Sutherlandia frutescens, is a much-respected and long-used medicinal plant that is also an attractive garden plant, and has been cultivated in gardens for many years, for its fine form, striking colour and luminous flowers.

Description
Sutherlandia is an attractive small, soft wooded shrublet, 0.5 to 1 m in height. The leaves are pinnately compound . The leaflets are 4-10 mm long, grey-green in colour, giving the bush a silvery appearance. They have a very bitter taste.

The flowers are orange-red, up to 35 mm long, and are carried in short racemes in the leaf axils at the tips of the branches in spring to mid-summer (September - December). The flowers are not typical 'pea' flowers, the wing petals are very small and are concealed in the calyx, and the standard petal is much shorter than the keel.

The fruit is a large, bladder-like, papery inflated pod and is almost transparent. It can be used in dry flower arrangements as it dries well, maintaining its colour and form.

Ecology
Sunbirds pollinate the attractive, butterfly-like red flowers. The lightweight, papery, inflated pods enable the seed to be dispersed easily by wind. Stock browse the foliage.

Ecologically legumes are well known for fixing nitrogen in the soil through a symbiotic relationship with bacteria. The bacteria infect the roots, forming small growths or nodules. Inside the nodules, atmospheric nitrogen, which the plants cannot use, is converted to ammonia, which plants can use. The plant supplies sugars for the bacteria, while the bacteria provide the biologically useful nitrogen that the plant absorbs.

Distribution
Sutherlandia frutescens occurs naturally throughout the dry parts of southern Africa, in Western Cape and up the west coast as far north as Namibia and into Botswana, and in the western Karoo to Eastern Cape. It shows remarkable variation within its distribution.

Derivation of name and historical aspects
The genus Sutherlandia is so closely related to Lessertia and some botanists consider that it should be sunk in to Lessertia. This species is sometimes called Lessertia frutescens. The genus Sutherlandia was named after James Sutherland, ?1639-1719, first Superintendent of the Edinburgh Botanic Garden. The genus Lessertia is named after Jules Paul Benjamin de Lessert, 1773-1847, a French industrialist, banker, amateur botanist and owner of an important private herbarium used by De Candolle. The species name frutescens means bushy in Latin.

Sutherlandia frutescens has many common names. It has become widely known as sutherlandia, The name cancer bush, kankerbos, comes from its reputation as a cure for cancer. The names balloon-pea, blaasbossie or blaas-ertjie (meaning bladder-bush or bladder-pea) all refer to the inflated, bladder-like fruits. The name klapper (meaning rattle) is a name applied to many species whose seeds rattle about in the mature, dry pods. The name hoenderbelletjie is in reference to the bright red flowers that are suggestive of the wattles (belletjies) of a fowl (hoender). The names eendjies and gansiekeurtjie are in reference to the inflated fruits which float on water and which are used by children as toy ducks (eendjies) and toy geese (gansies). Keurtjie is an old name applied mainly to species of Podalyria and occasionally to Sutherlandia and used as far back as 1680, derived from the Dutch keur meaning 'the pick of' or 'choice' in reference to their showy flowers. The Zulu name unwele means 'hair' - alluding to the fact that the plant stops people 'pulling out their hair' with distress.

The Fabaceae (pea & bean or pod-bearing family) is the second largest flowering plant family. It contains more than 600 genera and 12 000 species and is found throughout the world. In southern Africa this family is represented by 134 genera and more than 1 300 species.

The genus Sutherlandia, which has since been sunk in Lessertia, used to contain only 5 species, widespread throughout southern Africa. The genus Lessertia, which now includes Sutherlandia, is widely distributed in Africa, consists of ± 60 species, with ± 50 in southern Africa.

There are other closely related species that are often confused with Sutherlandia frutescens, these are Sutherlandia montana the mountain cancer bush, Sutherlandia microphylla commonly known as bitterblaar or grootgansiesbos, and Sutherlandia tomentosa, also known as eendjies or rooikeurtjie.

Uses and cultural aspects:
This plant is one of the most talked about in the ethnobotanical world because it has a strong reputation as a cure for cancer and now increasingly as an immune booster in the treatment of HIV/AIDS. Research on its properties is ongoing.

It has long been known, used and respected as a medicinal plant in southern Africa. The original inhabitants of the Cape, the Khoi San and Nama people, used it mainly as a decoction for the washing of wounds and took it internally to bring down fevers. The early colonists regarded it as giving successful results in the treatment of chicken pox, stomach problems, and in the treatment of internal cancers. It is also known to have been used in the treatment of eye troubles, the eyes being bathed with a decoction of the plant. It continues to be used to this day as a remedy for the above-mentioned ailments. It is still used as a wash for wounds, to bring down fevers, to treat chicken pox, for internal cancers, and farm workers in the Cape still use it to treat eye troubles. It is also used to treat colds, 'flu, asthma, TB, bronchitis, rheumatism, rheumatoid arthritis and osteo-arthritis, liver problems, haemorrhoids, piles, bladder, uterus & 'women's' complaints, diarrhoea & dysentery, stomach ailments, heartburn, peptic ulcers, backache, diabetes, varicose veins and inflammation. It is also used in the treatment of mental and emotional stress, including irritability, anxiety and depression and is used as a gentle tranquillizer. It is said to be a useful bitter tonic and that a little taken before meals will aid digestion and improve the appetite. It is considered to be a good general medicine.

There is as yet no scientific support for the numerous claims and anecdotes that this plant can cure cancer, but there is preliminary clinical evidence that it has a direct anti-cancer effect in some cancers and that it acts as an immune stimulant.

Sutherlandia should not be regarded as a miracle cure for cancer, its real benefits are as a tonic that will assist the body to mobilize its own resources to cope with the illness. It is known to decrease anxiety and irritability and to elevate the mood. Cancer patients, as well as TB and AIDS patients, lose weight and tend to waste away. Sutherlandia dramatically improves the appetite and wasted patients start to gain weight. It is also known to improve energy levels and gives an enhanced sense of well-being. It is hoped that treatment with sutherlandia will delay the progression of HIV into AIDS, and even remission of the disease is hoped for.

Growing Sutherlandia frutescens

Sutherlandia is fast growing and easy to grow, but short-lived as a garden subject. It is a tough, hardy plant that does well in full sun and tolerates all soil types. It occurs both in summer and winter rainfall regions, and is quite drought tolerant so does not require much watering. When growing it in containers, make sure that it is well drained and don't over-water. The plant is also quite pest resistant. Plants seed themselves readily, so that as the older plants start to look past their best they can be removed.

It makes interesting temporary filler in the mixed border, rockery or shrubbery, especially if it is planted in groups or en masse. It is also a good contrast foliage plant against a green backdrop and can be used effectively to punctuate a soft landscape planting. It is also a must for the herb garden. It grows well in containers, and can be used as a temporary decoration for the patio or courtyard. Because they are fast and tough, they also work quite well as pioneers in a new garden, where they give cover and colour while the slower growing perennials get going.

The cancer bush seeds itself readily, and grows easily from seed. Sow in autumn or spring in well-drained soil. Germination is improved if seeds are left to soak for about 4 hours or overnight in water hot enough for you to put your hand in. We have found that many members of the pea & bean family are susceptible to pre-emergence damping off. Using sterile soil and treating the seed with the Apron (a.i. metalaxyl) effectively combats fungal infection. Keep the seed trays warm (not hot) and damp but not wet. Germination should occur in 2 to 3 weeks and seedlings can be transplanted as soon as they are large enough to handle. Planting the plants close together in groups of 3 or 5 will give you a fuller, more attractive bush.

References

• GOLDBLATT, P. & MANNING, J.C. 2000. Cape plants. A conspectus of the Cape flora of South Africa. Strelitzia 9. National Botanical Institute, Pretoria & Missouri Botanical Garden Press, Missouri.
• JACKSON, W.P.U. 1990. Origins and meanings of names of South African plant genera. U.C.T. Printing Dept., Cape Town.
• LEISTNER, O.A. (ed.) 2000. Seed plants of southern Africa: families and genera, Strelitzia 10. National Botanical Institute, Pretoria.
• POOLEY, E. 1998. A field guide to wild flowers KwaZulu-Natal and the Eastern Region. Natal Flora Publications Trust, Durban.
• ROBERTS, M. 1990. Indigenous healing plants. Southern Book Publishers, Halfway House, Gauteng, South Africa.
• SMITH, C.A. 1966. Common names of South African plants. Memoirs of the Botanical Survey of South Africa No. 35. Dept. of Agricultural Technical Services, Pretoria.
• VAN WYK, B.-E., VAN OUDTSHOORN, B. & GERICKE, N. 1997. Medicinal plants of South Africa. Briza Publications, Pretoria.
• VAN WYK, B-E. & GERICKE, N. 2000. People's plants. A guide to useful plants of southern Africa. Briza Publications, Pretoria.
• Website: http://www.sutherlandia.org

Authors: Phakamani M' Afrika Xaba & Alice Notten
Kirstenbosch National Botanical Garden
April 2003