Planting the Future

BLACK COHOSH

Cimicifuga racemosa

MATTHEW WOOD

Although black cohosh is not native quite as far west and north as my farm, it remains one of my favorite medicinal plants. It is characteristic of the “Big Woods” of eastern North America and the herbal tradition of the eastern woodland Indians. Within this tradition we find a large number of “female medicines,” of which black cohosh is probably the archetypal representative. We also find plants associated with medicine animals or spirits, because of a resemblance to an animal. Black snakeroot, one of black cohosh’s aliases, also scores here; the emerging flower spike resembles a snake, and the seedpods rattle like a rattlesnake. It is one of the Indian “snake medicines” considered to have a great deal of power, not just medicinal but also transformative and psychological. And finally, the physical properties of the plant suggest its established uses; black cohosh is thus a plant that illustrates the ancient doctrine of signatures, the idea that an herb “looks like what it treats.”

Black cohosh was one of the many important and distinctive remedies that the pioneers learned about from the Native Americans. Members of all the important medical schools of the nineteenth century, including the allopaths, homeopaths, Eclectics, and physio-medicalists, used it. It has proven to be a widely useful medicine. It not only acts on important and common physical problems but also has properties that run in a deep psychological vein. Today it is still widely used, both by the more scientific phytotherapists and by the traditional community of herbalists drawing on established lore.

Cimicifuga racemosa is a member of the Buttercup, or Ranunculaceae, family. This makes it a cousin of goldenseal, columbine, Anemone pulsatilla, and many other denizens of the field and wood. It is closely related to the genus Actaea. Indeed, it was originally classified as a member of that group and still appears, sometimes, in the older medical literature under the name Actaea racemosa. It is closely allied with two rare cousins, C. americana and C. cordifolia, which also grow in the eastern United States, and with C. elata, a native of the Pacific Northwest. The latter is similar to the Eurasian species, C. foetida, which is official in Chinese herbalism.

The botanical kinship of Cimicifuga racemosa to Anemone pulsatilla is notable since the former is the most important female remedy in eastern American Indian medicine, while the latter is the most important member of this class in European homeopathy. Both are used for PMS, scanty menses, cramps, problems dating to the onset of menstruation, irregular menses in teenage girls, fluid retention, menopausal problems, and eruptive diseases. There are also differences: Black cohosh is suited to a dark, brooding mentality, whereas A. Pulsatilla has a happy/sad, changeable, yielding disposition.

Black cohosh is native from the Atlantic seaboard to Oklahoma, northward as far as the lower Great Lakes, and down the Appalachian Highlands into Georgia and Alabama. It commonly grows on lightly wooded hillsides and slopes, especially in association with oak openings. C. racemosa and C. americana are also widely grown as shady ornamentals.

Black cohosh is a perennial that establishes a knotted cluster of roots and rhizomes from which a number of stalks shoot up, dividing into a crown of leaves 1 to 2 feet above the ground. The leaves are described in technical terms as large, alternate, and ternately compound; the leaflets, ovate-oblong, incisely serrate, and opposite. From the crown of leaves emerge spikes or racemes that rise 3 to 9 feet with a few leaves here and there and toward their ends are lined by long rows of small, round, creamy white flowers that look like tiny clouds. The flowers have a strange smell that makes you feel as if you’re enclosed in a stuffy room. In technical terms the flowers are described as follows: sepals four or five in number, rounded, and white; petals from four to six, small, not so long as the sepals; stamens numerous and showy; anthers introrse and white; stigma sessile and lateral in the capsules when mature.

Several features of the plant suggest the traditional medicinal uses. The stems unravel like the tops of a fiddlehead fern in the spring, resembling a fetus; black cohosh was one of the most important birthing herbs in American Indian practice. As the spikes rise high above the ground, the flowers appear in a line, making a picture of the human spine. The wind, catching them, snaps them back and forth. To my eye this suggests the use of the plant for whiplash. I have had great success here. More generally, black cohosh is used to soothe painful muscles, what today would be called fibromyalgia, and back problems. This is a medicine plant that looks like and acts strongly on the spine. It is an important remedy in congestion of the cerebrospinal fluids, nervous spasm, and muscular pain. The dark, massed, fibrous root suggests the idea of congestion, as does the curious smell of the flower, which creates a contained, entrapped feeling. Both of these signatures point to the use of black cohosh by those suffering from dark, black, introspective, brooding, melancholic moods, and this usage has long been established in homeopathy. All of these signatures point to the main uses of the plant: as a female and pregnancy medicine; as a neurological and muscular remedy; in meningeal, cerebral, and spinal problems; and for a dark, brooding state of mind, particularly before the menses.

The name cohosh seems to come from an Algonquian word associated with pregnancy. The two cohoshs, black and blue, have long been used as parturient remedies. Indian women were famous for the ease of their deliveries, and this was one of the herbs used, in the last few weeks, in small doses, to instill a successful parturition. It was also used for menstrual problems, especially for difficulties in young women, irregular periods, or problems dating to the onset of menstruation.

Another set of uses is indicated by the names black snakeroot and rattle root. J. I. Lightall, the great Indian medicine man, says of the latter name: “When the stalk is shaken the seeds will rattle, producing a sound like that of a rattlesnake, from which it takes the name of rattle root.”¹ The stalk also looks like a snake when it first begins to grow.

Cimicifuga was one of the important “snake roots” used in American Indian medicine. The Indians considered it an important remedy for snakebite, though scientific medical authorities disparaged this usage. As usual, such critical comments were offered without proof or testing. The same remarks were made about its reputation as a treatment for smallpox. Here, however, we do find medical doctors who observed its positive effects; also, the Chinese Cimicifuga is used to bring out the rash from “toxic fevers.”

The snake medicines of American Indian lore are a group of plants that resemble a snake in one fashion or another. Other examples would include Aristolochia serpentaria (Virginia snake-root), Eryngium yuccifolium (rattlesnake master), Poly gala seneca (Seneca snakeroot), and even the naturalized Plantago major (plantain, snake-weed). All these plants are used as snakebite remedies but also have deeper psychospiritual associations and uses. When a plant resembles an animal, it becomes the conduit for that animal. Snake medicine thus conveys the spirit of the snake.

What does this mean? I think we can safely draw analogies between the American Indian snake medicines and other traditions that use this animal as a psychospiritual symbol and see it as a real, active-in-life power. It would be safe to say that the Native American concept of snake medicine is similar to the concept of kundalini or serpent power in Ayurvedic medicine. The latter is seen as an energy that rises up the spine, actualizing the intellectual, psychological, and psychic faculties but also bringing with it a fierce, magnetic, seductive, sometimes fear-inspiring and nerve-disturbing power that is a challenge to live with and adjust to. When it actualizes the psychic faculties, serpent power allows greater insight and awareness but also brings the challenge of dealing with knowledge and power.

It is a striking feature of black cohosh—one that I’ve often observed in my own practice—that people who need this remedy are characteristically very aware on a psychic level. Many of their problems come from feeling entrapped, addicted, or abused in some relationship that exerts a psychic grip upon them. Last year, for instance, I saw a woman who with no prodding at all described herself as a “psychic/intuitive transmedium”—a pretty sophisticated and self-knowledgeable concept for a twenty-two-year-old. She had all the characteristic symptoms calling for black cohosh: neurological shocks of energy, spasms, involuntary (but not consciousness-diminishing) convulsions, meningeal swelling, stiff upper and lower back, irregular periods (her problems beginning with puberty), and brooding and pensive states of mind before her period, which became better as soon as her flow began. Her physicians, with rather less inventiveness, diagnosed her as suffering from a “brain virus” that was “unnamed.” She is now fully recovered and leading a normal life for the first time since puberty.

The use of black cohosh as a remedy for female and other disorders was picked up by the early settlers and pioneers. Benjamin Smith Barton first mentions the plant’s use as a medicine among the Indians and settlers in 1801. It already saw widespread acceptance for veterinary use in cattle, so the white settlers had been learning from their own experiences with it for some time. Smith notes that it was highly esteemed by the Native people. Both conventional and unconventional physicians used and wrote about black cohosh in the 1820s and 1830s. It became official in the United States Pharmacopoeia in 183 0 and was widely used by the middle of the century. Cimicifuga was the favorite remedy of Dr. John King, one of the founding fathers of Eclecticism. The American Medical Association reviewed it in 1848 and, after skeptically dismissing many traditional uses, concluded that it was a nervine sedative of the highest rank. In particular, it was defined carefully as fitting cases where the pulse was rapid and forceful (“hard or tense”—the old terminology is rather vague), indicating nervous irritation. It remained official in the United States Pharmacopoeia until 1936 and in the National Formulary until 1950. It is still well regarded in European phytotherapy, as well as in North American herbalism.

In 1856 Cimicifuga was given a homeopathic proving by Dr. C. J. Hemple, and it has continued to be used extensively in homeopathy, though not as much so as its cousin Anemone pulsatilla. The homeopathic and botanical uses of Cimicifuga are essentially in agreement.

Modern research on Cimicifuga has not advanced very far. It has been shown to contain cimicifugin (an amorphous resinous body), a volatile oil, sugars, tannins, phosphates, and sulfates. It contains small amounts of estrogenlike substances—not enough to substitute for the hormone, but evidently enough to have a stimulating effect on hormonal processes.

The majority of nineteenth-century physicians determined black cohosh’s center of action to be the nervous system. More specifically, it was associated with the cerebrospinal system. From my own experience, I believe that it acts through the cerebrospinal fluid. This would explain why it is so strongly associated with the nerves, but also why it influences conditions associated with menstruation and the economy of liquids in the body. A characteristic symptom observed by so many women who respond to black cohosh is significant: Moods and neurological symptoms are better by the onset of menses.

Poetically generalizing, I believe (along with the medieval European authors) that the cerebrospinal fluids, which circulate in and out of the ventricles of the brain and down each nerve fiber, which they coat and soothe, are the vehicle of the soul or psyche, and that the strong action of this plant on people who describe themselves as psychics and transmediums (able to pickup on and feel other people’s feelings) is appropriate. The psychically bound-up, congested psychological state of the black cohosh person is analogous to the bound-up cerebrospinal fluid. I have seen the one loosen up with the other so many times I can hardly count them.

Once we understand these affinities, we see how black cohosh is a remedy that acts strongly on the brain, meninges, spine, nerves, and muscles. It is specifically indicated in cases where there is brooding, a dark state of mind, or entrapment in romantic, sexual, or business affairs. Use it also to treat conditions where there are inequalities of the “charge on the nerves”—so that there are sensations of shocks and streamings through the nerves—and as a remedy for congestion and pain in the muscles and muscular attachments. A highly characteristic symptom is swelling and pain in the attachments of the trapezius muscle to the top of the shoulder blade, usually on both sides. This symptom is well known to most bodyworkers. Furthermore, black cohosh seems to directly associate with the fluid economy, so that the neurological and muscular symptoms are better by the onset of the period or worse from the cessation of the menstrual cycle at menopause. The tonifying effect of Cimicifuga in late pregnancy is probably associated with its relaxing effect on the nerves and muscles and the decongesting effect on the fluids.

Cimicifuga figures prominently as a remedy for fevers that affect the nerves and meninges. It has a history of successful use in cerebral meningitis and is beneficial in people who have headaches and pains lingering after such diseases. As noted above, it lessens the frequency and tension of the pulse. Finally, both the American and the Chinese Cimicifuga have a long history of use to lessen the severity of smallpox and skin rashes. (Coincidentally, homeopathic Anemone pulsatilla is also used to treat chicken pox.) This widely scattered testimony refutes the skepticism of nineteenth-century authors, who were only too willing to dismiss the wisdom of the American Indian medicine people and illiterate pioneers who had long turned to black cohosh for such complaints.

One very important modern use of black cohosh is as a hypotensive to relieve high blood pressure. Research on animals has shown that it has the effect of decreasing vasomotor tensions caused by clamping and unclamping the carotid arteries.² The explanation for this hypotensive effect is probably that black cohosh decongests the head and brings the nervous system as a whole into a state of relative balance, relieving local congestion and generalizing tensions. Many chiropractors feel that in a significant percentage of high blood pressure cases, the problem lies in cerebral congestion.

Case histories in my books Seven Herbs, Plants as Teachers (1986) and The Book of Herbal Wisdom (1997) illustrate most of these uses. Temple Hoyne, Clinical Therapeutics (1879-1880), gives a good selection of case histories from homeopathic literature. A comprehensive account of Cimicifuga racemosa, including some case histories, is given byj. U. and C. G. Lloyd in Drugs and Medicines of North America, Bulletin No. 30 (1931). J. I. Lightall (c. 1875) gives an account largely based on the Indian experience mixed with Eclectic indications.

Black cohosh preparations are almost uniformly made from the dried root or rhizome. However, the fresh substance has a life, smell, and taste that the dried does not possess; you cannot boast of having really tasted or known this medicine until you’ve tried the fresh article. It tastes, somehow, like the deep, humus-laden forest floor from whence it comes. Black cohosh contains an appreciable amount of sugars, making the flavor pleasant if not exactly sweet.

The original method of preparation was tea. Dr. William Cook, the physiomedicalist, notes that black cohosh tea should always be prepared as an infusion—not by boiling, as is customary with most medicinal roots. “The usual direction for preparing this infusion is to boil the root; but boiling, or even the use of boiling water, damages it greatly. Nothing above a lukewarm temperature should be employed. The infusion represents most fully the nervine qualities of the article.”³ The infusion is made by pouring 2 to 3 cups of water on 1 ounce of the powdered dried or bruised fresh root. Of this, a wineglassful may be taken two or three times a day. The dried root or rhizome is also available in tablets and capsules.

A simple tincture can be made from the fresh or dried article. The former yields a product so far superior in taste and medicinal effect as to be almost incomparable, in my opinion, but the latter is the usual source. Cook gives the formula: Macerate 4 ounces of bruised black cohosh root or rhizome in 2 cups of 50 percent alcohol for ten days and filter.

The official extract, according to the United States Pharmacopoeia of 1870 and subsequent editions, is made from 16 troy ounces of powdered Cimicifuga extracted in 2 cups of 85 percent alcohol according to the usual procedures. The great Eclectic pharmacist John Uri Lloyd approved of this method.

Cimicifuga is generally not considered to have strong toxic properties, but it can be upsetting. Gastrointestinal discomfort can occur; large doses may cause vertigo, headache, nausea, impaired vision, vomiting, and impaired circulation.⁴ I have seen aggravations occur from standard doses of the capsule or extract, but this is entirely avoided in small doses, which do the job certainly and slowly. Black cohosh often has serious structural changes to make in a person, and I believe this should be achieved slowly.

I personally use black cohosh in very small doses of the tincture: 1 to 3 drops, one to three times a day, for about six weeks. For menstrual problems, give the dose for two weeks before the period, for perhaps three cycles. J. I. Lightall gives the dose as 1 to 30 drops, with the average dosage being 5 to 10 drops of the tincture in water four times a day⁵

“The combinations into which it may suitably enter are numerous, according to the end sought,” remarks Dr. Cook. “With aralia hispida and fraxinus for dropsy, with cypripedium and scutellaria for neuralgic affections, with xanthoxylum or jeffersonia or the berries of phytolacca for rheumatism, with liriodendron and caulophylum in hysteria and other general spasms, etc.”⁶ These are mostly American Indian remedies and formulations. Pokeroot, prickly ash, and black cohosh, in equal parts, and in small doses, is an old remedy for rheumatic complaints.

A famous compound designed for the neurological effect is the B & B formula developed by Dr. John Christopher. Herbalist Terry Willard calls this “one of the most famous formulas” in Western herbalism. It consists of equal parts of blue vervain, black cohosh, blue cohosh, skullcap, and lobelia. Willard comments, “I have found this formula valuable for hiccups, ear infections, and medulla oblongata damage, and especially when medulla damage is caused by abuse of hallucinogenic drugs. It is also useful for asthma, whooping cough, and chorea.”⁷ Chorea is an old name for “spasm.”

I once mixed up some B & B formula for an elderly woman who was using it to remove a tumor on the palate of her mouth. The first batch I made using black cohosh tinctured fresh, the second from the usual commercial extract made from the dried rhizome. A few weeks after leaving with the second formula, she came back to me very angry. She thought I was trying to rip her off. I didn’t understand what she was talking about until she brought in the remnant of the first bottle to compare with the second bottle. The tastes were entirely different, and the commercial batch was not as good. Finally I realized that the difference was due to the substitution of black cohosh made from the dried article for that made from the fresh. This was the first time I became aware of the significant difference between these two forms of preparation.

For technical information about propagation, I sought the help of horticulturist Heather McCargo, who passed on to me the following information. Black cohosh can easily be grown from seeds. It can also be propagated by breaking up the crown, but this is more tedious and does not yield as many plants. The seeds need to be stratified in a sequence of warm temperature, followed by cold for several months, and then warm again. The reason for this is to mimic the conditions of the central temperate region, where black cohosh grows wild, ripening its seeds in midsummer. It can be sown in the ground right then and will sprout the following spring. Farther north it does not ripen its seeds until August. This seems to be a limiting factor—causing it not to propagate naturally in the northern climes, since the seeds need warm, cold, warm stratification. If you do this artificially, the seeds will be ready to sprout in the spring.

Although Cimicifuga is native to woodlands, it is readily cultured in the sunlight, hence it can be grown fairly easily as a crop. This is important, since it is widely used in traditional and modern herbal medicine. This is one plant we should not be exterminating in the wild.

The roots and rhizomes are dug in the fall, after the seeds have matured. Wash the dirt out of the fibrous, dense, compacted mass, then break apart the roots and rhizomes, spread them out, and slowly dry them in semishade. As mentioned above, the fresh article has more intense properties.

UpS RECOMMENDATIONS

• No wild harvest is recommended at this time.

• Purchase cultivated resources.

• Possible alternatives include yucca for musculoskeletal concerns; skullcap for headache relief, mood swings, and anxiety; and pulsatilla, motherwort, and chaste berries for general substitution.

Cook, William. The Physio-Medical Dispensatory. 1st ed., 1869. Reprint, Portland, Oreg.: Eclectic Medical Publications, 1985.

Hoyne, Temple. Clinical Therapeutics. 2 vols. 1979–1980. Reprint, New Delhi: B.Jain Publisher, 1984.

Lightall, J. I. The Indian Folk Medicine Guide, c. 1875. Reprint, New York: Popular Library, 1973.

Lloyd, J. U., and C. G. Lloyd. Drugs and Medicines of North America. Bulletin No. 30, Reproduction Series No. 9. Part 2. Cincinnati: Lloyd Library of Botany, Pharmacy, and Materia Medica, 1931.

McGuffln, Michael, Christopher Hobbs, Roy Upton, and Alicia Goldberry. Botanical Safety Handbook. New York: CRC Press, 1997.

Willard, Terry. Textbook of Modern Herbology. Calgary: Progressive Publishing, 1988.

Wood, Matthew. Seven Herbs, Plants as Teachers. Berkeley, Calif.: North Adantic Books, 1986.

________. The Book of Herbal Wisdom. Berkeley, Calif.: North Atlantic Books, 1997.