Prickly Ash Bark (Zanthoxylum americanum or Zanthoxylum clava-herculis) has a long history of use in North American traditional medicine, particularly among Native American and early European settlers. It was commonly employed as a circulatory stimulant and a remedy for various conditions thought to be related to poor blood flow, including symptoms that could be associated with angina (such as chest pain or discomfort). Herbalists in the 19th and early 20th centuries sometimes recommended prickly ash as a "stimulating tonic" for the heart and peripheral circulation.

However, scientific evidence supporting the use of prickly ash bark specifically for angina is virtually nonexistent. While there are some laboratory studies indicating mild vasodilatory or circulatory effects from compounds found in the bark (such as alkaloids and essential oils), there have been no controlled clinical trials evaluating its efficacy or safety for angina pectoris. Modern herbal references may mention its traditional use for circulatory complaints, but do not endorse it as a validated treatment for angina.

In summary, the use of prickly ash bark for angina is justified by traditional practice rather than scientific validation, and the overall level of supporting evidence is very weak.