Comfrey Ointment

Comfrey (Symphytum officinale) has a long history of use as a food item, fertiliser and as medicine.  The scientific name Symphytum means ‘growing together’ while the officinale means official (in a pharmacological sense).

As a source of food, comfrey has been considered as superfood, with the young leaves being used in much the same way as spinach and the stalks were blanched and eaten with butter.  The roots were roasted to make a sort of coffee in the same way as chicory or dandelion roots.  However due to the discovery that comfrey contains some pretty nasty chemical components called pyrrolizidine-alkoloids (PA) comfrey SHOULD NOT BE EATEN.  Perhaps the best way to use it to gain food is as a liquid fertiliser.  Add the leaves to a bucket of water and leave it until the water turns brown and smelly and then use it to water the vegetables.

It has been used internally and externally as a medicine for over 2000 years.  As a medicine, it has been applied internally – usually as a tea – to alleviate stomach ulcers, bronchitis and chest complaints, coughs and sore throat, treating heavy periods and angina amongst others.  But as is contains those pyrrolizidine-alkoloids, it should NOT be taken internally.  However, with some qualification, it can be used externally.  Indeed, it has been used for a range of issues including the treatment of wounds, bone fractures, sprains, back pain, gout, rheumatoid arthritis, osteoarthritis, varicose veins, and hematomas.  Its external application has been either using the root or the leaves both as a direct poultice of the plant or via an infused oil/ointment.

We are going to concentrate on a couple of the healing properties of comfrey that can be utilised through external application and will go through the process of preparing a comfrey ointment. 

Identification of comfrey

There are a five different species of comfrey found in the UK, but the main three we are likely to find are Common comfrey (Symphytum officinale), Russian comfrey (Symphytum x uplandium) and in the south east, White comfrey (Symphytum orientale).  All of which have similar properties when it comes to medicine that is being externally applied but there are reports that as a food stuff or internal use as a medicine the Russian comfrey has higher levels of a group of chemicals that are associated with liver cancer (pyrrolizidine alkoloids).

All three have similar characteristics with the differences being relatively minor.  On the whole, they can be widely found in England in damp meadows and near ditches and riverbanks usually in lowland areas rather than in mountain areas.  In Scotland and Wales, they are less common, found mainly in the south of Scotland and the east of Wales.  Its leaves are quite large and oval/spear shaped with a rough hairy texture typically around 10-12 inches (25-30cm) long and 4-5inches (10-12cm) wide with a smooth border.  On Common and Russian comfrey the upper leaves on the stem are sessile which means that they do not have leaf stalks and are decurrent which means the base of leaves extend down the stem almost as if they ‘wrap’ around it.  While White comfrey leaves do have stalks on the upper leaves and white flowers. Its flowers are bell-like, yellow, creamy white, or pink fading to bluish, and occur in a 1-sided curled cluster accompanied by a pair of wing like leaves. Comfrey grows to a height of 2-3 feet (75-100cm).  The main difference between Common and Russian comfrey is in the leaves, and flowers, Russian comfrey leaves do not extend down the stem very much while Common comfrey leaves extend down the stem quite far.  The flowers of the Russian comfrey also tend to be a pinkish blue, purplish or violet colour while Common comfrey flowers are yellowish white to pinkish colour.

When not in flower, it is possible to confuse comfrey with foxglove (Digitalis purpurea) which is highly poisonous so please be absolutely certain of your identification.  The main difference between foxglove and comfrey is that the leaves are toothed in foxglove while comfrey leaves have smooth edges.

Comfrey ointment uses:
The external application of comfrey ointment is for the treatment of open wounds, to relieve back pain, for soft tissue damage to muscles, ligaments, and tendons, and for osteoarthritis.  The active ingredients that are responsible for these treatment affects are not known for certain but seems to be associated with allantoin and rosmarinic acid, both of which are found in the leaves and roots of comfrey (with higher concentrations in the roots).

Possibly because of its long and enduring history of use in medicine, comfrey has been the object of a number of randomised control trials to test a range of its medicinal properties.  It is clinically proven to relieve pain, inflammation and swelling of muscles and joints in the case of degenerative arthritis, acute myalgia in the back, sprains, contusions and strains after sports injuries and accidents.  It has also been shown to reduce the healing time of fresh abrasions.

Possible side effects if taken internally:
While historically comfrey has been used as a food stuff and taken internally as a medicine for a few thousand years, it is not considered safe to ingest.  Although, there was no evidence of liver damage in a group of people who had regularly consumed comfrey, there are a number of case reports that implicate the consumption of comfrey in the development of liver toxicity, predominantly a condition in which some of the veins in the liver are blocked.  This causes a decrease in blood flow inside the liver and may lead to liver damage.

It has also been discovered that it contains a set of compounds called pyrrolizidine-alkoloids (PA) and in particular symphytine which is considered a carcinogen.  However, while experiments on rats that had a diet of 10-30% comfrey leaves showed that PA are almost completely excreted in the urine within 24 hours of ingestion experiments on rats fed comfrey leaves daily for 480-600 days showed an increase in the incidence of hepatocellular adenoma – a benign form of liver tumour.

It is because of these experiments that the internal use of comfrey is discouraged.  While it is believed to pose little or no harm if applied to skin, the advice often given for the external use is to limit it to a period of 6 weeks in any one period of treatment.

Preparing the comfrey ointment:
Ingredients:

• 8-10 Comfrey leaves
• 20g Beeswax
• 200-300ml Extra virgin olive oil
• 20 drops Tea tree essential oil

Method:

1. Firstly, puck fresh comfrey leaves.  The amount will depend on how much ointment you wish to make but to make 2 jars of ointment 8-10 leaves is sufficient.
2. Next dry the leaves in a warm but dark place until they become crisp and will crumble. This takes about a week.  Alternatively, they can be put in a dehydrator.  Drying in the dark allows for the leaves to dehydrate while retaining the active ingredients.  Drying in the sunlight means the active ingredients may be broken down.
3. Crumble the leaves or put them in a blender.
4. Place the leaves in a jar of vegetable oil and stir well.  I used extra virgin olive oil but any vegetable oil can be used.
5. Leave the jar in the sunlight for weeks two to three weeks giving it a good shake once a day.  At this stage the sunlight acts to leach the active ingredients into the oil which is what we will use to make the ointment.
6. Strain off the comfrey infused oil into a saucepan using a muslin cloth.
7. If you wish, you can add any essential oils you wish at this stage.  I added around 20 drops of tea tree oil, partly for the aroma and partly because tea tree oil also has healing properties.  Specifically tea tree is good for bruising.
8. Gently warm the oil over a hob adding beeswax into the oils so that it melts.  I added about 20g of cosmetic grade beeswax that I bought in small pellets that were easy to melt.  Alternatively grate beeswax into the oil.  Do not overdo the beeswax or else you will end up with a hard waxy lump that is not so easy to rub into your injury!
9. Once melted together and well mixed, pour into sterilised jar or jars to set.
10. Label and date the jars.  I keep mine in the fridge to increase the longevity of the ointment.

Rub the ointment onto the injured area 2 or 3 times a day.

As you can see, while it might take a few weeks to go from fresh leaf to finished ointment, it really is quite simple to do.  You may enjoy it so much that you would like to try the hedgerow medicine and medicinal wild plant day course that we run.

References:

Bruton-Seal, J., 2017.Hedgerow Medicine. Merlin Unwin Books Limited.

Irving, M., 2009. The Forager Handbook. Ebury Press.

Tice, R., 1997. Comfrey and One of Its Constituent Alkaloids Symphytine Review of Toxicological Literature https://ntp.niehs.nih.gov/ntp/htdocs/chem_background/exsumpdf/comfrey_508.pdf accessed 1/9/2020

Staiger, C., 2012. Comfrey: A Clinical Overview in Phytotherapy Research Oct; 26(10): 1441-1448 Published online 2012 Feb. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491633/#!po=0.877193 accessed 24/9/2020 Staiger, C., 2013. Comfrey root: from tradition to modern clinical trials https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580139/ accessed 24/9/2020

Gianneti, B. M. et al 2010 Efficacy and safety of comfrey root extract ointment in the treatment of acute upper or lower back pain: results of a double-blind, randomised, placebo controlled, multicentre trial in Br J Sports Med 2010 Jul;44(9):637-41 https://pubmed.ncbi.nlm.nih.gov/19460762/  accessed 24/9/2020

Grube B, et al 2007. Efficacy of a comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: results of a double-blind, randomised, bicenter, placebo-controlled trial in Phytomedicine. 2007 Jan;14(1): https://pubmed.ncbi.nlm.nih.gov/17169543/ accessed 24/9/2020

Barna, M., et al 2012. Randomized double-blind study: wound-healing effects of a Symphytum herb extract cream (Symphytum×uplandicum Nyman) in children in Arzneimittelforschung 2012 Jun;62(6):285-9. https://pubmed.ncbi.nlm.nih.gov/22549241/ accessed 24/9/2020 Araujo, L.M., 2012.  In vivo wound healing effects of Symphytum officinale L. leaves extract in different topical formulations in Pharmazie 2012 Apr;67(4):355-60.  https://pubmed.ncbi.nlm.nih.gov/22570943/ accessed 24/9/2020