In northern Europe, in Denmark, Ireland, Norway, Sweden and United Kingdom. In southeastern Europe, within Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Italy, Montenegro, North Macedonia, Romania, Serbia and Slovenia. Also in southwestern Europe, it is found in France, Portugal and Spain. Herbalism Usage of this plant as medicine began in Europe in the late Middle Ages, although it was known since antiquity. In 17th century Europe it was publicised as good for the eyes (due to remarks by Pliny and later Olivier de Serres that rubbing its juice in one's eyes caused excessive tearing). The most common traditional uses were as a digestive aid and a diuretic, but various folk traditions throughout Europe ascribed to it a multitude of uses: constipation, cystitis, arteriosclerosis, rheumatism, arthritis, as a blood purifier, for hypoglycaemia, infections, and possibly to cleanse the kidneys. In Sicily and perhaps elsewhere it was used to treat skin blemishes, and in Britain into the modern era as an eyewash to treat conjunctivitis. Since 1963 it has been marketed as a herbal medicine in France. As of 2011 herbal products made from this plant are legally sold in various forms in Austria, Germany, France and Spain. Products may be legally sold in the British market (it is on the British General Sales List), although no products were sold there as of 2011. In the European Union as a whole marketing of the plant is not necessarily legal: it has been rejected from the Community List by the Committee on Herbal Medicinal Products due to the lack of toxicology studies. Products in France and Spain are marketed as a digestive (said to work by increasing bile flow), in Austria it is sold for treatment of dyskinesia of the biliary duct, in Germany it is simply sold as an herbal tea. There is some evidence from animal models that it modifies abnormal bile flow, although it has no effect on normal choleresis. An antispasmodic effect on the upper digestive tract in vitro and in animal studies is considered sufficiently documented. The efficacy of the herbal products in humans is considered plausible but yet unproven in clinical studies. Numerous clinical studies in its amphocholeretic uses in humans have demonstrated the tolerability and safety of dosages used, but there has only been one small double-blind trial with placebos which was inconclusive regarding efficacy. A larger double-blind trial with placebos investigating and comparing its