The use of complementary and alternative medicines seems to be on the rise here in Britain. It is now not uncommon to see multiple alternative health stores on the high-street selling a plethora of products that claim to cure all your aches and pains. Nearly all of the treatments and remedies on sale have very little if any evidence to prove their effectiveness, yet the British people have shown their support with their wallets. To keep up with this ever-growing demand for alternative treatments, a cottage industry has developed online that, unlike the high-street shops, is not bound by the Trade Description or Medicines Act. This has led to a lot of vulnerable people being exposed to some truly insidious products that have the potential to cause a lot of pain and suffering. Perhaps one of the more shocking examples of this is the promotion of a paste called Black Salve (also known as Casema) to people suffering from cancer.
The story of Black Salve starts in 1930 with a medical student at the University of Wisconsin who created a paste that, when applied in a carefully calculated manner, could not only kill nonmelanoma skin cancer but also preserve tissue for surgical extraction and histology study. The idea was that this paste would be applied directly to the tumour, left for 24 hours and then the affected area would be removed by a surgeon. The process would then be repeated until microscopic examination of the removed tissue was negative for tumours. The medical student’s name was Frederic Mohs and he coined this new technique “chemosurgery” but this paste is now better known as Black Salve.
The paste is an escharotic substance meaning that when applied directly to the skin, it causes the cells to die – creating a thick black dry clump of necrotic tissue called an “eschar”. These differ from scabs which are composed of dried blood and not dead tissue which will eventually separate from the surrounding area and fall off. This often causes scarring and can potentially cause serious injury and disfigurement. The paste itself is made from a mixture of bloodroot (Sanguinaria canadensis) extract and zinc chloride. Bloodroot is a flowing plant native to eastern North America whose roots contain several compounds known as alkaloids. When cut, red liquid flows from the plant that coagulates like blood to form a thick paste. The most abundant compound in this thick paste is the benzylisoquinoline sanguinarine which is responsible for bloodroots escharotic properties. This compound works by inhibiting sodium-potassium pumps on the surface of the cell resulting in cell death. Its properties have been known for some time and in the past have been used by Native Americans on infected limbs and gums to “burn out” infections and for the topical destruction of skin lesions. Zinc chloride is an inorganic compound that causes severe skin burns and when applied directly to the skin causes a painful inflammatory response with a subsequent eschar formation.
Although Mohs chemosurgery has limited success in treating superficial cancers, it was soon demonstrated that preserving tissue in this manner was not essential and that better results could be obtained by simply freezing the area. This had the added benefit of being less painful, shortened the surgical time, and unlike Mohs’ technique did not prevent immediate surgical repair. Nowadays the use of Mohs paste is practically nonexistent with dermatologists using more effective conventional treatments with nearly a 100% success rate. However, there is a growing interest in the paste in the alternative health scene online.
Black Salve is now, in some parts of the internet, being marketed as a magical cure for cancer that will not only destroy superficial cancers but can also “draw out” cancers from underneath the skin. There is also a growing consensus within this group that Black Salve only kills cancer cells and that it can somehow distinguish them from healthy cells. In reality, Black Salve will damage and destroy any tissues it comes into contact with and has no possible mechanism of it drawing anything out. This has led to a lot of vulnerable people trying this product out of desperation and being left disfigured – people who are being sold this product on its own without complimentary surgery.
Not content with only targeting people who have been diagnosed with cancer, these groups encourage amongst their peers self-diagnosis and treatment using Black Salve. This results in a lot of unnecessary pain and suffering but also a false sense of accomplishment from people who likely never had cancer to begin with. The most famous example of the dangers of using Black Salve is the case of Ruth Conrad who in 1984 visited a naturopath for a sore shoulder. Whilst there, she mentioned that she has a bump on her nose which the naturopath stated without a biopsy, histological examination, or medical training that it was cancer and recommended Black Salve. Within just a few days her face became painful, but her naturopath encouraged her to apply more paste to her face. Within a week a large part of her face, including her nose dropped off.
It’s worrying just how many websites there are out there promoting escharotic substances like Black Salve to cancer patients and those who believe they have cancer, whilst downplaying the very real and life-threatening dangers of using it. None of them show the true horror of what the product they are selling can do to a person, or how there is no evidence that this stuff will do anything other than burn a hole in your skin. Instead, we get testimonials and anecdotal reports of treatment success from those who have self-diagnosed cancer or those who are also undergoing conventional treatment. It’s a self-correcting group because the people who this product has hurt the most are now unable to contribute to the conversation.