Eden Apothecary · Herb Profile
Frangula purshiana
Pronounced Cascara Sagrada: kass-KAR-ah sah-GRAH-dah. Frangula purshiana: FRAN-gyoo-lah purr-shee-AH-nah.
Cool, dry, and downbearing: a bitter that drains heat and damp accumulation and rouses a torpid, atonic bowel to move without heating.
No pre-1900 source found for this reading.
Avoid. German Commission E and the AHPA Botanical Safety Handbook (class 2b (not verified against AHPA)) advise against use of anthraquinone stimulant laxatives in pregnancy. Available human data are somewhat reassuring against teratogenicity (Briggs, Drugs in Pregnancy and Lactation, 10th ed., reports no increased malformation risk in a prospective series of 53 first-trimester mother-child pairs, though the numbers are small), but reflex uterine stimulation and maternal fluid and electrolyte loss are theoretical concerns. Bulk-forming laxatives are preferred; use only if bulk laxatives fail and under professional supervision.
Avoid; prefer alternatives. Small amounts of active anthraquinone metabolites pass into breast milk (cascara was qualitatively detected in the milk of 5 of 10 women in one study). Loose stools have been reported in breastfed infants (10 of 22 newborns across two small uncontrolled studies; a separate observational case series of 142 mother-infant pairs found no diarrhea). The NIH LactMed database (2021) advises that maternal cascara might cause loose stools in some breastfed infants and lists alternatives such as bisacodyl, magnesium hydroxide, or senna. The American Academy of Pediatrics has historically rated it compatible with breastfeeding (per Briggs, 10th ed.), but the conservative recommendation is to avoid. AHPA class 2c (not verified against AHPA).
Not recommended under 12 years. Stimulant laxatives risk dehydration, electrolyte imbalance, and cramping in children, who dehydrate more readily. Use in older children or adolescents only under medical supervision. Bulk-forming or osmotic laxatives are preferred in pediatrics (Commission E; NCCIH).
Only aged (one year or more) or heat-treated bark is used: fresh bark is rich in free anthrones that provoke violent griping, colic, and vomiting. As a stimulant laxative, habitual or long-term use causes laxative dependency, loss of bowel tone, chronic diarrhea, and fluid and electrolyte loss (especially potassium). Prolonged use may produce pseudomelanosis coli, a benign, reversible dark pigmentation of the colon lining. May harmlessly color the urine reddish or yellow-brown. Overdose causes watery diarrhea, cramping, and dehydration. Rare hepatotoxicity has been reported with prolonged use.
Intestinal obstruction or ileus; acute inflammatory bowel disease (Crohn's, ulcerative colitis); appendicitis or any acute abdomen; undiagnosed abdominal pain; severe dehydration with electrolyte depletion; children under 12 years; pregnancy and lactation (see safety fields); known hypersensitivity to anthraquinone laxatives.
Harvested by destructive bark-stripping and girdling, which kills the tree. Historic demand exceeded 5 million pounds of bark in a single year, and United Plant Savers flags regional overharvest of wild stands (some California populations are especially vulnerable) despite a global IUCN Least Concern rating. Source only cultivated or verifiably sustainably coppiced bark, avoid wild-stripped material, and prefer suppliers who harvest from managed, resprouting stands.
Not in canonical biblical texts and unknown to the ancient Mediterranean world. Native to the Pacific Northwest of North America, where the aged bark was a staple laxative of the Coast Salish, Quinault, and Chinook peoples (chittem or chitticum bark). Spanish missionaries named it cascara sagrada, sacred bark. It entered Western medicine through the Eclectic physicians in 1877 and soon became the dominant natural laxative in North America.
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