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''Symphytum officinale'' is a
perennial A perennial plant or simply perennial is a plant that lives more than two years. The term ('' per-'' + '' -ennial'', "through the years") is often used to differentiate a plant from shorter-lived annuals and biennials. The term is also wide ...
flowering plant in the family
Boraginaceae Boraginaceae, the borage or forget-me-not family, includes about 2,000 species of shrubs, trees and herbs in 146, to 156 genera with a worldwide distribution. The APG IV system from 2016 classifies the Boraginaceae as single family of the ...
. Along with thirty four other species of ''Symphytum'', it is known as comfrey. To differentiate it from other members of the genus ''Symphytum'', this species is known as common comfrey or true comfrey. Other English names include Quaker comfrey, cultivated comfrey, boneset, knitbone, consound, and slippery-root. It is native to Europe, growing in damp, grassy places. It is locally frequent throughout Ireland and Britain on river banks and ditches. It occurs elsewhere, including North America, as an introduced species and sometimes a weed. The flowers are mostly visited by
bumblebee A bumblebee (or bumble bee, bumble-bee, or humble-bee) is any of over 250 species in the genus ''Bombus'', part of Apidae, one of the bee families. This genus is the only extant group in the tribe Bombini, though a few extinct related gener ...
s. Internal or long-term topical use of comfrey is discouraged due to its strong potential to cause
liver toxicity Hepatotoxicity (from ''hepatic toxicity'') implies chemical-driven liver damage. Drug-induced liver injury is a cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn fro ...
.


History

Over centuries, comfrey was cultivated in Asia, Europe, and the United Kingdom as a vegetable and herbal medicine. Its early common names, ''knitbone'' or ''boneset'', reflect its historical use by
poultice A poultice, also called a cataplasm, is a soft moist mass, often heated and medicated, that is spread on cloth and placed over the skin to treat an aching, inflamed, or painful part of the body. It can be used on wounds, such as cuts. 'Poultice ...
s of leaves and roots to treat sprains, bruises or bone fractures. Also the roots could be mashed then packed around a broken limb, when dried they formed a hardened 'plaster cast'.


Description and botany

Comfrey is a perennial plant found in moist grasslands in western Asia, Europe, and North America. The hardy plant can grow to a height of . It is a perennial herb with a black, turnip-like root and large, hairy broad leaves. The leaves on the stem have margins which extends down the stems. The hairy stems are branched. Between May and June it bears small bell-shaped flowers of various colours, typically cream, white, pink or purplish. They are coiled at first and then open out. A common hybrid is formed between ''Symphytum officinale'' and '' S. asperum'', ''Symphytum'' × ''uplandicum'', also known as Blue Comfrey, or Russian comfrey, which is widespread in the British Isles, and which interbreeds with ''S. officinale''. Compared to ''S. officinale'', ''S.'' × ''uplandicum'' is generally more bristly and has flowers which tend to be more blue or violet. ''Symphytum'' × ''uplandicum'' flowers later than ''S. officinale'', in June and August. The plant produces significant nectar when compared to other UK plants tested. Although, it has a long tube, meaning only insects with long tongues reach the nectar, some bees have been known to bite into the side of the flower to reach the nectar.


Traditional medicine

In folklore, ''Symphytum officinale'' roots were used in
traditional medicine Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...
internally (as an herbal tea or tincture) or externally (as ointment, compresses, or alcoholic digestion) for treatment of various disorders, including commonly as a treatment for reducing the pain of osteoarthritis.
John Gerard John Gerard (also John Gerarde, c. 1545–1612) was an English herbalist with a large garden in Holborn, now part of London. His 1,484-page illustrated ''Herball, or Generall Historie of Plantes'', first published in 1597, became a popular gard ...
, an English herbalist (1545–1612), mentions "the slimie substance of the roote made in a
possett A posset (also historically spelled poshote, poshotte) was originally a popular British hot drink made of milk curdled with wine or ale, often spiced, which was often used as a remedy. The original drink became extinct and the name was revived ...
of ale" would help back pains. The leaves were also thought to be edible as a vegetable, similar to spinach. A 2013 review of clinical studies assessing the possible effect of comfrey on osteoarthritis found the research quality was too low to allow conclusions about its efficacy and safety. In Europe as of 2015, there were no comfrey products for oral use, and those for topical uses to treat bruises or joint pain were evaluated as having risk of liver toxicity.


Toxicity and adverse effects

Comfrey contains
pyrrolizidine alkaloid Pyrrolizidine alkaloids (PAs), sometimes referred to as necine bases, are a group of naturally occurring alkaloids based on the structure of pyrrolizidine. Pyrrolizidine alkaloids are produced by plants as a defense mechanism against insect he ...
s which are toxic compounds readily absorbed via the stomach or skin, and have potential to increase the risk of fatal liver toxicity. In 2001, the US Food and Drug Administration and
Federal Trade Commission The Federal Trade Commission (FTC) is an independent agency of the United States government whose principal mission is the enforcement of civil (non-criminal) antitrust law and the promotion of consumer protection. The FTC shares jurisdiction ov ...
banned the sale of comfrey products for internal use and use on open wounds due to its potential toxicities. A 2018 review on pyrrolizidine alkaloids present in comfrey indicated widespread potential toxicity to humans and livestock, and the opportunity for drug development from these compounds.


References


External links

{{Authority control officinale Demulcents Plants described in 1753 Taxa named by Carl Linnaeus