This remedy is exclusively prescribed for symptoms in women who tend to be prone to restlessness, nervousness, and insomnia, if they have drunk too much coffee. In severe cases they may be unable to speak. Caulophyllum is used primarily for problems of the uterus, such as excessive bleeding and lack of tone in the uterine muscles. There may be erratic or absent uterine muscle action during menstruation or during or following labor. Inner trembling may also occur. The remedy is also used for rheumatic joint pains affecting the small joints, particularly if they occur in conjunction with menstruation or uterine problems. The fingers, toes, and ankles may be stiff, and the wrists may ache. Native Americans valued this herb highly for women, using it as a contraceptive, to regulate menstrual cycles, to induce labor, and for children's colic. The root of blue cohosh was used as an herbal remedy by Native Americans to prevent long and painful labors and to quicken childbirth. The herb is still used in herbal medicine as a tonic and uterine stimulant. Caulophyllum was first introduced to homeopathy in 1875 by Dr. Hale, a well-known American homeopath. Caulophyllum has two main uses in homeopathy: the first is for rheumatism that affects the small joints of the hands and feet with erratic, shooting cramping pain; the second is to help labor that does not progress properly, for example, when there is weak, irregular labor pain, or very painful but ineffectual contractions. Caulophyllum is also given for false labor pain. This remedy can help prevent habitual miscarriages and to ease severe pain following childbirth and menstrual pain. Because it is a uterine stimulant it may stimulate menstruation in women suffering absent menstruation.