Wren, followed by the National Botanic Pharmacopoeia, gives the actions of alterative, diuretic and anodyne. Figwort is considered not ‘of paramount importance as an internal remedy”. Priest & Priest repeat Cook’s description as a gently stimulating and relaxing alterative with lower abdominal and pelvic emphasis, but emphasize the deobstruent action on enlarged and engorged lymph glands, for mammary tumours and nodosities and enlarged glands, and externally for haemorrhoids. Deobstruent is a term used to describe the action of removing obstructions to flow, and they suggest the addition of hepatics and more stimulating diuretics. In more recent years, figwort is used as a more general alterative for all skin conditions. The British Herbal Pharmacopoeia recommends it for chronic skin disease, eczema, psoriasis and pruritus.
Although I have used this plant for 20 years, I had not previously grown it and was unaware of the tuberous roots until reading Dodoens. Going outside, digging a plant and finding the root was quite a shock. In addition, although suggested by recent authors, I have not used it externally. For example, Chevallier recommends external usage in healing wounds, burns, haemorrhoids and ulcers, and Bartram emphasizes the use of figwort in exudative skin eruptions and to encourage discharge and thus cleansing of abscesses, boils and infected wounds. In contrast, I have used it consistently internally as an alterative in chronic skin disease, in eczema, acne or psoriasis, and when looking for an alterative with some ‘bite’. It has proved useful in itching. I had a very elderly patient who had recovered from cirrhosis of the liver and continued to take liver remedies, but who periodically suffered from intense itching, especially on the shoulders in the evening. Alternation of various herbs in the medicine showed that it was the figwort which most effectively controlled this symptom. Hoffmann perceives figwort as acting in a broad way to improve body function and bring about a state of inner cleanliness which he ascribes partly to diuretic and mild laxative actions. Chevallier describes it as a herb that supports detoxification of the body and advises it in any skin condition with itching and irritation. Hoffmann and Chevallier both recommend figwort in eczema and psoriasis. This is how I have used it over the years but the recommendations given by the authors suggest a usage in more deep-seated problems.
Figwort: Recommendations On Safety
• Do not use figwort alongside digitalis or when the patient has a pacemaker or when there is tachycardia or an unstable heart rate.
The British Herbal Pharmacopoeia states that figwort contains cardioactive glycosides, increases myocardial contraction and therefore is to be avoided in ventricular tachycardia. Bartram gives the contraindication in tachycardia. Chevallier gives a contraindication if suffering from a heart condition, which is completely appropriate as he is writing for lay usage.
We have been unable to verify the presence of cardioactive glycosides, although they are referred to by Faivre (2007). Cardioactive glycosides or cardenolides are found in Digitalis species, which are either placed in the Scrophulariaceae family or in the Plantaginaceae. Triterpene glycosides are found in other Scrophularia such as Scrophularia ningpoensis. The uncertainty could reflect the lack of recent investigation into constituents other than the iridoid glycosides or could result from less exact methods of chromatography used in the past. There were two relevant references in older texts. Ellingwood (1919) states that ‘according to Professor Lloyd a yellow powder has been obtained from the extract which has some of the properties of digitalis’. The American Dispensatory refers to a statement made in 1896 that the seeds are toxic, belonging to the digitalis group.
The lack of firm evidence supports the above recommendation but otherwise there appear to be no contraindications. Equally figwort cannot be expected to support cardiac function.