In early fall, our increasingly sleepy woodland scenes are punctuated by clusters of fluffy, white flowers. At first glance, all these plants appear to be botanical besties, presumably sharing a species name. They proudly display their teeny, tubular blossoms, forming flat floral umbrellas atop long, leggy stems — luring all the autumn pollinators to the yard.
Though often found in overlapping forest circles, and genetically born of the same flora family, these native look-alike bloomers are actually two distinct representatives of the daisy, or asteraceae. One never lost its fabled title as a medicinal marvel, and the other endured an unfortunate reputation flip, going from venom remedy to highly toxic imitator.
They are common boneset and white snakeroot.
And in truth, both of these budding beauties contain alkaloids harmful to human and animal livers in large doses. But snakeroot is boneset’s notoriously more dangerous doppelgänger — indirectly responsible for thousands of deaths.
Old texts suggest boneset got its common name hundreds of years ago, when it was used as an Indigenous antidote for the debilitating symptoms of break-bone fever, aka dengue. Foliage of Eupatorium perfoliatum was macerated for a healing extract, and European colonizers (who imported the mosquito-borne disease) adopted the traditional Native American treatment.
“Common boneset was used as compress for sore muscles, bones and to reduce inflammation in joints,” Roxanne Swan, Native Plant Coordinator at the Audubon Society of Western PA (ASWP), located at Beechwood Farms Nature Reserves in Fox Chapel, tells Pittsburgh City Paper. “Tea made from dried leaves and sometimes flowers was used to treat colds, along with other common ailments, and to induce sweating and vomiting.”
Boneset quickly grew into a catch-all cure for anything from congestion to constipation, and it’s still recommended by some holistic practitioners as a way to alleviate flu ailments today.
Snakeroot, or Ageratina altissima, also has an eponymous moniker. In Native American folk medicine, when someone suffered a snakebite, the plant’s rhizomes were prepared as a soothing poultice and applied to wounded skin, reputedly triggering an anti-inflammatory response. Colonizers assumed and reinforced the practice, so the name stuck. But, for good reason, snakeroot’s herbal esteem was ultimately fleeting.
Throughout the 19th century, European immigrants expanded westward via the Ohio River in search of cheap, fertile farmland, bringing their cattle herds with them. They moved along the Rust Belt’s rural waterways, whose backwoods banks were idyllic for livestock free-ranging. Cattle cleared more and more pasture until moist meadows across the eastern and central US were rendered the perfect hosts for sprouting snakeroot. The opportunistic perennial seized the moment to aggressively spread, and soon, whole states were teeming with this tempting bovine treat.
Frontier cows gobbled up the deadly snakeroot, leeching poison right into the local milk supply. Families would fall fatally ill within days of consuming affected milk. “Allegedly, Abraham Lincoln’s mother died from ‘milk sickness,’” recounts Chris Bason, Executive Director at the ASWP.
No one understood what was happening and they were terrified — frenzied, even. Since the area’s geography imposed healthcare gaps on its remote communities, new-world pharmacology was still scarce and unaffordable. Botanicals were integral to household survival, and, therefore, unsuspecting people blamed witches and invented ideas about inexplicable surface vapors and even abandoned entire towns, desperate for an explanation and a cure.
Then, in 1834, a midwife from Philadelphia, Anna Pierce, noticed the seasonal incidence of milk sickness, and aptly attributed it to the food cycle. She consulted a Shawnee woman for guidance, who identified snakeroot as the horticultural culprit. Mystery solved! Being a woman, though, Pierce’s discovery wasn’t well regarded. Snakeroot pursued its path as an infamous nuisance and people continued to pass in great numbers for a few more decades until industrialized dairy became the agricultural norm.
From root to bud, the plant is packed with a fat-soluble alcohol compound called tremetol, which has an odor and consistency similar to turpentine. Ingesting the chemical causes violent reactions, including severe trembling and intestinal pain, vomiting, and muscle degradation that leads to heart failure. Tremetol accumulates in the body over time. It’s estimated that once snakeroot consumption is above 5% of a person’s weight, they’re too far gone.
These two plants are all around us. It’s likely every Pittsburgher encounters both boneset and snakeroot and the differences are subtle. So, how do residents discriminate between the two?
“Common boneset is distinguished by perfoliate leaves — leaves look like they pass through and join the opposite leaf, making them appear to be diamond-shaped,” Swan says. “The plant has hairy stems and white flowers in large flat clusters. It’s also a different shade of green from White Snakeroot.
“Snakeroot has textured leaves with prominent veins on the leaf back and a small serrate margin … it has leaves that are cordate/heart shaped with long petioles and prominent serrate margins,” she explains. “The plant has smooth stems and smaller white flower clusters than Eupatorium perfoliatum.”
Today, thanks to grazing best practices and increased safety precautions, the chances of contracting snakeroot-induced milk sickness are nearly none. But in a foraging game where misidentification is a lethal mistake, herbal experts always urge an extreme dose of caution when plucking wild plants.
Bason says hopeful harvesters can avoid confusing the two plants by heeding some important warnings:
“Make certain plant identification is correct before you even consider ingesting any wild plant. Check and double-check,” he says. “If there is any doubt, do not ingest.”He also encourages foragers to discourage children from putting wild plants into their mouths and to avoid collecting plants that have been sprayed with pesticides. “Be sure you know what part of the plant is safe to be used and when,” he tells City Paper. “Know which season the harvest should take place.”
This article appears in Nov. 5-11, 2025.
