Author’s Accepted Manuscript

Use of medicinal plants by health professionals in

Mexico

Angel Josabad Alonso-Castro, Fabiola Domínguez,

Juan José Maldonado-Miranda, Luis Jesús Castillo-
Pérez, Candy Carranza-Álvarez, Eloy Solano,
Mario Alberto Isiordia-Espinoza, María del Carmen
Juárez-Vázquez, Juan Ramón Zapata-Morales, www.elsevier.com/locate/jep

Marco Antonio Argueta-Fuertes, Alan Joel Ruiz-

Padilla, César Rogelio Solorio-Alvarado, Joceline
Estefanía Rangel-Velázquez, Rolffy Ortiz-Andrade,
Ignacio González-Sánchez, Gustavo Cruz-Jiménez,
Luis Manuel Orozco-Castellanos

PII: S0378-8741(16)31175-8
DOI: http://dx.doi.org/10.1016/j.jep.2016.12.038
Reference: JEP10634
To appear in: Journal of Ethnopharmacology
Received date: 11 October 2016
Accepted date: 21 December 2016
Cite this article as: Angel Josabad Alonso-Castro, Fabiola Domínguez, Juan José
Maldonado-Miranda, Luis Jesús Castillo-Pérez, Candy Carranza-Álvarez, Eloy
Solano, Mario Alberto Isiordia-Espinoza, María del Carmen Juárez-Vázquez,
Juan Ramón Zapata-Morales, Marco Antonio Argueta-Fuertes, Alan Joel Ruiz-
Padilla, César Rogelio Solorio-Alvarado, Joceline Estefanía Rangel-Velázquez,
Rolffy Ortiz-Andrade, Ignacio González-Sánchez, Gustavo Cruz-Jiménez and
Luis Manuel Orozco-Castellanos, Use of medicinal plants by health professionals
in Mexico, Journal of Ethnopharmacology,
http://dx.doi.org/10.1016/j.jep.2016.12.038
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Use of medicinal plants by health professionals in Mexico

Angel Josabad Alonso-Castro a*, Fabiola Domínguez b, Juan José Maldonado-Miranda c,

Luis Jesús Castillo-Pérez d, Candy Carranza-Álvarez c, Eloy Solano e, Mario Alberto

Isiordia-Espinoza f, María del Carmen Juárez-Vázquez g, Juan Ramón Zapata-Morales a,

Marco Antonio Argueta-Fuertes h, Alan Joel Ruiz-Padilla a, César Rogelio Solorio-

Alvarado a, Joceline Estefanía Rangel-Velázquez a, Rolffy Ortiz-Andrade i, Ignacio

González-Sánchez h, Gustavo Cruz-Jiménez a, Luis Manuel Orozco-Castellanos a

a
División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato,

México
b
Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social,

Metepec, Puebla, México

c
Unidad Académica Multidisciplinaria de la Zona Huasteca, Universidad Autónoma de

San Luis Potosí, Ciudad Valles, San Luis Potosí, México.

d
Programa Multidisciplinario de Posgrado en Ciencias Ambientales, Universidad

Autónoma de San Luis Potosí. San Luis Potosí, México

e
Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México,

Ciudad de México, México

f
Departamento de Investigación, Escuela de Odontología, Universidad Cuauhtémoc plantel

San Luis Potosí, San Luis Potosí, San Luis Potosí, México
g
Departamento de Productos Naturales, Instituto de Química, Universidad Nacional

Autónoma de México, Ciudad de México, México

1
h
Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana unidad Xochimilco,

Ciudad de México, México

i
Facultad de Química, Universidad Autónoma de Yucatán, Mérida, Yucatán, México

[email protected]

[email protected]
*
Corresponding author: Angel Josabad Alonso-Castro; Address: Cerro de la Venada S/N,

Col. Pueblito de Rocha, C.P. 36040, Guanajuato, Gto. Telephone +52 473 732 0006 ext

5409

2
Abstract

Ethnopharmacological relevance:

The use of medicinal plants in Mexico has been documented since pre-Hispanic times.

Nevertheless, the level of use of medicinal plants by health professionals in Mexico

remains to be explored.

Aim of the study:

To evaluate the use, acceptance and prescription of medicinal plants by health professionals

in 9 of the states of Mexico

Materials and methods:

Direct and indirect interviews, regarding the use and acceptance of medicinal plants, with

health professionals (n=1614), including nurses, physicians, pharmacists, and odontologists

from nine states in Mexico were performed from January 2015 to July 2016. The

interviews were analyzed with the factor the informant consensus (FIC).

Results:

The information obtained indicated that 46% of those interviewed feel patients should not

use medicinal plants as an alternative therapy. Moreover, 54 % of health professionals, and

49% of the physicians have used medicinal plants as an alternative therapy for several

diseases. Twenty eight percent of health professionals, and 26% of the physicians, have

recommended or prescribed medicinal plants to their patients, whereas 73% of health

professionals were in agreement with receiving academic information regarding the use and

prescription of medicinal plants. A total of 77 plant species used for medicinal purposes,

belonging to 40 botanical families were reported by the interviewed. The results of the FIC

showed that the categories of diseases of the digestive system (FIC = 0.901) and diseases of

the respiratory system (FIC = 0.898) had the greatest agreement.

3
Conclusions:

This study shows that medicinal plants are used for primary health care in Mexico by health

professionals.

Abbreviations:

The Mexican Institute of Social Security (IMSS), 2) the Institute for Security and Social

Services for State Workers (ISSSTE), and 3) the Ministry of Health (SSA), the factor of

informant consensus (FIC).

Keywords: factor of informant consensus, Mexican traditional medicine, health

professionals

4
1. Introduction

Mexico is considered as one of the most biodiverse countries in the world. There are an

estimated 23 400 vascular plants in Mexico, of which 3000 have medicinal effects (Bye,

1993; Argueta et al., 1994; CONABIO, 2006). The use of medicinal plants in Mexico has

recorded since pre-Hispanic times (Viesca, 1992).

Mexican health authorities have shown interest in the research of medicinal plants and

the General Health Office published the Herbal Pharmacopeia in 2001 and 2013 (FHEUM,

2001; FHEUM, 2013). Nevertheless, only a small group of medicinal plants have been

studied for their pharmacological, phytochemical, and toxicological effects, as well as for

their pharmacokinetics. In 2012, 52.6% inhabitants were covered by public health insurance

(INEGI, 2012). This means that almost a half of the population have no access to a public

health institution. Therefore, this population needs to appeal to alternative medicine,

including medicinal plants, which are prescribed by “yerberos” or traditional healers (Casas

et al., 2001; Canales et al., 2006).

The use and acceptance of medicinal plants by the general population in Mexico has

been documented (e.g. Frei et al., 1998; Canales et al., 2005; Estrada et al., 2007; Robles-

Zepeda et al., 2011; Beltrán-Rodríguez et al., 2014). The acceptance and use of medicinal

plants by health professionals in Mexico has not yet been reported. Taddei-Bringas et al.,

(1999) carried out a survey in the state of Sonora (Northern Mexico) about the use and

acceptance of herbal medicine by physicians, whereas Romero-Cerecero et al., (2004)

carried out a study regarding the use and acceptance of phytomedicines by physicians in the

states of Morelos and Guerrero (Centre of Mexico). The aim of this study was to evaluate

the use, acceptance and prescription of medicinal plants by health professionals in Mexico.

5
2. Methods

2.1 Data collection

Direct and indirect interviews with health professionals (nurses, physicians,

pharmacists, and odontologists) from the Mexican states of Baja California, Mexico City,

state of Mexico, Guanajuato, Jalisco, Nayarit, Puebla, San Luis Potosi, and Yucatan, were

performed from January 2015 to July 2016. A total of 1614 health professionals were

interviewed individually in private sectors and the three main public health institutions in

Mexico: 1) the Mexican Institute of Social Security (IMSS), 2) the Institute for Security

and Social Services for State Workers (ISSSTE), and 3) the Ministry of Health (SSA).

Sociodemographic characteristics are given in table 1. Interviews were conducted through a

structured questionnaire. The inclusion criteria were health professionals: graduated with at

least one year of work experience, currently working in a private or public health institution

in Mexico. Health professional that were undertaking specialty training were also included

in this survey. There was no age restriction. Before beginning the interviews, the consent of

participation was obtained. The questions were regarding: the common and local name of

the plant used, medicinal use of plant species, preparation, and the plant parts used.

Questions regarding the acceptance of medicinal plants, recommendation in the use of

medicinal plants, and the agreement to receive academic information about the use and

prescription of medicinal plants were included in this survey. The validation of the survey

was performed with 100 people in Guanajuato city. The informants were requested to

provide a brief botanical description of the plant species that they mentioned. The

specimens indicated by the respondents were collected in different areas from Mexico,

identified and deposited at herbarium of Facultad de Estudios Superiores Zaragoza,

Universidad Nacional Autonoma de México (FEZA), and the National Herbarium of

6
Mexico (MEXU). The botanical names were corroborated at Missouri Botanical Garden-

Tropicos (2010) and International Plant Names Index (2008).

2.2 Data analysis

The diseases treated with medicinal plants were grouped into 11 categories based on

the classification used by the International Classification of Diseases used by the World

Health Organization (ICD, 2007).

The Factor of Informant Consensus (FIC), adapted by Heinrich et al. (1998), estimates

the level of agreement between interviewees about which plants to use for each category,

and was calculated as follows:

ur − t
FIC =
ur − 1

Where nur is the number of citations of the medicinal plant in each category and nt is

the number of taxa or plant species that are used in each category. The result of this factor

ranges from 0 to 1, where a value close to 1 indicates a well-defined selection criterion in

the community and/or if that information is exchanged between informants, whereas a low

value indicates that plant species are chosen randomly, or that informants do not exchange

information about their use.

7
3. Results and discussion

3.1 Use of medicinal plants

The information obtained indicated that 46% of the interviewed, and 51% of the

physicians, feel patients should not use medicinal plants as an alternative therapy due to the

following reasons: a) are inefficient in the treatment of diseases (n=286), b) medicinal

plants lack scientific evidence (n=200), and c) are not safe (n=197), among others. These

trends found in Mexico and other countries range from 44.6% to 83% (Taddei-Bringas et

al., 1999; Romero-Cerecero et al., 2004; Fakeye and Onyemadu, 2008; Rodríguez-Torres et

al., 2013).

The results showed that 54 % of health professionals, and 49% of the physicians, have

used medicinal plants as an alternative therapy for several diseases due to the following

reasons: their efficacy (n=402), family tradition (n=349), and to reduce the consumption of

allopathic medicine (n=112). Our results are in agreement with other studies carried out in

Latin America, where the use of medicinal plants in traditional medicine is a common

practice (Clement et al., 2005; Oliveira et al., 2012). Twenty eight percent of health

professionals, and 26% of the physicians, have recommended/prescribed medicinal plants

to their patients. The trends found in Latin America ranges from 27% to 94.4% (Taddei-

Bringas et al., 1999; Romero-Cerecero et al., 2004; Clement et al., 2005; León-Espinosa et

al., 2008; Oliveira et al., 2012). The differences among these results rely on whether the

interviews were carried out in rural or urban areas. Health professionals who prescribe

medicinal plants took academic courses about herbal medicine after graduating.

Twenty nine percent of the respondents would replace the allopathic medications with

herbal remedies for the following reasons: a) in non-severe diseases (n=200), b) because

herbal medicines are cheaper (n=139), and c) due the safety and efficiency of medicinal
8
plants (n=125). Traditional medicine in Mexico is the first alternative in health care

because many drugs for the treatment of gastrointestinal and respiratory diseases are

expensive or not available in rural areas, which may explain the trends we find herein. The

use of medicinal plants could be a strategy to reduce prescription of antibiotics or other

allopathic medicines.

In addition, 73% of health professionals were in agreement with receiving academic

information regarding the use and prescription of medicinal plants. Currently, health

professionals in Mexico do not receive information about traditional medicine during their

professional training. Similar results were reported in other studies (Romero-Cerecero et

al., 2004; Romero-Cerecero et al., 2005; Romero-Cerecero et al., 2006; Oliveira et al.,

2012). Considering that a great proportion of the general population uses herbal medicine

as complementary and alternative medicine. These results clearly indicate the need to

incorporate courses regarding the use of medicinal plants among health professionals. The

prevention of potentially serious risks from misuse of some medicinal plants will be

beneficial for the health of the patient.

A total of 77 plant species with medicinal purposes, belonging to 40 families were

reported. The medicinal plants were reported to treat 30 illnesses (Table 2). None of the

medicinal flora mentioned by the informants are endangered species. The most commonly

mentioned species were Matricaria recutita (n =117), Mentha spicata (n =51), Gnaphalium

oxyphyllum (n =47), Psidium guajava (n =27), and Chenopodium ambrosioides (n =22)

(Table 2). The results indicated that 50% of plant species are reported to cure more than

one ailment and most of the folk remedies are administrated in the form of infusions (Table

2). Our results are in agreement with other studies (Taddei-Bringas et al., 1999; Romero-

Cerecero et al., 2004; León-Espinosa et al., 2008; Rodríguez-Torres et al., 2013).

9
3.2 Factor of informant consensus

The results showed that diseases of the digestive system (FIC = 0.901), diseases of the

respiratory system (FIC = 0.898), and diseases of the musculoskeletal system and

connective tissue (FIC = 0.784) had the highest FIC values (Table 3). The findings show

that the main ailments treated by medicinal flora by health professionals in Mexico are

diseases of the respiratory and digestive systems, and there is also a consensus about the

plants to treat these ailments. This might be because most of these illnesses are acute and

are not considered to be serious.

3.3 General comments

It is essential to identify the risks associated to the consumption of medicinal plants and

establish a national program of pharmacovigilance. Clinical trials with the most frequent

medicinal plants used in this study are necessary to provide pharmacological and

toxicological evidence about their safe use in patients and health professionals. This study

indicates that the use of medicinal plants among health professionals in Mexico is common

practice.

Statement of authors' contributions to manuscript

AJAC designed research and wrote the paper. FD, JJMM, LJCP, ES, MAIE, MC JV, CCA,

JRZM, MAAF, AJRP, JERV, ROA, IGS, GCJ, and LMOC conducted the survey and

contributed to the analysis data. All authors read and approved the final manuscript.

Conflict of interest

The authors declare no conflict of interests.

10
Acknowledgements

The authors wish to thank the Directorate for Research Support and Postgraduate Programs

at the University of Guanajuato for their support in the editing of the English-language

version of this article.

11
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15
Table 1. Sociodemographic characteristics

Characteristic Value Frequency [n (%)]

Age group (years) 19-29 560 (34.7)
30-39 470 (29.1)
40-49 303 (18.8)
50-59 199 (12.3)
60-69 70 (4.4)
70-79 12 (0.7)

Gender Men 828 (51.3)

Women 786 (48.7)

Occupation Physicians 810 (50.2)

Nurses 520 (32.2)
Pharmaceutists 159 (9.9)
Odontologists 125 (7.7)

Work practice (years) 1-9 888 (55)

10-19 394 (24.4)
20-29 232 (14.4)
30-39 88 (5.5)
40-49 12 (0.7)

Workplace sector Public 830 (51.4)

Private 784 (48.6)

Specialist degree Yes 250 (15.5)

No 1364 (84.5)

State of residence Baja California 44 (2.7)

Guanajuato 241 (14.9)
Jalisco 148 (9.2)
Mexico city 294 (18.2)
Nayarit 68 (4.2)
Puebla 363 (22.5)
San Luis Potosi 200 (12.4)
State of Mexico 195 (12.1)
Yucatan 61 (3.8)

16
Table 2 Plants species prescribed or recommended health personal in Mexico

17
Family Scientific name Common Part Preparation / Ailment/symptoms Frequency of
Voucher name used application individual
(Spanish) citations
Acanthaceae Justicia spicigera Muicle, Leaves Infusion/ oral Diabetes, 7
Schltdl FEZA 4656 mohuite immunostimulant
Amaranthaceae Amaranthus Amaranto Seeds Infusion/ oral Diuretic, diarrhea 5
hypochondriacus L.
MEXU 1219
Amaryllidaceae Allium cepa L. Cebolla Bulb Raw Tuberculosis, cough 10
MEXU 128
Amphipterygium Cuachalalate Bark Infusion/ oral Wound healing, 18
adstringens gastritis,
Anacardiaceae (Schltdl.) Standl. stomachache
FEZA 12900
Mangifera indica L. Mango Leaves Infusion/ oral Cough 2
MEXU 2025
Schinus molle L. Pirul Leaves Infusion/Topical Cough 9
FEZA 7283
Apiaceae Eryngium carlinae Hierba del Whole Infusion/ oral Urinary tract 9
F. Delaroche FEZA sapo plant infection, diuretic,
13628 body pain
Foeniculum vulgare Hinojo Whole Infusion/oral Cough, bronchitis 2
(L.) Mill FEZA plant
3919
Apocynaceae Nerium oleander L. Laurel Leaves Infusion/oral Gastritis 6
MEXU 254
Arecaceae Cocos nucifera L. Coco Shell Infusion/Oral Diarrhea, vermifuge 3
MEXU 4451

Asparagaceae Agave lecheguilla Lechugilla Aerial Decoction/topica Wound healing 2

Torr. MEXU 44 parts l

Asphodelaceae Aloe vera (L.) Burm. Sábila Aerial Infusion/Oral Diabetes 7

f. MEXU 19481 parts

Asteraceae Artemisia Ajenjo Aerial Infusion/oral Stomachache 3

18
absinthium L FEZA parts
4669
Artemisia Estafiate Whole Infusion/oral Stomachache, 4
ludoviciana Nutt plant colitis, menstrual
FEZA 8142 colic
Bidens odorata Cav Aceitilla Leaves Infusion/oral Diarrhea, vomiting 5
FEZA 15784
Calendula officinalis Calendula Whole Infusion/oral Stomachache, cough 6
L. FEZA 3650 plant
Gnaphalium Gordolobo Aerial Infusion/Oral Cough, 47
oxyphyllum DC. parts stomachache,
MEXU 18996 vermifuge, urinary
tract infection
Heliopsis longipes Chilcuague Roots Infusion/Oral Toothache, 10
(A. Gray) S.F. Blake vermifuge,
FEZA 11837 rheumatism
Heterotheca Arnica Leaves Maceration/Topi Wound healing, 16
inuloides Cass. cal body pain,
FEZA 15758 rheumatism
Matricaria recutita Manzanilla Whole Infusion/Oral Stomachache, nasal 117
L. plant lubricant, menstrual
FEZA 13617 colic, headache,
body pain, diarrhea,
bronchitis, cough,
gastritis, wound
healing, nervousness
Parthenium Té de la Whole Infusion/Oral Stomachache, 12
hysterophorus L. hormiga plant vermifuge, diabetes
FEZA 1903
Schkuhria pinnata Canchalagua Aerial Topical/ Wound healing 2
var. wislizeni (A. parts decoction
Gray) B.L. Turner
MEXU 20869
Tagetes erecta L. Cempazúchitl Flower Infusion/Oral Stomachache, 11
FEZA 7273 Diarrhea
Tagetes micrantha Anis Whole Infusion/Oral Stomachache, 8

19
 Cav. plant menstrual colic
MEXU 1395
Tanacetum Santa Maria Aerial Infusion/Oral Menstrual colic 5
parthenium (L.) Sch. parts
Bip. MEXU 2339
Bignoniaceae Tecoma stans (L.) Tronadora Aerial Infusion/Oral Diabetes 7
Juss. ex Kunth parts
FEZA 13746
Buddlejaceae Buddleja americana Salve real Leaves Infusion/Oral Stomachache, 6
L. asthma
MEXU 7391
Cactaceae Opuntia ficus-indica Nopal Cladode Decoction/oral Diabetes 8
(L.) Mill. MEXU s
6445
Cannabaceae Cannabis sativa L. Marihuana Leaves Tincture/Topical Body pain 5
FEZA 7303

Caprifoliaceae Sambucus mexicana Flor de sauco Leaves Infusion/Topical Skin infections 4

C. Presl ex DC.
FEZA 7278
Sambucus nigra L. Flor de sauco Leaves Infusion/Topical Cough, fever 3
FEZA 13781
Valeriana sorbifolia Valeriana Leaves Infusion/Oral Nervousness 7
var. sorbifolia
FEZA 1722
Caricaceae Carica papaya L. Papaya Leaves Infusion/Oral Laxative, gastritis, 16
MEXU 1650 asthma
Chenopodioideae Chenopodium Epazote Leaves Infusion/Oral Diarrhea, 22
ambrosioides L. stomachache
FEZA 4537 vermifuge, vomiting
Cucurbitaceae Cucurbita pepo L. Calabaza Seeds Raw Vermifuge 2
MEXU 799
Ibervillea Wereke Bulb Infusion/Oral Diabetes 4
sonorae (S. Watson)
Greene FEZA 14176
Equisetaceae Equisetum Cola de Whole Infusion/Oral Urinary tract 11

20
 myriochaetum caballo plant infection, diuretic,
Schltdl. & Cham. diabetes
FEZA 14994
Ericaceae Arctostaphylos Pingüica Whole Infusion/Oral Urinary tract 6
pungens Kunth plant infection
FEZA 8328 Diuretic
Euphrobiaceae Cnidoscolus Chaya Leaves Infusion/Oral Diabetes Urinary 7
chayamansa tract infection
McVaugh FEZA
13972
Euphorbia Noche buena Whole Infusion/Oral Cough 1
pulcherrima Willd. plant
ex Klotzsch
MEXU 104
Fabaceae Medicago sativa L. Alfalfa Whole Maceration/Oral Diabetes 1
FEZA 7550 plant

Mimosa albida Uña de gato Leaves Infusion/Oral Cancer 1

Humb. & Bonpl. ex
Willd
MEXU EML014
Lamiaceae Marrubium vulgare Marrubio Leaves Infusion/Oral Diabetes 1
L.
FEZA 13622
Mentha × piperita Hierba buena Aerial Infusion/Oral Diarrhea 1
L. MEXU 909 parts
Mentha spicata L. Hierba Buena Leaves Infusion/Oral Headache, 51
FEZA 13823 Whole Stomachache,
plant cough, menstrual
colic, bronchitis,
wound healing
Origanum majorana Mejorana Aerial Infusion/Oral Stomachache, flu 12
L. MEXU 832 parts
Origanum vulgare Oregano Leaves Infusion/Oral Vomiting, diarrhea 3
L. MEXU 4322

21
 Ocimum basilicum Albahacar Leaves Infusion/ Oral Stomachache 5
L.
FEZA 13883
Rosmarinus Romero Whole Burn Body pain, 17
officinalis L. plant plant/Inhalation stomachache,
FEZA 5554 menstrual colic,
cough
Thymus vulgaris L. Tomillo Whole Infusion/ Oral Cough 15
FEZA 5534 plant
Malvaceae Hibiscus sabdariffa Jamaica Flowers Infusion/ Oral Diuretic 11
L. FEZA 7829
Tilia mexicana Tilia Flowers Infusion/ Oral Nervousness 4
Schltdl. FEZA
13412
Myrtaceae Psidium guajava L. Guayabo Leaves Infusion/Oral Menstrual colic, 27
FEZA 13422 diarrhea,
Stomachache
Nyctaginaceae Bougainvillea Bugambilia Leaves Infusion/Oral Asthma, cough 15
glabra Choisy Flower
FEZA 13982
Onagraceae Oenothera rosea L' Hierba del Bark Infusion/Oral Body pain 1
Hér. ex Aiton golpe
MEXU 8287
Passifloraceae Passiflora edulis Pasiflora Leaves Infusion/Oral Muscle relaxant, 10
Sims and nervousness
MEXU 308 flowers
Piperaceae Piper auritum Kunth Hierba santa Leaves Infusion/Oral Stomachache 7
MEXU 157
Poaceae Avena sativa L. Avena Seeds Infusion/Oral Diabetes 4
FEZA 3312
Cymbopogon Zacate limón Leaves Infusion/Oral Stomachache, 1
citratus (DC.) Stapf nervousness
MEXU 1863
Zea mays L. Cabello de Leaves Infusion/Oral Diuretic 5
MEXU 9369 Elote
Polemoniaceae Loeselia mexicana Espinosilla Branche Infusion/Oral Fever 1

22
 (Lam.) Brand s
MEXU 23984
Portulacaceae Portulaca oleracea Verdolaga Whole Infusion/Oral Vermifuge 2
L. MEXU 58 plant
Punicaceae Punica granatum L. Granada Fruit Infusion/Oral Diarrhea, headache 3
MEXU 346

Rhamnaceae Rhamnus purshiana Cáscara Bark Infusion/Oral Laxative 4

DC. MEXU 39395 sagrada

Rubiaceae Morinda citrifolia L Noni Fruits Infusion/Oral Immunostimulant, 20

FEZA 16407 cancer
Rutaceae Casimiroa edulis La Zapote blanco Leaves Decoction/topica Body pain 1
Llave MEXU 250 l
Citrus limetta Risso Lima Fruits Infusion/Oral Weight loss 3
MEXU 2291
Citrus limon (L.) Limón Leaves Infusion/Oral Cough 11
Osbeck
MEXU QD131
Citrus paradisi Toronja Fruits Infusion/Oral Weight loss 2
Macfad MEXU
16868
Citrus sinensis (L.) Naranja Shell Infusion/Oral Nervousness 1
Osbeck Fruit
MEXU 205
Ruta chalepensis L. Ruda Whole Infusion/Oral Stomachache, 6
FEZA 13863 plant Infusion/Topical cough, body pain,
diarrhea
Saururaceae Anemopsis Hierba del Whole Decoction/topica Burns, wound 2
californica Hook. & manso plant l healing
Arn. MEXU 4582
Selaginellaceae Selaginella Doradilla Whole Infusion/Oral Diuretic 3
lepidophylla (Hook. plant
& Grev.) Spring
MEXU 003

23
Verbenaceae Aloysia triphylla Cedrón Leaves Infusion/Oral Diarrhea, vomiting, 8
Royle MEXU 1965 flu
Lippia Orégano Whole Infusion/Oral Cough, stomachache 2
berlandieri Schauer plant
MEXU 10688
Verbena carolina L. Verbena Whole Infusion/Oral Fever 2
FEZA 7261 plant

Zygophyllaceae Larrea tridentata Gobernadora Leaves Infusion/Oral Urinary tract 8

(DC.) Coville FEZA infection
14606

24
 Table 3 Factor of informant consensus

Category Taxons Uses FIC

Certain infectious and parasitic diseases 7 14 0.538
Diseases of the circulatory system 2 3 0.500
Diseases of the digestive system 29 284 0.901
Diseases of the musculoskeletal system 12 52 0.784
and connective tissue
Diseases of the nervous system 7 18 0.647
Diseases of the respiratory system 20 186 0.898
Diseases of the skin and subcutaneous 7 12 0.454
tissues
Diseases of the genitourinary system 18 67 0.734
Endocrine, nutritional and metabolic 14 52 0.745
diseases
Undefined illnesses 3 5 0.500

25
Graphical abstract

26