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Aristolochia clematitis
Toxic🐾Gewöhnliche Osterluzei · (Aristolochia clematitis)
Birthwort family (Aristolochiaceae)
Description
The curved, kettle-shaped flower tube of this birthwort-family plant is lined internally with downward-pointing hairs and attracts small flies with a carrion-like scent, briefly trapping them for pollination — a classic textbook example of a kettle-trap flower. The plant grows as a naturalised weed along vineyard edges and ruderal sites across Central and Southern Europe, flowering from May to July. Its German name Osterluzei and the English 'birthwort' both point to the long-obsolete historical use as a supposed childbirth aid in medieval folk medicine. This use is now considered entirely obsolete and dangerous: every plant part contains aristolochic acid, classified by IARC as a top-category carcinogen and known to cause severe, often irreversible kidney damage. A 1992–1994 scandal at a Brussels clinic involving a related species led to dialysis, transplants and cancer in over 100 women. WARNING: fully banned from medicinal products in the EU since 2001. There is NO safe dose — no use whatsoever.
CONTRAINDICATED during pregnancy
ABSOLUTELY CONTRAINDICATED. Aristolochic acid crosses the placenta, is embryotoxic, teratogenic and genotoxic; animal studies document abortions and malformations. The historical name 'birthwort' rests on labour-inducing action combined with severe fetal harm — a supposed 'midwife's aid' that gravely damaged pregnant women and their children. ANY use during pregnancy is prohibited.
CONTRAINDICATED during breastfeeding
CONTRAINDICATED. Aristolochic acid is nephrotoxic and carcinogenic; passage into breast milk is assumed. Infants with immature tubular function are particularly sensitive. NO use during breastfeeding, neither internal nor external.
CONTRAINDICATED for children
STRICTLY CONTRAINDICATED. Children are particularly endangered due to low body weight and developing kidneys. Confusion risk with other medicinal or kitchen plants (peppermint, sage) must be absolutely excluded in school gardens and family households. NO use under 18 years, NO 'child-friendly' infusions, NO homeopathic dilutions below D6 without pharmaceutical supervision.
Critical drug interactions with:
Nichtsteroidale Antirheumatika (NSAR: Ibuprofen, Diclofenac, Naproxen) · Aminoglykosid-Antibiotika (Gentamicin, Tobramycin, Amikacin) · Calcineurin-Inhibitoren (Ciclosporin, Tacrolimus) · Jodhaltige Kontrastmittel (radiologische Diagnostik) · Chemotherapeutika mit renaler Elimination (Cisplatin, Methotrexat-Hochdosis)
HISTORICALLY OBSOLETE — Antique and medieval wound treatment: Pliny the Elder (Naturalis Historia), Dioscorides (De Materia Medica) and medieval herbals recommended compresses of crushed Aristolochia leaves for purulent wounds, ulcers and snakebite — hence the generic name from Greek áristos (best) + locheía (birth/cleansing). Percutaneous uptake of aristolochic acid may also contribute to renal damage; external use is now likewise rejected. Pure ethnobotanical note, NOT a use recommendation.
Biological phenomenon — The flower of birthwort is an 'Aristolochia trap' (pitfall flower): the curved perianth tube is lined internally with downward-pointing trichomes and attracts small Diptera (especially fungus gnats) via a carrion-like scent. Insects fall into the kettle chamber and are detained until pollination; after pollen release the trichomes wither and free the exit. Classical textbook example of temporary kettle-trap flowers in botany; NO medicinal relevance, purely pollination ecology.
OBSOLETE / RARE — Historically Aristolochia clematitis was cultivated as a monastery garden plant and apothecary 'hortus medicus' species (Hildegard tradition, Abbey of St. Gall, monastic pharmacies). Extremely rare in modern gardens, since toxic and banned in the EU as a medicinal plant; occasionally still seen in botanical collections and ethnobotanical demonstration gardens. Naturalized stands persist in vineyards and ruderal sites of Central and Southern Europe. Cultivation in domestic gardens is discouraged due to confusion risk (see poisoning warning).
Historical documentation only — do NOT use
These internal applications are historically documented. This plant is highly toxic — self-treatment can cause severe poisoning or death. For documentation only, explicitly NOT a recommendation.
HISTORICALLY OBSOLETE AND DANGEROUS — Medieval and early modern folk medicine: infusions or decoctions of the root were considered a 'midwife' and labour-inducing remedy; the German name 'Osterluzei' and the English 'Birthwort' refer directly to this supposed obstetric use. Hildegard of Bingen mentions the plant (Physica) as a circulation-stimulating agent. The application followed the Doctrine of Signatures, since the curved perianth tube resembles a birth canal. Today NO application is permitted: aristolochic acid is nephrotoxic and a proven carcinogen (IARC Group 1); fully banned from medicinal products in the EU since 2001. Documentation purely ethnobotanical.
HISTORICALLY OBSOLETE AND HIGHLY DANGEROUS — In traditional Chinese medicine (TCM), Aristolochia species (Mu Tong, Guang Fang Ji) were prescribed as 'diuretic' and 'heat-clearing' drugs until the 1990s. From 1992 to 1994, accidental substitution of Stephania tetrandra by Aristolochia fangchi in a Brussels slimming clinic caused 'Chinese Herbs Nephropathy' (CHN, today Aristolochic Acid Nephropathy/AAN): over 105 mostly young women developed severe interstitial renal fibrosis; many required dialysis or transplantation, and urothelial carcinomas (ureter/bladder) emerged. This catastrophe led to the EU-wide ban. Documented purely as a warning — NO use.
HISTORICALLY OBSOLETE — Antique medicine (Hippocrates, Galen, Dioscorides) used root and rhizome decoctions of birthwort against intermittent fever, as a 'cleansing' postpartum agent (lochia-promoter) and against snakebite. Medieval pharmacopoeias (Macer Floridus, Salernitan Antidotarium) list it as 'Aristolochia rotunda/longa' for internal applications. We now know: such infusions contain free aristolochic acids I and II, which form DNA adducts (aristolactam-dA) on adenine residues and induce A:T → T:A transversions in TP53 — molecular signature of AA-induced carcinogenesis. NO use.
EXTREMELY TOXIC — CARCINOGENIC — BANNED IN THE EU. Aristolochia clematitis contains aristolochic acid I and II (AA-I, AA-II) and aristolactams in every plant part (root, rhizome, leaves, stem, flowers). Aristolochic acid is an IARC Group 1 carcinogen (highest level, confirmed human carcinogen) and severely nephrotoxic. The substance causes Aristolochic Acid Nephropathy (AAN, formerly 'Chinese Herbs Nephropathy'): rapid interstitial renal fibrosis progressing to end-stage renal failure, together with urothelial carcinomas of the upper urinary tract (ureter, renal pelvis, bladder). The Brussels disaster of 1992-1994 (slimming clinic with Aristolochia fangchi substitution) led to dialysis, kidney transplantation and cancer in at least 105 mostly young women. Banned EU-wide in medicinal products since 2001 (Commission of the European Communities decision); US FDA Import Alert 2001; EMA Public Statement 2014 confirms the full ban. There is NO safe therapeutic index, NO minimum dose without risk. In case of accidental ingestion: IMMEDIATELY contact poison control and nephrology. NO self-medication, NO teas, NO tinctures, NO cultivation for medicinal use.
ABSOLUTELY CONTRAINDICATED. Aristolochic acid crosses the placenta, is embryotoxic, teratogenic and genotoxic; animal studies document abortions and malformations. The historical name 'birthwort' rests on labour-inducing action combined with severe fetal harm — a supposed 'midwife's aid' that gravely damaged pregnant women and their children. ANY use during pregnancy is prohibited.
CONTRAINDICATED. Aristolochic acid is nephrotoxic and carcinogenic; passage into breast milk is assumed. Infants with immature tubular function are particularly sensitive. NO use during breastfeeding, neither internal nor external.
STRICTLY CONTRAINDICATED. Children are particularly endangered due to low body weight and developing kidneys. Confusion risk with other medicinal or kitchen plants (peppermint, sage) must be absolutely excluded in school gardens and family households. NO use under 18 years, NO 'child-friendly' infusions, NO homeopathic dilutions below D6 without pharmaceutical supervision.
Drug interactions
Nichtsteroidale Antirheumatika (NSAR: Ibuprofen, Diclofenac, Naproxen)
NSAIDs reduce renal perfusion through prostaglandin inhibition; combination with nephrotoxic aristolochic acid massively accelerates interstitial fibrosis and acute kidney injury risk. STRICTLY avoid.
Aminoglykosid-Antibiotika (Gentamicin, Tobramycin, Amikacin)
Aminoglycosides are themselves tubularly nephrotoxic; additive damage with aristolochic acid leads to accelerated tubular cell injury and renal insufficiency.
Calcineurin-Inhibitoren (Ciclosporin, Tacrolimus)
Cyclosporine and tacrolimus are widely used after kidney transplantation and in autoimmune disease; they exert vasoconstrictive-nephrotoxic effects. In patients with prior aristolochic acid exposure, combined renal toxicity would be catastrophic.
Jodhaltige Kontrastmittel (radiologische Diagnostik)
Contrast-induced nephropathy (CIN) adds to aristolochic acid damage; renal function (creatinine, eGFR) must be monitored before any imaging.
Chemotherapeutika mit renaler Elimination (Cisplatin, Methotrexat-Hochdosis)
Cisplatin and high-dose methotrexate are directly tubule-toxic; patients with aristolochic acid exposure have markedly increased risk of irreversible renal failure during oncologic therapy.
Contraindications
- ANY internal use (tea, tincture, powder, fresh plant, TCM blend) — generally banned in the EU; IARC Group 1 carcinogen with no therapeutic index
- ANY external use on broken skin or mucosa — percutaneous and mucosal uptake of aristolochic acid documented
- Existing renal disease (renal insufficiency, chronic kidney disease CKD all stages, tubulopathies) — even trace amounts can cause dialysis-dependent kidney damage
- Pregnancy and breastfeeding (see above)
- Children and adolescents under 18 years
- Pets (dog, cat, horse, ruminants, rodents) and grazing animals — poisoning cases in horses on contaminated pastures documented; hay from sites with birthwort is NOT suitable for feeding
- Personal or family history of urothelial carcinoma — additive carcinogenic risk
Harvested part: herb and root
- Time of day:
- Historically in early spring before sprouting; today NO harvest for medicinal use is permitted — entry kept purely as ethnobotanical and phytochemical documentation.
- Drying:
- Today NO harvest for medicinal use is permitted. Aristolochia clematitis is banned from EU medicinal products since 2001 (IARC Group 1 carcinogen, nephrotoxic). Historically the root was air-dried in the shade at 30-40 °C, because at higher temperatures aristolochic acid degradation products form — this information is given solely for phytochemical documentation, NOT for use. If Aristolochia is accidentally discovered in a garden: remove with gloves, dispose in residual waste, do NOT compost, do NOT feed to animals, do NOT use as cut flower.
- Storage:
- Not applicable to current practice — no authorized trade as a drug in the EU. Historical sources mention tight, light-protected containers in apothecary cellars; even there no protection against slow oxidation of aristolochic acid.
- Time of day:
- Historically at flowering time (May-July); today relevant only for botanical survey and population control (vineyard management), NO medicinal harvest.
- Drying:
- Today NO drying for medicinal purposes. Control on agricultural land (vineyards, fallow) is by pulling before seed maturity with protective gloves; dispose of plant material in residual waste, do not mix into hay — horses in Western Europe have repeatedly been poisoned by contaminated hay. Avoid skin contact during fieldwork.
- Aristolochic acid I (AA-I)AlkaloidContent: 0.05-0.6 %Root
Main active and lead compound; nitrated phenanthrene-1-carboxylic acid (8-methoxy derivative). After metabolic activation (nitroreduction by NQO1 and cytochrome P450), reactive N-hydroxyaristolactam intermediates form covalent aristolactam-dA adducts with DNA — molecular signature of AA-induced mutagenesis (A:T→T:A transversions, particularly TP53 codon 139). IARC Group 1 carcinogen.
- Aristolochic acid II (AA-II)AlkaloidContent: 0.01-0.2 %Root
Demethoxy analogue of AA-I (lacking 8-methoxy group); somewhat lower DNA adduct formation, but still nephrotoxic and carcinogenic; present in lower concentration than AA-I, contributes to overall toxicity.
- Aristolactam IAlkaloidContent: Spuren - 0.1 %Root
Reduction and metabolic product of aristolochic acid; pentacyclic phenanthrene lactam. Detectable in vivo as DNA adduct (aristolactam-dA adduct); serves as biological marker for AA exposure in urine and renal biopsy tissue.
- MagnoflorinAlkaloidContent: 0.01-0.05 %Root
Quaternary aporphine alkaloid; widespread in Aristolochiaceae and Magnoliaceae; pharmacologically hypotensive and circulation-active. Contributes to the historical 'circulation-stimulating' note of Hildegard, yet pharmacologically overshadowed in Aristolochia drugs by the toxic aristolochic acids.
- Ätherisches Öl (Borneol, Spuren)Essential oilContent: < 0.1 %Aerial parts
Small amounts of volatile mono- and sesquiterpenes with borneol and camphene fractions; responsible for the faint aromatic-carrion scent of the plant that attracts pollinators (fungus gnats). Pharmacologically insignificant compared with the aristolochic acids.
- AllantoinOtherContent: Spuren - 0.5 %Aerial parts
Classical tissue-repair nitrogen derivative (best known from comfrey); also detected in Aristolochia leaves. Allantoin in itself is not toxic; in birthwort, however, inseparably associated with highly toxic aristolochic acid and therefore clinically unusable.
- Bitterstoffe (nicht-charakterisierte Iridoide / Sesquiterpenlactone)BitterContent: nicht quantifiziertAerial parts
Bitter-tasting secondary metabolites contribute to the historical use as 'digestive' and circulation-stimulating agent; detailed structural data for A. clematitis are only partially available. Taste warning: the intense bitter and unpleasant flavour has historically limited accidental large ingestion.
- Flavonoide (Kaempferol-, Quercetin-Glykoside)FlavonoidContent: ca. 0.2-1 %Leaf
Antioxidant companion substances typical for Aristolochiaceae; analytically detected in leaves. No independent therapeutic significance in birthwort and absolutely no justification for use — aristolochic acid carcinogenicity outweighs any flavonoid benefit by orders of magnitude.
- [4]MonographIARC Monograph Vol. 100A — Aristolochic acids (Group 1 carcinogen)(accessed: 2026-05-27)
- [5]MonographEMA Public Statement on Aristolochia and herbal medicinal products containing aristolochic acid (HMPC, 2014)(accessed: 2026-05-27)
- [7]MonographGrollman AP et al. — Aristolochic acid and the etiology of endemic (Balkan) nephropathy (PNAS 2007)(accessed: 2026-05-27)
- [3]BookPlants for a Future — Aristolochia clematitis(accessed: 2026-05-27)
- [8]BookFloraWeb (BfN) — Aristolochia clematitis L.(accessed: 2026-05-27)
- [1]WikipediaGewöhnliche Osterluzei — Wikipedia (DE)(accessed: 2026-05-27)
- [2]WikipediaAristolochia clematitis — Wikipedia (EN)(accessed: 2026-05-27)
- [6]WikipediaAristolochic acid nephropathy — Wikipedia (EN)(accessed: 2026-05-27)