In Pozzuoli, vegetable poisoning: 8 people in hospital. One of the people hospitalized is in a reserved prognosis. Symptoms attributable to the ingestion of "mandrake", a plant that was confused with spinach and chard.
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Tonight the Carabinieri of the Pozzuoli company intervened at the Santa Maria Delle Grazie hospital for some people admitted for poisoning. These are people from different families, between 12 and 85 years old, who had ingested vegetables that were probably poisonous, purchased in different shops in the municipalities of Quarto and Monte di Procida.
The symptoms could be traced back to the “mandrake”, a plant that was confused with spinach and chard. One of these is in a reserved prognosis. ASL and Carabinieri investigations are underway. Initial investigations show that the vegetables were loose, not bagged. Investigations are underway in the shops where the accused vegetables were seized.
The first to report the incident was the association Nobody touches Hippocrates, who added on his Facebook page: “The accident seems to be due to the similarity of this plant to common spinach, a mistake by some local greengrocer?”
What is Mandrake?
Mandrake (Mandragora officinarum L.) – or mandrake, if you prefer – is a plant belonging to the Solanaceae family.
Having become famous and appreciated in ancient times for its alleged magical properties, today mandrake is a rather feared plant, because it is highly toxic and easily confused with other edible plants. In fact, there have been several cases of poisoning following the ingestion of mandrake leaves, mistakenly mistaken for leaves of other edible plant species, such as spinach, borage, some types of lettuce, etc.
Characteristics and botanical notes
As mentioned, mandrake is a plant belonging to the Solanaceae family and is native to the Mediterranean regions.
The drug consists of the dried underground parts, the fresh herb and the root.
Mandrake is a perennial herbaceous plant, almost without a stem, whose leaves form a basal rosette. Usually, the leaves are ovate-lanceolate in shape, dark green in color and have an unpleasant odor.
The flowers have a lanceolate calyx and the corolla has a color that varies from light green to yellow. The fruits are berries with a globose shape and yellow color, whose size can vary from two to four centimeters.
The root is often branched, brown in colour and anthropomorphic, and can reach considerable dimensions, penetrating the ground to a depth of 60 centimetres.
Active substances contained within Mandrake
The main active substances contained within the mandrake and responsible for its toxicity are tropane alkaloids. Among these, the main ones are represented by:
L-hyoscyamine;
Atropine (racemic mixture composed of D-hyoscyamine and L-hyoscyamine);
Scopolamine (also known as L-hyoscine).
This mixture of tropane alkaloids is present in the root as well as in the leaves of the plant.
Similar active substances are also present in other plants belonging to the Solanaceae family, such as, for example, Atropa belladonna.
Toxicity
Toxicity of Mandrake and Mechanism of Action of Tropane Alkaloids
The toxicity of mandrake is due to its content of tropane alkaloids which – acting at the level of muscarinic receptors (or cholinergic, if you prefer) – are able to produce toxic effects on various districts and organs (central nervous system, gastrointestinal system, cardiovascular system, etc.).
More precisely, these tropane alkaloids exert an antimuscarinic action, that is, they are able to block the muscarinic acetylcholine receptors, preventing this neurotransmitter from carrying out its normal functions within the organism. It is precisely because of this block that the typical symptoms of mandrake poisoning appear.
Symptoms of Mandrake Poisoning
The symptoms of mandrake poisoning manifest themselves in different areas of the body, since muscarinic receptors are present in various organs and tissues. The type of symptoms and the intensity with which they manifest themselves can vary depending on the quantity of toxic substances ingested.
In any case, the symptoms of mandrake poisoning are characterized by the appearance of:
Dry mouth;
Blurred vision and mydriasis;
Increased body temperature;
Difficulty urinating;
Drowsiness;
Constipation;
Tachycardia;
Dizziness;
Heachache;
Delirium and hallucinations;
Manic episodes;
Mental confusion;
Respiratory difficulties.
In the most serious cases, ingestion of mandrake – and therefore of the toxic substances it contains – can lead to coma and even death.
Treatment of Mandrake Poisoning
In case of suspected ingestion of mandrake and/or if the above symptoms appear after ingestion of apparently edible plants, it is necessary to contact medical assistance immediately.
If treated promptly, in fact, mandrake poisoning can be resolved without serious consequences. However, the complete resolution of such an event depends heavily on the quantity of toxic substances ingested and the sensitivity of the individual to these same substances.
However, fortunately, in case of poisoning by tropane alkaloids it is possible to resort to a specific antidote: physostigmine. This active ingredient is administered parenterally and – thanks to its mechanism of action – is able to increase the levels of acetylcholine at the level of cholinergic nerve endings, thus promoting the restoration of normal conditions of the organism.
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In addition to the administration of the antidote, patients with mandrake poisoning should receive all necessary supportive therapies, such as emptying the stomach contents by gastric lavage, lowering the body temperature (but without the use of antipyretics), administration of oxygen and/or possible intubation to counteract respiratory difficulties, and so on.
Therapeutic uses
Therapeutic uses of tropane alkaloids contained in Mandrake
Given its toxicity, mandrake has no use in the medical field, nor in phytotherapy or herbal medicine. However, the alkaloids it contains are used - at appropriate doses - in the pharmaceutical field for the production of medicines suitable for the treatment of various disorders.
For example, scopolamine is available in injectable pharmaceutical preparations and transdermal patches for the treatment of nausea and vomiting. In the form of a quaternary ammonium compound (scopolamine butylbromide), it can be found in medicinal specialties used to treat painful spasms of the gastrointestinal tract and the genitourinary tract (biliary and urinary colic).
Atropine, on the other hand, is used for the treatment of sinus bradycardia and for pre-anesthetic medication to reduce salivation and excessive respiratory tract secretions. Atropine is also used in ophthalmology to induce mydriasis for the purpose of performing specialist examinations.
Article published on 6 October 2022 - 09:35
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