Other studies concluded that liver damage from use of black cohosh is unlikely. Flowers include painted trillium, small purple-fringed orchids, black cohosh, broad beech ferns. Among these are&colon; tansy, pennyroyal, black cohosh, and the now-extinct silphium. Native Americans used black cohosh to treat gynecological and other disorders. Black cohosh has been implicated in a case of liver failure. Additionally, black cohosh is being harvested from the wild for use as a dietary supplement. Black cohosh has been shown to have no estrogenic effect "in vivo" or "in vitro".