Etoposide is among the World Health Organisations's list of essential medicines and it is derived from podophyllotoxin. Mayapple can be also used topically as an escharotic in removing warts, and two of its derivatives, etoposide and teniposide, have shown promise in treating some cancers. The rhizome of the mayapple has been used for a variety of medicinal purposes, originally by indigenous inhabitants and later by other settlers. Mayapple has been used by American Indians as an emetic, cathartic, and antihelmintic agent. Mayapple contains podophyllotoxin, which is highly toxic if consumed, but can be used as a topical medicine. The rhizome, foliage, and roots are also poisonous. The ripened yellow fruit is edible in small amounts, and sometimes made into jelly, though when consumed in large amounts the fruit is poisonous. Plants are commonly found infected by the rust Allodus podophylli, appearing as honeycomb-patterned orange colonies under the leaves, and yellowish lesions on the upper surface. Mayapple plants are considered obligately dependent upon such mycorrhizae, although it may also be facultatively dependent upon rhizome age and soil nutrient levels. Many species of plants have mycorrhizae to assist with nutrient uptake in infertile conditions. The fruit or "apple" is usually produced early in summer and ripens later in summer. Though the common name is mayapple, in some areas it is the flower that appears in early May, not the "apple". They are also grown as ornamental plants for their attractive foliage and flowers, and they are a larval host for the golden borer moth and the may apple borer. Podophyllotoxin is highly toxic if consumed. Posalfilin is a drug containing podophyllin and salicylic acid that is used to treat the plantar wart. The substance they contain ( podophyllotoxin or podophyllin) is used as a purgative and as a cytostatic. The ripe fruit does not produce toxicity. Īll the parts of the plant are poisonous, including the green fruit, but once the fruit has turned yellow, it can be safely eaten. The flowers are white, yellow or red, 2–6 cm (1" to 2") diameter with 6–9 petals, and mature into a green, yellow or red fleshy fruit 2–5 cm (1 in to 2 in) long. The plants produce several stems from a creeping underground rhizome some stems bear a single leaf and do not produce any flower or fruit, while flowering stems produce a pair or more leaves with 1–8 flowers in the axil between the apical leaves. The stems grow to 30–40 cm (12 in to 16 in) tall, with palmately lobed umbrella-like leaves up to 20–40 cm (8 in to 16 in) diameter with 3–9 shallowly to deeply cut lobes. Mayapples are woodland plants, typically growing in colonies derived from a single root. It is widespread across most of the eastern United States and southeastern Canada. Its common names are mayapple, American mandrake, wild mandrake, and ground lemon. Podophyllum peltatum is an herbaceous perennial plant in the family Berberidaceae.
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