Don't eat the, um, weeds

So one summer evening in 2008, a Maryland family sits down to a dinner of home-made beef stew flavored with mint from the backyard and, oh yeah, some other plant growing in the leafy borders by the fence. It looks like this:An hour after dinner, another relative shows up to find the members of the dinner party dazed and incoherent, some giggling uncontrollably, some staggering with hallucinations. Then they start to throw up. The dismayed relative calls 911; by the time all six of the stew-eaters arrive at the emergency room, two are unconscious. All are struggling for breath, their heart-rates are tripping at super-speed, they're desperately thirsty, and becoming so violently agitated that the doctors start dosing them with sedatives.

No one is able to tell the physicians what exactly went into that stew.

And so, according to a report newly published by the U.S. Centers for Disease Control, investigators went to the stricken family's house, trying to figure out what had happened. The results, written up for CDC's Morbidity and Mortality Weekly Report, tell us just how grubby this kind of investigation can be. Investigators sifted through the left-over stew "which was green in color with cooked leaves visible in the bottom of the pot." They sorted through the kitchen trash, pulling out wilting stems of plant material.

And they brought out a horticulture specialist to tell them what they'd actually found. The  expert promptly identified both the cooked leaves and the stems as belonging to the jimsonweed plant. Jimsonweed is known scientifically as Datura Stramonium. But its nicknames - devil's trumpet, locoweed - give you a better sense of the plant's reputation among those who know it well.

Jimsonweed contains two potent and dangerous plant alkaloids: atropine and scopolamine. Atropine is so potentially lethal that it is named after Atropos, one of the three Fates of Greek mythology, who determined a mortal's method of death.  Both of these alklaloids directly interfere with the nervous system, blocking a neurotransmitter called acetylcholine, which helps control muscle movement. In measured doses, atropine is used as a medical treatment for heart conditions, among other things, because it can help speed up the heart rate.

Or in the case of the Maryland stew-eaters send the heart stuttering into super-speed. Other classic symptoms of an atropine overdose, as the CDC notes, include "dry mucous membranes and skin, thirst, flushing, fever, blurred vision, altered mental status, urinary retention, tachycardia, coma" and sometimes death. In the end, all the family members from the 2008 case did survive. But in the 1990s, there was a rash of atropine deaths after adventurous teenagers took to chewing jimsonweed seeds for their hallucinogenic properties.

I've tried to think of a good moral lesson here regarding chewing on the seeds of a famously poisonous plant or stewing up unidentified weeds in the backyard. But I keep getting stuck on the rather obvious conclusion of 'don't be stupid'. Not all plants are our friends. Think of it like this - it's a jungle out there.

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I often work with patients who choose to use "natural" remedies instead of medication prescribed by a physician. Reminding them that hemlock is natural doesn't change their minds, maybe referring them to this blog will.

By Kathleen Jacobs, RN (not verified) on 01 Mar 2010 #permalink