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Medicinal ethnobotany of wild plants: a
cross-cultural comparison around Georgia-
Turkey border, the Western Lesser Caucasus
Ceren Kazancı
1*
, Soner Oruç
2
and Marine Mosulishvili
1
Abstract
Background: The Mountains of the Western Lesser Caucasus with its rich plant diversity, multicultural and
multilingual nature host diverse ethnobotanical knowledge related to medicinal plants. However, cross-cultural
medicinal ethnobotany and patterns of plant knowledge have not yet been investigated in the region. Doing so
could highlight the salient medicinal plant species and show the variations between communities. This study
aimed to determine and discuss the similarities and differences of medicinal ethnobotany among people living in
highland pastures on both sides of the Georgia-Turkey border.
Methods: During the 2017 and 2018 summer transhumance period, 119 participants (74 in Turkey, 45 in Georgia)
were interviewed with semi-structured questions. The data was structured in use-reports (URs) following the ICPC
classification. Cultural Importance (CI) Index, informant consensus factor (FIC), shared/separate species-use
combinations, as well as literature data were used for comparing medicinal ethnobotany of the communities.
Results: One thousand five hundred six UR for 152 native wild plant species were documented. More than half of
the species are in common on both sides of the border. Out of 817 species-use combinations, only 9% of the use
incidences are shared between communities across the border. Around 66% of these reports had not been
previously mentioned specifically in the compared literature. Only 33 species have similar use reports in both
countries, most important of which are Plantago major,Urtica dioica,Picea orientalis,Anthemis spp., Sambucus
ebulus,Achillea millefolium,Helichrysum rubicundum,Mentha longifolia,Pinus sylvestris var. hamata,Hypericum
perforatum,Tussilago farfara,Helichrysum plicatum,Rumex crispus,Berberis vulgaris, and Origanum vulgare. More than
half of species reported in each country were found to have more than one part of the plant valued for medicinal
use. The most common way of using plants medicinally in both countries is drinking the water infusion of aerial
parts with flowers. Based on CI index value, two-thirds of the salient 15 genera in both countries have use reports
in at least seven medicinal use categories. While the most cited category with highest FIC is digestive in Georgia, it
is skin category in Turkey. Patterns of medicinal plant knowledge among studied communities appear to be
connected with more than one cultural factor, in particular ethnolinguistic diversity, cultural background, and access
to multilingual written folk and scientific literature, or probably a combination of various factors.
(Continued on next page)
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* Correspondence: ceren.kazanci.1@iliauni.edu.ge
1
School of Natural Sciences and Medicine, Ilia State University, Cholokashvili
3/5 Avenue, 0162 Tbilisi, Georgia
Full list of author information is available at the end of the article
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71
https://doi.org/10.1186/s13002-020-00415-y
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
(Continued from previous page)
Conclusion: Considering the regions’floral similarity, common historical-cultural contact, and similar livelihood
strategies of the communities, shared ethnomedicinal knowledge across the Georgia-Turkey border is quite low.
Even though the impacts of accessing multilingual folk and scientific literature are likely to be significant, the factors
that shape the medicinal plant knowledge patterns of the communities are shown to be variable among species,
needing further research into intracultural diversity and socio-economical conditions, as well as the political history
across the border.
Keywords: Medicinal ethnobotany, The Caucasus, Medicinal plants, Transhumant people, Cross cultural research,
Border ethnobotany, Georgia, Turkey, Biocultural conservation
Introduction
The mountains of the Western Lesser Caucasus are part
of the Caucasus Hotspot, one of the 36 global biodiversity
hotspots of the world [1–3]. This hotspot harbors around
7000 vascular plant species, around 25% of which are en-
demic to the region [4]. Moreover, it is known to be a
home to high linguistic, genetic, and ethnic diversity [5].
Indeed, various travelers and researchers have been
impressed by the diversity of language and ethnicity of the
region, calling here “the mountain of tongues”[6]. Simi-
larly, several researchers highlight the significance of
mountainous regions worldwide not only for biodiversity
but also for biocultural diversity [7–9], “the diversity of life
in all its manifestations: biological, cultural, and linguistic”
[10]. Despite this, the lack of information on plant re-
sources in ethnographic studies in particular has been
identified [9], as well the lack of studies on the relation-
ship between mountains, biodiversity, and cultural diver-
sity [7]. More effort to document and protect traditional
knowledge and practices in mountainous areas has been
called for, to sustain continued social-ecological health
and wellbeing of humanity [9].
Recent studies conducted in Georgia (Sakartvelo) re-
veal a noteworthy ethnobotanical knowledge of people
living in various regions [11–17]. Furthermore, the book
“Ethnobotany of the Caucasus”presents detailed infor-
mation on about culturally salient 130 plant species cur-
rently and historically noted in the South Caucasus
(Georgia, Armenia and Azerbaijan) [18]. However, apart
from a number of ethnobotanical studies published in
certain parts of the Western Lesser Caucasus region, lit-
tle ethnobotanical knowledge has yet been systematically
documented in the mountains around Turkey-Georgia
border. For instance in Turkey, two general surveys con-
ducted in some parts of Artvin province report the me-
dicinal ethnobotany of 20 plant species [19,20]. A
recent survey conducted in a national park in Artvin also
states medicinal knowledge of 37 plant species [21]. The
neighboring province of Ardahan is another ethnobota-
nically least studied area of East Anatolia [22]. Folk
knowledge of 18 medicinal plant species were reported
around the Göle and Çıldır districts of Ardahan [20],
while the ethnobotanical knowledge of 65 plant species
were reported from the Çıldır district [23]. On the Geor-
gian side, medicinal folk knowledge of at least 27 rare
and endangered medicinal plants were recorded for the
Samtskhe-Javakheti region [24]. In addition, around 40
medicinal plant species were listed in a systematic
ethnobotanical study in Samtskhe-Javakheti region [14].
A study of folk usage of medicinal plants in Adjara re-
ported knowledge relating to 194 plant taxa [25].
Recent studies conducted in Europe highlight the sig-
nificance of cross-cultural and cross-border ethnobotan-
ical research to fully understand the factors that shape
plant knowledge and uses by communities living closely
under similar environmental conditions [26–28]. Differ-
ences in cultural backgrounds (e.g., ethnicity, language,
medicinal belief systems, religion) are proposed to be
significant factors affecting varying concepts of medi-
cinal knowledge within such communities in Europe
[29–32]. Moreover, the influence of written literature on
the current medicinal plant knowledge and usage has
been highlighted in detail [30,31] and the influence of
USSR Pharmacopedia, especially for post-Soviet coun-
tries is discussed [27]. Similarly, the impact of “official”
sources from Soviet times on traditional ethnomedicinal
knowledge was investigated in a study in Armenia,
which identified a “new tradition,”which they suggest
has indirectly promoted the enrichment and preserva-
tion of phytomedicinal knowledge and traditions [33].
Given the above situation, the objectives of this study are:
To document the medicinal folk knowledge about
wild plants and highlight shared and divergent
knowledge of use between transhumant
communities around Georgia-Turkey border, as well
as comparing the knowledge with the ethnomedic-
inal literature sources.
To evaluate the cultural significance of the most
salient plant families, genera, species, and their
medicinal uses among participants in Georgia and in
Turkey. Furthermore, the underlying factors of use/
knowledge patterns for these plant species will be
discussed.
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 2 of 20
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Material and methods
Area of study
The geographical area covered in this study is located
along the border between Georgia and Turkey, in the
Western Lesser Caucasus (Fig. 1). This corresponds to
part of the highlands between the Hopa-Artvin-
Ardahan-Çıldır main road (41° 23′38′′ N, 41° 25′08′′′
E–41° 01′33′′ N, 43° 28′14′′ E) in Turkey and Batumi-
Khulo-Akhaltsikhe-Ninotsminda main road (41° 36′03′′
N, 41° 34′30′′ E–41° 08′30′′ N, 43° 47′24′′ E) in
Georgia. It falls within the borders of Adjara and
Samtskhe-Javakheti regions in Georgia; Artvin and
Ardahan provinces in Turkey. The area includes the
characteristics of three of the world’s ecological regions:
The Caucasus Mixed Forest Ecoregion, Euxine Colchic
Deciduous Forest Ecoregion, and to a lesser extent
Eastern Anatolian Montane Steppe Ecoregion [34]. Its
principal climates range from humid subtropical and
mildly dry subtropical mountainous to continental cli-
mates. Dominant natural landscapes extend from forest
and high mountain vegetation to Caucasian sub-alpine
meadows and steppe meadows with freshwater lakes,
mainly located along the Ardahan and the Samsthke-
Javakheti border [35].
Between 1300 BCE and 580 ADE, the area fell within
the kingdoms of Colchis, Diauehi, and Iberia. The region
witnessed various wars, migrations, and deportations
and several kingdoms, empires, principalities, and coun-
tries succeeded until the current day. The variety of
ethnolinguistic groups inhabiting the area include Turks,
Georgians, Armenians, Kurds, Azeris, Laz people, Hem-
shins, and Russians, with small-scale agriculture and
relatively large-scale livestock farming as the main eco-
nomic activities. Nearly all participants in this study
were transhumant, maintaining an agro-pastoral way of
life. Highland pastures, referred to as “yayla”in Turkey,
are known as “mta”and/or “ialagi”(iala) in Georgia.
People move to their summer pastures at the end of
May, where for 3 to 5 months they live mainly in
wooden houses, some living in dry stone dwellings or
even in tents.
Ethnobotanical data collection
To restrict the focus of the study on the ethnobotanical
knowledge of transhumant people, more than two-thirds
of the fieldwork was conducted in highland pastures
along the Georgian-Turkish border. Firstly, over 150 po-
tential highland pastures were identified between alti-
tudes of 1600 m and 2500 m within the study area, using
Google Earth. Later, possible research locations were se-
lected from among those settlements according to a
number of geographical barriers (mountains, rivers,
lakes, passes) that would help identify high diversity of
floral and cultural characters. By attempting to reach
Fig. 1 Map of the study area: Distribution of visited highland pastures and villages. Black dots correspond to places in Turkey; white dots refer to
places in Georgia
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 3 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
people who had maintained their agro-pastoral transhu-
mance lifestyle, it was expected that these people would
have been in contact with a variety of vegetation types
during regular seasonal migrations, thus having a rela-
tively strong living memory of traditional knowledge and
practices related to wild plants.
In the summer of 2016, 2 weeks of non-systematic pre-
liminary fieldwork were conducted, with the undertaking
of informal interviews in 20 highland pastures and vil-
lages in Georgia and Turkey [36]. Over the following
two summers (2017–2018), a total of around 90 days of
systematic fieldwork were carried out during the period
of transhumance (approximately June 15–September
15), visiting 102 highland pastures, 65 in Turkey and 37
in Georgia (Fig. 1). During that time, 119 participants
were interviewed, 74 in Turkey (41 female; 33 male), and
45 in Georgia (28 female; 17 male). The mean ages of
participants were 57 and 58 respectively in Georgia and
in Turkey.
Official research and plant collection permits were ob-
tained from the Ministry of Forest and Water Affairs
(Issue date-no: 09/02/2018-E.8919), as well as from the
Scientific Research and Ethical Committee of Artvin
Çoruh University in Turkey (Issue date-no: 14/02/2018-
E.2708). Ilia State University in Georgia was informed,
and necessary official scientific research and travel per-
mits were obtained from the Department of Land Border
Protection of the Border Police of the Ministry of
Internal Affairs of Georgia.
Initial investigation considered the flora in different
vegetation zones (forest, meadow, wetlands, steppe,
rocky areas) en route to and in the vicinity of each se-
lected highland pasture. This process took around 2–3h
for each highland pasture. This reconnaissance involved
the identification of wild plants, where possible to spe-
cies level, in which photographs and a minimum of three
samples were collected for each. This had a dual pur-
pose, firstly to be able to show participants for them to
identify plants they would talk about, and secondly to
prepare herbarium voucher specimens for later detailed
identification.
The research team was composed of three or four
people. The first (female) and second (male) authors
were always involved in the interviews, with a transla-
tor—either male or female. Throughout the study, the
first author was always the principal interviewer. In
Turkey, the interviews were conducted directly in the
Turkish language, while in Georgia, interviews were in
Georgian, Russian, or Turkish. The majority of the inter-
views in Georgia were performed with the help of trans-
lators who spoke Georgian, Russian, and English, either
as a mother tongue or as a second language. Interviews
were later translated into English. Two weeks before the
fieldwork, the translators were provided with
information and terminology relevant to the research.
Information relating to the purpose of the study was
given to all participants and their free, prior informed
consent—for interviewing, recording, photographing,
and/or publishing their knowledge—obtained orally from
each at the beginning of their interviews. All interviews
conformed to the International Society of Ethnobiology’s
Code of Ethics [37]. The obligations of the Nagoya
Protocol also being considered, it was approved that “the
right of use and ownership of any traditional knowledge
of all informants remains with them, and that any use of
the information except for scientific publication, requires
the additional consent of the traditional owners, and
consensus on access to benefits derived possibly later
use”[38].
A snowball technique was used to find participants
who held significant traditional knowledge regarding
wild plants and their usage. The majority of the partici-
pants were elderly transhumant people. Each was inter-
viewed individually, for an average of 2 h, with semi-
structured questionnaires. Usually, the person’s relatives
and neighbors also contributed to the interview. The
first author took notes directly in a notebook during all
interviews. Depending on participants’wishes, audio or
video recordings were made of the interviews. Informa-
tion about plants collected from the wild was docu-
mented, specifically with data regarding (1) their folk
names in different languages and dialects, (2) collection
time and place, (3) parts used for medicinal purposes,
(4) processes of preparation and administration, and (5)
source of the plant knowledge. In addition, observations
were made and photos taken in byres, cellars, and other
relevant places whenever possible so as to document un-
mentioned uses and also observe living ethnobotanical
practices.
Initially, participants were asked to discuss points
about wild plants that immediately came to mind (~ 15
min). Then they were shown fresh plants and asked to
identify the vernacular names and usage of the plants
(~ 45 min). Depending on the weather and partici-
pants’willingness, a “walk around the house”was
undertaken to observe wild plants in the proximity
(~ 15 min). To confirm previous information and to gain
further learning about various plants, participants were
shown an illustrated plant catalog, including 400 plant
species from the flora of the region (~ 45 min.). Certain
participants were visited a second time to complete
the first interview or to confirm information.
Taxonomic identification of plants
Preliminary identification of plant species was carried
out in the field by the authors. The plants were photo-
graphed with their coordinates and then voucher herbar-
ium specimens were prepared by the first author for
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 4 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
further identification. Relevant flora resources were used
for identification [39–44]. Identified specimens from
Georgia were checked by the third author, and stored in
the National Herbarium of Georgia and in Ilia State Uni-
versity. Specimens identified in Turkey were checked by
Prof. Özgür Eminağaoğlu and stored in the Herbarium
of Artvin Çoruh University. Species were named based
on current accepted names [45]. Furthermore, plant
synonyms were given after consulting “Plant List of
Turkey–Vascular Plants”[46] and “Vascular Plants of
Georgia–A nomenclatural checklist”[47].
Data analysis
Firstly, all reported plant species and their relevant
ethnobotanical data were entered into a Microsoft® Excel
spreadsheet in a use-report (UR) based order, following
the categories in the Economic Botany Data Collection
Standard [48]. Under each use-category, each different
use was counted as one UR. For example, if a participant
mentioned a species used for headache and coughing, it
counted as 2 UR. Secondly, the data of wild plants and
their related medicinal use reports were extracted. After
a final classification of the categories, pivot tables were
constructed for further analysis. The final classification
of reported ailments and diseases considered The Inter-
national Classification of Primary Care (ICPC-2-R)
developed by World Organization of Family Doctors
[49] and accepted by the World Health Organization
(WHO), on suggestions by several authors of compara-
tive ethnomedicinal studies [50,51]. Thirteen medicinal
use-categories for several emic subcategories were deter-
mined (Table 1).
To reduce error and better confirm the local percep-
tions of participants, minor modifications were made to
the ICPC categories.
This paper considers ethnomedicinal data of wild plant
species encountered during the 2017 and 2018 fieldwork
for the current data analysis. Ethnobotanical interviews
and data analysis focused on “wild”(non-cultivated)
plants native to the study area. For instance, species such
as Malus domestica,Prunus x domestica,Morus alba,
Robinia pseudoacacia, etc. were excluded from the study
since they are either widely cultured or exotic. Although
they are also cultivated, Corylus avellena,Juglans regia,
Ribes rubrum, etc. were included as they are native to
the area or have run wild and become naturalized.
There was no focus on or promotion of exotic plant
species or unconventional (introduced) knowledge re-
lated to them. This choice was made not only for lo-
gistical reasons but also because even though exotic
plants may somewhat enrich local ethnobotanical
knowledge [52], there are also documented adverse
effects on local biodiversity, ecosystem services and
local community livelihoods as well as cultural diver-
sity [52–54]. Furthermore, participant knowledge and
perceptions of plant collecting places were used to
Table 1 Assigned medicinal use categories for reported ailments and uses
Medicinal use categories Ailments/Uses
Digestive Constipation, diarrhea, dysentery, gastrointestinal infection, indigestion, liver disease, stomach
ache, tooth bleaching, tooth inflammation, toothache, worm, clean intestine, gall disease,
intestinal disease, jaundice, ulcer (mouth, stomach), induce vomiting, prevent vomiting
Respiratory Asthma, bronchitis, cold, cough, influenza, lung disease, throat ache, throat inflammation, tonsil,
shortness of breath, expectoration, nasal obstruction, mumps, quinsy
Cardiovascular Vasodilator, hemorrhoids, heart disease, high blood pressure, varicose vein, blood circulation
Skin Antiseptic, blister, boil, bruises, burn, eczema, irritation, wart, wound, antifungal, itching, belief
(wart), psoriasis, rash, insect and snake bites, bleeding wound, skin care complaints, callus, chap,
hair care complaints (dandruff, hair loss, wash and growth), herpes, inflammation
Endocrine Diabetes, thyroid, increase milk supply, loss of appetite, sexual development (induce estrogen level)
General health and unspecified Allergy, cleaning organs, fever, general disease, good for health, measles, tiredness and weakness,
tuberculosis, vitamin deficiency, cancer, chickenpox, feeling ill, pain killer, sunstroke
Genitourinary High menstrual bleeding, incontinence urine, kidney disease, kidney pain, kidney stone, prostate,
urinary disease, vaginal discharge, women disease (infertility, inflammation), abortion, diuretic,
bladder infection, man disease (infertility), menstruation problems, menopausal complaint
Muscle-skeletal back pain, bone and joint pain, rheumatism, sprain, knee ache, fracture, cramp, footsoreness, induce
synovia, numbness in arm, rachitic
Eye Eye diseases, good for eyes, hypopyon
Ear Earache
Blood Anemia, cleansing blood, hematinic, iron deficiency
Neurological Headache, dizziness, epilepsy, increase memory, nervous disease
Psychological Relaxing, sedative, sleep disorders
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 5 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
decide which species qualified as “wild.”Based upon
these criteria, a total of 152 wild plant species were
included in the analysis.
Firstly, the number of species mentioned on both sides
of the Georgia-Turkey border were compared using
Venn diagrams. This illustrates the level of species rich-
ness and shared species for the evaluation of regional
ethnomedicinal knowledge.
Secondly, common and distinct ethnomedicinal know-
ledge and use were compared among communities
researched on both sites of the border as well as with
relevant ethnobotanical literature in the Caucasus Eco-
region. A species-use combinations approach involved
both medicinal sub-categories (reported ailments) and
medicinal categories (e.g., digestive, respiratory, etc.).
This presents the level of shared use/knowledge inci-
dence and its variations among communities studied.
The shared knowledge is given in bold, with knowledge
unique to Turkey italicized and that unique to Georgia
not italicized (Table S1).
Thirdly, the medicinally valuable plants were quanti-
fied and compared in function of most salient plant fam-
ilies, genera, species, as well as their plant parts,
medicinal use, preparation, and application methods
across the border. The following indices were used to
evaluate the relative cultural significance, versatility of
species and consensus on medicinal use and knowledge
on the both sides of the border.
a) The Cultural Importance index (CI): A widely used
index in ethnobotanical studies (e.g., [55,56]), it is
known to produce reliable results in assessing the
relative cultural significance of each plant species
while comparing different regions with different
participant numbers [57]. This is known to be
effective not only in presenting the spread of use
(number of participants) but also to highlight the
diversity of uses (versatility) for certain plant species
in cross-cultural ethnobotanical studies [57].
CI values are calculated by adding the number of use
reports (UR) of all the participants in every use-category
mentioned for a species, divided by the number of
participants in the survey [57].
CI ¼X
i¼NU
i¼1
URI
N
NU: Total number of uses; i: varies from one use to NU;
N: number of participants in the survey.UR: Use report.
In the case of this study, although the CI values of
each species (CI
s
) were calculated separately (see in
Table S1) instead of comparing only CI
s
, attention was
paid to the Cultural Importance of each plant genus
(CI
g
: total value of CI
s
in the same genus) to reveal the
more versatile genera. Besides, the cultural importance
of each family (CI
f
) was computed by summing CI
g
values for all genera of the same family [56]. These ap-
proaches will reduce the risks of under or over estima-
tion of the CI for certain plant species due to
misidentification of very similar species and subspecies;
this would also compensate for possible effects of differ-
ent folk taxonomic classifications among participants. It
is known that closely related plant species share com-
mon natural products [58], whose type of usage may also
clump phylogenetically [59].
Therefore, we believed that a CI
g
-based comparison
would also serve as a sufficient indicator to illustrate key
points of the study. The CI Index was also applied to
medicinal use categories to estimate the contribution of
each use category to CI
g
[60,61]. This time, the number
of URs for each use-categories was divided by the
number of participants in the survey.
b) Informant consensus factor (FIC): Another
commonly used index for exploring potentially
active medicinal plants for certain ailments, FIC was
first proposed and used in medicinal ethnobotany
studies to estimate the agreement of participants on
a number of plant species according to specific use-
categories (illnesses or ailments) [62].
FIC values are obtained as follows: number of use-
reports in each use category (n
ur
) minus the number of
taxa used (n
t
), divided by the number of use-reports in
each category minus one [62,63].
Fic ¼nur −ntðÞ=nur −1ðÞ
n
ur
: number of use-reports in each use category; n
t
:
number of taxa used for that use category.Where FIC
ranges from 0 to 1.
In this study, by using FIC index, the level of agree-
ment of participants on the ethnomedicinal knowledge
of wild plants species were evaluated.
FIC values close to 1 reflect a high consensus on a cer-
tain plant species for a given ailment (use-categories).
On the other hand, FIC closer to 0 (zero) would indicate
either a high degree of intracultural variation or a signifi-
cant lack of documentation of the participants’know-
ledge [64].
Results and discussion
Overall results, comparisons, and extrapolations
One thousand five hundred six use-reports for 152 na-
tive wild plant species are documented for medical
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 6 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
purposes in the study area. Figure 2shows the overlaps
between the recorded numbers of wild plant species
among studied communities. The regions on either side
of the border share 83 of the reported plant species.
Considering the fact that almost the same flora is found
in the two regions, the level of similarity is low. In
addition, the number of unique species (43 species)
mentioned only by participants in Georgia is significantly
higher than the number of unique species (26 species)
mentioned only in Turkey (Fig. 2).
Table S1summarizes the information about use re-
ports of the 152 wild plant species and comparison with
the literature sources. In the comparison of the 817 dis-
tinct species-use combinations based on medicinal emic
categories (e.g., asthma, ulcer, wound healing, etc.),
participants in both countries share similar medicinal
knowledge of only 77 use incidences (9% of total
species-use combinations) for 33 wild plant species (22%
of reported species) in common (Fig. 3a). Most import-
ant of these species based on CI index are Plantago
major,Urtica dioica,Picea orientalis,Anthemis spp.,
Sambucus ebulus,Achillea millefolium,Helichrysum
rubicundum,Mentha longifolia,Pinus sylvestris var.
hamata,Hypericum perforatum,Tussilago farfara,Heli-
chrysum plicatum,Rumex crispus,Berberis vulgaris, and
Origanum vulgare. In contrast, 433 distinct uses were re-
ported only from Georgia, whereas only 307 unique uses
were reported from Turkey.
When comparisons were based on medicinal use cat-
egories (e.g., digestive, respiratory, cardiovascular system
etc.), out of 490 species-use combinations, only 120
(24% of the reports) of these were found to be in com-
mon in both countries (Fig. 3b). The results in Fig. 3a
and b indicate significantly low consensus of medicinal
knowledge about shared native wild flora across the
border. Participants in both countries use a significant
number of shared species for different purposes. This
lack of shared ethnomedicinal knowledge might be a
sign of different epidemiology of certain ailments in
communities studied as well as various medicinal know-
ledge systems in ethnolinguistically diverse communities
on both sites of the border.
Table S1reflects similarities and differences seen between
information reported in this study and reports from 26 main
literature sources related to folk knowledge of medicinal
plants from the Caucasus Ecoregion, mainly North-Eastern
and Eastern Black Sea Region of Turkey and Georgia, as well
Fig. 2 Overlaps between the recorded numbers of wild plant
species among studied communities. *Note that the studied sites in
Turkey include highland settlements of Artvin and Ardahan; the
studied sites in Georgia include highland settlements of Adjara and
Samtshke-Javakheti around the border
Fig. 3 Overlap of species-use combinations. acomparing the emic/folk use category and bcomparing medicinal use category
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 7 of 20
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as Armenia and Azerbaijan, including literature from Soviet
period. Of this study’s 817 distinct species-use combinations
based on medicinal sub-categories (asthma, ulcer, wound
healing, etc.), only 275 of them are similar with those
in the above mentioned literature reports. This means
that around 66% of this study’s use reports (as a
species-medicinal subcategory combination) have not
been mentioned specifically in these items of literature.
Even, when comparisons are based on medicinal use
categories, out of 490 species use combinations, only 276
of them are similar and around 44% of these use reports
also have not been mentioned in these literature sources.
Nevertheless, although very limited, the fact that a num-
ber of plant species and similar medicinal reports are in
common with various areas of the Caucasus Ecoregion
would be indicative of consensus and high cultural value
for the medicinal knowledge of certain wild plant species
in the Ecoregion. The most important fifteen wild plant
species consistent with both this study’s reports and those
in literature sources are Urtica dioica,Plantago major,
Mentha longifolia,Hypericum perforatum,Pinus sylvestris
var. hamata,Rosa canina,Achillea millefolium,Berberis
vulgaris,Chelidonium majus,Sambucus ebulus,Vacci-
nium myrtillus,Picea orientalis,Helichrysum plicatum,
Tussilago farfara,andHyoscyamus niger.
Cultural importance index of families, genera and species
Figure 4shows the cultural importance (CI) index of
most important families reported in Georgia and in
Turkey. Out of 36 plant families recorded on the whole
study area, 25 of them were recorded in both countries,
whereas 8 of them were only from Georgia and 3 of
them were only from Turkey. The three most important
families according to CI index in order of importance in
Georgia are Asteraceae, Rosaceae, and Lamiaceae while
in Turkey they are Asteraceae, Plantaginaceae, and Rosa-
ceae. Most of the important families are represented by
several genus in Georgia, while most of them are
represented by one or two genus in Turkey. The most
important genera in order of importance are Plantago,
Urtica,Anthemis,Helichrysum,Sambucus in Georgia
and Plantago,Urtica,Picea,Rosa,Helichrysum in
Turkey (Fig. 5).
Asteraceae is seen to have the highest number of
genus (16 in Georgia; 15 in Turkey) in both countries.
The CI index of this family in Georgia is more than
threefold that of Turkey. Significant differences in CI are
also noted at the species level. While Anthemis spp. (CI
0.96) are the most important species following Achillea
millefolium (CI 0.62) on the Georgian side, in Turkey
Helichrysum rubicundum (CI 0.28) is the most import-
ant, following Anthemis spp. and Achillea millefolium
with same CI value of 0.23. These results might be a sign
of differences in the level of knowledge regarding medi-
cinal use of this plants among studied communities. The
Rosaceae is the second culturally most important family
in Georgia and third in Turkey, mostly respresented by
Rosa genus comprising approximately half of the CI
value of Rosaceae in both countries. Although several
Rosa species have been recorded for medicinal use, a
particular selection between two different species be-
tween two countries is noted. While Rosa canina with a
CI of 0.31 is the most important Rosa species in Georgia;
Rosa spinosissima (syn. R. pimpinellifolia) with a CI of
0.32 is the most important Rosa species in Turkey, being
more than threefold that the CI index of R. spinosissima
in Georgia (0.09). The small CI index value of Rosa spi-
nosissima in Georgia may be due to the fact that it has a
narrow distribution and low abundance in Georgia.
However, as far as observed, this species has a relatively
wider distribution and high abundance in Turkey.
Another possible and more plausible explanation is that
the particular medicinal use of this species in Turkey,
especially in Ardahan, could be related to similar cul-
tural background and unique ethnomedicinal knowledge
of the people living there. The frequent use of Rosa
Fig. 4 Cultural importance (CI) index of the 10 most important families in Georgia (left) and in Turkey (right). Each gray tones reflects the
contribution of different genus to the total CI of each family
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 8 of 20
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spinosissima roots as medicinal tea in this province is an
uncommon medicinal use, which has so far rarely been
cited in the literature in Turkey. One previous report
was from Çıldır, Ardahan [23] within the area of this
study, while a further two more reports were from the
nearby region, in Erzurum [65,66]. Consensus in this
traditional knowledge in Ardahan is likely to reflect the
therapeutic efficacy of this plant, a point of interest to be
noted for further ethnobotanical and ethnopharmacolo-
gical studies.
Plantaginaceae is the second most important family in
Turkey and fourth in Georgia. Their CI vlaues are close
to each other (1.51 in Georgia; 1.26 in Turkey). Plantago
spp. (P. major and P.lancelolata) are in the first place
within the top 15 culturally salient genera in both coun-
tries. Indeed, Plantago major is one of the most fre-
quently reported medicinal species in cited literature
(Table S1). In addition, the third family in Georgia,
Lamiaceae CI, is significantly greater than that in
Turkey, being 1.69 and 0.62 respectively. Even the most
reported genera in both countries are the same (Mentha
and Origanum); Mentha with CI of 0.56 in Georgia and
0.19 in Turkey is a sign of significant differences be-
tween the two countries. Actually, Mentha is a widely
known, reported, and used plant species as a food addi-
tive in the study area, in Turkey. Therefore, its low me-
dicinal CI value could be related to its less known
specific medicinal properties. Same reason might be
relevant for Polygonaceae and Ericaceae families which
are not represented in CI index of top ten families in
Turkey. Polygonum spp., Rumex spp., and Vaccinium
spp. are not consumed specifically as medicine but
mainly known as food in Turkey.
Plant parts used and preparation and administration
methods
More than one plant part is known/used medicinally for
54% of the wild plants mentioned in Georgia and 57% of
them in Turkey. Most commonly, the leaves is given for
27% of the URs in Georgia and 26% of URs in Turkey
(Table 2). Plantago spp. constitute majority of the leaf use
reports in both countries. The use of aerial parts with
flower comes after leaf use in both countries. Most of the
contribution to this use originates from Helichrysum spp.,
Achillea millefolium, Mentha longifolia and Origanum
vulgare. Fruits have also similar use percentage in each
country. Rosa spp., Sambucus spp., and Crateagus spp. are
frequently used species for their fruits in the study area.
Among the preparation methods, the most common
one in both countries is infusion in water/milk/votka/
oil/whey/sugar (48% of URs in Georgia, 32% of URs in
Turkey). They are followed by decoction in water/milk/
oil and fresh use.
Fig. 5 Cultural importance (CI) index of the 15 most important genera in the study area. (spp. indicates the contribution of more than one
species, while sp. indicates the contribution of only one species)
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 9 of 20
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A major application method in both countries is in-
ternally, specifically, drinking or eating. In Georgia,
drinking and eating constitute 49% and 11% of the URs
respectively; in Turkey, the corresponding UR data are
37% and 12% respectively. Plastering and bathing are
major external application in both countries.
To summarize, communities in both countries utilize
many parts of wild medicinal plants, with a variety of
modes of preparation and application methods. How-
ever, the most common way of using wild plants medi-
cinally in both countries is drinking the water infusion
of aerial parts with flowers.
Medicinal use-categories and salient species
In the study area on either side of the Georgian-Turkish
border, the cultural importance of medicinal use cat-
egories as well as salient species used varies significantly
among communities.
Table 3shows the number of use-reports, number of
species, cultural importance, and informant consensus
for each medicinal use-categories. Comparison of the re-
sults in Table 3reveals that ailments related to digestive
and skin problems have the highest number of use-reports
in both countries (in total, 43% of URs in Georgia, 49% of
URs in Turkey). In order of importance, these categories
are followed respectively by respiratory, cardiovascular,
and muscle-skeletal disorders in both countries. Con-
versely, complaints related to ear, eye, blood, psycho-
logical, and neurological conditions have the least (or not
any) use-reports in both countries. On the other hand, the
informant consensus factor (FIC) in medicinal use cat-
egories are, in order of importance, digestive, skin,
muscle-skeletal in Georgia and skin, digestive, muscle-
skeletal in Turkey. There is no statistical consensus in the
ear category in both countries; neither is there any con-
sensus in the psychological and blood category in Turkey.
However, it is noted that low (e.g., eye and neuro) or ex-
ceptionally high (e.g., in psych) FIC values in this table can
be misleading since they were represented by very low use
reports; it should not be interpreted as a high degree of
intracultural variation but it might be a sign of insufficient
documentation of participants’knowledge [64].
To summarize, the most commonly cited and valued
medicinal knowledge/use with high agreement among
participants dealt with the treatment of digestive disorders
in Georgia, whereas it is related with skin complains in
Table 2 Comparison of URs (%) for plant parts used, preparations, and applications in Georgia and in Turkey
a
Plant parts used UR (%) UR (%) Preparations UR (%) UR (%) Applications UR (%) UR (%)
Geo Tur Geo Tur Geo Tur
Leaves 26.66% 25.83% Infusion in water/milk/votka/oil/whey/sugar 47.99% 32.33% Drink 49.41% 37.01%
Aerial parts with flowers 17.77% 19.49% Decoction in water/milk/oil 22.63% 29.91% Plaster 15.76% 22.51%
Fruits 13.98% 10.27% Fresh or mixed with honey/olive/salt/another
plant/beewax/spores/votka/yoghurt/resin
18.25% 23.72% Bath 15.05% 20.54%
Aerial parts 11.26% 11.78% Macerated 4.50% 7.70% Eat 11.02% 11.78%
Flowers 9.36% 8.46% Sweet dishes 2.37% 1.21% Gargle 4.38% 1.06%
Roots/bulbs 5.33% 5.89% Juice (fresh, vinegar) 1.54% 0.60% Chew 1.90% 3.02%
Resin 3.08% 7.10% Warmed on stove 1.18% 1.06% Inhalation 1.07% 2.42%
Seeds 1.54% 4.38% Burned 0.24% 1.96% Embrocation 0.83% 0.60%
Entire plant 3.44% 1.36% Ritual 0.71% 0.45% Headbands 0.24% 0.45%
Branches 1.42% 2.57% Dried and powdered 0.12% 0.76% Ritual 0.12% 0.45%
Young seed cones 1.42% 0.76% As vegetable (pickle, soup) 0.47% 0.30% Fumigate –0.15%
Pollen cones 1.66% 0.15% Tamp 0.12% –
Outer barks 1.54% –Beating of skin 0.12% –
Sap 0.47% 0.76%
Young seed cones
and pollen cones
0.71% –
Inner barks 0.24% 0.30%
Pericarp/husk –0.45%
Aerial roots –0.30%
Heartwood 0.12% –
Receptacles –0.15%
a
Note that the information (words) in each row do not match with each other (see in Table 2for the preparation and application of each plant part). Information
was ranked in accordance of importance based on mean UR (%) values of the countries
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 10 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Turkey, a result possibly pointing to the fact that commu-
nities living in the study area tend to suffer from ailments
of these two medicinal categories. These use categories
also have the highest wild plant richness in both countries.
Skin
As stated previously, skin ailments are the most important
category in Turkey (CI 2.61, FIC 0.76) comprising 29% of
URs, while being the second category in Georgia (CI 3.62,
FIC 0.73), with 19% of the URs (Table 3). Fifty-six percent
of the URs mentioned by participants in Turkey are
related to wound and boil. While Plantago major is the
most important plant for boil treatment, Picea orientalis
and Plantago major are the most important plants for
wound healing in both countries. Plantago major leaves
specifically is used for boils either macerated or plastered
on skin after warming on stove in the study area. The use
of Plantago major for boils and wounds was also fre-
quently cited in the literature [12,16,17,19–21,23,25,
65–72]. On the other hand, macerated resin of Picea
orientalis, locally called “pisi,”is applied as a plaster for
any kind of wound, a widely known application in Turkey,
and is also mentioned for wounds and boils in Georgia.
One unique report describes using it in a homemade
wound healing salve, a mixture of Picea resin, beeswax,
butter and olive oil. Such healing properties of Picea
orientalis are also consistent with applications mentioned
in several sources from Turkey [71,73–76] and one
source from Georgia [14]. In addition, Urtica dioica and
Anthemis spp. are commonly reported species to treat
hair care complaints by participants from both countries.
A bath with water decoction of aerial parts of Urtica
dioica or with the infusion of Anthemis spp. flowers are
stated to treat hair care problems.
Sap of Chelidonum majus is the only shared species
commonly used externally to cure warts in both coun-
tries. Magic rituals are also reported for this skin dis-
order. Alnus glutinosa and Salix spp. are the ones to
cure warts in Turkey. With the former, as many Alnus
glutinosa leaves as the number of warts are hung on the
wall. It is thus believed that the warts will disappear
when the leaves dry and fall to the ground. In the latter
practice, people carve as many notches as the number of
warts in a branch of Salix spp. and keep it over the roof
of the house. The wart is predicted to disappear when
the branch falls from the roof.
Digestive system
The most widely used traditional cures for digestive com-
plaints differ in both countries. In Georgia, the species
with highest cultural importance in this category is Plan-
tago major (CI
s
0.42), whereas in Turkey, Picea orientalis
has the highest CI
s
(0.28) for digestive problems. URs for
Plantago major in Georgia and Picea orientalis in Turkey
mainly stem from stomachache. Among the applications,
drinking a water infusion of the leaves of Plantago major
is commonly known for treating stomachache in Georgia.
The use of Plantago major for stomach-related disorders
was also reported in both countries [12,16,19,66,67,75,
77]. Moreover, fresh resin of Picea orientalis is found to
be commonly used as chewing gum or swallowed for
stomach ache in Turkey. The use of Picea resin for
Table 3 Number of use reports (URs), number of species, CI, and FIC values for each medicinal use category
a
Medicinal use categories Georgia Turkey
♯UR (%) ♯of spp. CI FIC ♯UR (%) ♯of spp. CI FIC
Skin 163 (19.31%) 45 3.62 0.73 193 (29.15%) 47 2.61 0.76
Digestive 203 (24.05%) 51 4.51 0.75 128 (19.34%) 44 1.73 0.66
Respiratory 105 (12.44%) 37 2.33 0.65 75 (11.33%) 34 1.01 0.55
Cardiovascular 100 (11.85%) 50 2.22 0.51 69 (10.42%) 37 0.93 0.47
Muscle-skeletal 73 (8.65%) 25 1.62 0.67 58 (8.76%) 22 0.78 0.63
Genitourinary 69 (8.18%) 35 1.53 0.50 55 (8.31%) 34 0.74 0.39
Ghus 56 (6.64%) 37 1.24 0.35 23 (3.47%) 20 0.31 0.14
Endocrine 39 (4.62%) 24 0.87 0.39 35 (5.29%) 22 0.47 0.38
Neurological 11 (1.30%) 10 0.24 0.10 11 (1.66%) 10 0.15 0.10
Psychological 15 (1.78%) 5 0.33 0.71 2 (0.30%) 2 0.03 –
Blood 6 (0.71%) 4 0.13 0.40 7 (1.06%) 7 0.09 –
Eye 4 (0.47%) 3 0.09 0.33 4 (0.60%) 3 0.05 0.33
Ear –4––2 (0.30%) 2 0.03 –
Total 844 (100%) 126
b
18.8 662 (100%) 109
b
8.95 0.76
a
Use categories were ranked in accordance of importance based on mean CI values
b
As some species are cited in more than one use categories, these numbers (126 and 109) indicating the number of species recorded in Turkey and in Georgia
are lower than the total of number of species recorded for each medicinal use category
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 11 of 20
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stomach-related disorders was also reported in both
countries [12,71,75,76].
Berberis vulgaris is another important species for
digestive problems with similar cultural importance in
each country. Jaundice is the only illness mentioned for
its use in Turkey. Participants frequently called it “sarılık
ağacı”which literally means “the tree of yellowness”in
Turkish. Similarly, it is frequently said to cure jaundice
and liver-associated diseases in Georgia. Drinking of or/
and bathing in a water decoction of Berberis vulgaris
branches are the common mode of applications for jaun-
dice in both countries. Using roots, bark, and also fruits
had been previously noted for treatment of jaundice in
Georgia [78]. An infusion of the fruit in salty water had
been reported to cure jaundice in Azerbaijan [78]. Simi-
lar medicinal knowledge was reported close to the
current study area only in the Turkish province of Erzu-
rum. Bathing and drinking a water decoction of Berberis
vulgaris root, and licking the root of Berberis vulgaris x
crateagina for curing jaundice in this province were
mentioned in several studies [20,65,66,79].
The other commonly mentioned digestive-related
problems and plants are Sambucus ebulus used for con-
stipation and, Anthemis spp. and Quercus petrea species
used to cure tooth ailments. Interestingly, only Quercus
petrea has no mentions in Turkey. Among the applica-
tions, gargling a water decoction of the outer bark of
Quercus petraea is commonly known for treating tooth-
ache in Georgia. There is not any reports of medicinal
usage of Quercus species in previous studies conducted
in the Turkish part of the Caucasus or even in the eth-
nomedicinal review for East Anatolia [80]. However, a
similar use was reported in Georgian sources [81]. Thus,
its unique medicinal use knowledge recorded in Georgia
might be attributed to cultural background as well as to
the remedies written in the literature, especially in ancient
traditional medical books. Indeed, when participants were
asked about the origin of their ethnomedicinal knowledge,
although most in Georgia referred to their elders’know-
ledge as a primary source, some also acknowledged their
primary school education and others recalled Russian bot-
anists who had conducted research in the region. Further-
more, several referred to the fifteenth century Georgian
book “Karabadini,”which had formerly been known as
“Ustsoro Karabadini,”the first almanac of medicinal rem-
edies and medicinal knowledge, written by Kananeli Kar-
aba in the tenth century. A further source of knowledge
mentioned was the “Turmanidze family,”an acknowl-
edged traditional Georgian medical family. Some also
made a reference to Russian medicinal plant guidebooks
and web pages. In contrast, no similar examples was men-
tioned by participants in Turkey, whose sole source of
plant knowledge was their elders and people around. They
also complained about lack of scientifically sound
medicinal plant sources in Turkish. Georgian participants’
multilingualism enabled them to access a diverse range of
literature related to medicinal plants that could account to
some degree for the resulting variation in people’s
ethnomedicinal knowledge across this border.
Respiratory system
In accordance with measures of cultural importance
(CI), diseases related to the respiratory system are the
third most important medicinal category in both coun-
tries. The species with the highest cultural importance
for respiratory diseases are Pinus sylvestris var. hamata.
(CI
s
0.40) and Tussilago farfara (CI
s
0.38) in Georgia. In
contrast in Turkey, Helichrysum rubicundum (CI
s
0.14)
and Rosa spinosissima (CI
s
0.09) are mostly used for
respiratory diseases.
The most common respiratory ailments in Georgia are
cough (30% of respiratory URs), lung diseases (20%), and
bronchitis (15%). Water infusions of young seed cones
and pollen cones, or a mixture of both plant parts of
Pinus slyvestris var. hamata are widely known tea rem-
edies for treating common respiratory diseases. Mainly
pollen, as well as cone, have been reported for these dis-
orders and for asthma, from different parts of Georgia
[12,13,15]. On the other hand, a decoction of the nee-
dles for cough was reported in Azerbaijan [82]. However,
in Turkey, Pinus sylvestris has a very low value (CI
s
0.03). Only the infusion of young seed cones are
reported for cough and asthma with a UR value of 2.
Another treatment reported only in Georgia, to be good
for asthma, bronchitis and lung diseases is a jam made of
young seed cones and pollen cones and also pollen cones
mixed with honey. Indeed, during fieldwork in Georgia,
the sale in local bazaars of fresh Pinus sylvestris cones and
pollens as a medicine was frequently observed, traders in-
viting shoppers to taste their pollen. One participant of-
fered jam made of young seed cones of Pinus sylvestris.
This events revealed the continuing existence of a living
traditional phytomedicine heritage in Georgia. In contrast,
no participant in Turkey gave any clue of similar tradi-
tions related to Pinus sylvestris. In fact, most were aston-
ished to hear of the usage of Pinus cones as a jam.
Although the species is homogeneously distributed across
the study area, and used across the border in various ways
(material, construction, fuel), the greatly contrasting high
medicinal CI values in Georgia and very low CI values in
Turkey might be associated with cultural background of
the communities as well as participants’in Georgia acces-
sing medicinal knowledge in multilingual literature
sources. The high regard of local people for the Russian
name, “sosna,”for Pinus sylvestris might be a reflection of
multilingual literature on medicinal knowledge in Georgia.
Similary, the leaves of Tussilago farfara has a wide range
of uses in respiratory diseases (cough, bronchitis, asthma,
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Content courtesy of Springer Nature, terms of use apply. Rights reserved.
lung diseases) in Georgia but in Turkey it is not reported
in this research, even though it was widely reported in the
literature [12,14,16,17,72,83,84].
Cough (14% of the respiratory URs), throatache (5%),
bronchitis (5%), and asthma (4%) are the most com-
monly mentioned diseases in Turkey. A water infusion
or decoction of Helichrysum rubicundum aerial parts
with flowers, for cough and throat complains, is one of
the most mentioned remedy (10 UR) only in Turkey. Its
use in respiratory disease was scarcely mentioned in the
cited literature in Turkey [65]. A water decoction of
Rosa spinosissima root, mainly for cough and bronchitis,
is another common remedy in Turkey. Furthermore, a
water decoction of its fruits was given for cough which
had also been reported from Turkey before [77]. Water
decoction of roots is also mentioned to cure influenza,
which has also been reported in this and other studies
[23,67]. Interestingly, for Georgia and other neighboring
countries, no use-reports were found to be specified for
Rosa spinosissima (syn. R. pimpinellifolia)orHelichry-
sum rubicundum for these respiratory disorders.
Cardiovascular system
It is the fourth most important medicinal use category
in Georgia (CI 2.22) and in Turkey (CI 0.93).
Hemorrhoid (including its itching symptoms) is the
most widely mentioned complaint among the partici-
pants in Turkey (66 UR, 39% of the cardiovascular URs).
Similarly, in Georgia, it is comprising 31% of cardio-
vascular URs.
In Turkey, Rosa spp., in particular, R. canina (4 UR)
and R. spinosissima (7 UR), are the most important
species used against hemorrhoids. Fruits of R. canina
and roots of R. spinosissima (occasionally their fruits)
are widely known/used for hemorrhoids by participants
in Turkey. A review related to plants used to treat hem-
orrhoids identified Rosa canina as most frequently used
species in Turkey, while Rosa spinosissima (syn. R. pim-
pinellifolia) was mentioned in only one study conducted
in Erzurum in 1999–2000 [79] in which only fruits, not
roots, were reported to be used [85]. Later research did
report the use of roots [66] and several other studies
mentioned the use of fruits [70,77]. The use of fruits
and/or roots together to treat hemorrhoids was also re-
ported as well [65]. However, in this particular fieldwork
in Georgia, among Rosa spp., only Rosa canina (2 UR)
was mentioned for hemorrhoids. Furthermore, neither R.
spinosissima nor R. canina was mentioned for hemor-
rhoids in the sources from Georgia, Azerbaijan, or
Armenia [86]. Gentiana spp. (9 UR) are widely recorded
second species in Turkey for hemorrhoids.
On the other hand in Georgia, Gentiana spp. are the
most important ones, mainly G.septemfida (8 UR) is
used for hemorrhoids. A bathing water decoction or
drinking water infusion of aerial parts with flowers is ap-
plied for treatment. This species has not been reported
for hemorrhoids in the cited literature. Here, high blood
pressure and hearth disease are the other major reports
(65% of cardiovascular URs). The tea of Helichrysum pli-
catum,Mentha longifolia, and Thymus spp. are widely
known to decrease high blood pressure. Crataegus spp.
have notable importance (11 UR) for heart health in
Georgia, where the fruits of these species are eaten fresh,
consumed as compote or drunk as tea. Several studies
from Georgia [12,16,87] and relevant sources from
Azerbaijan and Armenia [88] also mention similar use-
reports of fruits, flowers, or leaves of Crataegus spp.
(mainly C. pentagyna and C. monogyna).
Muscle-skeletal system
Muscle-skeletal complaints are among the top five medi-
cinal use categories in both Georgia (CI 1.62) and
Turkey (CI 0.78) with relatively high FIC values (0.67 in
Georgia; 0.63 in Turkey) in both countries. Bone and
joint pain, and rheumatism problems are widely reported
by the participants in both countries (34% of the
muscle-skeletal URs in Tukey; 74% of them in Georgia).
A bathing in water decoction of Urtica dioica aerial parts
or Equisetum arvense aerial parts is the most commonly
used remedy in both countries. Plastering of body with
fresh leaves of U.dioica is also applied for rheumatism
in the study area. Among the rheumatism reports, local
names given for the species indicate a very diverse
ethnolinguistic background of the communities. The use
of U.dioica for rheumatism is also frequently cited in
the literature [18,20,21,23,65,66,69–71,75,76,83].
These consensus might show the potential activity of the
Urtica dioica for rheumatism. However, Equisetum
arvense for rheumatism was only reported in one litera-
ture [83]. Moreover, a serious muscle-skeletal disease,
rachitism, is mentioned only from Georgia. Bathing in
water decoction or plastering of Tussilago farfara leaves,
and bathing in water decoction of Equisetum arvense
aerial parts are suggested as its remedies in Adjara.
Genitourinary system
In this study, genitourinary disorders are more com-
monly mentioned in Georgia (69 UR, CI 1.53) than in
Turkey (55 UR, CI 0.74). The majority of the use reports
(64%) in Georgia concern the kidneys (kidney stones,
pains, and other kidney diseases), while female (vaginal
discharge, abortion, infertility) and male (prostate) geni-
tal conditions are proportionally more reported (60% of
URs) in Turkey than in Georgia. Helichrysum spp. (H.
plicatum,H.rubicundum) and Rosa spp. (mostly R.
canina) are most frequently mentioned species for kid-
ney related problems in Georgia. Helichrysum spp. were
also widely reported species to cure kidney problems in
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 13 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
the cited literature [18,66,69,70,73,76,77], but Rosa
canina has few reports [18,77]. In addition, Plantago
major is used for various genitourinary diseases in
Turkey. Drinking water infusion of Helichrysum spp.
aerial parts with flowers, and water infusions or decoc-
tions of Rosa fruits are the most common remedy for
kidney-related problems in Georgia, whereas in Turkey
drinking water decoction of Rosa spp. are mentioned to
be good for the prostate. On the other hand, bathing
with Helichrysum spp. is reported for women diseases in
Turkey. Interestingly, there are several plants mentioned
for abortion only in Turkey namely Malva neglecta,
Cephalaria gigantea,Achillea millefolium,Sambucus
ebulus, and Viscum album.
General health and unspecified illnesses
The use of wild plants as preventive medicine for general
health has 6.6% of the total medicinal use reports in
Georgia, while in Turkey this constitutes 3.5% of them.
A cure-all (panacea) and using plants against fever and
pain are the most common emic categories in both
countries. Origanum vulgare,Ribes spp., and Satureja
spicigera species are mentioned for them in Georgia,
while Rosa,Heracleum,andThymus species are men-
tioned in Turkey. Ribes spp. are frequently mentioned
against fever in Georgia, a use not previously specified in
the literature. Moreover, Picea orientalis,Pinus sylvestris
var. hamata,Abies nordmanniana, and Tussilago farfara
are mentioned by participants for use against tubercu-
losis in Georgia. Others have previously reported these
species except Tussilago farfara for the treatment of tu-
berculosis in Georgia [12,16], while a similar record was
made for Picea orientalis in Turkey [71].
Endocrine system
Diabetes is the most commonly mentioned disease in
both countries. It constitutes 69% of the endocrine re-
ports in Georgia and 77% of them in Turkey. Vaccinium
spp. (V.mrytillus,V.arctostaphylos, and V. uliginosum)
and Satureja spicigera are the most important species
used for the treatment of diabetes in Georgia, while in
Turkey, Crataegus spp. (C. monogyna,C. azarolus,C.
pentagyna) and Sorbus aucaparia are the most import-
ant species. Aerial parts of Satureja spicigera mixed with
yoghurt is eaten or water infusion of the aerial part is
drunk in Georgia. On the other hand, water infusion of
young branches of both Vaccinium spp. with leaves is a
widespread application employed for the treatment of
diabetes by participants in Georgia, with one report of
the eating of their fresh fruits. The same details, espe-
cially for V.arctostaphylos, were also mentioned in sev-
eral studies from Georgia only [12,16,17,25]. Similarly,
although less commonly reported, V.mrytillus was men-
tioned in the same ways in Turkey, with fruits or/and
leaves of V.mrytillus having been reported for diabetes
around the study area, and in general in the Eastern
Black Sea Region of Turkey [21,68,73,74]. Moreover,
the eating of fresh ripe fruits of Crataegus spp. and Sor-
bus aucuparia are recorded as the common treatment
for diabetes in Turkey and, although uncommon, the
same use is also reported in Georgia. The utilization of
Sorbus aucuparia against diabetes has not been previ-
ously reported in/around this particular study region ei-
ther in Turkey or in Georgia although its antidiabetic
uses were reported in several sources [89]. Similarly,
Crataegus spp. (C.azarolus var. pontica,C.monogyna,
C.pentagyna) have not been mentioned as antidiabetic
in the cited references (Table S1).
In summary, the six medicinal use categories men-
tioned above are represented by 17 plant species having
at least seven UR in one of these categories in either
country. They are ranked in accordance with the
number of mean UR for each use category in Table 4.
The 15 genera/species with highest CI and their rela-
tive importance in each medicinal use-category are
shown in Figs. 6and 7. It seems that the culturally most
important species are also the most versatile species in
terms of number of different uses. Based on CI index
value, two-thirds of the top 15 genera in both countries
have use reports for at least seven medicinal use catego-
ries. Therefore, the diversity of usage makes these spe-
cies and genera of top priority for our participants’
health, well beings and cultures.
Other medicinal use-categories
The categories with the fewest use reports (URs) in Georgia
are psychological, neurological, blood, and eye complaints.
Similar categories have the fewest reports in Turkey,
namely neurological, blood, eye, psychological, and ear.
Drinking water infusions of Tilia rubra subsp. cauca-
sica flowers is mentioned to be relaxing in Georgia.
Regarding psychological complaints, tea of Clinopodium
grandiflorum,Mentha longifolia, and Hypericum perfora-
tum, seeds of Papaver orientale and flowers of Tilia
rubra subsp. caucasica are mentioned for relaxing, sleep
disorders, and as sedative by participants in Georgia.
While in Turkey, Echinops pungens and Papaver orien-
tale are mentioned for sleep disorders and as sedative.
In the former, water infusion of leaves, while in the latter
tea made of milk infused flowers is used.
As for neurological disorders, ten species are men-
tioned in each countries mostly for headache. Among
these species, only Urtica dioica is shared by participants
in both countries. Other than internal use of these spe-
cies for headache as a tea, some species are applied ex-
ternally as a headbands. Petasites spp. and Rumex
crispus leaves are mentioned for this in Georgia while
Trachystemon orientalis and Urtica dioica leaves are
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 14 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
used in Turkey. Two previous unique reports from the
Eastern Black Sea Region of Turkey also mention the
external use of fresh Rhododendron ponticum leaves for
headache [72,73].
Considering blood-related problems, four species are
given in Georgia. Cornus mas and Urtica dioica are used
for anemia; Rosa canina,Plantago major, and Urtica
dioica for cleansing the blood. All these species have also
been reported for similar diseases in literature sources
[14,18,76,86]. On the other hand, seven species are
named for blood problems in Turkey, six of which are
used for anemia (Rosa spinosissima, Prunus avium,
Hypericum linarioides, Urtica dioica, Prunus laurocera-
sus, Rosa canina), one for iron deficiency (Vaccinium
myrtillus). A report of enhanced blood production of
Vaccinium myrtillus and Prunus laurocerasus have also
been mentioned in Turkey [71,75].
For eye conditions, a drinking water infusion of Vacci-
nium myrtillus leaves and the eating of its fresh fruits
are mentioned to be good for sight in Georgia. These
remedies have also been reported from Georgia [25] and
from Turkey [74]. External application of a water infu-
sion of Salix capraea flower and a water infusion of
Mentha longifolia aerial parts are reported to cure eye
diseases in Georgia. On the other hand, in Turkey, a
drinking water decoction of Crataegus rhipidophylla
fruits and plastering Arctium platylepis leaves are men-
tioned for eye diseases. In addition, bathing with water
Table 4 The most salient species with more than 6 UR for a medicinal category in either country
Latin name UR Georgia UR Turkey
Skin
Plantago major L. 38 65
Urtica dioica L. 27 19
Picea orientalis (L.) Peterm. 8 18
Anthemis sp. 14 7
Achillea millefolium L. 10 5
Digestive
Picea orientalis (L.) Peterm. 8 21
Plantago major L. 19 7
Berberis vulgaris L. 8 14
Anthemis sp. 18 2
Sambucus ebulus L. 16 4
Achillea millefolium L. 12 6
Hyoscyamus niger L. 6 12
Hypericum perforatum L. 9 3
Quercus petraea subsp. iberica (Steven ex M.Bieb.) Krassiln 11 –
Respiratory
Pinus sylvestris var. hamata Steven 18 2
Tussilago farfara L. 17 –
Picea orientalis (L.) Peterm. 9 1
Helichrysum rubicundum (K.Koch) Bornm. –10
Rosa spinosissima L. –7
Cardiovascular
Gentiana septemfida Pall. 8 3
Rosa spinosissima L. 2 7
Muscle and skeletal
Urtica dioica L. 21 23
Equisetum arvense L. 9 5
Genitourinary
Rosa canina L. 9 –
Plantago major L. 1 7
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 15 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
decoction of Teucrium polium species aerial parts with
flowers is reported for babies against hypopyon. Ear
complaints are only mentioned in Turkey with two spe-
cies. Plastering leaves of Arctium platylepis and drinking
water infusion of Tanacetum macrophyllum flowers are
reported to cure earache.
Conclusions
Theresultsofthisstudyindicatethat,duetocombinations
of high plant diversity, multicultural and multi-linguistic
nature of the study area, the richness of traditional plant
wisdom, unique knowledge, and depth of botanical under-
standing of people are reflected in the number of plant spe-
cies they know, with their diverse folk plant names as well
as methods of harvesting, preparing, and using these plants.
Thus, this study area still maintains clear medicinal know-
ledge and practices regarding wild plants. Indeed, more
than half of the distinct ethnomedicinal usage of wild plants
documented in this study have not been reported in the
Caucasus literature before. The majority of this plant
Fig. 6 Cultural Importance (CI) index of top 15 genera in Georgia and their contribution to medicinal use categories. (spp. indicates contribution
of more than one species, while sp. indicates the contribution of only one species)
Fig. 7 Cultural importance (CI) index of top 15 genera in Turkey and their contribution to medicinal use categories. (spp. indicates contribution of
more than one species, while sp. indicates the contribution of only one species)
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 16 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
knowledge is still present, partly in use or at least harbored
in memories. However, especially in Turkey, many of the
reported uses are no longer implemented in practice, only
remaining in the memory of elders who still maintain their
traditional agro-pastoral transhumant lifestyles.
What is striking is the fact that, despite environmental
and floral similarity, common historical/cultural contact,
and similar livelihood strategies, at the present time,
shared ethnomedicinal knowledge/use across the border
is unexpectedly low, forming less than 10% of the re-
ported ethnomedicinal use incidences. It seems that pat-
terns of medicinal knowledge in the study area are
connected with multiple cultural factors, in particular
ethnolinguistic diversity, cultural background, and access
to multilingual written folk and scientific literature.
These factors are shown to be variable among species.
Due to its complex nature, while a generalized definite
conclusion cannot be drawn, access to multilingual liter-
ary sources seems to be one of the most relevant driving
forces to account for the medical plant knowledge pat-
terns in the study area. To better understand the under-
lying factors and driving reasons for the shared and
separate plant knowledge among different communities
on both sides of this international border, future studies
should consider cultural diversity (language, ethnicity),
socio-economic conditions, as well as the political his-
tories of each community. Restricting the comparison
unit to a single plant genus, with structured questions
may provide a more rigorous approach to the evaluation
of patterns and dynamics of ethnobotanical knowledge.
Most importantly, to identify factors that shape medi-
cinal plant knowledge in such a multicultural area,
strong collaboration between local people, botanists, eth-
nologists, ecologists, pharmacologists, linguists, anthro-
pologists, and sociologists is essential for future research
in the field of ethnobotany.
A number of practical implications related to medi-
cinal wild plants have emerged from this study. Firstly,
unique and shared plant species and their use knowledge
documented in this study could encourage further
phyto-pharmaceutical research for the development of
natural botanical-based pharmaceuticals and phytother-
apy practices. It is hoped that these will contribute to
the health, well-being, and livelihood of these communi-
ties, in the Caucasus and worldwide. Secondly, Georgia’s
National Biodiversity Strategy and Action Plan (2014–
2020) has a recommendation for restoring traditional
knowledge of local peoples related to biodiversity con-
servation and sustainable resource use, to be integrated
into their legislation and national strategies by 2020 [87].
In Turkey, a recent Project of the Ministry of Forestry
and Water Affairs has also taken a valuable step toward
documenting biodiversity-based traditional knowledge
[90]. As the links between traditional knowledge and the
conservation of biodiversity receive increasing attention
from the scientific community worldwide, ethnobotan-
ical knowledge and practices related to plant resources
in mountainous regions along the Georgia-Turkey
border might contribute to future cross-border action
plans and policies for plant conservation and manage-
ment of vegetation resources. It is hoped this will add
value to the development of functional models for bio-
cultural diversity conservation, restoration, and sustain-
able uses of natural resources in the Caucasus.
Supplementary information
Supplementary information accompanies this paper at https://doi.org/10.
1186/s13002-020-00415-y.
Additional file 1: Table S1. Medicinal ethnobotany of reported wild
plants in the study area.
Abbreviations
UR: Use-report; FIC: Informant consensus factor; CI: Cultural importance;
ICPC: Index International Classification of Primary Care
Acknowledgments
This study was possible with the help of friendly people from Artvin,
Ardahan, Adjara and Samtskhe Javakheti who shared their knowledge and
experience. We are grateful to them for their willingness to interview and
allocating significant time for us. Heartfelt thanks to all of them. We would
like to thank to our friends Nikita Ivanov, Shota Gelashvili, Nini Khuroshvili, Oli
Lamm, Tamar Nadiradze, Sopo Kiknavelidze and Natalie Kuljanishvili for their
translation of the interviews and field assistance during the surveys in
Georgia. We also thank to our friends Zeynep Türkmen, Nihan Dilşad Dağtaş,
KasımKırlangıç, Dr. Ali Haydar Altuğ, Muharrem Çavuşoğlu, Birsen Civelek,
Utkan Bugay, Bilgen Kazancıand Çağla Kazancıfor their valuable assistance
and support during our fieldworks in Turkey. Many thanks to Prof. Özgür
Eminağaoğlu and Dr. Hayal AkyıldırımBeğen for providing us a work
environment in the Herbarium of Artvin Çoruh University in Turkey and for
their help during identification of the plant specimens. Thanks to Çağatay
Altın and Nature Conservation and National Park Branch of Ardahan for their
concerns during our fieldwork in Turkey. Moreover, many thanks to Dr.
Temur Vasadze, Dr. Nino Memiadze and the staff of the Batumi Botanical
Garden, Goderdzi Alpine Botanical Garden; Dr. Manana Khutsishvili, Eto
Svanidze, and the staff of the National Herbarium of Georgia, Javakheti
Protected Areas Administration and Border police and army in Georgia.
Many thanks to Prof. Zaal Kikvidze for his interest and kind support during
funding applications in Georgia and to all funders including hundreds of
nature and culture lovers who valued and made precious contributions to
our study with their small drops via crowdfunding. We are also indebted to
Dr. Füsun Ertuğfor her long-termed encouragement, love and support for
our ethnobotanical research. We also appreciate the comments and
suggestions of Dr. Marco Leonti and an anonymous reviewer from JEP, Dr.
Andrea Pieroni and anonymous reviewers from JEE leading us to improve
our manuscript. Many thanks to Claire Özel for her comment and efforts for
the revision of the English.
Authors’contributions
CK (ceren.kazanci.1@iliauni.edu.ge) and SO (soneroruc@gmail.com) designed
the study, organized, and conducted all the fieldworks and wrote all sections
of the manuscript together. CK conducted the interviews, identified the
plant specimens, constructed the database, analyzed the data, and
generated all the tables, graphs, and map of the study area. MM (marine_
mosulishvili@iliauni.edu.ge) partially participated in the fieldworks in Georgia,
made advice and revisions during plant identifications and for the
manuscript. All authors read and approved the manuscript.
Kazancıet al. Journal of Ethnobiology and Ethnomedicine (2020) 16:71 Page 17 of 20
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Funding
In Georgia, Ilia State University partially funded the fieldworks of this study
for three summer seasons (2016–2017-2018). GIZ Georgia also partially
supported the fieldworks in 2017 as a scholarship to first author, Ceren
Kazancı. Authors and people in crowd funding contributed to the rest. In
Turkey, funding support for this study was provided from crowdfunding, the
authors’own budgets and the first authors’parents. The funding sources did
not have a role in the writing of the paper or the decision to submit the
paper for publication.
Availability of data and materials
All data generated or analyzed during this study are included in this
published article.
Ethics approval and consent to participate
All interviews conformed to the International Society of Ethnobiology’s Code
of Ethics. Scientific Research and Ethical Committee of Artvin Çoruh
University in Turkey (Issue date-no: 14/02/2018-E.2708) approved the study.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Author details
1
School of Natural Sciences and Medicine, Ilia State University, Cholokashvili
3/5 Avenue, 0162 Tbilisi, Georgia.
2
Faculty of Forestry, Forest Botany, Artvin
Çoruh University, Seyitler Yerleşkesi, 08100 Artvin, Turkey.
Received: 18 May 2020 Accepted: 2 October 2020
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