Recent authors identify agrimony as a topical astringent for wounds, ulcers and sore throats and an astringent, bitter tonic, indicated for gastrointestinal and urinary problems such as indigestion, diarrhoea and colitis, urinary tract infections, enuresis and incontinence and kidney and bladder gravel. Because of its gentleness it is particularly suitable for children and the elderly. These indications are largely represented in the British Herbal Pharmacopoeia (1983): a mild astringent for diarrhoea in children, mucous colitis and grumbling appendicitis; a diuretic for cystitis and kidney stones; and external use as a gargle for acute sore throat and chronic nasopharyngeal catarrh. Agrimony has also been used in France for venous insufficiency and heavy legs, and for haemorrhoids.

Among the German authors, Schulz et al (1998) suggest agrimony only for mild, transient forms of diarrhoea and inflammations of the oropharyngeal mucosa, while Weiss specifies its use in chronic cholecystopathies with gastric subacidity, but requiring consistent use for some time to achieve success. Williamson references research indicating anti-diabetic activity, lending weight to the claim of Hool and Robinson 100 years earlier. Hoffmann offers it as a herb of choice in early-stage appendicitis and mentions human trials in which beneficial effects on chronic gastroduodenitis and cutaneous porphyria were found. In the latter, 20 patients, aged 27-66, with non-acute porphyria, took infusions three to four times per day for 15 days with no other treatment. The skin eruptions improved with less hyperpigmentation and serum iron levels and urinary porphyrins decreased. Participants also had improved appetite and less dyspepsia. Hoffmann also refers to agrimony’s long tradition of use as a spring tonic (which appears to go back only to Grieve) and Bartram gives a prescription for this: equal parts agrimony, raspberry leaves Rubus idaeus, lemon balm Melissa officinalis and nettles Urtica dioica. Priest and Priest classify agrimony as a gently stimulating tonic with gastrointestinal emphasis. It benefits the elderly by restoring debilitated conditions and can help with rheumatism and arthritis, urinary incontinence, a relaxed bowel and leucorrhoea in females. An additional indication is liver atrophy. Menzies-Trull refers to respiratory conditions: asthma, bronchitis and tuberculosis. He also quotes uses dating back to Culpeper and earlier: gout, dysentery, malaria, leucorrhoea. These physiomedical authors expect agrimony to be prescribed with other indicated herbs for the conditions listed.

Wood offers other indications for agrimony with reference to the plant’s use as one of the 38 remedies discovered by Dr Bach, in this case for those who hide their worries behind a brave face. Wood suggests it is indicated for those under work-related tension and problems between employer and employee, or who hold their breath to suppress pain or ‘who are tortured to capture the breath’ in conditions such as whooping cough, bronchitis and asthma.

Astringent herbs like agrimony are traditionally used to treat diarrhoea, and are thought to influence the digestive tract membrane, to limit loss of fluid, to reduce permeability of the gut wall and to decrease secretions. The intensity of action in the gastrointestinal tract (measured as binding potency) is not directly associated with the intensity of the sense of astringency in the mouth, but the indications for agrimony in such documents as the Commission E Monographs from Germany is limited to what could be achieved with its moderate content of tannins: mild, non-specific, acute diarrhoea; inflammation of oral and pharyngeal mucosa, and topically for mild, superficial inflammation of the skin. This is to be effected by an average daily dose of 3 g of the dried aerial parts or equivalent preparations.

It may be that the action of agrimony actually depends more on a broad range of polyphenols rather than just tannins. In-vitro studies have attempted to show a link between antioxidant activity and concentration of polyphenols, including phenolic acids, flavonoids, condensed and hydrolysable tannins. The role of antioxidants in foods and herbal medicines has been investigated as it is argued that components in the diet may protect the body against cell damage caused by excess reactive oxygen species. Tringali (2001) argues that flavonoids in the diet may be of especial significance in protection of cell membranes from lipid peroxidation, thus protecting cells from damage.

Studies on agrimony suggest it has a range of antioxidant constituents. Correia (2007) found strong antioxidant activity and associated this activity with total polyphenolic content. Venskutonis (2007) found that radical scavenging capacity varied depending on the solvent and was highest in more polar solvents. Ivanova (2005) investigated infusions (1:200) of 21 Bulgarian medicinal plants for total phenolic content and antioxidant activity. Agrimonia eupatoria was amongst seven plants shown to have high phenolic content and high antioxidant activity. Origanum vulgare and Melissa officinalis showed highest antioxidant activity, and Heilerova (2003) also found that aqueous extracts of Origanum vulgare, gathered wild in Slovakia, and cultivated Melissa officinalis Citra exhibited significantly higher antioxidant activity than wild-crafted Agrimonia eupatoria.

The drying quality of agrimony recorded in classical texts thus has a link with the current phytotherapeutic indications of the herb, but, removed from its Galenic therapeutic context, there is nothing to support the idea of the plant’s fire, of its warmth and light. However, Pelikan’s focus is on the connection between agrimony’s reported silica content and its quality of light: ‘from a short rootstock, the plant, held in closely, soars upward in a straight line … and the richly flowered floral spike becomes the principal organ … the small flowers are a warm glowing golden yellow. A delicate aromatic scent, somewhat like turpentine, is emitted by the root and by leaf and stem glands, enveloping the plant. Light and dryness seem to have given it form.’

Pelikan lists the plant’s chemical constituents as tannins, bitter principles, volatile oil and niacinamide, while the ash contains much silica. He credits the plant’s tannins for the main traditional indications. Elsewhere Pelikan discusses how tannins can be perceived as a tool fashioned by the astral nature of the plant as a medium of communication between the astral and etheric. Being thus associated with the astral nature – the flowering, air aspect – of a plant may account, Pelikan explains, for some properties of tannins: their particular occurrence in plants with abundant flowering processes, and especially plants producing flowers ‘against’ a strong etheric, or watery, influence as in marsh and water-based plants. It explains the desire of tannin solutions to absorb air, the element belonging to the astral sphere and their ability to make animal substances resist putrefaction and maintain their form. Pelikan cites the traditional use of agrimony for haemorrhages, badly healing wounds, varices, diarrhoea and digestive disorders.

Its silica content, through its relationship to skin and light, disposes agrimony towards chronic skin conditions and pulmonary TB. The properties and roles of silica are broad-ranging but Pelikan does comment that ‘in the organic sphere, silica is able to follow the paths of protein synthesis from changeable and unformed to a defined shape; it can be the vehicle and tool of those particular form principles. It ‘takes its actions along metabolic pathways to the very regions of the body where live principles become lifeless’ and where the form principle takes effect in the enveloping structures of organs, skin and bone. In ‘silica plants’ one may frequently see a form principle going right into the smallest detail.’

It would seem that agrimony has had a consistent use as a topical herb for a variety of conditions and was held in high esteem as a wound herb. Internally there are reports of its use for conditions of the gastrointestinal tract, respiratory and urinary systems. While Dioscorides gave it as a treatment for diarrhoea and dysentery, Galen elaborated a more complex use for the liver due to its gently heating and drying qualities, and its use for treating liver conditions was reported in 19th century England, while Weiss more recently recorded its use in chronic gall bladder problems associated with gastric subacidity In 19th century America during the same period it was popular for treating productive coughs and phlegm on the chest, and was a remedy for the urinary system, not only as a tonic astringent but to treat dysuria, irritability and congestion of the kidneys. Agrimony is suitable for childhood exanthemas and also for the elderly, for stress incontinence, cachexia and as a general tonic. It is likely that agrimony will not be prescribed on its own, but with other relevant herbs.