. Moreover, this study will evaluate the authenticity of ethno-medicinal uses with the already found phytochemical in such plants. The present study would prove very useful by depicting the traditional affiliation and dependence of rural people on the highly utilized medicinal flora. This work will serve as the baseline information for ethno-botanists, ecologists, phytochemists and pharmacologists for future research. Dissemination of the study outcomes among the locals will also help in the acceptance for the preservation of indigenous knowledge.

Materials and Methods

Study area

The study was carried out in Nathiagali located in North-West of Pakistan (Figure 1). It lies between 34°-01 to 34°-38 latitude and 73°-22.8 E longitudes under the altitudinal range between 1220 m to 2865 m. The study area includes Nathiagali and adjoining villages (Malachh, Kalaband, Kala Pani, Kanisan and Dounga Gali), surrounding Ayubia National Park (ANP). The Park supports one of the best examples of moist Himalayan temperate forest in Pakistan and is surrounded by a human population of about 50,000 people living in 8000 households. The community living around the ANP depends on the natural resources of the park for their livelihoods (Aumeeruddy, 2004). Most of the vegetation in and around Ayubia National Park is heavily influenced by the action of humans.

Figure 1.

Map of the study area.

Plants and uses

The Park is comprised of sub-alpine meadows, moist temperate forests and the sub-tropical pine forest ecotype (Aumeeruddy, 2004). About 410, species of combined vegetation have been reported from the study area belonging to Fungi, Lichens, Pteridophytes and Spermatophytes (Shafiq, 2003). Of these, about 200 are reported to be herb species including ferns (Shinwari, 2010). About 152 species are of medicinal and economic importance (Adnan et al., 2012). Many of them are of medicinal and economic importance. Dominant tree species are Abies pindrow Royel, Cedrus deodara G. Don, Pinus roxburghii Sargent, Pinus wallichiana A.B. Jacks, Quercus incana Roxb and Taxus wallichiana Zacc (Shafiq, 2003). Fuel wood consumption by each household in the study area has been estimated at 11,000 kg/year (Adnan & Hölscher, 2010). Large amounts of fodder, mainly grasses and herbaceous species, are collected by women from May to November each year. Annually, 13 tons of fodder is consumed per household (Rabia & Khan, 2004).

Data collection

Data on ethno-botany and ethno-medicines was collected from May–September 2012, through a semi-structured questionnaire. Data was collected on those plants that were highly utilized in the study area as mentioned in previuos study by Adnan et al. (2012). Data was randomly collected from 80 local people belongs to 80 households especially older people, women's and rural herbalists (Hakeems) above the age of 35 years who were familiar with traditional uses of plants particularly for medicinal, veterinary, fruit, vegetable, fodder, fuel and others. The purpose behind selecting mostly elder people compared to young people was to collect reliable and effective data regarding traditional utilization of plants. Questionnaire contained all the appropriate questions required for the collection traditional knowledge on plants. This included data on non timber forest products (medicinal, fodder, fuel wood, vegetable etc). Local names, medicinal uses (antipyretic, gastro-intestinal disorders, respiratory disorders etc), plant part used (leaves, stem, roots, fruit etc), were also gathered. Additional data on the route of administration of medicinal plants (Oral, dermal, ear & nose, eyes and both oral/dermal), medicinal recipes preparation method (decoction, crushed, powder, infusion, juice etc), and ingredients used when taking these recipes were recorded. Data was also collected on the number of children, women and men involved in the collection and processing of medicinal plants per household.

Market survey was also conducted for only those medicinal plants, which were highly marketable amongst the highly utilized species in the study area (Adnan et al., 2012). Moreover, 25 research articles were reviewed regarding the presence of active chemical constituents in such medicinal plants. All the data was organized using Microsoft Excel. Field trips were made with local people for the collection of recorded medicinal plants. The plants were identified by the taxonomists of Kohat University of Science and Technology. Scientific names, family names and publication authors were corrected according to the Flora of Pakistan and software index kewensis (Ali and Qaiser, 2010; Index kewensis, 1997).

Results

Altogether 53 plants belonging to 38 families were documented from the study area. Maximum number of 43 plants was used medicinally followed by 23, as fodder (Table 1). Most of the plants recorded were herbs (94%) followed by trees (4%), and shrubs (2%). The most widely sought plant parts in the preparation of different medicinal recipes were the leaves (53%), followed by roots (34%), (Figure 2). Majority of the medicinal plants were used as antipyretic (14), followed by gastro-intestinal disorders (13) (Figure 3). Medicinal plants such as Achillea millefolium, Bergenia ciliata and Hedera nepalensis consisted phytochemical like flavonoids, phenols and alkaloids (Table 3), that have therapeutic action against gastrointestinal disorders and antipyretic.

Table 1.

Plants and uses.

Botanical Name	Local Name	Family Name	Habit	Parts Used	NTFP's Uses	Medicinal Uses	Recipes	Route
Achillea millefolium	Sounfi buti	Compositae	Herb	Whole	Medicinal,	Antipyretic, gastroinstestinal	The whole plant is first mashed and then boiled in milk to	Oral
L.				plant	fodder, cosmetics	and	extract different therapeutic compounds and decoction is
					and dye	diabetes	used as remedy in severe fever and constipation
Adiantum incisum	Kakhpai	Adiantaceae	Herb	Whole	Medicinal and	Respiratory	Infusion is made in water and is taken Oral for treating	Oral
Forsk.				plant	fodder	problems, antipyretic	disorders.
						and gynea
Agrimonia eupatoria	Kanachika	Rosaceae	Herb	Leaves	Dye	------	------
L
Ajuga bracteosa Benth.	Ratti butti	Lamiaceae	Herb	Whole plant	Medicinal	Antipyretic and gastro-intestinal	Leaf paste is used Oral to relief fever and constipation	Oral
Althaea rosea (L)	Gul-e-khaira	Malvaceae	Herb	Roots	Medicinal	Hepatitis, gastrointestinal,	Roots are dip in new earthen pot for whole night. In the	Oral
Cav.						liver, kidney problems	following morning the water juice is drunk for kidney and other problems
Androsace	Kounki	Primalaceae	Herb	Leaves	Medicinal	Urinary infections	The leaves are crushed and the paste of the leaves is taken	Oral
rotundifolia Y Nasir.	butti						along water.
Angelica glauca Edgew.	Chora	Apiaceae	Herb	Roots	Ethno-veterinary	Gastro-intestinal	Powdered roots are taken with milk for Gastro-intestinal disorders.	Oral
Aquilegia pubiflora	Phool	Rananculaceae	Herb	Stem	Medicinal and	Ulcer, Gynea	Paste is prepared in water and used for skin infection	Dermal/Oral
Wal.ex.Royle.					fodder		externally and Oral with milk to treat ulcer and gynea
							problems
Arisaema flavum	Adbis	Araceae	Herb	Root and	Medicinal, ethno-veterinary	Skin	The root and stem paste is externally applied on skin	Dermal
(Forssk) Schott.				stem	and insecticide
Arisaema	Adbis	Araceae	Herb	Fruit	Insecticide and	Antipyretic	Fruit is poisonous and used as insecticide. Very small	Oral
jacquemontii					medicinal		quantity is used during meal for relieving fever.
Arisaema ringens	Cobra plant	Araceae	Tree	Whole	Medicinal	Pain relief	-----	Oral
				plant
Artemisia fragrans Wild.	Chaoo	Asteraceae	Herb	Leaves	Medicinal	Antipyretic and skin diseases	Juice of fresh leaves mixed with brown sugar and given Oral in fever and skin disease	Dermal/Oral
Berberis lyceum	Sunmbal	Berberidaceae	Spiny	Leaves,	Medicinal, ethno-veterinary	Gastro-intestinal,	The paste of root bark is externally applied on wounds.	Dermal/Oral
Royle.			Shrub	fruits, bark	fodder	diabetes, wounds	Crushed bark is soaked in water and the resultant extract
				and roots	and dye		is taken early morning to treat diabetes and Gastrointestinal
							disorders. Leaves are used as fodder.
Bergenia ciliata	But phay	Saxifragaceae	Herb	Roots	Medicinal, fodder	Digestive disorders,	Roots are dried in sunshine and then grind to make	Oral
(Haw) Sternb.					and cosmetics	Diabetes	powder. Half tea spoon of this powder in the following
							morning is taken along desi ghee to treat digestive and
							diabetic problems
Bistorta amplexicaulis D.Don	Masloon	Polygonaceae	Herb	Leaves and roots	Medicinal and fodder	Respiratory disorders, gastrointestinal and antipyretic	Powder mixed with little salt is used for treatment of various disorders.	Oral
Canabis sativa L.	Bhangh	Cannabinaceae	Herb	Leaves &	Medicinal,	Antispasmodic	The leaves are antispasmodic, narcotic. They are boiled	Dermal
				branches	narcotic and		and the warmed leaves are tied over the affected parts
					handicraft		of the body for the treatment of spasm.
Chenopodium album	Sarmay	Chenopodiaceae	Herb	Leaves	Vegetable and	Anthelmentic	Leaves are cooked and taken to expel worms	Oral
L.					medicinal
Chrysanthemum Leucanthemum Linn	Chity Phool	Euphorbiaceae	Herb	Whole plant	Fodder, handicraft and insecticide	-------
Clematis grata Wall.	Bilri	Ranunculaceae	Herb	Whole plant	Fodder	-------	Whole plant is used as fodder	Oral
Coptis tecta Wall.	Mamera	Mimosaceae	Herb	Whole plant	Medicinal	Eye infections	-------	Eyes
Dispacus inermis Wall	Tandi	Dispaceae	Herb	Leaves	Vegetable	-------	Leaves are cooked and used as vegetable	Oral
Dryopteris ramose	Pakha	Aspidiaceae	Herb	Leaves	Medicinal, fodder	Vegetable	Young leaves are collected between March-May and dry	Oral
(Hope) C. Chir.					and vegetable	constipation and aphrodisiac	to make powder and mix with milk and used again constipation
Euphorbia wallichii	Hirvy	Euphorbiaceae	Herb	Whole	Medicinal and	Skin diseases	For the treatment of eczema, equal quantity of the plant	Dermal
Hook f.				plant	fodder		with Cuscuta reflexa is made into paste and applied on
							the affected parts twice a day.
Frageria nubicola	Pinjakha	Rosaceae	Herb	Leaves,	Medicinal, fodder	Anti-inflammatory,	Fruit juice extracted and believed to cure gastro-intestinal	Oral
Lindl ex Lacaita.				seeds and	and vegetable	gastro-intestinal and	problems
				fruits		Diuretic
Gallium aparine L.	Kochan	Rubiaceae	Herb	Whole	Medicinal and	Gastro-intestinal,	Juice is extracted from the whole plant and is used for	Oral
				plant	fodder	antipyretic and diuretic	different ailments.
Gentiana kurroo	Nile kanth	Gentianaceae	Herb	Roots	Medicinal and	For stomach pain and	Roots are taken and dried in sunshine to make powder	Oral
Royle.					vegetable	urinary infections	and taken along desi ghee to cure different infections
Geranium	Ratunjot	Geraniaceae	Herb	Roots	Medicinal,	Joints pain	The roots are dried and grinded, sugar and milk are added	Oral
wallichianum D.					vegetable and		in it, and it is used for pain in joints.
Don ex sweet.					fodder
Glycyrrhiza glabra	Mullathi	Papilionaceae	Herb	Roots	Medicinal	Gastro-intestinal	The aqueous extract from boiled roots is taken Oral to	Oral
Waldst and Kit.							treat abdominal pain.
Hedera nepalensis	Albumber	Araliaceae	Herb	Leaves	Medicinal, ethno-veterinary	Diabetes	The dried branches and leaves are grinded and the powder	Oral
K. Koch(Syn:H.helix L)					veterinary and fodder		is used early in the morning with water against diabetes
Impatien bicolor	Batmandar	Balsaminaceae	Herb	Seeds and	Medicinal and	Antipyretic and	Paste of leaves is prepared and with sugar used against	Oral
Royle				leaves	fodder	diuretic	fever and urinary infection
Leucanthemum	Margue rite	Asteraceae	Herb	Whole	Fodder		------
vulgare Lam.				plant
Mentha arvenses L.	Chita	Labiateae	Herb	Leaves	Medicinal and	Vomiting and	Dried leaves are taken Oral to stop vomiting. Its leaves	Oral
	podina				ethno-veterinary	stomach problems	are added in green tea and used for digestive problems
							and cholera.
Mentha longifolia L.	Gangli podina	Labiateae	Herb	Leaves	Medicinal and ethno-veterinary	Gastro-intestinal disorders	Leaves of Mentha longifolia, young fruits of Zanthoxylum alatumare grinded with seeds of Punica granatum, and green chilies to make “Chatni” which is used to treat gastro-intestinal problems	Oral
Morchella esculenta L.	Gucchhi	Morchellaceae	Herb	Leaves	Medicinal	Tonic	Locally the morels are fried with cows ghee and used after meal which is considered as a general body tonic.	Oral
Nepeta leavigata	Muskbal	Lamiaceae	Herb	Leaves	fodder		Used as fodder	Oral
(D.Don) Hand. - Mazz.						------
Oxalis debilis L	Teenpatra	Oxalidaceae	Herb	Leaves	Medicinal	Skin, antipyretic,	The leaves of the plant are crushed and the extract is used	Oral
						asthma, anti-diabetic and Anthelmentic	Oral against fever and diabetes
Paeonia emodi Wall. Ex Royle.	Mameikh	Paeoniaceae	Herb	Roots	Medicinal, ethno-veterinary and vegetable	Backache, antipyretic and epilepsy	Roots are dried and their taken along sweet dishes to cure backache	Oral
Podophyllum	Bankakri	Berberidacea	Herb	Fruit &	Medicinal	Stomach and liver	Highly poisonous but expert healers use it in little amount	Oral
hexandrum Royle.				seeds		disorders	to cure stomach and liver disorders
Polygonum	Musloon	Polygonaceae	Herb	Roots	Medicinal, fodder	Antipyretic	Roots and flowers are crushed to obtained juice and taken	Oral
amplexicaul D. Don.					and vegetable		Oral with sugar to reduce fever
Pronella vulgaris L	Na	Lamiaceae	Herb	Leaves	Medicinal and	Anti-inflammatory	Both fresh and dry leaves are used against inflammation	Dermal
				fodder
Ranunculus	Rat mondia	Rananculaceae	Herb	Leaves	Fodder		It is used as fodder.	Oral
muricatus L
Rheum webbianum	Chutiyal	Polygonaceae	Herb	Roots	Medicinal	Healing internal	Rhizomes are cooked and eat to cure internal wounds	Oral
Royle.						wounds
Rubdosia longituba	Boi	Lamiaceae	Herb	Roots	Medicinal and	Ear and nose	------	Ear and
					fodder	infections		nose
Rumex dentatus	Khatimble	Polygonaceae	Herb	Leaves & roots	Medicinal and fodder	Healing wounds and jaundice	The extract of the leaves is used as antiseptic against wounds. Leaves are grinded and used against jaundice	Oral/Dermal
Rumex nepalensis Spreng.	Hoola	Polygonaceae	Herb	Leaves	Medicinal	Healing wounds	The extract of the leaves is used as antiseptic against wounds.	Dermal
Senecio salignus DC	Chita ula	Asteraceae	Herb	Leaves,	Medicinal, ethno-veterinary	Anti-inflammatory	Crushed leaves and roots are taken along milk to cure	Oral
				roots,	veterinary and	and gastro-intestinal	gastro-intestinal diseases
				seeds and	fodder
				fruit
Solanum nigrum L.	Katch	Solanaceae	Herb	Roots,	Medicinal	Gastro-intestinal	Leaves and fruits are cooked and used against abdominal	Oral
	mach			leaves and			swellings and stomach-ache.
				Fruit
Swertia chirata	Charieta	Apiaceae	Herb	leaves	Medicinal	Antipyretic, skin	The leaves are grinded and the paste is dissolved in water	Oral/Dermal
Buch.						diseases	along with some brown sugar and is used against fever
							especially malaria.
Urtica dioka L	Bichu boti	Urticaceae	Herb	leaves and	Medicinal, ethno-veterinary	Astringent and	Decoction of the plant is astringent and anthelmentic.	Oral
				roots	veterinary and	anthelmentic	Leaves cause severe irritation which can be soothed by
					vegetable		rubbing leaves of Rumex.
Valeriana jatamansi Wall.	Mushkebala	Velerianaceae	Herb	Roots	Medicinal and fodder	Antipyretic and Skin disease	Decoction of roots is prepared and used again fever and externally for skin	Oral/Dermal
Viola canescens Wall.	Pholala	Velerianaceae	Herb	Leaves & roots	Medicinal, fodder and vegetable	Cough and respiratory problems	The leaves paste is mixed with brown sugar to be used against cough, cold and other respiratory problems.	Oral
Viola serpens Wall.	Banafsha	Violaceae	Herb	Leaves and flowers	Medicinal	Cooling agent	Flowers and Leaves are boiled in water for one hour. One cup of this decoction is used three times in a day to reduce body weakness and provide cooling effect	Oral
Zanthroxylum armatum DC.	Timber	Rutaceae	Tree	Fruit & stem	Medicinal, ethno-veterinary, vegetable and cosmetics	Antipyretic, Gastrointestinal and dental pain	Young fruits are grinded with seeds of Punica granatum, leaves of Mentha longifolia and green chilies to make “Chatni”. Its fruits are highly carminative and also used against stomach-ach. Young branches are used as “Miswak” just like toothbrush.	Oral

Figure 2.

Number of plants based on their part use for making medicinal recipes.

Figure 3.

Number of medicinal plants used for treating various ailments in the study area.

Table 3.

Phytochemical review of highly marketable species.

Botanical Name	Part Used	Chemical Constituent	References	Market prices (US$ Kg−1)
Achillea millefolium	Leaves and flower	Saponins, flavonoids, alkaloids, essential oil, volatile oil, proazulene, azulene, terpenes, tannin, coumarins, sterols, vitamins, amino and fatty acid, phenol carbonic acid, ethanol and hydroalcoholic.	(Kumar et al., 2011; Gupta & Sharma, 2006)	3.15
Adiantum incisum	Whole plant	Triterpenoids, Noroleanane, adininaonol, adiantuoleanone, flavonoids	(Pan et al., 2011)	8.1
Bergenia ciliata	Roots	Flavonoids, tannins, phenols, sterol, alkaloid,	(Ruby et al., 2012)	2.5
		glycosides, tannin acid, gallic acid, berginin,
		catechin, gallicin, anthraquinone.
Dryopteris ramose	Leaves	Phenols, tannins, flavonoids, alkaloids.	(Gupta & Sharma, 2006)	7.15
Fragaria nubicola	Fruit, leaves and roots.	Resin, tannin, carotenoids, ellagic acid, flavonoids.	(Shinwari, 2003)	8.1
Hedera nepalensis	Aerial parts, leaves, stem	Tri terpenoid, saponins, polyynes, steroids and flavonoids.	(Ahmad, 2012; Uddin et al., 2012)	5.11
Paeonia emodi	Rhizomes	Saponins, ash, oleanolic acid, betulinic acid, ethyl gallate, methyl grevillate and 1, 5-dihydroxy-3-Chaurasia methylanthraquinone, monoterpene.	(Khan et al., 2005; Chaurasia et al., 2010)	2.25
Podophyllum hexandrum	Fruit and seeds, leaves, root	Podophyllotoxins, podophyllin, podophyllic acid, podophylloquercin, starch and tannin, lignans, resin.	(Sharma, 2013)	2.15
Valeriana jatamansi	Rhizome	Alkaloids, flavonoids, tannins and saponins, volatile oil, citric acid, malic acid, maliol, succinic acid and tartaric acid.	(Fazal, 2007)	3.75
Viola canescens	Whole Plant	Alkaloids, tannin, coumarins, flavonoids, glycosides, carbohydrates, phenolic compounds, saponins.	(Barkatullah et al., 2012)	8.75

The inhabitants of the study area were making ethno-medicines mostly in crushed form (26%) followed by powder (23%) (Table 2). The traditional healers of the study area used single or mixture of plants to prepare different recipes for the treatment of variety of diseases. It was observed that the recipes are mostly taken as oral (74%), followed by dermal (10%) (Table 1.). It has been found that various ingredient such as butter, milk, water and sugar were used along medicinal recipes.

Table 2.

Common preparation methods for ethono-medicines.

Method	Preparations	% age
Crushed	14	26
Powder	12	23
Cooked	8	15
Others	8	15
Decoction	6	11
Juice	4	8
Infusion	1	2
Total	53	100

A total of 10 species were found to be highly valuable medicinal species from the local perspective having higher market prices (Table 3). Women (45%), were mostly involved in the collection and processing of medicinal plants followed by children (32%), and men (23%).

Discussion

People of the Nathiagali depend on plant resources and extensive use of those for various ailments. They know useful plants and the preparation of recipes through personal experience, ancestral prescription and long utility. Herbs are mostly the primary source/s of medicinal plants in the study area. Abundant use of herbs for medicinal purposes might be due to its wide occurrence, easy availability and high therapeutic activity as compared to other growth forms. Our study is in line with the findings of Mohammed (2004), Gebre (2005) and Teklehaymanot and Giday (2007), which shows that herbs are more effective in the treatment of ailments as compared with other growth forms.

Almost all plant parts are used in the study area for the preparation of different ethno-medicines but the leaves and roots are mostly preferred parts to be used. The basic reason behind collecting leaves may be attributed to its easy availability in all four seasons of the year and the relatively easy collection method. This type of harvesting is non-destructive because it does not affect the life cycle of the plant. Roots are the second most common harvested plant part in the investigated area. This could be associated with the fact that roots remain in the soil and are easily available even during the dry season. Another possible reason could be that the roots of herbaceous plants can be easily harvested by digging out the whole plant. Same results were also reported by Ketema et al. (2013), and Hussain et al., (2006), where leaves and roots are mostly used for the treatment of variety of diseases. However the use of medicinal plants roots either for the immediate treatment of ailment or for commercialization purpose to generate income, could have negative impact on the biological diversity and conservation.

Mostly the plants are used in the study area to treat different ailments like antipyretic and gastro-intestinal problems. Same findings were reported from other regions of Pakistan (Adnan et al., 2012; Khan et al., 2011). The possible reason behind these ailments is bad hygienic conditions and fuel wood smoke inside houses. People of the area drink bacterial contaminated water due to the lack of water filtering facilities that result in gastro-intestinal diseases (Azizullah et al., 2011). The traditional uses of plants have been scientifically proved by various studies like roots of Bergenia ciliata in the present study is used against gastro-intestinal disorders and diabetes. This, may be due to the presence of different therapeutic compounds in the roots like phenols, tannins, steroids, saponins, flavonoids, gallic acid and gallicin, which have strong antidiabetic, antiulcer, antidiarrheal and antioxidant activities (Ruby et al., 2012; Singh et al., 2011). In another example, Achillea millefolium is traditionally used as antipyretic, antidiabetic and treating gastro-intestinal disorders. The presence of phytochemical in this plant species such as flavonoids, terpenoids, lignans, amino acid derivatives, fatty acids and alkamides have proven strong action against such disorders (Saeidnia et al., 2011). Moreover, Ahmad et al., (2012), found that the leaves of Hedera nepalensis contain tri-terpenoid, saponins, polyynes, steroids, and flavonoids that are having strong antidiabetic potential. Hence, each medicinal plant consisted of therapeutically active agents that are active against certain disease exactly as treated locally using traditional methods. These scientific explanations authenticate the reliability of ethno-medicines and also encourage pharmacologists and chemists to carry out further chemical investigation on traditionally used medicinal plants.

The traditional healers of the Nathiagali use different methods of drugs preparation. Most of the ethno-medicines are taken in crushed and powder form. According to Deeba (2009) these two are the most common and effective methods of drugs extraction. Majority of the recipes in the study area are made by using single plant material while there are certain remedies that are the mixture of two or more plant species like Euphorbia walichii is mixed with Cuscuta reflexa and used against skin infections. Similarly, the leaves of Mentha longifolia, young fruits of Zanthoxylum alatumare, seeds of Punica granatum and Capsicum annum are grinded together to make “Chatni” (paste like) that is proved effective in curing gastro-intestinal disorders. The use of crushing and powder technique and mixing two or more plants could be associated with the healer's belief of neutralizing the synergistic effect in treating an illness. This finding is consistent with earlier reports (Teklehaymanot and Giday, 2007; Filate et al., 2009), however, disagree with other studies (Yirga, 2011; Lal and Yadav, 1983) where the frequent use of concoction was the main use form. It is likely that these differences are associated with the differences in culture and knowledge in different socio-cultural groups. Remedies are mostly taken orally in the study area. The choice of oral administration may be related to the use of some solvents or additives (milk, butter, water and sugar) that are commonly believed to serve as a vehicle in transporting the remedies inside. The additives are also important in minimizing discomfort; improve the taste and reduce adverse effects like vomiting and diarrhea, and enhance the efficacy and healing conditions (Ketema et al., 2013). Supporting findings to our study were also reported by other researchers indicating the oral route is the most preferred mode of administration (Filate et al., 2009; Mesfin et al., 2009).

Medicinal plants serve as an income generation source for most of the local people besides using it for the treatment of various diseases (Adnan et al., 2012). Most of the medicinal plant resources used by the marginal communities have not been conserved but rather irrationally exploited. Medicinal plants have been unsustainably collected from wild habitats for domestic and commercial purposes without any strategies reported to conserve them. This lack of efforts to sustain these resources may result in depletion from natural habitats (Qureshi et al., 2006). In our study it was found that mostly women are collecting medicinal plants. Ahmad and Javed (2007), found that women and other collectors have no proper training of harvesting and processing of medicinal plants, which may result in tremendous losses both in terms of quality and quantity. Ecologically, improper harvesting leads to damage the survival of individual plants (Ticktin, 2004).

The study shows that people of the area are much dependant on the native flora for acquiring their basic requirements. One of the major reasons is that the whole area is rural in nature and most of the people keep livestock as other source of income. The analysis of the ethno-botanical data shows that a large number of medicinal plant species are also used for fodder/forage purpose. Hence, the area is facing a threat of overgrazing and over collection of plants as fodder. Moreover, trampling of animals makes the soil compacted and seed germination and seedlings are also getting damaged (Sher and Hussain, 2008). People of the area are also involved in cutting trees for fulfilling the fuel wood requirement and income generation due to the absence of modern fuel resources. Ahmed et al., (2013) also recorded similar results in their study conducted in new Muree, Pakistan. Deforestation is another major threat towards the extinction of such species as mentioned in a study conducted by Adnan and Hölscher (2011, 2012). Hence, medicinal plants are valuable for the rural livelihood, however at the same time are also facing certain conservation concerns. High utilization of plants and lack of conservation initiatives may result in depletion of the precious flora, which as a consequence may reduce the indigenous knowledge on ethnomedicines.

Conclusions

The study proved that medicinal plants are playing significant role/s in meeting the primary health care and economic needs of the people in the study area. The people of the region especially women have much knowledge that has been transferred from their parents on the treatments of various health disorders with the use of ethno-medicines. However, it is a dilemma that the younger generation is totally ignorant about such precious traditional knowledge on plants that might be due to their reliability on allopathic drugs and modernization. This study has contributed in the documentation of enormous indigenous knowledge on medicinal plants and plant-based remedies practiced among the natives of the study area. Moreover, the ethno-medicinal uses have been confirmed by the presence of phytochemical in these medicinal plants that are proven in the modern day pharmaceutical science against certain diseases. Furthermore, the information generated may validate studies on the acceptability of plant-based remedies on human health both nationally and internationally. There are certain threats to this valuable flora of the region like overexploitation, improper collection, grazing and deforestation. Future studies can be done on such aspects and to quantify the loss of valuable flora due to such malpractices. Moreover, it is recommended to give proper training to the medicinal plants collectors to avoid losses. Protection should be given to those forests where there is overexploitation. Reforestation in the region can also be a way forward for the recovery of medicinal plants. Such highly utilized medicinal flora must be subjected to cultivation trials under agro-forestry system. This may improve rural livelihood, address conservation concerns on this precious flora and ecological restoration in the study area.