Journal of Ethnobiology and
Ethnomedicine
BioMed Central
Open Access
Reviews
Ethno-diversity within current ethno-pharmacology as part of
Israeli traditional medicine – A review
Efraim Lev*
Address: Dep. of Eretz Israel Studies and School of Public Health, University of Haifa, Har Carmel, Haifa, 31905, Israel
Email: Efraim Lev* - efraiml@research.haifa.ac.il
* Corresponding author
Published: 09 January 2006
Journal of Ethnobiology and Ethnomedicine 2006, 2:4
doi:10.1186/1746-4269-2-4
Received: 15 November 2005
Accepted: 09 January 2006
This article is available from: http://www.ethnobiomed.com/content/2/1/4
© 2006 Lev; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The Holy Land has absorbed millions of immigrants in recent centuries: Jews from East and West,
Druze, Circassians, Muslim and Christian Arabs. The land is unique and diverse in geographical
location and ethnic groups, and also in its cultural characteristics, including traditional medicine and
use of materia medica. However, these traditions have waned over the years. The young state of
Israel adopted a "melting pot" approach to fashion Jews from all over the world into Israelis.
The traditional medicine and materia medica of different ethnic groups (Yemenite, Iranian, and Iraqi
Jews) are reviewed in this paper, as well as the ethno-botanical survey (first conducted in the 1980s,
covering Bedouins, Druze, Circassians, and Muslim and Christian Arabs), and the matching ethnopharmacological survey (conducted in the late 1990s) covering the medicines sold in stores.
Present-day healers are usually not young and are believed to be the end of the chain of traditional
medical knowledge. The ethno-diversity of Israel is becoming blurred; modernity prevails, and
ethnic characteristics are fading. The characteristic lines of traditional medicine and materia medica
have hardly lasted three generations.
A salient former dividing line between ethnic groups, namely their use of different medicinal
substances, paradoxically becomes a bridge for conservative users of all groups and religions. Shops
selling these substances have become centers for "nostalgia" and preserving the oriental heritage,
traditional medicine, and medicinal substances!
Introduction
The Land of Israel has absorbed millions of immigrants at
the last several centuries. Bedouins and the Druze arrived
on account of internal Middle Eastern politics in the early
Ottoman period (16th–17th centuries). Other different
ethnic groups such as Bosnians and Circassians were
deported from their homelands to the Holy Land by the
Ottomans in the 18th and 19th centuries, the most important ethnic group that stayed in Israel being the Circassians. Later, in the 19th and 20th centuries, at the end of
Ottoman rule and under the British mandate, Muslim
Arabs and fewer Christian Arabs immigrated from neighboring Arab countries in parallel with Jewish immigration, because of the improvement of the economic
situation and opportunities for work.
Jewish immigration to the Holy Land from Eastern
Europe started in 1882, and was followed by several subsequent waves. Yemenite Jews came later, at the beginning
of the 20th century. Most of the next waves of immigration
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were the result of international political events: Jews who
fled Nazi Europe, Holocaust survivors after World War II,
and Jewish refugees from Arab countries, who came after
the establishment of the state of Israel. These newcomers
replaced Arab refugees, who left for neighboring Arab
countries. Since then immigration has continued on a
smaller scale and the most abundant waves have been of
Jews from USSR (1970s to 1990s) and most recently Ethiopian Jews (1990s) and Jews from Argentina (2002–
2004).
These events, which are not the main subject of the article,
along with the religious-political history of the Holy Land,
have created a unique mosaic of a wide range of ethnic
and religious groups. Their existence in such a small land
caused unfortunate and familiar disputes, though from a
purely academic point of view this circumstance creates an
opportunity for research in many fields, among which we
can cite anthropology and ethno-pharmacology.
The land itself is unique, in its natural diversity due to its
geographical location at the meeting point of three continents (Asia, Africa, and Europe), the desert and the Mediterranean Sea, and the Rift Valley. Different climatic,
phyto-geographic, and zoo-geographic zones converge
here, creating great biological multi-diversity [1]. The
region served as an important crossroads for international
trade from early antiquity, between Mesopotamia and
Egypt, and the East (Asia) and West (Europe); this added
to the diversity of the materials used as medicines [2].
The ethnic groups which compose this impressive mosaic
in the Holy Land retained to varying degrees their languages, religions, traditional food, clothing, ceremonial
customs, and traditional medicine, including the use of
special medicinal materials. However, the diversity of
medicinal substances in this land is not a new phenomenon; evidence of the existence of an remarkable inventory
and international trade, caused by factors similar to those
outlined, can be found in the Bible, in classical literature,
in Arabic sources, and in other contemporary historical
sources. The diversity of the medieval inventory of materia
medica has also been researched, and it displays notable
variety [3].
However, cultural traditions have dwindled over the
years, especially in the State of Israel. The young state contributed heavily to cultural homogenization, by imposing
an unwritten rule of the "melting pot" in order to transform Jews from all over the world into new, modern Jews
– Israelis [4]. This approach has accelerated the natural
process of cultural assimilation during the last 55 years.
The unique, distinctive ethnic mosaic of Israel is blurring
rapidly, succumbing to processes of modernity and glo-
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balization. This article sets out to study, understand,
record, hence preserve, ethno-diversity from an unusual
angle, namely traditional medicine in general and the
medical uses of natural materials in particular.
Mapping the mosaic: a cultural, numerical, and
geographical description of the ethnic groups
The population of the state of Israel in 2004 was approximately 6,750,000 people, most of whom (91%) live in
towns and pursue a highly Westernized and modern life
style. The majority consists of 5,450,000 (81%) Jews;
there are several minority groups, mainly Muslims
(1,000,000) and Christians (142,000) [5].
Jewish sector
Eastern Europe, America, and Western Europe
Hundreds of thousands of Israeli Jews, most of whom
arrived from eastern European countries, have immigrated to Israel over the last 70 years; their traditional culture and habits mostly do not include special or unique
traditional medicine [6].
India
More than 23,000 Jews of Indian origin had immigrated
to Israel by 1970. They are a small, united community,
separated into two main subgroups according to their
place of origin in India [6]. They preserve their culture, but
no data regarding special traditional medicine in Israel
have been published.
Yemen
Yemeni Jews arrived in Israel in two waves, one at the
beginning of the 20th century and the other in the 1950s.
It is estimated that altogether about 45,000 Jews from
Yemen immigrated to Israel [6]. A few more families
arrived in the late 1990s; anecdotally the interesting and
vanishing tradition of eating locusts was recorded from
them. Since they were a small community (and for other
anthropological reasons) they have maintained their culture and tradition, including traditional medicine, better
than other ethnic groups. Yemeni Jews are known for their
good health, longevity, and, by contrast, specific diseases.
Iraq
Most of Iraqi Jewry immigrated to Israel between 1948
and 1951; they numbered about 123,500 people. They
came as an organized community and were mainly of
urban origin, and merged well into Israeli society [6]. Yet
they retained their language and some cultural characteristics and traditions, including traditional medicine.
Iran
More than 55,000 Jews have immigrated to Israel over the
years, mainly between 1948 and 1968. Though many others emigrated to the USA, this community has kept its tra-
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dition better than others [6]. Specialized shops dealing in
spices and medicinal substances (with original names different from those of other ethnic groups) still do business
in Tel Aviv and Jerusalem [7].
Kurds
It is estimated that more than 32,000 Jews of Kurdish origin have immigrated to Israel (from both Iraq and Iran).
Most of them came from agricultural areas and small
towns [6]. This ethnic group was scattered over a wide territory in their land of origin and its members did not
engage in well organized communal activity after their
arrival in Israel.
Morocco
More than 200,000 Moroccan Jews immigrated to Israel
during the 1950s and 1960s. This was the biggest North
African ethnic group ever to arrive, although tens of thousands of other Moroccan Jews, including most of their
religious and communal leaders, went to France and Canada [6]. Several traditional characteristics were maintained for several decades, but no proper study of their
traditional medicine has ever been conducted. The data
are scattered in general literature and books on daily life
[8].
Other countries of North Africa
About 100,000 Jews from elsewhere in North African Jews
entered Israel between 1948 and 1970, mainly from Libya
(30,000), Tunisia (40,000), and Algeria (30,000). A large
part of each community, including leaders and wealthy
families, emigrated to France and other locations [6].
Middle Eastern Arab countries
More than 45,000 Jews arrived in Israel (1948–1968)
from Syria (5,000), Lebanon (5,000), and Egypt (35,000)
[6].
Ethiopia
Tens of thousands of Jews have entered Israel from Ethiopia since the early 1980s, in a few large waves and secretly
as a steady flow. This unique ethnic group represents the
most recent influx of Jews to Israel. Their remote origin in
Central East Africa forced this group to keep and preserve
their tradition for centuries due to their isolation, their
strong communal sense, and their powerful awareness of
their Jewish religion. Their circumstances have been studied from diverse angles. Besides interesting social and religious traditions, they brought to Israel an entire culture of
unique foods, spices, traditional medicine, and medicinal
substances [9,10].
Oriental Jews of Moroccan, Middle Eastern, and North
African origin are the best customers at shops selling
spices and medicinal substances in cities such as Jerusa-
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lem, Tel Aviv, Haifa, Acre, Ramlah, and Lod (personal
observations).
Minority groups
Minority groups tend to maintain traditions and culture
better than majority groups. Such seems to be the case in
the State of Israel, although modernization and globalization are not passing the younger generation of these
groups by. The "global melting pot" seems to include
minority groups whose youth tend to prefer general
knowledge more than the traditional. Practical and theoretical knowledge of plants and animals and their uses
tends to be poor among Jewish students as well as among
Muslims, Christians, Druze, and Circassians; very few of
any group show any interest in studying it at all! [Personal
observations and oral communication with other scholars.]
Arab Muslims
These form the biggest minority group in Israel, numbering about one million (16% of the total population). This
ethnic group is geographically concentrated in two major
centers, Galilee and north central Israel [5]. The Muslims
live in towns, cities, and villages.
Bedouins
Muslim by religion, the Bedouin ethnic group comprises
nomadic tribes from neighboring Arab countries, mainly
of Arabian origin. Most of the Bedouin tribes' ancestors
reached Israel around the 7th century CE. Today they live
mainly in two centers: the Negev desert (85,000) and a
much smaller center in the Galilee [11].
Arab Christians
The members of this ethnic group (115,000) constitute
different communities according to their religious affiliation and membership of congregations [5]. Most of the
Arab Christians in Israel form urban communities in
Haifa and Nazareth, and the rest reside in adjacent small
towns and villages.
Druze
This minority community in Israel (100,000) is a closeknit monotheistic religious sect that broke away from
Islam in Egypt in the 11th century. In Israel the Druze live
in 20 villages in the Golan, Galilee, and Mount Carmel. As
a closed sect, they tend to keep and preserve their culture
and traditional habits [5].
Circassians
These are a small minority community (3500), Muslims
of Asian origin, who were transported to the Holy Land by
the Ottomans at the 18th century. Today they live in two
villages in Galilee [5]. They use local non-cultivated
medicinal plants collected in the wild, as well as cultivated
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Table 1: Lists of materia medica compiled among Israeli ethnic groups and minorities
Ethic Group
Plants
Animals
Inorganic
Total
Reference
Yemenite Jews
Iranian Jews
Iraqi Jews
Bedouins
151
65
150
193
21
3
16
42
10
2
15
15
182
70
181
250
[18]
[21]
[20]
[17]
• The data were gathered from diverse sources on different academic levels of research.
• The only group whose members still live an active life in the wild are the Bedouins, so the lists of plants and animals recorded as used in their
medicine are larger than in other groups.
plants, in the manner of their Arab neighbors. No use of
special plant species had been recorded.
Current research overview
During the last 40 years several ethno-botanical and
ethno-pharmacological studies have been conducted with
the aim of learning about and conserving traditional medicine and the medicinal uses of plants, animals, and minerals by different ethnic groups. The studies were done by
different scholars from a wide range of academic disciplines such as medicine, anthropology, pharmacology,
botany, and folklore. Because the data extend over four
decades, and were gathered by different methods and
skills, their analysis and synchronization remain a difficult and even hazardous task, although it is possible. Brief
descriptions and evaluations of the main research studies
are listed below (available quantitative data are shown in
table 1).
An ethno-botanical survey
was conducted in Israel in the 1980s and covered about
100 informants belonging to most minority ethnic groups
(Arab Muslims and Christians, Druze, Bedouins, and Circassians). This survey yielded information on the medicinal uses of some 447 plants [12,13]. Prior to this field
survey a few smaller-scale studies had been conducted
over the years [14]. Several regional surveys have been
published as well [11,15,16].
Bedouins
The traditional medicine of the Bedouins in southern
Israel was investigated by A. Abu-Rabi'a. Himself a
Bedouin born in the Negev, he interviewed dozens of
informants, recording the use of 193 medicinal plants,
wild as well as cultivated [17].
Yemeni Jews
A member of this ethnic group, Y. Raiany conducted
research on their traditional medicine and materia medica
for an MSc thesis in pharmacology, interviewing 57
informants. This unpublished work, recording 151 medic-
inal plants, which was written in the early 1960s [18], has
become an important source, together with newly published book on the special diet and traditional medicine
of Yemeni Jews [19].
Iraqi Jews
A. Ben-Ya'akov researched Iraqi Jews' traditional medicine
and presented it in a two-volume book. It contains a vast
amount of information on the traditional medicine of this
ethnic group in Iraq, the names of healers, and the techniques, methods, and medicinal materials used by Iraqi
Jews in Iraq and in Israel. He interviewed scores of healers,
recorded booklets of some of the most important of them,
and reported on the use of 150 medicinal plants [20].
Persian Jews
The Persian (Iranian) Jews have kept the habit of using
their special traditional materia medica better than other
ethnic groups in Israel. The Persian materials, some of
which are unique and used only by them, have Persian
names and are sold in several instances in specialist shops
in Tel Aviv and Jerusalem [7]. A. Pikel conducted and published research on the traditional medicine of the Iranian
Jews in Israel, based on interviews with a few remaining
healers, describing the substances (65 medicinal plants)
and their uses [21].
Ethiopia
A study on their materia medica is being conducted in
Israel. We found it extremely hard to obtain information
from the healers for fear of competition and other reasons. Israeli-born students were not acceptable as interviewers; students of Ethiopian origin did better, but still
not well enough – they recorded only the basic materials
(personal observation). Research of the medicinal substances of the Ethiopian Jewish community in Israel will
apply qualitative methods based on accepted ethnobotanical and ethno-pharmacological principles [22,23].
We intend to interview twenty prominent elderly sages of
this ethnic group who are known as healers, or are sons of
well known healers. Ethiopia has a unique bio-diversity,
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Table 2: Quantitative data on materia medica of the Land of Israel
(ethno-pharmacological market survey)
Origin
No. of materials
Percentage
Animals
Inorganic
Others
Plants
Total
20
19
7
264
310
6.5
6.1
2.3
85.1
100
and a great many medicinal plants used and traded extensively in the past have been recorded among its wild flora
(e.g., kinds of myrrh and frankincense).
The ethno-pharmacological survey
The survey of the late 1990s complemented the ethnobotanical survey of the 1980s. It covered medicinal materials purchased at stores and not available in the wild. The
survey made it possible to prepare a summary list of all
the materials in use today in Israeli traditional medicine.
This list opens a window to a whole and usually hidden
world of medicine, traditions, and customs that still persist in Israel and neighboring countries [7,24]. It includes
information regarding medicinal substances of all ethnic
and religious groups in Israel. The numerical data are
summarized in Table 2.
Missing from the list may be wild plants known to be used
in folk medicine today, as they were used in the past.
These plants are still gathered by the traditional healers or
by the patients themselves in open spaces, and are not regularly sold on the markets or at spice and drug vendors'
stores. Other ethno-botanical studies examined some of
these plants and their uses among the diverse communities and minorities in Israel [12]. The combined results of
our survey and those of the ethno-botanical surveys provide a reliable picture of the totality of folk medicinal
materials in use among the many and varied religious and
ethnic populations in Israel. The researchers who conducted the ethno-botanical survey published a comprehensive list of the medicinal plants of Israel, including
wild flora; that list contains 447 species of plants [13].
Together, the data yield a theoretical (potential) inventory
of 629 materials (table 3).
Discussion
The materia medica
Plants
Plants yield most of the medicinal materials, a persistent
feature evident in medical literature throughout history
[3,24]. The vast majority of plants sold in the stores as
popular remedies are cultivated, and only a few are wild.
This is understandable, particularly considering the argument that wild plants are collected privately and used
widely on a non-commercial basis by the patients or folk
healers; this is why they were not found in the shops or
included in our lists. However, the greater part of the local
medicinal plants (447) are wild, and far fewer (28) are
cultivated: almonds, apple. beet, carrot, eggplant, garlic,
lettuce, olive, onion, pomegranate, quince, radish, and
spinach.
Geographical location is crucial issue in the case of the
wild plants, mainly due to the unique differences in,
hence bio-diversity of, climate (temperature, humidity,
wind, rainfall), elevation, soil, and other abiotic characteristics. The wild flora of the Land of Israel's southern
(Negev) and eastern parts (Rift Valley and Judean desert)
consists of desert and tropical plants, while the northern
part (Carmel, Galilee, and Golan Heights) is more replete
with Mediterranean species.
The Druze of the Golan Heights, Mount Carmel, and Galilee, as well as the Bedouins and the Arab Muslims and
Christians of the Galilee, mainly use common wild plants
such as knee-holly (Ruscus aculeatus L.), laurel (Laurus
nobilis L.), lemon balm (Melissa officinalis L.), rue (Ruta
chalepensis L.), sage (Salvia fruticosa L.), and wild majoram
(Origanum syriacum L.) [11,12,15]. These are wholly different from the desert plants that are used regularly by the
Bedouins of the Negev and the Judean Desert, such as ben
tree (Moringa peregrina L.), Syrian rue (Peganum harmala
L.), toothbrush tree (Salvadora persica L.), Judean wormwood (Artemisia judaica L.), and white wormwood (Artemisia herba-alba Asso.) [11,13,17]. A few plants that grow all
over the country are used by all religious and ethnic
groups in northern as well as southern Israel and the Middle East; two examples are the castor oil plant (Ricinus
communis L.) and Christ thorn (Ziziphus spina-christi
Willd.) [25]. There are very few inter-ethnic differences in
Table 3: Quantitative data on Materia medica of the Land of Israel (including the ethno-botanical survey)
Origin
Wild/Local
%
Domesticated
local
%
Imported
%
Total
%
Animals
Inorganic
Others
Plants
Total
8
2
2
447
459
40
10.5
28.6
76.9
73.2
3
28
31
15
4.8
4.9
9
17
5
106
137
45
89.5
71.4
18.3
21.9
20
19
7
581
627
3.5
3.0
1.1
92.4
100
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Table 4: Lists of materia medica compiled in some Middle Eastern countries
Country
Plant
Animal
Inorganic
Other
Total
Source
Syria
Jordan
Israel
189
236
264
11
30
20
31
29
18
13
9
7
244
304
309
[39, 40]
[38]
[24, 26]
the use of wild medicinal plants in Israel apart from those
due to climate and geography. An example of such a difference in use of cultivated plants is Jews mallow (Corchorus olitorius L.): it is eaten and used for medicinal purposes
by Muslims, Christians, and Jews of diverse origin, mainly
Yemen, Egypt and Iraq. But due to religious laws it is not
consumed or used medicinally by the Druze [3,24,26].
In this research, spices and condiments are included as
medicinal substances, in addition to their important role
as foodstuffs. Almost all of them are known as medicinal
plants in different cultures. The different Israeli purchasers
and consumers of medicinal plants buy spices and condiments for their medicinal properties, their nutrition, and
in some cases even as incense (e.g., cinnamon).
Animals
The use of animal organs and products did not flourish
towards the end of the second millennium; this is understandable in light of changes of patterns of medical practice among consumers of traditional medicine, and
perhaps also in connection with changes in moral standards and attitudes to animals and their use in medicine
[24,27]. Nine substances are imported into Israel; however, the data clearly show that most (8) of the local
medicinal materials obtained from animals originate
from wild species, and only a minority (3) from domesticated species. A possible explanation is the massive stock
of animal products in the general stores; also, patients and
folk healers may prefer to buy products such as cheese,
milk, meat, eggs, chicken, and animal parts, which are
used in folk medicine, in non-specialist shops, where
good quality and freshness is promised. Therefore, the
folk remedy vendors in the shops and markets sell mainly
traditional products derived from wild species and special
animal products unavailable in regular shops, such as wax
and hard dry cheese. Because most of the population in
Israel is urban and far from wild animals, and because the
nature preservation laws are strictly enforced, products
from wild animals are found in only few shops [28].
Geographical location is crucial in this case too; for example, the Sinai desert Bedouins make medicinal use of several Red Sea animals [29].
Inorganic
Inorganic material likewise is used much less than plants.
The explanation for this discrepancy seems to lie in the
users' perception that some inorganic materials used in
the past are poisonous. We may also mention that in the
past too, in all cultures, inorganic substances formed only
a small part of the inventory of medicinal materials
[24,30-32].
Origin
The great majority of the materials used in folk medicine
in Israel are of local origin, very few being brought in from
other countries. A comparison makes clear that wild and
cultivated plants, for eating and for use in folk medicine,
are collected in open areas, fields, and plantations by
patients, healers, and folk medicine practitioners. These
plants did not appear in the survey of shops and markets,
but we made a point of not overlooking their use. Recall
also that a large proportion of the imported plants that
appear in the list are spices originating in Asia, as well as
local and imported condiments. These are used by regular
customers for seasoning and cooking, but as noted in
many cases are also used as medicinal plants in local ethnic folk medicine.
Past versus present
From analysis of the list of materia medica we can learn
sources of the various materials and past and the present
trade routes. We can also test claims arising from historical research that a local medical and pharmacological tradition existed in Israel and its surroundings, and the area
served as a junction for the transit of medicinal materials
and as a base for exporting many other materials. Information on the inventory of the materia medica used in the
Holy Land in the Middle Ages, prior to the waves of immigration, is available [3,26]. So is a rare record of a visit to
the markets by the Swiss physician Dr. Tobler at the mid19th century [33,34].
Israel compared with neighboring countries
Supporting information regarding the traditional uses of
natural medicinal substances, may be derived from ethnobotanical and ethno-pharmacological surveys conducted
in neighboring countries such as Egypt [35-37], Jordan
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Table 5: Reconstructed core inventory of Middle Eastern materia medicaInorganic
Name
Main Uses
Alum
Citric acid
Galena
Lead
Sulfur
General tonic, reduces liver size, disinfection
Digestive aid
Cosmetic, eye diseases
Skin diseases, evil eye
Fertility, skin diseases
Animals
Scientific Name
English Name
Part or Product
Main Uses
Apis mellifera L.
Physeter catodon L.
Scincus scincus L.
Sepia officinalis L.
Honey bee
Ambergris
Medical skink
Cuttle fish
Wax & Honey
Secretion
Dry body, Skin
Skeleton
Purgative, reduces eye inflammations, sore throat, burns, coughs
Reinforces potency, kidneys, and General
Fertility of men and women
Skin diseases, mania
Scientific Name
English Name
Part or Product
Main Uses
Aloe vera L.
Alpinia galanga willd.
Artemisia herba-alba Asso.
Boswellia carteri Birdw.
Cassia acutifolia Delile.
Cinnamomum zeylanicum Nees.
Coriandrum sativum L.
Crocus sativus L.
Cuminum cyminum L.
Curcuma longa L.
Elettaria cardamomum White & Maton
Eugenia caryophyllata Thumb.
Foeniculum vulgare Mill.
Glycyrrhiza glabra L.
Laurus nobilis L.
Lawsonia inermis L.
Lepidium sativum L.
Linum usitatissimum L.
Matricaria aurea Boiss.
Mentha spicata L.
Myristica fragrans Houtt.
Nigella sativa L.
Olea europaea L.
Peganum harmala L.
Petroselinum sativum Hoffm.
Pimenta officinalis Lindl.
Pimpinella anisum L.
Pinus pinea L.
Piper nigrum L.
Pistacia lentiscus L.
Prunus mahaleb L.
Rhus coriaria L.
Rosa sp.
Rosmarinus officinalis L.
Saccharum officinarum L.
Salvia fruticosa L.
Sinapis alba L.
Tamarindus indica L.
Trigonella foenum-graecum L.
Zingiber officinale Rosc.
Aloe
Galingale
Wormwood
Frankincense
Senna
Cinnamon
Coriander
Saffron
Cumin
Turmeric
Cardamom
Clove
Fennel
Liquorice
Laurel
Henna
Garden-cress
Flax
Chamomile
Mint
Nutmeg, mace
Black cumin
Olive tree
Syrian rue
Parsley
Pimento
Anise
Stone-pine
White pepper
Mastic tree
Perfumed cherry
Tanning sumach
Rose
Rosemary
Sugar cane
Sage
Mustard
Indian date
Fenugreek
Ginger
Juice
Root
Foliage
Resin
Leaf
Bark
Seed
Stigma
Seed
Root
Fruit
Flower
Seed
Root
Leaf
Leaf
Seed
Seed
Flower
Branch
Seeds and fruit peels
Seed
Oil
Seed
Seed
Fruit
Seed
Seed
Fruit
Resin
Seed
Fruit
Water, flowers, fruits
Foliage
Juice
Leaf
Seed
Fruit
Seed
Root
Skin diseases, heals wounds, purgative
Cleans digestive system, reproductive system problems
Asthma, sore throat
Flatulence, heart diseases, general tonic
Purgative
Cleans the female genital system after childbirth
Reduces sugar, stomachache
Sore throat, blood pressure
Flatulence
Disinfects sores
Blood sugar, stomach acidity
Local anesthetic, general remedy
Stomachache, intestinal diseases
Heartburn, coughs, blood cleansing
Arthritis, sugar in blood
Wound healing, hemorrhages, fungi
Stomachache, hair strengthening, aphrodisiac
Hormonal regulation, calcium supplementation
Respiratory canals, stomachache
Flatulence, acidity neutralization
Intoxicant, aphrodisiac, painkiller
Dizziness, sugar in blood
Skin diseases, many medications
Tonic, heart diseases, sugar in blood
Kidney stones, impotence
Stomachache, flatulence
Stomachache, aphrodisiac
Tonic
Coughs, reinforces stomach
Heartburn, soothes stomach
Digestive system, children's pains, flatulence
Perspiration stimulant, diarrhea, cholesterol reduction
Perfume production, cleanses facial skin
Kidney stones, sugar in blood
Tranquilizer, tonic, respiratory canals
Hemorrhages, intestinal diseases and pains
Pains and infections
Cleanses blood and stimulates circulation
Sugar reduction, diuretic
Flatulence, digestive system, impotence
Plants
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[38], Syria [39,40], Lebanon [41], and other Middle Eastern countries [42] (see Table 4).
Other surveys have been conducted in the countries of origin of some Jewish ethnic groups mentioned in this study
such as Iraq [43,44], Iran [44], Libya [45], Egypt and
Morocco [42], and Yemen [39]. These helped us to identify the special materials and better understand their
inventory and regional uses.
Core inventory
Horizontal study and analysis of the materia medica of all
the different ethnic and religious groups in Israel [7,1721,24] revealed a core inventory (the most important and
used substances of all Israeli ethnic and religious groups,
according to market and literature surveys), which we
believe satisfies the basic needs in traditional medicine of
any Middle Eastern ethnic group [38-40,42-44]. It consists
of about 40 plant materials, five animal, and five inorganic. Each ethnic, religious, or geographic group has a
further 100–150 general materials and a dozen special
materials, mainly plants, usually of local origin, which are
uniquely its own. In most cases these materials bear special local names! The core inventory is alike for most Middle Eastern ethnic groups, so its items will be available in
most shops. It is presented in Table 5.
Geographical aspects
International geo-diversity
International geographical location is an important factor, especially considering the different ethnic Jewish
groups. Each group, according to its geographical origin,
brought to Israel the customs of using local medicinal
plants which were common there. Thus the Jews that
came from Syria and Lebanon did not bring with them
ways of using different substances from those that prevailed among the local Arab population in Israel. But Jews
who immigrated from more distant parts, such as Iran,
Iraq, Yemen, India, Ethiopia, or North Africa, introduced
their own ways of using local substances or those
imported from their homeland, the latter often being
exotic. In general, they bought their special medicinal substances as well as their traditional spices and condiments
at the town markets of their new home, Israel. However,
during the 1950s and 1960s some of the newcomers, in
particular the healers, might have gathered some local
wild plants (non-cultivated) near their dwelling places.
These could be the borderland in the north or south of
Israel, where the development towns were located to
absorb the mass immigration, or farms and small villages
where they were placed by the immigration authorities.
Since the 1970s this phenomena has become very rare,
and no research has recorded new immigrants of the last
few decades such as Ethiopian or Yemenite Jews collecting
wild plants for medicinal uses.
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However, in the markets of big cities and towns such as
Jerusalem, Tel Aviv, Ramlah, Lod, Tiberias, and Haifa, and
in other small towns, where groups of new immigrants of
particular origin reside, specialist shops do exist, selling
ethnic foods, spices, and medicinal substances, especially
plants imported from Ethiopia.
We have chosen to enumerate here, as an example, some
of the special, and common medicinal plants of the Yemeni, Iranian, Iraqi, and Ethiopian Jews. The aim is to help
the reader understand the characteristic features of these
ethnic groups, and to highlight the differences among
them, in contrast to the similarities that emerge from the
core inventory presented in table 5.
Yemeni Jews
asafetida (Ferula assa-foetida L.), Christ thorn (Ziziphus
spina-christi Willd.), common jujube (Ziziphus jujube
Lam.), pine tar (Pinus sp.), katarn (Cedrus sp.) purging cassia (Cassia fistula L.), screw pine (Pandanus odoratissimus
L.) [18,19].
Iranian Jews
alhagi manna (Alahgi graecorum Medic.), areca nut (Areca
catechu L.), basil (Ocimum pilsum L.), descurainia
(Descurainia sophia (L.) Webb.), lallemantia (Lallemantia
royleana (Wall. ex Benth.) Benth.), matchbox bean (Entada
scandens Benth.), white pilsum (Ocimum canum Sims)
[7,21].
Iraqi Jews
bdellium tree (Commiphora mukul Engl.), black myrobalan (Terminalia chebula Retr.), sweet lemon tree (Citrus
limetta R.), sweet violet (Viola odorata L.), yellow myrobalan (Terminalia citrina Roxb.), white willow (Salix alba L.)
[20].
Ethiopian Jews
black mustard (Brassica nigra Koch.), henna (Lawsonia
inermis L.), Madagascar cardamums (Amomum angustifolium Sonner.), Niger seed (Guizotia abyssinica (L.f.) Cass.),
mustard collard (Brassica carinata L.), spinach rhubarb
(Rumex abyssinicus Jacq.) [46,47].
The geography of trade in materia medica
The trading habits of the drug sellers reflect the actual
demands of the community of clients they serve. In-depth
investigation shows that the relationship and affiliation
with suppliers in Arab countries is a matter of geography,
whose chart is a relic of the pre-modern political map. The
only traditional drug seller working in Nazareth has family ties in Jordan, and used to buy special materials,
mainly of animal and mineral origin (which are rarely
imported into Israel by Jewish dealers due to low demand
and strict laws), in the city of Shechem (Nablus). Since the
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Journal of Ethnobiology and Ethnomedicine 2006, 2:4
peace agreement between Israel and Jordan was signed, he
has imported them directly; his preferred suppliers are in
the northern cities and towns of Jordan. On the map of
the state of Israel and its Arab neighbors, the family and
business connections and affiliations in many fields,
including imports of materia medica, are quite evident
[Shechem & Jenin – northern Jordan and Amman; Jerusalem & Ramallah – Amman; Hebron – Egypt] [24]. This
phenomenon is not unique to Israel: in an ethno-pharmacological survey conducted in Jordan we discovered a similar geo-diverse relationship with the other Arab
neighboring countries. This system affects the types of
substances in the shops, and reflects the impact of these
countries on the local inhabitants. Drug sellers in northern Jordanian cities have ties with Syria and Lebanon and
stock special Syrian and Lebanese materia medica, those in
the central and eastern cities sell to Iraq and Iran, and
those in the southern cities deal with Egypt, Yemen, and
Saudi Arabia [38].
The practice and business of traditional medicine
Present-day healers
Clearly, present-day healers, regardless of origin or religion, are not young, and rarely are their children willing
to learn from them! In my opinion, the current generation
of traditional healers in most of the aforementioned ethnic groups represents the end of a chain of medical knowledge that started in prehistory. In today's world, where
modern Western medicine dominates, it is the task of the
ethno-botanist and ethno-pharmacologist to collect the
remnants of information and knowledge and conserve
them for use in the future.
Healing methods
The healing methods are varied (diets, aromatic baths,
medicinal potions, pills, ointments, inhaling aromatic
plants, steam, etc.) and are not the topic of this article. In
most cases, though, they are based on medieval Arab medicine [48-50] which in turn was based on classical
Hippocratic-Galenic methods and theory. The uses of the
materia medica and the pharmacology derive from Arabic
sources. Examples are books by the medieval Jewish
(Karaite) physician Ibn Abi 'l-Bayan, al-Dustur al-Bimaristani (The Hospital Handbook) [51] and by al-Kohen al'Attar, Minhaj al-Dukkan (The store guide) [52], and classical sources such as Dioscorides [53]. One historical casestudy of medieval medical theories practiced in the Levant
revealed traces of the use of the doctrine of signature [54].
Interestingly, evidence of similar usage has been detected
in present-day traditional applications of medicinal
plants in Israel [55]. A survey made on the use of the
Solanaceae species in traditional medicine in Israel clearly
indicated that healers deliberately avoided the use of narcotic agents found in this family [56]; another survey
http://www.ethnobiomed.com/content/2/1/4
examined the role of Labiatae among medicinal plants in
Israel [57].
Present-day traditional drug vendors
Another phenomenon is that the drug shops are usually
operated by young people (30–50), sometimes the third
generation of drug sellers; yet their education is not of a
high level and they lack crucial knowledge. When they are
asked a specific question, they look at one of the abovementioned books or call their elderly parents who consult
the book at home! I have seen several cases of a seller who
learned about the medical use of one of the plants in his
shop from a client, and conveyed it to the next customer
when asked about its uses.
In the special inter-religious/ethnic relationship in the
materia medica trade it is common, for example, to see
Arab Muslim or Christian dealers from Nazareth, Acre, or
Jerusalem buying imported Indian products from a shop
in Tel Aviv owned by a Jewish Yemeni. Sometimes they
will sell the same products to Ethiopian or Moroccan
Jews, as well as Arab Muslim and Christian women, in
their shops the next day.
Shops selling traditional materia medica
The number of shops in the Arab sector and the Jewish
sector has been falling steeply, although the number of
modern shops selling spices and "modern" alternative
medicinal materials is increasing (in most cases they sell
identical substances, but in fancier packaging). The large
and well established shops have survived this process by
selling other goods besides spices, grains, and medicinal
substances. Lately, as mentioned above, a few new specialist shops have opened near neighborhoods with a high
percentage of new immigrant Ethiopian Jews. These shops
supply food, spices and materia medica, mostly imported
from Ethiopia by specialized traders [46,47].
The "customers"
The customers
Customers are from all religious and ethnic groups,
though traditionally they would look for a shop holding
stock comprising the special material of their own ethnic
group.
Minorities sector
No major differences were found in the traditional medicine habits of the different minority religions (Muslim,
Christian, and Druze). However, diversity enhanced by
geographical location (geo-diversity) is a common feature, mainly expressed in gathering plants in the wild.
Jewish sector
The inventories of the Jewish ethnic groups when compared with surveys made in their countries of origin
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Journal of Ethnobiology and Ethnomedicine 2006, 2:4
showed, not surprisingly, that the Jewish communities
practice similar traditional medicine, both in healing
methods and medicinal substances. The explanation lies
in the history of the region: in the Middle Ages the Islamic
world, where for centuries Syria, Iraq, and Egypt consecutively constituted the center, Jews and Muslims maintained very close relations, including business
partnerships. Many Jews were physicians, pharmacists,
drug sellers, and potion makers, and they ran international businesses, trading mainly in materia medica [58].
Jews treated the rulers, sometimes the highest religious
authorities of the country; they were admired by the Muslim physicians and wrote some of the most important and
widely read medical books. These were of immense
importance, and as mentioned, are used by Muslim drug
vendors in Israel and the Arab countries to the present day
[37]. Accordingly, the hundreds of thousands of Jewish
refugees and new immigrants to Israel from the Arab
world satisfied their basic demand for their familiar materia medica at Arab shops. At first this occurred mainly in
the big cities, where Arabs lived alongside Jews, for example, Acre, Beer Sheba, Jerusalem, Nazareth, Lod, Ramlah,
and Tel Aviv-Jaffa. Later, new shops were opened by members of the ethnic group, some of whom traded with their
home countries, (in many cases hostile to the state of
Israel) in order to supply the demand for special ethnic
materials.
General aspects
"Melting pot" results
Over the years modernization, globalization, and intercommunal marriage have blurred the main ethnic characteristics and differences such as appearance (hair, skin,
and eye color), language (accent, vocalization), and customs (food, religious ceremonies). The typical features of
traditional medicine and the inventory of materia medica
have hardly lasted three generations in modern Israel.
Here is one example from my experience: young Ethiopian students who were born in Israel have no knowledge
of, nor any desire to learn, the traditional medicine of
their ethnic group. Moreover, some of them can hardly
communicate with their grandparents due to lack of adequate language abilities (personal observations).
Recording traditional medicine and materia medica
Several ethnic groups have not been studied, and their
unique knowledge of traditional medicine and medicinal
substances has not been recorded. These include mainly
Jews from Morocco, Libya, Algeria, Syria, Lebanon, Egypt,
India, Ethiopia, and other eastern parts of the world. With
the help of academics these communities should make a
last-ditch effort to preserve their knowledge for future generations.
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Demands and availability
Inter-ethnic and religious borders are fading rapidly with
time; many medicinal materials described in the books no
longer exist on the market. The cause is economic: without real demand, the drug vendors will not make any
effort to buy these substances in Israel or abroad. The
same picture is elicited from the Cairo Genizah in letters
of Jewish traders in materia medica. They would exchange
information, mainly those at the great seaports around
the Mediterranean, about demand and prices, and act
accordingly [58].
The borders of Israel, Jordan, Egypt, and Morocco are
open today, so theoretically it is possible buy, indirectly,
any desired medicinal substances from any Arab country.
However, buying exotic and expensive substances bears
unnecessary financial risks – especially in the present-day
Middle East, which is unlike modern Europe where the
border-crossing is unhindered. Anyone entering any Middle Eastern country is subjected to stringent customs and
security checks. Therefore, the market in special products
from Morocco, Iran, and lately Ethiopia, which flourishes
today, will dwindle markedly in the next few years as the
rising generation loses interest in such products.
Conclusion
The study of folk medicinal materials available in shops
uncovered the remains of ancient medical practices that
still exist in traditional societies and ethnic groups in
Israel and in various other countries and cultures around
the world. Due to its geo-diversity, bio-diversity, and
ethno-diversity, the Land of Israel is an in-situ laboratory
for a variety of processes that are studied by scholars of
different fields, and should continue to be studied by
more. The ethno-pharmacological surveys conducted in
the Middle Eastern countries in the last 15 years are
important. They recorded the materia medica, medicinal
knowledge, and actual demand at the time they were
made. Information on wild medicinal plants was gathered
in a few ethno-botanical surveys.
Differences between the traditional medicine of various
ethnic groups, slight as they are, still exist, and were presented above in the sense of medicinal plants used
uniquely by them according to their origin (in the case of
the different Jewish ethnic groups) or subsequently, in the
case of local Arab inhabitants, according to their geographic (latitude) locations. Similarity among these ethnic groups lies first of all in the use of the same basic group
of medicinal substances, presented above as the "core
inventory" of materia medica. It also features in the sense
of using similar healing techniques (Hippocratic-Galenic,
improved by the Arabs), the importance of beliefs in
saints, magic, admiration of holy graves or trees, use of
amulets, etc.
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Journal of Ethnobiology and Ethnomedicine 2006, 2:4
However, the main traits of traditional medicine and
materia medica appear to have hardly survived three generations. At the very start of the third millennium only a
small minority of the population of each ethnic group, in
the Jewish sector as well as in the Muslim and Christian
ones, practice traditional medicine at all. We can assess
that the present users as well as the healers are mostly old
people (70–80 years old) and their second generation
(50–70 years old). Member of the youngest generation, in
most cases, ignore or are even ashamed of these channels
of healing and prefer to use modern medical services.
http://www.ethnobiomed.com/content/2/1/4
13.
14.
15.
16.
17.
18.
19.
An interesting issue, however, is that one of the most distinct former dividing lines between ethnic groups, namely
the use of different medicinal substances, has paradoxically become a bridge linking conservative users of all
groups and religions. Shops selling these substances have
nowadays become centers for "nostalgia" and the preservation of the eastern heritage, folklore, food, spices, traditional medicine, and medicinal substances!
24.
Acknowledgements
25.
The article is dedicated to the late Prof. Dan Palevitch, one of the most
important ethno-botanist and ethno-pharmacologist in Israel. This research
could have not taken place without the generous support of St. John's College, Cambridge, which hosted me as an Overseas Visiting Scholar (2003–
2004). I would like to express my thanks to all researchers who have studied traditional medicine, ethno-botany, and ethno-pharmacology in Israel
and around the Middle East, especially to my colleagues A. Dafni and Z.
Yaniv, from whom I learnt so much. I am deeply indebted to Z. Amar for
his cooperation in years of collaboration on several research projects.
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