There is a plant that grows along roadsides and stream banks across eastern North America, tall, white-flowered, blooming in late summer, that was once the most widely used medicinal herb in the United States. Doctors prescribed it. Households kept it. Herbalists across traditions, from Indigenous medicine to frontier folk practice to 19th-century professional medicine, reached for it consistently.
Then, in the 20th century, it largely disappeared from common knowledge. Most people today have never heard of it.
The plant is boneset. Eupatorium perfoliatum. And understanding it requires going back to a time when people knew the plants growing around them the way we now know the contents of a pharmacy shelf.
What the plant is
Quick answer: Boneset (Eupatorium perfoliatum) is a North American native wildflower used extensively in traditional medicine by Indigenous peoples and early settlers. It has white flowers that bloom in late summer and was historically used primarily for fever, respiratory conditions, and what was called "break-bone fever." It appeared in the US Pharmacopeia from 1820 to 1916.
Boneset is a tall, sturdy perennial, typically 2 to 5 feet high. The leaves are long, lance-shaped, and slightly rough-textured. Their most distinctive feature is also the easiest to remember: the stem appears to grow directly through the leaf, emerging from the center of the leaf base. Botanists call this "perfoliate", which is where the species name perfoliatum comes from. You can't mistake it once you know what to look for.
Flat-topped clusters of small white flowers appear in July through September. The plant grows in moist, partially shaded areas: edges of streams and wetlands, low-lying fields, roadsides in damp areas. It's widespread across the eastern half of North America.
One important clarification: boneset is sometimes confused with comfrey, which is also occasionally called "boneset" in folk tradition. They are completely different plants with different properties. Eupatorium perfoliatum is the plant with the long history in North American herbal medicine.
Why it's called boneset
There are two explanations for the name, and both have historical backing.
The most likely origin: boneset was used extensively for what 18th and 19th century Americans called "break-bone fever", an old name for dengue fever, characterized by severe pain in muscles and joints so intense that it felt as though bones were breaking. Boneset was used during these episodes for the fever and the associated discomfort. The name reflects the use context, not a literal claim about what it did to bones.
The secondary theory: boneset was used in poultices for broken bones, and the name reflects that external application. Botanical historians find this explanation less well-supported, but it persists in the folk record.
Indigenous use: centuries before European contact
Boneset's medical history in North America predates European settlement by an unknown length of time. Daniel Moerman's Native American Ethnobotany database, the most comprehensive compilation of Indigenous plant use in North America, documents boneset use among the Iroquois, Cherokee, Menominee, Ojibwe, Delaware, Potawatomi, and dozens of other nations.
The documented uses vary but cluster around fever, respiratory conditions, and rheumatic pain. The consistency across geographically distant nations with distinct medical traditions is one of the strongest indicators that a plant's traditional use reflects genuine utility. These were not people sharing notes. They were arriving independently at similar conclusions about the same plant.
Boneset in 19th-century American medicine
By the early 1800s, boneset was the most widely used medicinal herb in the United States. That is not a figure of speech. It appeared in the first edition of the United States Pharmacopeia in 1820, the official government publication listing medicines recognized by the medical establishment, and remained there until 1916, almost a century of official recognition.
The Eclectic physicians, a 19th-century school of American medicine that favored plant-based treatments over the harsher interventions common in conventional practice, used boneset extensively, particularly for acute febrile illness and what they called "catarrhal" conditions: respiratory infections with mucus and fever. Wooster Beach and John Scudder, two of the most prominent Eclectics, both wrote about boneset in detail.
Household medical manuals of the era, the equivalent of what you'd look up on WebMD today, listed boneset as a standard remedy for cold, flu, fever, and rheumatic pain. It was made as a tea from dried aerial parts and taken during acute illness.
Then antibiotics arrived. The entire tradition of plant-based American medicine largely gave way to pharmaceutical medicine in the 20th century. Boneset went from a household staple to an obscurity known mainly to herbalists.
What's in boneset: known constituents
Modern phytochemistry has identified several classes of compounds in boneset that researchers have studied for biological activity. These include sesquiterpene lactones (eufoliatin, eupafolin, and related compounds), flavonoids, polysaccharides, and volatile oils.
Research has looked at these constituents in the context of anti-inflammatory activity, fever reduction, and immune modulation. The findings are preliminary, this is not a plant with an extensive clinical trial database, but the laboratory evidence provides a scientific basis for understanding some of why traditional herbalists have long found it useful for acute febrile illness.
Traditional preparation and use
The classic preparation is a tea. Dried boneset aerial parts (the leaves and flowering tops) are steeped in hot water, typically for 10 to 15 minutes, and taken during acute illness. The taste is distinctly bitter. Traditional herbalists consider the bitter taste part of the action, and the bitterness is a reliable indicator that you have the right plant and a reasonably potent preparation.
A tincture, an alcohol extract of the dried herb, is the modern equivalent that preserves the active constituents and has a longer shelf life than tea. This is the form Nettie's Bees prepares: small-batch, traditionally made, following the same basic extraction method that Eclectic physicians would have recognized.
Traditional use context is important here: boneset is traditionally a short-term herb for acute situations, not a daily supplement taken indefinitely. It was reached for during illness and set aside when illness passed.
Safety and appropriate use
Boneset is a plant for knowledgeable users. A few things to know:
Large doses or extended use are not supported by tradition and may cause adverse effects including nausea and vomiting, which, in smaller doses for acute illness, was sometimes considered part of the action in 19th-century medicine but is not a desirable outcome in modern use.
Boneset is not recommended during pregnancy.
People taking prescription medications should consult a healthcare provider before using boneset, as the research on herb-drug interactions is limited.
Some members of the Eupatorium genus contain pyrrolizidine alkaloids (PAs), which are toxic to the liver. Boneset (E. perfoliatum) has been shown to have low PA content relative to more concerning species, but anyone with liver conditions should exercise caution and consult a practitioner.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
A plant worth knowing
Boneset is one of those plants whose story involves most of American history. Indigenous knowledge developed over millennia. Colonial medicine adopting and integrating that knowledge. The 19th-century flowering of American herbal medicine. The pharmaceutical turn of the 20th century and everything that got set aside in that shift.
Knowing boneset means understanding that pharmacy shelf as a very recent phenomenon, and that people navigated illness for a very long time with what grew around them. Not perfectly, there's plenty in 19th-century medicine that was wrong. But not nothing, either.
Boneset deserves to be known again.
Frequently asked questions
What is boneset used for?
Boneset has a long history of traditional use for fever, acute respiratory illness, and rheumatic pain. It was the most widely used medicinal herb in 19th-century America and appeared in the US Pharmacopeia from 1820 to 1916. Modern use by herbalists follows this traditional pattern, primarily for short-term support during acute febrile illness. No claims are made that it treats or cures any disease.
What does boneset look like?
Boneset is a tall native wildflower, 2 to 5 feet, with white flower clusters appearing in late summer. Its most distinctive feature is its perfoliate leaves, the stem appears to grow through the center of the leaf base. It grows in moist, partially shaded areas across eastern North America.
Why is it called boneset?
Most likely because it was used for "break-bone fever", an old name for dengue fever, which causes severe muscle and joint pain. The name reflects the use context. A secondary folk explanation involves use in poultices for broken bones, but this is less well-documented by botanical historians.
Is boneset safe to use?
In traditional doses and for short-term use, boneset has a long history in herbal medicine. It is not recommended in large doses or for extended periods. Not recommended during pregnancy. People on medications or with liver conditions should consult a healthcare provider. As with all herbal preparations, knowledgeable use with appropriate context is important.
What Native American tribes used boneset?
Documented use appears in the ethnobotanical records of the Iroquois, Cherokee, Menominee, Ojibwe, Delaware, Potawatomi, and many other nations, according to Moerman's Native American Ethnobotany database. The consistency of use across geographically distinct cultures is notable.
Is boneset the same as comfrey?
No. They are different plants from different plant families. Both are sometimes called "boneset" in folk tradition, which creates confusion. Comfrey is Symphytum officinale; boneset is Eupatorium perfoliatum. They have different appearances, different properties, and different traditional uses. When seeking boneset for traditional herbal use, confirm you have Eupatorium perfoliatum.
