University of La Salette College of Medicine and Medical Allied Programs B.S.

Pharmacy

In Partial Fulfillment of the Requirements in Technical Writing A Research Paper entitled:

Level of Awareness and Extent of Utilization of the Ten Medicinal Plants Approved by the Department of Health In Purok 5, Barangay Plaridel Santiago City

Submitted to: Mrs. Merly D. Agura, Professor

Juancho Martin T. Soriano BS-Pharma 3B January, 2014

INTRODUCTION
The Philippines is abundant with botanical or herbal medicines. In ancient times, in the absence of technology, the forefathers depended on the potent healing powers and herbal medicines to cure diseases. Today however, modern living dictates that we should take medications that are prescribed by doctors that usually come in tablet or capsule form. Prescribed medicines can be costly and may be out of reach from the larger population relying on meager income. The Department of Health (DOH) launched in 2002 a campaign to promote the various local herbal medicines available. The project is to provide the Filipinos medicines that are reasonably priced. The DOH wants to promote the manufacture and use of medicines from herbal plants that are found within the Philippines lush flora. Woman stands to benefit more from these herbal medicines because they are usually more open to alternative healing than men. The Department of Health prioritized 10 of these herbal plants during the information drive. These 10 herbal plants were subjected to major studies to find out their viability as alternative drugs to be marketed commercially. The ten herbal plants are: Lagundi, Sambong, Tsaang Gubat, Akapulko, Bayabas, Bawang, Ampalaya, Niyug-niyogan, Yerba Buena and Ulasimang Bato. Lagundi or Vitex negundo is a large shrub native to the Philippines which has been used as a traditional herbal medicine for centuries. Research on lagundi conducted by the Philippine Department of Health has suggested that the plant has a number of practical uses and the use of lagundi is actively promoted by the government. Lagundi have been used for a wide variety of complaints traditionally, although scientific research has concentrated on its use for respiratory complaints. Lagundi is generally accepted in the Philippines to be useful for coughs, asthma symptoms, and other respiratory problems, and the Philippine government actively promotes it as an alternative to Western cough medicines. Sambong is an amazing medicinal plant. It is an antiurolithiasis and work as a diuretic. It is used to aid the treatment of kidney disorders. The Sambong leaves can also be used to treat colds and mild hypertension.

Since it is a diuretic, it helps dispose of excess water and sodium (salt) in the body. Tsaang Gubat is a shrub (small tree) that grows (from 1 to 5 meters) abundantly in the Philippines. In folkloric medicine, the leaves has been used as a disinfectant wash during child birth, as cure for diarrhea, as tea for general good health and because Tsaang Gubat has high fluoride content, it is used as a mouth gargle for preventing tooth decay. Research and test now prove its efficacy as an herbal medicine. Aside from the traditional way of taking Tsaang Gubat, it is now available commercially in capsules, tablets and tea bags. Akapulko is used an herbal medicine and is a shrub that grows wild in the tropical climate of Philippines. Akapulko is widely used in the Philippines as herbal medicine. The Akapulko leaves contain chrysophanic acid, a fungicide that is used to treat fungal infections, like ringworms, scabies, and eczema. Akapulko leaves are also known to be sudorific, diuretic and purgative, used to treat intestinal problems Including intestinal parasites. Akapulko is also used as herbal medicine to treat bronchitis and asthma. Niyug Niyogan is large climbing shrub. Leaves are oblong and opposite, rounded at the base. The most Frequently encountered species, and the one often simply referred to as the guava, is the Apple Guava (Psidium guajava). Guavas are typical Myrtoideae, with tough dark leaves that are opposite, simple, elliptic to ovate and 5-15 cm long. The flowers are white, with five petals and numerous stamens. Yerba Buena is an important medicinal plant. Primarily a pain reliever, it is also used in gaseous distention and as mouthwash. Bawang (garlic) has been used for culinary and medical purposes throughout history, and also has a reputation as a repellent of irritants from mosquitoes to vampires. Ampalaya is specifically used as a folk medicine for diabetes. Recent researches have established that it contains a hypoglycemic or insulin-like principle, designated as plant-insulin, which has been found highly beneficial in lowering the blood and urine sugar levels. It should, therefore, be included liberally in the diet of the diabetic. Ulasimang-bato also known as pansit-pansitan and are good for kidney problems as it cleanses the kidneys.

FRAMEWORK

The study was supported by the Health Belief Model developed by Irwin M. Rosenstock (1966). The model explains and predicts preventive health behavior. A variant of the model include the perceived costs of adhering to prescribed intervention as one of the care beliefs. The HBM was one of the first model that adopted theory from the behavioral sciences to health problems, and it remains as one of the most widely recognized conceptual frameworks of health behavior (Glanz, et. al.: 2002, Ogden: 2007). The model has four components, namely: perceived benefits/advantage (assessment of the positive consequences of adopting the behavior); perceived susceptibility (assessment of the risks of getting the condition); and perceived barriers (assessment of the seriousness of the condition); and perceived barriers (assessment of the influences that discourage adoption of the promoted behavior). According to Bown and Garden (2007) herbal remedies against common ailments eliminating or curing the ailments/diseases preventing the risk of common ailments and preventing the seriousness/ complications of common ailments. The research flow of the study shows the respondents level of awareness on the medicinal plants approved by the DOH, the extent of utilization those medicinal plants, and the problems encountered in the utilization of medicinal plants. The most common reasons that people use medicinal plants are: to ensure good health; improve energy; to prevent or treat colds and flu; to improve memory; to ease depression; and to prevent or treat serious illness. Many believe that because herbal remedies are natural, they are less harmful. These remedies are milder, less concentrated. However, overdosed of herbs could have adverse effects and serious problems. Several advocates of herbal medicine advised users to be sensible in following the essential guides on the preparation and dosage of herbal remedies (Foster and Tyler; 2009; Tucker and De Baggio: 2008). In the Philippines, the Department of Health (DOH), through its Traditional Health Program has approved ten medicine plants/ herbs. These have been thoroughly tested and have been chemically proven to have medicinal value in the relief and treatment of various ailments

(http://www.scribd.com/doc). The Filipinos are expected to be aware of these medicinal herbs which are briefly discussed below: Akapulko. Also known as bayabas-bayabason. This herbal medicine is used to treat ringworms and skin fungal infections. For external use only, pound the leaves, squeeze the juice and apply on affected areas. The herb preparation must be disposed after one day. As expectorant for bronchitis and dyspnea, drink decoction (soak and boil for 10-15 minutes) of Akapulko leaves. Ampalaya. It is most common treatment of diabetes mellitus, for non-insulin dependent patients. For coughs, fever, worms, diarrhea, juice Ampalaya leaves and drink a spoonful daily. For headaches, wounds, burns and skin diseases, apply warmed leaves to afflicted area. Internal parasites are proven to be expelled when the ampalaya juice, made from its leaves, is extracted. Bawang/Garlic. It mainly reduces cholesterol in the blood and hence, helps control blood pressure. For disinfecting wound, crush and juice the garlic bulb and apply. For sore throat and toothache, peel the skin and chew and swallow the juice. Cloves of garlic may be crushed and applied to affected areas to reduce the pain caused by arthritis, toothache, headache, and rheumatism. Bayabas/Guava. It is primarily used as an antiseptic, to disinfect wounds. Also, it can be used as a mouthwash to treat tooth decay and gum infection. The fresh leaves are used to facilitate the healing of wounds and cuts. A decoction (boiling in waster) or infusion of fresh leaves can be used for wound cleaning to prevent infection. For toothaches, chew the leaves. For diarrhea, boil the leaves for 15 minutes and strain. Let coal, and drink a cup every three to four hours. To stop nosebleed, densely roll the leaves, then place in the nostril cavities. Lagundi. Its main use is for the relief of cough and asthma. Boil half cup of chopped fresh or dried leaves in 2 cups of water for 10-15minutes. Drink half cup three times a day. For skin diseases, apply the decoction of leaves and roots directly on skin. The root is especially good for treating dyspepsia, worms, boils, colic, and rheumatism. Niyog-niyogan. It is effective in the elimination of intestinal worms. Only the dried matures seeds are medicinal. Crack and ingest the dried seeds (5-7 seed for children and 8-10 seeds for adults for

one week). Leaves are used to cure body pains by placing them on specific problematic areas of the body. Sambong. It is used mainly in the excretion of urinary stones. A decoction (boil of water) of Sambong leaves as like tea and drink a glass 3-4 times a day. For headaches, apply crushed and pounded leaves on forehead and temples. Decoction of the roots, on the other hand, is to be taken in as cure for fever. Tsaang Gubat. Prepare like tea, this herbal medicine is effective in treating intestinal motility and also used as mouth wash since the leaves of this herb has high fluoride content. Thoroughly wash the leaves in running water. Chop to a desirable size and boil one cup of chopped leaves in 2 cups of water. Take a cupful every 4 hours for diarrhea, gastroenteritis, and stomach pains. Gargle for stronger teeth and prevent cavities. Drink tea daily for general health. Ulasimang bato/Pansit-pansitan. It is effective in fighting arthritis and gout. The leaves can be eaten fresh (about a cupful) as salad. Yerba Buena/Peppermint. This vine is used as an analgesic to relieve body aches and pain. It can be taken internally as a decoction or externally by pounding the leaves and applied directly on the afflicted area. Wash the leaves with running water. Chop to size and boil 2 teaspoons of leaves in a glass of water in medium heat for 15-20 minutes. As analgesic, take a cupful every 3 hours. The leaves could be heated over fire and placed over the forehead headaches. The stems may be crushed and applied directly to bruises. The Philippine Institute of Traditional and Alternative Health Care was established for the following purposes and objectives: (a) to plan and carry out research and development activities in the areas of traditional and alternative health care and its ultimate integration into the national health care delivery system; (b) to verify, package and transfer economically viable technologies in the field of t raditional and alternative health care, giving emphasis on the social engineering aspects necessary for group endeavor; (c) to provide the database for policy formulation that will stimulate and sustain production, marketing and consumption of traditional and alternative health care products; (d) to organize and develop continuing training programs for physicians, nurses, pharmacists, physical therapists, and

other professional health workers and students, as well as scientists, research managers and extension workers in the field of traditional and alternative health care; (e) to formulate policies that would create public awareness through educational activities, conventions, seminars, conferences, and the like by focusing on the promotion of healthy living for preventing diseases, thereby uplifting the health care industry; (f) to acquire or obtain from any governmental authority whether national or local, foreign or domestic, or from any person, corporation, partnership, association or other entity, such charters, franchises, licenses, rights, privileges, assistance, financial or otherwise, and concessions as are conducive to necessary proper for the attainment of its purposes and objectives; (g) to receive and acquire from any person and/or government and private entities, whether foreign or domestic, grants, donations and contributions consisting of such properties, real or personal, including funds and valuable effects or things, as may be useful, necessary or proper to carry out its purposes and objectives and administer the same in, accordance with the terms of such grants, donations and contributions, consistent with its purposes and objectives; (h) to serve as the coordinating center of a national network of traditional and alternative health care stations located in the different regions of the country; (i) to formulate a code of ethics and standards for the practice of traditional and alternative health care modalities for approval and adoption by the appropriate professional and government agencies; (j) to formulate standards and guidelines for the manufacture, marketing and quality control of different traditional and alternative health care materials and products for approval and adoption by the Bureau of Food and Drugs; (k) to coordinate with other institutions and agencies involved in the research on herbal medicines. In a local study, it was found that Lagundi was utilized for the treatment of fever, asthma, and cough with the procedure of boiling the lagundi leaves in five glasses of water for at least 5-10 minutes. Each child affected with fever, asthma, or cough is given at least 2 glasses a day. Most of the parents still used herbal therapies as alternative medicine to their children. Utilization of herbal medicine still exists even though modern generation and pharmacological medicine are very affordable in the market or pharmacy. Several parents preferred to use herbal medicine since it does not cost too much for them and sometimes they just asked it from the neighborhood. Hardworking and interest of planting of medicinal plant are easy access

for them in time of emergency situation especially if their children are sick. It was recommended that parents should prepare it properly and prepared it with aseptic techniques this is to avoid any contamination that can cause infection to the patients (Tadlas, F. et. al., 2009). A study was conducted on utilization of herbal home remedies in Barangay Macanhan. The study focused on the common ailments/ diseases of pre-school children (3-6 years old) for the past two years; herbal home remedies given by the mothers in terms of type of herbs, method of preparation, dosage, frequency of use, and number of days the effectiveness is observed; and the mothers perceptions of herbal remedies in terms of susceptibility (risks prevention), severity prevention, and barriers. Herbal remedies were utilized to cure common ailments among pre-school children which the mothers were able to manage at home. The most common of the ailments were cough and fever, LBM, and skin problems. Lagundi and kalabo were the most common medicinal herbs for the treatment of cough while tawa-tawa is most frequently used for treating fever. Akapulko and guava leaves were utilized for skin problems. ABC leaves were utilized for LBM. The mothers considered herbal remedies for preschool children to be beneficial and advantageous because they are accessible, convenient, no side effects, and economical. It was also perceived that herbal remedies prevent risks, complications, and severe cases of other ailments because the common ailments are effectively remedied. However, the barrier of herbal utilization is that the medicinal herbs will dry or die during hot season. It was also found that some of these medicinal plants were not approved by the DOH. However, it was proven in curing common diseases as shown by the experiences of the residents (Valero, M.D., et. al. 2010). Herbal medicine is growing in popularity in the United States. About 49 percent of adult Americans reported using a herbal remedy for the previous twelve months, and 24 percent reported using herbal remedies on a regular basis. The most common regularly used medical herbs were garlic (13 percent), ginseng (8 percent) and ginkgo (7 percent). The most common reasons that people used herbs were: to ensure good health (75 percent), to improve energy (61 percent), to prevent or treat colds and flu (58 percent), to improve memory (43 percent), to ease depression (35 percent), and to prevent or treat serious illness (29 percent). It was also reported that the reasons why people utilized herbs were: prefer natural products (43

percent), fever side effects (21 percent), more effective (14 percent), less expensive (8 percent), and more mild (6 percent) (Summer, 2006; OMathura and Limore, 2001). Herbal medicines are widely used in the United States, with approximately one quarter of adults reporting use of an herb to treat a medical illness within the past year. Herbs contain complicated mixtures of organic chemicals, the levels of which may vary substantially depending upon many factors related to the growth, production, and processing of the herbal product. While many manufacturers attempt to provide products with consistent levels of suspected active ingredients through a process known as standardization, this technique has uncertain effects on the safety and efficacy of the final product. Herbs are considered to be dietary supplements in the United States and therefore are subjected to a very limited form of regulation and oversight. Although herbs are often believed to be natural and therefore safe, many dangerous and lethal side effects have recently been reported, including direct toxic effects, allergic reactions, effects from contaminants, and interactions with drugs and other herbs. Of the ten most commonly used herbs in the United States, systematic reviews have concluded that only four are likely to be effective, and there is very limited evidence to evaluate the efficacy of the approximately 20,000 other available herbal products. Because herbs may contain potent bioactive substances and are often marketed to treat specific diseases, many have argued that they should be subject to more stringent regulation, similar to over-the-counter drugs. To improve the safety and consistency of herbs, additional research is needed to define the pharmacology, stability, and bioavailability of these products (Green, 2000; Grieve, 2001).

OBJECTIVES OF THE STUDY

This study aims to a) determine the level of awareness among the respondents on the ten medicinal plants approved by the DOH in terms of what medicinal plants are they aware of, sources of information, indication, dosage, and preparation; b) describe the extent of utilization of the ten medicinal plants approved by the DOH in terms of parts of the plants utilized for preparation, methods of preparation, methods of application, and duration of use; and c) describe the problems encountered in the utilization of medicinal plants. RESEARCH FLOW

Level of Awareness of the Ten Medicinal Plants approved by the DOH in Brgy. Plaridel, Santiago City Medicinal plants they are aware of Sources of Information Indication, Dosage and preparation a

Extent of the utilization of these ten medicinal Plants Parts of the plant utilized for preparation Methods of Preparation Methods of application Duration of use

Problems encountered in the use of these medicinal plants

SIGNIFICANCE OF THE STUDY

The study will be beneficial to the following people: Barangay Health Staff. This study will give information for them to identify the residents level of awareness and utilization of the approved medicinal plants and will provide them a basis to improve the residents proper utilization of these medicinal herbs. They will provide an awareness campaign relevant to the DOH program on traditional and alternative health care. DOH. They may intensify their campaign to promote the various local herbal medicines available for a more effective utilization in an economical way. The Public. Their health care needs will be assisted through medicines which are reasonably priced. Other Researchers. The recommendation of the study may serve as a significant framework and review for a related study in another research setting.

SCOPE AND LIMITATIONS OF THE STUDY

The data which were gathered were limited to ten (10) mothers who qualified for the inclusion criteria and who are residing in Purok 5 Barangay Plaridel, Santiago City. The variables will be limited to the level of awareness and extent of utilization of the ten approved medicinal plants by the DOH.

MATERIALS AND METHODS

The study was done through the descriptive research design with both quantitative and qualitative approach. According to Venzon (1993) a descriptive research describes, interprets what is and reveals conditions and relationships that exist, practices that prevail, beliefs that are held, procedures that are going on, effects that are being felt or trends that are developing. The study was done in Purok 5, Barangay Plaridel, Santiago City. The respondents were ten (10) mothers who were chosen through the

purposive sampling technique. The respondents were chosen through the following criteria: a) must have at least 3-5 medicinal plants in their environment or backyard; b) they reside in the barangay for at least two years; and c) full-time housewives/non-working. The interview was used in gathering the data. The questions were arranged according to the order of the objectives of the study. The data were gathered after approval was sought from the Barangay Captain of the said Barangay through proper endorsement. The data were presented through the matrix format and the data were summarized through the frequencies and ranking of frequencies.

RESULTS AND DISCUSSION

Objective 1. To determine the level of awareness among the respondents on the ten medicinal plants approved by the DOH in terms of what medicinal plants they are aware of, sources of information, indication, dosage, and preparation. The data reveal that the respondents were aware of six (6) medicinal plants approved by the DOH. Eight (8) of the respondents (1st rank) were aware of bawang or garlic including its indications for lowered blood pressure, decreased cholesterol, toothache, headache, insect bites, rheumatism, and arthritis. They were also aware that the standard method of the preparation of bawang as discussed in the DOH manual include crushing and pounding of garlic cloves and slicing of garlic cloves into halves to be applied in tooth decay, headache, insect bites, rheumatism and arthritis. They were also aware of the dosage that the crushed/pounded cloves should be rubbed on affected areas at least three times a day. The second in rank with a frequency of 7 were aware of ampalaya. They were also aware of its indications in lowering blood sugar levels and heals skin burns. They were also aware on the correct preparation that is, drinking juice from ampalaya leaves at least a spoonful everyday and applying warmed leaves to skin burns. In the preparation of ampalaya, the respondents really knew the parts to be used which are the fruits and the leaves. The third in rank with a frequency of 6 is the awareness of bayabas/ guava. They knew that

bayabas are indications for wound cleaning, vaginal washing after birth, and toothache. They were aware of the dosage that the decoction for washing/cleaning wounds is 2 times a day and 3 times a day in gargling warm decoction 3 times a day. These indications, dosage, and preparation that they were aware of are really the correct procedures in the preparation of bayabas as prescribed by the DOH. The 4.5 rank of the medicinal plants that they were aware of the akapulko (5) and lagundi (5). They knew that the indications for akapulko are ap-ap, skin itching, and ringworm and lagundi is indicated for cough and asthma. They also knew that for skin disorders as mentioned above, pounded l eaves for akapulko are used and apply freshly on the affected skin part and that dosage is twice daily for 2-3 weeks. They were not aware on the procedure in making akapulko ointment. Sambong was the 6th medicinal plant which 2 of the respondentsare aware of. They knew that the dosage for adults is 3x a day with a part equivalent to 4-5 tablespoonful. They were also aware that the decoction of fresh leaves is a prescribed method of preparation. The medicinal plants that they were not aware of were niyogniyogan, tsaang gubat, ulasimong bato, and yerba Buena.

Objective 2. To describe the extent of utilization of the ten medicinal plants approved by the DOH in terms of the parts of the plants utilized for preparation, methods of preparation, methods of application, and duration of use. Findings showed that almost all of the respondents who were aware of the six medicinal plants also utilized the medicinal plants in treating common illnesses. For instance, the 8 respondents who were aware of bawang, also utilized it for prescribed indications. The 7 respondents who were aware of ampalaya also utilized it for certain illnesses specifically diabetes and skin burns. Additionally, 4 out of 6 respondents who were aware of bayabas utilized it except for 2 who did not utilize it for reason of too much time in its preparation. Moreover, 3 out of 5 who were aware of akapulko utilized it in treating skin disorders. The other 2 did not utilized as they claimed that it is time consuming. The 5 who were aware of lagundi utilized it for cough and asthma. However, they just bought lagundi tablets from drugstores

for the reasons of scarcity because other people asked for it from their area. Lastly, one out of 2 who were aware of sambong utilized it for increased urination. The overall scenario is that awareness and a utilization of medicinal plants tended to be associated. On the opposite scenario, the residents do not utilize medicinal plants that they are not aware of. The parts of the medicinal plants used in preparation were fresh leaves as responded by 21 respondents (1st rank). This is true for the preparation of akapulko, bayabas, sambong, and ampalaya. On the other hand, for bawang, the cloves were the parts of the plant being used in the preparation as reported by 10 respondents (second rank). The fruit of the medicinal plant was also used in the preparation as responded by 2 ampalaya users who preferred the fruit. But other ampalaya users utilized the leaves for its preparation.

Objective 3. To describe the problems encountered in the utilization of medicinal plants. Two (2) major problems came out with 4 responses each with a rank of 1.5. These were: the need for further awareness and knowledge of the other medicinal plants approved by the DOH; and seemed to worry for using other medicinal plants (ex. ABC, Kalabo, atay-atay, and tawa-tawa) which are not included in the list of the DOH approved medicinal plants. The need for further information, education, and communication campaign is a felt needs for the four medicinal plants which they were not aware of, such as: niyog-niyogan, tsaang gubat, ulasimang bato, and yerba Buena. Another problem which was experienced by the respondents was that the preparation of medicinal plants is quite time consuming (3 or third rank). According to them, a specific example of this problem is the preparation of lagundi, so they just bought lagundi tablet from pharmacies rather than preparing it. Other problems included that the price per kilo of ampalaya and bawang has increased. It is a problem because they are buying them. Another problem was that the medicinal plants will become scarce if many will use. Another one is that sambong is effective but it is scarce.

CONCLUSIONS

The respondents level of awareness of the medicinal plants approved by the DOH accounted to sixty percent as they are aware of the indication, dosage, and preparation of six plants, such as akapulko, ampalaya, bawang, bayabas, lagundi, and sambong. They are not aware of the other four medicinal plants. They utilized the medicinal plants which they are aware of four specific common diseases/ ailments which they experienced. However, they are also utilizing other medicinal plants, such as ABC, kalabo, atay-atay, and tawatawa. This scenario led them to be worried because they found these plants effective in treating common ailments, but consequently, they felt a need for further awareness and knowledge of the other medicinal plants which they are not aware of.

RECOMMENDATIONS
It is recommended that: 1.The Barangay Health Sector conduct an IEC (Information- EducationCommunication/Campaign on the four (4) medicinal plants which are: niyog-niyogan, tsaang gubat, ulasimang bato, and yerba buena. They must also provide guidance on the use of other medicinal plants not approved by the DOH. 2. The BHWs during their home visits shall explain the correct procedure in the preparation of bawang for lowering blood pressure. It should not be prepared by soaking garlic gloves in a glass of cold water but rather a decoction of leaves and bulbs. In addition, the residents should be taught also in preparing akapulko ointment which they had never done. 3. The residents shall maintain or grow in their backyards the medicinal plants which they are utilizing and found effective rather than buying them and in case the medicinal plants will be scarce. 4. Other researchers are encouraged to onduct a similar study in other barangays.

BIBLIOGRAPHY

Traditional Health Program 2000 DOH Retrieved August 5, 2010, from http://www.scribd.com/ doc.Philippine Herbal Medicine.

Retrieved August 5, 2010 from http://www.philippineherbalmedicine.org/doh-herbshtm. Herbal Medicine. Tucker, A. and T. De Baggio 2008 The Big Book of Herbs: A Comprehensive Illustrated Reference to Herbs of Flavor and

Fragrance. Overland, CO: Interweave Press. Bown, Deri and G. Chelsea 2007 Essential Guide to Herbs for Modern Living. Londong: Pavilion.

Fetrow, W. Charles and R. Juan Avila 2000 Handbook of Complementary and Alternative Medicine.Springhouse, Penn: Springhouse.

Foster, Steven and T. Varro 2000 A Sensible Guide to the Use of Herbs and Related Remedies. New York: Haworth Herbal Press.

Gladstar, Ro. 1993 Herbal Healing for Women. New York: Fireside.

Glanz, K. et. al. 2002 Health Behavior and Health Education. ISBN 0787957151.

Green, J. 2000 The Herbal Medicine Makers Handbook. New York: Crossing Press.

Grieve, M. 2001 A Modern Herbal. New York: Dover Publication.