Sanguinaria canadensis (Bloodroot) by Justin Brower

Give me a sign, any sign, that winter is over. Here in North Carolina, that sign is Sanguinaria canadensis, commonly known by the sinister-sounding name Bloodroot. As soon as we get a bit of warm weather, in late February or early march, Bloodroot emerges and graces us with magnificent blooms of dainty white flowers. It is often the first new foliage of the year, but it’s not long-lasting, as the flowers last only a few days, and any rain will cause the petals to drop.

Bloodroot is easy to spot in the wild, even without the frail flower, as it has a single unique, multiply lobed leaf. Sprouting from a rhizome (like Horseradish), that grow larger each year, you often see colonies, or clumps. So if you see one, look around, you’ll likely see many more. It’s distribution is throughout the eastern United States, from Florida up to Canada, then hanging a left over to the Great Lakes. Around here at least, Bloodroot prefers damp, shaded slopes, and I usually find it in the same areas as I do “wild ginger,” Hexastylis arifolia.

It’s a pretty flower with a cool, unusual leaf, and a sign that Spring is right around the corner. So what gives? Why the name Bloodroot? To understand, you’ve got to dig one up. Luckily, I did that for you. The rhizome, or “root”, looks fairly ordinary, with a sweet potato color, but when cut, a thick, blood-red latex oozes out. This latex is sticky stuff! I got a drop on my finger while digging up this sample, and I had a heck of a time washing it off, and when I did, my finger was stained orange for over a week. I was mildly worried. Why? It’s toxic, of course.

Sanguinaria canadensis (Bloodroot) by Justin Brower

The latex contains a mixture of isoquinoline alkaloids, with the most predominate being sanguinarine [of Mexican Prickly Poppy and toothpaste fame], with others being sanguilutine, sanguirubine, chelerythrine, chelilutine, and chelirubine. There will be a quiz later. Alkaloid concentrations are highest in the rhizome, with very little found in flowers and leaves. Concentrations are also highest in specimens found in southern, versus northern, states. Sanguinarine, when applied topically, is called an escharotic – not to be confused with erotic. Simply put, an escharotic is a substance that promotes cell death. It literally kills tissue it comes in contact with, hence my nervousness for getting some on me.

Sanguinarine

Topical Bloodroot’s mechanism of action is interesting. Sanguinarine exists at physiological pH in either a charged iminium, or uncharged alkanolamine, state (ref. 1). As the pseudo-base alkanolamine, the molecule is a lipophilic – fat loving – big ol’ ball of grease, and able to permeate the phospholipid bylayer of cell walls. Once inside the cell, it is the charged iminium that wreaks havoc. It inserts itself between the bases of DNA, in a process known as intercalation, and inhibits DNA polymerases, causing damage to DNA and ultimately leading to cell death. This process is how many anti-cancer drugs work, such as doxorubicin, used to treat Hodgkin’s lymphoma and many types of cancers, and dactinomycin, used to treat Ewing’s Sarcoma. (For more detailed information on mechanism of action, including interaction with telomeres, RNA, and gene regulation, see ref 2.)

Some people view Bloodroot as “Nature’s chemotherapy” and use it to treat their own ailments, usually some sort of skin cancer, but also warts, moles, and skin tags, and use a preparation generally known as “black salve,” with disastrous effects. The problem lies in the fact that black salve preparations are high in sanguinarine concentration and is indiscriminate – both cancerous and normal cells are affected, resulting in healthy tissue necrosis and necrotizing vasculitis. Once applied on the skin, it dissolves the tissue, then scars over. Repeat many times. Eventually the “scab,” lovingly called an eschar (hence the name escharotic mentioned earlier), pops out, leaving a giant gaping open wound. The cancer may or may not still be there. Take a look at these photos of a case (adapted from ref. 3). If you want more, just Google “Black Salve” and click on “images.”

Eschar. From The Journal of the American Academy of Dermatology (2011)

I’m acutely aware of the problems with health care and health insurance in the United States, but one additional problem with self-medication is the self-diagnosis that often precedes it. Sometimes people that use Bloodroot preparations for “skin cancer” don’t have cancer at all, and are disfiguring themselves for naught. So be on the lookout in the eastern states for Bloodroot, and take it for what it is, a sign that spring is near and you can leave those winter blues behind, just be sure to leave it in the ground where it belongs.

** Featured image of Sanguinaria canadensis (Bloodroot) by Justin Brower **

References:

1. Helena Absolínová, Luděk Jančář, Irena Jančářová, Jaroslav Vičar, Vlastimil Kubáňˆ. “Acid-base Behaviour of Sanguinarine and Dihydrosanguinarine.” Open Chemistry 7.4 (2009): 876-883. [FREE]
   
2. Croaker, Andrew, Graham King, John Pyne, Shailendra Anoopkumar-Dukie, and Lei Liu. “Sanguinaria Canadensis: Traditional Medicine, Phytochemical Composition, Biological Activities and Current Uses.”International Journal of Molecular Sciences 17.12 (2016): 1414. [FREE]
3. Eastman, Kristin L., Lynne V. McFarland, and Gregory J. Raugi. “Buyer Beware: A Black Salve Caution.” Journal of the American Academy of Dermatology 65.5 (2011): e154-e155.
4. Eastman, Kristin L., Lynne V. Mcfarland, and Gregory J. Raugi. “A Review of Topical Corrosive Black Salve.” The Journal of Alternative and Complementary Medicine 20.4 (2014): 284-89.

Sanguinaria canadensis (Bloodroot) by Justin Brower