Figwort is mainly used now internally but Renaissance authors describe external and internal use together. Bauhin recommends a preparation from the root for hard tumours of the glands described as scrofula, since figwort helps by softening a tubercle caused by freezing cold humours. Parkinson recommends the decoction of figwort taken and the bruised herb applied to dissolve congealed, clotted blood after wounds, both internal and external, the kings evil and other ‘knobs and kernels’. Gerard, Parkinson and Miller recommend figwort for scrofula in any part of the body, swellings and painful swelling of haemorrhoids if used inwardly or outwardly, as also cancerous stubborn ulcers. Bauhin gives the advice of 1 drachm (4 g) of root in a drink for worms in the belly but this is not repeated by other authors.
Before moving on to a discussion of usage as an alterative, it is worth looking at the description of the qualities of figwort given by the authors and the interpretation of the term scrofula. Fuchs states that figwort dries, thins and disperses, and the bitterness of taste indicates that it is of thin parts. Dodoens describes figwort as hot and dry in the third degree and of subtle parts, and Gerard repeats it as hot and dry. Bauhin described it as hot and dry, bitter and of subtle parts so that it thins and disperses. Looking at the use of words here, it is possible that it was described as hot and dry by virtue of its actions in that it was used for swellings which were considered to be caused by the agglomeration of cold humours.
The term ‘scrofula’ is used by the authors but interpretation of this term is difficult. Scrofula refers to the large swellings in the cervical glands caused by tuberculosis but Kiple (1997) argues that this would primarily have been bovine tuberculosis caught from drinking contaminated milk. A relevant modern study in Nepal of 155 adults aged 8-71 with cervical lymphadenitis found that 54% had tubercular lymphadenitis, 33% had reactive lymphadenitis and 11% had metastatic neck nodes. French (1993) argues that scrofula was used by Renaissance authors in place of the term ‘struma’ from the Latin struo, ‘to build up’, which refers to a swelling or tumour. It would thus have been used to describe enlarged lymph nodes in any part of the body. Finally, Cullen describes four categories of scrofula, including scrofula vulgaris, of which the symptom was an itchy rash. Interpretation of the term scrofula becomes even more difficult because of its association in England and France with ‘the king’s evil’. Even the radical Culpeper uses the term ‘the king’s evil’ although the Stuart kings used the effectiveness of the royal touch in curing this condition as evidence for the divine right of kings. French (2003) argues that no conclusion can be reached on its meaning partly because of the association with monarchies, pointing out that it was not used in Holland, which had no monarchy. As an example, he notes that when a new doctor arrived from Leiden in the late 18th century, the diagnosis of scrofula disappeared from the record book of the Aberdeen Infirmary. To conclude, it does seem possible that figwort was used in the treatment of lymphadenitis, ulceration and skin infections. It could therefore be recommended for infected eczema and other skin infections but also any condition where infection has led to enlarged lymph nodes.
In the 18th century, Quincy lists figwort as a detergent in Class 4 of the balsamics but says it is very little used. Hill refers to figwort merely as Scrophularia but describes Scrophularia nodosa. Hill repeats the recommendation for use of the fresh roots bruised and applied ‘for the evil’ and as a cooling poultice for piles. He recommends juice of the fresh root as an ‘excellent sweetener of the blood’ if taken in small doses for a long time. It is noteworthy that he gives the root whereas current practice is to use the aerial parts, but he is the first author to describe figwort as an alterative in the wider sense.
Cook recommends the use of a figwort Scrophularia marilandica, which grows in North America. He describes it as chiefly alterative, ‘soothing and leaving behind a fair tonic impression’. He recommends it for ‘irritable forms of scrofula’ and for scaly and irritable skin affections, with yellow dock root Rumex crispus and Stillingia sylvatica. He claims ‘an unusually excellent influence on kidneys which relieves torpor’, moderate increase in flow of urine and describes figwort as ‘amongst the most soothing tonics for irregular and painful menstruation’. The word tonic is used where the action of a herb is considered to improve the function of an organ, and this recommendation could reflect an antiinflammatory action as discussed below. The dose given is 2 fl oz three to four times a day of the decoction of 2 oz in 1 pint water, strained with force.
Scudder (1870) describes figwort as an alterative of which not too much must be expected but makes use of it in scrofula, secondary syphilis, ‘chronic inflammation with exudation of material of low vitality’ and chronic skin disease. Felter & Lloyd (1898) describe figwort as a pronounced but slow alterative and add use in dropsy and as a general deobstruent to the glandular system to the indications given by Scudder. The root in decoction ‘is said’ to relieve period pains. They recommend a fomentation or ointment in bruises, mammary inflammation, ringworm, piles, painful swelling, itch and skin eruptions ‘of a vesicular character’. The dose of the infusion, or syrup, is given as 2-4 fl oz whereas the dose of a strong tincture (76% alcohol) is given as only 10-40 drops. They state that Goss valued it highly in conditions where the skin condition is poor so that ulceration arises from wounds, abrasions or bruising. Ellingwood gives some specific recommendations by Goss for use in ‘enlarged lymphatics with perverted nutrition’, ulcerations around the eyes, ears, nose, or face, full lips with a pink and white countenance and puffiness of the nostrils, and lastly, epiphyseal thickening and fullness of the joints. This list reflects the late 19th century interest in giving specific herbs for specific indications.