IngredientsSpigelia marilandica, the woodland pinkroot or Indian pink, is a herbaceous perennial wildflower in the Loganiaceae family, native to inland areas of the Southeastern and Midwestern United States. The genus name was given by Linnaeus and honors Adrian van der Spigel, a Brussels doctor who wrote a text in 1606 detailing the procedure for developing an herbarium to preserve dried plants; marilandica is a reference to the state of Maryland. Paradoxically, Spigelia marilandica is not known to occur in Maryland.
Other common names include Carolina pinkroot, pinkroot, Carolina pink, Maryland pink, Indian pink, starbloom, wormgrass, wormweed, and American wormroot. The plant belongs to the Loganiaceae family, which houses notoriously poisonous species that contain strychnine.
Spigelia marilandica is a clump-forming herbaceous perennial that grows to a height of 30–60 cm from a rhizomatous base, producing multiple upright, unbranched stems that are wiry and square in cross-section. A member of the Loganiaceae family, this compact herbaceous perennial produces vivid flowers: erect, pencil-slender scarlet tubes, 1.5 to 2 inches long, that flare dramatically at the tip to reveal a luminous five-pointed yellow interior. It flowers in late spring and early summer and tends to be found in low moist woods, ravines, or stream banks in partial or full shade.
The official drug material consists of the rhizome and roots of Spigelia marilandica, Linné. Historical preparations included a Fluid Extract of Spigelia, Compound Fluid Extract of Spigelia, and a Fluid Extract of Spigelia and Senna. The root is best used when fresh, but can be harvested in the autumn and then dried for herbal use. The root is best used when fresh but can be harvested in the autumn and stored; it should not be stored for longer than two years.
In contemporary commerce, the plant is encountered primarily as a homeopathic preparation. According to Michael McGuffin, president of the American Herbal Products Association, it has very limited contemporary use and is available mainly as a homeopathic remedy.
Several Spigelia species act as worm-expelling herbs — for example, S. flemmingiana, native to Brazil, and S. anthelmia, native to the Caribbean, Venezuela, and Colombia. S. anthelmia also contains isoquinoline alkaloids and is used in the treatment of heart disease. Much of the pharmacological laboratory research cited in this article pertains to Spigelia anthelmia, the closely related tropical species whose alkaloid profile overlaps with S. marilandica and which is the species most commonly used in homeopathic preparations labeled as "Spigelia."
Spigelia marilandica was used historically by the Cherokee and the Creek to treat worms. Numerous Eastern tribes used preparations of the roots as a powerful anthelmintic (worm expellant), regarding it as one of the most effective native plants for expelling intestinal parasites, particularly roundworms and pinworms. In a 1802 medical paper preserved in PMC, physician Benjamin Smith Barton of Philadelphia recorded that in some parts of Carolina, the plant was known by the name of "snake-root" and was the unsteetla of the Cherokee Indians. Every part of the plant was considered to possess the anthelmintic property, and physicians in Carolina employed the whole plant chiefly in decoction, though the active power was recognized as residing more especially in the roots.
Early ethnobotanical notes from the late 1700s record it was sometimes chewed directly or brewed as a bitter decoction. The Cherokee and other American Indian tribes also used it as a ritual and ceremonial herb to induce visions and foretell the future.
The Cherokee and Creek people both used the roots to cure intestinal worms and passed this knowledge on to European settlers. With European colonization, Spigelia's use spread into folk medicine traditions of the Appalachian region. Frontier doctors included it in proprietary bitters and tinctures advertised in 19th-century journals like The North American Medical and Surgical Journal (circa 1825).
An important historical document attesting to its commercial significance is preserved in a 19th-century medical account of Cherokee, Georgia: traders sent to market pink root, serpentaria, senega, and ginseng, with Spigelia and serpentaria likely predominating. One trader was in the habit of shipping Spigelia with the top attached, exchanging it for salt, powder, and dry goods, allowing the Indian two cents the pound.
In Medical Flora, written by C.S. Rafinesque and published in 1830, he suggested broader uses for the plant as a "narcotic, vermifuge, sedative, cathartic, and febrifuge [effective against fever]," noting that unlike most worm treatments, Spigelia was much more palatable to children.
In the Eclectic medical tradition of the 19th and early 20th centuries, Spigelia was regarded as specific in the removal of intestinal worms and said not to need large doses for efficacy if used with proper care. The 1919 American Materia Medica by Finley Ellingwood recorded a formula combining fluid extract of spigelia (two drams), pulverized santonine (fifteen grains), and simple elixir to make two ounces, with a teaspoonful given on rising and retiring; if followed on the third day by a non-irritating laxative, it was said to seldom fail in removing lumbricoids. It was also stated to be beneficial in angina, in all neuralgic heart affections, and in functional palpitations.
Samuel Hahnemann, the founder of homeopathy, incorporated Spigelia anthelmia (the closely related South American species) into his Materia Medica Pura. It was known in Europe in Hahnemann's time as an anthelmintic, a property learned from the people of the Antilles. Hahnemann's proving revealed many other virtues; he noted that a single unrepeated dose usually increases somewhat daily during the first seven to ten days, so that 60, 80, to 100 drops of the tincture produce violent effects even in robust persons. In classic homeopathic materia medica, Spigelia is described as an important remedy in pericarditis and other diseases of the heart, with marked elective affinity for the eye, heart, and nervous system, and with neuralgia of the fifth nerve being very prominent in its effects.
In modern homeopathic practice, Spigelia (Pinkroots) appears as an active ingredient in combination homeopathic products (e.g., at an 8X potency) for the temporary relief of headache. These claims are based on traditional homeopathic practice and are not accepted by medical evidence; they are not FDA evaluated.
Pink Root was used in early herbal medicine in North America but is rarely used today, as there are safer herbal remedies for de-worming. By the early 1900s, interest waned as synthetic anthelmintics emerged.
The medicinal and toxic properties of Pink Root are attributed primarily to its alkaloid content. Every part of this plant contains the alkaloid spigiline, which is considered the active medicinal component but is also poisonous to humans. Classical pharmaceutical sources describe the principal constituents as a volatile alkaloid, spigeline (resembling coniine and nicotine), volatile oil, resin, and a bitter body.
For the closely related species S. anthelmia, which has been more extensively studied, the plant contains quaternary alkaloids, the major ones being spiganthine, ryanodine, and structurally related compounds. The highest concentrations of alkaloids are present in the roots and in the fruit wall. Spiganthine and ryanodine are the main cardioactive principles; the effect is characterized by a delay in contraction development of the heart muscle.
A dedicated PubMed-indexed study confirmed that spiganthine was isolated as the main cardioactive principle from medicinally used extracts of Spigelia anthelmia, its structure was established by spectroscopic methods, and the biological effect is characterized by a delay in contraction development of the heart muscle.
The medicinal properties of S. marilandica are attributed to its bioactive alkaloids, primarily spigeline (also spelled spigiline), along with volatile oils, resins, and tannins. These compounds enable the plant's antiparasitic effects by paralyzing intestinal worms, facilitating their expulsion — often in combination with a laxative to mitigate side effects.
Anthelmintic action: In vitro mode-of-action studies indicate that the primary alkaloid (spigelin/spigiline) interacts with acetylcholine receptors in helminths, causing paralysis and eventual expulsion. This mirrors the clinical behavior of synthetic anthelmintics, but with a different binding profile.
Cardiovascular action: Pharmacological screening of S. anthelmia fractions published in the International Journal of Pharmacognosy found that Fraction A produced hypotensive and bradycardic effects in the anesthetized cat, effects that appeared to be associated with muscarinic receptors, since they were completely blocked by atropine. The intraperitoneal injection of Fraction A in anesthetized rats produced hypotension, bradycardia, and a variable effect on cardiac contraction.
Smooth-muscle effects: Fraction A produced contractions of both guinea pig and rat isolated ileums; this effect appeared to be associated with H₁ receptors, as chlorpheniramine blocked 100% of the contractile response.
Skeletal muscle effects: An ethyl acetate extract of aerial parts was shown to induce tonic paralysis in vivo; it decreased amplitude of twitches and increased tonus of skeletal muscle in vitro.
The most rigorously studied application — even if still primarily in animals — is the expulsion of intestinal helminths. A 2006 peer-reviewed study published in the Journal of Veterinary Science (indexed on PMC) screened aqueous fractions of an ethanolic extract of Spigelia anthelmia for anthelmintic activity in a rat model of Nippostrongylus braziliensis infection. The aqueous portion of Spigelia anthelmia was found to have an acceptable anthelmintic efficacy, with a calculated median effective dose (ED50) of 21 mg/kg body weight. The therapeutic index obtained in the study suggested that the extract was quite safe even at higher doses.
Pink Root is most popular as an anthelmintic and is said to be most potent for tapeworm and for the roundworm. Extracts may be useful in the control of gastrointestinal nematodes of sheep and goats.
Evidence strength: The anthelmintic evidence is principally pre-clinical (animal models and in vitro), with no published controlled human clinical trials identified. The traditional record of use is extensive, but formal human efficacy evidence is absent. Despite intriguing preliminary studies, high-quality clinical trials remain scarce.
Pharmacological research on Spigelia extracts — carried out predominantly with the related S. anthelmia — has demonstrated meaningful cardiovascular activity in animal models. A 2010 study published in the Journal of Ethnopharmacology examined the cardiovascular effects of Spigelia extract on rats; the results suggested significant hypotensive and antiarrhythmic effects.
The preliminary pharmacological evaluation published in the International Journal of Pharmacognosy demonstrated in anesthetized animals that the intravenous infusion in rats of Fractions A and C produced a prompt, more or less short-lasting hypertension after 1 and 10 mg/kg, while a dose of 30 mg/kg led to acute lethal intoxication with signs of cardiorespiratory depression. This dose-dependent biphasic response underscores the narrow therapeutic index of these extracts.
In traditional Eclectic medicine, cardiac neuralgia with palpitation and pain extending along the arm was also said to be relieved by Spigelia, with fractional doses preferred for this purpose. Large doses were said to debilitate the heart.
Evidence strength: Cardiovascular evidence is exclusively pre-clinical (animal studies). No controlled human clinical trials have been conducted. More research on the pharmacological activities of the different compounds in the leaves, fruits, and roots is needed, especially on the anthelmintic and cardiac effects.
Researchers investigated Spigelia extract's anti-inflammatory properties in animal models in a 2012 study published in the Journal of Ethnopharmacology; the researchers found that the bioactive compounds present in Spigelia anthelmia extract had significant anti-inflammatory properties.
Evidence strength: Preliminary animal model data only. No human trials have been conducted on this indication.
In homeopathic practice, Spigelia is used for a wide range of neurological and sensory complaints. These include trigeminal neuralgia, eye pain, headache, and toothache. This medicine is said in homeopathic literature to have a marked action on the heart to manage palpitations, stitching pain in the heart, and pericarditis; for palpitations, it is indicated when these occur from bending forward, from the least movement, and from deep inhalation.
It is important to note that these are the main rubriks of Spigelia Marilandica in traditional homeopathic usage and are not approved by the FDA. There are no peer-reviewed randomized controlled trials evaluating homeopathic preparations of Spigelia for any of these indications. The homeopathic use therefore rests entirely on classical "provings" and practitioner tradition, not on clinical evidence.
All dosages below are reported from historical pharmaceutical sources and a pre-clinical study and are cited as documented — not as recommendations.
Every part of this plant contains the alkaloid spigiline, which is considered the active medicinal component but is also poisonous to humans. Symptoms of toxicity include dimness in vision, nausea and vomiting, dilation of the eyes, and convulsions. The alkaloid spigiline can cause increased heart action, vertigo, convulsions, and death if overdosed.
Pink Root can be a safe and efficient herbal remedy, if administered in proper doses and always followed by a saline aperient, such as magnesium sulphate; otherwise it can be unpleasant and serious side effects may occur. The root is potentially toxic if it is absorbed through the gut, which is why traditional practice consistently required a cathartic or purgative to be administered after the root so that it would be expelled from the body along with the worms.
Large doses are said to debilitate the heart. Animal pharmacology confirmed a biphasic dose-dependent cardiovascular response: intravenous infusion in rats at a dose of 30 mg/kg led to acute lethal intoxication with signs of cardiorespiratory depression. The Spigelia anthelmia species is thought to be more active in its influence upon the heart than Spigelia marilandica; otherwise there is said to be little difference between the two species.
Historical overdose records documented severe central nervous system effects. The symptoms of S. marilandica are mainly from overdosing; a state of mania was induced in a boy from large and frequent doses of a decoction of the root. Pinkroot is said to be narcotic in large doses, causing increased heart action, dizziness, vertigo, disturbed vision, muscular spasms, convulsions, and possibly death.
The root is best used when fresh but can be harvested in the autumn, then dried and stored; it should not be stored for longer than two years.
Reports indicate it can be used with other herbs such as Foeniculum vulgare (fennel) or Cassia senna; these will ensure that the root is expelled along with the worms, since the root is potentially toxic if absorbed through the gut.
Spigelia is a member of the Loganiaceae family, which houses notoriously poisonous species that contain strychnine. While pinkroot has an ethnobotanical history, it is toxic if ingested in quantity and contains the alkaloid spigiline.
Spigelia marilandica holds a global conservation status of apparently secure (G4) according to NatureServe, indicating it is apparently secure across its range and not currently at risk of extinction on a global scale, though it exhibits regional vulnerability at the periphery of its distribution. It is listed as state endangered in Indiana (S1), where populations are limited to fewer than six occurrences as of October 2025; in North Carolina (S1), it is classified as threatened, with occurrences restricted primarily to the southwestern mountains. Wild-collection of roots for medicinal purposes may have reduced populations in the eastern United States. It is included on the United Plant Savers' "To Watch List," indicating that wild populations are potentially threatened due either to market demand or ecological threats.
Pink Root (Spigelia marilandica) occupies an unusual position in the landscape of botanical medicine: it is a well-documented traditional anthelmintic with a robust 18th- and 19th-century medical record, a narrow but real pharmacological profile supported by pre-clinical research, and essentially no modern controlled clinical trial evidence in humans. Despite intriguing preliminary studies, high-quality clinical trials remain scarce, and dosage protocols often draw from 19th-century folk texts or small pilot trials. Spigelia anthelmia will likely spread into more African countries as a traditional anthelmintic; however, more research on the pharmacological activities of the different compounds in leaves, fruits, and roots is needed, especially on anthelmintic and cardiac effects. Its primary contemporary role is as a homeopathic ingredient, where it appears in products targeting neuralgic pain, headache, and heart palpitations — uses that rest on traditional homeopathic "provings" rather than clinical trial data.
Health conditions that Pink root may help support.
Body systems that Pink root may help support.
Go back