American Liverleaf (Hepatica americana) has a long history of use in North American traditional herbal medicine, particularly among indigenous peoples and early European settlers. The plant was primarily employed for liver ailments, as its name suggests, but it has also been cited in some historical sources as a remedy for hemorrhoids. The rationale for its use in hemorrhoid treatment was largely based on the doctrine of signatures and folk traditions, rather than any specific pharmacological understanding.

While historical herbal texts occasionally recommend Liverleaf for piles (hemorrhoids), the evidence is anecdotal and based on empirical tradition rather than controlled observation. There are no modern clinical studies, pharmacological investigations, or robust preclinical data to support the effectiveness or safety of American Liverleaf for hemorrhoids. The plant contains compounds such as saponins and tannins, which have mild astringent properties; this may have contributed to its historical use for conditions involving bleeding or inflammation, such as hemorrhoids.

In summary, the use of American Liverleaf for hemorrhoids is rooted in traditional herbal practice rather than scientific evidence. The supporting evidence is weak and limited to historical anecdote, and there is no modern clinical validation for this use.