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  • Herb overview

    Safety

    Avoid in pregnancy. Toxicity concern.

    Sustainability

    Lower risk

    Key constituents

    Sesquiterpene lactones
    Flavonoids (Eupatorine)
    Polysaccharides

    Quality

    North America
    Wild harvested and cultivated
    Adulteration with other species common

    Key actions

    Diaphoretic
    Febrifuge
    Bitter
    Anti-inflammatory

    Key indications

    Fever
    Respiratory infection
    Viral induced malaise
    Allergic rhinitis

    Key energetics

    Bitter
    Cooling
    Dry
    Astringent

    Preperation and dosage

    Aerial parts
    0.7–2 g per day
    1:5 4 ml per day

  • How does it feel?

    Boneset is a bitter herb with a predominantly diaphoretic action (1). Its effects are most apparent in acute febrile states, where it supports sweating and assists in the regulation of body temperature (2). Taken as a hot infusion, it acts to relieve the heaviness, aching, and congestion associated with influenza and similar infections (1).

    Boneset (Eupatorium perfoliatum)
    Boneset (Eupatorium perfoliatum)
    Boneset (Eupatorium perfoliatum)

  • Into the heart of boneset

    Boneset carries a distinctly bitter, cooling and drying energetic profile, with an affinity for conditions of cold, stagnation and systemic congestion. Its action moves inward and downward, engaging the core of the body rather than acting superficially. This makes it particularly suited to conditions that feel heavy and exhausting, where fever struggles to resolve and pain penetrates deeply. The plant’s bitterness supports its capacity to stimulate hepatic processes, while its diaphoretic action and heat encourage movement, circulation and release (2).

  • What practitioners say

    Respiratory systemRespiratory system

    Boneset is widely recognised for its effects on the respiratory system. It has been used for influenza, acute bronchitis, and fevers accompanied by deep body aches, and was even used successfully during yellow fever outbreaks according to Bartram (6). For children with colds or feverishness, it is often combined with yarrow (Achillea millefolium) or elderflower (Sambucus nigra) and traditionally administered three times daily (6).

    It is also indicated for conditions such as nasopharyngeal catarrh or influenza with congested respiratory mucosa and pronounced aching (3). A hot infusion is considered the most effective way to promote diaphoresis and sweating, supporting the body’s natural response to fever (3). Hot infusions are also used to ease symptoms of allergic rhinitis, bronchitis, catarrh, colds, and coughs, and externally, a tea made from boneset can be applied to the skin to help reduce fevers (1).

    Immune system

    Boneset is indicated for flu as it promotes sweating, clears heat, and helps the body eliminate toxins (1). Laboratory studies suggest that its polysaccharides and sesquiterpene lactones can enhance white blood cell production and stimulate phagocytosis, providing measurable immune support (1). It also has anti-inflammatory properties, and some constituents, including sesquiterpene lactones and eupatorin, exhibit cytotoxic activity in vitro, although these effects are not applied clinically (1).

    Digestive system

    The bitterness of boneset can lead to a laxative effect, especially when used in larger doses, supporting digestive function (3). Because of boneset’s bitter compounds, this herb can relieve indigestion, bloating, wind and spasmodic abdominal pain (1). Additionally, boneset supports the body’s elimination processes through mild hepatic stimulation, and asa mild laxative, which explains its traditional use in arthritis, skin conditions and intestinal worms (1).

  • Boneset research

    Boneset (Eupatorium perfoliatum)
    Boneset (Eupatorium perfoliatum)

    Research into the effects of boneset in humans has not been conducted. 

    Eupatorium perfoliatum counteracts TNF-α mediated pathogenesis in chikungunya virus infection (9)

    This study aimed to evaluate whether an ultradiluted hydroethanolic preparation of Eupatorium perfoliatum could counteract TNF-α-mediated pathogenic processes in chikungunya virus (CHIKV) infection, focusing on inflammatory mechanisms rather than direct antiviral effects.

    No human participants were involved; the research was conducted using in silico molecular docking, in vivo transcriptional and translational analyses, and in vitro cytopathic assays in experimental models to simulate disease processes and treatment effects. The primary outcome was reduction of TNF-α transcription and translation levels, with secondary outcomes including lowered expression of hub genes implicated in CHIKV pathogenesis and reduced cytopathic effects following infection.

    Results showed strong predicted molecular interactions between boneset’s constituents and TNF-α, and treatment with the candidate preparation was associated with lowered TNF-α expression, attenuation of inflammatory pathology, and reduced cytopathic impacts in the models used, suggesting potential to modulate inflammation linked to CHIKV pathogenesis (9).

    Anti-inflammatory activity of Eupatorium perfoliatum L. extracts, eupafolin, and dimeric guaianolide via iNOS inhibitory activity and modulation of inflammation-related cytokines and chemokines

    This study investigated the anti-inflammatory effects of Eupatorium perfoliatum extracts and isolated compounds (eupafolin and a dimeric guaianolide) using LPS-stimulated RAW 264.7 macrophage cells (in vitro). The extracts and compounds were tested for inhibition of nitric oxide (NO) production and modulation of pro-inflammatory cytokines and chemokines.

    The dichloromethane extract and the isolated compounds showed significant inhibition of NO and reduced expression of cytokines including IL-1α, IL-1β, CCL2, CCL22, and CXCL10, while TNF-α was moderately affected. These results demonstrate measurable anti-inflammatory activity at the cellular level, providing experimental support for boneset’s traditional use in inflammatory conditions, although no human or animal subjects were involved (10).

    Antiviral activity of hydroalcoholic extract from Eupatorium perfoliatum L. against the attachment of influenza A virus

    This study investigated the antiviral activity of hydroalcoholic extracts from Eupatorium perfoliatum against influenza A virus in MDCK II cells (in vitro). No human participants were involved. The extract was tested for its ability to inhibit viral attachment, plaque formation, and hemagglutination. It significantly reduced viral binding and plaque formation at concentrations of ~1–10 µg/mL, with low cytotoxicity, and high-molecular-weight polyphenols were identified as likely active compounds.

    These results suggest that boneset extracts can inhibit influenza A virus attachment in cell culture, supporting further investigation as a potential antiviral agent (11).

  • Historical use of boneset

    Boneset (Eupatorium perfoliatum)
    Boneset (Eupatorium perfoliatum)

    Boneset has a long history of use in North America, particularly among Indigenous peoples of the eastern woodlands, where it was regarded as an important remedy for fever and systemic illness (6). Native American tribes used the plant extensively for influenza, febrile conditions, and severe musculoskeletal pain (1,6). The common name “boneset” reflects its traditional use in illnesses where pain was described as penetrating ‘to the bones’, such as severe influenza and other high-fever conditions. 

    During the 18th and 19th centuries, boneset was adopted into European-American medical practice and became a well-established remedy in Eclectic and Physiomedical medicine. It was used in the treatment of intermittent fevers, including malaria, as well as serious infectious diseases such as typhoid and yellow fever (3,6). Boneset appeared in the United States Pharmacopoeia from 1820 until 1916, where it was classified as a stimulant and diaphoretic, reflecting its perceived ability to promote sweating and support the resolution of fever during acute illness (6).

    In addition to its role in febrile conditions, boneset was traditionally used for muscular rheumatism, dyspepsia, and digestive weakness, particularly in older adults (1). Its bitter properties were used to improve digestive function and appetite during convalescence. Other historical applications included the treatment of cutaneous diseases and the elimination of intestinal parasites, such as tapeworm (1). 

  • Boneset’s herbal actions

    Herbal actions describe therapeutic changes that occur in the body in response to taking a herb. These actions are used to express how a herb physiologically influences cells, tissues, organs or systems. Clinical observations are traditionally what have defined these actions: an increase in urine output, diuretic; improved wound healing, vulnerary; or a reduction in fever, antipyretic. These descriptors too have become a means to group herbs by their effects on the body — herbs with a nervine action have become the nervines, herbs with a bitter action are the bitters. Recognising herbs as members of these groups provides a preliminary familiarity with their mechanisms from which to then develop an understanding of their affinities and nuance and discern their clinical significance.

    Western actions

  • Boneset’s energetic qualities

    Herbal energetics are the descriptions Herbalists have given to plants, mushrooms, lichens, foods, and some minerals based on the direct experience of how they taste, feel, and work in the body. All traditional health systems use these principles to explain how the environment we live in and absorb, impacts our health. Find out more about traditional energetic actions in our article “An introduction to herbal energetics“.

  • What can I use boneset for?

    Boneset (Eupatorium perfoliatum)
    Boneset (Eupatorium perfoliatum)

    Boneset (Eupatorium perfoliatum) is used in the management of acute infectious and febrile conditions, particularly influenza and influenza-like illnesses (3). It is indicated where symptoms include fever, chills, profound fatigue, and deep musculoskeletal aching (1,3). Its primary application is during the early stages of acute illness, where it supports diaphoresis and assists the body in regulating temperature and resolving fever. Boneset is not used as a long-term immune tonic but rather as a short-term medicine during acute infection.

    Boneset is also used to support immune function during acute illness (1). Its polysaccharides have been shown to influence immune activity, including enhancement of phagocytosis, while the sesquiterpene lactones contribute to its anti-inflammatory action (4,5). These actions support its use in infections characterised by systemic involvement (like fever and general malaise) and inflammatory symptoms (1,6). Although some constituents demonstrate cytotoxic activity in vitro, boneset is not used clinically as a herb with antitumour properties (7).

    In the respiratory system, boneset is used for acute conditions involving fever and congestion of the respiratory mucosa (1,3).Taken as a hot infusion, it is used in influenza, acute bronchitis, nasopharyngeal catarrh, colds, coughs and allergic rhinitis (1,8). Its diaphoretic and mild expectorant actions assist in clearing congestion and supporting the resolution of respiratory symptoms associated with infection.

    Boneset can also be used to improve digestion. In small doses, its bitterness supports digestion, relieving indigestion, wind and bloating (1,3). In larger doses, its bitter principles can contribute to a laxative effect and mild hepatic stimulation, supporting elimination during short-term use (1). These actions support its use in conditions associated with metabolic congestion, such as inflammatory joint conditions and certain skin disorders (1).

  • Did you know?

    The name Eupatorium perfoliatum comes from the unique way its leaves grow. The stem appears to pass through a single pair of joined leaves, a feature called “perfoliate” leaves, which is uncommon and makes the plant easy to identify in the wild (12).

  • Botanical description

    Boneset is a perennial herb in the Asteraceae family, growing 0.6–1.8 m tall with erect, branching, hairy stems. It arises from a fibrous root system and is found in moist habitats such as marshes, wet meadows and stream banks.

    The leaves are opposite, lance-shaped to triangular, with serrated margins. Mid- and lower-stem leaves are perfoliate, with their bases joined around the stem, giving the appearance that the stem passes through the leaf. Stems are green and hairy, sometimes reddish at the base.

    White flowers are grouped in flat-topped or slightly convex clusters (corymbs) at the ends of stems from mid-summer to early fall. Each cluster contains 9–23 small disk flowers. The fruit is a small, dry achene with fine hairs that helps wind dispersal (13).

  • Common names

    • Boneset
    • Feverwort
    • Thoroughwort (1, 3, 6, 13)

  • Habitat

    It is native to North America from Nova Scotia to Florida, Louisiana, Texas and North Dakota, growing in moist woods or thickets (3). It thrives in moist to wet environments such as marshes, wet meadows, stream banks, and low prairies (12). The plant prefers full to partial sunlight and is commonly found in open, damp areas where the soil remains consistently moist.

  • How to grow boneset

    Boneset can be propagated from seed or by root division. Spring growth is slow, but the plant is frost-resistant and tolerant of periods of drought (3). It prefers moist, rich soils and full to partial sunlight. The aerial parts are harvested during or just before flowering for medicinal use, when the concentration of active constituents is highest (3).

  • Herbal preparation of boneset

    •  Hot infusion
    •  Ethanolic extract (tincture)
    •  Powder or capsules

  • Plant parts used

    Aerial parts (1)

  • Dosage

    • Tincture (1:5 | 45%): 1–4 ml a day (3,8)
    • Fluid extract (1:1 | 25%): 1–2 ml per day (3)
    • Infusion/decoction: 0.7–2 g per day, one heaped teaspoon to each cup boiling water, infuse 5–20 minutes (6,8). Drink half to one cup every two hours if needed for acute or three times daily if chronic (6)
    • Powder: 375 mg (quarter of a teaspoon) (6)

  • Constituents

    • Sesquiterpene lactones: Eupafolin, euperfolitin, eufoliatin, eufoliatorin, euperfolide, eucannabinolide and helenalin (3)
    • Polysaccharides: 4-O-methylclucuroxylans (1,3,8)
    • Flavonoids: Eupatorin, astragalin, kaempferol, quercetin, hyperoside, rutin (1,3)
    • Diterpenes (1,3)
    • Phytosterols (3,8)
    • Volatile oils (1,3,8)
    • Tannins (1,8)
    • Caffeic acids (14)
    • Alkaloids: Pyrrolizidine alkaloids (1)

  • Boneset recipe

    Boneset infusion

    A hot infusion of Eupatorium perfoliatum aerial parts, traditionally prepared to support sweating and respiratory ease in acute febrile conditions. The bitter infusion is taken warm in small quantities.

    Ingredients

    • 1–2 teaspoons dried boneset aerial parts 
    • 250 ml boiling water

    How to make a boneset infusion

    • Place the dried boneset in a teapot or heat-proof cup.
    • Pour 250 ml of boiling water over the herb.
    • Cover and steep for 10–15 minutes.
    • Strain and drink while warm.
    • Repeat up to 2–3 times daily when needed.
Are herbs safe?

Are herbs safe?

  • Safety

    Boneset contains pyrrolizidine alkaloids (PAs), which are potentially toxic compounds that can cause liver damage with long-term or excessive use, making caution essential when considering extended use (15,16).

    There is no information on safety during pregnancy and breastfeeding, but due to the PA content, it is not recommended during pregnancy or breastfeeding. Large doses may cause gastrointestinal upset, including vomiting and diarrhoea (1).

  • Interactions

    None described (1,15,16)

  • Contraindications

    None known (1,8,15)

  • Sustainability status of boneset

    Eupatorium perfoliatum was most recently been assessed for The IUCN Red List of Threatened Species in 2015 and is listed as Least Concern (17). It appears in NatureServe Explorer with a G5 (secure) global conservation status, indicating that the species is widespread, abundant and not at risk of extinction across its range (eastern North America) (18).

    There are no records of boneset being monitored or listed by TRAFFIC (the organisation that tracks trade in wildlife species), suggesting it is not a species of concern in international trade monitoring (19). Boneset is not listed on Species+, meaning it is not protected under Multilateral Environmental Agreements like CITES (20).

    Read our article on Herbal quality & safety: What to know before you buy and Sustainable sourcing of herbs to learn more about what to look for and questions to ask suppliers about sustainability.

  • Quality control

    Boneset is harvested from both wild and cultivated sources for medicinal use. Analyses show variation in toxic alkaloid content among samples, possibly due to hybridisation or contamination with related species (15). Authentication and quality control are important to avoid adulteration and ensure correct botanical identity.

Meet our herbal experts

Dr. Amparo Aracil
- Herbalist, Physician

Amparo Aracil is a medical herbalist and doctor interested in community herbalism and acute medicine.

Read Dr. Amparo's articles

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Aromatic
An ‘aromatic’ remedy, high in volatile essential oils, was most often associated with calming and sometimes ‘warming’ the digestion. Most kitchen spices and herbs have this quality: they were used both as flavouring and to ease the digestion of sometimes challenging pre-industrial foods. Many aromatics are classed as ‘carminatives’ and are used to reduce colic, bloating and agitated digestion. They also often feature in respiratory remedies for colds, chest and other airway infections. They are also classic calming inhalants and massage oils, and are the basis of aromatherapy for their mental benefits.
Astringent
The astringent taste you get with many plants (the most familiar is black tea after being stewed too long, or some red wines) is produced by complex polyphenols such as tannins. Tannins are used in concentrated form (e.g. from oak bark) to make leather from animal skins. The process of ‘tanning’ involves the coagulation of relatively fluid proteins in living tissues into tight clotted fibres (similar to the process of boiling an egg). Tannins in effect turn exposed surfaces on the body into leather. In the case of the lining of mouth and upper digestive tract this is only temporary as new mucosa are replenished, but in the meantime can calm inflamed or irritated surfaces. In the case of open wounds tannins can be a life-saver – when strong (as in the bark of broadleaved trees) they can seal a damaged surface. One group of tannins, the reddish-brown ‘condensed tannins’ are procyanidins, which can reduce inflammation and oxidative damage.
Bitter
Bitters are a very complex group of phytochemicals that stimulate the bitter receptors in the mouth. They were some of the most valuable remedies in ancient medicine. They were experienced as stimulating appetite and switching on a wide range of key digestive functions, including increasing bile clearance from the liver (as bile is a key factor in bowel health this can be translated into improving bowel functions and the microbiome). Many of these reputations are being supported by new research on the role of bitter receptors in the mouth and elsewhere round the body. Bitters were also seen as ‘cooling’ reducing the intensity of some fevers and inflammatory diseases.
Bland
Blandness refers to a mild, plain, non-stimulating taste and an energetic action that neither irritates nor strongly activates physiological processes. In traditional Chinese medicine, bland substances gently drain dampness and promote urination, relieving excess fluid whilst also preserving qi and yin. Western traditional medicine similarly associates healing with bland substances that avoid extremes of heat or cold and promote restoration of balance. Blandness signifies regulation by supporting elimination and normal tissue function without forceful stimulation, helping to create a gentle and balanced state of homeostasis.
Cooling
Traditional ‘cold’ or cooling’ remedies often contain bitter phytonutrients such a iridoids (gentian), sesiquterpenes (chamomile), anthraquinones (rhubarb root), mucilages (marshmallow), some alkaloids and flavonoids. They tend to influence the digestive system, liver and kidneys. Cooling herbs do just that; they diffuse, drain and clear heat from areas of inflammation, redness and irritation. Sweet, bitter and astringent herbs tend to be cooling.
Hot

Traditional ‘hot’ or ‘heating’ remedies, often containing spice ingredients like capsaicin, the gingerols (ginger), piperine (black or long pepper), curcumin (turmeric) or the sulfurous isothiocyanates from mustard, horseradish or wasabi, generate warmth when taken.

In modern times this might translate as thermogenic and circulatory stimulant effects. There is evidence of improved tissue blood flow with such remedies: this would lead to a reduction in build-up of metabolites and tissue damage.

Heating remedies were used to counter the impact of cold, reducing any symptoms made worse in the cold.

Mucilaginous
Mucilages are complex carbohydrate based plant constituents with a slimy or ‘unctuous’ feel especially when chewed or macerated in water. Their effect is due simply to their physical coating exposed surfaces. From prehistory they were most often used as wound remedies for their soothing and healing effects on damaged tissues. Nowadays they are used more for these effects on the digestive lining, from the throat to the stomach, where they can relieve irritation and inflammation such as pharyngitis and gastritis. Some of the prominent mucilaginous remedies like slippery elm, aloe vera and the seaweeds can be used as physical buffers to reduce the harm and pain caused by reflux of excess stomach acid. Mucilages are also widely used to reduce dry coughing. Here the effect seems to be by reflex through embryonic nerve connections: reduced signals from the upper digestive wall appear to translate as reduced activity of airway muscles and increased activity of airway mucus cells. Some seed mucilages, such as in psyllium seed, flaxseed (linseed) or guar bean survive digestion to provide bulking laxative effects in the bowel. These can also reduce rate of absorption of sugar and cholesterol.
Neutral
Neutral herbs are characterised as by balanced temperature and energetics — neither warming nor cooling, nor strongly dispersing nor consolidating, and are, therefore, used across a wide spectrum of constitutional and pathological states. In Chinese medicine, this level, calm quality supports the centre, and gently strengthens digestion, regulates fluids, and resolves damp without provoking too much heat or cold. In Western medicine, neutral herbs are regarded as equal in relation to hot/cold or damp/dry and capable of maintaining a state of equilibrium. Neutral herbs can be seen as moderating reactivity, and supporting homeostasis rather than forcing change.
Pungent
The pungent flavour refers to the powerful taste of hot spices including mustard (Brassica spp.), ginger (Zingiber officinale), horseradish (Amoracia rusticana), chilli (Capsicum spp.), and garlic (Allium sativum). These herbs act to enliven and invigorate the senses, and they often also have heating qualities. Unlike other tastes, the effect is not linked to a specific receptor on the tongue and instead acts through direct irritation of tissues and nerve endings. Energetically, pungent herbs are known to disperse energy (qi) throughout the body. Pharmacologically, pungent herbs dry excess moisture and mucus, as well as stimulate digestion and metabolism.
Resinous
Resins are most familiar as tacky discharges from pine trees (and as the substance in amber, and rosin for violin bows). They were most valued however as the basis of ancient commodities like frankincense and myrrh (two of the three gifts of the Three Wise Men to the baby Jesus) and getting access to their source was one benefit to Solomon for marrying the Queen of Sheba (now Ethiopia). Resins were the original antiseptic remedies, ground and applied as powders or pastes to wounds or inflamed tissues, and were also used for mummification. With alcohol distillation it was found that they could be dissolved in 90% alcohol and in this form they remain a most powerful mouthwash and gargle, for infected sore throats and gum disease. They never attracted much early research interest because they permanently coat expensive glassware! For use in the mouth, gums and throat hey are best combined with concentrated licorice extracts to keep the resins in suspension and add extra soothing properties. It appears that they work both as local antiseptics and by stimulating white blood cell activity under the mucosal surface. They feel extremely effective!
Salty
The salty flavour is immediately distinctive. A grain dropped onto the tongue is instantly moistening and a sprinkle on food enkindles digestion. This easily recognisable flavour has its receptors right at the front of the tongue. The salty flavor creates moisture and heat, a sinking and heavy effect which is very grounding for the nervous system and encourages stability. People who are solid and reliable become known as ‘the salt of the earth'.
Sharp
The sharp taste of some fruits, and almost all unripe fruits, as well as vinegar and fermented foods, is produced by weak acids (the taste is generated by H+ ions from acids stimulating the sour taste buds). Sour taste buds are hard-wired to generate immediate reflex responses elsewhere in the body. Anyone who likes the refreshing taste of lemon or other citrus in the morning will know that one reflex effect is increased saliva production. Other effects are subjective rather than confirmed by research but there is a consistent view that they include increased digestive activity and contraction of the gallbladder.
Sour
The sour taste occurs because of the stimulation of hydrogen ions which trigger the sour taste receptors on the tongue. The more acidic a substance, the more hydrogen ions will be released. The sour taste comes from acidic substances including citrus, fermented foods, tannins, and vinegars. Sour foods and herbs absorb excess moisture, whilst also increasing the production of saliva. Energetically, sour substances tonify the lungs, playing a role in disease prevention. Excessive use, however, can result in malabsorption of nutrients. Examples of sour herbs include, rosehips (Rosa canina), raspberry (Rubus idaeus), rhubarb (Rheum palmatum), schisandra (Schisandra chinensis), hawthorn (Crataegus monogyna) and ginkgo (Ginkgo biloba).
Sweet
In the days when most people never tasted sugar, ‘sweetness’ was associated with the taste of basic foods: that of cooked vegetables, cereals and meat. In other words sweet was the quality of nourishment, and ‘tonic’ remedies. Describing a remedy as sweet generally led to that remedy being used in convalescence or recovery from illness. Interestingly, the plant constituents most often found in classic tonics like licorice, ginseng are plant steroids including saponins, which also have a sweet taste.
Umami
The umami taste was originally discovered in 1985 in Japan and is directly translated from the Japanese as a ‘pleasant savoury taste’. It is referred to as the ‘fifth taste’ and is a salty, rich, and meaty flavour. The umami flavour is produced by amino acids (glutamic acid and aspartic acid) found in many food and plant sources including tomatoes, mushrooms, seaweeds and soy-based foods. Umami foods can improve nutritional absorption and digestion as there are also umami receptors in the gut as well as the mouth. Examples of umami herbs include green tea (Camellia sinensis), reishi (Ganoderma lucidum), nettle (Urtica dioica), cordyceps (Ophiocordyceps sinensis), shitake (Lentinula edodes) and bladderwrack (Fucus vesiculosus).

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