Fragrant sumac

Bedwetting in a child where the bladder seems weak and lax rather than irritated or infected, with a large volume of pale urine passed at night

Profuse, painless, watery diarrhea without cramping or heat signs

Passive, oozing hemorrhage from relaxed, atonic tissue rather than active bleeding from inflammation

Overview. Rhus aromatica is a low, spreading shrub native to eastern and central North America, valued by the eclectic physicians for its astringent root bark. The fresh or dried root bark, prepared as a fluid extract or specific tincture, was a mainstay of nineteenth century American practice for lax, atonic states of the urinary and gastrointestinal tract. It has largely fallen out of mainstream use but retains a following among herbalists treating enuresis and passive bleeding.

Clinical Notes. Fragrant sumac root bark is reached for when the underlying picture is one of tissue laxity and weak sphincteric tone rather than infection or irritation. The classic case is a child who wets the bed because the bladder neck simply does not hold, passing a large volume of pale urine at night without dysuria, urgency, or a history of urinary tract infection; in that setting it can succeed where other astringents and bladder tonics fail, though eclectic writers were candid that results were inconsistent and depended on correctly identifying the atonic, non-irritable pattern.

Action and Therapy. Rhus aromatica is a remedy for excessive discharges of urine and painless but profuse forms of diarrhoea. It is also serviceable in some forms of passive hemorrhage, particularly malarial hematuria, a disorder quite prevalent in the Southern States.

Therapy. The direct influence of this agent is exerted in certain cases of polyuria. It is said to be specific also to nocturnal enuresis in children, and yet our knowledge is not sufficient to define the exact cases, consequently its use is more or less empirical.