Common Names: Black cohosh, black snakeroot, macrotys, bugbane, bugwort, rattleroot, rattleweed

Black cohosh, the root of a member of the buttercup family, is found in rich woods of the eastern deciduous forest from southern Ontario south to Georgia, west to Arkansas, and north to Wisconsin.

Most of the root is wild-harvested, while some is grown commercially in Europe. It is called Black Snake Root to distinguish it from the Common Snake Root (Aristolochia serpentaria). The blackish, cylindrical root of this plant gives this herb its name.

Among Native Americans and early settlers in North America, black cohosh root was an important folk medicine for menstrual irregularities and as an aid for relieving pain in childbirth. North American Indians also used it as medicine for malaise, gynecological disorders, kidney disorders, malaria, rheumatism, sore throat, colds, cough, constipation, hives, and backache and to induce lactation.

In 19th-century America, black cohosh was a home remedy used for rheumatism and fever, as a diuretic, and to bring on menstruation. It was extremely popular among a group of alternative practitioners who called black cohosh “macrotys” and prescribed it for rheumatism, lung conditions, neurological conditions, and conditions that affected women’s reproductive organs (including menstrual problems, inflammation of the uterus or ovaries, infertility, threatened miscarriage, and relief of labor pains).

In the early nineteenth century, it enjoyed a great reputation as an anti-inflammatory for arthritis and rheumatism and was also used for nervous disorders. The root was an official drug in the U. S. Pharmacopoeia from 1820 to 1926.

Black Cohosh as an Herb for Medicinal Uses

black cohosh rootBlack cohosh root is approved for use in Germany for the treatment of premenstrual symptoms, painful or difficult menstruation, and for menopausal symptoms such as hot flashes. A number of studies have confirmed its mild sedative and anti-inflammatory activity.

In fact, black cohosh has become famous in recent years as a treatment for menopause. It seems to produce an estrogen-like effect that reduces symptoms, such as hot flashes and vaginal dryness. Many herbalists use black cohosh for PMS symptoms as well. According to many reports it reduces all major symptoms, including anxiety, irritability, fluid retention, and breast pain for many women.

In small doses, it is useful in children’s diarrhea. It is also supposed to be an antidote against poison and the bite of the rattlesnake. The fresh root, dug in October, is used to make a tincture.

In whooping-cough, black cohosh proves very effective. The infusion and decoction have been given with success in rheumatism.

This versatile herb has been recommended for respiratory ailments (especially asthma and bronchitis), rheumatism, muscle cramps and neuralgia.

Black Cohosh Tincture: Root infused in 80 proof vodka; average daily dose is 20 drops on tongue. Take in hot water to evaporate alcohol.

Black Cohosh Decoction: Add 2 teaspoons dried rootstock to 1 pint of water, boil and let cool. Give 2 to 3 tablespoons up to six times a day.

Culinary Uses of Black Cohosh

Culinary use not recommended.


Black Cohosh root was used by Native Americans to treat snake bite and as a ceremonial herb to bring visions. The root was thought by some early American settlers to be the main ingredient in witches brew, and any female caught with it in her possession was burned as a witch.


Clinical trials comparing estrogens with black cohosh preparations have shown a low incidence of adverse effects associated with black cohosh; headaches, gastric complaints, heaviness in the legs, and weight problems were the main adverse effects noted. Of course, these are also common symptoms of menstruation, so it is difficult to pinpoint the cause or source of the symptoms. More studies are needed.

The use of Black Cohosh is contraindicated during pregnancy due to an increased risk of spontaneous abortion.

No interactions have been reported between black cohosh and prescription medicines. (NCCAM)

Black cohosh should not be confused with blue cohosh (Caulophyllum thalictroides), which has different properties, treatment uses, and side effects. Black cohosh is sometimes used with blue cohosh to stimulate labor, but this therapy has caused adverse effects in newborns, which appear to be due to the blue cohosh. (NCCAM)

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