The Blood-root, or Puccoon, commonly found throughout the United States and Canada, is the sole representative of the genus Sanguinaria of the Papaveraceae. It is herbaceous, has a thick, branching root stock, which creeps along underground; and in early spring sends up from the ends of the little side branches a single long-stalked leaf, and another stalk bearing a solitary flower. The leaf is wrapped round the flower-bud when it rises from the ground, and is bluntly five to nine-lobed, roundish at first, but afterwards kidney-shaped. The American Indians formerly used the orange-coloured juice of the root for smearing their bodies, and for staining various domestic articles. The plant has also been successfully used by American and French dyers (Treas. of Bot.). Hale says of the root: "It is succulent, and when cut or broken emits from numerous points on the transverse surface a light orange, or rather dark vermilion-coloured juice, which has a bitterish, acrid but peculiar taste, which remains long in the mouth and leaves a persistent burning in the throat. The juice of the stem is between a red colour and a yellow, as that from the stem of Chel. maj. is pure yellow, and that from Papaver somnif. [Opium] is white." It is well to bear in mind the parallelism observable between these three Poppies, no less in their medicinal than in their physical properties. The time for collecting the root is early spring or late autumn. An alkaloid, Sanguinarin (identical with Chelerythrin of Chelidonium majus), has been isolated, and the Nitrate of this has been studied separately. Hale refers to a paper by Dr. Tully, published in 1813, in which Sang. is described as being analogous in its action to Squills, Senega, Digitalis, Guaiacum, and Ammonia, which shows an accurate conception of its range. In doses of from eight to twenty grains of the powdered root, Sang. is an active poison producing Nausea; burning in stomach; tormenting thirst; faintness; vertigo indistinct vision; violent, spasmodic efforts of the stomach, free vomiting, followed by alarming prostration. S. L. Mitchell has recorded fatal poisoning of four workmen who drank the tincture in mistake for brandy. They were all soon seized with severe racking and burning pains in the stomach and bowels with intense thirst. "Burning" is one of the leading notes of the remedy, and is found in many different parts. Winterburn has published (H. M. vii. 532) two cases illustrating this indication in the region of the stomach: (1) Mr. F., 48, of sanguino-bilious temperament, energetic, refined, had been ill with pains in the stomach several months. A clairvoyant had recommended "a decoction of blood-root and bone-set in tablespoonful doses." Each dose produced "intense burning pains in the stomach lasting for hours," and it had to be discontinued. Several-weeks later Winterburn was consulted, and this is the condition he found: Burning in epigastrium, with pressure, < at night, but coming on soon after lying clown and compelling patient to arise. Eructations gave no >. Appetite great; bowels torpid, an unsatisfactory relief each morning, leaving a sense of discomfort. Peculiar drawing pain in shoulders and arms during sleep, so that when she woke the lists were tightly clenched and flexed on the sternal end of clavicle; lameness and weariness of the muscles followed. Sang. 200, chosen after careful comparison with Nux, Graph., and others, was given every night at bedtime. After the first dose the symptoms disappeared "like magic," and the patient was soon well. (2) Mrs. S., 30, a chronic inebriate, had been drinking steadily for three weeks when sickness and diarrhoea set in. Nux 1x aggravated the nausea. Ars. 6 checked the diarrhoea and relieved the intense thirst, but did nothing to allay the vomiting. Patient was irritable, angry. Everything she took, even water, was instantly ejected. About every twenty minutes she had a spasm or cramp of the stomach, with gagging and coughing, bringing up some frothy mucus. The straining caused great pain in chest and abdomen. There was, besides, the most intense burning, extending from the stomach up the oesophagus to pharynx, which felt swollen and dry. The only tolerable position was lying slightly turned on her left side. Lying on right side was impossible. Rising from lying = vertigo. Cheeks and hands livid. She believed she would soon die, and was unwilling to be left alone. Sang. 200 was given every two hours. By evening the nausea had ceased, but the burning pain remained as before. The smallest particle of food gave great agony; it seemed as if a spot the size of a florin was ulcerated, and any contact with this was excruciating. She slept better, but awakened next morning in a fright. Next afternoon she was able to take a little solid food, and from that time recovery was rapid. Burning is a leading note of Sang. Burning of eyes; of ears. Tongue and throat feel as if they had been burnt or scalded. Burning palms and soles. Burning in chest; between breasts, streaming from breasts to abdomen. Leonard (Min. H. Mag., ii. 295) says "a circumscribed burning in the chest, commonly followed by heat through abdomen and diarrhoea," is a strong indication for Sang. in pneumonic conditions. Sang. has also the circumscribed hectic flush on the cheeks, as in phthisis, in which it is frequently indicated. (Sang. has also the "hopefulness" of phthisical patients.) The flushed face, at times dark red or livid, is also a prominent feature of Sang., as it is of Op. Sang. affects the whole respiratory tract, irritates the nasal mucous membrane, and causes coryza, with pain at root of nose, lost or perverted sense of smell, and sensitiveness to the odour of flowers. Influenza, hay-fever, ozaena, and polypus have all come within its range. Laryngitis and membranous croup have been cured by it; and I have found it meet a greater proportion of the tracheal and bronchial coughs of epidemic influenza than any other remedy. The chief features are: Violent, dry cough; wheezing, whistling, metallic; sputa almost impossible to raise. I have seen several cases of this kind rescued from apparently imminent death by Sang., the relief conies by the expectoration of a thick plug of mucus which was causing suffocation, and which the patient was too weak to dislodge. Like Chel., Sang. is a right-side medicine, and affects especially the right lung; and is suited to pulmonary affections with liver involvement. After influenza children often get a cough scarcely distinguishable from whooping-cough. I have found Sang. the chief remedy for this. It is also the remedy for severe cough after whooping-cough—the cough returns with every fresh cold. Sang. also acts powerfully on the outer chest, sternum, and mammae. Like Chel., it has a reputation for curing cancer, polypi, and new growths. I have seen breast tumours diminish under its action. Offensiveness and acridity characterise the discharges of Sang.; and the breath and flatus are also offensive. Menses offensive, flow bright red; later blood darker and less offensive. Before menses itching of axillae. Eruption on the face of young women, especially during scanty menses. Climacteric disorders: flashes of heat; leucorrhoea; painful enlargement of breasts. The headaches of Sang. are of great intensity, and have some striking characteristics. They are (1) periodic—every seventh day; (2) begin in the morning, increase to noon, and then diminish; (3) are bursting, or as if the eyes would be pressed out; (4) begin at occiput, spread upwards and forwards, and settle over right eye; (5) like a flash of lightning in occiput; (6) > by sleep; (7) return at climacteric. Hering described the headache of Sang. as the "American sick-headache"—rush of blood causing faintness and nausea, pains lancinating or throbbing. Can neither bear light nor odours nor least jar, as any one stepping across the floor; at height of headache vomiting of food and bile; pain so violent patient goes out of her mind or seeks relief by pressing head against pillow or with the hands. Cooper gives as a keynote: "If he goes without food, gets bilious headaches." Sang. has also neuralgia of the face > by kneeling down and pressing head firmly against the floor; pain extends in all directions from the upper jaw. The ears are strongly affected by Sang. Cooper gives me this case: Girl, 19, had her throat bad three years from scarlatina, and lately increasing deafness; noises all over head, and vertigo and sudden flushings in daytime; menses too frequent, and profuse leucorrhoea; it pains tier to walk from backache; had to give up teaching from this; appetite poor from the headaches and tinnitus; often has pain behind angles of lower jaw and swellings of gland. All disappeared after a single dose of Sang. Ø, though at first the leucorrhoea was increased. "Fulness and tenderness behind angle of jaws" is, according to Cooper, a keynote. Sang. causes many symptoms of rheumatism, but the most characteristic is a rheumatic pain in right arm and shoulder; cannot raise the arm, < at night. Pains in places where the bones are least covered. Peculiar Sensations are: As if paralysed. As if forehead would burst. As of a band across forehead. As if head were drawn forward. As if electric current shooting through head. As if temples and scalp were alive with irrepressible pulsation. As if eyes would be pressed out. As if hairs were in eyes. As if she was in a railway car which was moving and jarring her, and as if all about her moved rapidly and confusedly. Pain like drawing a rope on a windlass as tight as possible. Tongue as if burnt. Tip of tongue as if scalded. Tongue as if in contact with something hot. Throat as if swollen. Throat so (try it seems as if it would crack. Pharynx as if burnt or scalded. As if some hard substance in stomach. Constriction in pit of stomach as if suffocating. As of a mass in lower part of rectum. As if upper part of chest were too full of blood. Larynx as if swollen. F. Nichol in giving Hale his experience with Sang. in croup, says he used (following Paine, eclectic) a solution of Sanguinarin in vinegar, and he found that the most effective preparation. The symptoms are < by touch. [A painful sensitiveness is very characteristic of Sang.: Temporal veins painfully sensitive; head and eye very painful; nipples sore.] Hard pressure >; (must kneel down and press head hard to floor in neuralgia). Slightest jar <. Lifting = lumbago. Lying dawn > rheumatism and headache; but < cough and most other complaints. Cough <. Lying with head low < cough. Lying on left side >. < Lying on right side. Sitting up and passing flatus > cough. Motion; turning head quickly; turning in bed; stooping; coughing; exercise <. Cannot raise arm from side but can swing it to and fro (in rheumatism). Eating <. Going without food = headache. > Eructations (mind confused). Swallowing <. Vomiting > (Nausea; headache). Smoking = hiccough, < At night. > After sleep. Headache < by day, sunrise to sunset. Cold open air >. Cold room < cough. Damp weather <. The right side is more affected than the left. Symptoms go from right to left. Periodicity is very marked.