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Zanthoxylum capense – the treatment for the influenza epidemic of 1918

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Family: Rutaceae

Scientific name: Zanthoxylum capense

Authority: (Thunb.) Harv.

Common names: umnungamabele (Zulu), knobwood (English), kleinperdepram (Afrikaans)

Plant description

Zanthoxylum capense is one of the most versatile plants in traditional medicine. It is a tree with a height between 4 to 10 m. It is indigenous to South Africa, Zimbabwe and Mozambique. In South Africa, it can be found in Eastern Cape, KwaZulu Natal, Free State, Gauteng, Limpopo, and Northwest Province. 

The English common name, knobwood, comes from the fact that this tree has numerous thorn branches that develop into tapered knobs on mature trunks. The leaves have a citrus aroma when squeezed – hence, they are used to treat colds, flu, and respiratory related infections. 

Throughout history, Z. capense has been used to treat a range of conditions, ailments, and diseases. The twigs were flattened to make toothbrushes. The powdered bark and roots have been used to treat toothache and the root-bark infusions have been used as an oral rinse to gargle. During the 1918 influenza pandemic, Z. capense was a popular treatment and subsequently used against flu and colds. 

The 1918 Influenza pandemic

Before Covid-19, the most devastating pandemic in the 20th century was the 1918 influenza virus, which killed 50 million people worldwide in just one year. South Africa was among the most affected countries with the reported death toll at 139 471, however the actual number is believed to be more than double that number. The first case is believed to have come from the docks in Durban in KwaZulu Natal. In September, the Reuters reported on 28 September 1918 that “in view of the fact that such a very large number of people have been affected, the fact there has been only one death must be considered to be reassuring”. Concurrently, trains carrying South African soldiers who were fighting in the World War I were leaving Cape Town to the rest of South Africa. As the soldiers disembarked at the various pit stops to go home to their friends and family. They didn’t know that they were carrying and spreading the virus, which was incorrectly named the Spanish flu.  

The name Spanish flu came from the fact that the first wave of the pandemic reached Spain and France in March 1918, amid World War 1. The rest of Europe experienced the first wave in the months that followed. The second wave began in August in France and Spain, spreading to the other countries in the following month. During the world war most countries censored the reported news to maintain morale. At the time, Spain was one of only a few countries in Europe that remained neutral, as such it was free to report on the horrendous details. The news of the flu first made headlines in Madrid, the Capital city of Spain, in late May 1918. A week later the coverage of the flu increased significantly after the King of Spain, King Alfonso XIII, was infected. The media censorship led to Spain being the main country giving in depth reports about the flu. Naturally, other countries assumed that Spain was where the pandemic started as they had so much information on the virus. Meanwhile Spain thought the virus had spread from France to Spain, hence they called the French flu. To this day, scientists are still unsure of the source of the virus. 

In South Africa, the influenza did not affect the South African regions equally, the then Cape Province, which included the Transkei was more impacted than the other three provinces, namely, Zululand, Orange Free State, and the Transvaal.   

At the time of the pandemic, South Africa was also experiencing racial tensions that resulted in the disease being called the “White man’s flu” as most black people thought the disease was a weapon used to kill off the indigenous people. As a result, most indigenous people turned to traditional medicine to cure the influenza. Traditional healers used Z. capense to address the influenza.

Plant properties

Z. capense has a significant amount of anti-mycobacterial activity that is effective against Mycobacterium tuberculosis and antibacterial activity against Staphylococcus aureus including the two strains:

  • Methicillin Resistant Staphylococcus aureus (MRSA) strain 
  • Methicillin Susceptible Staphylococcus aureus (MRSA) strain 

The plant also contains antimicrobial, anti-inflammation, anticonvulsant, anti-epileptic, antitumor, antifungal, antimalarial, antioxidant, and antibiotic modulatory activities. The plant also contains a significant amount of saponins, hence, it froths up (i.e., becoming foamy and white) when stirred. 


In traditional medicine, Z. capense is used to treat a wide array of conditions, ailments, and life-threatening diseases:

The bark

  • The bark is used to make uzifo zonke
  • The bark is used as umuthi omhlophe
  • The bark is used to make umuthi obovu
  • The bark is used as a imbiza, a tonic
  • The bark is used to make ibhodlela (“the bottle”)
  • The bark is used to relieve body pain
  • The bark treats boils 
  • The bark (and thorns) is used to treat ibhande (shingles)
  • The bark treats tooth related conditions and ailments
  • The bark is used to treat gall sickness in cattle

The roots

  • The roots are used to treat stomach cramps
  • The roots and bark are used to treat meat allergies
  • The roots are used to produce yellow dye
  • The roots are used to treat toothache
  • The roots are used to cleanse and purify the blood
  • The roots are used to treat scrofula 
  • The roots treat new wounds
  • The roots treat infertility and impotence
  • The roots treat snake bites and blood poisoning
  • The roots treat pimples and acne 

The leaves

  • The leaves are used to treat colds and influenza
  • The leaves are used to treat gastric problems
  • The leaves are used to treat intestinal parasites
  • The leaves are used to treat pleurisy

Preparation and application

Z. capense can be prepared and administered in numerous ways, the following lists some of the more popular preparation methods: 

  • The roots are boiled in water to make a decoction that treats snake bites and tuberculosis (scrofula).
  • The bark is added to water and stirred until it froths up to make umuthi omhlophe. This type of medicine is administered by steaming.
  • The bark is boiled for a long time in water to make umuthi obovu. This medicine is mixed with other plants that will produce a red colour. This decoction is taken as a hot tonic and as an emetic.  
  • The bark is mixed with other versatile plants such as ubuhlungu benyoka (Acokanthera oblongifolia) to make uzifo zonke and ibhodlela
  • The bark is ground to powder and applied onto the boil (i.e., the part of the skin affected by boils). 
  • The bark is charred and applied onto the boil opening and the remainder is cooked and administered as an enema.
  • The powder bark is also boiled and administered as emetic.
  • The powdered bark is used to relieve body pains. 
  • The leaves are an ingredient in cold infusions that are used to treat gastro-intestinal problems and pleurisy. 

Learn about other versatile plants such Alepidea amatymbica (Ikhathazo), Rhoicissus tomentosa (Isinwazi), and Psoralea pinnata (Umhlonishwa) by accessing the article on Alepidea amatymbica, Rhoicissus tomentosa, and Psoralea pinnata,

Safety precaution

The use of traditional medicine in prescribed dosages will yield good results. Misuse and abuse may lead to complications. To learn about correct dosage, consult a traditional healer or a herbalist. You can also visit or email: to learn more about traditional medicine.

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