| gynecology
The primary clinical application of Black Cohosh is the treatment of menopausal symptoms. It is also used for post-operative functional deficits following ovariectomy or hysterectomy, for the treatment of premenstrual syndrome, and for juvenile menstrual disorders. The herbal extract, as well as homeopathic preparations, are used as an emmenogogue (a substance that promotes menstrual flow), (NAPRALERT 1997) and to correct atony of the reproductive tract (Hoffman, no date). The German Commission E cites evidence for efficacy in its use for dysmenorrhea or painful menstruation.
ANTIINFLAMMATORY/ANALGESIC USES
There are reports of its use in treating rheumatoid and osteoarthritis, fevers, mumps, epilepsy, cough, as a sedative, and in the treatment of snakebite. Black Cohosh is often used in therapeutic herbalism for various types of pain, including headache, and joint and muscle pain associated with smallpox and measles, cramps and spasms. Some of these uses may be related to Cimicifuga species' demonstrated analgesic, antiinflammatory, antipyretic/hypothermic, and antispasmodic activities as demonstrated in animal studies.
THERAPEUTIC USES IN CHINESE MEDICINE
Related species (C. heracleifolia, C. dahurica, & C. foetida) are used in traditional Chinese medicine (TCM) for a variety of infectious diseases, including influenza, mumps, measles complicated with pneumonia, congenital syphilis, tonsillitis, and in some cases of plague. It has also been used in TCM for uterine and rectal prolapse, and as a mouth wash preparation for halitosis and mouth diseases. These applications are tenuous since only in vitro antibacterial effects for these species have been demonstrated. It is a component of "Qingwei San" (Stomach Heat Clearing Powder), a multicomponent herbal preparation used for gum swelling and erosion, acute periodontal and pharyngeal diseases. It is an important component of "Buzhong Yiqi Tang"(Decoction for Reinforcing the Middle Burner and Replentishing Vital Energy). C. foetida or C. dahurica have been used in lotions for skin "protection". A preparation known as Cimicifuga-Amyda Shell Decoction is used in the treatment of thrombocytopenia (abnormal reduction in number of blood platelets) and nephritis with hematuria (Chang & But 1986).
Although extensively used by the Eclectic medical doctors of North America for specific conditions of pregnancy, labor and post-partum (Brinker 1996), there are no recent studies clarifying the pharmacological effects of Cimicifuga during pregnancy and labor. Cimicifuga racemosa has a documented uterine stimulant effect and can induce labor according to a NAPRALERT summary (1997).
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