The Lakota people called E. angustifolia Icahpe hu and used it for snake bites, sepsis, and rabies.^6,24 The Blackfoot saw the plant as a remedy for toothache and other tribes used it for cough medicine (Choctaw), venereal disease (Delaware), sore throats (Comanche), rheumatism and colds (Cheyenne), and eye infections (Dakota).²⁵ Among the early European settlers, Echinacea purpurea first appeared in John Clayton's 1762 Flora Virginica as a remedy for saddle sores on horses.²⁵ In Europe, Dr. Johann Heinrich Dierbach published a discussion of the plant's volatile oils in 1831.²⁵

Echinacea became a favorite of the Eclectic physicians in the U.S. when H.C.F. Meyer produced a commercial medicine from E. angustifolia.^26,27 After investigating Dr. Meyer's claims about the plant, Dr. John King and John Uri Lloyd determined that it had significant value.²⁵ The Lloyd Brothers pharmaceutical firm of Cincinnati created an Echinacea Specific Medicine for sepsis, cancerous growths, typhoid, puerperal fever, throat infections, wound healing, and inflammatory skin conditions.^5,14,25 In Ellingwood's American Materia Medica, Echinacea is listed as a treatment for syphilis, typhus, diphtheria, chronic mastitis, and tuberculosis as well.¹⁹

Echinacea preparations fell out of favor in the U.S. with advances in antibiotics and the decline of the Eclectics²⁸, though both E. angustifolia and E. pallida remained in the National Formulary though its 1947 edition.²⁵ Despite its reduction in use in the U.S., Echinacea became increasingly interesting to European researchers, especially the Germans.²⁵ Gerhard Madaus, a German pharmaceutical manufacturer imported E. purpurea seeds to Germany in the 1930s. Since then, German scientists have conducted research into the biochemistry, pharmacology, and clinical usefulness of the herb.²⁹

Echinacea is the most commonly used herbal product in the U.S.: 40.3% of adults surveyed in 2002 reported that they had taken the herb over the past 12 months.³⁰ The herb continues to enjoy popularity in Europe as well, especially in Germany where over 200 Echinacea products are available.³¹ Retailers sold $58 million worth of Echinacea products in 2000.⁵ Manufacturers market Echinacea as an immune stimulant and the public uses it most often to prevent or treat cold symptoms.^32-36

Modern herbalists continue to value Echinacea for treatment of a variety of infectious conditions, such as upper respiratory infections, urinary tract infections, otitis media, vaginal candidiasis, and skin infections.^6,9,19,27 Echinacea is often combined with herbs with antimicrobial activity, such as goldenseal or other berberine containing herbs.⁶ Because of its anti-inflammatory properties, Echinacea is also helpful as part of a formula to treat acute arthritic conditions.^6,27