Archived Mountain Voices

Medicinal uses of black cohosh

“The first large, successful American business run by a woman was said to be the Lydia E. Pinkham Medical Company, founded in 1875 by Lydia Estes Pinkham. Her main product was Lydia E. Pinkham’s Vegetable Compound, a patent medicine to treat “all those painful complaints and weaknesses so common to our best female population’ — in other words, menstrual pain. A main ingredient was black cohosh, but the concoction’s popularity might have been due to its nearly 20 percent alcohol content.”

— Jack Sanders, The Secrets of Wildflowers, (2003)


Black cohosh — sometimes known as black snakeroot or bugbane — is one of the more eye-catching mid-summer wildflowers. Growing in the dappled shadows of rich woodland borders and openings throughout the Smokies region, the plant literally lights up the forest when its long white-flowered candelabra-like stalks that grow up to three feet high come into bloom.

You probably know black cohosh when you see it, but you may not be aware that there are two distinct species of the plant. Both are large with leaves divided into numerous egg-shaped or oblong, sharply-toothed leaflets. The white flowers appear to be without petals as they are primarily composed of fluffy stamens. The most common species (Cimicifuga racemosa) has ill-scented flowers that bloom from early June into August. These bear a single female pistil. It has been reported from all of the counties in Western North Carolina.

The second species (Cimicifuga americana) has flowers that aren’t ill scented and bears flowers from August into September. These display three or more pistils. It has been reported from most of the counties in WNC, excepting Graham, Clay, and Cherokee.

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The generic designation “Cimicifuga,” which is derived from “cimex” (bug) and “fugere” (to drive away), indicates that the ill scented species with its fetid odor drives away most of the insects that normally visit showy flowers, while attracting carrion-flies that effect pollination. Thus the name “bugbane.”

The common name “snakeroot” indicates that it was used as remedy for serpent bites. I only recently discovered why the plant is also known as “cohosh.” According to North Carolina naturalist Doug Elliott in his Roots: An Underground Botany and Forager’s Guide to the Useful Wild Roots, Tubers, Corms and Rhizomes of North America (1976), “The Algonquins called the root ‘cuski,’ meaning rough, from the appearance of the rootstock. The white settlers supposedly twisted the word into ‘cohosh,’ prefixing the black because of the roots’ dark color.”

The Cherokees utilized the roots in alcoholic spirits for a variety of ailments, including rheumatism, and made concoctions from various parts of the plant for constipation, fatigue, and backache. This use indicates that black cohosh probably contains some very active ingredients, which the recent literature on the subject confirms.

In their informative two volume study titled “Herbal Medicine Past and Present” (1990), John Crellin and Jane Philpott presented anecdotal folk testimony concerning a number of Appalachian plants then described the current scientific knowledge for each plant.

Their informant was Tommie Bass, a well-known Alabama herbalist, who passed away in recent years. In regard to black cohosh, Bass told Crellin and Philpott, “Well, I could sit here and talk all day about black cohosh ... It’s at the top of the list but it’s scarce .... It has a black, woody root and is a favorite Indian medicine — a tonic for blood and heart, and for rheumatism. It’s a good female medicine. It stimulates circulation. It’s been a beneficial medicine forever.”

In their commentary, Crellin and Philpott noted that during the mid-1800’s the plant “was said to be unquestionably one of the most valuable of our indigenous medicinal plants . . . In fact, the reputation of the plant — which owed something to its bitterness — subsequently developed to the level of a veritable panacea. A 1912 survey of physicians revealed it to be one of the most popular prescribed drugs.”

The authors located in the medical literature concerning black cohosh reports findings for a wide range of constituents, including actein (“which lowers blood pressure in rabbits and cats, but not dogs”) and tannins. They observed that “recent studies suggest a chemical basis — perhaps linked to isoflavones — which may account for the reputation as a female medicine through action on female hormones,” and suggested that a recent medical conclusion which discounts the plant’s potential value “seems premature.”

They also warned, however, that the toxic effects of black cohosh can be severe, involving tremors and vertigo, so that it not something for non-professionals to mess around with. And they noted the current “lack of discrimination mirrored in its promotion as a health food.”

While I remain interested in the folklore and potential medicinal properties of the various native plants one can locate and identify here in the mountains, I’m not one to gobble them up for either sustenance or relief. For that I go to our family’s gardens or the grocery store or the local pharmacy.

Lighting the dappled high-country trails like fairy candles, black cohosh is spectacular enough to be valued solely for its aesthetic properties and left alone for someone else to enjoy in its native woodland setting.

George Ellison wrote the biographical introductions for the reissues of two Appalachian classics: Horace Kephart’s Our Southern Highlanders and James Mooney’s History, Myths, and Sacred Formulas of the Cherokees. In June 2005, a selection of his Back Then columns was published by The History Press in Charleston as Mountain Passages: Natural and Cultural History of Western North Carolina and the Great Smoky Mountains. Readers can contact him at P.O. Box 1262, Bryson City, N.C., 28713, or at This email address is being protected from spambots. You need JavaScript enabled to view it..

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