Black Cohosh

Cimicifuga racemosa


Names: Black Snakeroot, Bugbane, Rattleroot, Rattleweed, Squawroot.

Habitat: USA and Canada.

Collection: The roots are unearthed with the rhizome in autumn after the fruits have ripened. They should be cut lengthwise and dried carefully.

Part Used: Root and rhizome; dried, not fresh.


  • Triterpene glycosides, including actein, cimigoside, cimifugine (=macrotin), racemoside
  • Isoflavones such as formononetin
  • Isoferulic acid
  • Miscellaneous; volatile oil, tannin.

Actions: Emmenagogue, anti-spasmodic, alterative, nervine, hypotensive.

Indications: Black Cohosh is a most valuable herb that has a powerful action as a relaxant and a normalizer of the female reproductive system. It maybe used beneficially in cases of painful or delayed menstruation. Ovarian cramps or cramping pain in the womb will be relieved by Black Cohosh. It is very active in the treatment of rheumatic pains, but also in rheumatoid arthritis, osteo-arthritis, in muscular and neurological pain. It finds use in sciatica andneuralgia. As a relaxing nervine it may be used in many situations where such an agent is needed. It has been found beneficial in cases of tinnitus. Because of the wealth of accrued experience, it is worth quoting from Kings American Dispensatory:

Kings “This is a very active, powerful, and useful remedy, and appears to fulfill a great number of indications. It possesses an undoubted influence over the nervous system. In small doses the appetite and digestion are improved, and larger amounts augment the secretions of the gastro-intestinal tract. Excretions from the skin and kidneys are increased by it, the peculiar earthy odor of the drug being imparted to the urine; the secretions of the bronchial mucous surfaces are also augmented under its administration. The heart-beat is slowed and given increased power by it, while arterial tension is elevated.

Upon the reproductive organs it exerts a specific influence, promoting the menstrual discharge, and by its power of increasing contractility of the unstriped fibers of the uterus, it acts as an efficient parturient. The venereal propensity in man is said to be stimulated by Cimicifuga.

Few of our remedies have acquired as great a reputation in the treatment of rheumatism and neuralgia. Indeed, few cases of rheumatism, or conditions depending upon a rheumatic basis, will present, which will not be influenced for the better by Cimicifuga. Rheumatism of the heart, diaphragm, psoasmuscles, “lumbago” “stiff neck” in fact all cases characterized by that kind of pain known as “rheumatic” dull, tensive intermittent, as if dependent upon a contracted state of muscular fibre, soreness in muscular tissue, especially over the abdomen and in the extensor and flexor muscles of the extremities, all yield readily to it.

Muscular pain of a rheumatoid character, when not amounting to a true rheumatic attack, and other rheumatoid pains when acute and not of spinal origin such as gastralgia, enteralgia, tenesmic vesical pains, pleurodynia, pain in the mediastina orbits or ears, are relieved by Cimicifuga. In diseases of the ear the drug is indicated when the condition is aggravated by rheumatic association, or in neuralgia of the parts with stiffness in the faucial and pharyngeal muscles. In eye strain, giving rise to headache, and associated with a sensation of stiffness in the ocular muscles, or a bruised feeling in the muscles of the frontal region, it will give marked benefit. In doses of 1 fluid drachm of the tincture, repeated every hour, it has effected thorough cures of acute conjunctivitis, without the aid of any local application.

Cimicifuga plays a very important part in the therapeutics of gynecology. It is a remedy for atony of the reproductive tract. In the painful conditions incident to imperfect menstruation, its remedial action is fully displayed. By its special affinity for the female reproductive organs, it is an efficient agent for the restoration of suppressed menses. It is even a better remedy in that variety of amenorrhoea termed “absentio mesium”. In dysmenorrhoea it is surpassed by no other drug, being of greatest utility in irritate and congestive conditions of the uterus and appendages, characterized by tensive, dragging pains, resembling the pains of rheumatism. If the patient be despondent and chilly, combineCimicifuga with Pulsatilla, especially in anemic subjects. It is a good remedy for the reflex “side-aches” of the unmarred woman; also for mastitis and mastodynia. It should be remembered in rheumatism of the uterus, and in uterine leucorrhoea, with a flabby condition of the viscus, its effects are decided. When there is a disordered action or lack of functional power in the uterus, giving rise to sterility, Cimicifugaoften corrects the impaired condition and cures. Reflex mammary pains during gestation are met by it, and in rheumatic subjects it promptly relieves such ovarian troubles as ovarialgia and neuralgia, the pain being of an aching character. Orchialgia and aching sensations of theprostate are conditions calling for Cimicifuga, and as a tonic it is not without good effects in spermatorrhoea.

Cimicifuga has proved a better agent in obstetrical practice than ergot. It produces natural intermittent uterine contractions, whereas ergot produces constant contractions, thereby endangering the life of the child, or rupture of the uterus. Where the pains are inefficient, feeble, or irregular, Cimicifuga will stimulate to normal action. It is an excellent”partus praeparator” if given for several weeks before confinement. It is a diagnostic agent to differentiate between spurious and true labor pains, the latter being increased, while the former are dissipated under its use. It is the best and safest agent known for the relief of after-pains, and is effectual in allaying the general excitement of the nervous system after labor.

Cimicifuga exerts, a powerful influence over the nervous system, and has long been favorably known as a remedy for chorea. It may be used alone or with Valeriana, equal parts. It is, particularly useful here when associated with amenorrhoea, or when the menstrual function fails to act for the first time. Its action is slow, but its effects, are permanent. It has been used successfully as an antispasmodic in hysteria, epilepsy when due to menstrual failures, asthma and kindred affections, periodical convulsions, nervous excitability, pertussis, delirium tremens and many other spasmodic affections.

For headache, whether congestive or from cold, neuralgia, dysmenorrhoea, or from la grippe, it is promptly curative. As a palliative agent in phthisispulmonalis, good results are obtained, in that it lessens cough, soothes the pain, especially the “aching” under the scapulae, lessens secretions and allays nervous irritability. Fevers, intermittent and remittent have been benefited by it; well-marked antiperiodic and tonic virtues having been observed in the drug. In the exanthemata, it is a valuable agent, controlling pain, especially the terrible “bone aches” of smallpox, rendering the disease much milder. Inscarlatina and measles, it relieves the headache and the backache preceding the eruptions. It is stated that it has been used in the south with some success as a prophylactic against variola. Cimicifuga exerts a tonic influence over both the serous and mucous tissues of the system, and will be found a superior remedy in the majority of chronic diseases of these parts. In all cases where acidity of the stomach is present, this should first be removed, or some mild alkaline preparation be administered in conjunction with the remedy, before any beneficial change will ensue. As a remedy for pain, Cimicifuga is a very prompt agent, often relieving in a few hours, painful conditions that have existed for a long time

The saturated tincture of the root is recommended as a valuable embrocation in all cases where a stimulant, tonic, anodyne, and alterative combined is required, as in all cases of inflammation of the nerves, tic-dolloureux, periodic cephalic pain, inflammation of the spine, ovarian inflammation, spasms of the broad ligaments, rheumatism, crick in the back or side, inflammation of the eyes, old ulcers, etc. Preparations of Cimicifuga, to be of any medicinal value, must be prepared from recently dried roots.

Preparations & Dosage : Decoction: pour a cup of water onto l/2-l teaspoonfuls of the dried root and bring to boil. Let it simmer for l0-l5 minutes. This should be drunk three times a day.

Tincture: take 2-4 ml of the tincture three times a day.

“As a partus accelerator, it may be substituted for, and should be preferred to, ergot; 1/2 drachm of the powdered root may be given in warm water every 15 or 20 minutes, until the expulsive action of the uterus is induced, and which it seldom fails to bring on speedily and powerfully. In acute troubles, as acute muscular rheumatism, and in false pains, and as an oxytocic, Webster prefers the strong decoction of the recent root in tablespoonful doses. The fluid extract of black cohosh may be used in all cases where the article is indicated; its dose is from 1/2 fluid drachm to 2 fluid drachms. The ordinary dose for its specific effects is a teaspoonful of a mixture of from 10 drops to 1 drachm of Cimicifuga tincture in 4 ounces of water, the larger or smaller dose being determined by the condition of the patient.”

Citations from the Medline database for the genus Cimicifuga

Black Cohosh Duker EM Kopanski L Jarry H Wuttke W Effects of extracts from Cimicifuga racemosa on gonadotropin release inmenopausal women and ovariectomized rats.

Planta Med 1991 Oct;57(5):420-4 Ito M Kondo Y Takemoto T spasmolytic substances from Cimicifuga dahurica maxim.

Chem Pharm Bull (Tokyo) 1976 Apr;24(4):580-3>Jarry H Harnischfeger G [Endocrine effects of constituents of Cimicifuga racemosa. 1. The effect onserum levels of pituitary hormones in ovariectomized rats]

Planta Med 1985 Feb(1):46-9 (Published in German)>Jarry H Harnischfeger G Duker E [The endocrine effects of constituents of Cimicifuga racemosa. 2. In vitrobinding of constituents to estrogen receptors]

Planta Med 1985 Aug(4):316-9 (Published in German) Shibata M Ikoma M Onoda M Sato F Sakurai N [Pharmacological studies on the Chinese crude drug “Shoma”. III. Centraldepressant and antispasmodic actions of Cimicifuga rhizoma, Cimicifuga simplex Wormsk (author’s transl)]

Yakugaku Zasshi 1980 Nov;100(11):1143-50 (Published in Japanese) Shibata M Sakurai N Onoda M [Pharmacological studies on the Chinese crude drug “Shoma”. II. Anti-inflammatory action of Cimicifuga rhizoma, Cimicifuga simplex Wormsk (author’stransl)]

Yakugaku Zasshi 1977 Aug;97(8):911-5 (Published in Japanese) Shibata M Yamatake Y Amagaya Y Fukushima M [Pharmacological studies on the Chinese crude drug “Shoma”. I. Acutetoxicity and anti-inflammatory action of Cimicifuga rhizoma, Cimicifugadahurica Maxim. (author’s transl)]

Yakugaku Zasshi 1975 May;95(5):539-46 (Published in Japanese)

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Written by David L. Hoffmann BSc Hons MNIMH

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