American elder was widely employed as a medicinal herb by many native North American tribes who used it to treat a wide range of complaints. It is still commonly used as a domestic remedy.

A tea made from the inner bark and root bark is diuretic, emetic and a strong laxative. A tea made from the root bark is used to promote labour in childbirth and in treating headaches, kidney problems and mucous congestion. The inner bark is also applied as a poultice to cuts, sore or swollen limbs etc in order to relieve pain and swelling.
A poultice of the leaves is applied to bruises and to cuts in order to stop the bleeding.
An infusion of the leaf buds is strongly purgative.

Medicinal virtues: The bark, leaves, flowers and berries all have medicinal properties. The first shoots to appear, boiled like Asparagus, and also the young leaves and stalks boiled in fat broth, carry forth phlegm and choler.

The middle or inward bark boiled in water and given in drink works much more violently. The berries, either green or, dry, expel the same humour. They are also often given with good success to help the dropsy. The bark of the root boiled in wine, or the juice thereof drank, is more powerful than the leaves or fruit.

The juice of the root causes vomiting and purges the watery humours of' the dropsy. A decoction of the root mollifies the hardness of the mother, if women sit thereon, and opens their veins and brings down their courses. The berries boiled in wine perform the same effect. The juice of the green leaves applied to hot inflammations of the eyes assuages them. The decoction of the berries in wine provokes urine.

The leaves or flowers distilled in the month of May and the legs washed with it takes away ulcers and sores. The hands washed with it helps the shaking of them and the palsy.

Elder flowers are stimulant, diaphoretic and diuretic. A warm tea of the flowers is stimulant and induces sweating, taken cold it is diuretic. It is used in the treatment of fevers and infant colic. An infusion of the leaves and flowers is used as an antiseptic wash for skin problems, wounds etc.

The fresh juice of the fruit, evaporated into a syrup, is laxative. It also makes a good ointment for treating burns when mixed with an oily base. The dried fruit can be made into a tea that is useful in the treatment of cholera and diarrhoea.

Some caution should be exercised if using any part of the plant fresh since it can cause poisoning.