Indigenous health system and the use of herbal plants have been recognized as pivotal in primary health care and a system to reckon with in achieving one of the targets of the millennial goals on health. An ethnobotanical survey was conducted to identify indigenous herbal remedies for diarrhoea and associated stomach ailments in rural areas of the O.R. Tambo district municipality in the Eastern Cape province of South Africa. The main objective of the study was to gather ethnomedical data on potentially valuable indigenous medicinal plants for the eventual development of new pharmaceuticals and also emphasize the role of ethnomedicine in primary health care. The use of herbal remedies in the treatment of diarrhoea and dysentery was investigated using interviews. The survey was conducted among traditional healers and knowledgeable local elders who use medicinal plants to treat common illnesses. Data from the survey indicated the names of plants commonly used in the treatment of diarrhoea and associated ailments, the methods of preparation, parts used and administration. A total of 32 plant species belonging to 26 families were reportedly used as diarrhoea remedy in the study area. The most predominant families of medicinal plants employed and most frequently recommended were Fabaceae (16.67%), followed by Hyacinthaceae and Hydnoraceae (8.33% each). The most commonly utilized portions of plants for medicinal purposes included roots and leaves. Other parts were corms, bulbs, tubers, fruits and bark. The methods of preparation often employed were decoctions and infusions whilst medication was frequently administered orally or as enema. Some of the plants were used singly or mixed with other plant(s) while some edible ones are consumed as food. The survey documented a diversity of plants employed as remedy for diarrhoea. Integration of this form of health care system into western medicine is warranted. The propagation of such medicinal plants is vital for sustainable use of these medicinal plants.

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The use of complementary and alternative medicine from plants in South Africa, as in the rest of the world, continues to increase. Heteropyxis natalensis, known as the Lavender tree, is indigenous to South Africa and is traditionally used for oral care. The ethanolic extract, of the leaves and twigs, of H. natalensis was investigated for antimicrobial activity against selected oral microorganisms. Actinomyces israelii was found to be the most sensitive oral microorganism to the extract, with a minimum inhibitory concentration (MIC) of 0.88 mg/ml and an MIC of 2.6 mg/ml against Streptococcus mutans. Five known compounds were identified from the ethanolic extract of H. natalensis. The compounds were identified as aurentiacin A (1), cardamomin (2), 5-hydroxy-7-methoxy-6-methylflavanone (3), quercetin (4) and 3,5,7-trihydroxyflavan (5). The MICs of the compounds 1 and 4 were found to be 0.06 mg/ml and 1 mg/ml, respectively, against A. israelii. The cytotoxicity, acute and sub-acute toxicity in pre-clinical studies were also determined for H. natalensis. The extract showed moderate cytotoxicity (35.56 ± 0.16 μg/ml) on human monocyte cells. The acute and sub-acute toxicity analysis of H. natalensis indicated the NOEL (no-observed-effect level) at 200 mg/kg. Interleukin-8 (IL-8) is a chemokine that stimulates the recruitment of leukocytes. A significant reduction of IL-8 production by macrophage cells was observed when exposed to the extract of H. natalensis. It is possible that H. natalensis can prevent excessive tissue damage in periodontal diseases through its reduction of inflammation. Enzymatic bioanalysis of lactic and acetic acid production from Streptococcus mutans and Lactobacillus paracasei was done. A reduction in the acid production from each bacterium was observed on exposure to the extract of H. natalensis. Consequently, this increased the pH, which could possibly reduce the demineralization of enamel which may help prevent the formation of dental caries. In addition the extract may be considered for preventing periodontal diseases.

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