Cimicifuge racemosa - Black Cohosh

Description

Black Cohosh is a perennial plant growing in Eastern North America and is cultivated in Europe. The dark brown roots are given off by underground rhizomes that are bluntly quadrangular and furrowed. The stem is slender and unbranched, 1.5 - 2.5 m tall. The palmately compound leaves have incised leaflets. It flowers from June to July with regular, numerous, small white racemes 20 - 50 cm long, having a peculiar scent. Recently (1998) there has been a move to place the entire genus of Cimicifuga into the genus of Actaea (baneberry). This is due to morphological and DNA sequence studies.

Part Used

Root.

Constituents

Black Cohosh contains a resinous material called cimicifugin (macrotin) 15-20% which is the active principal. (1-4) Black Cohosh also contains tannin, isoferulic acid, volatile oil, triterpine glycosides (actein, cimigoside and others) racemosin, and acetic, palmitic, salicylic, gallic, butyric and oleic acids.(5) There also is said to be an alkaloid, N-methylcytisine, as well as some un-named alkaloids.(6)

Mode of Action

Black Cohosh has been used as an analgesic. (7,8) Actein has been shown to be hypotensive in cats and rabbits but not dogs.(9) It has anti-inflammatory activity in animals and acts as a peripheral vasodilator in man. Extract of Black Cohosh creates selective reduction in luteinizing hormone (LH) levels by 20% with no effect on follicle-stimulating hormone (FSH) or prolactin levels by acting on the hypothalamus and vasomotor centers to reduce menopausal symptoms. This suggests we don`t need progesterone ‘opposing` therapy as found with HRT (Hormone Replacement Therapy) when using Black Cohosh. Black cohosh as a root extract works, but none of the single ingredient do, thus showing it is the sum total of many factors that makes it work. One of the most significant factors of using Black Cohosh over HRT is that it does not have to be consumed on a long term basis. It helps a person through the symptom stages of menopause.

In Germany, it was introduced under the brand name Remifemin in the mid-1950s, and is still being one of the prominent products used to reduce menopause symptoms in that country. Black Cohosh is currently being used by 1.5 million German women annually or nearly 10 million monthly doses.(10,11) The use of this product has been shown to be more effective for common menopausal symptoms (hot flashes, vaginal atrophy, depression and anxiety) than conjugated estrogen (HRT). Many people know that one of the risks of HRT is the stimulation of estrogen receptor cancer growth in the breast and uterus. Black Cohosh has been shown to not stimulate established breast tumor, and in fact has a inhibitory effect. Black Cohosh has been shown to exert no effect on endometrium, so there is no need to ‘oppose` therapy with progesterone as is done with conventionalHRT.(12)

Therapeutic Action

Nervine, tonic, antispasmodic, an alterative, sedative and emmenagogue.(13-20) It is also used as an antitussive, a bitter stomachic, a diuretic and diaphoretic.(21)

Energetics

Traditional Chinese

(related spp. C. heracleifolia, C. dahurica, C. foetida, C. simplex) The flavor is sweet, pungent; with a mild, cold property. These herbs enter the Lung, Spleen, Colon and Stomach meridians. The action resolves surface, promotes eruptions, removes toxic heat, and raises yang Qi.(22,23)

Other

Holmes finds Black Cohosh bitter, a bit pungent, cool and dry; with secondary action of relaxing, calming, stimulating and restoring. It enters the Lung, Heart, Kidney, Chong and Ren meridians; has a warm organism and is air quality. Its action is on the lung, heart, circulation, stomach, kidney and reproductive organs.(24) Tierra lists the herb as sweet, pungent, slightly bitter and cool; influencing the Liver, Spleen, Stomach, and Colon.(25)

Folklore

Black Cohosh is well regarded as both a nervine and as a specific for female problems. Its roots are often used for their antispasmodic and alterative properties. They are employed in many nerve formulas, in epilepsy, for soothing local pain, for headaches, and for alleviating nervous excitement.

The root was used by the Indians as an antidote for poison and snakebite, kidney ailments, malaria, female reproductive problems, rheumatism, and sore throat.(26) It was also used by early American colonists for bronchitis, dropsy, fevers, uterine problems, malaria, nervous disorder and yellow fever.(27) Early Eclectic practitioners also made heavy use of the plant as indicated in the publications of Schoepf (1785) and Barton (1801). From 1832-1852, Professor King introduced several uses drawing from Native American tradition and using the extracts of the day. He gave Black Cohosh great prominence.(28) This genus was listed in Chinese medicine first in the Divine Husbandman`s Classic of the Materia Medica (Later Han Dynasty 25-220 A.D.).

Dr. Young introduced Black Cohosh as a successful cardiac tonic, especially for fatty hearts. It slightly lowers the heart rate while it increases the force of the pulse and equalizes the circulation. Black Cohosh has a stimulating effect on the secretion of the liver, spleen and lymphatic system. It has often been employed for nervousness and the afterpains of delivery. Eastern North American tribes (Cherokee, Delaware-Okl, Iroquois, Micmac) made use of Black Cohosh for colds, coughs, pediatric complaints and a number of other ailments.(29)

Dosage

Liquid extract - 0.3 to 1.8 ml(30) NF 1.0 ml(31)
Tincture - 1.8 to 3.6 ml(32)
Root powder N.F. - 1.0 gram(33,34)
Root powder - 0.3 to 2.0 grams U.S. Dispensory(35-37)

Toxicity and Contraindications

Spoerke(38) notes that the toxicity data on Black Cohosh is conflicting. As with many herbs, researchers confuse information from homeopathic provings (on sensitive people) with research data on the herb. All other sources say it is non-toxic. This is probably due to a mild non-violent emetic effect and the ability to cause nausea in large doses.(39) Large doses may produce giddiness and headache. Black Cohosh is contraindicated in the first trimester of pregnancy. Used in the third trimester, it can hasten delivery. The FDA classifies this herb as undefined safety: ``No pharmacologic evidence of any therapeutic value.``

Official Recognition and Medical References

UK - General sale list Scedule 1, Table A 200 mg maximum single dose
German Commission E - 2.3.89, menopause, lowering symptoms related to PMS, and painful menstruation
PDR of Herbal Medicine p. 746
Extractum Cimicifugae U.S.P.
Extractum Cimicifugae Liquidum U.S.P.(40)

References

1. Gathercoal, E.N. and Wirth, E.H., Pharmacognosy, Lea & Febiger, Phila., PA, 1936. p. 259.
2. Spoerke, D.G., Herbal Medications, Woodbridge Press Publ. Co., Santa Barbara, CA, 1980. p. 37.
3. Allport, N.L., Chemistry and Pharmacy of Vegetable Drugs, George Newnes Ltd., London, 1943. p. 150.
4. The Merck Index 5th ed., Merck & Co. Inc., Rahway, NJ, 1940. p. 147.
5. Leung, A.Y., Encyclopedia of common natural ingredients used in food, drugs, and cosmetics, John Wiley & Sons Inc., New York, 1980. p. 66.
6. Duke, J.A., Handbook of Medicinal Herbs, CRC Press Inc., Boca Raton FL, 1985. p. 121.
7. Squire, P.W., Squire`s Companion to the Latest Edition of the British Pharmacopeia, J & A Churchill, London, 1908. p. 380.
8. Leung, A.Y., Ibid.
9. Tyler V.E., The Honest Herbal, George F. Stickley, Phil, 1983, p. 263.
10. Hobbs,C.; Black Cohosh - A woman`s herb comes of age; Herbs for Health; March 1998
11. Murray, M; Remifemin: Answers to Common Questions; Am. J. of Nat. Med; Vol 4, # April 97, p. 3-5
12. The Lawrence Review; Black Cohosh; May 1998.
13. Gathercoal, E.N. and Wirth, E.H.,Ibid.
14. The Merck Index 5th ed., Ibid.
15. Wren, R.C., Potter`s New Cyclopaedia of Botanical Drugs and Preparations, Health Science Press, Rustington, Sussex, U.K., 1975. p. 89.
16. Lloyd, J.U. and C.G., Drugs and Medicines of North America Vol. 2, Cincinnati, OH, 1886 - 1887. p. 273.
17. Squire, P.W., Ibid., p. 380.
18. Herbal Pharmacology in the People`s Republic of China, Trip Report of the American Herbal Pharmacology Delegation, National Academy of Sciences, Washington DC, 1975. p. 195.
19. Veninga, L. and Zaricor, B.R., Goldenseal/Etc.: A Pharmacognosy of Wild Herbs, Ruka Publications, Santa Cruz CA, 1976. p. 103-104.
20. Leung, A.Y.,Ibid.
21. The Merck Index 5th ed., Ibid.
22. Bensky, D. and Gamble, A., Chinese Herbal Medicine: Materia Medica, Eastland Press, Seattle, WA, 1986, p. 71.
23. Hsu, H.Y., Chen, Y.P., et al., Oriental Materia Medica: a concise guide, Oriental Healing Arts Institute, Long Beach, CA, 1986, p. 73-74.
24. Holmes, P., The Energetics of Western Herbs (2 vols.), Artemis Press, Boulder CO, 1989, p. 436.
25. Tierra M.; Planetary Herbology; Lotus Press; Santa Fe; 1988 p. 229-30
26. Duke, J.A., Ibid.
27. Krochmal. A. and Krochmal, C., A Guide to the Medicinal Plant of United States, 3rd ed. Quadrangle/The New York Times Book Co., New York, 1975, p. 259.
28. Felter, H.W. and Lloyd, J.U., King`s American Dispensatory (Vol. 1), (18th ed., 3rd Rev.). 1898 (Repr. 1983), Eclectic Med. Publ., Portland, OR, p. 528-533.
29. Moerman, D.E., Medicinal Plants of Native America, University of Michigan Museum of Anthropology, Technical Reports, Number 19, Ann Arbor, Michigan, 1986, Vol.1, p. 122.
30. Squire, P.W., Ibid., p. 381.
31. The National Formulary 6th ed., American Pharmaceutical Association, Washington DC, 1935. p. 162.
32. Squire, P.W., Ibid.
33. Gathercoal, E.N. and Wirth, E.H., Ibid.
34. The National Formulary 6th ed., Ibid., p. 81.
35. Wood, H.C. and Osol, A., Dispensatory of the United States of America 23rd ed.,J.B. Lippincott, Montreal, P.Q., 1943. p. 309.
36. Veninga, L. and Zaricor, B.R., Ibid.
37. The Merck Index 5th ed., Ibid.
38. Spoerke, D.G., Ibid.
39. Leung, A.Y., Ibid.
40. Lucus, E.W. and Stevens, H.B., The Book of Pharmacopeias, J & H Churchill, London, 1915, p. 92.