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Black Cohosh

Selected references:

Foster S. 1999. Black Cohosh: Cimicifuga racemosa. A Literature Review. HerbalGram. 45:35-50.

Foster, S. 2013. Exploring the Peripatetic Maze of Black Cohosh Adulteration. HerbalGram 98:32-51.

For more recent abstracts and references use the National Library of Medicine's PubMed site.

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Black Cohosh Actaea Racemosa (Cimicifuga Racemosa) Article and Photos by Steven Foster

Black cohosh Actaea racemosa (Cimicifuga racemosa) is equally at home in the perennial border as it is in its shaded haunts in the eastern deciduous forest. Pre-colonial botanical observers in America couldn't help but notice the handsome, robust foliage, with the tall spikes of brilliant white flowers, waving like a flag to attract attention. Native American groups looked deeper than its obvious beauty, believing that the thick, knobby, resin-scented roots hold medicinal value. Black cohosh fits into several categories including woodland wildflower, garden perennial, and medicinal herb. Backed by an intriguing botanical, horticultural, and medicinal history, a new generation of baby boomer women - at the steps of menopause - are discovering that this traditional First Nation remedy for female conditions is emerging as a new treatment for symptoms associated with menopause, backed by modern clinical research. Black cohosh is a rising star on the herbal horizon.

Black cohosh is a member of the buttercup family (Ranunculaceae) found in rich woods of the eastern deciduous forest from southern Ontario south to Georgia, west to Arkansas, north to Wisconsin. This perennial woodland plant likes the deep shade of moist hillsides; the home of other important medicinal plans such as goldenseal and ginseng. It has robust, three-divided leaves, with three-lobed terminal leaflets. The middle lobe of the sharply-toothed leaflets is the largest. The plant is little-noticed until it sends up its tall spikes of showy white flowers, three to eight feet tall. Petals are not to be seen; the chief feature is tufts of conspicuous stamens surrounding the pistil in the center. In begins blooming in May in the southern part of its range, continuing to flower into September in more northerly regions. Black cohosh was first described in 1705. By 1732, it had been introduced into English gardens as a hardy ornamental perennial.

The root and rhizome are the parts used in herbal traditions. Most of the rhizome is wild-harvested, while some is grown commercially in Europe. The genus Actaea includes twenty-seven species, found in Europe, North America, and eastern Asia. Collectively, they are commonly known as bugbanes, primarily referring to the single native European species, Actaea europaea (Cimicifuga europaea) and the Asian species Actaea foetida (Cimicifuga foetida), which have strong, unpleasant smelling herbage, earning it a reputation as an insect-repelling plant. The genus name Cimicifuga, itself, honors this olfactory observation. It comes from the Latin cimex meaning bug (specifically the bed bug Cimex lectularius) and fugare "to drive-away" in reference to the insect-repelling attributes. These species are also known by the common names bugwort or bugbane. Bugbanes have been used independently as insect repellents throughout their extensive ranges from India to Western Europe to eastern Siberia. The herbage of the American black cohosh does not possess a strong odor.

Black cohosh in History

American Indian groups of eastern North America used black cohosh to treat female conditions and for rheumatism, long before Europeans landed on American shores. The Delaware, whom were moved to the Indian Territories of modern Oklahoma a century ago, used black cohosh in combination with other herbs as a female tonic. The Iroquois used a strong tea of the root as a footbath, soaking the feet while bathing sore, stiff areas of the body to treat rheumatism. The Cherokee are said to have used the roots to treat rheumatism and various female conditions. They also valued it as a tonic and diuretic.

Early medical authors note that use of the plant was learned from Native Americans. The importance of black cohosh as a medicinal plant was recognized in the first works on American herbs, dating back to 1801. The root was an important folk medicine among American Indian groups and early settlers for menstrual irregularities and as an aid in childbirth. It was widely prescribed by physicians in nineteenth century America, where it had a great reputation as an anti-inflammatory for arthritis and rheumatism, and played an important role for normalizing suppressed menses, painful or difficult menses, and to relieve pain after childbirth. It was also used for nervous disorders. The root was an official drug of the United States Pharmacopoeia from 1820 to 1926. In historical works, information on the herb can be found under several names. Early editions of the United States Pharmacopoeia gave its official name as "black snakeroot," a name that persisted in medical books into the 1890s. Eclectic medical practitioners of the late nineteenth and early twentieth centuries knew it by the name "macrotys" (as misspelling of the obsolete genus name Macrotrys, both a botanical and common name that was never widely recognized, and is lost in obscurity.

It was the Eclectics who championed the use of black cohosh, particularly Dr. John King, (1813-1893), who also first brought Echinacea to the attention of the medical community. Black cohosh was more important to King than Echinacea, since he was a professor of obstetrics at the old Eclectic medical college in Cincinnati (which closed its doors in 1943). He spoke about black cohosh to his students as his "favorite remedy. " He had used it in his own clinical practice from 1832 until his death, as an important remedy in both acute and chronic cases of rheumatism and related inflammatory conditions, plus various lung and nervous affections. King recognized it as his primary treatment "in abnormal conditions of the principal organs of reproduction in the female." If King had not been such a strong proponent of the herb, it may have faded away into obscurity. Like several important herbs, such as Echinacea and saw palmetto, in the early part of this century, the Eclectic’ extensive use and advocacy of black cohosh attracted the attention of the German medical community. As use of herbs faded in American medicine by the 1930s, the Germans picked-up the reins and catapulted these herbs into modern use.

Black Cohosh Today

Used in Europe for over 60 years, with experience in million cases, black cohosh is again becoming known in its native land as a possible alternative for reducing unpleasant symptoms associated with menopause. Efficacy and safety are confirmed by long-term clinical experience, as well as recent controlled clinical studies, along with acute toxicity studies that help to corroborate its safety. Black cohosh will become of increasing interest to women looking for an alternative to estrogen therapy in the treatment of menopausal symptoms. Not only is it widely used in Europe, black cohosh and related species have a long history of use in both Asia and North America. Among women's herbs, black cohosh is the most important rising star.

For more information on black cohosh see links in left sidebar to my 1999 literature review of black cohosh and my 2013 comprehensive paper on black cohosh adulteration, reviewing the nomenclature, distribution, chemistry, market status, analytical methods, and safety concerns of this popular herb.