and headache’. However, citing Moerman’s work to support any specific
usage needs a critical appraisal of the sources of information culled by
Moerman; these, variable in quality, commonly raise questions over, for
example, the correctness of plant identification, type of preparation used or
other details, some of which Moerman felt necessary to omit given the scope
of the database.
Such limited information strongly suggests that the use of alder for a
headache is a local reputation – all the more so as published accounts of
Mi’kmaq usage do not record ‘headache’.^21 On the other hand, the oral
tradition includes:
Well an old man had a bad head one time, a headache and I used to
go out and pick glossy alder leaves for him and he put it on a rag and
tied it around his head and in a half hour or so them alder leaves
would turn brown and I would change them. I kept doing that for
about all one day, four or five hours I suppose.^22Limited or local usage of any medicine is especially difficult to evaluate
and is invariably labelled as anecdotal. However, to avoid a minimal
response to questions (e.g. ‘there is no evidence to support it’), which
patients may well perceive as judgemental, practitioners will find it useful
to do some preparation/education (step 1) on the different levels of
evidence noticed.
Black cohosh
This second herb for consideration, black cohosh, offers a different set of
circumstances for discussion with patients. As a top-selling dietary supple-
ment – largely because of a reputation for relieving menopausal symptoms
(and, to a lesser extent, menstrual symptoms, e.g. cramps) – it has been
subjected to many laboratory and clinical studies. However, although tradi-
tional aboriginal knowledge has seemingly been superseded by modern
scientific/clinical studies, practitioners may well face queries on at least two
matters: (1) the aboriginal reputation and (2) efficacy and safety.
Uses
Published accounts of both the herb and its commercial promotion
commonly refer to a history of aboriginal usage, e.g. ‘American Indian
groups of eastern North America were using the root of black cohosh to
treat female conditions and for rheumatism, long before Europeans landed
on American shores’.^23 Such statements, commonly offered without docu-
mentation or context, generally serve to bolster confidence in recent scien-
tific/clinical data that suggest benefits. Aboriginal women have specifically
Aboriginal/traditional medicine in North America | 51