Box

Recurrent low fevers in a patient for whom quinine has become unavailable or poorly tolerated, historically substituted with box leaf decoction

Chronic joint pain with a sluggish, congested liver picture, once treated with small alterative doses of the leaf

Overview. Buxus sempervirens, common box, is a small slow-growing evergreen tree or shrub of the family Buxaceae, native to southern Europe, North Africa and parts of western Asia, and long cultivated as an ornamental hedge plant. The leaves were the part used medicinally, chiefly by nineteenth century eclectic and European physicians who valued box as a bitter febrifuge and alterative, at times promoted as a substitute for cinchona bark when quinine was scarce or unavailable. Its use has almost entirely fallen away in modern practice because of its narrow margin of safety and the arrival of safer, better studied alternatives.

Clinical Notes. Box leaf appears in nineteenth century eclectic materia medica as a bitter, diaphoretic and mild alterative given for intermittent fevers, chronic rheumatism, and skin conditions thought to reflect an impure blood state.