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\title{A Review on Medicinal Plants used for Nausea and Vomiting in Persian Medicine}
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             \author[1]{Mohammad  Azadbakht}

             \author[2]{Sharareh  Darvishpor}

             \author[3]{Amirsaeed  Hosseini}

             \affil[1]{  Mazandaran University of Medical Sciences}

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\date{\small \em Received: 10 December 2017 Accepted: 31 December 2017 Published: 15 January 2018}

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\begin{abstract}
        


Nausea and vomiting are common digestive symptoms of various illnesses, pregnancy, chemotherapy and motion sickness. They are very unpleasant and affect the quality of life. There are many drugs to control nausea and vomiting but in many cases they are uncontrollable, so helping to new drug discovery is necessary to control of these symptoms. This article showes the plants that used to control these syptoms in Persian medicine books such as: Canon of medicine, Al-Abnieah, Tohfeh, Ekhtiarat, Al-shamel and makhzanul-advieh. About 126 plants were identified to treatment of nausea and vomiting and in this paper 94 plants were presented. The most medicinal plants for the treatment were: Citrus lemon, Berberis vulgaris, Malus domestica, Mentha piperita, Valeriana officinalis and Zingiber officinale. 

\end{abstract}


\keywords{plant, nausea; vomiting; traditional medicine; zingiber officinale}

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\let\tabcellsep& 	 	 		 \par
I. Introduction ausea and vomiting are common digestive problems that affect the quality of life. They also are common problems in patient with chronic disease conditions (40-70\%) such as cancer. Nausea and vomiting can be disease or adverse effect of drugs. It can be due to various reasons such as: motion sickness, pregnancy, stomach irritation, chemotherapy, and post-operative factors \hyperref[b0]{[1]}\hyperref[b1]{[2]}\hyperref[b2]{[3]}.\par
Nausea is an unpleasant subjective sensation and a feeling close to vomiting. Vomiting includes two stages; retching stomach and exit of the material through the mouth \hyperref[b3]{[4,}\hyperref[b4]{5]}. 
\section[{Fig. 1:}]{Fig. 1:}\par
This figure shows some of the factors that initiate vomiting and the neurotransmitter that involved in nausea and vomiting and where the antiemetic drugs involve to preventing nausea and vomiting Nausea and vomiting mechanism is complex. Excessive secretion of saliva occurs while nausea that shows the involvement of autonomic nervous system, so nausea is an event that involves a wide range of central nervous system and gastrointestinal tract \hyperref[b5]{[6]}.\par
There are two areas of the brain that are important in vomiting; the vomiting centre (VC) and the chemoreceptor trigger zone (CTZ) (Fig.  {\ref 1}). The VC makes network in parts of the brain stem and coordinates the actions of smooth muscles and skeletal functions involved in the vomiting \hyperref[b6]{[7,}\hyperref[b7]{8]}.\par
Persian medicine (PM) is a set of knowledge and practices used for the prevention, diagnosis and treatment of diseases \hyperref[b8]{[9]}. This knowledge has been transferred from generation to generation since ancient times. World Health Organization (WHO) to implement the slogan "Health for all" is intended to develop traditional medicine, this decision was based on two fundamental: first, lack of people (up to 80\% in some areas) to access primary health care and second, the lack of satisfaction with the treatment of modern medicine \hyperref[b9]{[10]}\hyperref[b10]{[11]}\hyperref[b11]{[12]} {\ref [13]}. 
\section[{II. Factors that Initiate Vomiting}]{II. Factors that Initiate Vomiting}\par
There are number of medicines to control of nausea and vomiting (Table \hyperref[tab_0]{1}) that with these antiemetic drugs, vomiting can be prevented in up to 70-80 \% of patients  {\ref [14]}. Table \hyperref[tab_0]{1} shows the modern drugs that use to treatment of nausea and vomiting. 
\section[{III. Methods}]{III. Methods}\par
In this article we used "comprehensive library of Islamic and traditional medicine software" and from about one thousands book we choose six important Persian Medicine (PM) book such as: Canon of medicine, Al-Abnieah, Tohfeh, Ekhtiarat, Al-shamel and Makhzan-ol-advieh. These books are written between 9-19 centuries. In other hand we searched Scopus, Pubmed, Google scholar and Science Direct for some of these plants that are effective in treatment of nausea and vomiting.\par
There are several terms that associated with nausea and vomiting in PM such as: "Ghe'y", "Ghesyan", "Tahavo", and "Taghalobenaphs" refers to ''vomiting'', ''nausea'', ''retching'', and ''permanent nausea'', respectively. Herbal medicines specifications include: scientific, PM and common names, also their part(s) of used, some notifications and references that can use as drug to control of nausea and vomiting in PM were presented in this article. 
\section[{IV. Results and Discussion}]{IV. Results and Discussion}\par
In this paper, we investigated six important books of Persian medicine and the result was about 126 plants that use for treatment of nausea and vomiting and in this paper 94 plants were presented.\par
Table \hyperref[tab_1]{2} shows the plants that used for curing nausea and vomiting. This table sort by family name of plants and including data on the subject of: scientific name, PM name, and common name, part used, notice and the collection source. a) Lemon (Citrus Lemon) Rutaceae are a great family that has about 1800 species in 160 genera. Essential oil of C. lemon that was extracted with hydro-distillation includes volatile (\%85-99) and non-volatile (\%1-15). Chemical constituents that identified in C. lemon essential oils are: Limonene (it is the major compound in citrus peels), limonene oxide, ?terpineol, carvone, carveol, eugenol, spathulenol, caryophyllene oxide, ?-terpineol, 3-cyclohexane-1methanol. A study was conducted to evaluate the effect of aromatherapy essential oils in the control of nausea and vomiting associated with pregnancy. The study was conducted on 100 pregnant women showed that inhaling lemon can be effective in reducing nausea and vomiting in pregnancy.\par
A study on 180 people in three groups: control group, treated with intramuscular inject of metoclopramide and was treated with lemon peel; results showed that the group who were treated with lemon peel their symptoms were better control.\par
In a study of 50 women who had undergone caesarean section and vaginal deliveries has been shown that nausea and vomiting in group that used Lemon peel is significantly lower than the control group.\par
In addition, nasal spray formulation of lemon essential oil (that extracted from peel of Citrus sinensis) has been showed significant effects on the control of nausea and vomiting \hyperref[b99]{[123]}\hyperref[b100]{[124]}\hyperref[b101]{[125]}\hyperref[b102]{[126]}. Barberry has about 500 species around the world. Berberine and berbamine are the main constituents that found in different species of Barberry. There are several pharmacological and biological effect for B. vulgaris such as: antihistaminic and anticholinergic. These two effects can be helping the improvement of nausea and vomiting \hyperref[b103]{[127,}\hyperref[b104]{128]}. 
\section[{c) Apple (Malus Domestica)}]{c) Apple (Malus Domestica)}\par
There are about 100 varieties of apples commercially. Apples contain flavonoids, fibre, pectin, high potassium, low sodium, zero of fat. In a study on 19 patients treated by cisplatin showed that eating three times a day from a diet that includes: vanilla ice cream, cheese and apple sauce can be effective to control nausea and vomiting in this category of people \hyperref[b105]{[129,} {\ref 130]}. 
\section[{d) Peppermint (Mentha Piperita)}]{d) Peppermint (Mentha Piperita)}\par
The result of GC-MS analysis of essential oils from hydro-distillation extract of Menthe piperita showed that there are many compounds in the essential oil, such as: camphene, sabinene, ?-pinene, ?-terpinene, limonene, terpinolene, p-cymene, menthone, menthol, ?-terpineole, trans-carveol, carvone, pipertitone oxide, and ?-caryophllene. Peppermint oil can be effective in controlling nausea and vomiting that caused by chemotherapy. In a study in patients with gynecologic surgery, was shown that peppermint is very effective in reducing nausea and vomiting after surgery.\par
In another study in 123 patients who is undergoing cardiac surgery, shown that the use of nasal inhaler of peppermint oil can be useful in controlling nausea and vomiting after cardiac surgery \hyperref[b107]{[131]}\hyperref[b108]{[132]}\hyperref[b109]{[133]}. 
\section[{e) Valerian (Valeriana Jatamansi)}]{e) Valerian (Valeriana Jatamansi)}\par
Valerian is scattered around worldwide with about 250 species. Valerian contains more than 150 chemical compounds such as; pyridine alkaloids, organic acids and terpenes, in particular valepotriates and esterifies iridoid-monoterpenes, but the main three chemicals that are active are the essential oils, valerenic acid and valenol, valepotriates, and a few alkaloids.\par
A study about antiemetic effects of V. officinalis in chickens has been studied against nausea and vomiting that induced by copper sulphate. The results indicate that valerian has significant effect on the control of nausea and vomiting \hyperref[b110]{[134]}\hyperref[b111]{[135]}\hyperref[b112]{[136]}. 
\section[{f) Ginger (Zingiber Officinale)}]{f) Ginger (Zingiber Officinale)}\par
Ginger liquid and capsules preparations are a herbal medications used to control nausea and vomiting due to chemotherapy, postoperative and pregnancy. Ginger extract because of gingerols and shogaol, effects on stimulate gastric contractions. These effects mainly occur by involving serotonergic 5-HT and 5-HT receptors and cholinergic M receptors \hyperref[b98]{[122,}\hyperref[b113]{137,}\hyperref[b114]{138]}. 
\section[{VI. Conclusion}]{VI. Conclusion}\par
Since nausea and vomiting affect the quality of life and in many patients despite the use of antiemetic agent. We also seen these symptoms, so need for further investigation of the discovery of new drugs is felt, therefore, use the traditional medicine can help us do towards to this goal. \begin{figure}[htbp]
\noindent\textbf{}\includegraphics[]{image-2.png}
\caption{\label{fig_0}}\end{figure}
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\noindent\textbf{1} \par 
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\multicolumn{3}{l}{Line Chemical class Antiemetic drugs}\tabcellsep Root\tabcellsep Neurotrans mitters\tabcellsep Rider\tabcellsep References\\
\tabcellsep 5-Hydroxy-\tabcellsep Ondansetron\tabcellsep Oral ,**IV\tabcellsep \tabcellsep Common side effect includes\tabcellsep \\
1\tabcellsep tryptamine (5-HT3)\tabcellsep Granisetron\tabcellsep Oral, IV, patch\tabcellsep 5-HT\tabcellsep headaches, flushing, constipation/ diarrhea, malaise/ fatigue and\tabcellsep {}[15-17]\\
\tabcellsep antagonists\tabcellsep Dolasetron\tabcellsep Oral, IV\tabcellsep \tabcellsep bradycardias.\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep As Anti-nausea drug that is\tabcellsep \\
2\tabcellsep Steroids\tabcellsep Dexamethasone\tabcellsep IV\tabcellsep -\tabcellsep effective in *PONV and chemo-\tabcellsep {}[18, 19]\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep therapy\tabcellsep \\
\tabcellsep \tabcellsep Cyclizine\tabcellsep Oral\tabcellsep \tabcellsep Pain while injecting and tachycardia limited it use. It often\tabcellsep \\
3\tabcellsep Antihistamines\tabcellsep Promethazine\tabcellsep Oral, IV , ***IM\tabcellsep Histamine\tabcellsep use in motion sickness. IV administration can cause tissue injury including: gangrene,\tabcellsep {}[20-22]\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep burning.\tabcellsep \\
\tabcellsep \tabcellsep Prochlorperizine\tabcellsep IV ,IM\tabcellsep \tabcellsep Extra-pyramidal effect and\tabcellsep \\
4\tabcellsep Phenothiazines\tabcellsep \tabcellsep \tabcellsep Dopamine\tabcellsep sedation limited it use. Avoiding\tabcellsep {}[22-24]\\
\tabcellsep \tabcellsep Perphenazine\tabcellsep IV\tabcellsep \tabcellsep using in Parkinson's patient.\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep It has the risk of sudden deaths\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep because of long QT syndrome\tabcellsep \\
5\tabcellsep Butyrophenones\tabcellsep Droperidol\tabcellsep IV, IM\tabcellsep Dopamine\tabcellsep and torsades de pointes.\tabcellsep {}[25]\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep 0.625-1.25 mg may be more\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep effective for PONV\tabcellsep \end{longtable} \par
 
\caption{\label{tab_0}Table 1 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{2} \par 
\begin{longtable}{P{0.03546433378196501\textwidth}P{0.09037685060565276\textwidth}P{0.053768506056527596\textwidth}P{0.04576043068640646\textwidth}P{0.056628532974428\textwidth}P{0.510228802153432\textwidth}P{0.057772543741588155\textwidth}}
Family\tabcellsep Scientific name\tabcellsep Persian Medicine name\tabcellsep Common name\tabcellsep Part(s) Used\tabcellsep Notice\tabcellsep References\\
Acanthaceae\tabcellsep Justicia adhatoda\tabcellsep Ajhose\tabcellsep Tentacle\tabcellsep Root\tabcellsep Its root can use for treatment of nausea\tabcellsep {}[32-34]\\
Alliaceae\tabcellsep Allium cepa\tabcellsep Bassal\tabcellsep Onion\tabcellsep Bulb\tabcellsep Cooking or fostering it with vinegar prevents nausea.\tabcellsep {}[32, 33, 35]\\
\tabcellsep Mangifera indica\tabcellsep Anbaj (anbeh)\tabcellsep Mango\tabcellsep Peduncle\tabcellsep Peduncle near the leaf with black pepper can stop vomiting.\tabcellsep {}[32, 33, 36]\\
\tabcellsep Pistacia intigerrima\tabcellsep Kakera\tabcellsep Crab's claw, Kakkar\tabcellsep Gall\tabcellsep It is more effective in vomiting.\tabcellsep {}[32, 33, 37]\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep Drinking of it with appropriate\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep spices use for treatment of\tabcellsep \\
Anacardiaceae\tabcellsep Pistacia lentiscus Pistacia vera\tabcellsep Mastaci Fastagh\tabcellsep Mastic Pistachio\tabcellsep Resin Peel and kernel\tabcellsep vomiting.2.5 g of it with 450 g of water boil in a new pitcher until 1/3 of it remain, then drink it, if to be finished use a new pitcher, it use for treatment of emesis. Macerate external Green peel in water and drink it can prevent vomiting. It can prevent nausea and lock\tabcellsep {}[32, 33, 38] [32, 33, 39]\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep vomiting.\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep Seed that be crushed with\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep caraway-seed can calm emetic\tabcellsep \\
\tabcellsep Rhus coriria\tabcellsep Sumac\tabcellsep Sumac\tabcellsep Seed and leaf\tabcellsep by drinking with cold water, in a person that always have emesis.\tabcellsep {}[1, 32, 33]\\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep (12.5 g of the syrup.)\tabcellsep \\
\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep It remove/calm emetic.\tabcellsep \\
Apiaceae (Umbelliferae)\tabcellsep Anethum graveolens Apium graveolens\tabcellsep Shabat (shivid) Karafs\tabcellsep Dill Celery\tabcellsep Leaf and seed Leaf, seed and root\tabcellsep Eating its cooked leaves and seed remove nausea Drinking 37.5 g of extract/7.5 g of it/ 12.5 g of cooked root, use for remove emesis. Drinking of leaf and root that mixed with honey can calm emesis.\tabcellsep {}[32, 33, 40]\end{longtable} \par
  {\small\itshape [Note: A]} 
\caption{\label{tab_1}Table 2 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{} \par 
\begin{longtable}{P{0.8418269230769231\textwidth}P{0.0022290209790209793\textwidth}P{0.0011145104895104896\textwidth}P{0.002972027972027972\textwidth}P{0.0018575174825174825\textwidth}}
\multicolumn{5}{l}{in pregnancy: a randomised controlled trial.}\\
\multicolumn{3}{l}{Midwifery. 2009; 25(6): 649-53.}\tabcellsep \tabcellsep \\
\multicolumn{5}{l}{13. Bodeker G, Kronenberg F. A public health agenda}\\
\multicolumn{5}{l}{for traditional, complementary, and alternative}\\
\multicolumn{5}{l}{medicine. American journal of public health. 2002;}\\
92(10): 1582-91.\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
\multicolumn{5}{l}{14. Chan A, Low XH, Yap KY-L. Assessment of the}\\
\multicolumn{5}{l}{relationship between adherence with antiemetic}\\
\multicolumn{5}{l}{drug therapy and control of nausea and vomiting in}\\
\multicolumn{5}{l}{breast cancer patients receiving anthracycline-}\\
\multicolumn{5}{l}{based chemotherapy. Journal of Managed Care}\\
\multicolumn{3}{l}{Pharmacy. 2012; 18(5): 385-94.}\tabcellsep \tabcellsep \\
\multicolumn{5}{l}{15. Ryu J, So Y-M, Hwang J, Do S-H. Ramosetron}\\
\multicolumn{5}{l}{versus ondansetron for the prevention of}\\
postoperative\tabcellsep nausea\tabcellsep and\tabcellsep vomiting\tabcellsep after\\
\multicolumn{5}{l}{laparoscopic cholecystectomy. Surgical endoscopy.}\\
\multicolumn{2}{l}{2010; 24(4): 812-7.}\tabcellsep \tabcellsep \tabcellsep \\
\multicolumn{5}{l}{16. Boccia RV, Gordan LN, Clark G, Howell JD,}\\
\multicolumn{5}{l}{Grunberg SM, Group SS. Efficacy and tolerability of}\\
\multicolumn{5}{l}{transdermal granisetron for the control of}\\
\multicolumn{5}{l}{chemotherapy-induced nausea and vomiting}\\
\multicolumn{5}{l}{associated with moderately and highly emetogenic}\\
\multicolumn{5}{l}{multi-day chemotherapy: a randomized, double-}\\
\multicolumn{5}{l}{blind, phase III study. Supportive Care in Cancer.}\\
\multicolumn{2}{l}{2011; 19(10): 1609-17.}\tabcellsep \tabcellsep \tabcellsep \\
\multicolumn{5}{l}{17. Schwartzberg L, Barbour SY, Morrow GR, Ballinari}\\
\multicolumn{5}{l}{G, Thorn MD, Cox D. Pooled analysis of phase III}\\
\multicolumn{5}{l}{clinical studies of palonosetron versus ondansetron,}\\
\multicolumn{5}{l}{dolasetron, and granisetron in the prevention of}\\
\multicolumn{5}{l}{chemotherapy-induced nausea and vomiting}\\
\multicolumn{5}{l}{(CINV). Supportive Care in Cancer. 2014; 22(2):}\\
469-77.\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
\multicolumn{5}{l}{18. Aapro M, Fabi A, Nole F, Medici M, Steger G,}\\
\multicolumn{5}{l}{Bachmann C, et al. Double-blind, randomised,}\\
\multicolumn{5}{l}{controlled study of the efficacy and tolerability of}\\
\multicolumn{5}{l}{palonosetron plus dexamethasone for 1 day with or}\\
\multicolumn{5}{l}{without dexamethasone on days 2 and 3 in the}\\
\multicolumn{5}{l}{prevention of nausea and vomiting induced by}\\
\multicolumn{5}{l}{moderately emetogenic chemotherapy. Annals of}\\
\multicolumn{3}{l}{oncology. 2010; 21(5): 1083-8.}\tabcellsep \tabcellsep \\
\multicolumn{5}{l}{19. De Oliveira Jr GS, Castro-Alves LJS, Ahmad S,}\\
\multicolumn{5}{l}{Kendall MC, McCarthy RJ. Dexamethasone to}\\
\multicolumn{5}{l}{prevent postoperative nausea and vomiting: an}\\
\multicolumn{5}{l}{updated meta-analysis of randomized controlled}\\
\multicolumn{5}{l}{trials. Anesthesia \& Analgesia. 2013; 116(1): 58-74.}\\
\multicolumn{5}{l}{20. Anderka M, Mitchell AA, Louik C, Werler MM,}\\
\multicolumn{5}{l}{Hernández-Diaz S, Rasmussen SA. Medications}\\
\multicolumn{5}{l}{used to treat nausea and vomiting of pregnancy}\\
\multicolumn{5}{l}{and the risk of selected birth defects. Birth Defects}\\
\multicolumn{5}{l}{Research Part A: Clinical and Molecular Teratology.}\\
\multicolumn{2}{l}{2012; 94(1): 22-30.}\tabcellsep \tabcellsep \tabcellsep \\
\multicolumn{5}{l}{21. McDevitt L, Mowat I. Transient paralysis after}\\
\multicolumn{5}{l}{cyclizine administration. Anaesthesia. 2013; 68(10):}\\
1084-.\tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
22.\tabcellsep \tabcellsep \tabcellsep \tabcellsep \end{longtable} \par
  {\small\itshape [Note: (Allium cepa): a review of their relationship to cardiovascular disease. Preventive medicine. 1987; 16(5): 670-85.]} 
\caption{\label{tab_2}}\end{figure}
 		 		\backmatter  			 
\subsection[{Conflict of Interest Statement}]{Conflict of Interest Statement}\par
We declare that we have no conflict of interest.			 			  				\begin{bibitemlist}{1}
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