Red puccoon
StarSanguinaria canadensis
Synonyms: Belharnosia canadensis, Sanguinaria vernalis, Sanguinaria stenopetala, Sanguinaria grandiflora, Sanguinaria virginiana, Sanguinaria acaulis, Sanguinaria canadensis f. multiplex, Sanguinaria canadensis var. multiplex, Belharnosia mesochora, Sanguinaria canadensis var. rotundifolia, Sanguinaria dilleniana, Sanguinaria australis, Sanguinaria mesochora, Sanguinaria rotundifolia
Western Herbalism Properties
Traditional Uses
Sanguinaria canadensis was one of the most widely employed medicinal plants among Eastern Woodland peoples, with documented uses across at least twenty tribes. The Cherokee took a decoction of the root in small doses for coughs and lung inflammations, and used a wash of the root for ulcers, sores, and skin conditions (Hamel & Chiltoskey, 1975). The Iroquois used infusions of the root for inside pain, as a blood purifier, for colds, and as a carminative for stomach gas (Herrick, 1977). The Chippewa employed a compound root decoction for cramps and stomach complaints, and the powdered root as a snuff for head colds (Densmore, 1928). The Ojibwa, Meskwaki, Micmac, Malecite, Mohegan, and Potawatomi used the rhizome as a blood medicine, throat aid, tonic, and gastrointestinal remedy (Smith, 1932; Smith, 1933). The Delaware reserved a pea-sized piece of the root taken daily for thirty days as a strengthener for general debility, and used the red root sap as ceremonial face paint for the Big House Ceremony (Tantaquidgeon, 1942; Tantaquidgeon, 1972). The roots were also boiled with other barks to produce red and yellow dyes among the Chippewa, Cherokee, and other peoples (Densmore, 1928; Witthoft, 1947).
Gallery
Botanical Description
Sanguinaria canadensis, the bloodroot, is a low-growing perennial herb in the Papaveraceae family, native to deciduous woodlands of eastern North America. From a thick, branching rhizome that exudes a vivid orange-red sap when cut arises a single, deeply lobed, palmate leaf wrapped around an upright flower stalk. The solitary white flower, opening briefly in early spring before the canopy closes, bears eight to twelve petals around a cluster of yellow stamens. Following pollination by small bees, an oblong capsule develops containing dark seeds with fleshy elaiosomes attractive to ants, which disperse them. The whole plant rarely exceeds 25 cm in height, and the colonies often persist for decades in undisturbed leaf litter on shaded slopes.
Active Constituents
Sanguinarine
Quaternary benzophenanthridine alkaloidConcentration: Major alkaloid; rhizome content ranges ~0.6-6.3%
The principal bioactive alkaloid. It intercalates with GC-rich DNA, inhibits NF-kB and tubulin polymerisation, activates caspase-mediated apoptosis, and inhibits Na+/K+-ATPase (IC50 ~6 uM). It is antimicrobial and cytotoxic but also a caustic escharotic and, with chronic mucosal exposure, has been linked to oral leukoplakia.
Chelerythrine
Quaternary benzophenanthridine alkaloidConcentration: Co-major alkaloid (~33% of alkaloid fraction)
A protein kinase C inhibitor with pro-apoptotic and antimicrobial activity; induces apoptosis in cardiac myocytes at 6-30 uM via reactive oxygen species, contributing to the toxicity of the crude drug.
Chelirubine / sanguirubine / chelilutine / sanguilutine
Minor benzophenanthridine alkaloidsConcentration: Minor (each ~1-9% of alkaloid fraction)
Structurally related coloured alkaloids that contribute to the antimicrobial and cytotoxic activity of the rhizome extract.
Protopine
Protopine-type isoquinoline alkaloidConcentration: ~4% of alkaloid fraction
Blocks cardiac Ca2+, K+ and Na+ channels and shows potent antiplatelet activity, with IC50 values against several platelet agonists reportedly lower than those of aspirin.
Allocryptopine
Protopine-type isoquinoline alkaloidConcentration: ~4% of alkaloid fraction
A potassium-channel blocker with antiarrhythmic activity reported to be more effective than quinidine in preventing induced arrhythmias in rats.
Long-chain alcohols, phytosterols and triterpenes
Lipids / sterolsConcentration: Minor
C26-C34 alcohols, phytosterols and triterpenes accompany the alkaloids in the rhizome; they are not considered pharmacologically important.
⚠ Drug Interactions
Digoxin and other cardiac glycosides
Sanguinarine inhibits Na+/K+-ATPase (the pump targeted by digoxin) in vitro, so concurrent exposure could theoretically produce additive inhibition and increase the risk of cardiac glycoside toxicity and arrhythmia.
Clinical note: Extrapolated from in vitro pharmacology; bloodroot is not recommended for internal use, and combination with cardiac glycosides should be avoided.
Anticoagulant / antiplatelet drugs (warfarin, aspirin, clopidogrel)
Protopine has potent antiplatelet activity and sanguinarine inhibits thromboxane B2 production, so systemic exposure could add to the bleeding risk of antiplatelet or anticoagulant therapy.
Clinical note: Theoretical, based on isolated-alkaloid studies; relevant only if the plant is taken internally, which is discouraged.
Antiarrhythmic agents
Allocryptopine and protopine block cardiac ion channels and have quinidine-like antiarrhythmic effects, raising the theoretical possibility of additive conduction effects with antiarrhythmic drugs.
Clinical note: Avoid internal use with cardiac medications; monitor for arrhythmia if inadvertent exposure occurs.
Preparation Methods
Topical / escharotic (historical, discouraged)
Parts: rhizome, root latex
Safety warning: Bloodroot rhizome and its red latex are strongly caustic escharotics. So-called 'black salve' and other topical cancer remedies containing bloodroot have caused extensive tissue destruction, disfiguring scarring, and delayed diagnosis with metastatic progression of skin cancers. These uses have no supporting clinical trials and are strongly discouraged by dermatologists and cancer centres.
Diluted tincture (traditional expectorant, not recommended internally)
Parts: dried rhizome
Historically a highly diluted rhizome tincture was used in minute doses as an expectorant and emetic. Internal use is hazardous: it can cause nausea, vomiting, dizziness, vertigo and, with chronic mucosal exposure, leukoplakia. Internal self-medication should be avoided.
Clinical Studies
Sanguinaria canadensis: Traditional Medicine, Phytochemical Composition, Biological Activities and Current Uses
Comprehensive review of the eight isoquinoline alkaloids of bloodroot and their antimicrobial, anticancer, cardiovascular and anti-inflammatory activities. It documents the absence of human clinical trials, the withdrawal of sanguinarine mouthwash after association with oral leukoplakia, and cases of tissue destruction, treatment failure and metastatic progression following use of 'black salve' escharotic preparations.
Bloodroot (Sanguinaria canadensis L., Papaveraceae) Enhances Proliferation and Cytokine Production by Human Peripheral Blood Mononuclear Cells in an In Vitro Model
In vitro study showing that low concentrations of a bloodroot extract stimulated proliferation and cytokine production by human peripheral blood mononuclear cells, illustrating dose-dependent immunomodulatory effects of the alkaloid fraction.
Historical Texts
Eastern North American Indigenous ethnobotany (Cherokee, Iroquois and others)
Pre-1800 traditional useKing's American Dispensatory (Felter & Lloyd), 'Sanguinaria'
1898References
- Croaker A, King GJ, Pyne JH, Anoopkumar-Dukie S, Liu L. Sanguinaria canadensis: Traditional Medicine, Phytochemical Composition, Biological Activities and Current Uses . International Journal of Molecular Sciences (2016) [DOI]
- Slavik J, Slavikova L. Alkaloids of the Papaveraceae. On the alkaloids of Sanguinaria canadensis L. . Collection of Czechoslovak Chemical Communications (1960) [DOI]
- Memorial Sloan Kettering Cancer Center. Bloodroot - Integrative Medicine Herb Monograph . MSKCC About Herbs database (2023) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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