Black cohosh (Actaea racemosa L.), Ranunculaceae, thrives in temperate climates east of the Mississippi River in the USA. It is economically important to the Appalachian region where it is wild harvested, but it has resisted most efforts at deliberate cultivation. Black cohosh has been used for many centuries both in Europe and in the US (by indigenous people and subsequent Caucasian medical practitioners), most notably for indications of premenstrual syndrome (PMS), menstrual pain and cramping.