This kind of "black sesame" cannot be eaten, be careful of Datura poisoning!

Datura is an annual herbaceous plant of the Solanaceae family, which is widely distributed throughout my country. Wild plants have small white trumpet-shaped flowers and small meteor-shaped fruits. When ripe, the fruit shells crack, revealing the black seeds inside. The seeds are like fat black sesame seeds, and the surface is not smooth. Datura is toxic throughout the body. Although its seeds, flowers and leaves have medicinal value, such as calming asthma, dispelling wind and relieving pain, do not take them blindly. The scopolamine component contained in Datura can cause human poisoning.

Datura in full bloom. Photo by Zhou Xiangyu

Image source: Xinhuanet

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Why does Datura cause poisoning?

The main ingredients of hyoscine are atropine and scopolamine. Atropine and scopolamine are clinically used as M cholinergic receptor blockers, which can treat abdominal pain caused by gastrointestinal smooth muscle spasms, organophosphorus pesticide poisoning, septic shock, etc. They can only be used under the guidance of professional doctors.

What are the common causes of Datura poisoning?

Common causes of poisoning are eating datura seeds as black sesame seeds and soaking them in medicinal wine. The poisoning dose for adults varies from person to person, and the poisoning dose for children is one-tenth of that for adults. The medicinal dose of datura is 0.15-0.3 grams. It has been reported that consuming 10-30 seeds can cause poisoning symptoms, and 2-3 datura fruits can cause poisoning and death. Usually, poisoning symptoms can be caused within 0.5-3 hours of taking it. It manifests as inhibition of the parasympathetic nerves and excitement of the central nervous system, which is similar to the symptoms of atropine drug poisoning.

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What are the main symptoms of Datura poisoning?

1. Dry mouth and no sweat on the skin.

Scopolamine can inhibit the secretion of salivary glands and sweat glands. The poisoned person will feel dry mouth and dry skin without sweat. In addition, swallowing becomes difficult due to reduced saliva secretion.

2. Flushed complexion.

Scopolamine can dilate capillaries, improve microcirculation, accelerate blood flow to the face and cause facial flushing, and the facial expression is similar to a person's face facing the wind in winter.

3. Increased heart rate and irritability.

Scopolamine can inhibit the vagus nerve of the heart, causing the heart rate to increase and blood pressure to rise. The poisoned person will experience panic, heart palpitations, and irritability.

4. Difficulty urinating.

Scopolamine can block the smooth muscle of the bladder, causing the smooth muscle to not contract. At this time, urine will be stored in the bladder. Because the bladder muscle cannot contract, urine cannot be discharged and the patient will show urinary retention.

5. Dilated pupils and blurred vision.

Daturoscopolamine can relax the pupillary sphincter, causing mydriasis and increased intraocular pressure, and also relax the ciliary muscle and flatten the lens, resulting in a state where distant objects are clear but near objects are blurred, manifesting as accommodative paralysis.

6. Vertigo and ataxia.

Scopolamine poisoning can cause damage to the central nervous system, resulting in dizziness with spinning vision, unsteady standing, clumsy and uncoordinated movements, and in severe cases, ataxia symptoms such as falls.

7. Severe cases may cause convulsions, coma, and high fever.

Mandrostenolone can stimulate the central nervous system, causing patients to experience convulsions, shaking, chorea-like movements, incoherent speech, confusion and other mental symptoms. In severe poisoning, the central nervous system turns from excitement to inhibition, leading to coma and respiratory depression. High fever can be caused by the absence of sweat and paralysis of the body temperature center.

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How is Datura poisoning diagnosed?

1. Contact history.

The patient had a history of eating or contacting Datura before the onset of the disease.

2. Clinical symptoms.

Symptoms similar to atropine poisoning appear, mainly including dry lips and mouth, no sweat on the skin, flushed face, rapid heart rate, dilated pupils, difficulty urinating, irritability, delirium, coma, convulsions, high fever, etc.

3. Qualitative laboratory tests.

Including qualitative analysis of urine atropine and detection of blood atropine concentration.

4. Rule out other diseases.

Exclude diseases such as acute cerebrovascular disease, intracranial space-occupying lesions, epilepsy, intracranial infection, and perform routine blood tests, blood sugar tests, and biochemical tests.

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How to save yourself and provide first aid for Datura poisoning?

1. Call 120 emergency number immediately and go to the hospital as soon as possible.

While waiting for the ambulance, induce vomiting as soon as possible. You can use your fingers or the handle of a spoon to stimulate the throat to produce vomiting. The earlier you induce vomiting, the better. Try to vomit out all the contents of the stomach.

2. Induce vomiting and wash the stomach repeatedly with warm water.

Inducing vomiting and gastric lavage is not difficult and can be done by yourself. The details of the operation should be noted to avoid using cold water and hot water that are too different from body temperature. Repeated drinking of cold water can cause stomach discomfort or gastrointestinal spasmodic pain. Water temperature that is too high will accelerate gastrointestinal blood circulation and accelerate toxin absorption. The water drinking technique is to drink 300-500ml of warm water at a time. Drinking too little water will not have a good flushing effect in the stomach. Drinking too much water will increase the intragastric pressure and promote the stomach contents to enter the intestines. Reduce pauses as much as possible and avoid drinking mouthfuls of water. The purpose is to shorten the entire gastric lavage time. Then use the pharyngeal stimulation method to induce vomiting by yourself. Drink water repeatedly to induce vomiting to wash the stomach until the vomited water becomes clear and free of residue. If you cannot induce vomiting and gastric lavage by yourself, you need to insert a gastric tube and use a gastric lavage machine to wash the stomach. If bleeding is found during gastric lavage, gastric lavage should be stopped.

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3. Catharsis treatment.

Generally, the gastric contents will be emptied into the intestines within 4 hours. If the medication is taken for a long time, the poison has already entered the intestines, and the effect of gastric lavage will be greatly reduced. At this time, the poisoned person should also be treated with catharsis. The purpose of catharsis is to reduce the absorption of toxins and accelerate their discharge. Mannitol and magnesium sulfate are commonly used for catharsis. They are osmotic laxatives. They are mainly because they cannot be absorbed, thereby increasing the osmotic pressure in the intestinal cavity, allowing the water in the intestinal wall to passively enter the intestinal cavity, resulting in diarrhea and bowel cleansing. Drink about 800-1000ml of warm water after taking the cathartic agent, and diarrhea usually begins in half an hour. For people with long-term constipation, it is necessary to increase the dose of catharsis and add enema. Judge whether the catharsis is clean based on the stool you excrete. The stool is light yellow, transparent and has no fecal residue, which indicates that the catharsis is successful. If the fecal water discharged is still turbid and has a lot of residue, the catharsis is not thorough, and you need to continue drinking water or drink a small amount of laxatives.

4. Drug antagonism therapy.

Doctors will use drugs such as neostigmine and pilocarpine to treat and relieve the symptoms of poisoning, depending on the dose and symptoms of poisoning. Neostigmine is an anticholinesterase drug with a complete cholinergic effect, while pilocarpine selectively acts directly on the M cholinergic receptor. These two drugs have an antagonistic effect on scopolamine poisoning.

5. Symptomatic treatment and treatment to protect gastric mucosa.

The previous vomiting, repeated gastric lavage and diarrhea may cause dehydration, acute gastric mucosal bleeding, and a decrease in important electrolytes such as potassium ions and sodium ions in the body, as well as a disorder of the body's acid-base balance. The doctor will intravenously infuse an appropriate amount of glucose or saline according to the results of blood tests, and give intravenous potassium and sodium supplements for electrolyte disorders such as hypokalemia and hyponatremia. Gastric mucosal protective drugs can be used to reduce gastric bleeding and gastric mucosal damage. Patients with irritability and convulsions can be given appropriate sedatives.

6. Treatment with traditional Chinese medicine.

Use 200g mung bean, 25g licorice, 100g honeysuckle, 50g forsythia, add 1000ml water, boil until 200mL, take in divided doses.

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What is the prognosis for Datura poisoning?

Generally speaking, patients who seek medical treatment in time can fully recover through gastric lavage, catharsis, medication and careful nursing. A small number of patients die of respiratory failure due to delayed treatment, huge poisoning doses and the influence of underlying diseases. The key to preventing and treating Datura poisoning is to avoid accidentally eating Datura seeds and not to abuse the medicinal wine made from Datura seeds.