Medical Toxicology of Natural Substances

Dr. Donald G. Barceloux is presently a Staff Physician in the Department of Emergency Medicine at Pomona Valley Community Hospital. He is also a teacher at UCLA, an active consultant on medical toxicology, and a fellow at the American Academy of Clinical Toxicology, American College of Medical Toxicology, and the American College of Emergency Medicine. In addition, he has written an array of papers and co-authored a medical toxicology reference book.

• FOREWORD xvPREFACE xviiACKNOWLEDGMENTS xixREVIEW PANEL xxiPART 1 FOODBORNE and MICROBIAL TOXINS 1I Chemical Contamination and Additives 5by Cyrus Rangan, MD, FAAP1 Food Contamination 52 Food Additives and Sensitivities 22II Staples and Spices 343 Akee Fruit and Jamaican Vomiting Sickness (Blighia sapida Köenig) 344 Cinnamon (Cinnamomum Species) 395 Cyanogenic Foods (Cassava, Fruit Kernels, and Cycad Seeds) 446 Cycad Seeds and Chronic Neurologic Disease (Cycas Species) 547 Djenkol Bean [Archidendron jiringa (Jack) I. C. Nielsen] 598 Grass Pea and Neurolathyrism (Lathyrus sativus L.) 629 Nutmeg (Myristica fragrans Houtt.) 6710 Pepper and Capsaicin (Capsicum and Piper Species) 7111 Potatoes, Tomatoes, and Solanine Toxicity (Solanum tuberosum L., Solanum lycopersicum L.) 7712 Rhubarb and Oxalosis (Rheum Species) 84III Microbes 89A Bacteria 89by Cyrus Rangan, MD, FAAP13 Bacillus cereus 8914 Campylobacter jejuni 9615 Clostridium botulinum (Botulism) 10316 Clostridium perfringens 11417 Escherichia coli 12018 Listeria monocytogenes 13319 Salmonella 14120 Shigella Species (Shiga Enterotoxins) 15021 Staphylococcus aureus 15622 Streptococcus Species 16223 Vibrio Species 16724 Yersinia enterocolitica 174B Other Microbes 18125 Cyanobacteria 18126 Protozoa and Intestinal Parasites 19127 Gastrointestinal Viruses 202IV Seafood 21228 Amnesic Shellfi sh Poisoning and Domoic Acid 21229 Azaspiracid Shellfi sh Poisoning and Azaspiracid Toxins 21830 Diarrhetic Shellfi sh Poisoning and Okadaic Acid 22231 Neurotoxic Shellfi sh Poisoning and Brevetoxins 22732 Paralytic Shellfi sh Poisoning and Saxitoxins 23133 Ciguatera Fish Poisoning and Ciguatoxins 23834 Puffer Fish Poisoning and Tetrodotoxin 24735 Red Whelk and Tetramine 25336 Scombroid Fish, Scombrotoxin, and Histamine 256PART 2 FUNGAL TOXINS 261I Mushrooms 26537 Amatoxin-Containing Mushrooms 26538 False Morel and Gyromitrin Poisoning 28539 Gastroenteritis-Producing Mushrooms 29040 Inky Cap and Coprine Toxicity [Coprinus atramentarius (Bull.) Fr.] 29441 Isoxazole-Containing Mushrooms and Pantherina Syndrome (Amanita muscaria, Amanita pantherina) 29842 Muscarine-Containing Mushrooms and Muscarine Toxicity (Clitocybe and Inocybe Species) 30343 Orellanine-Containing Mushrooms and Nephrotoxicity (Cortinarius Species) 30744 Paxillus and Other Mushroom Syndromes 312II Mycotoxins 31745 Mycotoxins 317PART 3 MEDICINAL HERBS and ESSENTIAL OILS 373I Medicinal Herbs 37746 Aloe Vera [Aloe vera (L.) Burm. f.] 37747 Aristolochic Acid and Chinese Herb Nephropathy 38248 Black Cohosh (Actaea racemosa L.) 38849 Blue Cohosh [Caulophyllum thalictroides (L.) Michx.] 39450 Borage (Borago offi cinalis L.) 39751 Burdock Root (Arctium lappa L.) 40052 Calamus (Acorus calamus L.) 40353 Camphor (Cinnamomum camphora T. Nees & Eberm.) 40754 Cascara (Frangula purshiana Cooper) 41455 Cat’s Claw [Uncaria tomentosa (Willd. ex Schult.) DC.] 42156 Chamomile [Chamomilla recutita (L.) Rauschert, Chamaemelum nobile L.] 42557 Chaparral [Larrea tridentata (Sesse & Moc. ex DC.) Vail] 42958 Chaste Tree (Vitex agnus-castus L.) 43459 Clove and Eugenol [Syzygium aromaticum (L.) Merr. & L. M. Perry] 43760 Colocynth [Citrullus colocynthis (L.) Schrad.] 44361 Coltsfoot (Tussilago farfara L.) 44662 Comfrey and Other Pyrrolizidine-Containing Plants 44963 Cranberry (Vaccinium macrocarpon Aiton) 45864 Dong Quai [Angelica sinensis (Oliv.) Diels] 46165 Feverfew (Tanacetum parthenium Schultz Bip.) 46566 Garlic (Allium sativum L.) 47067 Germander (Teucrium chamaedrys L.) 47768 Ginger (Zingiber offi cinale Roscoe) 48269 Ginkgo Tree (Ginkgo biloba L.) 48870 Ginseng 49771 Goldenseal (Hydrastis canadensis L.) 50472 Hawthorn (Crataegus Species) 51073 Impila, Pine Thistle, and Atractyloside 51474 Jin Bu Huan and Tetrahydropalmatine 51875 Juniper (Juniper communis L.) 52276 Kava (Piper methysticum Forster) 52577 Lavender (Lavandula Species) 53278 Licorice (Glycyrrhiza Species) 53779 Ma Huang (Ephedra Alkaloids) 54580 Milk Thistle [Silybum marianum (L.) Gaertner] 55381 Passionfl ower (Passifl ora incarnata L.) 55882 Pennyroyal and Pulegone (Mentha pulegium L.) 56383 Purple Conefl ower and Other Echinacea Species 56884 Rosemary (Rosmarinus offi cinalis L.) 57485 Rue (Ruta graveolens L.) 57986 Sassafras [Sassafras albidum (Nutt.) Nees] 58287 Saw Palmetto [Serenoa repens (Bartram) J.K. Small] 58688 Senna (Senna alexandrina P. Mill.) 59189 Skullcap (Scutellaria laterifl ora L.) 59690 St. John’s Wort (Hypericum perforatum L.) 60091 Star Anise (Illicium verum Hook. F. and Illicium anisatum L.) 60792 Star Fruit (Averrhoa carambola L.) 61193 Tansy (Tanacetum vulgare L.) 61494 Valerian (Valeriana offi cinalis L.) 61795 Yarrow (Achillea millefolium L.) 62396 Yohimbe Bark and Yohimbine (Pausinystalia yohimbe Pierre ex Beille) 627II Essential Oils 63297 Citronella Oil [Cymbopogon nardus (L.) Rendle] 63298 Citrus Oil and Limonene 63599 Eucalyptus Oil (Eucalyptus Species) 644100 Neem Oil (Margosa Oil) (Azadirachta indica Adr. Juss.) 648101 Peppermint Oil (Mentha x piperita L.) 653102 Tea Tree Oil (Melaleuca Species) 658103 Tung Oil (Aleurites fordii Hemsl.) 663104 Turpentine and Pine Oil (Pinus Species) 666PART 4 TOXIC PLANTS 673I Plant Dermatitis 677105 Plant Dermatitis 677II Bulbs, Rhizomes, and Tubers 690106 Buttercup Family 690107 Colchicine-Containing Plants 693108 Daffodils and Other Emetic Bulbs 703109 Death Camas 707110 Kaffir Lily [Clivia miniata (Lindley) Bosse] 710111 Snowdrop (Galanthus nivalis L.) 712112 Zephyr Lily (Zephyranthes Species) 716III Beans 718113 Castor Bean and Ricin (Ricinus communis L.) 718114 Cowitch and Horse Eye Bean (Mucuna Species) 727115 Jequirity Bean and Abrin (Abrus precatorius L.) 729116 Mescal Bean [Sophora secundifl ora (Ortega) Lagasca ex DC.] 733IV Nonwoody Plants (Herbs) 736117 Aconite Poisoning and Monkshood 736118 African Blue Lily (Agapanthus Species) 743119 Red Baneberry [Actaea rubra (Aiton) Willd.] 745120 Begonias 747121 Yellow Bird-of-Paradise [Caesalpinia gilliesii (Hook.) Wallich ex D. Dietr.] 749122 Century Plant (Agave americana L.) 751123 Cleistanthin, Diterpene Esters, and the Spurge Family (Euphorbiaceae) 754124 Cyanogenic Plants and Laetrile® 760125 Dieffenbachia and Other Oxalate-Containing House Plants 768126 Digitalis-Containing Flowers (Foxglove, Lily of the Valley) 773127 Jimson Weed and Other Belladonna Alkaloids 776128 Lupines and False Lupine 784129 Mayapple (Podophyllum peltatum L.) 788130 Mistletoe 792131 Poison Hemlock (Conium maculatum L.) 796132 Pokeweed (Phytolacca americana L.) 800133 European Bittersweet and Other Solanum Species 803134 Sweet Pea and Osteolathyrism 806135 Tree Tobacco and Other Piperidine-Containing Plants 809136 Veratrum Alkaloids 815137 Wandering Jew (Tradescantia fl uminensis Vellozo) 819138 Water Hemlock and Water Dropwort 821139 White Snakeroot [Ageratina altissima (L.) King & H.E. Robins] 826V Shrubs and Vines 829140 Barbados Nut (Jatropha curcas L.) 829141 Boxwood (Buxus sempervirens L.) 832142 Buckthorn [Karwinskia humboldtiana (J.A. Schultes) Zucc.] 834143 Cactus 837144 Carolina Jessamine [Gelsemium sempervirens (L.) St. Hil.] 841145 Daphne (Daphne mezereum L.) 843146 Dog Laurel (Leucothoe Species) 845147 Dogbane Family and Cardenolides 847148 Holly (Ilex Species) 861149 Honeysuckle (Lonicera Species) 863150 Ivy and Falcarinol 865151 Lantana (Lantana camara L.) 867152 Rhododendrons and Grayanotoxins 870153 Snowberry [Symphoricarpos albus (L.) Blake)] 874154 Squirting Cucumber [Ecballium elaterium (L.) A. Richard] 876155 Wisteria 879VI Trees 881156 Black Locust (Robinia pseudoacacia L.) 881157 Buckeye (Aesculus Species) 883158 Chinaberry (Melia azedarach L.) 886159 Golden Chain Tree (Laburnum anagyroides Medikus) 889160 Karaka Nut (Corynocarpus laevigatus J.R. & G. Forst.) 892161 Oaks (Quercus Species) 894162 Pepper Tree (Schinus Species) 897163 Yew (Taxus Species) 899PART 5 VENOMOUS ANIMALS 905I Arthropods 909A Arachnids 909164 Mites and Ticks (Order: Acari) 909165 Scorpions (Order: Scorpiones) 914166 Spiders (Order: Araneae) 925B Centipedes 950167 Centipedes (Subclass: Chilopoda) 950C Insects 954168 Bees, Wasps, and Ants (Order: Hymenoptera) 954169 Bugs and Blister Beetles 969170 Fleas (Order: Siphonaptera) 976171 Flies and Mosquitoes (Order: Diptera) 979172 Lice (Order: Phthiraptera) 983173 Moths and Butterflies (Order: Lepidoptera) 988II Reptiles 996174 Amphibians—Toads, Frogs, Salamanders, and Newts (Class: Amphibia) 996175 Gila Monster and Beaded Lizard 1008176 Terrestrial Snakes (Suborder: Serpentes) 1013177 Sea Snakes 1074III Marine Invertebrates 1078178 Cone Shells and Blue-Ringed Octopus (Phylum: Mollusca) 1078179 Jellyfish, Hydroids, Sea Anemones, and Corals (Phylum: Cnidaria) 1085180 Sponges (Phylum: Porifera) 1102181 Starfish, Sea Urchins, Sea Cucumbers, and Fireworms (Phylum: Echinodermata) 1105IV Eels and Lampreys 1112182 Moray Eel (Superclass: Agnatha) 1112V Fish 1115183 Bony Fish (Class: Osteichthyes) 1115184 Cartilaginous Fish (Class: Chondrichthyes) 1128VI Mammals 1132185 Mammals 1132INDEX 1135

"Overall, this book would be a useful addition to the libraries of medical students, graduate students in pharmacology and toxicology, and natural products scientists. Furthermore, because of its "multidisciplinary evidence-based approach", the book presents an easy-to-follow and valuable resource for clinical toxicologists and analytical chemists, as well as those involved in the regulation of toxic substance exposure. It is a superb resource for a natural products clinical toxicology course." (Journal of Natural Products, 17 August 2011) "[The book] provides in-depth, evidence based coverage of the most important natural toxins found in foods, fungi, medicinal herbs, plants and venimous animals." (Food Science and Technology Abstracts, July 2010)“This wonderful book covers an enormous subject with attention to detail and direct clinical relevance in a style that is surprisingly easy to read. The remaining volumes will be eagerly awaited by clinical toxicologists everywhere." (The Medical Journal of Australia, January 2010)“This text provides a comprehensive guide to the medical toxicology of natural substances and is considered an excellent reference for forensic scientists including pathologists, toxicologists, criminalists, and scene investigators.” (Journal of Forensic Science, September 2009)“Entries vary from single species to large groups; hence coverage is quite variable, though always informative. This volume will be useful for researchers and clinicians.” (CHOICE, October 2009)“Medical Toxicology of Natural Substances provides a reliable and easily accessible source on what is known about this topic.” (JAMA, July 2009)"It should be a part of the library any scientist who deal wit natural products research, as well as toxicologists and pharmacologists. It should be a principle reference for poison control centers." (Journal of Medicinal Chemistry, published online March 26, 2009)