River Medicine: Alder’s Transformation of Lymph, Blood, and The Human Ecology
by Kiva Rose
“Eventually, all things merge into one, and a river runs through it.”
- Norman MacLean
Botanical Name: Alnus spp. specifically the A. oblongifolia and A. incana that grow in my local area, other species commonly used in medicine include A. rubra and A. serrulata
Botanical Family: Betulaceae
My affection for this elegant and common tree is second to none. One of the key species in wetland areas on the canyon and mountain Southwest recovering from overgrazing, its curved branches shade the waterways all through the Gila bioregion I call home. I cannot imagine my home or practice without the silver- barked grace of the Alders that intermingle with the Wild Roses and Coyote Willow all along the canyon walls and rocky sandbars of the San Francisco River. Of our local Canyon Alder, A. oblongifolia, naturalist and tree lover Donald Peattie writes:
“Like almost all of the other Alders it loves a rushing stream to cool its roots, and the head of the cool canyons whre the shadows lie long. But this species, which thrusts farther south in the desert states tha any other Alder (going right over the Border into Mexico), is especially delightful when you come upon it after a long trip across the burning desert and a long climb through the arid lower slopes of mountains like those around Tucson. As slim as young Birches, as cool as broad Beeshes, as tall, sometimes 60 or even 80 feet high, the Alders form delicious groves, wit hthe tingling of the streams forever making music.”
Indeed, the complex knotwork of the Alders’ silver roots thrust into the sweet rushing water of the mountains rivers makes a song of which there is no match in any forest I have yet wander. I can think of almost nothing as sweet as walking by the swollen river during the monsoon season when the canyon is lush and green and the Alder trees curve out from the banks and over the water, creating a verdant and shaded tunnel. The sweet and delicate spice scent of the trees mingles with the richer fragrance of Narrowleaf Cottonwoods and provides an intoxicating experience.
Habitat & Ecology:
Widespread and abundant throughout much of the temperate world, Alder is even considered weedy in many moister climates. In truth, it is a pioneer species with nitrogen fixing roots that nourishes and improves previously disturbed or depleted soils. Here in the Southwest, its appearance almost always signifies recovering wetland habitat and is a sight I always welcome. The nitrogen it provides helps to feed the other species that follow it in the riparian forest succession. Overall, Alder seems to prefer riverside or swampy habitat where it usually grows in great intertwined thickets. Our local Alder, Alnus oblongifolia, is something of an exception to this, growing into colonies of medium to large sized individual trees alongside rivers and streams. They are a fairly short- lived genus, with the average lifespan being approximately 100 years, but grow rapidly and provide shade, soil nutrients and forage for wildlife, including a number of butterfly species.
Identification & Botanical Description:
Alder trees vary in stature from small shrubs to large trees, growing as tall as 120 feet tall. Their bark is usually smooth with darker lenticels as well as some furrows in older trees, usually from scarring. The outer bark tends toward brownish-red in color but may also be gray or silver in color with red to rust colored inner bark. Donald Peattie remarks of Alnus rubra:
“The bark is the loveliest feature of the tree. It is, in youth, a soft and grayish white, quite as pleasing as any Aspen’s or Beech’s bark… And the very rainy or foggy climate of this Alder’s range induces long lines of dark green moss to grow, especially on the north and west. The resultant mottling of colors is exquisitely subtle and harmonious. One could not ask for a lovelier sylvan presence than this…. Lumbermen prefer to call this the Red Alder – a most misleading name to the student of the field, for not Alder has so white a bark. But scratch the bark with your penknife and you will find that inside it is a rich red.”
Alders are almost always deciduous and their serrated, straight-veined leaves are simple and alternate. Those unfamiliar with the genus may easily mistake an Alnus for its close cousin Betula (Birch). While there are other, more dependable ways ways of definitively identifying the tree (see the information below on differentiating flowers), one of the easiest features is the scent. Some Betula spp. are virtually scentless, but many have a distinct Wintergreen like scent while Alnus spp. tend to have a sweet, spicy scent. They flower in the form of unisexual (separate male and female) catkins, the male flowers are elongated while the female are cone-like and woody. They greatly resemble Betula species except for the fact that the female flowers of Alder are woody and persist after maturity, bearing much resemblance to the cones of many coniferous trees. After fertilization, these conelets ripen and release tiny winged seed-like nuts.
Parts, Use, & Harvesting
Twigs, leaf buds, leaves and catkins (both male and female) are all medicinal. Some people harvest the bark of the body of the tree, but it seems more astringent and less useful for the primary purposes I discuss in this article. The young twigs are sweeter and more aromatic and less astringent as well as easier to harvest. Different subgenera of Alnus flower at different times, and I tend to harvest twigs and catkins just when they begin to flower. Research your local species for when that time will be in your area. I harvest leaves as needed for poultice use, and when most sticky (usually the first half of July) for infusing into oil or tincturing.
Taste & Impression
Taste of bark tends to vary across Alnus species and habitat to some degree but some level of sweet, astringent, aromatic and slightly bitter seems to be fairly standard. Some species of Alder possess very resinous, sticky leaves with asweet taste where others are more straightforwardly astringent.
Generally mildly cooling and moderately drying.
Alterative, lymphatic, blood moving, astringent, anodyne, vulnerary
Anti-inflammatory, anti- infective,immunostimulant,
Systemic or local microbial infections, chronic or acute. Hypoimmunity with swollen lymph glands, poor digestion of fats and proteins and slow healing wounds/injuries.
Lore & Story
Our Canyon Alder (Alnus oblongifolia) has beautiful silver bark with an underlying skin of blood red revealed by the scratching of bear claws (who are inordinately fond of this tree). It lives right on the river bank with its roots dangling in a silver web in and just above the water,. And indeed the Alder is a bear medicine. In a literal sense, the bears love this tree — they climb it, mark it and nibble on it. On another level, Alder (and bears) belongs to the water element, to the deep within where primal transformation takes place. This tree has always spoken to me of the balance of fire and water, of rebirth and change. My partner Jesse Wolf Hardin wrote eloquently of Alder’s mythological and spiritual aspects in his novel, The Medicine Bear:
The alder would have felt special to Omen even if she had never learned any of its story, or learned to read by studying its myths. She loved that it had been long known as the King Of The Fairies, that the faces of the Sacred Kings during the Midsummer rituals were painted with the red dye of its inner bark. That the fairies were said to use the Alder catkins to dye their clothes, thereby making themselves invisible to human eyes. That while its wood burned slow, it nevertheless made the best and hottest charcoal, and had once been the choice of medieval warriors for forging their magically imbued swords. That woodsmen would sometimes strike the silvery barked trees with an axe, and then upon seeing the bright red flesh beneath, be reminded of blood and made too sympathetic to continue an assault. For these reasons and more, the alder was considered to embody the power of fire. And because of the way it turned water into steam, it was called the Tree Of Resurrection by Homer. The alder was the botanical Phoenix, Omen had decided… the leaf-feathered firebird of rebirth.
River Medicine: A Therapeutic Overview
Alder is river medicine, a remedy deeply aligned with the flow and transformation of fluids in the waterways of the wetland ecologies it grows within as well as the blood and lymph of the human body. Even in its role as an “anti-microbial” in herbal medicine, its primary action seems to be in supporting the inherent immune ecology rather than as a ruthless bacteria assassin.
Its place in the recovery of damaged wetland habitat also speaks to its relationship with the metabolic processes of our bodies. Just as it heals stripped soil by assisting in the microbial balance, it also supports our innate ecology and microbial balance. Through its work as pioneering colonies on overgrazed or logged waterways, thereby transforming the quality of the water, so too it acts on the body’s ability to transform food into nourishment and supports the eliminatory organs’ role in moving and removing waste.
Alder is a staple of my clinical work and one of my most beloved herbal allies. Its consistent and powerful ability to act as a profound alterative and lymphatic while addressing even the most severe microbial infections makes it truly invaluable to almost any practitioner, and especially those focused on working with locally available and common weedy plants.
The actions discussed here are based on my direct clinical experience. While I certainly learned a great deal about this herb from others (especially Darcy Williamson), any assertion made about Alder’s properties stem directly from my clinical experience with the plant and not from hearsay, literature or extrapolation.
Alterative & Lymphatic: Directing the Flow & Strengthening the Inner Ecology
“This agent combines both alterative and tonic astringent properties. It removes waste products, improves the tone of mucous structures and increases the secretory action of the glands of these structures. At the same time it prevents the flow of an excessive quantity of mucus into the stomach, and stimulates the flow of gastric juice and aids the digestion. It cures various forms of ulcerations in the mouth, or in the gastro-intestinal canal. It is advised in rhus poisoning. It has accomplished satisfactory cures in pustular and eczematous disease of the skin.” - Finley Ellingwood
Having a range of actions extending from alterative to lymphatic to pain reliever/blood mover to astringent to powerful anti-bacterial agent, there’s a reason this tree has been considered an overall tonic by many indigenous tribes. When it comes down it though, the medicine is all about the transformation and nourishment of the body’s vital fluids, whether through lymph, blood, bile, digestive fluids, urine etc It’s not a yin tonic, it doesn’t add to the fluids, nor does it simply move or contain them; rather, it improves/transforms the quality of the fluids. I believe it has something in common with Redroot (Ceanothus spp.) in this regard but with broader application. It teams up very well with Oregon Grape Root for constipation (or constipation rotating with diarrhea) with poor protein/fat digestion and accompanying skin disorders. This is usually a pattern of sluggish liver and deficient kidneys that cause the body to fall into in overall sluggish state where the fluids are NOT being transformed and waste is not being removed properly from the body. Alder and Oregon Grape Root will help. If there’s significant adrenal involvement, add some Nettles to the picture. Tommie Bass said:
“If you got any kind of skin condition like eczema or scale, the [alder] tea will help your body heal itself. It cleanses the liver and you know, the liver controls everything else.”
This same pattern of sluggishness leading to inflammation and buildup of waste products also has a tendency to result in chronic infections in the body. The tissues get boggy and soft and can’t move wastes out of themselves any more. Time for some Alder! Often Spanish Needles (Bidens spp) is a nice combo here, especially for chronic infections of the mucus membranes. I want to talk a bit more about Alder’s very efficient ability to effect the lymphatic system as well as other systems that enhance elimination. I expect it is this strong alterative capacity that makes it so effective against infections as well. I’ve found that a small amount of Alder tincture to be a powerful yet gentle way to move sluggish lymph indicated by swollen glands, slow healing wounds, chronic sore throat and other typical symptoms. It also has a remarkably quick action on all kinds of skin conditions, from PMS related outbreaks to scaly patches and red rashes. It works especially well with Dandelion for any hot, inflamed skin condition. Despite the fact that I work closely with several other well known Alterative/Lymphatic herbs such as Violet, Mullein, Burdock and Cleavers I find myself consistently choosing Alder for most situations, especially when I need something to get things moving very quickly. I am of the opinion that it often works even quicker than Redroot (Ceonothus spp) and that they make a superb pair for severe lymphatic congestion.
“This much neglected, but very important, remedy is a valuable agent in scrofulosis, especially in those cases marked by glandular enlargements and suppuration. Prof. Scudder speaks of it as one of the most valuable of our indigenous remedies, and points to its use in “superficial diseases of the skin and mucous membranes, taking the form of eczema or pustular eruption.” Administered internally and applied locally in these conditions, we may expect from alnus the best of results. Impetigo, prurigo, herpes, and scorbutus, are diseases in which alnus will be of great utility…. The happiest results are obtained from its use in successive crops of boils.” - King’s American Dispensatory
I have also seen protracted durations of flu/cold with immune sluggishness and swollen glands clear up in a matter of a few days with persistent doses of Alder, usually accompanied by a warming circulatory stimulant like Ginger or Monarda, with or without the addition of the immune modulating Elderberry. Sources which directly list Alnus species as a glandular or lymphatic remedy include Lyle, Boericke (homeopathic), Ellingwood, King’s American Dispensatory, and is also inferred by Cook and Felter. TJ Lyle said that:
“The bark is a mildly stimulating and gently astringing tonic alterative, influencing mainly the cutaneous and renal secretions, glands and lymphatics; and is therefore valuable in scrofula, glandular swellings, skin diseases and mercurial cachexia. It is also valuable in chronic diarrhoea, sore mouth, sore throat, especially when arising from some impurity in the blood. In the treatment of dyspepsia it influences the flow of gastric juice and invigorates the appetite. Its action is excellent on the mucous membrane in catarrh of the stomach or bowels. Acting as it does on the circulation it is valuable in rheumatism, and in the treatment of syphilis and in chronic and acute inflammation of the stomach and bowels and in cases of hemorrhages. It is a gentle stimulant of the kidneys and absorbents. ”
and John Scudder stated:
“It is an agent that has not been much employed by the majority of the profession, and yet those who have used it consider it one of our most efficient alterative agents.”
And he specifically recommends it for scrofula with glandular enlargement. Alder is historically associated with the treatment of scrofula and syphilis, both diseases that deeply affect and eventually derange the lymphatic system. Alder was considered by many of the older herbalists to be a very effective treatment for the these diseases as well as for glandular swellings and disorder in general. Many more general references to this kind of treatment can also be found in various ethnobotanical texts. Both the ethnobotanical literature and my personal conversations with indigenous people of the American West indicate its popularity when treating almost any acute viral affliction, including not only cold and flu but also childhood eruptive diseases and TB. While the term immunostimulant can be nebulous at best when it comes to experiential work with the human body, Alder has several more obvious actions that allow us to see its effect on the immune system. Most notably is the effect on lymphatic stagnation, which is often obvious and quick where there’s swollen and/or painful glands. It also appears to increase non-specific resistance to infection of many kinds, including bacterial, fungal and viral. It does not, however, seem to elicit any negative reaction in those with autoimmune disorders and I have used it frequently to clear up infections in clients with Lupus, Type II Diabetes and Rheumatoid Arthritis.
Anti-Infective: Balancing Microbial Proliferation
Occasionally other herbalists will look at me as if I’m quite mad when I mention my frequent use of Alder, especially for microbial infections. However, my experience with this plant is nothing new and many of the uses are well recorded in ethnobotany and older herbal/medical literature from North America and Europe, especially those relating to lymphatic stagnation and pain.
An herb so widely applicable to microbial infections will inevitably provoke comparisons to Echinacea. I certainly don’t find the two plants analogous based on their tastes and overall profile but I do use Alder in many situations where other would choose Echinacea. If Alder can effectively be used in some of these situations it would create less pressure in the market for wildcrafted Echinacea. Certainly there’s an organic market for Echinacea, but Alder is an incredibly widespread plant and could provide cheap (and often free), accessible medicine for many people.
My experience is that Alder tends to work best for microbial (including gram negative and positive bacteria and many fungi and viruses) infections of the gut, gums/mouth, urinary apparatus, vagina, skin and systemic infections and less well for those of the respiratory tract. However, given its lymphatic, immune enhancing and other actions it is well suited to many respiratory formulae when combined with more directly respiratory anti- microbial herbs such as Elecampane, Cottonwood and Osha.
I have repeatedly seen cases of staph (including several confirmed cases of MRSA) infection manifesting as repeated outbreaks of boils clear up with the consistent use of Alder tincture. It works similarly on cellulitis and even on cases of sepsis when treated quickly and aggressively enough. Vaginal and urinary tract infections also respond very favorably to Alder, and I have seen it clear up even several year long and seemingly intractable combined Vaginal/UTI type situations.
Alder appears to act both topically and internally on microbial infections, and local application of leaf poultice, salve or infused honey is often enough to clear up a mild infection. Dealing with more serious or systemic infections however, it is best to use the plant internally as well. Specifically, I use the recently dried twigs, cones and catkins in a 1:5 tincture made with 50% alcohol. Frequency and dosage in systemic infections is critical and for an average sized adult, I usually recommend 1/2-2/4 ml every 3 hours for a progressing, acute infection.
In the treatment of infections, I find that Alder works even more efficiently and rapidly when combined with a diffusive, circulatory stimulating herb such as Monarda. Formulating the herb in this way speeds its impact on the body and seems to add to overall effect on the infection.
Anti-Inflammatory: Cooling, Tonifying and Soothing
Alder can act as an anti-inflammatory both internally and externally and is excellent for relieving acute inflammation from microbial infection, waste product buildup from poor metabolism and even seems to initiate an overall cooling action in many cases of acute hepatitis. Combined with its blood moving action, Alder is ideal in many cases of excess heat with pain. Alnus spp., like their Betula relatives, contain salicin, a constituent that acts as an anti-inflammatory in the human body. I have been unable to track down solid research citing the amount of salicin found in Alnus bark, but its presence seems worth mentioning in this monograph, as it likely has some bearing on the overall anti-inflammatory and anodyne effects of the herb.
Anodyne: Remediating Pain
Alder can provide significant pain relief, both externally and internally. It seems specifically suited for head/tooth/gum pain when used internally and general topical pain relief. It is especially ideal for the headache and radiating facial pain of toothaches. Not only does the Alder help with the pain, but it also directly addresses any occurrence of infection and inflammation. The bark and leaf of this remarkable tree are nearly always present in my pain liniment and salve formulations and I find that the addition of Alder to these blends significantly improves their ability to lessen swelling and pain in both chronic and acute injuries. I find that it blends especially well with resinous Populus spp., as well as Solidago spp., and Artemisia spp., in the treatment of injured or strained muscles.
Drawing Agent: Poultice Plant Extraordinaire
I often use Alder leaves in place of where many would reach for Plantain leaves when treating venomous stings and bites as well as simple wounds, splinters and scrapes. This began simply because Plantain isn’t very common where I live while Alder grows all along the rivers, streams and seeps with leaves aplenty. It works well to alleviate pain, lessen inflammation, draw out venom or splinters, stop or prevent infections and I have even seen it address festering sores that were refusing to heal even with the standard antibiotic and steroid treatment. It combines especially well with Peach leaf/twig when treating inflamed insect bites/stings where it is unclear whether there is a histamine reaction or bacterial infection or a bit of both. Applying a poultice or compress of both herbs covers both bases, with Peach working to allay excessive histamine and Alder addressing infection and overall inflammation.
Vulnerary: Wound Healing, Injury Soothing, Burn Cooling & Pain Relieving
Alder has a place in almost every salve recipe I use. Its overall healing effects make it broadly useful for almost any abrasion, wound, bruise or musco-skeletal injury. This in combination with its complete lack of toxicity makes it a great salve to have on hand for little ones, including babies. Baths, compresses or liniment made of the twigs and leaves are all effective for treating muscular and joint pain. Indigenous tribes such as the Mohegans used it in this and Culpeper recommended similar treatment. In my practice I’ve found Alder to be an invaluable addition to my pain salves and liniments. It’s not an analogue for the similarly useful Birch, but complements it very nicely in formulae and can provide a reasonable substitute in recipes calling for Birch. It’s my impression and experience that Alder tends to treat surface inflammation most effectively when used alone and works well with other herbs that help to drive it deeper, especially with warming counterirritants such as Arnica, Goldenrod and Cottonwood. It’s also excellent when combined with pain relieving herbs with an affinity for nerve pain such as St. John’s Wort and Vervain.
1. Confirmed MRSA with boils - 28 year old woman who works as an RN presenting with reoccurring sores and boils, diagnosed as MRSA. Previously treated by primary care doctor with 3 rounds of undisclosed antibiotics which gave mild temporary relief but each time the boils/sores would reappear within days after antibiotics were completed. Client also has mild Type II Diabetes following standard American diet and a history of poor healing wounds. Glands in neck found to be swollen and mildly tender to the touch. Treatment consisted of a tincture formula made with 3 parts Alnus oblongifolia (freshly dried twigs, catkins and cones, 1:5, 50%) and 1 part Monarda fistulosa var. menthifolia (fresh flowering tops, 1:2, 95%), 1/2 ml every 3-4 hours. Boils/sores resolved completely within 1 week, formula was continued for another week after that. 6 week followup indicated no return of symptoms, as did 1 year followup.
2. Lymphatic stagnation with hypoimmunity - 5 year old girl with extremely swollen glands, too sore to touch and so swollen she was unable to turn her head without crying from the pain. Other complaints included fatigue, listlessness, inability to sleep from glandular discomfort and frequent influenza onset as well as slow-healing wounds and injuries. Extensive examination and testing by primary care doctor, ER doctors and oncologists were inconclusive. Multiple rounds of antibiotics and steroids were given over a period of several months with no perceivable results. Treatment was a tincture formula of 1 part Elderberry (Sambucus neomexicana, dried berries, 1:5 40%), 1 part Alnus oblongifolia (freshly dried twigs, catkins and cones, 1:5, 50%) and 1/4 part Ginger root (fresh rhizome, 1:2, 95%), 1/3 ml 4x/day. Glandular swelling and soreness resolved entirely within 1.5 weeks, with no reoccurrence at 10 month followup. Vulnerability to viral onset was at least temporarily abated, and wounds were healing more normally at the 10 month followup.
3. Tooth/Gum Infection with acute pain - 54 year old male with extensive dental issues, including advanced periodontal disease and several severely infected areas in the gums where teeth were rotting and needed to be extracted. Due to financial limitations and unavailability of oral surgeon, client came to me for help with pain relief. Treatment was a tincture formula of 3 parts Alnus oblongifolia (freshly dried twigs, catkins and cones, 1:5, 50%) and 1 part Monarda fistulosa var. menthifolia (fresh flowering tops, 1:2, 95%), 1/2 ml every 3-4 hours. Pain abated by 50% within 24 hours, all swelling and 85% of total pain relieved within one week. Dropped dosage to 1 ml 2x/day at one week as maintenance dose until able to see surgeon. Pain, infection and swelling kept at bay until the teeth were extracted a month later. Surgeon noted no active infection or acute inflammation, only prolonged decay and previous tissue damage.
4. Insect bites with infection - 32 year old female was bitten 6 times on right hip while in bed by unidentified insect, likely a spider. Client ignored bites for 4 days until each bite was a purple-red mark the size of a half dollar and rapidly widening. Bites were hard and swollen, itching and painful enough that client was unable to lay on the side or wear jeans or other restrictive/tight clothing on the area. After examination and noting rapid spreading of inflammation, I told the client that if there wasn’t significant improvement within 24 hours of beginning herbal treatment that I would recommend she see her primary care doctor for further treatment. Treatment was a tincture formula of 1 part Alnus oblongifolia (freshly dried twigs, catkins and cones, 1:5, 50%) and 1 part Peach (Prunus persica, fresh leaves, twigs and flowers, 1:2, 40%), 1/2 ml every 3-4 hours internally, and applied externally diluted 1:2 with distilled water as a compress every four hours. Inflammation, pain and itching receded 50% within 24 hours, and cleared entirely within 4 days.
Tincture – The preparation I most commonly work with for internal use is the lovely red tincture made from the freshly dried twigs, cones and catkins. It takes a few days to dry and then only requires about 40-50% alcohol for optimal extraction.
Infused Honey - The infused honey made with fresh twigs and/or leaves is also a very effective medicine and quite tasty as well. I use this externally for wounds and burns and internally for immune support, some infections, lymphatic stagnation and even just for the lovely flavor it adds to tea.
Salve - Infused into oil or tallow/lard, Alder makes a wonderful and widely applicable salve. It formulates well but is also quite lovely all on its own.
Liniment - A combination of alcohol tincture, vinegar tincture (optional) and infused oil, Alder liniment is a multi-purpose medicine for muscular pain, inflammation and infections.
Considerations & Contraindications
Alder is one of the safest and most effective herbs I know of, with very few contraindications. While not a food-like medicine, it’s only real side effects seems to have to do with its inherent astringency which, in water-based preparations, can prevent nutrient absorption and will cause nausea, vomiting and other digestive upset when used in large doses or over a long period of time. This consideration does not seem to apply to the tincture which apparently does not sufficiently exact enough tannins into the maceration to be an issue. Fresh Alder is sometimes called an emetic, but this definitely doesn’t seem to apply to fresh plant tincture, and this attribution may be simply due to the astringent nature of fresh bark preparations. Otherwise, simply keep in mind that this is a cooling, drying remedy and use in the appropriate constitutional context and/or formulate it with balancing herbs.
William Cook – The Physiomedical Dispensatory
Harvey Wickes Felter and John Uri Lloyd – King’s American Dispensatory
Jim McDonald – Correspondence and classes
Daniel Moerman - Native American Ethnobotany
Donald Culross Peattie – A Natural History of Western Trees
Darcy Williamson – Healing Herbs of the Rocky Mountains
Ananda Wilson – Writings and correspondence.