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Used as an infusion, decoction, extract and tincture.

Known as squawroot or papooseroot, Blue Cohosh was widely used in Native America as a uterine toner, especially prior to delivery. Some Indian women drank a strong decoction as a contraceptive. The herb was official in the US Pharmacopeia as a labor inducer from 1882 to 1905.

Blue Cohosh's saponin, called caulosaponin, has been shown to stimulate uterine contractions. Several other alkaloids are also known to be active.

As an anti-spasmodic, it eases false labor and menstrual cramps. It also helps ease delivery. As Grieve puts it, 'In use it is preferable to Ergot, expediting delivery, where delay results from debility, fatigue or want of uterine nervous energy.'

It is a safe emmenagogue.

Grieve's classic 'A Modern Herbal': 'Emmenagogue, antispasmodic, diuretic, diaphoretic and anthelmintic. Said to be successfully used in rheumatism, dropsy, epilepsy, hysteria and uterine inflammation, specially for chronic cases. It is sometimes combined with Mitchella repens and Eupatoria aromatica.'

'In use it is preferable to Ergot, expediting delivery, where delay results from debility, fatigue or want of uterine nervous energy.'

'Doses: Decoction or Infusion. 1 oz. of root to 1 pint of boiling water, macerated for ½ hour. Dose, 2 to 4 fluid ounces three or four times a day.'

'Tincture: 3 oz. of finely powdered root to 1 pint of alcohol, allowed to soak for two weeks, then well shaken and filtered. Dose, ½ fluid drachm to 2 fluid drachms. Fluid extract, 10 to 30 drops. Solid extract, 5 to 10 grains. Caulophyllum, 2 to 5 grains.'

King's 1898 Dispensatory: 'Of caulophyllum, Rafinesque states that 'as a powerful emmenagogue it promotes delivery, menstruation, and dropsical discharges,' and that 'it was employed by the Indians and their imitators for rheumatism, dropsy, colic, sore throat, cramp, hiccough, epilepsy, hysterics, inflammation of the uterus, etc.'

'Blue cohosh is reputed antispasmodic, emmenagogue, and parturifacient, besides being diuretic, diaphoretic, and expectorant.'

'Its use as a parturient originated in the custom of the Indian squaws of employing a decoction of the root for 2 or 3 weeks previous to labor to facilitate child-birth. This became known to the whites through Smith's publication. There is no doubt but that caulophyllum has a decided action upon the gravid uterus. During labor it relieves false pains and coordinates muscular contractions, at the same time increasing their power. Like macrotys, it is a better oxytocic than ergot. Unlike the latter agent it stimulates normal contraction instead of inducing spasmodic uterine action.'

'It is most valuable in those cases where delay is due to debility, fatigue, or lack of uterine nervous energy, and for deficient contractions where the tissues feel full, as if congested. As a partus praeparator, blue cohosh has enjoyed a well-merited reputation. When used by delicate women, or those who experience prolonged and painful labors, for several weeks previous to confinement, it gives tone and vigor to all the parts engaged in the accouchement, facilitating its progress, and relieving much suffering. Prof. Hale testifies that women who have taken caulophyllum previous to confinement, have overrun their time from 10 to 12 days, but all had very easy labors and made good recoveries.'

'It is a good remedy for after-pains, especially when spasmodic in character. Caulophyllin has also been used for this purpose. It is a remedy for hour-glass contraction and for spurious labor-pains. Blue cohosh acts as an antiabortive by relieving the irritation upon which the trouble depends. King states that for this purpose it is fully equal to viburnum.'

'As a gynecian remedy it has been employed to relieve irritation of the reproductive organs as if dependent on congestion. It controls chronic inflammatory states of these organs and gives tone in cases of debility. In the sexual disorders of the female it is indicated by tenderness and pain in the uterus, in debilitated patients. It has been very successfully used in cases of hysteria to overcome the attack, and to relieve ovarian, or mammary pain, or irritation when accompanying that disorder. Chronic corporeal, or cervical endometritis, metritis, ovaritis, ovaralgia, uterine leucorrhoea, amenorrhoea, and dysmenorrhoea, are conditions in which it has been most successfully employed. It has an established reputation as a remedy for rheumatism of the uterus, with nervous excitement, for uterine cramps attending menstruation, and for menorrhagia, depending on uterine subinvolution.'

'By lessening irritation it has been serviceable in cystitis, urethritis, chronic nephritis, and albuminuria. Spasmodic retention of urine is relieved by it. It is a good remedy for some cases of rheumatism, though not so valuable as macrotys. It effectually overcomes rheumatoid conditions of the uterus and of the stomach—in the latter instance when crampy pains follow the ingestion of food. While valuable in all chronic cases of muscular rheumatism, it is especially adapted to articular rheumatism, particularly when confined to the smaller joints, as of the toes and fingers.'

'By its sedative action it is valuable in some cases of insomnia, and has been suggested as a remedy for bronchitis and catarrhal pneumonia. It is also a remedy for gastric nausea and vomiting.'

'Dose of the infusion, from 1 to 3 ounces, every 3 or 4 hours; of specific caulophyllum, from 3 to 10 drops; of caulophyllin, from 2 to 4 grains.'

'Lloyd's Leontin (the1 per cent solution of the emmenagogue principle of blue cohosh) has been very successfully employed in amenorrhoea, dysmenorrhoea, and chlorosis. The dose ranges from 5 to 15 drops in syrup or sweetened water.'

American Materia Medica, 1919 (Ellingwood): 'In chronic uterine disorders, in broken down constitutions with various reflex symptoms, the remedy is a specific. In the amenorrhea of young women, at the commencement of the menstrual period, it may be given with confidence. In painful menstruation it has an established reputation.'

'From the end of the sixth month to the close of pregnancy is a period when many distressing symptoms are manifested, which may, in a measure, be relieved by caulophyllum.'

'The growth of the fetus has been compared to an apple, which, when fully ripened, falls from the tree. The effect of caulophyllum is to prolong gestation till the fetus is fully developed, labor being a physiological process at full term, and not pathological, therefore less protracted, less painful, and less liable to accidents.'

'Many writers confirm the opinion that caulophyllum or caulophyllin are excellent remedies in labor, contributing to the relaxation of a rigid os, increasing the strength of the pains. It will also assist materially in controlling an abortion. Using it in conjunction with viburnum, this influence will be enhanced.'

'This remedy as a partus preparator is equal in some cases to cimicifuga, and comparable with viburnum and helonias. It prevents premature delivery by a superior tonicity, which it induces in all the reproductive organs. It has caused many cases to overrun their time a few days, and yet easy labors and excellent recoveries have followed. It is a satisfactory remedy where there is a habit of having severe after pains, or where there are false labor pains, not productive of good, or where subsequent to the labor there are hourglass or other undue spasmodic uterine contractions.'

'It is a beneficial remedy in hysteria, and where there is constant ovarian irritation, or pain in the mammary glands, accompanied with general irritation; also in chronic disease of the uterus and ovaries or of the cervix. Also where there is cramp-like pains during menstruation or pain and soreness of the uterus, attributed to rheumatism. It is of much benefit in subinvolution.'

'Caulophyllum, although chiefly known as a remedy for the diseases peculiar to women, has been employed with advantage as a sedative and to control congestion, in bronchitis, pneumonitis and whooping-cough.'

'In deficient labor pains, caulophyllum is generally a reliable remedy.'

'A sufficient dose of the remedy may be given every ten minutes, till the pains become regular and efficient.'