Overview

Comprehensive Description

Comments

Bloodroot is one of the spring ephemerals of deciduous woodlands. It has very showy flowers and unusual-looking, but attractive, foliage. Unfortunately, the flowers are relatively short-lived. Across different localities, there are significant variations in this plant, involving such characteristics as the number of petals and size of the flowers, and the appearance of the foliage. On rare occasions, light pink flowers are produced. The Amerindians created a red dye from the juice of the rhizomes. The juice of plants in this genus possesses anti-bacterial properties with possible pharmaceutical applications, including an anti-plaque mouthwash.
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Description

Depending on its stage of development, this herbaceous perennial plant is about 3-12" tall. It produces only basal leaves that are about 3-5" wide and across. Each of these basal leaves is wrapped around the stalk of a single flower (sometimes two stalks are produced) as the flower begins to bloom. The basal leaves continue to unfold to their fullest extent as the flowers wither away. Each basal leaf is oval-orbicular in outline and palmate-reticulately veined, with 5-9 major lobes and several minor lobes along the undulating margins. The palmate-reticulate venation is fairly prominent and provides the rather succulent leaves with a wrinkly appearance, especially on their lower surfaces. The color of the leaves on the upper surface is light green, sometimes with greyish or bluish tints, while the lower surface is whitish green. The terete petioles are about 4" long and rather stout. The foliage of this plant is glabrous and glaucous.  The flowering stalk is terete, stout, glabrous, and sometimes slightly reddish, terminating in a single large flower. This stalk is about 3-4" tall when the flower begins to bloom. The flower is about 1½–3" across, consisting of 8-16 white petals, a green oval pistil, and numerous stamens with prominent yellow anthers. The pistil has a pale yellow stigma at its apex. There are 2 light green sepals that are nearly as long as the petals, but they fall off the flowering stalk as soon as the flower begins to bloom. The blooming period occurs from early to mid-spring, lasting about 2 weeks. Each flower remains in bloom for only 1 or 2 days (when it is sunny), producing a fragrant scent. Afterwards, each flower is replaced by a seed capsule that becomes enlarged and eventually turns yellow, splitting open to release its seeds. The root system consists of thick reddish rhizomes with coarse fibrous roots. Both the foliage and the rhizomes contain an acrid reddish juice. This plants often forms vegetative colonies. Cultivation
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Distribution

Range and Habitat in Illinois

Bloodroot is a common plant that occurs in most counties of Illinois (see Distribution Map), where it is native. Habitats include rich deciduous woodlands, wooded slopes, edges of bluffs, shaded ravines, banks of rivers in wooded areas, and areas along woodland paths. Faunal Associations
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National Distribution

Canada

Origin: Unknown/Undetermined

Regularity: Regularly occurring

Currently: Unknown/Undetermined

Confidence: Confident

United States

Origin: Native

Regularity: Regularly occurring

Currently: Present

Confidence: Confident

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Global Range: Eastern North America, from southern Quebec (Labrecque pers. comm.), New Brunswick and Nova Scotia west to southeast Manitoba (Punter pers. comm.), northeast Nebraska (Steinauer pers. comm.); disjunct to the Black Hills, South Dakota (Ode pers. comm.); south to Texas, Louisiana, Florida (USDA-NRCS 1999).

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Man., N.B., N.S., Ont., Que.; Ala., Ark., Conn., Del., D.C., Fla., Ga., Ill., Ind., Iowa, Kans., Ky., La., Maine, Md., Mass., Mich., Minn., Mo., Nebr., N.H., N.J., N.Y., N.C., N.Dak., Ohio, Okla., Pa., R.I., S.C., S.Dak., Tenn., Tex., Vt., Va., W.Va., Wis.
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Physical Description

Morphology

Description

Plants to 4(-6) dm, glabrous; rhizomes branching. Leaves: petiole to 15 cm; blade orbiculate-reniform to cordate-sagittate, mostly palmately 5-7-lobed, to 25 cm wide; margins scalloped; adaxial surface glaucous. Inflorescences: scape to 15 cm. Flowers: sepals ca. 1 cm; petals white or pinkish, oblong to oblanceolate, 15-30 mm; style to 3 mm. Capsules fusiform, 35-60 mm, glabrous. Seeds black to red-orange, obscurely reticulate. 2 n = 18 (cult.).
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Diagnostic Description

Synonym

Sanguinaria australis Greene; S. canadensis var. rotundifolia (Greene) Fedde; S. dilleniana Greene
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Type Information

Type collection for Sanguinaria australis Greene
Catalog Number: US 391299
Collection: Smithsonian Institution, National Museum of Natural History, Department of Botany
Verification Degree: Original publication and alleged type specimen examined
Preparation: Pressed specimen
Collector(s): F. S. Earle & E. S. Earle
Year Collected: 1900
Locality: Auburn., Lee, Alabama, United States, North America
  • Type collection: Greene, E. L. 1905. Pittonia. 5: 307.
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Ecology

Habitat

Range and Habitat in Illinois

Bloodroot is a common plant that occurs in most counties of Illinois (see Distribution Map), where it is native. Habitats include rich deciduous woodlands, wooded slopes, edges of bluffs, shaded ravines, banks of rivers in wooded areas, and areas along woodland paths. Faunal Associations
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Comments: Rich, mesic to somewhat dry deciduous forests and coves with fertile soils and circumneutral to basic soil pH (Rock pers. comm., Enser pers. comm., Punter pers. comm., Schafale pers. comm.). In portions of its range, this species is often encountered with sugar maple (Labrecque pers. comm.). Occasionally, this species occurs in well-drained soils along ridge tops, from aspen/poplar woodlands in northwest portion of range to montane oak-hickory forests, high-elevation red oak forests and northern hardwoods in the southern Blue Ridge (Punter pers. comm., Schafale pers. comm., Penskar pers. comm.). In the Black Hills of South Dakota, this species occurs with Betula occidentalis, Picea glauca, Pinus ponderosa (Ode pers. comm.).

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Moist to dry woods and thickets, often on flood plains and shores or near streams on slopes, less frequently in clearings and meadows or on dunes, rarely in disturbed sites; 0-1300m.
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Associations

Flower-Visiting Insects of Bloodroot in Illinois

Sanguinaria canadensis (Bloodroot)
(Bees collect pollen, while flies & beetles feed on pollen; some insects explore the flowers while vainly searching for nectar, as indicated below; observations are from Robertson, Graenicher, Schemske et al., and Motten as indicated below)

Bees (long-tongued)
Apidae (Apinae): Apis mellifera cp fq (Rb, Shm, Mtt); Apidae (Bombini): Bombus bimaculatus cp (Mtt), Bombus griseocallis cp (Gr); Anthophoridae (Ceratinini): Ceratina dupla dupla cp (Gr), Ceratina calcarata exp (Rb), Ceratina tejonensis exp (Gr); Anthophoridae (Nomadini): Nomada sayi exp (Gr); Anthophoridae (Xylocopini): Xylocopa virginica cp (Mtt); Megachilidae (Osmiini): Osmia lignaria lignaria cp (Rb)

Bees (short-tongued)
Halictidae (Halictinae): Halictus confusus cp (Gr), Halictus rubicunda cp (Gr), Lasioglossum sp. cp (Mtt), Lasioglossum foxii cp (Rb), Lasioglossum imitatus cp (Rb, Gr), Lasioglossum zephyrus cp (Rb, Gr); Andrenidae (Andreninae): Andrena carlini cp fq (Rb, Mtt), Andrena milwaukeensis cp (Gr), Andrena vicina cp icp (Gr)

Flies
Syrphidae: Unidentified sp. fp (Mtt), Brachypalpus cyanogaster fp (Gr), Eupeodes americanus fp (Rb, Gr, Shm), Toxomerus marginatus fp (Gr); Bombyliidae: Bombylius major fp/exp fq (Rb, Gr, Mtt); Tachinidae: Gonia capitata fp (Rb)

Butterflies
Pieridae: Pieris rapae exp (Gr)

Beetles
Oedmeridae: Asclera ruficollis fp fq (Rb)

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Population Biology

Number of Occurrences

Note: For many non-migratory species, occurrences are roughly equivalent to populations.

Estimated Number of Occurrences: 81 to >300

Comments: There are probably tens or hundreds of thousands of populations rangewide. Iowa: hundreds; Indiana: thousands; Kansas: 30; Maryland: hundreds; North Carolina: thousands; Nebraska: 25-50+; Rhode Island: 10; South Carolina: hundreds; South Dakota: 40 to 50; Tennessee: several hundred; Vermont: thousands; Manitoba: >8; Quebec: >100 (Brumback and Mehrhoff 1996, APSU 1999).

Since this is such a common species throughout much of its range, these numbers can only be estimates. Additional information on species distribution and the number of populations can be gleaned from county occurrence dot maps (USDA-NRCS 1999).

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General Ecology

This species is ant dispersed (Ode pers. comm.).

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Life History and Behavior

Cyclicity

Flowering/Fruiting

Flowering earliest spring.
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Molecular Biology and Genetics

Molecular Biology

Barcode data: Sanguinaria canadensis

The following is a representative barcode sequence, the centroid of all available sequences for this species.


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Statistics of barcoding coverage: Sanguinaria canadensis

Barcode of Life Data Systems (BOLDS) Stats
Public Records: 4
Specimens with Barcodes: 6
Species With Barcodes: 1
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Conservation

Conservation Status

National NatureServe Conservation Status

Canada

Rounded National Status Rank: NNR - Unranked

United States

Rounded National Status Rank: N5 - Secure

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NatureServe Conservation Status

Rounded Global Status Rank: G5 - Secure

Reasons: This species has a very broad range and is a frequent component of mesic hardwood forests in across the eastern US and southeastern Canada. It is likely declining locally through much of its range due to the combination of habitat conversion and collection from wild populations. At present, this species is demonstrably secure given its extremely broad distribution and the sheer number of populations.

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Global Short Term Trend: Decline of 10-30%

Comments: The species is speculated to be declining globally. It is probably stable in parts of its range, though it is likely declining locally through much of its range due to the combination of habitat conversion and collection from wild populations. This species appears to have very stable wholesale prices compared to other wildcrafted medicinal herbs such as Cimicifuga and Podophyllum. As such, it probably will continue to experience steady or increased harvesting every year until the cost of cultivated sources drops compared with wild sources (Kauffman pers. comm.).

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Threats

Comments: There is reliable evidence that collecting from wild populations is occurring for the plant trade in Great Smoky Mountains N.P., southern Blue Ridge Mountains of North Carolina and Tennessee (Rock pers. comm., Kauffman pers. comm.); central Tennessee; Hoosier National Forest and elsewhere in Indiana (Jacquart pers. comm., Homoya pers. comm.). Collecting for the plant trade is suspected in New England (Brumback pers. comm.).

Collection of this species has been observed simultaneously with American ginseng (Rock pers. comm., Corbin pers. comm.). Collection of this species was first observed by Corbin about 4 years ago, and is now much more widespread. Apparently, this species is being actively sought on the Chinese and Korean black market, where it may get prices between $15-30 per pound (dry weight; Corbin pers. comm.). This was the third most-collected species (after ginseng and goldenseal) in Hoosier National Forest prior to the cessation of herb collection permitting there recently (Jacquart pers. comm.). There are consistently low prices for this species and a relatively small but stable market for this species, including toothpaste companies (Blakley pers. comm., Suggs pers. comm.). Wildcrafters and tradesmen are very quiet and proprietary about how much is collected and where (Suggs pers. comm., Penskar pers. comm., Corbin pers. comm.), so information on amounts is very difficult to come by. Most or all material on the market is from wildcrafted sources (Blakley pers. comm., Fletcher pers. comm.). There are reports that migrant workers are now being employed for wildcrafting, resulting in much more thorough collection from populations of other species (Corbin pers. comm.). Small and Catling (1999) claim that most plant material of this species comes from wild areas in the United States. In Tennessee, this plant is collected from the wild and sold as nursery stock in bundles of 50 (Warren Co. Nursery).

According to Kauffman (pers. comm.), collection permits for Pisgah and Nantahala National Forests in North Carolina were for the following amounts (dry weight): 1997 - 5400 lbs.; 1998 - 4500 lbs.; 1999 - 5000 lbs. These amounts may not have been met by actual collections.

Total trade of this species has consistently been estimated at a few thousand pounds (dry weight) per year for the past few years (Blakley pers. comm.). However, a large dealer in herbs based in the southern Appalachians, sold 40,000-55,000 lbs. (dry) in 1999 (Fletcher pers. comm.).

This species appears to have very stable wholesale prices compared to other wildcrafted medicinal herbs such as Cimicifuga and Podophyllum. As such, it probably will continue to experience steady or increased harvesting every year until the cost of cultivated sources drops compared with wild sources (Kauffman pers. comm.).

A person knowledgable about the herbal medicinal trade says that the plant is traded to a fairly significant degree and estimates that 5,000-10,000 pounds of dry root is in U.S. trade each year (M. McGuffin pers. comm.). The root is used so harvest is deadly to the plant.

The plant is apparently an ingredient in the toothpaste Viadent (McGuffin pers. comm.).

As with all native forest herbs, habitat conversion and urban/rural development are significant direct threats (Homoya pers. comm., Enser pers. comm., Kunsman pers. comm., Pearson pers. comm., Punter pers. comm., Steinauer pers. comm.). Equally significant threats include habitat fragmentation and displacement by exotic species (Schafale pers. comm., Homoya pers. comm., Penskar pers. comm., Frye pers. comm., Enser pers. comm., Steinauer pers. comm.). Cattle grazing and surface mining are threats in portions of its range (Ode pers. comm., Punter pers. comm., Steinauer pers. comm.). Introduction of non-native genotypes from other regions in attempt to cultivate this species may be of some concern (Brumback pers. comm.). Feral hogs tend to uproot this species, and therefore may be an additional non-native threat in portions of its range (Schotz pers. comm.).

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Management

Biological Research Needs: There is a strong need to develop adequate propagation techniques for cultivation of this species, and to determine sustainable collection levels from healthy, wild populations (Kauffman pers. comm., Punter pers. comm.). Further work on the demography of this species is needed to determine minimum viable population sizes. A better understanding of the natural history, breeding systems, and genetic variation both within and between populations is also needed.

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Relevance to Humans and Ecosystems

Benefits

Economic Uses

Uses: MEDICINE/DRUG, LANDSCAPING, OTHER USES/PRODUCTS

Production Methods: Cultivated, Wild-harvested

Comments: Prices for this species were found as follows:

Southeast U.S., black market (Corbin pers. comm.): $15-30/lb (dry)

Central Tennessee, nursery: $0.40/bare root whole plant (wild-collected and sold in bundles of 50)

Nationwide, internet: $9/fluid oz. (1:10 ratio)

Nationwide, internet: $9/fluid oz. (1:4 ratio)

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Wikipedia

Sanguinaria

"Bloodroot" redirects here. For other plants known as bloodroot, see Eomecon and Lachnanthes.
Not to be confused with the grass genus Sanguinaria now considered divided between Digitaria and Paspalum

Sanguinaria canadensis or bloodroot,[1] is a perennial, herbaceous flowering plant native to eastern North America. It is the only species in the genus Sanguinaria, included in the family Papaveraceae, and most closely related to Eomecon of eastern Asia.

Sanguinaria canadensis is also known as bloodwort,[1] redroot,[1] red puccoon,[1] and sometimes pauson. It has also been known as tetterwort,[1] although that name is also used to refer to Chelidonium majus. Plants are variable in leaf and flower shape and have in the past been separated out as different subspecies due to these variable shapes. Currently most taxonomic treatments lump these different forms into one highly variable species. In bloodroot, the juice is red and poisonous.[2]

Description[edit]

Sanguinaria canadensis, is a variable species growing from 20–50 centimetres (7.9–19.7 in) tall, normally with one large, sheath-like basal multi-lobed leaf up to 12 centimetres (4.7 in) across. Bloodroot stores sap in an orange colored rhizome, that grows shallowly under or at the soil surface. Over many years of growth, the branching rhizome can grow into a large colony. Plants start to bloom before the foliage unfolds in early spring and after blooming the leaves expand to their full size and go summer dormant in mid to late summer.

The flowers are produced from March to May, with 8-12 delicate white petals and yellow reproductive parts. The flowers appear over clasping leaves while blooming. The flowers are pollinated by small bees and flies, seeds develop in elongated green pods 40 to 60 mm in length and ripen before the foliage goes dormant. The seeds are round in shape and when ripe are black to orange-red in color.

Distribution and habitat[edit]

Bloodroot is native to eastern North America from Nova Scotia, Canada southward to Florida, United States, and west to Great Lakes and down the Mississippi embayment.

Sanguinaria canadensis plants are found growing in moist to dry woods and thickets, often on flood plains and near shores or streams on slopes. They grow less frequently in clearings and meadows or on dunes, and are rarely found in disturbed sites. Deer will feed on the plants in early spring.

Ecology[edit]

Bloodroot is one of many plants whose seeds are spread by ants, a process called myrmecochory. The seeds have a fleshy organ called an elaiosome that attracts ants. The ants take the seeds to their nest, where they eat the elaiosomes, and put the seeds in their nest debris, where they are protected until they germinate. They also get the added bonus of growing in a medium made richer by the ant nest debris.

Cultivation[edit]

Sanguinaria canadensis is cultivated as an ornamental plant. The double flowering forms are prized by gardeners for their large showy white flowers, which are produced very early in the gardening season. Bloodroot flower petals are shed within a day or two of pollination so the flower display is short lived. The double forms bloom much longer than the normal forms, the double flowers are made up of stamens that have been changed into petal looking like parts, making pollination more difficult.

The cultivar S. canadensis f. multiplex 'Plena' has gained the Royal Horticultural Society's Award of Garden Merit.[3]

Toxicity[edit]

Bloodroot produces benzylisoquinoline alkaloids, primarily the toxin sanguinarine. The alkaloids are transported to and stored in the rhizome. Comparing the biosynthesis of morphine and sanguinarine, the final intermediate in common is (S)-reticuline.[4][5] A number of plants in Papaveraceae and Ranunculaceae, as well as plants in the genus Colchicum (family Colchicaceae) and genus Chondodendron (family Menispermaceae), also produce such benzylisoquinoline alkaloids.

Plant geneticists have identified and sequenced genes which produce the enzymes required for this production. One enzyme involved is CYP80B1,[6] which produces (S)-3'-hydroxy-N-methylcoclaurine and mendococlaurine from (S)-N-methylcoclaurine.

Toxicity to animal cells[edit]

Sanguinarine kills animal cells by blocking the action of Na+/K+-ATPase transmembrane proteins. As a result, applying bloodroot to the skin may destroy tissue and lead to the formation of a large scab, called an eschar. Bloodroot and its extracts are thus considered escharotic.

Internal use is inadvisable. Applying escharotic agents, including bloodroot, to the skin is sometimes suggested as a home treatment for skin cancer, these attempts can be severely disfiguring.[7] Salves derived from bloodroot cannot be relied on to remove an entire malignant tumor. Microscopic tumor deposits may remain after visible tumor tissue is burned away, and case reports have shown that in such instances tumor has recurred and/or metastasized.[8]

Numerous pre-clinical in vitro studies have demonstrated that sanguinarine causes targeted apoptosis in human cancer cells with little reaction from normal cells, and recommend future study of sanguinarine as a potential cancer treatment.[9]

Uses[edit]

Complementary and alternative medicine[edit]

Bloodroot was used historically by Native Americans for curative properties as an emetic, respiratory aid, and other treatments.[10]

In physician William Cook's 1869 work The Physiomedical Dispensatory is recorded a chapter on the uses and preparations of bloodroot,[11] which described tinctures and extractions, and also included at least the following cautionary report:

The U. S. Dispensatory says four persons lost their lives at Bellevue Hospital, New York, by drinking largely of blood root tincture in mistake for ardent spirits [...]

Greater Celandine (Chelidonium majus), a member of the Poppy family (Papaveraceae) was used in Colonial America as a wart remedy. Bloodroot has been similarly applied in the past. This may explain the multiple American and British definitions of "Tetterwort" in 1913.

Bloodroot extracts have also been promoted by some supplement companies as a treatment or cure for cancer, but the U.S. Food and Drug Administration has listed some of these products among its "187 Fake Cancer 'Cures' Consumers Should Avoid".[12] Indeed, far from curing cancer, products containing bloodroot are strongly associated with the development of oral leukoplakia,[13] which is a premalignant lesion that may develop into oral cancer.

Canada puccoon by Sydenham Edwards from The Botanical Magazine (1791)

Commercial uses[edit]

Commercial uses of sanguinarine and bloodroot extract include dental hygiene products. The United States FDA has approved the inclusion of sanguinarine in toothpastes as an antibacterial or anti-plaque agent.[14][non-primary source needed][15][non-primary source needed][16][17] However, the use of sanguinaria in oral hygiene products is associated with the development of oral leukoplakia, a premalignant lesion which may develop into oral cancer.[13][18] On 24 Nov 2003, the Colgate-Palmolive Company of Piscataway, New Jersey, United States commented by memorandum to the United States Food and Drug Administration that then-proposed rules for levels of sanguinarine in mouthwash and dental wash products were lower than necessary.[19] However, this conclusion is controversial.[20]

Some animal food additives sold and distributed in Europe such as Phytobiotics' Sangrovit contain sanguinarine and chelerythrine. On 14 May 2003, Cat Holmes reported in Georgia Faces[21] that Jim Affolter and Selima Campbell, horticulturists at the University of Georgia College of Agricultural and Environmental Sciences, were meeting with Phytobiotics to relate their research into commercial cultivation of bloodroot.

Plant dye[edit]

Bloodroot is a popular red natural dye used by Native American artists, especially among southeastern rivercane basketmakers.[22] The blood of the root (when cut open) was used as a dye. A break in the surface of the plant, especially the roots, reveals a reddish sap.

See also[edit]

References[edit]

  1. ^ a b c d e "USDA GRIN Taxonomy". 
  2. ^ "Bloodroot Wildflowers". 
  3. ^ "RHS Plant Selector - Sanguinaria canadensis f. multiplex 'Plena'". Retrieved 3 July 2013. 
  4. ^ Alcantara, Joenel; Bird, David A.; Franceschi, Vincent R.; Facchini, Peter J. (2005). "Sanguinarine Biosynthesis is Associated with the Endoplasmic Reticulum in Cultured Opium Poppy Cells after Elicitor Treatment". Plant Physiology 138 (1): 173–83. doi:10.1104/pp.105.059287. JSTOR 4629815. PMC 1104173. PMID 15849302. 
  5. ^ KEGG PATHWAY: Alkaloid biosynthesis I - Reference pathway
  6. ^ KEGG ENZYME: 1.14.13.71
  7. ^ Don't Use Corrosive Cancer Salves (Escharotics), Stephen Barrett, M.D.
  8. ^ McDaniel, S.; Goldman, GD (2002). "Consequences of Using Escharotic Agents as Primary Treatment for Nonmelanoma Skin Cancer". Archives of Dermatology 138 (12): 1593–6. doi:10.1001/archderm.138.12.1593. PMID 12472348. 
  9. ^ Han, M.H.; Park, C.; Jin, C.-Y.; Kim, G.-Y.; Chang, Y.-C.; Moon, S.-K.; Kim, W.-J.; Choi, Y.H. (2013). "Apoptosis Induction of Human Bladder Cancer Cells by Sanguinarine through Reactive Oxygen Species-Mediated Up-Regulation of Early Growth Response Gene-1". PLoS ONE 8 (5): e63425. doi:10.1371/journal.pone.0063425. 
  10. ^ Native American Ethnobotany (University of Michigan - Dearborn: Sanguinaria canadensis' . accessed 12.1.2011
  11. ^ Sanguinaria Canadensis'. | Henriette's Herbal Homepage
  12. ^ "187 Fake Cancer "Cures" Consumers Should Avoid". United States Food and Drug Administration. Retrieved 2010-04-15. 
  13. ^ a b Bouquot, Brad W. Neville , Douglas D. Damm, Carl M. Allen, Jerry E. (2002). Oral & maxillofacial pathology (2. ed. ed.). Philadelphia: W.B. Saunders. p. 338. ISBN 0721690033. 
  14. ^ Godowski, KC (1989). "Antimicrobial action of sanguinarine". The Journal of clinical dentistry 1 (4): 96–101. PMID 2700895. 
  15. ^ Southard, GL; Boulware, RT; Walborn, DR; Groznik, WJ; Thorne, EE; Yankell, SL (1984). "Sanguinarine, a new antiplaque agent: Retention and plaque specificity". Journal of the American Dental Association 108 (3): 338–41. PMID 6585404. 
  16. ^ How to Report Problems With Products Regulated by FDA
  17. ^ Kuftinec, MM; Mueller-Joseph, LJ; Kopczyk, RA (1990). "Sanguinaria toothpaste and oral rinse regimen clinical efficacy in short- and long-term trials". Journal of the Canadian Dental Association 56 (7 Suppl): 31–3. PMID 2207852. 
  18. ^ Leukoplakia, (pdf format) hosted by the American Academy of Oral and Maxillofacial Pathology. Page accessed on December 19, 2006.
  19. ^ Letter to FDA, Collgate-Palmolive Company, 24 Nov. 2003
  20. ^ Letter to FDA, Professor George T. Gallagher, Boston University Goldman School of Dental Medicine, 23 June 2003.
  21. ^ Georgia FACES
  22. ^ Nolan, Justin. "Northeast Oklahoma, USA." Society of Ethnobotany. 2007 (retrieved 9 Jan 2011)

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Sanguinaria canadensis has been reported from Mississippi, but no specimens are known. 

 The leaves of Sanguinaria canadensis are quite variable in shape and size, and the scape and petals vary considerably in length. In some plants the petals are clearly differentiated into sets of two different sizes, but in others the differentiation is barely perceptible. Extremes of variation in these characters have been the bases for recognizing several forms, varieties, and even distinct species, but intermediates of all degrees are found and the variation is only loosely correlated with geography or habitat. Thus, it seems best to limit formal recognition to a single, quite variable species.

Although bloodroot is an ingredient of some compound cough remedies, it contains the poisonous alkaloid sanguinarine, and the U.S. Food and Drug Administration has characterized Sanguinaria canadensis as an unsafe herb (J. A. Duke 1985). Native Americans used it medicinally to treat ulcers and sores, croup, cramps, burns, tapeworms, fevers, diarrhea, and irregular periods, in cough syrups, as a spring emetic and blood purifier, to stop vomiting, and as a love charm, as well as in cermonial face paint (D. E. Moerman 1986).

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