Prefers a rich moist neutral to acid soil in woodland or a shady position in the rock garden. Other reports say that this plant prefers a calcareous soil. Plants are hardy to at least -15°c. The flowers are malodorous and are pollinated by flies. The root has a pungent, aromatic smell like mild pepper and ginger mixed, but more strongly aromatic. Plants often self-sow when growing in a suitable position. This plant was at one time commonly cultivated as a medicinal herb.

None known

Seed - best sown in a cold frame as soon as it is ripe in the summer. Stored seed will require 3 weeks cold stratification and should be sown in late winter. The seed usually germinates in the spring in 1 - 4 or more weeks at 18°c. When large enough to handle, prick the seedlings out into individual pots and grow them on in light shade in the greenhouse for at least their first winter. Plant them out when large enough in late spring. Division in spring or autumn. Plants are slow to increase. It is best to pot the divisions up and keep them in light shade in the greenhouse until they are growing away strongly.

Open woodland and waterside thickets, especially in beech woodlands.