This occurs mostly in mesic to subxeric woods of east-central states. It is relatively abundant throughout Ky. and in other Appalachian states, but it si much less common on the Coastal Plain, where largely replaced by villosa (see earlier W). D. quaternata does occur in more northern states, but it has often been combined with, or reported as, villosa in floristic manuals. The rhizomes of quaternata and villosa have had much traditional use for menstrual cramps and problems related to childbirth, as well as for upset stomach and coughs. Such uses have been attributed to diosgenin, a phytoestrogen that can be chemically converted into mammalian hormones; however, the benefits of rhizome-extracts remain largely unproven (Jesus et al. 2016). In addition to diverse steroidal saponins and flavanol glycosides, the unusual chemistry of these rhizomes includes diarylheptanoids (Dong et al. 2012).