Northern Prickly Ash (Zanthoxylum americanum) has a well-established history of traditional use in North American herbal medicine, particularly among Native American peoples and later among eclectic and physiomedicalist practitioners in the 19th and early 20th centuries. It was commonly used as a "blood mover" or "alterative"—terms that often implied support for the lymphatic and circulatory systems. Herbalists traditionally valued Northern Prickly Ash bark and berries for their purported ability to stimulate lymphatic flow, reduce lymphatic congestion, and assist in conditions featuring swollen lymph nodes or sluggish lymph movement. These uses were based on empirical observation and the doctrine of signatures rather than scientific validation.

However, scientific research specifically validating these traditional claims is minimal. Most available studies on Zanthoxylum species focus on antimicrobial, anti-inflammatory, and analgesic properties, primarily in vitro or in animal models. There is a lack of rigorous clinical evidence demonstrating a direct effect on human lymphatic function. Nonetheless, the historical and ethnobotanical record is strong, justifying its classification as a traditional lymphatic-supportive herb, albeit with a modest evidence rating due to the absence of modern clinical trials.