United States

Department

of Agriculture

Forest Service

Southern

Research

Station

General

Technical

Report

SRS–86

United States

Department

of the Interior

National 

Park Service
Cover photograph by Thomas G. Barnes

Bloodroot (Sanguinaria canadensis)

is an important herbal medicinal 

plant collected from the hardwood 

forests of the Southern United States.

THE AUTHORS:

Mary L. Predny, Research Associate, Virginia Polytechnic Institute and State 

University, Wood Science and Forest Products Department, Blacksburg, VA 24061.

James L. Chamberlain, Research Scientist, U.S. Department of Agriculture, 

Forest Service, Southern Research Station, Blacksburg, VA 24060.
i

Bloodroot (Sanguinaria canade

An Annotated Bibliograph

Mary L. Predny and James L. Chambe

Statements made by authors cited in this document conc

medicinal uses and properties may not have been evalua

the Food and Drug Administration, and are included for

educational purposes only. Discussion of medical uses i

intended for diagnoses, treatment, cure, nor prevention 

disease. Bloodroot is toxic and should not be ingested.

Information in this publication about medicinal uses is

intended for educational purposes only and is not a subs

for the advice of qualified healthcare professionals. Ma

presented in this document is for reader information onl

does not imply endorsement by the U.S. Department of

Agriculture.
ii
iii

Botany and Ecology ............................................................

Chemical Constituents .......................................................

Uses ......................................................................................

Medicinal ..........................................................................

Dental ................................................................................

Other Uses .........................................................................

Market Trends.....................................................................

Conservation .......................................................................

Discussion ............................................................................

Acknowledgments ...............................................................

Literature Cited ..................................................................

Annotated Bibliography .....................................................

Research Literature ...........................................................

Popular Press .....................................................................

Other Information Sources................................................

Commercial Vendors .........................................................

Author Index .......................................................................

Subject Index.......................................................................

Disclaimers ..........................................................................
iv
1

Mary L. Predny and James L. Chambe

Abstract

Bloodroot (Sanguinaria canadensis) is a spring-blooming herbaceous perenn

in rich woods throughout the Appalachian Mountain regions and across the E

States. The common name bloodroot and scientific name Sanguinaria denot

found throughout the plant, particularly in the roots. This sap contains the al

this plant so valuable. Native Americans used bloodroot as a dye, love charm

European colonists adopted Native American medicinal uses to suit their ow

was described in pharmacopoeias as early as the 1800s, with detailed descrip

constituents, therapeutics, and case studies. The popular use of herbal remed

1920s with the development of the pharmaceutical industry, though there ha

interest in herbal medicine as research confirms the efficacy of some traditio

Bloodroot is still wildcrafted in the United States for domestic and internatio

report describes the characteristics and growth habits of bloodroot, summari

uses of the herb, reviews the global market and trade, examines the conserva

plant, and identifies needs for future research.

Keywords: Bloodroot, conservation, dental products, medicinal herbs, nonti

products, Sanguinaria.

Nomenclature

Bloodroot (Sanguinaria canadensis), a member of the Papave

is known by several common names. According to Sanders (2

various common names refer to the many uses or properties o

Bloodroot and red root are two names that refer to the dark-re

throughout the plant, particularly in the roots. Puccoon is a N

term for a red dye; the names puccoon, paucon, pauson, red p

coonroot, and Indian paint are all references to the Native Am

the plant to color skin, clothes, and baskets. Tetter is an Old E

for skin disease; the name tetterwort refers to the external use 

to treat warts, benign skin tumors, eczema, and other afflictio

The name sweet slumber denotes the use of the plant to induc

snakebite indicates the plant’s poisonous elements, which hav

to be fatal when ingested in large amounts.
2

Botany and Ecology

Bloodroot is one of the first herbaceous perennials to emerge 

(Reed 1999–2002). Plants reach a height of 6 to 12 inches at 

though they are typically only half that height at the time of b

and Duke 2000). Each plant consists of a single leaf wrapped 

a flower bud; the leaf opens to expose the flower as it blooms 

Botanical Garden 2002, Sievers 1930) (fig. 1).

Bloodroot leaves are kidney shaped, with five to nine rounde

arranged palmately and covered with a whitish-gray down (G

Harding 1936, Sievers 1930). The pale underside of the leaf i

veined (Grieve 1931, Harding 1936). Once the flowers have f

leaves persist until August, when they turn a deeper green and 

maximum size of 6 to 10 inches (Harding 1936, Missouri Bo

2002, Sievers 1930).

Each waxy, white flower grows on a single stem up to 8 inche

blooming around late March and early April (Harding 1936, S

Flowers are roughly 2 inches in diameter, with gold-colored s

center (Foster and Duke 2000, Harding 1936, Miller 1988). W

Figure 1—Bloodroot plant (Britton and

Brown 1913).
3

p, 

partially or completely replaces another.

Bloodroot flowers typically bloom for only a few days, openi

day and closing each night (Hendershot 2002). Two mechanis

this are temperature and sunlight. Flowers do not open when 

are under 8 oC (46 oF) (Lyon 1992). As temperatures rise, flow

earlier and close later; though on cloudy days when the sun is 

will open later and close earlier.

Bloodroot flowers are hermaphroditic, with both male and fe

(Fern 1997–2000). According to Lyon (1992), this makes it p

plants to be facultatively xenogamous, with the ability to eith

pollinate or be cross-pollinated. The initial female phase lasts 

Self-pollination cannot occur during this time, because the st

positioned to avoid contacting the stigma even when the flow

night. The main pollinators during this phase are bees (memb

Adrenidae, Apidae, and Hallictidae), but can also include oth

as Hymenoptera, Hemiptera, and Coleoptera (Judd 1977, Lyo

flowers have not been pollinated in the initial 3 days due to co

temperatures, rain, or lack of pollinator visitation, the stamen

contact the stigma and self-pollination occurs (Lyon 1992).

Bloodroot seeds produce a lipid-rich appendage called an ela

nutritious food source for ants (Hendershot 2002). Ants colle

seeds and carry them back to their nest, where they consume 

and discard the intact and viable seeds in old galleries or refu

These refuse areas tend to be high in organic matter, phospho

and nitrogen—ideal for germinating bloodroot seeds. This mu

beneficial relationship between the bloodroot plant and native 

as “myrmecochory” or ant farming (Beattie and Culver 1982

2002). The ants benefit from the nutritious food source, while 

are “planted” in ant nests are safe from predation by rodents, 

competition with parent plants, and have access to the essenti

present in the underground nests (Heithaus 1981, Pudlo and o

The native range of bloodroot extends from Nova Scotia sout

Florida, and west to Manitoba, western South Dakota, and ea

(fig. 2) (Foster and Duke 2000; Miller 1988; U.S. Departmen

Agriculture, Natural Resources Conservation Service 2001). 
4

mostly found in rich woodlands or on sunny-to-shady edges o

areas (Fern 1997–2000), on slopes (Reed 1999–2002), or on 

along shaded streams (Miller 1988). The global heritage statu

and the national heritage status rank is N5, indicating that blo

currently secure within its range (NatureServe Explorer 2002

Bloodroot prefers light-to-medium well-drained soils with a s

texture (Fern 1997–2000). Though most often found in semi- 

conditions, research has shown that in areas with sufficient so

increased light levels from openings in the forest canopy due 

Figure 2—Bloodroot range and distribution [adapted from NatureServe Exp

U.S. Department of Agriculture, Natural Resources Conservation Service (2
5

y

optimal (Fern 1997–2000). Bloodroot is an indicator species 

maple-basswood (Betula spp., Acer spp., and Tilia americana

forests (Sutherland 1999). Dormant plants can tolerate tempe

to –20 oC (–4 oF) (Fern 1997–2000), and are hardy in U.S. De

Agriculture zones 4A to 9A (Horticopia, Inc. 2001).

Bloodroot can be propagated by seed, root division, or leaf cu

1997–2000). Seeds can be sown in outdoor beds in the spring 

in a cold frame in winter. A cold stratification period is requi

to produce a root, then another warm and cold period to prod

(Fern 1997–2000). Rhizomes can be divided by breaking them 

pieces, each of which should contain one bud. This is typicall

summer or early fall after the leaves die back (Miller 1988). L

can be taken from shoots in late spring and set in a protected 

until the plants are established (Fern 1997–2000).

Chemical Constituents

Bloodroot exudes a bright orange-red sap from all parts when 

highest concentrations found in the rhizome where the juices 

sap contains isoquinoline alkaloids, red resin, and an abundan

(Foster and Duke 2000). Sanguinarine is the predominant alk

up 50 percent of the total alkaloid content (Bennett and other

alkaloids in the sap contribute to the medicinal properties of t

though they can also be poisonous in large doses, causing nau

dizziness or fainting, dilated pupils, and heart failure (Russel

Studies on environmental variables that affect the concentrati

in bloodroot rhizomes have shown that favorable environmen

result in higher concentrations of active constituents (Bennett 

1990, Salmore and Hunter 2001b). Sources have indicated th

levels in roots are higher during and just after bloom (Bennet

1990, Farwell 1915); however, the rhizomes are traditionally 

autumn after dieback to allow plants the opportunity to dispe

(Grieve 1931, Harding 1936, Sievers 1930).
6

Native Americans used bloodroot as a dye, love charm, and p

(Moerman 1999). European colonists learned of the Native A

medicinal uses for the herb and adopted them to suit their ow

Bloodroot was described in pharmacopoeias as early as the 1

detailed descriptions of the plant, constituents, therapeutics, a

(Cook 1869, Ellingwood 1919, Felter 1922, Felter and Lloyd 

1905, Potter 1902, Winterburn 1882–1883).

The alkaloids in bloodroot have strong antibiotic and anti-inf

properties (Godowski 1989). The herb has also been describe

antiseptic, cathartic, diuretic, emetic, emmenagogue, escharo

expectorant, febrifuge, sedative, spasmolytic, stimulant, and t

(Fern 1997–2000, Grieve 1931, Haughton 2001). In small do

is relaxing and soothing, particularly on the bronchial muscle

doses, the herb has stimulating and emetic properties. Large d

irritation of the mucus membranes (Grieve 1931, Haughton 2

Bloodroot is currently used to cause expectoration and to clea

respiratory pathways of mucus. The herb can be taken interna

variety of ailments such as asthma, emphysema, laryngitis, br

pharyngitis, sore throats, and croup (Fern 1997–2000, Haugh

Cough lozenges are made by mixing fresh sap from roots wit

or sugar (Miller 1988, Sanders 2002). A homeopathic remedy 

bloodroot has also been used to treat migraines (Fern 1997–2

2001).

Fresh bloodroot sap or an infusion of the root can be applied 

treat warts, benign skin tumors, ulcers, eczema, chilblains, or 

(Fern 1997–2000, Foster and Duke 2000, Grieve 1931). The d

can be sniffed to treat nasal polyps (Fern 1997–2000, Haught

Of particular note is the use of bloodroot to treat skin cancers 

2000, Foster and Duke 2000, Grieve 1931). In the mid-19th ce

London Middlesex Hospital, Dr. J. Weldon Fell experimented 

of bloodroot to treat skin cancers. Although used extensively 

the treatment eventually fell out of use until its revival in the 

minor skin tumors, particularly those in the nose and ears (Sa

From the 1920s up to 1960, Harry Hoxsey operated a medica

with clinics in several States—treating cancer patients with a 
7

y ppp, 

him to shut down his clinics. Hoxsey reopened his clinic in T

where it continues to operate today. Most of the herbs in Hox

such as bloodroot, have been found to have antitumor propert

scientific research. Several biographies and articles have been 

Harry Hoxsey and the conflict between natural homeopathic 

conventional medicine (Center for Alternative Medicine Rese

University of Texas 1999; Phillips 2001; Walters 1993). Rese

currently studying the ability of bloodroot alkaloids to selecti

cancer cells without harming normal cells. Although it has ex

shown antiproliferative potential towards human carcinoma c

vitro studies are not conclusive and more research is needed b

bloodroot is considered for development as a commercial ant

(Ahmad and others 2000).

Dental

Sanguinarine, the medicinally valuable alkaloid found in bloo

purported to have antibacterial and anti-inflammatory proper

the formation of plaque and reduce gingival inflammation an

(Foster and Duke 2000, Miller 1988, Sanders 2002). Researc

that the alkaloid is retained in the mouth for long periods afte

providing longer resistance to plaque and gingival inflammat

1989). Sanguinarine has been used in toothpaste and oral rins

most widely available dental products containing the alkaloid 

a Colgate-Palmolive product originally formulated by Vipont 

ceutical, Inc.

During the 1980s and 1990s, clinical studies on both animals 

debated the safety and effectiveness of dental products contai

sanguinarine (reviewed in Frankos and others 1990, Munro an

Schwartz 1986). Some studies found the sanguinarine regime

significantly effective in controlling plaque, gingival inflamm

bleeding (Hannah and others 1989; Harper and others 1990; K

Roth 1986; Kopczyk and others 1991; Southard and others 19

Tenenbaum and others 1999; Wennstron and Lindhe 1985), w

found no significant difference from toothpastes or oral rinse

contain sanguinarine (Cullinan 1997, Drisko 1998, Mallatt an

Mauriello and Bader 1988, Polson and others 1996). After ye

several sources conceded that the differing results of these stu
8

, )

In the preceding studies, only a few individuals had adverse r

products. The observed negative side effects were either a bur

stinging sensation in the mouth, or a sloughing of the epitheli

(Frankos and others 1990, Kopczyk and others 1991). In 199

experts was hired by Vipont Pharmaceutical, Inc. to thorough

literature and published research on sanguinarine to determin

danger of the products containing the alkaloid. The panel con

appropriate safety research had been completed; none of the 

the level of sanguinarine present in Viadent® products to be o

danger to consumers, even under exaggerated use conditions 

others 1990). In 1999, however, Damm and others (1999) pub

that indicated an association between Viadent® usage and the 

precancerous disease of the mouth known as leukoplakia. Leu

appears as a white patch on the tongue, gums, or inside of the 

cannot be rubbed off, and cannot be diagnosed clinically or

histopathologically as any other condition (Allen and others 2

Leukoplakia lesions are often associated with tobacco use, th

occasionally appear ideopathically. Because most of the prev

sanguinarine concluded after just 6 months, the association o

with long-term use of sanguinarine products had not been ide

and others 1999).

In the following years, several additional studies concluded th

development of oral leukoplakia of the maxillary vestibule w

higher in Viadent® users than in nonusers, and sanguinarine w

from the Viadent® product formula (Allen and others 2001, E

others 2000, Mascarenhas and others 2001, Wagner 2001). R

additional studies concluded that:

• Viadent® users were 10 times more likely to develop lesion

• Risk was highest with use of both toothpaste and oral rinse

use of oral rinse alone, and lowest for users of toothpaste o

• There was a dose-response reaction (increased incidence o

increased duration or intensity of use)

• Risk of developing lesions increased with age
9

evaluation of these lesions has not yet been determined) (A

2001, Eversole and others 2000, Mascarenhas and others 2

2001)

Other Uses

Feed additive—Bloodroot can be used as a botanical deworm

and sheep (Duval 1997). A German company, Phytobiotics G

bloodroot to produce livestock feed that fattens animals natur

the company purchased 40 metric tons of bloodroot from the 

Appalachians, which was less than a third of what they neede

2002). Bloodroot is not grown commercially anywhere in the 

new use of the herb as a feed additive puts added pressure on 

populations. Yellow Creek Botanical Institute in Graham Cou

recently began experimentally cultivating bloodroot under for

help meet this high demand without threatening the sustainab

resources (Clark 2002). Successful cultivation would mean n

opportunities for area landowners.

Pesticide—Previous uses of bloodroot have implied insectici

phototoxic properties for the herb, though the compounds res

these effects were not isolated or studied until recently. Tuves

(1989) found that sanguinarine chloride, when irradiated with 

ultraviolet light in the presence of a catalyst, produces hydrog

The photoionization of sanguinarine also produces hydrated e

which are very reactive towards numerous biological targets s

acids and DNA bases. Tuveson and others (1989) also found 

chloride to be significantly toxic to certain strains of bacteria

cabbage looper larvae (Trichoplusia spp.). Arnason and other

expanded this research to test sanguinarine’s toxicity to mosq

(Aedes atropalpus) at varying concentrations; they found pho

qualities similar to those found by Tuveson and others (1989)

significant mortality of mosquitoes in the larval stage. The ex

mechanisms causing these reactions are still uncertain.

Market Trends

In the early 1990s, the estimated domestic market for bloodro

tons annually, while the estimated world market was 2,000 to
10

; pq

$3.05 per ounce of cut and sifted wildcrafted root; and $0.54 

propagation (Green Canyon, n.d.; Herbal Wise, n.d.; HerbTra

Conservation

Bloodroot is listed as “At-Risk” by the United Plant Savers or

Often collected from the wild and marketed domestically and

internationally, the plants on the “At-Risk” list have experien

due to overcollection or habitat loss. This pressure, combined 

innate sensitivity and rarity of the plants listed, has led to the 

of wild populations in their native ranges (United Plant Saver

Several recent publications have evaluated ecological issues t

the conservation and future proliferation of bloodroot. Fritz a

(1993) studied the ability of several forest species to survive 

row habitats that connect isolated patches of plants. They con

bloodroot could persist in these exposed conditions, but that n

populations are unlikely to become established.

Pudlo and others (1980) studied the dispersal of bloodroot se

areas with varying degrees of disturbance. In highly disturbed 

diversity of ant populations decreased, resulting in a decrease 

dispersal and an increase in asexual reproduction. Without a m

dispersal, the advantages a species such as bloodroot gains th

reproduction and adaptation are lost. In areas colonized by in

(Solenopsis invicta), native ant species have decreased by as m

percent (Porter and Savignano 1990). This decrease of native 

had a strong negative impact on myrmecochorous species suc

Fire ants also collect seeds with elaiosomes, but often damag

while consuming the appendage, or deposit them in areas tha

unfavorable to germination and establishment. As the range o

continues to spread throughout the Southeastern United State

threat of vulnerability to the obligate myrmecochorous blood

and others 2001). Heithaus (1981) showed that with decreasin

native ant species, bloodroot seeds are not as likely to be distr

from the parent plants and are also more susceptible to preda
11

received a lot of attention, with an abundance of literature de

botanical properties. The unique flowers and myrmecochorou

plant have also made bloodroot the subject of numerous ecolo

With a long history of medicinal use, clinical research on the 

effectiveness and safety is readily available. Ongoing research 

applications for bloodroot, particularly in animal feeds or as a 

pesticide, may lead to additional markets for the plant. Conse

caused by habitat loss and decreasing numbers of seed disper

be speculated about, but without more information on the pla

adapt and regenerate after harvest, the projected outlook on s

remains incomplete.

Acknowledgments

This publication was produced in cooperation with Virginia P

Institute and State University (College of Natural Resources, 

Hall, Blacksburg, VA 24060), under Cooperative Agreement 

11330142-522; and the National Park Service (Shenandoah N

Luray, VA 22835), under Cooperative Agreement 02-IA-1133

This research was supported by funds provided by the U.S. D

Agriculture, Forest Service, Southern Research Station, Ashe

The authors express their sincere appreciation to Patricia De A

(Botanist, U.S. Fish and Wildlife Service, Division of Scienti

and Wayne Owen (National Botany and Rare Plant Program L

Department of Agriculture, Forest Service) for their diligence 

in reviewing this document, which helped to ensure its qualit

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Reed, D. 1999–2002. Wildflowers of the Southeastern United States. http://2

[Date accessed: March 10, 2004].
15

alkaloid content in Sanguinaria canadensis. Journal of Chemical Ecology

1729-1747.

Sanders, J. 2002. A bloody early bloomer. http://www.acorn-online.com/hed

[Date accessed: October 8, 2004].

Schwartz, H.G. 1986. Safety profile of sanguinarine and Sanguinaria extra

Supplement. 7: S212-S217.

Sievers, A.F. 1930. The herb hunters guide. Misc. Publ. 77. Washington, DC

of Agriculture. Hypertext version. April 8, 1998. http://www.hort.purdue

herbhunters/bloodroot.html. [Date accessed: May 24, 2004].

Southard, G.L.; Boulware, R.T.; Walborn, D.R. [and others]. 1984. Sangu

anti-plaque agent: retention and plaque specificity. Journal of the Americ

Association. 108(3): 338-341.

Sutherland, Z. 1999. Zen’s WNC nature notebook plant index. http://main.n

naturenotebook/plants/bloodroot.html. [Date accessed: May 24, 2004].

Tenenbaum, H.; Dahan, M.; Soell, M. 1999. Effectiveness of a sanguinarin

scaling and root planing. Journal of Periodontology. 70(3): 307-311.

Tuveson, R.W.; Lawson, R.A.; Marley, K.A. [and others]. 1989. Sanguina

H2

O2-producing alkaloid. Photochemistry and Photobiology. 50(6): 733-7

United Plant Savers. [n.d.]. At risk plants. http://www.plantsavers.org/. [Da

10, 2004].

U.S. Department of Agriculture, Forest Service. 1993. Income opportuniti

products: self-help suggestions for rural enterprises. Agric. Inf. Bull. 666

206 p.

U.S. Department of Agriculture, Natural Resources Conservation Servic

PLANTS database. Version 3.1. Baton Rouge, LA: Plant Data Center. htt

plants.usda.gov/. [Date accessed: March 15, 2004].

Wagner, H. 2001. Dentists see legacy of discontinued ingredients in patients

State University Research. http://www.osu.edu/units/research/archive/via

accessed: March 8, 2004].

Wennstrom J.; Lindhe, J. 1985. Some effects of a sanguinarine-containing 

developing plaque and gingivitis. Journal of Clinical Periodontology. 12(

Winterburn, G.W. 1882–1883. Transactions of the national eclectic medica

Scanned version by M. Moore, 2001–2002. Vol. 10. http://www.ibiblio.or

eclectic/journals/nat-ecl-trans-1882.html. [Date accessed: March 10, 200

Zettler, J.A.; Spira, T.P.; Allen, C.R. 2001. Ant-seed mutualisms: can red im

sour the relationship? Biological Conservation. 101(2001): 249-253.
16

Ahmad, N.; Gupta, S.; Husain, M.M. [and others]. 2000. D

antiproliferative and apoptotic response of sanguinarine fo

versus normal cells. Clinical Cancer Research. 6: 1524-15

Explores the cancer-fighting abilities of sanguinarine in a clin

For both human epidermal carcinoma and normal human epid

keratinocytes, sanguinarine has shown dose-dependent antipr

apoptotic (cell death) potential, without harming normal cells

materials, methods, results, and a discussion are presented.

Keywords: Cancer, medicinal uses, research, sanguinarine.

Allen, C.L.; Loudon, J.; Mascarenhas, A.K. 2001. Sanguin

leukoplakia: epidemiologic and clinicopathologic features 

described entity. General Dentistry. 49(6): 608-614.

Describes the oral mucosa leukoplakias associated with Viad

Leukoplakias are premalignant white patches that cannot be r

diagnosed clinically or histopathologically as any other condi

lesions are usually idiopathic or associated with tobacco use. 

bloodroot extract used in dental products was initially consid

harmless, the mixture of benzophenanthridine alkaloids in th

shown to interact with DNA in vitro, indicating mutagenic po

case study presented in this article shows that Viadent® usage 

risk of developing these lesions by 10 times, with a dose-dep

response. Because the harmful effects of dental products cont

bloodroot have only recently been discovered, the understand

knowledge of treatment is limited.

Keywords: Alkaloids, cancer, case studies, oral leukoplakia, r

Viadent®.

Arnason, J.T.; Guerin, B.; Kraml, M.M. [and others]. 199

and photochemical properties of sanguinarine. Photochem

Photobiology. 55(1): 35-38.

Examines the photochemical properties of sanguinarine. Sang

phototoxic to mosquito larvae in the presence of near-ultravio

concentrations as low as 0.05 parts per million (ppm). This to
17

p

Keywords: Pesticide use, phototoxicity, research, sanguinarin

Beattie, A.; Culver, D.C. 1982. Inhumation: how ants and ot

invertebrates help seeds. Nature. 297(5868): 627.

Describes the mutual benefits of inhumation, where ants and 

invertebrates disperse seeds of certain plants and aid in germ

example of this is myrmecochory—where ants collect seeds, 

their nest to consume the nutritious appendage called an elaio

discard the viable seeds in old chambers that are perfect for g

Ants benefit from the nutritious elaiosome, and seeds benefit 

dispersal and nutritious soil for germination. When ants are a

bloodroot can propagate vegetatively by the rhizome; howeve

populations benefit from increased density and seed dispersio

presence of ants. Seeds that are relocated to ant nests are also 

from predators.

Keywords: Ants, elaiosome, myrmecochory, seed dispersal.

Bennett, B.C.; Bell, C.R.; Boulware, R.T. 1990. Geographic 

alkaloid content of Sanguinaria canadensis (Papaveraceae

92(870): 57-69.

Compares the alkaloid content of bloodroot plants in various 

Populations in the Southern Appalachians had higher alkaloid 

populations found north of West Virginia and Pennsylvania. T

found in the North Carolina Coastal Plain had lower alkaloid 

those in the western part of the State. Ecological conditions w

correlation to alkaloid content included soil clay content, soil 

slope, and leaf litter depth. The highest alkaloid concentration

in populations growing in mature, undisturbed deciduous fore

mountain-like habitats. Other related factors include light, pH

soil chemistry, temperature, altitude, successional status, geo

location, plant tissue, tissue age, cell age, and herbivory. A co

between the weight and volume of rhizomes and sanguinarine 

accumulation of the alkaloid over time. Leaf size was not cor

alkaloid content. The concentration of alkaloids in the rhizom

early spring, and gradually decreases throughout the summer
18

g g

conjunction with initial periodontal therapy. Australian De

42(1): 47-51.

Investigates the effectiveness of a toothpaste and oral rinse th

bloodroot extract for reducing gingival inflammation in patie

periodontal disease. A randomized, double-blind study divide

into 2 groups: 1 group used toothpaste and rinse with bloodro

chloride, while the other group used a placebo toothpaste and 

were examined for gingival index, plaque index, and probing 

(bleeding upon probing) at the time of initial therapy, then 2 a

later. Although the results showed significant improvement fo

after the initial therapy, there was no significant difference be

treatment with the bloodroot extract and the placebo.

Keywords: Clinical studies, dental uses.

Damm, D.D.; Curran, A.; White, D.K.; Drummond, J.F. 1

Leukoplakia of the maxillary vestibule – an association wi

Oral and Maxillofacial Pathology. 87(1): 61-66.

Uses dental case studies to identify an association between re

use and a type of oral precancer known as leukoplakia. A rev

patients with leukoplakia of the maxillary vestibule showed t

percent were regular users of Viadent®; only 3 percent used o

products. The lesions were confined to a specific area in the a

mouth that is not adjacent to any major salivary gland ducts. 

this section of the mouth remain more concentrated and are l

diluted by saliva. The appearance and characteristics of the le

lesions are specific, and are described. Previous research on t

bloodroot in dental products generally concluded at 6 months

sufficient time to observe negative effects.

Keywords: Case studies, dental uses, leukoplakia, research, V

Drisko, C.H. 1998. The use of locally delivered doxycycline 

treatment of periodontitis. Clinical results. Journal of Clin

Periodontology. 25(11, pt 2): 947-952.

Compares the effectiveness of locally delivered doxycycline t

chloride, scaling and root planing, and a vehicle control for th
19

g gp

Keywords: Clinical studies, dental uses.

Duval, J. 1997. The control of internal parasites in cattle and 

Agric. Proj. Publ. - 70. http://www.eap.mcgill.ca/general/

home_frames.htm. [Date accessed: March 8, 2004].

Lists bloodroot as a plant with deworming properties when in

cattle or sheep.

Keywords: Animal feed additive, dewormer.

Dzink, J.L.; Socransky, S.S. 1985. Comparative in vitro acti

sanguinarine against oral microbial isolates. Antimicrobial 

Chemotherapy. 27(4): 663-665.

Shows that dental products with sanguinarine effectively decr

formation of plaque, and are held in the mouth in high conce

several hours after use. Methods of action are discussed in de

Keywords: Clinical studies, dental uses, sanguinarine.

Eversole, L.R.; Eversole, G.M.; Kopick, J. 2000. Sanguina

oral leukoplakia. Oral Surgery, Oral Medicine, Oral Pathol

Radiology and Endodontics. 89: 455-464.

Characterizes the maxillary gingival leukoplakia lesions asso

use of dental products containing bloodroot. Biomarkers and 

were compared and contrasted for leukoplakias and other for

and premalignant oral cancers believed to be caused by denta

containing sanguinarine. The analysis and findings are descri

The lesions associated with dental products containing blood

the anterior maxillary gingiva/mucobuccal fold region, which 

pouched during forced rinsing. This area is not a common sit

forms of leukoplakia. The lesions do not show evidence of se

nor have any cases of carcinoma been reported; therefore, the 

squamous cell cancer is unknown.

Keywords: Clinical studies, dental uses, leukoplakia.
20

p, g y

evaluation of alkaloid content in bloodroot rhizomes. The aut

that the flowering period, when the alkaloid concentration is h

best time to collect roots.

Keywords: Alkaloids, harvest, research.

Frankos, V.H.; Brusick, D.J.; Johnson, E.M. [and others]. 

Sanguinaria extract as used in commercial toothpaste and 

products. Journal of the Canadian Dental Association. 56(7

Presents the results of an evaluation of clinical safety studies 

dental products containing sanguinarine. The expert panel co

evaluation concluded that data from previous research suffici

demonstrated the safety and effectiveness of these products. T

concluded that the clinical study findings of adverse effects s

reproductive, cardiovascular, or ocular toxicity or carcinogen

unfounded, anecdotal, not sufficiently corroborated, nor cons

to substantiate concern. Provides a thorough review of resear

and discussion.

Keywords: Adverse reactions, clinical studies, dental uses, re

toxicity, Viadent®.

Fritz, R.; Merriam, G. 1993. Fencerow habitats for plants m

farmland forests. Biological Conservation. 64(2): 141-148

Tests the ability of several woodland herbs to survive and pro

fencerow habitats. Fragmentation of forested areas has decrea

and increased isolation of many plant species. The ability of a 

to survive in a fencerow, riparian strip, hedgerow, or roadside 

determines the genetic and demographic flow and links to oth

populations. In order for plants to survive as a population, the

the environment suitable to grow and reproduce repeatedly in 

over a period of years. Plants must be able to thrive under inc

exposure to light and wind, with increased temperatures and d

humidity. The studies found that although bloodroot could su

conditions, plant populations were ephemeral and unlikely to 

themselves in numbers suitable for incremental movement.

Keywords: Ecology, habitat, research.
21

ppg, 

effectiveness in reducing plaque and gingivitis when used in 

products. Sanguinarine is antibacterial for both gram-positive 

negative bacteria, antifungal against Candida and dermatophy

antiprotozoal against Trichomonas, and anti-inflammatory. C

research has shown that sanguinarine is not absorbed orally, d

mucosal irritation or sensitization in exaggerated doses, and d

mutagenicity in vitro or in vivo. Sanguinarine is effective in p

adhesion of plaque to the salivary pellicle covering the tooth, 

contained in the mouth in effective concentrations for long pe

A table of clinical studies on dental products containing sang

included. It is concluded that the combined use of dentifrice a

containing sanguinarine significantly reduces plaque, gingivi

bleeding indexes. Mechanisms of action are discussed.

Keywords: Clinical studies, dental uses, research reviews, san

Hakim, S.A.E. 1968. Sanguinarine, a carcinogenic contamin

edible oils. Indian Journal of Cancer. 10: 183-197.

Describes cases of food poisoning in India caused by adultera

oils with seeds from the weed argemone (Argemone mexican

contains the alkaloid sanguinarine. Adulteration of oils with a

associated with high incidence of dropsy, heart disease, abort

glaucoma, diarrhea, and death. This publication describes epi

by argemone food poisoning, the alkaloid sanguinarine which 

poisoning, clinical animal studies demonstrating the detrimen

sanguinarine, the metabolism of sanguinarine into carcinogen

the causes and hazards of adulteration of edible oils, and canc

been attributed to consumption of related substances through

Keywords: Cancer, research, sanguinarine.

Hannah, J.J.; Johnson, J.D.; Kuftinec, M.M. 1989. Long-t

evaluation of toothpaste and oral rinse containing Sanguin

controlling plaque, gingival inflammation, and sulcular ble

orthodontic treatment. American Journal of Orthodontics a

Orthopedics. 96: 199-207.
22

gpg p

receiving products with the same base formula, but without b

Results showed that the bloodroot products were significantly 

placebos at reducing plaque, gingival inflammation, and sulc

Keywords: Clinical studies, dental uses, Viadent®.

Harkrader, R.J.; Reinhart, P.C.; Rogers, J.A. [and others]

history, chemistry, and pharmokinetics of Sanguinaria extr

the Canadian Dental Association. 56(7): 7-12.

Presents the sources, historical uses, chemical analysis, bioch

pharmokinetics of benzophenanthridine and related alkaloids 

bloodroot extract, particularly as they are used in dental prod

products and manufacturers is included.

Keywords: Alkaloids, dental uses, history, products.

Harper, D.S.; Mueller, L.J.; Fine, J.B. [and others]. 1990. 

months use of a dentifrice and oral rinse containing Sangu

and zinc chloride upon the microflora of the dental plaque 

tissues. Journal of Periodontology. 61(6): 359-363.

Supports previous research findings that dental products cont

Sanguinaria extract are clinically effective at reducing plaque 

Sixty gingivitis patients were divided into 2 groups—with 30 

treatment (Viadent® products) and 30 receiving comparable p

products in a randomized, double-blind, parallel-design study

month trial period, participants receiving the Viadent® treatm

significant reduction in plaque accumulation, gingivitis, and 

individuals in the placebo group dropped out of the study due 

conflicts, two individuals in the active group dropped out bec

didn’t like the taste of the products, and one individual in the 

dropped out due to an intra-oral condition not related to the s

adverse side effects were reported.

Keywords: Clinical studies, dental uses.

Heithaus, E.R. 1981. Seed predation by rodents on three ant

plants. Ecology. 62(1): 136-145.
23

pgg pj

areas with fewer ant populations, loss of seeds to rodents was 

This decreases local genetic variability, and plant sexual repr

efforts are wasted.

Keywords: Ecology, research, seeds.

Judd, W.W. 1977. Insects associated with flowering bloodroo

canadensis L., at Fanshawe Lake, Ontario [pollinators]. En

News. 88(1/2): 13-17.

Observes pollinators of bloodroot at Fanshawe Lake in Ontar

Insects in Hemiptera, Coleoptera, and Hymenoptera were col

most dominant pollinators were bees in the Andrenidae, Halli

Apidae.

Keywords: Pollinators, research.

Karlowsky, J.A. 1991. Bloodroot: Sanguinaria canadensis L

Pharmaceutical Journal. 124: 260, 262-263.

Provides details on the harvest and drying of bloodroot, chem

constituents and their physiological actions, historical and pre

products and dosage, dental uses, side effects, and toxicity. R

clinical research are included.

Keywords: Alkaloids, chemical constituents, medicinal action

reviews, toxicity.

Keller, K.A.; Meyer, D.L. 1989. Reproductive and developm

toxicology evaluation of Sanguinaria extract. The Journal 

Dentistry. 1(3): 59-66.

Evaluates the toxicity of bloodroot extracts in rats and rabbits

were observed on fertility, reproduction, or fetal development

Keyword: Toxicity.

Klewanski, P.; Roth, D. 1986. Sanguinaria in the control of 

periodontal patients. Compendium, Supplement. 7: S218-S
24

gpqg

Keywords: Clinical studies, dental uses.

Kopczyk, R.A.; Abrams, H.; Brown, A.T. [and others]. 199

microbiological effects of a Sanguinaria-containing mouth 

dentifrice with and without fluoride during 6 months of us

Periodontology. 62: 617-622.

Uses American Dental Association guidelines to test the safet

of dental products containing bloodroot. The study involved 1

a 6-month, double-blind, placebo controlled, parallel investig

containing bloodroot and zinc chloride produced significant r

less plaque, gingival inflammation, and bleeding. The group u

with bloodroot, zinc chloride, and fluoride showed slightly be

than the group using products with bloodroot and zinc chlorid

subject experienced a burning sensation when using the prod

excluded from the study—about 1 percent of the population h

reactions to constituents in dental products. It was concluded 

dentifrice and rinse containing bloodroot is safe and significa

effective than placebos.

Keywords: Adverse reactions, clinical studies, dental uses.

Kuftinec, M.M.; Mueller-Joseph, L.J.; Kopczyk, R.A. 199

toothpaste and oral rinse regimen: clinical efficacy in shor

term trials. Journal of the Canadian Dental Association. 56

Evaluates previous studies on the effectiveness of dental prod

containing bloodroot. Both positive and negative results have 

from short- and long-term studies. Research that combined b

and rinse containing bloodroot for a period of 6 months consi

positive results for reducing plaque, gingival inflammation, a

Of the 260 subjects tested, no adverse hard tissue effects were 

Only one negative soft tissue effect was observed, and was re

discontinuation of use.

Keywords: Adverse reactions, clinical studies, dental uses, re
25

Reviews previous studies on the effectiveness of dental produ

sanguinarine in preventing plaque, gingival inflammation, an

Inconsistencies and varying methods have produced conflicti

However, all studies that combine the dentifrice with oral rins

instead of crossover designs, select appropriate subjects, use 

numbers of subjects to increase statistical power, use proper s

evaluation, and ensure intrarater or interrater reliability prior 

the research consistently show significant results. Guidelines 

clinical testing are included. Numerous studies are summariz

critiqued.

Keywords: Clinical studies, dental uses, research reviews, san

Lehmann, N.L.; Sattler, R. 1993. Homeosis in floral develo

Sanguinaria canadensis and S. canadensis “Multiplex” (P

American Journal of Botany. 80(11): 1323-1335.

Describes the evolutionary process of homeosis and the varia

result in bloodroot flowers. Other members of the Papaverace

family have four petals, whereas bloodroot has eight. The fou

petals, which are morphologically distinct from the first four 

where the first four stamens are positioned in other members 

family; it is thus concluded that the additional petals in blood

homeotic. Homeosis is the process where one plant structure 

completely or partially replaces another. It is believed that the 

cultivar “Multiplex,” which has numerous additional petals, a

this characteristic.

Keywords: Cultivars, flowers, homeosis, Papaveraceae family

Lyon, D.L. 1992. Bee pollination of facultatively xenogamou

canadensis L. Bulletin of the Torrey Botanical Club. 119(4

Observes conditions for bee pollination and self-pollination o

bloodroot flowers are not successfully pollinated by insects, t

of self-pollinating after a period of 3 days. During the first 2 

blooming, flowers are protogynous, with a female phase. At t

stigmas are receptive to pollination, but the stamens are posit

the petals to avoid contact with the stigmas both when the flo
26

pyg p

abdomen, enabling effective pollination. Pollinator activity is 

upon weather. Flowering is also dependent upon sunlight and 

with blooms opening earlier and staying open later on warm 

days. Bloodroot is one of the earliest spring blooms; facultati

pollination is an adaptive process that enables flowers to set f

insect pollinators are absent due to cold temperatures or rain.

Keywords: Flowers, pollination, pollinators.

Mallatt, M.E.; Beiswanger, B.B.; Drook, C.A. [and others]

Clinical effect of a Sanguinaria dentifrice on plaque and g

adults. Journal of Periodontology. 60(2): 91-95.

Describes a clinical trial to compare a bloodroot extract-zinc 

dentifrice, a sodium fluoride dentifrice, and a sodium fluorid

reducing plaque and gingival inflammation. After 21 days all 

returned to a twice-daily brushing and flossing regimen. Post

evaluations after 2 weeks showed significant improvement fo

using dentifrice compared to the rinse, but no significant diff

between the two dentifrices.

Keywords: Clinical studies, dental uses.

Marino, P.C.; Eisenberg, R.M.; Cornell, H.V. 1997. Influen

and soil nutrients on clonal growth and sexual reproductio

understory perennial herb Sanguinaria canadensis L. Jour

Torrey Botanical Society. 124(3): 219-227.

Examines the differences in leaf size, seedpod size, and clona

bloodroot plants in high and low light, and with or without ad

nutrients. At the completion of the study, plants that received 

high-light areas had fewer small leaves and more large leaves 

unfertilized plants. Fertilization did not affect leaf size on pla

areas. Fertilized plants in both high- and low-light areas had m

plant than the unfertilized plants; but both fertilized and unfe

in high-light areas had more leaves than all plants in the low-

Increased fertilization in low light had no effect or a detrimen

plants. Increased light and nutrient levels resulted in plants w

abundant and larger leaves. Plants responded more positively 
27

g ggp

vegetative production following increased light levels indicat

disturbances in the forest canopy from fallen trees can result 

colonies of plants.

Keywords: Ecology, fertilization, research, seeds, soil, sun re

Mascarenhas, A.K.; Allen, C.M.; Loudon, J. 2001. The ass

between Viadent® use and oral leukoplakia. Epidemiology. 

741-743.

Investigates the association between Viadent® use and the dev

oral leukoplakia lesions in a case-controlled study. A question

given to 148 cases and controls. Results of logistic analysis sh

patients who used Viadent® products were 8 to 11 times more 

develop lesions than nonusers. Risk increased with age, and w

and duration of use. Individuals using both the paste and rins

likely to develop lesions, followed by users of the rinse only, 

users of the paste only. Other variables investigated that did n

correlation included gender, use of a dental prosthesis, alcoho

tobacco use.

Keywords: Leukoplakia, research, Viadent®.

Mauriello, S.M.; Bader, J.D. 1988. Six-month effects of a sa

dentifrice on plaque and gingivitis. Journal of Periodontolo

238-243.

Compares the effectiveness of a sanguinarine dentifrice to a p

double-blind clinical trial of 6 months duration. Statistical an

no significant differences between the two groups.

Keywords: Clinical studies, dental uses, sanguinarine.

Morales, M.A.; Heithaus, E.R. 1998. Food from seed-dispe

shifts sex ratios in colonies of the ant Aphaenogaster rudis

79(2): 734-739.

Investigates the benefits of myrmecochory for ant population

seeds that have an elaiosome, or nutritious appendage. The se

back to the nests where larvae consume the appendage. The r
28

py , g; 

a fertile site for germination. Ants benefit from the nutritious 

but other ecological benefits have not been previously studied

Aphaenogaster rudis ants were fed bloodroot seeds, and ant p

dynamics recorded. Ant colony fitness is measured by the nu

reproductives, or gynes. Gynes are winged ants that are capab

becoming queens after mating. Colonies that received bloodr

produced significantly more gynes than control colonies. The 

workers and males, and queen size were comparable for both 

increased production of reproductive ants shows that myrmec

true mutualism.

Keywords: Ecology, elaiosome, myrmecochory, seeds.

Munro, I.C.; Delzell, E.S.; Nestmann, E.R.; Lynch, B.S. 19

usage and oral leukoplakia: a spurious association. Regula

Toxicology and Pharmacology. 30: 182-196.

Responds to the initial study by Damm and others (1999) sug

association between Viadent® use and oral lesions. Weakness

study include lack of proof that Viadent® use preceded the on

leukoplakia lesions, no dose response or biological plausibili

selective information bias. Numerous studies demonstrating t

dental products containing bloodroot are summarized and cri

Keywords: Leukoplakia, research reviews, Viadent®.

Nikiforuk, G. 1990. The Sanguinaria story – an update and n

perspectives. Journal of the Canadian Dental Association. 

Summarizes research on the safety and effectiveness of blood

Keywords: Research reviews, safety.

Polson, A.M.; Stoller, N.H.; Hanes, P.J. [and others]. 1996. 

center trials assessing the clinical efficacy of 5% sanguina

biodegradable drug delivery system. Journal of Clinical Pe

23(8): 782-788.
29

gpq

after 90 days. Scaling and root planing was the most effective 

all study parameters. Results from the sanguinarine treatment

plaque control, and vehicle control varied. Analysis showed t

sanguinarine used in the study was not potent enough to prov

results.

Keywords: Clinical studies, dental uses, sanguinarine.

Porter, S.D.; Savignano, D.A. 1990. Invasion of polygyne fir

decimates native ants and disrupts arthropod community. E

2095-2106.

Discusses changes in the abundance and diversity of ants and 

arthropods caused by the invasion of polygyne fire ants (Sole

in Texas. In areas where the invasive ants had colonized, nativ

decreased by 90 percent and total species richness declined b

The total number of ants in infested sites increased 10 to 30 t

percent of the ants being the invasive species. Several factors 

the ability of invasive ants to displace native species: (1) poly

colonies produce multiple reproductive queens, enabling them 

large communities that can outcompete native species; (2) the 

of fire ant workers is smaller than native ants, allowing for la

be supported by the same energy base; (3) fire ants may utiliz

food sources; and (4) invasive ants have fewer pathogens and 

compared to native species. Data from this study indicates th

polygyne fire ants are a significant threat to natural biodivers

where they have colonized.

Keywords: Ants, myrmecochory.

Pudlo, R.J.; Beattie, A.J.; Culver, D.C. 1980. Population co

changes in an ant-seed mutualism in Sanguinaria canaden

146: 32-37.

Compares ant-seed mutualisms for three populations of blood

different habitats with varying degrees of disturbance. High l

disturbance decreased the number and variety of ant colonies

undisturbed habitat, bloodroot seeds were removed more freq

distributed greater distances. Plant populations showed few c
30

ggp

removal rates by ants were low. The site with some disturbanc

intermediate results. This study shows that habitat disturbanc

number of ant populations, and in turn has direct consequenc

Bloodroot is capable of propagating asexually through the rhi

without ants to disperse seeds, the benefits of sexual propaga

Keywords: Ecology, habitat, myrmecochory, research, seeds.

Rho, D.; Chauret, N.; Archambault, J. 1992. Growth chara

Sanguinaria canadensis L. cell suspensions and immobiliz

production of benzophenanthridine alkaloids. Applied Mic

Biotechnology. 36: 611-617.

Describes tissue culture of bloodroot.

Keywords: Propagation, tissue culture.

Robbins, C. 1999. Medicine from U.S. wildlands: an assessm

plant species harvested in the United States for medicinal u

and evaluation of the conservation and management implic

Prepared by TRAFFIC North America for the Nature Cons

www.nps.gov/plants/medicinal/pubs/traffic.htm. [Date acc

8, 2004].

Summarizes conservation issues and concerns. In 1995, 35 p

bloodroot collection were sold in the Hoosier National Forest 

1996, 105 permits were sold in the Hoosier National Forest, 6

National Forest (Ohio), and 1 in the Daniel Boone National F

(Kentucky); and in 1997, 97 permits were sold in the Hoosier 

Forest, 57 in the Wayne National Forest, and 1 in the Daniel B

Forest.

Keywords: Conservation, harvest, permits.

Rockwood, L.L.; Lobstein, M.B. 1994. The effects of exper

defoliation on reproduction in four species of herbaceous p

northern Virginia. Castanea. 59(1): 41-50.
31

g yy, g

caused 100 percent defoliation and greatly reduced plant repr

Keywords: Defoliation, research.

Salmore, A.K.; Hunter, M.D. 2001a. Elevational trends in d

chemistry, vegetation, and reproduction in Sanguinaria ca

Journal of Chemical Ecology. 27(9): 1713-1728.

Evaluates the variability in alkaloid content, reproduction, an

growth of bloodroot as related to environmental conditions.

Benzophenanthridine concentrations decreased with increasin

whereas protopine, sanguinarine, and chelerythrine concentra

unchanged. Water content of roots also declined with increas

which may affect nutrient absorption. Alkaloid content either 

remained the same with increasing vegetative or reproductive 

lowest alkaloid concentrations were observed at the time of s

Sanguinarine levels increased with seed and elaiosome size a

weight. All alkaloids increased with root size. Hypotheses an

mechanisms are discussed.

Keywords: Alkaloids, ecology, research, sanguinarine.

Salmore, A.K.; Hunter, M.D. 2001b. Environmental and gen

influences on isoquinoline alkaloid content in Sanguinaria 

Journal of Chemical Ecology. 27(9): 1729-1747.

Evaluates environmental influences on alkaloid levels in bloo

and fertilizer levels increase, alkaloid levels decrease.

Keywords: Alkaloids, fertilization, research, sun requirement

Schwartz, H.G. 1986. Safety profile of sanguinarine and San

extract. Compendium, Supplement. 7: S212-S217.

Evaluates the safety of bloodroot extract, sanguinarine, and d

containing them, in accordance with the U.S. Food and Drug 

guidelines for toxicological testing. Several safety studies on 

summarized. Results show that a human would have to consu

amount of the dental products to experience toxicity. Even wi
32

gp

Keywords: Dental uses, research reviews, sanguinarine, toxic

Southard, G.L.; Boulware, R.T.; Walborn, D.R. [and other

Sanguinarine, a new antiplaque agent: retention and plaqu

Journal of the American Dental Association. 108(3): 338-3

Discusses the antiplaque effects of bloodroot and retention of 

compounds in plaque and saliva after use. Bloodroot was iden

possible dental use because it contains alkaloids similar to th

Fagara zanthoxyloides, a species used for tooth-cleaning stick

Methods of analysis are described in detail. Results show tha

both a preventive and therapeutic effect on plaque. Bloodroot 

the mouth at high levels for several hours after rinsing, extend

fighting abilities.

Keywords: Clinical studies, dental uses, sanguinarine.

Southard, G.L.; Parsons, L.G.; Thomas, L.G. [and others]

of Sanguinaria extract on development of plaque and ging

supragingivally delivered as a manual rinse or under pressu

irrigator. Journal of Clinical Periodontology. 14(7): 377-38

Compares the effects of a sanguinarine oral rinse and supragi

irrigation to a placebo rinse and supragingival irrigation. The 

designed as a repeated measure, single-blind crossover, wher

utilized either the active or placebo rinse or supragingival irri

brushing for 2 weeks. Results showed no significant differenc

oral rinse and supragingival irrigation method of application, 

products containing sanguinarine showed significantly greate

control plaque and gingivitis compared to placebos.

Keywords: Clinical studies, dental uses.

Tenenbaum, H.; Dahan, M.; Soell, M. 1999. Effectiveness o

sanguinarine regimen after scaling and root planing. Journ

Periodontology. 70(3): 307-311.

Describes a study on the effectiveness of sanguinarine in a fo

treatment for adults with periodontitis. Sixty patients received 
33

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concluded that sanguinarine optimized the effectiveness of ch

without side effects.

Keywords: Clinical studies, dental uses, sanguinarine.

Tin-Wa, M.; Farnsworth, N.R.; Fong, H.H.S.; Trojanek, J. 

Biological and phytochemical evaluation of plants. VIII: Is

new alkaloid from Sanguinaria canadensis. Lloydia. 33(2)

Identifies a new alkaloid in bloodroot rhizomes.

Keyword: Alkaloids.

Tuveson, R.W.; Lawson, R.A.; Marley, K.A. [and others]. 

Sanguinarine, a phototoxic H2

O2-producing alkaloid. Phot

Photobiology. 50(6): 733-738.

Investigates the phototoxicity of sanguinarine chloride. In the 

near-ultraviolet light, sanguinarine chloride produced hydrog

(H2O2). Sanguinarine chloride was phototoxic to catalase-def

Escherichia coli, but not to Trichoplusia ni, a cabbage looper 

which maintains a high level of catalase activity.

Keywords: Pesticide use, phototoxicity, research, sanguinarin

Walker, C. 1990. Effects of sanguinarine and Sanguinaria ex

microbiota associated with the oral cavity. Journal of the C

Dental Association. 56(7): 13-18.

Summarizes clinical studies on the safety and effectiveness o

dental products.

Keywords: Clinical studies, dental uses, research reviews, san

Wennstrom, J.; Lindhe, J. 1985. Some effects of a sanguina

mouth rinse on developing plaque and gingivitis. Journal o

Periodontology. 12(10): 867-872.

Assesses the effectiveness of a sanguinarine mouth rinse in re

and gingivitis. The study was set up as a blind crossover with 
34

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placebo were switched to the active compound and vice versa

showed that the sanguinarine mouth rinse was significantly e

reducing plaque and development of gingivitis.

Keywords: Clinical studies, dental uses, sanguinarine.

Zettler, J.A.; Spira, T.P.; Allen, C.R. 2001. Ant-seed mutual

imported fire ants sour the relationship? Biological Conser

101(2001): 249-253.

Discusses the impact that red imported fire ants (Solenopsis i

natural ant-seed mutualisms. Bloodroot is one of an estimated 

species that benefit from ant mutualism. The specific benefit

plants are summarized. The red imported fire ant established 

United States in the 1930s, and has continued to spread throu

Southeastern States. After fire ants become established, nativ

richness decreases by as much as 70 percent; this decrease in 

beneficial ants disrupts the dispersal of seeds. Red imported 

also damage elaiosome-bearing seeds making them nonviable

them in areas that are not fit for germination. These issues an

conservation implications are discussed in detail.

Keywords: Conservation, myrmecochory.

Popular Press

The following articles and websites have not been peer review

included to indicate popular views and perceptions.

Baldia, C.M. 2002. The cultural significance of bloodroot (S

canadensis). Ancient Textiles. http://home.columbus.rr.com

ancienttextiles/sanguinariacanadensis.htm. [Date accessed

2004].

Highlights general information on bloodroot, with a focus on 

herb as a dye for fabrics. Definitions for Sanguinaria canade

dictionaries and encyclopedias are offered, along with a brief 

ecological description. The alkaloids in bloodroot are related 

can be poisonous. Bloodroot is not grown commercially, so a
35

y, y, 

Center for Alternative Medicine Research, University of T

Hoxsey. The University of Texas-MD Anderson Cancer Ce

www.mdanderson.org/departments/CIMER/display.cfm?id

F06A-11D4-810200508B603A14&method=displayFull&p

 -EBD9-11D4-810100508B603A14. [Date accessed: May 1

Examines the cancer-fighting effects of a formula used by Ha

the early and mid-1900s. The American Medical Association 

Food and Drug Administration forced Hoxsey to close his cli

and prevented him from treating patients in the United States

his nurse, Mildred Nelson, reopened the clinic in Mexico in 1

continue to treat patients there. Two studies are cited—a study 

clinic’s pamphlet describing best-case scenarios, and a follow

no controls that observed patients from the clinic after treatm

used in the formula are identified and their cancer-fighting ca

discussed.

Keywords: Cancer, Harry Hoxsey.

Clark, P. 2002. Scientists hope bloodroot plant could be new 

farmers. Asheville Citizen-Times. May 19. http://www.gol

n20020519.html. [Date accessed: March 8, 2004].

Describes the cultivation of bloodroot at the Yellow Creek Bo

Institute located in Graham County, NC, and summarizes the 

market for roots both domestically and internationally. One G

company, Phytobiotics GmbH, uses 120 to 150 metric tons of 

year, adding the herb to animal feeds as an alternative to synt

antibiotics. Bloodroot is not currently cultivated on any scale

wildcrafted. Research on the cultivation of various medicinal 

Yellow Creek Botanical Institute is presented.

Keywords: Animal feed additive, cultivation, market, Phytobi

Yellow Creek Botanical Institute.

Hendershot, D. 2002. The naturalist’s corner. Smoky Mounta

3. http://www.smokymountainnews.com/issues/09_04/09_

out_naturalist.html. [Date accessed: October 8, 2004].
36

ppppp,p

Ants are attracted to an appendage on the seed called an elaio

insects carry the seeds back to their nests, depositing them in 

where they can germinate and grow. Bloodroot can also repro

vegetatively by the rhizome. Native Americans used the rhizo

various medicinal purposes and as a dye. Colonists who prac

doctrine of signatures (the belief that herbs contained signs to 

uses) used bloodroot to treat illnesses associated with blood, 

hemorrhages, and wounds. The medicinal properties of the pl

attributed to the alkaloids sanguinarine, chelerythrine, and pr

alkaloids can be toxic, and high doses may be fatal. The main 

use for bloodroot in the 1980s and 1990s was as an additive t

and mouth rinses, particularly Viadent®. When research ident

between Viadent® and oral precancerous lesions in 1999, sang

removed from the Viadent® formula. Several other brands of 

containing bloodroot have since reentered the market.

Keywords: Alkaloids, dental uses, dye uses, flowers, medicin

American uses, pollination, toxicity, Viadent®.

Phillips, G. 2001. The cancer racket. http://cancerinform.org

[Date accessed: October 8, 2004].

Offers a brief biography of Harry Hoxsey and the story of his 

remedy, which was banned in the United States in the 1960s. 

one of the many plants used in the formula.

Keywords: Cancer, Harry Hoxsey, medicinal uses.

Sanders, J. 2002. A bloody early bloomer. http://www.acorn-

hedge/blood.htm. [Date accessed: October 8, 2004].

Provides general information on bloodroot from a naturalist. 

one of the earliest plants to emerge in the spring, with a singl

protected by a small leaf. A member of the poppy family (Pap

Sanguinaria canadensis is the only plant of this genus. The c

bloodroot, comes from the dark-red color of the sap, which w

anything it touches. The sap was used by Native Americans a

common names include coonroot, snakebite (due to poisonou

characteristics), sweet-slumber (medicinally used to induce sl
37

p

treatment fell out of use for a period, but was revived in the 1

cancers and polyps. Bloodroot sap was mixed with maple sug

sore throats. It was used to treat influenza, whooping cough, 

catarrh, menstrual problems, and as an additive in toothpaste

rinses. The plant is poisonous and can cause skin irritation or 

ingested in large quantities. Plants can be propagated from se

contain no nectar, but are pollinated by bees and other insects

Keywords: Cancer, common names, dye uses, medicinal uses

family, toxicity.

Sutherland, Z. 1999. Zen’s WNC nature notebook plant inde

main.nc.us/naturenotebook/plants/bloodroot.html. [Date ac

24, 2004].

Provides a general overview of bloodroot. Includes botanical 

descriptions, and medicinal applications. Bloodroot is mainly 

streams with other early spring flowers, and is an indicator fo

basswood (Betula spp., Acer spp., and Tilia americana) hardw

The plant is poisonous, with overdose symptoms such as inte

burning stomach, vomiting, faintness, vertigo, prostration, an

Keywords: Habitat, medicinal uses, toxicity.

Wagner, H. 2001. Dentists see legacy of discontinued ingred

patients’ mouths. Ohio State University research. http://ww

units/research/archive/viadent.htm. [Date accessed: March 

Summarizes the results of studies on the association between 

lesions known as leukoplakias and the use of Viadent® dental 

containing bloodroot. Viadent® has since changed its formula 

contains bloodroot; however, some patients have either develo

had existing lesions persist even after discontinued use.

Keywords: Leukoplakia, research reviews.

Walters, R. 1993. Options: the alternative cancer therapy boo

Park, NY: Avery Publishing Group. 396 p.
38

yg, y 

supported by branches in 17 States. Hoxsey did not have a m

however, and pressure from the American Medical Associatio

Food and Drug Administration forced him to close his clinics

his clinic in Mexico with the help of one of his nurses, who c

direct the clinic after his death.

Keywords: Cancer, Harry Hoxsey, medicinal uses.

Other Information Sources

The following are general materials that provide background 

information. Included are encyclopedias, fact sheets, historic

planting guides, herbal manuals, and other miscellaneous info

Britton, N.L.; Brown, A. 1913. An illustrated flora of the No

States, Canada, and the British Possessions. In: U.S. Depar

Agriculture, Natural Resources Conservation Service. 200

PLANTS database. Version 3.1. National Plant Data Cente

Rouge, LA. Vol. 2. http://plants.usda.gov. [Date accessed: M

2004].

[No abstract].

Keywords: Botanical description.

Cook, W. 1869. The physiomedical dispensatory. Scanned ve

Medical Herbalism, 2001. http://www.ibiblio.org/herbmed

SANGUINARIA_CANADENSIS.htm. [Date accessed: M

Summarizes historical information on the medicinal uses of b

brief botanical description is provided. Roots are used medici

upon the mucus membranes, gall ducts, and secreting organs

are summarized, with detailed instructions for various prepar

Keywords: History, medicinal uses, preparations.

Ellingwood, F. 1919. The American materia medica, therapeu

pharmacognosy. Scanned version by M. Moore, 2001–200

www.ibiblio.org/herbmed/eclectic/ellingwood/sanguinaria

accessed: May 24, 2004].
39

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catarrh, lupus, and more.

Keywords: History, medicinal uses.

Felter, H.W. 1922. The eclectic materia medica, pharmacolog

therapeutics. Scanned version by M. Moore, 2001–2002. h

www.ibiblio.org/herbmed/eclectic/felter/sanguinaria.html. 

accessed: May 24, 2004].

Provides historical information on the medicinal use of blood

constituents include chelerythrine, sanguinarine, gammahomochelidilonine, protopine, sanguinarinic acid, and resin. P

indications, and medicinal uses are described. Bloodroot is u

to treat nasal polyps, frozen feet or chilblains, eczema, ringw

tinea. An extract from the roots is used internally as an emeti

cleanser, expectorant, and treatment for hepatitis, atonic dysp

duodenal catarrh, nasal catarrh, amenorrhea, dysmenorrhea, i

bronchitis, pharyngitis, laryngitis, whooping cough, and crou

Keywords: Chemical constituents, history, medicinal uses, pr

sanguinarine.

Felter, H.W.; Lloyd, J.U. 1898. King’s American dispensator

rev. Scanned version by H. Kress, 2000–2001. http://www

herbmed/eclectic/kings/sanguinaria.html. [Date accessed: 

Offers extensive historical information on bloodroot, includin

names, botanical description, ecology, distribution, chemical 

medicinal uses, indications, preparations, and dosage. In sma

bloodroot stimulates the heart, circulation, and digestive orga

as a general tonic. In large doses, it stimulates the liver but se

reduces the pulse, and causes nausea and expectoration. Toxic 

in nausea, emesis, vertigo, and prostration. Bloodroot has bee

medicinally to treat conditions such as inflammation, chronic 

atonic dyspepsia, catarrh, jaundice, headaches, rheumatism, d

scrofula, amenorrhea, dysmenorrhea, hysteria, lung hemorrha

debility, impotence, bronchitis, laryngitis, sore throat, croup, 

whooping cough, pharyngitis, pneumonia, syphilis, eczema, r

warts, carcinomata, ulcers, rhinitis, and nasal polyps. Various 

are described.
40

, p

www.ibiblio.org/pfaf/cgi-binarr_html?Sanguinaria+canade

LATIND. [Date accessed: May 24, 2004].

Provides information on common and scientific names, habit

uses, cultivation, and propagation. Bloodroot grows in a varie

types, but prefers moist, well-drained, semishaded sites. Med

are cathartic, diuretic, emetic, emmenagogue, expectorant, fe

homeopathic, odontalgic, sedative, stimulant, and tonic. Nativ

used bloodroot to treat fevers, rheumatism, and to induce vom

modern medicine the herb is used internally as an expectoran

treatment for bronchial, respiratory, and throat infections, mig

poor circulation. Bloodroot can be applied externally to treat 

warts, nasal polyps, and chilblains. Sanguinarine is extracted 

and added to dental products. Other uses include an insect rep

dye. The roots contain opium-like alkaloids and can be toxic 

Rhizomes are harvested in the fall, dried, and stored away fro

Details for cultivating bloodroot in the garden are provided. P

propagated by seed or by division of rhizomes.

Keywords: Cultivation, dental uses, dye uses, habitat, insect r

medicinal actions, medicinal uses, Native American uses, san

requirements, toxicity.

Foster, S.; Duke, J.A. 2000. A field guide to medicinal plant

Eastern and Central North America. 2d

 ed. The Peterson fi

series. National Audubon Society, National Wildlife Feder

Roger Tory Peterson Institute. New York: Houghton Miffli

Provides information on bloodroot ecology, botany, and medi

with photographs. Plants flower from March through June, an

rich woods from Nova Scotia to Florida, west to east Texas an

Small doses of the root are used to increase the appetite; larg

used as a sedative. Native Americans used the roots to treat rh

asthma, bronchitis, lung problems, laryngitis, and fevers. It w

a dye and love charm. Bloodroot contains the alkaloid sangui

has been shown to have antiseptic, anesthetic, and anticancer

Sanguinarine has also been added to commercial dental produ

antiplaque agent. Roots can be toxic and should not be ingest
41

, ypy 

1995–2002. http://www.botanical.com/botanical/mgmh/b/b

[Date accessed: May 24, 2004].

Provides a botanical description and summary of medicinal u

constituents include the alkaloids sanguinarine, chelerythrine

and B-homochelidonine as well as red resin and starch. Blood

used medicinally to treat dyspepsia, asthma, bronchitis, croup

dysentery, heart disease, high pulse, ringworm, ulcers, eczem

cancers. Toxic doses cause stomach burning, intense thirst, vo

faintness, vertigo, prostration, and dimness of eyesight. Root

used as a dye by both Native Americans and the French. Prep

doses are listed.

Keywords: Alkaloids, chemical constituents, dye uses, history

uses, preparations, sanguinarine, toxicity.

Harding, A.R. 1936. Ginseng and other medicinal plants. Sc

by M. Moore, 2002. http://www.ibiblio.org/herbmed/eclec

sanguinaria.html. [Date accessed: May 24, 2004].

Offers a thorough botanical description, with common names

market information. A member of the Papaveraceae family, b

related to the opium poppy (Papaver somniferum). Bloodroot 

open, wooded areas with rich soil. Rhizomes send up a single 

leaf from each bud. Both the leaf and bud are smooth, and co

whitish bloom. Leaves grow on a stem 5 to 14 inches tall, and 

with five to nine cleft lobes and prominent veins. The leaves 

partially developed when the plant flowers, and continue to g

7 inches long and 6 to 12 inches across after the flowers fade

inch wide, and have numerous yellow stamens. Petals do not 

flowers quickly give way to oblong narrow seedpods. The rhi

and fleshy, curved at the ends, 1 to 4 inches in length and 1/2- 

thick, with blood-red sap. Roots shrink considerably in dryin

with a sharp fracture. Roots are harvested in autumn after the 

back, then dried and sold for 5 to 10 cents per pound. Bloodr

the U.S. Pharmacopoeia as a tonic, alterative, stimulant, and e

sap of the plant was used by Native Americans to dye baskets

their own skin.
42

g, pgppp

uk/profiles/ bloodroot.htm. [Date accessed: May 24, 2004

Provides a botanical description, lists constituents and medic

and describes medicinal uses, combinations with other herbs, 

and doses. Medicinal actions are expectorant, spasmolytic, em

antiseptic, cardioactive, uterine stimulant, topical irritant, esc

antibacterial. Bloodroot is used to treat respiratory infections

croup, laryngitis, poor circulation, migraines, nasal polyps, w

infections. It is also used in dental products to reduce plaque. 

be poisonous and should not be used during pregnancy.

Keywords: Chemical constituents, medicinal actions, medicin

preparations, toxicity.

Horticopia, Inc. 2001. Sanguinaria canadensis. Horticopia p

information. http://www.horticopia.com/hortpix/html/pc48

accessed: May 24, 2004].

Summarizes bloodroot habitat information for gardeners. Blo

perennial that grows in hardiness zones 4A to 9A. Plants pref

partial shade and moist soil.

Keywords: Habitat, hardiness range, sun requirements, water 

Jackson, D.; Shelton, K. 1997–2001. Alternative nature onli

http://altnature.com/gallery/bloodroot.htm. [Date accessed

2004].

Offers a summary of medicinal uses and history. A brief bota

description is also provided. Roots are collected when flower

and dried for later use. The roots contain opium-like alkaloid

fatally poisonous; bloodroot is not edible and should not be u

pregnant women. Actions are anesthetic, cathartic, emetic, em

expectorant, diuretic, febrifuge, sedative, stimulant, and tonic

used in small doses to treat bronchial troubles, throat infectio

problems, migraines, plaque, skin diseases, warts, and tumor

Americans used the roots as a dye.

Keywords: Alkaloids, dye uses, harvest, medicinal actions, m

toxicity.
43

Patents the process for a special extract of bloodroot for use i

dental applications. Describes the process, summarizes the us

provides a history of previous patents for the medicinal use o

Keywords: Dental uses, patents.

Miller, R.A. 1988. Native plants of commercial importance. 

OR: OAK, Inc. 343 p.

Includes information on ecology and growth range, botany, m

actions and use by Native Americans and eclectic physicians,

 chemistry, marketing, prices for dried roots, and demand. Pla

found growing in rich woods, bottomlands, and along shady s

Nova Scotia south to Florida, and west to Manitoba and Okla

spring-blooming perennial produces one leaf and flower from 

the rhizome. Native Americans used the roots as a dye for ski

and to treat skin cancers. Other medicinal uses have included 

alcoholism, arthritis, asthma, breast tumors, bronchitis, cance

chest pains, colds, cough, croup, deafness, diphtheria, dysme

dyspepsia, ear polyps, gleet, headache, influenza, liver proble

pharyngitis, pneumonia, rheumatism, nausea, and whooping 

Constituents are listed, and their chemistry, particularly as rel

uses, is discussed. Plants are occasionally used in ornamental 

Instructions for collecting roots and dividing rhizomes for pr

cultivation are presented. The domestic market is estimated a

the world market at 2,000 tons. Plants are poisonous and shou

used by trained physicians.

Keywords: Chemical constituents, dye uses, habitat, market, 

Native American uses, range.

Missouri Botanical Garden. 2002. Plant finder. http://www

gardeninghelp/plantfinder/service.shtml. [Date accessed: M

Provides a summary of cultivation information useful to the g

Bloodroot is found in partial to full shade in moist, rich soil a

1

 Eclectic physicians were doctors who treated patients with herbal medicine

1800s and early 1900s.
44

, , p

numerous yellow stamens. Blooms open during the day and c

All parts of the plant have a bright-red sap that was once used 

Americans as a dye. There are no serious pest or disease prob

Bloodroot is best suited for shaded woodlands, native plantin

wildflower or rock gardens where the plants can naturalize.

Keywords: Botanical description, cultivation, disease, dye use

habitat, hardiness range, landscape uses, pests.

Moerman, D. 1999. Native American ethnobotany database: 

dyes, and fibers of native North American peoples. The Un

Michigan-Dearborn. http://herb.umd.umich.edu/. [Date acc

8, 2004].

Provides information on Native American uses of plants. Blo

used by many Native American tribes, including the Algonqu

Chippewa, Delaware, Iroquois, Menominee, Meskwaki, Micm

Ojibwa, Ponca, Potawatomi, Omaha, and Winnebago. Bloodr

medicinally as an abortifacient, tonic, emetic, blood purifier, 

medicine. It was also used as a wash for ulcers and sores, a sn

polyps, and as a treatment for heart trouble, catarrh, stomach 

ivy, earaches, fevers, asthma, tuberculosis, gonorrhea, syphili

rheumatism. The red juice from the roots was used to dye bas

and skin. Several tribes also used bloodroot as a love charm.

Keywords: Dye uses, love charm, medicinal uses, Native Am

NatureServe Explorer. 2002. An online encyclopedia of life 

application]. Version 1.6. Arlington, VA: NatureServe. http

www.natureserve.org/explorer. [Date accessed: March 10, 

Provides details on bloodroot ecology, conservation status, m

and distribution. Bloodroot has a global heritage status rank o

national heritage status rank of N5 (abundant and secure). Sta

status ranks are provided for all States reporting bloodroot. H

overcollection are contributing to declining populations range

monitoring is currently being done on wild populations. Poac

takes place on public lands, particularly to supply a growing 

the Chinese and Korean black markets, where roots sell for $
45

gy 

Keywords: Conservation, distribution, global heritage status r

market, national heritage status rank, poaching.

Petersen, F. 1905. Materia medica and clinical therapeutics. 

version by M. Moore, 2002. http://www.ibiblio.org/herbme

petersen/sanguinaria.html. [Date accessed: May 24, 2004]

Summarizes historical medicinal uses of bloodroot. Medicina

stimulant, tonic, emmenagogue, and emetic. Bloodroot is use

relaxed and constricted larynx, pharynx, and bronchi with bu

uneasiness, and dryness; nasal catarrh with no discharge; and 

cough. Additional uses are listed along with preparations and 

Keywords: History, medicinal actions, medicinal uses, prepar

Plyler, S.C. 2001–2002. Indian spring herbal encyclopedia. h

www.indianspringherbs.com/Bloodroot.htm. [Date accesse

2004].

Provides a general overview of bloodroot identification, histo

uses, preparations, and dosage. A brief botanical and habitat 

provided. Constituents of the root include sanguinarine, sang

cholerythrine, protopine, berberine, copticine, and red resin. N

Americans used bloodroot to treat rheumatism, asthma, bronc

laryngitis, fevers, and warts. The red juice was used as a dye 

skin stain. According to a legend from the Ponca Tribe, if a m

bloodroot juice on his hands before shaking hands with the w

wanted to wed, within 5 to 6 days she would be willing to ma

Medicinal properties assigned to bloodroot include antiseptic

antispasmodic, cathartic, diuretic, emetic, emmenagogue, exp

febrifuge, sedative, stimulant, and tonic. The plant is used to 

bronchitis, asthma, croup, laryngitis, pharyngitis, poor circul

cancers. Bloodroot is poisonous and should be used carefully 

assistance of a trained herbalist or physician; large doses can 

blood pressure, vertigo, tremors, vomiting, shock, and coma. 

provided.
46

Potter, S.O.L. 1902. A compend of materia medica, therapeu

prescription writing. Scanned version by H. Kress, 2000–2

www.ibiblio.org/herbmed/eclectic/potter-comp/sanguinaria

accessed: May 24, 2004].

Summarizes historical uses for bloodroot. Includes preparatio

and physiological actions. Roots were used medicinally to tre

nasal catarrh, acute bronchitis and asthma, chronic bronchitis

dyspepsia, impotence, amenorrhea, croup, pneumonia, scarla

polyps, hypertrophy, ulcers, and syphilitic afflictions.

Keywords: History, medicinal uses.

Reed, D. 1999–2002. Wildflowers of the Southeastern United 

2bnthewild.com. [Date accessed: March 10, 2004].

Describes the botanical characteristics of bloodroot, with a br

of medicinal uses and folklore. Bloodroot is an herbaceous p

single basal leaf that reaches 10 inches in height. A brief desc

Native American usage and folklore is included. Bloodroot is 

medicinally to treat skin afflictions such as ringworm, warts, 

growths, and skin cancer; added to toothpastes to fight plaqu

gingivitis; used to stimulate the digestive system; and as an e

roots are poisonous and self-medication is not recommended

Keywords: Botanical description, medicinal uses, toxicity.

Russell, A.B. 1997. Poisonous plants of North Carolina. Nort

State University, Department of Horticultural Science. http

www.ces.ncsu.edu/depts/hort/consumer/poison/Sanguca.ht

accessed: May 24, 2004].

Summarizes the toxic qualities of bloodroot. The isoquinoline 

the rhizomes are poisonous when ingested in large quantities

overdose include nausea, vomiting, faintness, dizziness, dilat

fainting, diarrhea, and heart failure. This plant is highly toxic 

fatal if ingested in large doses.

Keywords: Alkaloids, toxicity.
47

y , ]

Provides a description of the plant with common names, habi

and harvest information. Common names for Sanguinaria ca

include redroot, red puccoon, red Indian paint, puccoon root, 

white puccoon, pauson, snakebite, sweet-slumber, and tetterw

emerge in early April, with a single leaf enclosing a flower bu

covered with a smooth, whitish bloom. Leaves have five to ni

flowers die back, leaves mature to a size of 4 to 7 inches in le

12 inches wide. The flowers are 1 inch across, waxy white in 

to narrow oblong seedpods. The roots and stem contain blood

sap. The roots, collected in the fall, are used medicinally.

Keywords: Botanical description, common names, flowers, h

U.S. Department of Agriculture, Forest Service. 1993. Inco

opportunities in special forest products: self-help suggestio

enterprises. Agric. Inf. Bull. 666. Washington, DC. 206 p.

Estimates the domestic market for bloodroot at 200 tons and 

market at 2,000 tons.

Keywords: Market demand.

U.S. Department of Agriculture, Natural Resources Conse

Service. 2001. The PLANTS database. Version 3.1. Baton 

Plant Data Center. http://plants.usda.gov/. [Date accessed: 

2004].

Summarizes bloodroot range and distribution, with maps for 

Bloodroot is found in Arkansas, Connecticut, Florida, Georgi

Iowa, Kansas, Kentucky, Maine, Massachusetts, Michigan, M

Hampshire, North Carolina, North Dakota, Rhode Island, Sou

South Dakota, Tennessee, Vermont, Virginia, West Virginia, a

Keywords: Distribution, range.

United Plant Savers. [n.d.]. At risk plants. http://www.plants

[Date accessed: March 10, 2004].
48

Keyword: Conservation.

Winterburn, G.W. 1882–1883. Transactions of the national 

medical association. Scanned version by M. Moore, 2001–

http://www.ibiblio.org/herbmed/eclectic/journals/nat-ecl-tr

[Date accessed: March 10, 2004].

Provides detailed information on the historical uses of bloodr

medicinal actions vary with the dosage. Small doses stimulat

respiratory system, and act as a general tonic; whereas large d

heart activity, paralyze the respiratory system, and cause eme

lethargy. Bloodroot has strong actions upon the skin, mucus m

digestive system, respiratory organs, glandular structures, spi

muscular tissue, and female organs. Medicinal uses are listed 

descriptions of specific case studies.

Keywords: Case studies, history, medicinal actions, medicina

Commercial Vendors

Note: The following list of vendors is included to provide acc

information about availability and prices. The authors do not 

recommend these vendors over others not listed.

GardenMakers. [n.d.]. Bloodroot. http://www.gardenmakers

accessed: March 10, 2004].

Vendor of bloodroot plants for landscaping.

Keywords: Landscape uses, vendors.

Green Canyon. [n.d.]. Bloodroot. http://www.greencanyon.c

c100390.htm. [Date accessed: March 10, 2004].

Vendor of bloodroot for medicinal uses.

Keywords: Medicinal uses, vendors.
49

Keywords: Medicinal uses, vendors.

HerbTrader. [n.d.]. Bloodroot. http://www.herbtrader.com/

bloodsancan.html. [Date accessed: March 10, 2004].

Vendor of bloodroot for medicinal uses.

Keywords: Medicinal uses, vendors.
50
51

Arnason, J.T. 16

Baldia, C.M. 34

Beattie, A. 17

Bennett, B.C. 17

Britton, N.L. 38

Center for Alternative Medicine Research,

 University of Texas 35

Clark, P. 35

Cook, W. 38

Cullinan, M.P. 18

Damm, D.D. 18

Drisko, C.H. 18

Duval, J. 19

Dzink, J.L. 19

Ellingwood, F. 38

Eversole, L.R. 19

Farwell, O.A. 20

Felter, H.W. 39

Fern, K. 40

Foster, S. 40

Frankos, V.H. 20

Fritz, R. 20

GardenMakers 48

Godowski, K.C. 21

Green Canyon 48

Grieve, M. 41

Hakim, S.A.E. 21

Hannah, J.J. 21

Harding, A.R. 41

Harkrader, R.J. 22

Harper, D.S. 22

Haughton, C. 42

Heithaus, E.R. 22

Hendershot, D. 35

Herbal Wise 49

HerbTrader 49

Horticopia, Inc. 42

Jackson, D. 42

Judd, W.W. 23

Karlowsky, J.A. 23

Keller, K.A. 23

Klewanski, P. 23

Kopczyk, R.A. 24

Kuftinec, M.M. 24

Lehmann, N.L. 25

Lyon, D.L. 25

Mallatt, M.E. 26

Marino, P.C. 26

Mascarenhas, A.K. 27

Mauriello, S.M. 27

Miller, R.A. 43

Missouri Botanical Garde

Moerman, D. 44

Morales, M.A. 27

Munro, I.C. 28

NatureServe Explorer 44

Nikiforuk, G. 28

Petersen, F. 45

Phillips, G. 36

Plyler, S.C. 45

Polson, A.M. 29

Porter, S.D. 29

Potter, S.O.L. 46

Pudlo, R.J. 29

Reed, D. 46

Rho, D. 30

Robbins, C. 30

Rockwood, L.L. 30

Russell, A.B. 46

Salmore, A.K. 31

Sanders, J. 36

Schwartz, H.G. 31

Sievers, A.F. 47

Southard, G.L. 32

Sutherland, Z. 37

Tenenbaum, H. 32

Tin-Wa, M. 33

Tuveson, R.W. 33

U.S. Department of Agric

Service 47

U.S. Department of Agric

Resources Conservation 

United Plant Savers 47

Wagner, H. 37

Walker, C. 33

Walters, R. 37

Wennstrom, J. 33

Winterburn, G.W. 48

Zettler, J.A. 34
52
53

, , 

ant mutualism. See myrmecochory

ants 3, 10, 11, 12, 14, 15, 17, 27, 28, 29,

30, 34, 36

botanical description 2, 3, 38, 39, 41, 42,

44, 46, 47

cancer 6, 7, 11, 16, 19, 21, 35, 36, 37, 38,

43, 46. See also Leukoplakia

case studies 1, 6, 16, 18, 48

chemical constituents 5, 23, 39, 41, 42,

43, 46

clinical studies 7, 18, 19, 20, 21, 22, 24, 25,

26, 27, 29, 32, 33, 34

common names 1, 36, 37, 39, 41, 47

conservation 1, 3, 10, 11, 13, 15, 20, 30,

34, 38, 44, 45, 47

cultivars 25

cultivation 5, 9, 35, 40, 43, 44

defoliation 30, 31

dental uses 18, 19, 20, 21,22, 23, 24, 25,

26, 27, 29, 32, 33, 34, 36, 40, 41, 43

adverse reactions 8, 20, 24

dewormer 9, 19

distribution 4, 39, 44, 45, 47, 48

dosage 23, 39, 45, 46, 48

dye uses 6, 35, 36, 37, 40, 41, 42, 43, 44,

46

ecological studies 10, 11

elaiosome 3, 10, 17, 27, 28, 31, 34, 36

feed additive. See animal feed additive

Fell, J. Weldon 6

fertilization 26, 27, 31

flowers 2, 3, 11, 25, 26, 36, 37, 41, 42,

44, 47

pollination. See pollination

pollinators. See pollinators

global heritage status rank 4, 44, 45

habitat 4, 5, 10, 11, 18, 20, 29, 30, 37, 40,

41, 42, 43, 44, 45, 47

hardiness range 5, 42, 44

harvest 5, 11, 20, 23, 30, 41, 42, 47

history 1, 6, 11, 22, 38, 39, 40, 41, 42, 43,

45, 46, 48

homeosis 3, 14, 25

Hoxsey, Harry 6, 7, 35, 36, 38

insect repellent 9, 40

landscape uses 44, 48

, , , , 

market 1, 9, 35, 36, 41, 4

demand 9, 43, 44, 47

prices 10, 41, 43, 45, 4

medicinal actions 23, 37, 

46, 48

medicinal uses 1, 6, 16, 3

41, 42, 43, 44, 45, 46, 4

myrmecochory 3, 17, 27, 

National heritage status ra

Native American uses 6, 

44, 46

nomenclature 1

Papaveraceae family 1, 3

patents 43

permits 30

pesticide use 9, 17, 33

pests and disease 44

pH 5, 17

phototoxicity 9, 17, 33

Phytobiotics GmbH 9, 35

poaching 44, 45

pollination 3, 14, 25, 26, 

pollinators 3, 25, 26, 36

preparations 10, 38, 39, 4

products 1, 7, 8, 9, 11, 1

20, 21, 22, 23, 24, 25, 27, 

33, 36, 37, 40, 42, 47, 48

propagation 5, 10, 30, 40

range 3, 4, 5, 10, 18, 41, 

research 1, 4, 7, 8, 9, 11, 

21, 22, 23, 24, 25, 27, 28, 

36, 37

research reviews 1, 20, 2

32, 33, 37

rhizomes 5, 17, 20, 30, 3

43, 44, 46

safety 7, 8, 11, 13, 15, 18

31, 33

sanguinarine 5, 7, 8, 9, 1

16, 17, 18, 19, 20, 21, 25, 

32, 33, 34, 36, 39, 40, 41, 

seeds 3, 5, 10, 11, 12, 13

22, 23, 27, 28, 29, 30, 31, 

dispersal 10, 17

stratification 5

soil requirements 4, 40

sun requirements 4, 27, 3

tissue culture 30
54

vendors 48, 49

Viadent® 7, 8, 12, 14, 16, 18, 20, 22, 27,

28, 36, 37

water requirements 4, 42

Yellow Creek Botanical Institute 9, 35
55

Disclaimers

This annotated bibliography represents a comprehensive, but 

exhaustive, review of the literature on bloodroot. The referen

were identified through a detailed search of academic library

databases, regional literature, government documents, Intern

as well as commercial Internet sites. Bibliographic reference

into sections—Research Literature, Popular Press, Other Info

Sources—to indicate their origins. Research Literature inclu

to peer reviewed articles published in scientific journals, whi

references in Popular Press are not scientifically reviewed, bu

to indicate popular knowledge and perceptions. Other Inform

include technical bulletins, horticultural lists, historical docu

Web sites.

This document is available from the Non-Timber Forest Prod

of the U.S. Department of Agriculture, Forest Service, South

Station at http://www.sfp.forprod.vt.edu/.

Web sites listed in the bibliography were active at the time th

was prepared, but Web addresses may change or disappear ov

date accessed indicates the last time the Web sites were chec

The use of trade or firm names in this publication is for read

and does not imply endorsement by the U.S. Department of A

any product or service.
56

Predny, Mary L.; Chamberlain, James L. 2005. Bloodroot (San

canadensis): an annotated bibliography. Gen. Tech. Rep. SRS-8

NC: U.S. Department of Agriculture, Forest Service, Southern 

Station. 55 p.

Bloodroot (Sanguinaria canadensis) is a spring-blooming herbace

found mainly in rich woods throughout the Appalachian Mountain 

across the Eastern United States. The common name bloodroot an

name Sanguinaria denote the blood-red sap found throughout the 

particularly in the roots. This sap contains the alkaloids that make 

valuable. Native Americans used bloodroot as a dye, love charm, a

European colonists adopted Native American medicinal uses to su

needs. Bloodroot was described in pharmacopoeias as early as the 

detailed descriptions of the plant, constituents, therapeutics, and c

The popular use of herbal remedies declined in the 1920s with the 

of the pharmaceutical industry, though there has been a renewed i

herbal medicine as research confirms the efficacy of some traditio

Bloodroot is still wildcrafted in the United States for domestic an

uses. This report describes the characteristics and growth habits o

summarizes the various uses of the herb, reviews the global marke

examines the conservation status of the plant, and identifies needs 

research.

Keywords: Bloodroot, conservation, dental products, medicinal h

nontimber forest products, Sanguinaria.
Cover photograph by Thomas G. Barnes

Bloodroot (Sanguinaria canadensis)

is an important herbal medicinal 

plant collected from the hardwood 

forests of the Southern United States.

THE AUTHORS:

Mary L. Predny, Research Associate, Virginia Polytechnic Institute and State 

University, Wood Science and Forest Products Department, Blacksburg, VA 24061.

James L. Chamberlain, Research Scientist, U.S. Department of Agriculture, 

Forest Service, Southern Research Station, Blacksburg, VA 24060.
United States

Department

of Agriculture

Forest Service

Southern

Research

Station

General

Technical

Report

SRS–86

United States

Department

of the Interior

National 

Park Service