Caulophyllum thalictroides. Blue cohosh, Squaw root, Papoose root   Family: Berberidaceae  
North American Indians used the rhizome to facilitate childbirth, hence the synonyms.
PART USED: Underground parts, rhizome
TASTE: Bitter and acrid ODOR: Slight, sternutatory
ACTIONS
GROUP: The Endocrine and Reproductive Systems- Reproductive System Tonics
1. Antirheumatic.[1] Antiinflammatory.[4] Febrifuge.[4]
2. Antispasmodic.[1,4]
3. Emenagogue.[1,4]
4. Uterine tonic.[1]
5. Diuretic.[4]
6. Vermifuge.[4]
INDICATIONS
1. Amenorrhea.[1,4] Dysmenorrhea.[1] Dyspareunia.[2] Uterine inflammation.[2] Conditions associated with uterine atony, including difficult labor.[2] As partus prepaerator.[2] Threatened miscarriage.[1,4]- though should be avoided during the first trimester of pregnancy.[4] False labor pains.[1]
2 . Rheumatic pain.[1,4] Neuralgia.[2]
3 . Spasmodic conditions including epilepsy.[2]  Hiccoughs, cramps, colic.[2]
4. Nervous exhaustion.[2]
5. Whooping cough.[2]
SPECIFIC INDICATIONS: Conditions associated with uterine atony.[1]
COMBINATIONS
- Uterine weakness, use with Chamaelirium, Leonurus and Yarrow.[1]
PREPARATIONS: 3X/day
Dried underground parts  0.3-1 g,[1] or by decoction 1:20.[1,2] 0.3-2 g.[4]
Fluid extract  1:1 in 70%, alcohol  0.5-1 ml.[1]
Fluid extract 1:2 or 1:5 in 70%.[3]
Liquid extract (BPC1934) 0.6-2 ml.[4]
NOTE -The low recommended dose. During the first trimester of pregnancy only small doses should be taken.[1]


ORIGIN: Eastern USA and Canada
DESCRIPTION: A herbaceous plant. Rhizome brownish grey, about 10 cm long and 0.5-1 cm thick, knotty with short branches; with numerous, crowded, concave stem scars on the upper surface, and long, paler brown, tough rootlets about 1 mm thick underneath. Internally whitish with narrow, woody rays.
References
Inner Path can not take any responsibility for any adverse effects from the use of plants. Always seek advice from a professional before using a plant medicinally.
Constituents

Research
Experiments have shown that extracts timulate phagocytosis in mice.[1] Antiinflammatory in the rat paw edema test.[2]
References
[1] Di carlo, F. I. et al. (1964) J. Reticuloendothelial. Soc.1, 224
[2] Benoit, P. S. et al. (1976) Lloydia 39, 160

Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient.
Rao RB, Hoffman RS.
Abstract
Numerous natural products have been used as traditional abortifacients, each with their own efficacy and adverse effects. With the continued growth of the natural products industry, clinicians are more likely to see adverse effects from attempted abortions using these agents. A 21-y-old female developed tachycardia, diaphoresis, abdominal pain, vomiting and muscle weakness and fasciculations after using blue cohosh (Caulophyllum thalictroides) in an attempt to induce an abortion. These symptoms are consistent with nicotinic toxicity and probably resulted from methylcytisine known present in blue cohosh. The patient's symptoms resolved over 24 h and she was discharged. Whether successful or not, the use of natural agents to induce abortion is frequently associated with adverse effects in the mother or fetus. Clinicians should recognize the potential toxicity of these agents.
PMID: 12136970 Vet Hum Toxicol. 2002 Aug;44(4):221-2. ncbi.nlm.nih.gov

Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation.
Dugoua JJ, Perri D, Seely D, Mills E, Koren G.
Abstract
BACKGROUND:
There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and safety of herbal medicines in pregnancy and lactation. This is one article in a series that systematically reviews the evidence for commonly used herbs during pregnancy and lactation.
OBJECTIVES:
To systematically review the literature for evidence on the use, safety and pharmacology of blue cohosh, focusing on issues pertaining to pregnancy and lactation.
METHODS:
We searched 7 electronic databases and compiled data according to the grade of evidence found.
RESULTS:
According to a survey of midwives in the United States, approximately 64% of midwives reported using blue cohosh as a labour-inducing aid. There are three case reports in the scientific literature that blue cohosh taken at the time of delivery may cause; 1) perinatal stroke, 2) acute myocardial infarction, profound congestive heart failure and shock and 3) severe multi-organ hypoxic injury. There is one case report that blue cohosh possesses abortifacient properties. There is in vitro evidence that blue cohosh may have teratogenic, embryotoxic and oxytoxic effects. In lactation, the safety of blue cohosh is unknown.
CONCLUSIONS:
Based on the available scientific information, blue cohosh should; 1) be used with extreme caution during pregnancy, 2) be used only under medical professional supervision and 3) not be available to the public as an over-the-counter product. There is an urgent need to conduct a retrospective or prospective cohort study of midwifes using blue cohosh in order to determine its safety.
PMID: 18204101 Can J Clin Pharmacol. 2008 Winter;15(1):e66-73. Epub 2008 Jan 18. ncbi.nlm.nih.gov

Triterpene glycosides from the underground parts of Caulophyllum thalictroides.
Matsuo Y, Watanabe K, Mimaki Y.
Abstract
A total of 22 triterpene glycosides, including 10 new compounds (1-10), were isolated from the underground parts of Caulophyllum thalictroides. The structures of the new glycosides were determined on the basis of extensive spectroscopic analyses, including two-dimensional (2D) NMR data, and of hydrolytic cleavage followed by chromatographic or spectroscopic analyses. All 22 compounds were evaluated for cytotoxicity against HL-60 human leukemia cells. The triterpene monodesmosides based on oleanolic acid (1 and 11-16) showed cytotoxic activity against HL-60 cells with IC(50) values that ranged from 3.4 to 15.9 microg/mL.
PMID: 19449879 DOI: 10.1021/np900164b J Nat Prod. 2009 Jun;72(6):1155-60. doi: 10.1021/np900164b. ncbi.nlm.nih.gov

Toxins in botanical dietary supplements: blue cohosh components disrupt cellular respiration and mitochondrial membrane potential.
Datta S, Mahdi F, Ali Z, Jekabsons MB, Khan IA, Nagle DG, Zhou YD.
Abstract
Certain botanical dietary supplements have been associated with idiosyncratic organ-specific toxicity. Similar toxicological events, caused by drug-induced mitochondrial dysfunction, have forced the withdrawal or U.S. FDA "black box" warnings of major pharmaceuticals. To assess the potential mitochondrial liability of botanical dietary supplements, extracts from 352 authenticated plant samples used in traditional Chinese, Ayurvedic, and Western herbal medicine were evaluated for the ability to disrupt cellular respiration. Blue cohosh (Caulophyllum thalictroides) methanol extract exhibited mitochondriotoxic activity. Used by some U.S. midwives to help induce labor, blue cohosh has been associated with perinatal stroke, acute myocardial infarction, congestive heart failure, multiple organ injury, and neonatal shock. The potential link between mitochondrial disruption and idiosyncratic herbal intoxication prompted further examination. The C. thalictroides methanol extract and three saponins, cauloside A (1), saponin PE (2), and cauloside C (3), exhibited concentration- and time-dependent mitochondriotoxic activities. Upon treatment, cell respiration rate rapidly increased and then dramatically decreased within minutes. Mechanistic studies revealed that C. thalictroides constituents impair mitochondrial function by disrupting membrane integrity. These studies provide a potential etiological link between this mitochondria-sensitive form of cytotoxicity and idiosyncratic organ damage.
PMID: 24328138 PMCID: PMC3932489 DOI: 10.1021/np400758t J Nat Prod. 2014 Jan 24;77(1):111-7. doi: 10.1021/np400758t. Epub 2013 Dec 11. ncbi.nlm.nih.gov