Sambucus: Elderberry

by Paul Bergner

Medical Herbalism 01-31-97 8(4): 1, 11-12

Elderberry is a famous flu remedy from traditional medicine, its recorded medical uses going back at least to the time of the Romans. Unfortunately it has been pigeonholed by modern herbalists as a diaphoretic or diuretic, overlooking its broader potential as an immune-enhancer or “blood cleanser.” See the accompanying article on “bad blood” for a discussion of this term. A recent clinical trial in Israel showed that a preparation not only ended cases of the flu within three days, but increased antibody production. The accompanying Table shows some of its traditional medical uses, including those where immune-stimulating effects appear to be at work. Notice the similarity of this list to that in the accompanying article  [See Alteratives: Bad Blood in therapeutics volume] Although this herb is not nearly as well-researched as echinacea, it also appears to have immune-stimulating properties.

Some traditional uses of elderberry

alterative                   eczema

arthritis                     flu

blood purifier           gout

bronchitis                 nasal catarrh

chronic skin ulcers  rheumatoid arthritis

colds                       sciatica

diaphoretic            sore throats

diuretic                  spring tonic

erysipelas             syphillis

The two most frequently-used species of elderberry are the European black elder (Sambucus nigra) and American elder (Sambucus canadensis). The bark and leaves are laxative and can be toxic, as can all parts of other sambucus species with red berries.


The elderberry flowers have been traditionally used to make teas for colds and sore throats, taken hot before bed. A cup will usually induce perspiration. Grieve says: “Refreshing sleep will follow, and the patient will wake up well on the way to recovery and the cold or influenza will probably be banished within thirty-six hours” (Grieve 1931). The tea, taken cold daily was historically considered a spring medicine and a blood purifier. In more traditional times, before the advent of refrigerators, transportation and the industrialization of food, peoples diets changed radically between summer and winter. In winter, they ate mainly meat and stored grains without fresh fruits or vegetables. Life also tended to become more sedentary during the cold weather, with farm work at low ebb. Thus by spring, people were sluggish and toxic from the heavy diet, and were more prone to illness. Spring tonics, or blood cleansers are a common traditional remedy in such societies. Elder was such a tonic in 19th century Britain. German physician R.F. Weiss attested to this “spring tonic” action and says that “the resistance-enhancing action does indeed comes into play.” He lists elderberry in his medical textbook as a treatment for colds and flu (Weiss 1988).

Elderberry was an official medicine in the U.S. Pharmacopoeia from the year of its founding in 1820 until 1890, when, along with many other herbal remedies, it was dropped. In North American naturopathic medicine, it has been used as a blood purifier. A naturopathic textbook from the 1950s says that the cold infusion “is an excellent alterative and diuretic in many dermal manifestations of metabolic toxicosis” (Kuts-Chereaux 1952). This, translated, means that it will help detoxify the extracellular fluid. The naturopaths used it both internally and externally for eczema, and applied it externally to “indolent ulcers” and persistent skin inflammations (Kuts-Chereaux 1952)


From these traditional indications, it is clear that elder, among other things, builds up the resistance of the immune system.

Recent research from Israel and Panama has demonstrated that elderberry juice (Sambucus nigra) not only stimulates the immune system, but also directly inhibits the influenza virus (Zakay-Rones et al 1995; Mumcuoglu 1995). The trials used the juice of the berries, made into a syrup — in another traditional form of the elderberry plant. It has less tendency to induce sweating, but is considered effective in most of the same conditions as the tea of the flowers (Grieve 1931). The syrup of the berries will cause nausea if taken in large doses.

Israeli researcher Madeleine Mumcuoglu, Ph.D. of the Hadassah-Hebrew university Medical Center in Ein Karem, Israel, performed the initial research, and found that elder seems to be designed as a specific weapon against the flu virus. The influenza virus forms tiny spikes, called hemagglutinins, which are laced with an enzymes called neuraminidase. The enzyme helps the virus to penetrate the cell walls of a healthy organism. The virus then sets up shop in the cell, reproducing more viruses. The active ingredients that Mumcuoglu discovered disarm the neuraminidase enzyme within 24-48 hours, halting the spread of the virus.

In clinical trials, patients who took the elderberry juice syrup reported fast termination of symptoms. Twenty percent reported significant improvement within 24 hours, 70% by 48 hours, and 90% claimed a complete cure after three days. Patients receiving the placebo required six days for recovery. As proof that elder has more to it than the enzyme-neutralizing constituents, researchers found that the patients who took it also had higher levels of antibodies against the flu virus.

Elderberry has been proven effective against eight different influenza viruses. This may solve the perennial problem of the “mutating flu.” Viruses have the ability to alter their genetics and create new strains. This makes a problem for creating vaccines against viral diseases, such as flu or AIDS, because the vaccine can only be developed against known strains. The host remains unprotected against newly evolved forms of the virus. With the flu virus, the new evolving forms can sometimes be deadly as especially virulent strains develop periodically. We haven’t had an outbreak of deadly flu in recent decades, so many people do not realize how serious the illness can be. One strain killed more than 100,000,000 people worldwide in the second decade of this century — that’s more than have died in all the 20th century wars put together. Some epidemiologists have pointed out in recent years that we are overdue for another deadly flu epidemic, which reoccur, like earthquakes, at regular but not necessarily predictable intervals. Vaccines will be of no use against a new strain, at least when it initially appears. Elder may thus be able to literally save lives, because most strains of the virus use the same enzyme mechanism to penetrate cells. Elder preparations may be superior to flu shots for another reason: 50% of people who get the vaccines report side effects (Zakay-Rones 1995; Mumcuoglu 1995).

Use the tea or the juice rather than the tincture. A syrup of the juice — the same one used in the israeli clinical trial — is available in health foods stores as Sambucol(r).


Grieve, M. A Modern Herbal (2 vols.) New York: Dover Publications, 1931

Kuts-Chereaux, A.W. Naturae Medicina and Naturopathic Dispensatory. Des Moines, Iowa: American Naturopathic Physicians and Surgeons Associations, 1953

Mumcuoglu, M. Sambucus nigra (L), Black Elderberry Extract: A breakthrough in the treatment of influenza. Skokie, Illinois: RSS Publishing, 1995

Weiss R.F. Herbal Medicine. Beaconsfield, England: Beaconsfield Publishers, 1988

Zakay-Rones Z, Varsano N., Zlotnik M, Manor O., et al Inhibition of several strains of influenza virus in vitro and redution of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B in Panama. Journal of Alternative and Complementary Medicine. 1995;1(4):361-369

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