Ruta graveolens, rue

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THE WESTERN HERBAL TRADITION
283
CHAPTER 27
Ruta graveolens, rue
DESCRIPTION
Family: Rutaceae
Rue is included among the plants discussed in this book
not because we ourselves use it, but because of its reputa-
tion as a great healing medicine in the Western herbal
tradition and the suspicion that it is a neglected remedy.
Its application extends even to culinary purposes – rue
belongs to the citrus family – but it is said no longer to
suit the modern palate. From this it may be thought that
rue is a relatively innocuous herb, but current concerns
about the risks involved in its administration coupled with
a lack of a modern evidence base for its therapeutic ben-
efits has led to calls for rue to be withdrawn from over-
the-counter sale for safety reasons. If it is to remain in the
repertoire of registered herbal practitioners, then they
require a better understanding of its recorded actions and
uses in order to weigh this against potential toxicity and
safety concerns so that a judicious decision on the reasons
for employment and method of administration may be
properly reached.
In a section headed ‘Causes of contention’ and subtitled
‘False alarms?’, Mills & Bone (2000) record rue appearing
on a list of herbs circulated in 1992 by the European Com-
mission Committee for Proprietary Medicinal Products
which, in the committee’s opinion, should be withdrawn
from sale. It is, say Mills & Bone, one of a number of herbs
on the list that are widely used and popular among prac-
titioners. They bemoan the fact that there is too little
representation of herbal expertise on such controlling
bodies, making the herbal profession vulnerable to legisla-
tive decisions restricting the availability of medicinal
herbs. This can happen because ‘it may be easier to publish
reports in medical journals on the risks of herbal remedies
than it is to prepare a publishable account of their efficacy.
In the first case, anecdotal evidence is the norm, in the
latter case it would be dismissed out of hand’ (Mills &
Bone 2000). Writing more than a decade after the shock
announcement, the authors (2005) note that the list has
had little impact on availability, but they do not speculate
on the negative impact the call for withdrawal may have
had on practitioner use. Bartram, however, is quick to
suggest, writing in 1995, that the herb should be left to
practitioner use only, that ‘internal use today [is] discour-
aged in modern practice’ and that excessive handling of
the fresh plant may cause contact dermatitis.
The Commission E monograph for rue (dated 2 March
1989) (Blumenthal 1998) is one source from which the
European Commission Committee for Proprietary Medici-
nal Products will have drawn. Here the dried leaf or dried
aerial parts are linked with emmenogogic, antispasmodic,
diuretic and antiinflammatory actions for use in menstrual
disorders and discomforts; for loss of appetite and dyspep-
sia, circulatory disorders and arteriosclerosis, heart palpi-
tations, nervousness and hysteria, fever, pleurisy and
Part used: aerial parts
The genus includes six species found in Europe (Tutin et al 1968). The Flora of Turkey (Davis 1967) gives two Ruta
species, not including Ruta graveolens.
Ruta graveolens L. is a native of southeastern Europe but is widely naturalized in southern Europe and cultivated
worldwide. It is a shrubby perennial with a distinctive smell. Smooth erect stems (14–45 cm) bear alternate, stalked bluish-
grey-green pinnate leaves with deeply lobed obovate leaflets. Shiny yellow flowers with four spoon-shaped petals occur in
terminal umbel-like groups in June–August. A smooth green capsule containing many seeds develops in each flower while
other flowers around are still coming into flower.
Other species used: Ruta angustifolia Pers. and Ruta chalepensis L. are found in southern Europe and are similar but
with fringed cilia on the petal edge (Tutin et al 1968).
Quality
All Ruta species are associated with phytophotodermatitis (see below) and plants should not be touched with bare hands,
especially on sunny days.

THE WESTERN HERBAL TRADITION
284
Figure 27.1 Ruta graveolens, rue (a garden in Somerset, August).

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respiratory complaints, headache, neuralgic afflictions,
toothache and weakness of the eyes. Both internally and
externally, it is employed in arthritic complaints, disloca-
tions, sprains, bone injuries and skin diseases. This repre-
sents quite a range of possible therapeutic actions but,
according to the monograph, none of these applications
has a verified effectiveness. Instead there is an unfavour-
able ratio of benefit to risk. The risks include contact
dermatitis from the volatile oil component and
phytophotodermatitis from the furocoumarins, while
severe liver and kidney damage have been documented,
and the deaths of pregnant women who used rue as an
abortifacient reported. Therapeutic dosages can cause side-
effects of melancholic moods, sleep disorders, tiredness,
dizziness and spasms. The juice of the plant, particularly
a fresh plant preparation, has been associated with painful
irritations of the stomach and intestines, fainting, sleepi-
ness, low pulse, abortion, swelling of the tongue and
clammy skin.
Understandably, no dosage for rue is stated in the mon-
ograph but high doses are to be avoided, as the following
case shows (Seak & Lin 2007). A woman of 78 in Taiwan
took a decoction prepared with 50 g of fresh aerial parts
decocted in 1000 mL of water boiled down to 250 mL.
The plant material was positively identified as rue on
further investigation. She took two doses a day and over
the next 3 days developed increasing dyspnoea, dizziness,
nausea, weakness and decreased urination. On admission
she had a pulse of 41, blood pressure of 78/50, atrial
fibrillation and an abnormal electrocardiogram, an inter-
national normalized ratio of over 12, hyperkalaemia and
acute kidney failure, which was treated with haemodialy-
sis. She was in hospital for 5 days and was well at a
checkup 3 months later. She was taking medications for a
5-year history of hypertrophic cardiomyopathy and on
further investigation had some mitral regurgitation but
her normal pulse had been 78. The authors give a medical
history and review the case in detail, including the possi-
bility of a drug–herb interaction, and conclude that high
dosage was the most likely cause.
Rue is a known abortifacient and is one of the plants
traditionally used an as antifertility agent (de Laszlo &
Henshaw 1954, Mengue et al 1997, O’Dowd 2001,
Maurya et al 2004). It is also recommended to ‘promote
delayed menstruation’ in self-help books such as Parvati
(1979). Wood suggests that it is ‘probably the single most
important remedy in Latin American folk medicine’ and
Riddle (1991) cites ethnobotanical evidence of tradi-
tional abortifacient use among Hispanic people in New
Mexico. The following report brings into focus the
dangers of rue in this regard: a retrospective review of
cases where herbal infusions had been taken to procure
abortion found 86 cases (ages 14–47) from 1986 to 1999
which were reported to the Poison Centre in Montevideo,
Uruguay. Twenty-six women took rue (Ruta graveolens or
Ruta chalepensis), which was the most common herb
used. Seventeen had abdominal pain and vomiting, 13
had jaundice, 11 had genital haemorrhage, 9 had abor-
tion and 4 women died. One woman who died had also
suffered a self-inflicted instrumental attempt at abortion
(Ciganda & Laborde 2003). Gutiérrez-Pajares et al (2003)
carried out a study on mice to determine whether rue
affects preimplantation or embryo development, using
aqueous extracts of the herb on the basis of a report from
Chile that 500 mg twice a day is used by women there
to prevent pregnancy.
Both this last study and another by de Freitas (2005)
provide evidence that rue affects embryo development,
producing abnormalities which lead to death of the
embryo, while Al Mahmoud et al (2003), in a review of
other studies where a range of preparations were used,
found that implantation occurred but there was a higher
rate of deaths of embryos. If embryo death leads to a suf-
ficiently early spontaneous miscarriage, does this provide
a modern explanation for the historical use of rue as an
antifertility agent? Riddle, in reviewing this historical
usage (1991), discusses both abortifacient and antifertility
actions and explains how the extremely hot and particu-
larly drying qualities of rue provide the Hippocratic
rationale for the herb’s power to dry up the male sperm
or female seed, and both curb sexual desire and block
conception if intercourse nevertheless takes place. This
effect is enshrined in the Greek name for rue: peganon,
from pegas meaning a congealed thing. Since the quality
of moisture is required for fertility in Hippocratic and
Galenic medical theory, a drying out and congealing of
seed renders it unable to perform its role in conception.
Riddle points out that rue is still used to control fertility
today, but its employment in Western medicine came to
an end by the19th century.
Use of rue as an abortifacient or antifertility agent
requires knowledge of the correct dosage. Gutiérrez-
Pajares et al (2003) found a significant and dose depend-
ent increase in abnormal embryos in their study. Riddle
(1991) cites Gargilius Martialis, a 3rd century AD retired
soldier and land-owner, on concerns for the employment
of rue by women, deeming foolish those who declare its
power to inhibit and debilitate the generative seed and to
kill embryos in the womb without consideration of the
strength and dosage of the preparation, nor the circum-
stances in which it is taken. Rue must be taken in modera-
tion ‘so that it may not become a poison, rather than a
remedy’. These studies support the recommendation that
Rue should not be used in pregnancy or in women who
intend to become pregnant.
A moderate dosage for rue will be required when treat-
ing other indications. In order to utilize its rutin content,
which he says will be superior to rutin in isolated form,
Weiss proposes a tea made with 1–2 tablespoons of dried
rue to a cup of boiling water infused for 10–15 minutes.
This is surely a large dose? If rutin in a complex is
required for the treatment of circulatory disorders such as

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286
Menzies-Trull, Williamson and Hoffmann) repeat the
emmenogogue and spasmolytic actions listed in the British
Herbal Pharmacopoeia – both due to the quinoline alkaloid
arborinine according to Tyler (1993) – its indication in
amenorrhoea, prohibition in pregnancy and the British
Herbal Pharmacopoeia dose of 500 mg–1 g of dried herb
three times a day. Hoffmann proposes a larger dose of
1–4 mL tincture 1:5 40% and 1–2 teaspoons dried herb
to a cup of boiling water as an infusion. Wood takes a
different approach. He provides the same contraindication
and warning about contact but generally provides a
homoeopathic description of the uses of rue and gives a
dosage of 1–3 drops of the tincture. It is hard to agree with
arteriosclerosis and capillary fragility, then the other herb
he discusses in this regard, buckwheat Fagopyrum esculen-
tum, must be preferable, and can be enjoyed as an item of
the diet rather than as a medicine. Elsewhere in his text,
Weiss proposes equal parts of dried rue leaf, hedge hyssop
Gratiola officinalis and senna Senna alexandrina along with
its corrective fennel seed Foeniculum vulgare as an effective
emmenogogue. The inclusion of a laxative herb is very
important, he says. The dose is 1 tablespoon (15 g) of
herb to 500 mL of boiling water infused for 20 minutes.
It is taken once daily, in the mornings within 1 hour
of rising, on an empty stomach. Those among our
modern authors who discuss rue (Bartram, Chevallier,
Figure 27.2 Ruta graveolens, rue.

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bay, the liquid is rubbed into the head and neck. Apuleius
requires the herb to be mixed with vinegar and rose oil
and poured on the head for all head pains. Pliny states
that injections of rue decocted in wine with hyssop Hys-
sopus officinalis are made for nosebleeds, and of the juice
for earache. Honey and wine, or oil of rose or bay are
added for hardness of hearing and tinnitus. Apuleius
wants the herb itself inserted into the nose for bleeding
but gives no treatment for ear pains. Applications to the
abdomen for heartburn and severe colic are taken from
Diocles, a physician of the 4th century BC, and involve
mixing rue, vinegar and honey into barley meal, and for
the latter pains boiling it in oil and applying the liquid on
pieces of fleece. The simpler solution of Apuleius is to hold
the herb in position on the skin over the organ. Treatment
of skin eruptions and erysipelas in Pliny are the same as
in Dioscorides, while that for vitiligo/psoriasis, warts,
scrofula and the like require the addition of nightshade
(undefined), lard and beef suet. Only the ‘sacred fire’ or
erysipelas is mentioned in Apuleius, for which rue mixed
with oil and vinegar is rubbed on.
Pliny offers other mixtures for external uses not men-
tioned by Dioscorides: the leaves boiled in oil for frostbite;
carbuncles resolved by rue in vinegar, also cited in
Apuleius; the mixture for nosebleeds as a mouthwash; a
decoction of the plant applied to swollen breasts; an oint-
ment of wild rue amazingly to resolve hernias; broken
limbs healed by a wax plaster of rue seed; the root applied
to bloodshot eyes and to heal scars and clear spots; finally,
and despite it being a very heating herb which may be
expected to open the pores of the skin, a bunch of rue
boiled in rose oil with 1 oz of aloes checks the perspira-
tion of those who have rubbed themselves with it. This
formula is recommended for heartburn in Apuleius. The
Myddfai physicians support Pliny’s contention by recom-
mending pounded rue rubbed into the skin as ‘excellent
for those hectic perspirations which so weaken a man’.
These external uses are handed down, in total or in
part, through the Renaissance authors. They are partially
reported in Ibn Sina, who adds baldness to the list of
indications. Serapio only quotes Dioscorides. The medie-
val authors only report a few of the classical uses, but
notably those for dim-sightedness and inflammation of
the eyes. The Old English Herbarium reproduces fairly
exactly the formulae for topical use in Apuleius for nose-
bleeds, eye pain and swelling and headache, but omits
external applications for abdominal swelling. The Red
Book of the Myddfai physicians lists thigh pains and bites
of vipers, and the later 18th century prescriptions for
topical use covers parasites in the skin, carbuncles, whit-
lows, cancer, arthritis and other aches, eye pain, sore
throat with fever, a painful mouth and snake bites. The
Salernitan herbal suggests heating rue and sage Salvia
officinalis on a tile then apply to contusions, while Dodoens
describes bruising among the indications. Bauhin advises
the distilled water of rue for nasal polyps and to purge the
him that the vulnerary power of rue was unknown before
Hahnemann’s proving of the remedy to include strains,
sprains, bruises and blows, when so many external appli-
cations are stated in the texts of the herbal tradition.
RUE IN CLASSICAL MEDICINE
Dioscorides lists over a dozen external uses of rue. The
herb infused into olive oil by cooking and applied to the
abdomen helps inflations of the colon downwards and of
the uterus, while the herb ground up with honey and
applied to the perineum, ‘from the genitalia to the anus’,
relieves uterine suffocation. A similar application is made
to joints to relieve pain, while mixed with figs it disperses
oedema. As a plaster with barley groats, it assuages severe
eye pains and in combination with rose ointment and
vinegar it is rubbed onto the head in cases of headache.
Ground and inserted into the nostrils, it can stop nose-
bleeds; plastered on with the leaves of sweet bay, it helps
inflammation of the testicles or with a cerate (wax) of
myrtle it remedies their pustules. Rubbed on with salt and
pepper, it treats dull-white leprosy, which is either vitiligo
or psoriasis, and both raised and flat warts. Applied with
honey and alum it is good for lichen-like eruptions of the
skin. The fresh juice, warmed in a pomegranate shell and
instilled, combats earache or mixed with the juice of
fennel and honey then smeared on is a remedy for dim-
sightedness. Another mixture with vinegar, white lead and
rose ointment treats erysipelas, shingles and scurf. When
a fresh leaf or two are chewed, it stops the smell and pun-
gency of garlic and onions.
Pliny too records the majority of these uses, in some
cases with the same ingredients, suggesting a common
source. The herbal of pseudo-Apuleius, in a substantial
entry for rue, reproduces fewer than half of them. For
dimness of sight Pliny proposes the milk of a woman who
has just borne a male child as an alternative ingredient to
honey for the application of rue, or simply touching the
corners of the eyes with a little of the juice. Engravers and
painters, he adds, eat rue with bread or cress to preserve
their sight. Rue with barley treats inflamed eyes, and with
bay inflammation of the testicles. Apuleius requires the
leaves and flowers of rue mixed with wine and applied to
the eyes for mistiness and ulceration while restating Pliny’s
poultice with barley for inflammations, for which the
pounded root may also be used. The fresh herb cooked in
oil and mixed with wax as a cerate ‘for the groin’ copies
the advice of Dioscorides for inflammation and swelling
of the testicles but without the addition of myrtle. Pliny
replaces the rose ointment in Dioscorides’ mixture for
headaches with rose oil, but if the headaches are chronic,
he continues, barley flour should be used instead of rose
oil. The juice of rue in vinegar is poured over the head in
cases of phrenitis, or with the addition of wild thyme and

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288
same intention, since the quantity of volatile oils will be
reduced in the drying process, but it is not the case that
the Ancients did not appreciate the dangers of rue. We
have already heard the opinion of Gargilius Martialis, and
earlier Pliny too affirmed the risks to pregnant women of
consuming rue in their diet, ‘for I find that the foetus is
killed by it’. It seems that the Romans, much more than
the Greeks, used rue as a condiment. Fresh and dried rue
were employed in the form of a bouquet garni or a sprig
used to stir a sauce in the recipes of Apicius, while bunches
of rue were pickled in brine for use at the table. ‘It is
prudent to assume that in his recipes rue was meant to be
used invariably with moderation, even when this was not
specifically recommended’ (Andrews 1948).
Dioscorides does not warn that pregnant women should
not eat rue, but states that it is emmenogogue. This action
has passed down to the present day, in statements such as
Fuch’s ‘if a pregnant woman drinks the juice, she will
abort’ and Turner’s citing of Seth ‘the juice of this herb is
evil for women with child’. It is the only action listed in
the British Herbal Pharmacopoeia to yield an indication
(atonic amenorrhoea). According to Dioscorides the
seed of rue quells the organ of generation, and this linked
effect is discussed in herbals down to the 17th century, as,
for instance, Pliny’s ‘for spermatorrhoea and frequent
amorous dreams’, Galen’s ‘inhibiting the appetite of
Venus’, ‘for the flowing of semen’ in Apuleius, Ibn Sina’s
‘dries up the seed, checks its flow and kills lust’, Gerard’s
‘quencheth and drieth up the naturall seed of generation’
and Culpeper’s (1669) ‘consumes the seed, and is an
enemie to generation…is nought for women with child’.
Hildegard tells us that lack of sexual release is also harmful.
She advises that ‘if a man is sometimes stirred up in
delight, so that his sperm arrives at the point of emission
but has in some way been retained within his body and
he has begun to be ill from it’, that he should take a
preparation of rue and wormwood Artemesia absinthium in
sugar, honey and wine in order to help the body void the
‘noxious mucus’ via urine and stool. Applicable to both
sexes is Bauhin’s observation that those who have devoted
themselves and are sworn to chastity are greatly helped by
a daily dose of 1 oz of the seeds in drink. Riddle (1991)
interprets the statements in Soranus’ Gynaecology, another
1st century AD text, on the use of rue as a vaginal supposi-
tory to imply an antifertility effect through contraceptive
and abortifacient means. Both he and Mills & Bone (2000)
identify the use of euphemistic language: Riddle says that
Pliny’s citation from Hippocrates that rue removes ‘the
foetus that has died before delivery’ is a common circum-
locution for abortion, while Mills & Bone argue that
emmenogogues were used to ‘bring on the menses’ when
they were delayed by pregnancy. Thus Dioscorides’ words
may provide sufficient warning to women of rue’s power
in this respect.
Dioscorides is more specific on other aspects of rue’s
potential toxicity. Both garden and wild varieties burn and
head. Macer and the Arabic authors include external appli-
cations for headache, repeated many centuries later by Dr
Fernie (1897), from whom Grieve obtained the substan-
tial part of her entry for rue. Robinson (1868) cites Profes-
sor Herman Boerhaave (1668–1738), a physician famed
for his clinical teaching, on rue mixed with wine and salt
to stop gangrene, restore vitality to a part, prevent sup-
puration and heal wounds. Fernie also transmits the
benefit of rue for the eyes, reminding us that the visual
nerve of Adam was purged by Milton’s angel with ‘Euphrasy
[eyebright Euphrasia officinalis] and Rue’. He cites an old
rhyme: ‘Noble is Rue! It makes the sight of eyes both sharp
and clear. With help of Rue, oh blear-eyed man! Thou
shalt see far and near’. Bauhin reproduces the full Latin
saying: ‘nobilis est ruta qui alumina reddit acuta: auxilio
rutae, vir lippe vedebis acute’. In addition to eye problems,
Fernie proposes another external use, of compresses satu-
rated with a strong decoction of the plant applied to the
chest beneficially for chronic bronchitis.
We have seen weakness of the eyes listed among the
unverified indications of rue in the Commission E mono-
graph. Bartram also includes this indication, while Juliette
de Bairacli Levy (1966) offers seemingly her own prepara-
tion ‘for eye ailments, including treatment of cataract’:
infuse a tablespoon of rue flowers for 3 days in a cup of
water to which is added a teaspoon of white wine, the
preparation to sit in a shallow dish in sunlight, or slowly
heated in an oven with the door open if no sunshine is
available. The eyes are then bathed several times daily with
this water. A similarly gentle extraction is mentioned in
Apuleius, where morning dew is collected from the plant
in a small vessel and mixed with vinegar for bathing the
eyes. Levy is well aware of the potency of rue and advises
small doses. For internal use she suggests the ratio of a
small teaspoon to a glass of water, as a ‘standard brew’
with a dose of only 2 tablespoons of the liquid twice daily.
On the other hand, she seems familiar with the need for
a substantially larger dose as an antidote to snake bite
‘suck out the poison or cut out with the point of a sharp
knife, in the usual way. Infuse 2 oz of fresh rue in a pint
of beer, drink this and apply some frequently to the bitten
area’. This dose is similar to that in the case of poisoning
in the elderly Taiwanese woman but Levy’s preparation is
an infusion not a decoction and certainly not intended to
be given to a person with cardiac hypertrophy and on
medication for the problem.
It is apparent from the external applications, old and
new, that fresh rue is used. Pliny specified that rue juice is
extracted by pounding the plant with a sprinkling of water
and the juice must be kept in a copper box. Are the levels
of essential oil obtained sufficient to preserve the juice in
this way? Conversely, aqueous infusions of the fresh plant
will not extract as efficiently these same oils, thus render-
ing the resulting liquid for internal administration milder
and potentially less toxic. The specification of the Com-
mission E monograph for the dried leaves of rue has the

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called wild rue sets up a confusion. For Dioscorides’
peganon agrion or harmal is also used for dim-sightedness
but there is no internal use mentioned for either the seed
or root. Galen accords with Dioscorides in pointing out
that the wild form of rue and harmal are both called ‘wild
rue’ but differentiates garden and wild forms by attribut-
ing heating and especially drying qualities in the fourth
degree to wild rue (a category reserved for agents which
can inflame and blister the skin) and in the third degree
to garden rue. Mattioli tells us that harmal is also deemed
hot and dry in the third degree by Galen, and therefore it
cuts thick humours, provokes diuresis and menstruation,
and purges phlegm. Is this simply Galenic pharmacologi-
cal theory or was harmal used internally in this way? It
may be good for shoulder pain, according to Galen, but
this could perhaps be achieved through topical applica-
tion. Our later French edition of Mattioli, as well as pro-
viding a description of harmala, states that the seed of wild
rue (i.e. harmal) prepared and mixed with honey and
sesame or almond oil is remarkable in purging melan-
choly by vomit and also treats epilepsy. It is added that
the Arabs regard the seed as intoxicating and makes those
who take it sleep long. Modern research has identified that
one of the plant’s alkaloids, harmaline, has a monoamine
oxidase inhibitory effect, that as an entheogen (a sub-
stance that facilitates communion with the supernatural)
it has been likened to the South American ayahuasca
(which also causes vomiting) and that animal studies
show it is an abortifacient and can reduce spermatogene-
sis. In modern Turkey, the seeds of harmal are hung in a
house to protect from the ‘evil eye’ and in Iran an old
Zoroastrian ritual is still occasionally carried out in restau-
rants where diners are exposed to the gaze of strangers
whereby the seed capsules and other ingredients are placed
on hot charcoals whereupon the seeds explode, releasing
a fragrant smoke which is wafted about the diners’ heads
as protection.
Latin texts name garden rue ‘ruta sativa’ and wild rue
‘ruta agrestis’ or ‘ruta sylvestris’. Mattioli correctly reads
Dioscorides and comments that ruta sylvestris practically
covers mount Salvatinus, demonstrating again that the
wild peganon is found in mountainous areas. Gerard even
includes the hills of Lancashire and Yorkshire as locations
in which to find ruta sylvestris, though it is a native of
southern Europe, but Parkinson is doubtful of the claim,
sure that rue would not survive winter in the Pennines (the
fact that Fernie (1897) and Grieve repeat the claim shows
that they have read Gerard but not Parkinson on the
matter). Mattioli admits that he has not yet seen (in 1554)
the plant harmal, although it reportedly grows in the
botanic gardens in Padua. He chastises Fuchs in his work
called Paradoxes for misreading Ibn Sina on wild rue by
assuming that Ibn Sina was discussing harmal when in fact
he was following Dioscorides on the wild form of rue.
Equally, Mattioli reckons that when the Mauritanians
(Arabs of North Africa) speak of ‘armala’ (i.e. an
ulcerate. He points out that ‘the rue that grows on moun-
tains and the wild is harsher than the cultivated and unfit
to eat’, that ‘eating much wild rue is fatal: gathered for
pickling when in bloom, it does redden and puff up the
skin with itching and with a violent rash. People must thus
harvest it after they have anointed their face and hands’.
So, here is evidence of ancient knowledge of rue’s ability
to cause a contact dermatitis, and since rue flowers in the
summer months and in sunny climates, it would have
been difficult in former times to distinguish this from a
phototoxic dermatitis. Furthermore, for internal con-
sumption, the question of dosage is again crucial. Diosco-
rides balances his statement that eating much wild rue is
fatal with the notion, of which he is sceptical, that inges-
tion of any amount is immediately followed by death
‘They say…that the rue that grows in Macedonia by the
river Haliacmon is fatal when eaten; this place is moun-
tainous and full of vipers’. Pliny states that an overdose of
the juice, which is normally taken in wine in doses of one
acetabulum (around 60 mL), is poisonous, especially
from the Macedonian rue specified by Dioscorides.
‘Strangely enough, it is neutralized by the juice of
hemlock; so there are actually poisons of poisons, and
hemlock juice is good for the hands and face of those
who gather rue’.
Pelikan gives us a modern take on rue’s ability to
combat poisons and infectious diseases. He contrasts
abnormal astral forces operating in plants to render them
poisonous, with rue’s ability to assimilate these forces
through the dominance of a cosmic ‘I’-like nature. This is
apparent in its formation of volatile oils and expression
of a warmth principle, as also seen among the healing
aromatic plants of the Labiate family. However, this
warmth principle and expression through volatile oil pro-
duction is particularly strong in rue. In order for rue to be
tolerated, the human ‘I’-impulses within the patient must
also be strong. In this way rue protects the person from
outside influences like infectious disease and poison. The
strong fire and light forces within rue link both to its
ability to treat the eyes and its power to cause blistering
of the skin on contact.
RUE, HARMALA AND POISON
It will be useful now to clarify here the difference between
cultivated and wild rue, for there is some confusion in the
later tradition. Dioscorides writes of the cultivated or
garden rue and the wild rue that grows on mountains
together as ‘peganon’. He has a separate entry for the wild
rue ‘peganon agrion’ called ‘harmala’, by the Syrians
‘bessara’ and by the Cappodocians ‘moly’. It is sometimes
called ‘Syrian rue’ but is the white-flowered harmal
Peganum harmala from the Zygophyllaceae (USDA 2010).
The fact that these plants of different families are both

THE WESTERN HERBAL TRADITION
290
snake bite. Dioscorides includes not only reptile poisons
but all deadly poisons, requiring a dose of one oxybaphon
(a volume measurement of nearly 70 mL) of the seed
taken in wine. Pliny regards the pounded leaves of any
sort of rue in wine a powerful antidote, especially against
aconite, mistletoe, poisonous fungi, snake bites, rabid
dogs and scorpion and other stings. Apuleius advises the
powdered seed drunk in wine and laid on for scorpion
stings. Seth cited in Fuchs adds opium to the list of poisons
rue antidotes. Pliny notes that weasels about to fight with
snakes first protect themselves by eating rue. It is also good
for fevers with rigors.
Serapio calls rue ‘the ultimate medicine against the evil
of poisons’ and Dodoens, Gerard, Bauhin, Parkinson and
Culpeper want it as a remedy against the plague. It was,
after all, one of the ingredients of the ‘vinegar of the four
thieves’ who robbed the houses of plague victims under
the protection of their aromatic repellent. Quincy, Miller
and Hill consider it an alexipharmic remedy against the
plague or epidemic infections and fevers. Drury (1992)
comments that the English courtrooms of today no longer
have to contend with the threat of gaol fever (typhus) or
the plague from defendants in the dock or from members
of the public in the gallery, for which rue was used as a
strewing herb as proof against these contagions of the
Renaissance and early modern periods. A belief in rue’s
ability to combat poison thus has a long history and
strong recommendation, since it is a constituent of the
famous antidote of Mithridates, King of Pontus. Parkinson
informs us that each morning the king, to protect himself
against poisoning, would take 20 rue leaves mixed with a
little salt, two walnuts and two figs, the whole beaten to
a mass and ingested as a daily dose. We know this because,
as Fernie (1897) relates, the Roman general Pompey
found the formula in the satchel of the conquered king.
The formula turns up in the Red Book of the physicians
of Myddfai. Culpeper offers particular praise to Mithri-
dates for his researches in physic, dismisses arguments that
protection against cold poisons do not afford immunity
against hot poisons but recommends instead that Mithri-
dates’ formula, to which Culpeper adds 20 juniper berries,
taken in the quantity of a hazel nut, will preserve admira-
bly the health of the body. This is because rue is a herb of
the sun in Leo, an alexipharmic like juniper, which by
fortifying the heart strengthens resistance to all disease.
The herbs must be gathered, however, at the astrologically
propitious hour.
ANTHELMINTIC AND SPASMOLYTIC
Another traditional use for rue is as an anthelmintic.
Dioscorides wants it boiled in olive oil and drunk to
remove intestinal worms. This indication passes down
through the Arabic and Renaissance sources, then is
unaspirated form of harmala) they mean the wild form of
rue and if Italian apothecaries are following any of their
prescriptions, they should prepare wild rue when ‘armala
is required. Mattioli makes no comment on the advice of
Dioscorides not to use wild rue internally. Dodoens has a
separate section for harmal but tells us that the wild form
of rue is called ‘harmel’ in the apothecaries’ shops. Turner
regards the seeds of wild rue as safe to ingest but unhelp-
fully calls its root ‘moly of the mountains’ while Gerard
falls prey to Fuch’s misunderstanding by suggesting that
‘Harmala’, ‘Harmel’ and ‘Besara’ are simply alternative
names for wild rue among the Arabic writers. In the 18th
century Miller names the white-flowered harmal ‘wild rue’.
Location helps to distinguish the species, although this is
unhelpful if the only examples are seen in botanical
gardens. Cultivated or garden rue, according to Pliny,
loves to grow in open, dry places, especially on clay and
needs to be dressed with ashes, but it hates dampness,
winter and manure. The wild form is found in mountain-
ous areas, while harmal is a plant of desert regions. Harmal
has become an invasive weed since being planted in New
Mexico in the late 1920s and has since spread across the
salt-desert shrub lands of the western USA, successfully
competing with native species because of its drought toler-
ance (Moore 1989).
Despite the confusions over wild rue, Dioscorides’
warnings that eating too much of this wild form can be
fatal and handling it can blister the skin are passed down
the tradition, from the Arabic writers to the Renaissance
authors. Gerard, for instance, affirms that wild rue ‘scor-
cheth the face of him that looketh upon it, raising up
blisters, wheals, venometh the hands that touch it, and
will also infect the face if it be touched before they are
clean washed; therefore, it is not to be admitted to meat,
or medicine’. Fernie (1897) later quotes the same state-
ment and warns of inflammation of the skin but Grieve
omits it and styles rue a topical rubefacient agent without
this caution). Bauhin informs us that Guillaume Ron-
delais (1507–66), physician and botanist at the medical
school in Montpellier, used to tell a story about meeting
a man on pilgrimage to that city who came across rue on
his journey and, having heard that Montpellier was beset
by the plague, gathered the herb, placed it in his nostrils
and held it in his hand for some time, whence the parts
in contact with rue became greatly inflamed.
Rue is ‘among our chief medicinal plants’ says Pliny,
and its extensive uses by ingestion are consistently passed
down as far as Culpeper. We have heard of its emme-
nogogue action, to which is linked by Galenic pharmacol-
ogy a diuretic one, although the indication was given by
Hippocrates. Pliny, who tells us this and reckons the herb
good for the kidneys, then marvels at how some use rue
for incontinence of urine, while treatment of strangury is
made by the usual internal administration or the applica-
tion of an oil of rue over the bladder area. Mention has
also been made of its ability to antidote the poison of a

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stimulating effect has been thought useful for nervous
complaints. The old herbals mention more serious neuro-
logical problems: Pliny proposes a decoction of the juice
for epilepsy and Fernie (1897) writes that the Neapolitan
physician Piperno commended rue in 1625 as a specific
for epilepsy and vertigo. We may recall the Commission
E noting dizziness as an adverse effect; Fernie mentions an
unsteadiness of gait in regard to excessive doses, for a leaf
or two chewed is sufficient in his opinion to relieve
nervous headache, giddiness, hysterical spasm or palpita-
tion (the praecordial pain in Apuleius for which the herb
in wine is drunk before the patient lies down), and Grieve
and Hoffmann repeat this advice. Quincy reckons that rue
is good in all convulsive cases and thinks the best way to
take it is to eat the fresh leaves with bread and butter.
Cullen too is prepared to consider rue, ‘a plant of several
peculiarities’ in the treatment of epilepsy, for which the
inspissated juice or other extract may be used. Ibn Sina
advocates rue internally and externally for paralysis and
sciatica, for which latter Fernie suggests that the leaves
should be bruised and applied. Macer recommends the
bruised herb with cumin powder applied to an ache in any
part. Indeed, an external liniment of rue is used topically
for pain in present-day Mexico (Waldstein 2006). For leth-
argy, Turner’s ‘the forgetful disease’, rue may be taken
internally, as an enema or the vinegar of the fresh plant
smelled. In Apuleius rue in vinegar is poured onto the
head and in the Old English Herbarium it is sprinkled onto
the temples. For instance, some recent research records
application of a homoeopathic combination of rue and
calcium phosphate in the treatment of neurocysticercosis
which has neurological symptoms as the cysts are in the
brain tissues (Banerji & Banerji 2001). Thirty-six patients
were assessed with computerized tomography scans and
treated for between 3 and 65 months, and 25 subjects
became symptom-free.
The indication of paralysis is not continued, although
Gerard writes of oil of rue warming and chafing all cold
members that are rubbed with it. Instead Quincy naturally
places rue among the hysterics, with cephalic qualities,
and good for all nervous complaints in women which
originate from the womb. Miller, Hill, Cullen, the National
Botanic Pharmacopoeia and the British Pharmaceutical Codex
(1934) follow suit. In the last case a dose of 0.12–0.3 mL
of the oil should be taken on sugar or in hot water. The
essential oil of rue is no longer recommended and indeed
Wren prefers anyway an infusion of 1 oz to 1 pint (25 g
to 500 mL), to be taken in cupful doses for hysteria and
amenorrhoea. He warns that large doses are liable to
produce inflammation and nerve derangements.
The Commission E monograph lists several adverse
effects of rue on the nervous system: melancholic moods,
sleep disorders, tiredness, dizziness and spasms. Just as we
have seen with dizziness above, these anecdotal reports
are likely to be linked with excessive dosage. It is not news
to practising herbalists that a certain action of a herb
rarely mentioned, although Cullen recommends a strong
decoction as an enema for ascarides in the rectum. Wil-
liamson states that the herb is reportedly anthelmintic
and recent ethnobotanic research shows that rue is a
popular traditional medicine in rural parts of Italy for
worms and externally against head lice and parasites
(Guarrera 1999). Despite being a non-indigenous herb,
it is also in much demand by the people of the
Bredasdorp/Elim area of South Africa not only for worms
but also for bladder and kidney problems, convulsions,
diabetes, fever, headache, stomach complaints and sinus
problems, in doses of 1 teaspoon of the herb to a cup of
boiling water (Thring & Weitz 2006). An anthelmintic
action is derived from the volatile oils and bitterness of
rue and leads us to consider the plant’s actions in the
digestive tract. Dioscorides notes that eaten or drunk it
stops diarrhoea and, taken with dried dill Anethum gra-
veolens, abdominal colic. Pliny says that the pounded
leaves in wine with cheese are given to patients with dys-
entery. Rue soon relieves indigestion, flatulence and
chronic stomach pains, and should be decocted with
hyssop Hyssopus officinalis and taken in wine for colic and
internal haemorrhage, and can be used externally on the
abdomen and over the heart, as discussed above. Decocted
with figs in wine, and the liquid reduced by half then
drunk, it treats dropsy. Pliny wants rue for liver problems
generally and the Arabic writers mention the spleen. Indi-
cations for diarrhoea, flatulence and colic have passed
down the tradition to the present day. Hoffmann empha-
sizes the spasmolytic action of rue, easing griping and
bowel tension by relaxing smooth muscle. When Fernie
(1897) suggests that rue remedies the nervous indigestion
and flatulence from which the Greeks suffered when
eating before strangers and later mentions that it some-
times causes vomiting or purging, we wonder if he is a
victim of the confusion between wild rue and harmal.
Grieve too, following the National Botanic Pharmacopoeia,
warns of taking rue after food ‘on account of its emetic
tendencies’, whereas Bauhin proposes half a drachm
(2 g) of the powdered herb in warm wine to comfort the
stomachs of children weakened by frequent vomiting.
Rue has also been recommended for lung problems and
its spasmolytic action offers a rational therapeutic for
respiratory complaints. Only pleurisy is included in the
unverified uses of the Commission E monograph, which
disease fits the report of Dioscorides that the herb is ‘good
for pains on the side and chest, dyspnoea, cough, inflam-
mation of the lungs’. Pliny mentions asthma but the
British Herbal Pharmacopoeia restricts itself to an antitussive
action without indications and the National Botanic Phar-
macopoeia lists only croupy affections. Hoffmann suggests
spasmodic coughs. Indeed little has been made of rue for
lung problems since Culpeper’s day, when rue may also
have been given for purulent expectoration and the spit-
ting of blood, using for the latter three sprigs of rue boiled
in wine. Rather, the spasmolytic action combined with a

THE WESTERN HERBAL TRADITION
292
dosage of 1–4 mL of tincture 1:5 40% alcohol. Wren states
1 oz of dried herb infused in 1 pint of boiling water, the
infusion taken in cupful doses.
Bauhin writes that he must limit his comments on rue
to what he himself has experienced of its efficacy, since it
is virtually impossible to investigate the many claims
made for rue by other authors. He provides instructions
on how to prepare a distilled water, a conserve, a vinegar
and an oil. For the latter, chopped and crushed fresh rue
is infused in oil for 15 days in the sun or in a warm place,
then decocted in a bain marie. The oil is strained and the
process repeated twice more. As far as dosage is concerned,
he proposes 1 drachm (4 g) of the powdered herb in warm
wine for headaches due to cold. A handful of the (fresh?)
herb decocted in wine until reduced by one third then
strained, and with 4 oz sugar added, forms a drink for
chest pain due to cold, to be taken morning and evening.
In addition, 4 oz of the juice mixed with 1 drachm (4 g)
of asafoetida seed Ferula assafoetida taken in a warm drink
is helpful for epilepsy.
RECOMMENDATIONS
Since rue is according to Galenic pharmacology very
heating and drying, it is appropriate as an internal remedy
for cold and phlegmatic presentations. These imbalances
are much more likely in older people, whereas rue may be
too stimulating and heating for younger people.
Rue should be considered for internal administration
in:
• Obstructive lung diseases: asthma, chronic
bronchitis, croup and spasmodic coughs. It may
be considered for those convalescing from
pleurisy and other inflammatory diseases of the
lungs.
• As a carminative and antispasmodic it may be
used for dyspepsia, colic and some cases of
irritable bowel syndrome and diarrhoea.
• In nervous affections, including headache,
spasms, light-headedness and functional
palpitations. In small doses as a stimulant in
lethargic states.
• Secondary amenorrhoea not linked to underlying
disease. Weiss’ formula above should be
considered for use.
• Rue may have a role in premenstrual syndrome.
• To sharpen vision.
• Arthritis and rheumatism.
• For external use (with the need to protect the
area treated from exposure to sunlight):
• Neuralgic pain, including shingles; arthritic pain
of all kinds
• Scabies and other infestations, insect bites and
stings
obtained with a therapeutic dose can be paradoxically
reversed with a different dose, usually a much larger one
but also with micro-doses. Melancholy, poor sleep, tired-
ness and spasms may appear in the same disease, and may
be provoked by inappropriately large doses of a stimulant
medicine such as rue. On the other hand, there are two
reports in the literature we have consulted about the gen-
eration of melancholy. Turner cites Simeon Seth (although
this same statement does not appear in Fuch’s citation) on
the need for those of a choleric temperament suffering
from an imbalance of the yellow bile humour to abstain
from rue, since it will heat their blood too much, driving
off the thinner part of it and leaving it melancholic in
quality. Fernie (1897), not being attached to Galenic
theory, mentions dullness and weight of mind as products
of excessive dosage of rue. It is important with this herb,
as we have heard several times, to establish a correct
dosage for the indication.
A final set of indications listed by Dioscorides for inter-
nal use of rue is pains of the hip joints and of the joints,
and internal swellings and oedema. These passed down
through the Arabic and Renaissance writers before being
neglected. Treatment of the joints may be carried out by
internal medicine and by external applications, as we have
seen. A piece of recent research hints at some credence to
the advice in the old herbals. An extract of rue was found
to have an antiinflammatory action in vitro in a model
which measures nitric oxide production and showed that
this was related to inhibition of nitric oxide synthase. The
authors found that although it was much more effective
than pure rutin, the action was also related to concentra-
tion of rutin (Raghav et al 2006). Williamson mentions
the antioedema effect of rutin and cites other research on
the antiinflammatory action of rue. There are other plants
which are safer sources of rutin, as we have already stated,
but the unusual constituents of rue – aliphatic ketones,
furocoumarins and alkaloids – may have specific actions
of their own to complement this antiinflammatory effect.
We have seen a range of dosages employed in the above
uses of rue, from the dew shaken from the flowers for an
eye bath and a couple of fresh leaved chewed for nervous
headache, palpitation and giddiness, to 2 oz of the fresh
herb infused in a pint of beer for snake bite. This last use
is unlikely to be repeated by herbal practitioners in a
primary care setting, so we should instead consider the
typical doses advocated. Again these have been as small as
2 tablespoons twice daily of an infusion made with a small
teaspoon of rue to a glass of water, and as large as Weiss’
infusion to obtain the benefits of rutin from rue, where
1–2 tablespoons of dried herb per cup of boiling water is
used and the infusion taken three times daily. The British
Herbal Pharmacopoeia states 0.5–1 g of the dried herb, as
infusion, or 0.5–1 mL of the liquid extract 1:1 25%
alcohol, three times daily. Grieve proposes 15–30 grains
(1–2 g) of the powdered herb and 0.5–1 drachm (1.7–
3.5 mL) of the liquid extract. Hoffmann offers a tincture

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Dosage: the British Herbal Pharmacopoeia recommends
500 mg–1 g three times a day of dried herb. Equivalent
dosage in liquid extract or tincture forms may be consid-
ered. Infusions of the fresh herb and specific tinctures
should be used more cautiously in lower doses at first. A
suitable fixed oil of rue and a derived ointment could be
prepared for external use.
• Skin diseases where a stimulation of the affected
skin is required to improve healing, or an
anti-microbial effect is needed.
• As a rub for chest conditions such as bronchitis
• Research should be considered for the use of rue
in epilepsy, mild cases of frostbite, vitiligo,
lichen skin conditions and as a topical treatment
in eye problems.
CONSTITUENTS
Reviews: Williamson (2003), Stashenko et al (2000).
Alkaloids
Furoquinolines, quinolines (Stashenko et al 2000).
Quinoline: graveoline, furoquinoline: kokusagenine; quinoline (fresh leaves, cultivated, USA) (Oliva et al 2003).
Quinoline: graveoline and eight analogues; furoquinoline: kokusagenine, skimmianine (cultivated, Bulgaria) (Kostova et al
1999).
Acridones, unique to Rutacea, mainly in roots and slightly in leaf base (Junghanns et al 1998).
Volatile oil
Total 0.74% (38 compounds), linear ketones: 2-undecanone 47%, 2-nonanone 19%; monoterpenes 11%: alpha-pinene,
limonene; oxygenated monoterpenes: 1,8-cineole, methyl salicylate 4% (aerial parts, Italy) (De Feo et al 2002).
(37 compounds), linear ketones: 2-nonanone 45.3%, 2-undecanone 31.1%; oxygenated monoterpenes (leaves, cultivated,
Columbia) (Stashenko et al 1995).
Undecanone is responsible for the characteristic smell and insect repellant action and is used in sprays to repel dogs and
cats.
Furocoumarins
Total 0.4% (mean): psoralen 0.14%, bergapten (5-methoxypsoralen) 0.16%, xanthotoxin (8-methoxypsoralen) 0.1%,
isoopimpinellin (5,8-methoxypsoralen) (leaves, cultivated, 19 plants, France). Total concentration was highest in fruits and
leaves and similar in all 19 accessions (Milesi et al 2001).
Total 0.5% (mean): psoralen, xanthotoxin, bergapten. Total concentration was highest in leaves higher during fruiting, and
did not vary between sites (cultivation, France) (Poutaraud et al 2000).
Rutamarin, bergapten, xanthotoxin, chalepin, rutaretin (Kostova et al 1999).
Chalepin, chalepensis, bergapten, psoralen, xanthotoxin, isopimpinellin (leaves, cultivated, Colombia) (Stashenko et al
2000).
Flavonoids
Rutin 4% (Raghav et al 2006).
RECOMMENDATIONS ON SAFETY
1. Do not use in children.
Given the safety concerns discussed above, rue
should not be used in children under any
circumstances.
2. Use caution in dosage.
The dosage of this plant is discussed above.
3. Do not use where the patient may be pregnant or
could become pregnant.
The authors and other sources discussed above
indicate that rue can be an abortifacient.
4. Do not apply to the skin without first conducting a
small patch test. Avoid exposing the treated part to
the sun. Use gloves when gathering the plant as
contact can cause an unpleasant, phototoxic skin
reaction.
Phytophotodermatitis is a light-sensitive contact derma-
titis where skin which is exposed to sunlight comes into
contact with an irritant substance and a red, oedematous
rash, sometimes with blisters, develops, usually 1–2 days
after exposure (Deleo 2004). The furocoumarins are linear

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are psoralen, bergapten and xanthotoxin (Eisenbrand
2007). A group of four adults and seven children applied
fresh rue as an insect repellant and spent the afternoon
outdoors. After 24 hours they developed reddish-purple
rashes with blistering, which continued to erupt up to 12
days after the initial exposure. The rashes tended to be
linear where the plant had been rubbed on the skin and
people who had spent less time in the sun were less
affected (Eickhorst et al 2007). A 2-year-old child suffered
acute blistering on the hands and was poorly after touch-
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rue the day before visiting a suntan parlour and again the
rash was present where the rue extract had been applied
(Wessner et al 1999).
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