Black Cohosh
Common Name
: Black Cohosh,
Black Snakeroot, Bugbane, Bugwort, Rattleroot, Rattletop, Richweed, Rattleweed, Macrotys, Amerikanisches Wanzenkraut, Herbe au Punaise - The word Cohosh is from the Algonquian Indian language family; in the Massachuset language, koshki means "it is rough." This refers to the gnarled root of the plant which is rough in texture and black in color.

Scientific Name: Actaea racemosa - The genus name is derived from the Greek word acte which is the name of a type of elder that has leaves and berries that are similar in structure. Racemosa is Latin for racemose which is the adjectival form of raceme, an arrangement in which the flowers grow directly from the central stem or rachis. The species was known until 1998 as Cimicifuga racemosa.

Potpourri: The scientific name of the Black Cohosh has a long history that provides some insight into the challenges of taxonomy. It was originally placed in the genus Actaea, on account of the long racemose spike. Linnaeus separated the genus Cimicifuga from Actaea due to differences in the forms of the berries; Actaea have fleshy berries and Cimicifuga have dry follicles. The genus name Cimicifuga was derived from Cimex, the genus of the bedbug and the Latin word fuga meaning "flight" or "running away." Plants of the Cimicifuga genus were noted for their unpleasant aroma and were used as insect repellants, causing "the bedbugs to run away." The common names Bugbane and Bugwort also reflect the observation that A. racemosa is avoided by insects.

In the early 19th Century the botanist C. Rafinesque noted that C. racemosa did not really conform to the Linnaean description and proposed a new genus name, Macrotrys. Derived from the Greek words for "large" and "bundle," the genus nomenclature distinguishes the large raceme of the plant. The new genus name was adopted by many in the botanical community; Black Cohosh retains the common name Macrotys in many botanical references, particularly those with medicinal implications, due to this former genus name. The Black Cohosh was moved back into the original genus Actaea based on DNA sequence studies in 1998, its recognized designation according to the USDA.

Black Cohosh was used for a wide variety of medicinal applications by the Native Americans, primarily as a palliative for gynecological disorders and as an aid in parturition. Early colonists learned of the drug from the Indians, and herbalists prescribed it as a home remedy to treat not only female menstrual related maladies, but also a wide variety of unrelated ailments including rheumatism, fever, bronchitis, nervous disorders, lumbago and snakebite. It was given to children in a syrup form to relieve numerous infantile disorders, notably the shaking of chorea or Saint Vitus' dance. It was listed as black snakeroot in the first United States Pharmacopoeia (USP) in 1820 and may very well have been one of the drugs from which the notion of "snake-oil" as a folk synonym for a false remedy was derived. It continued in the USP form 1890 until 1936 under the names of Black Snakeroot, Black Cohosh, Cimicifuga and Macrotys.

The dark rhizome and roots of A. racemosa are the source of the dietary supplement that is sold commercially as a treatment for hot flashes and other aspects of the menopausal climacteric. Remifemin, the most well known Black Cohosh preparation, is made by a German company and consists of capsules that contain 20 milligrams of Cohosh root each, the recommended dosage being 2 capsules per day. The primary active ingredients are thought to be terpene glycosides (sugar derivatives) including actein and cimifugoside (note that these are from the genus names Actaea and Cimicifuga). It was originally thought that these compounds acted to activate estrogen receptors, but clinical studies have shown that this has little effect on the level of estrogen, a key aspect of the menopausal transition. It is still not known how or even if Black Cohosh has any effect on estrogenic activity.

The American College of Obstetrics and Gynecology provides guidelines on the use of dietary supplements for women. In 2001 the College stated on consensus and expert opinion that Black Cohosh may be helpful for up to six months in the treatment of menopausal symptoms. This was based on a number of trials that were conducted to demonstrate the efficacy of the botanical. Most of the trials were conducted in Germany and used Black Cohosh extract as compared to an estrogen product as a control. In one study involving 80 menopausal women, hot flashes decreased from 4.9 to 0.7 in the Black Cohosh Group, as compared to 5.2 to 3.2 in the estrogen group and 5.1 to 3.1 in a placebo group over a trial period of 12 weeks.