It’s September and nearly time to harvest medicinal roots. Here’s a profile of one of my favorite autumn-harvested medicinal plants, a plant whose use as the title suggests is controversial. This article originally appeared in the Summer 2015 issue of Plant Healer Magazine. Consider subscribing and you can read many excellent articles from herbalists far and wide that are not otherwise available.
Wild Ginger is one of my favorite plants. I am sure some of you feel the same. There’s nothing better than coming over a little ridge or walking down the side of a ravine in the deep woods and coming upon a hillside covered in thick, robust, beautiful heart shaped leaves. They stake out space and hold their own in their chosen forest environment. Pushing aside the leaves and looking at the unusual flowers blooming right along the ground is to experience one of nature’s delightful and playful surprises.
Wild Ginger was one of my first remedies I took when I was not the herbalist, but the one in need of healing. I loved taking Wild Ginger. It tastes of common culinary ginger plus so much more. There’s and earthy, woodsy element that is complex and subtle. When I was taking it all those years ago, in my early twenties, during the postpartum year following the birth of my first child I felt like I was failing apart. I was anxious, freezing, yet inflamed in other ways, dealing with chronic sinus stuff and allergies that I had never had before and my skin was freaking out. I had cramps like I had never had before and my digestion was terrible. It was all new to me. I had never had any health problems before being pregnant and giving birth. I took a number of remedies after that first visit to my herbalist but I could feel the action of the wild ginger. I took just one drop, but I could feel it warming my body, moving my blood, bringing warmth to my hands and feet but I could also feel it warming my spirit and personality. Warming to the core. All these years later as a professional herbalist and midwife, Wild Ginger still calls to me. Wild Ginger has many uses from acute, feverish and upper respiratory conditions, to chronic digestive woes, gynecological complaints and during childbirth. Yet the accounts of toxicity…carcinogenic compounds, toxic neuropathy give me pause. I see Wild Ginger on the lists of many herbalists of herbs to avoid. While we have many herbs that can be substituted for acute, feverish upper respiratory conditions, the recorded uses of Wild Ginger for the childbearing woman are unique and not easily duplicated. What to do about Wild Ginger? Each herbalist has to make his or her own decision. In my case, I continue using it but am dedicated to continuing to learn about it hopes of always moving my practice towards the highest specificity, the lowest dosage and the safest practice. Here, I will share with you what I’ve learned about Wild Ginger on my way.
Asarum Genus and Species
The native, local species of Wild Ginger where I live bears the scientific name, Asarum canadense. This plant is widespread in the eastern half of the United States. The Western United States hosts its own species, A. caudatum, used as medicine (and another 5 species) however, most published information about Wild Ginger as a medicinal plant refer to A. canadense. There are just under 20 species in the Asarum genus worldwide (Wikipedia). Six species in North America. While sometimes it doesn’t matter if you use various species within a genus as with the Viola or Stellaria plants, it may very well matter with Wild Ginger, due to the toxicity concerns touched upon above and which will be explored in further detail below. It’s for that reason that I don’t recommend that herbal wildcrafters use some of the cultivated Wild Gingers that are increasingly used in landscaping and gardening as a groundcover. European Wild Ginger has long been noted to be more toxic than our eastern American species (Grieves, Felter and Lloyd). In fact, one European herbalist writing in 1857 wrote that European Wild Ginger is an “acrid, violent emetic-cathartic.” Better safe than sorry, when you are thinking about the Wild Ginger in your neighbor’s landscaped yard.
Wild Ginger grows in moist, rich, shady forests. It is clonal, primarily reproducing by forming dense colonies of plants connected by thin, rhizomes spread out just below the surface. The heart-shaped leaves are notably veined. Beginners sometimes mistake violet and wild ginger at first glance but ginger leaves are thicker and hairier. The unusual maroon flowers are found at ground level as mentioned above, below the leaves and emerge quite early in the spring. It’s not a true ephemeral because the leaves persist throughout the summer and into the fall. The flowers are also unique in that they do not have petals. What we recognize as the flower is actually six styles fused into a column topped by six stigmatic lobes,” (Gracie). The seeds are oil-rich and are distributed by little ants that carry them away to feast.
Wild Ginger as Medicine
In herbal medicine the rhizome is the part used. For our purposes I will refer to it as the root, using the easy convention of calling all underground parts, roots. A quick score of the root with your fingernail and you can lift the roots to your nose and breathe in that gingery-earthy aroma. With an olfactory experience like that you can be sure you won’t mistake Wild Ginger for any other underground plant material you unearth while harvesting.
There is some history of use of the leaf. In fact, Wild Ginger (the western species, A. caudatum) was one of the plant specimens collected by Lewis and Clark on their famous expedition and a cure with Wild Ginger was recorded in their journals
Potts’s legg which has been much swolen and inflamed for several days is much better this evening and gives him but little pain. we applyed the pounded roots and leaves of the wild ginger & from which he found great relief. (http://lewisandclarkjournals.unl.edu/read/?_xmlsrc=1806-06-27.xml&_xslsrc=LCstyles.xsl )
Wild Ginger root is an aromatic stimulant, rich in volatile oils. As such, it behaves in ways that are similar to other aromatic stimulants. The lipid soluble volatile oils are excreted through many pathways of the body delivering their medicine to the farthest reaches of our bodies: the urinary system, the lungs and bronchial tree, the sweat, saliva, vagina and can be carried to the breastfeeding baby via the breastmilk. The aromatics (like the alteratives) are used for dozens and dozens of disparate symptoms. Understanding how volatile oils penetrate the human body helps make sense of these remedies that are used for such a variety of symptoms.
Most aromatics, including Wild Ginger, are experienced as warming. (There are a few exceptions: Lavender and Peppermint, notably). From TCM we learn that spicy-warm plants are blood movers that affect the lung and large intestine. They dry excessive moisture, dissolve phlegm and allow it to drain. They warm the cold and underactive lung. Aromatic/spicy herbs are classified as carminative in the Western tradition. Carminatives are herbs that relieve gas, sour stomach, griping in the intestines. The volatile oils marry a stimulating quality that stimulates circulation, provokes vasodilation, increase the appetite, salivation and other secretions with relaxant qualities that relieve tension in the visceral organs easing gas and griping, irritable bowel, stomach aches and sometimes asthma.
Additionally, all volatile oils are antimicrobial. Lipid-soluble constituents penetrate pathogens and kill them especially fungi and have a history of being used for worms. Volatile oils also increase white blood cell activity.
Wild Ginger does all these things that carminatives do and more. It was used and described by eclectic and physiomedicalist practitioners like Cook, Ellingwood, Felter and Lloyd. All historical sources suggest Wild Ginger was considered valuable during acute illness and fever, as a diaphoretic and expectorant for respiratory infections ranging from the common cold to whooping cough, scarlet fever, typhoid and pneumonia (Felter and Lloyd, Cook). Historical, ethnobotanical and folk usages also include the use of Wild Ginger for poor digestion, gas, colicky pains, etc. The theme with Wild Ginger is cold. Functions of the body—the digestion, circulation, menstruation or the respiratory system are inhibited by acute or chronic cold.
My mentor, Lise Wolff, an excellent clinician who successfully uses native and local plants for various injuries and musculo-skeletal issues uses Wild Ginger as a warming, stimulating agent that is especially useful for old injuries (class notes), especially spasms in long standing back problems.
If the poetry of the doctrine of signatures calls to you, I encourage you to notice the heart shaped leaves. We know that Wild Ginger is a potent circulatory stimulant, but from my own experience I learned that Wild Ginger warms not only the physical heart but the metaphysical heart as well. I use it for individuals with cold, hands and feet and poor digestion who also seem a bit closed off from what life or connection with other individuals has to offer. Perhaps the individual is afraid of being vulnerable. Wild Ginger melts away the ice and lets the love and openness that was there all along emerge and manifest its’ full expression. I can’t help but think that there’s something evocative about having to search for the flowers that hide beneath the leaves.
Wild Ginger and Women’s Health and Childbearing
Where Wild Ginger really shines is as a gynecological herbs used at various moments in the female lifecycle but particularly for the childbearing woman.
Ellingwood, that great writer on obstetrics, writes of the effect of Wild Ginger on labor:
During labor, when the pains are excessive,[…] a few drops of the tincture may be put in half a glass of water and a teaspoonful administered every five or ten minutes. It will induce quiet and render the labor more natural. It works in perfect harmony with small doses of cimicifuga.
This is similar to the usage described by contemporary herbalist, Susun Weed. Under the heading “exhaustion” in childbirth in her book, The Wise Woman Herbal for the Childbearing Year, Weed writes that “Wild Ginger increases the energy of the root chakra and reduces mental resistance to the birthing process.” (Weed). Weed recommends a tea of dried roots sipped throughout the birth. She further writes that “The tincture draws energy more rapidly, use 2-5 drops under the tongue, repeat no more than three times.”
In my practice I use the tincture and I also favor these tiny doses. I prefer Wild Ginger above all other herbs used for labor. In general, I seldom intervene with herbs into this process, preferring to use gravity, movement, positioning and emotional support to help a mom and baby move through the birthing process, however, sometimes, especially in the first-time mother, things move soooooo sloooowlyyyy and exhaustion and despair set in and contractions space out and become less effective. I like Wild Ginger coupled with Chamomile when a woman seems weepy, dependant and sensitive. Or I pair it with Wood Betony when a woman seems up in her mind, overthinking things, not grounded. If excessive, worry, fear and panic are present, I mix Wild Ginger with Motherwort of Lemon Balm. In either case, one drop of Wild Ginger repeated 2 or 3 times in relatively short intervals, such as every half hour, until a stronger labor pattern is established and a women has come to grips with what it will take to complete this process. Cook described a similar usage:
It exerts a direct influence upon the uterus, which is of value in supressions of an atonic and congested character; and as a promptly stimulating parturient, when the pains become feeble from nervous fatigue, it probably has few superiors. For such purposes, I frequently combine it with the more permanent caulophyllum,” (Cook).
The old authors also used Wild Ginger for all manner of menstrual issues including to bring on a period, menstrual cramps, menstrual flooding, metrorrhagia (essentially more than one period or episode of bleeding in a month)postpartum hemorrhage, threatened miscarriage and the evocative specific indication of “melancholy and nervous disturbance in the early part of pregnancy”(Ellingwood). Again Ellingwood eloquently describes the indications: “where there are cutting pains in the abdomen and groin, extending down the thighs, with aching in the back, the patient nervous and irritable, this remedy will restore the flow to its normal proportions, will relieve the nerve tension and subdue pain. Violent pain in the small of the back on the approach of the menstrual epoch, which seems to interfere with the breathing, is said to be a diagnostic indication for this remedy”.
In my practice I also have used Wild Ginger for missed abortion. A missed abortion is the medical terminology describing when a fetus has died in utero or was never even really alive, like a blighted ovum, but the body fails to expel the products of conception. I see about one case annually of missed abortion. There are many women who prefer to complete a miscarriage at home as opposed to experiencing a d&c. Wild Ginger may be part of a formula for a missed abortion particularly if the woman is of a cold constitution or shows signs of a cold tissue state.
Wild Ginger Toxicity
So Wild Ginger is an amazing herb. What’s the problem? Wild Ginger has a repuatation for toxicity. Preparations containing Asarum plants are banned for sale in consumption in countries around the world. I recently sat in a conference session presented by researcher who had written a book about herbs and the breastfeeding mother. She was not a practicing herbalist. Her general orientation to herbs and safety was that most common herbs are safe for the breastfeeding mom, which I appreciated, however, Wild Ginger and its’ relatives had their very own power point slide as one herb no one should ever, ever take.
The concern with Wild Ginger is a chemical family called Aristolochic acids. Aristolochic acids are found in plants in the Aristolochiaceae family, of which Asarum species are members. This large family has seven genera and about 460 species, they are distributed worldwide especially in Europe, North America and China (Elpel). Many Aristolochiaceae species are used in Chinese medicine in particular. In the early 90s, a weight loss clinic in Belgium dispensing combinations of herbs and medications for weight loss included Aristolochia fangchi to patients. 105 patients had acute renal failure and about one half of them required kidney transplantation. Later, 65 cases of renal toxicity where reported using different Aristolochia species. (Mills and Bone). Mills and Bone write that “the use of the combination treatment by the slimming clinic (herbs with anorectic, diuretic, tranquilizer, laxative and atropinergic drugs) is likely to have contributed to the severity of the AAN cases reported in Belgium. However, the subsequent reports show that combination therapy is not an essential factor for the development of renal damage associated with AAN.” The symptoms and results are devastating and gruesome for those individuals affected. While the Belgian tragedy garnered a lot of media attention, there are numerous other documented cases of toxicity related to AA containing herbal products in Europe and in Asia. This is called Chinese Herb nephropathy or AA nephropathy. The case reports also suggest an increased risk of cancer. Animal studies are conclusive the AA is carcinogenic(Toxnet). However, these animal studies often involve the injection of large amounts of purified AA. We herbalists are often rightly wary of drawing conclusions about the safe use of whole plant preparations from the information offered by studies that involve the injection of large amount of an isolated chemical into an animal because we don’t use pure AA and we don’t inject things. But we should not ignore evidence pointing to the toxicity and carcinogenicity of constituents found in Asarum species. I consider myself a traditional herbalist but I try to treat traditional use with the same critical eye that I would turn on any orthodox medical practice.
So what’s an herbalist like me or like you to do?
My first step was to seek out more information. Ask the critical questions. Do some research and find the relevant published research and case studies.
One of the most interesting things I found in my research about Wild Ginger and Aristolochic Acid was a study showing that AA levels vary greatly between and within a species. A. caudatum (the Western species) is reported to have less of the offending chemicals than A. canadense (the eastern species). Levels in A. caudatum are reported as “minute,” No AA was detected in A. wagneri, a green-flowered species that is found in Oregon. Even within A. canadense the levels can vary widely from locale to locale and based on population pressures:
“The highest amounts were found in small populations under environmental pressure; also, concentrations were higher in samples from the northeastern U.S. and North Carolina than in those from the upper Midwest and South Carolina” (Schanenberg et. al, 2002).
I live in the upper Midwest so my native species is riskier than those plants available to you herbalists out west, but safer than using the species found to the east and south of me. All of us should remember that stressed populations of Wild Ginger will produce more AA, so gather only from healthy, robust populations.
Next, we should consider types of preparation. We herbalists use powdered and dried herbs placed into capsules, teas and other water based preparations like syrups, made from either fresh or dried plant material, high alcohol tinctures, low alcohol (vodka or brandy) tinctures, and glycerites. We know that not all constituents are soluble (or extractable) in a given menstruum. We also know that some menstruum are more effective at extracting certain types of plant constituents.
According to toxnet, the government funded database dealing with the toxicity of all types of chemicals, (http://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+7179 AA is only “slightly” soluble in water; it is is very soluble in ethanol and vinegar. Slightly and very are not defined in the Aristolochic Acid monograph on toxnet.
A non-profit group devoted to furthering the work of Edgar Cayce, called the Meridian Institute, also did some work surrounding the levels of AA in various preparations. The institute used samples of dried Wild Ginger from Canada and Minnesota. The samples were tested at outside labs using FDA approved protocol for measuring AA using a water/ethanol/formic acid extraction and testing a tincture made by steeping ½ ounce of dried Wild Ginger in 1 pint of boiling water for 8 hours and 1.5 ounces of grain alcohol to preserve. According to the Meridian study (http://www.meridianinstitute.com/reports/wgreport.html ) the water extract of wild ginger had less than 1% of the concentration of AA found in the methanol/formic acid extract used in the FDA protocol used to induce cancer in rats, remember the one where they injected them with pure AA?
Now, admittedly the Edgar Cayce loving non-profit has an agenda to promote natural health care approaches and does not fit the model of high prestige scientific research, however, the results jive with what I know to be true about herbs and their chemical constituents. We herbalist know that not all plant constituents are available in water preparations. That’s why we use tinctures and vice versa.
This information can help us make good choices, safer choices about using Wild Ginger. Using it as a tea is clearly a much safer choice. You could preserve it for some time as a syrup by adding adequate sweetener to the infusion and refrigerating. You could also make an infusion and preserve it with adequate 195 proof alcohol and serve it up to your clients like a tincture—in a small bottle, no refrigeration necessary. Traditional/folk tinctures made with 80 proof alcohol are also likely to extract less AA. Volatile oils are highly soluble in water so those wonderful, fragrant, spicy-warming properties should be present in your water-based preparation or in a traditional/folk tincture.
I was not able to find any information about the presence of AA in dried vs. fresh plant material or as extracted in glycerin.
Dosage, of course, matters with this herb. I can’t say conclusively what a safe dose is. For some of you that favor higher doses you should consider using less when you use this herb. For those, like me, who use microdoses most of the time, you probably don’t need to worry too much, no matter what preparation or species you use. Precise herbalism, practiced within an energetic and constitutional framework offers us the ability to treat people efficaciously while saving our own labor as medicine makers, puts less pressure on plant communities from the effects of harvesting and saves our clients money and resources purchasing large quantities of herbs. Fortunately, Wild Ginger isn’t simply toxic, it’s also powerful and profound even at low and microdoses. Don’t take my word for it. Try it yourself. Take a drop or two under your tongue and be still for a few minutes. Let the warming power of Wild Ginger suffuse throughout your body.
I would like to conclude by reiterating my love for this plant. I love it for its own sake and not just as a medicine to be procured. But I do love it as a medicine. I use Wild Ginger as a traditionally/folk prepared tincture in tiny doses and I will continue to do so. It would be a shame to turn away from this medicine based on the fear that is born out of irresponsible use and studies that focus on isolated constituents given in massive doses to laboratory animals.
Read more about Wild Ginger, Aristolochic Acid and Other Related Topics
“Aristolochic Acids.” Toxnet. NIH, 11 Mar. 2003. Web. 20 Sept. 2013. <http://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+7179>
Cook, William, M.D. “Asarum Canadense. Coltsfoot, Canada Snakeroot.” The Physiomedical Dispensatory. N.p.: n.p., 1869. N. pag. Asarum Canadense. Coltsfoot, Canada Snakeroot. Henriette’s Herbal Homepage. Web. 15 Jan. 2015.
Crellin, John Keith, and Jane Philpott. Herbal Medicine : Past and Present. Vol. 2. Durham, [NC] [u.a.: Duke Univ. Pr., 1990. Print
Elliott, Douglas B. Wild Roots: A Forager’s Guide to the Edible and Medicinal Roots, Tubers, Corms, and Rhizomes of North America. Rochester, VT: Healing Arts, 1995. Print.
Elpel, Thomas J. Botany in a Day: The Patterns Method of Plant Identification: An Herbal Field Guide to Plant Families of North America. Pony, MT: HOPS, LLC, 2013. Print.
Gracie, Carol. Spring Wildflowers of the Northeast: A Natural History. Princeton, NJ: Princeton UP, 2012. Print
Mills, Simon, and Kerry Bone. The Essential Guide to Herbal Safety. St. Louis, MO: Elsevier Churchill Livingstone, 2005. Print
Parresol, Lisa. “A History of Asarum and Hexastylis.” Diss. University of North Carolina, n.d. Web. 20 Sept. 2013. <http://visionaryimage.com/documents/hexasarum.pdf>.
Schaneberg BT, Applequist WL, Khan IA; Applequist; Khan (October 2002). “Determination of aristolochic acid I and II in North American species of Asarum and Aristolochia“. Pharmazie 57(10): 686–9. PMID 12426949.
Shaw, Hank. “Wild Ginger: Delicious or Deadly?” Web log post. Hunter Angler Gardener Cook. N.p., May-June 2012. Web. 18 Sept. 2013
Weed, Susun S. Wise Woman Herbal for the Childbearing Year. Woodstock, NY: Ash Tree Pub., 1985. Print
Wood, Matthew. The Earthwise Herbal: A Complete Guide to New World Medicinal Plants. Berkeley, CA: North Atlantic, 2009. Print.