Pelargonium: Umckaloabo History and Wild Harvest

Few herbal medicines have a stranger biography than pelargonium root. It begins with traditional healers in southern Africa who used the roots mainly for diarrhoea and dysentery; passes through an English mechanic with tuberculosis who came home in the late 1890s convinced he had been cured; continues with a "Consumption Cure" sold in Britain and a Geneva doctor who treated hundreds of tuberculosis patients with it; and arrives at a modern European cough-and-cold medicine whose plant source nobody could identify until 1977. Today the roots are dug from the wild in South Africa and Lesotho to supply an international market, raising questions about conservation and about who benefits from traditional knowledge.

This article tells that story from the historical and regulatory sources, and is careful about one thing in particular: the tuberculosis claim that launched the remedy was never substantiated.

Table of Contents

  1. The Plant and Where It Grows
  2. Traditional Use Before Europe
  3. Charles Stevens and the 1897 Story
  4. Stevens' Consumption Cure
  5. Medical Interest Abroad: Geneva and Beyond
  6. What Became of the Tuberculosis Claim
  7. Identifying the Plant in 1977
  8. From Remedy to Registered Medicine
  9. Wild Harvest and Conservation
  10. The 2010 Patent Revocation
  11. African Medicine and Clinical Research
  12. What the History Shows
  13. Key Research Papers
  14. Connections

The Plant and Where It Grows

Pelargonium sidoides is a member of the geranium family (Geraniaceae) that a 2015 fact sheet from TRAFFIC, the wildlife-trade monitoring network, describes as endemic to Lesotho and South Africa. It has slightly aromatic, velvety, heart-shaped leaves and dark reddish-purple flowers. Its medicinal part is the root: tuberous storage organs that the TRAFFIC fact sheet calls "lingo-tubers". In Afrikaans the plant is kalwerbossie; in English it is sometimes called South African geranium.

A close relative, Pelargonium reniforme, has similar roots. A 2007 chemistry review describes how the two species' roots carry distinct patterns of coumarins that allow them to be told apart, with coumarin sulphates and glycosides apparently confined to P. sidoides. Both are covered by the European Pharmacopoeia definition of pelargonium root, but modern medicine is made from P. sidoides.

Traditional Use Before Europe

A 2008 review of the plant's historical, scientific and commercial background found that several tuberous Pelargonium species, including P. sidoides, are important traditional medicines with a rich ethnobotanical history, and that the use of their stems or tubers for a variety of ailments, including the complications of dysentery, is an important but under-estimated part of traditional medicine in southern Africa.

A pharmacology review by Kolodziej adds that extracts of the roots were most commonly used for dysentery and diarrhoea, and only occasionally for respiratory complaints. The EMA's assessment report lists the traditional uses as coughs, chest problems including tuberculosis, and digestive disorders such as diarrhoea and dysentery, with claims for liver disorders and painful periods, and the leaves used on wounds. TRAFFIC notes relief of colic, diarrhoea and dysentery. The respiratory emphasis of the modern product therefore picked out one strand of a wider tradition.

Charles Stevens and the 1897 Story

The story of how the root reached Europe is told in the EMA's 2024 assessment report, drawing on several historical studies. Charles Henry Stevens, an Englishman described as a mechanic, had tuberculosis. In 1897, on his doctor's advice, he went to South Africa hoping the clear mountain air would cure him. There a local traditional healer — described in the sources as a Zulu medicine man — treated him with a boiled root preparation. Three months later Stevens felt well and considered himself cured.

That account comes from Stevens himself and the later histories built on it. It is a single person's experience, without diagnosis by modern tests or any comparison. It explains why Stevens believed in the remedy; it does not show that the remedy cured him.

Stevens' Consumption Cure

After returning to Britain, Stevens set up a company to prepare and sell his remedy as "Stevens' Consumption Cure" — "consumption" being the common name for tuberculosis. According to the EMA's summary of the historical literature, the early product in England was a liquid containing alcohol, glycerine and a decoction of the root; elsewhere it was sold as a powder of crude root suspended in water, a fluid extract (probably the main form in Switzerland), or as powder, extract or tincture (in Germany). After the First World War, Stevens continued to promote it.

A historical table in the EMA report cites a 1909 British Medical Association source describing the powdered root used for tuberculosis as a boiled preparation to drink twice daily. The remedy also travelled under the name Umckaloabo, which became the name of the later European product and is still listed by the Cochrane review as another name for P. sidoides.

Medical Interest Abroad: Geneva and Beyond

In 1920 the French-Swiss physician A. Sechehaye began treating tuberculosis patients in Geneva with Stevens' Cure. Over nine years he documented the treatment of around 800 patients and reported successful cases to the Medical Society of Geneva, concluding that in many cases — apart from acute, malignant and complicated ones — the remedy appeared effective. He also investigated its antibacterial action in the laboratory. In 1933 a German physician, Bojanowski, reported five cases of successful treatment.

Interest reached North America too. In 1932 the Canadian Medical Association Journal published a short item titled simply "Umckaloabo" by a resident physician of the Nova Scotia Sanatorium, a tuberculosis hospital. (We have not been able to read its text and do not characterise its contents.)

All of these were reports of treated patients without untreated comparison groups. In the decades before effective tuberculosis drugs, this kind of evidence was common, and it could not separate a treatment's effect from natural variation in the disease, rest and sanatorium care.

What Became of the Tuberculosis Claim

No controlled trial ever showed that pelargonium root treats tuberculosis. Laboratory work summarised in the EMA assessment report gives a modest picture: extracts of P. sidoides were only moderately active against Mycobacterium tuberculosis in one assay and showed activity only at a high concentration in another, and the isolated coumarins and flavonoids tested showed no activity against the tuberculosis bacterium. Kolodziej's review likewise describes only moderate direct antibacterial activity, including against mycobacteria.

Tuberculosis became curable with combinations of antibiotics in the mid-twentieth century, and it is treated that way today. The modern European monograph for pelargonium root lists a single use — symptoms of the common cold — and no regulator recognises it as a tuberculosis treatment. The "Consumption Cure" claim is best understood as the origin story of the product, not as a finding.

Identifying the Plant in 1977

For most of the twentieth century the botanical source of the remedy was a mystery. According to the EMA report, despite repeated attempts it remained unidentified until 1977, when Bladt and Wagner at the University of Munich used ethnobotanical, comparative botanical and chromatographic methods to show that the roots came from Pelargonium sidoides and/or P. reniforme. That identification triggered renewed pharmacological research.

Later chemical work described the roots' unusual chemistry — a wealth of highly oxygenated simple coumarins, proanthocyanidins, and in P. reniforme a previously unknown diterpene named reniformin. A structural examination found that the profile of the modern extract agreed closely with that of P. sidoides root.

From Remedy to Registered Medicine

The EMA report records that marketing of the remedy for bronchitis and cold symptoms began in the 1970s, that the product received a full marketing authorisation from the German drug regulator in 2005, and that around that time the ingredient changed from a tincture of P. sidoides/reniforme to a solution of P. sidoides alone. The European Pharmacopoeia introduced a monograph on pelargonium root in 2008.

The 2008 historical review attributed the product's commercial success to the choice of species, a favourable cost-benefit ratio, innovative marketing over many years, good scientific evidence of the botanical and chemical identity of the product, and "convincing proof of concept". It counted 18 clinical studies by that time. The EU herbal monograph was first adopted in 2012 and most recently revised in 2024, registering pelargonium root as a traditional herbal medicine for the symptomatic treatment of the common cold. Outside Europe, the EMA notes, various preparations are sold as herbal supplements, especially in North America and Mexico.

Wild Harvest and Conservation

The medicine is made from roots, and most of the supply has come from wild plants. The TRAFFIC fact sheet reports that larger-scale commercial wild harvesting began in South Africa around 2001, and more recently in Lesotho, to supply the international market. A 2014 review in the Journal of Ethnopharmacology found that increasing international demand had led to localised overexploitation of wild populations and to localised illegal harvesting.

Key points from the TRAFFIC fact sheet:

The 2014 review argued that the plant's pharmacological usefulness has to be weighed within a wider need for conservation-friendly use, and that plant biotechnology, such as propagation in culture, could play a role.

The 2010 Patent Revocation

Traditional knowledge was also at issue in the patent system. In January 2010 the European Patent Office revoked a European patent on a method of producing extracts from the roots of P. sidoides and P. reniforme. Oppositions had been filed in 2008 by parties including the African Centre for Biosafety, a South African organisation, with the involvement of a community from Alice, in the Eastern Cape, which argued that local healers had used such methods for generations. The Patent Office found that the patent did not meet the inventive-step requirement of the European Patent Convention, and its hearing discussed access-and-benefit-sharing obligations under the international biodiversity conventions.

The case is often cited in debates about "biopiracy" — commercial use of traditional knowledge and biological resources without the consent of, or benefit to, the communities they come from.

African Medicine and Clinical Research

The plant also has a place in the history of clinical research on African medicines. A 2012 article in the South African Medical Journal reported that when its authors conducted systematic reviews of eight widely used African medicines, they found only one plant, Pelargonium sidoides, that had been extensively studied, including in a Cochrane systematic review. They described a university initiative launched in 2011 to build capacity for clinical trials of traditional medicines in Africa, after a needs analysis across 14 African countries found a lack of trial methodology and experience.

The irony is that the most-studied African medicinal plant was studied almost entirely in Europe and Eastern Europe, on a European product, by one research programme. The large trials described in Acute Bronchitis Trials were conducted mainly in Ukraine and Russia, according to the EMA.

What the History Shows

Key Research Papers

  1. Brendler T, van Wyk BE. A historical, scientific and commercial perspective on the medicinal use of Pelargonium sidoides (Geraniaceae). Journal of ethnopharmacology. 2008;119(3):420-33. PubMed PMID: 18725280
  2. Kolodziej H. Antimicrobial, Antiviral and Immunomodulatory Activity Studies of Pelargonium sidoides (EPs(®) 7630) in the Context of Health Promotion. Pharmaceuticals (Basel, Switzerland). 2011;4(10):1295-1314. PubMed PMID: 27721327
  3. Kolodziej H. Fascinating metabolic pools of Pelargonium sidoides and Pelargonium reniforme, traditional and phytomedicinal sources of the herbal medicine Umckaloabo. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2007;14 Suppl 6:9-17. PubMed PMID: 17188477
  4. Moyo M, Van Staden J. Medicinal properties and conservation of Pelargonium sidoides DC. Journal of ethnopharmacology. 2014;152(2):243-55. PubMed PMID: 24463034
  5. Siegfried NL, Hughes G. Herbal medicine, randomised controlled trials and global core competencies. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde. 2012;102(12):912-3. PubMed PMID: 23498035
  6. Beckwith CJ. Umckaloabo. Canadian Medical Association journal. 1932;26(5):620. PubMed PMID: 20318749
  7. Timmer A, Günther J, Motschall E, et al. Pelargonium sidoides extract for treating acute respiratory tract infections. The Cochrane database of systematic reviews. 2013;2013(10):CD006323. PubMed PMID: 24146345
  8. Perić A, Vezmar Kovačević S, Barać A, et al. Immunomodulatory Effects of Pelargonium sidoides Extract (EPs7630) in the Treatment of Acute Rhinosinusitis. Expert reviews in molecular medicine. 2025;27:e25. PubMed PMID: 40660733
  9. Reina BD, Malheiros SS, Vieira SM, et al. Unlocking the therapeutic potential of Pelargonium sidoides natural extract: A scoping review. Heliyon. 2024;10(23):e40554. PubMed PMID: 39654721
  10. Bourqui A, Corpataux O, Bonofiglio F, et al. Pelargonium sidoides extract (EPs® 7630) versus usual care for acute bronchitis in Swiss primary care (PHYTOBRONCH): a pragmatic, open-label, randomised controlled trial. NPJ primary care respiratory medicine. 2026;36(1). PubMed PMID: 42014704

PubMed Topic Searches

  1. PubMed: Umckaloabo
  2. PubMed: Pelargonium sidoides harvesting
  3. PubMed: Pelargonium sidoides ethnobotany

Historical, Regulatory and Conservation Sources

  1. European Medicines Agency, Committee on Herbal Medicinal Products. Assessment report on Pelargonium sidoides DC; Pelargonium reniforme Curt., radix. Revision 2. EMA/HMPC/765656/2022, 2024 (history and traditional use, section 1). EMA assessment report (PDF)
  2. TRAFFIC. Harvesting threats: sustainable management of Pelargonium sidoides in South Africa and Lesotho. Fact sheet, April 2015. TRAFFIC fact sheet (PDF)
  3. Intellectual Property Watch. African plant extract freed from German patent. 2010. IP Watch report

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Connections

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