Sunday, September 07, 2014

A Dangerous New Dish

Bibimbop Brugmansia *

* Do NOT try this at home.

Edible flowers can make for a beautiful garnish on salads and trendy Brooklyn cocktails, but these decorative flourishes can be a disaster for the oblivious amateur. An unusual case report in BMC Research Notes summarizes what happens when you sprinkle toxic flower petals on your bibimbop (Kim et al., 2014).

A 64 year old Korean woman came to the emergency room with incoherent speech and fluctuations in attention, orientation and comprehension. She had called her daughter for help but couldn't remember why. (Hint: that's because she ingested flowers containing scopolamine and atropine, two potent anticholinergic compounds that can cause amnesia).

In contrast to these alterations in her mental state, she did not show dilated pupils, dry mouth, increased heart rate, or other changes to the autonomic nervous system typically observed with anticholinergics [which seems odd to me]. After 10 hours had elapsed, she became fully conscious and remembered that she had added a few flowers to her bowl of bibimbop, a traditional Korean dish. Twenty-four hours later, her memory for the entire episode was hazy.

Angel's Trumpet (Brugmansia), a popular ornamental shrub, has a long history in ethnobotany and toxicology as a deliriant, differentiated from the psychedelic and dissociative hallucinogens. There are numerous case reports of presumed Angel's Trumpet poisoning in the literature. A 2003 review reported on 33 patients, 31 of whom deliberately consumed a brewed tea (Isbister et al., 2003). Dilation of the pupils (mydriasis) was seen in 100% of the patients, which is why it's odd that Kim et al. did not observe this.

In fact, one paper reported on accidental unilateral mydriasis in a 11 year old girl who touched “a nice pink flower, similar to a trumpet” and then rubbed her eye (Andreola et al., 2008).

But the most infamous case of deliberate Angel's Trumpet abuse is the young man who severed his own penis and tongue after drinking a tea, “illustrating that consuming this beautiful flower with the name of an angel and the poison of the devil can be very dangerous” (Marneros et al., 2006).

Scopolamine blocks M1 muscarinic acetylcholine receptors that are prominently distributed in the cerebral cortex, amygdala, and hippocampus. The septo-hippocampal cholinergic system plays an important role in learning and memory, accounting for the oft-observed amnesia.

Brugmansia was (and is) used by Native groups in South America for religious ceremonies. According to Lockwood (1979), the Jivaro in eastern Ecuador used Brugmansia in a boyhood rite of passage. The adults understood the potential danger of the delirious and hallucinatory state and closely supervised the child:
When a Jivaro reaches the age of six he seeks an arutam wakani, an acquired soul. ... To acquire an arutam soul, the boy, usually accompanied by his father, makes a pilgrimage to a sacred waterfall where he bathes, fasts, and drinks infusions of fresh tobacco water. If no vision or apparition appears, recourse may be to drink maikua, the juice of Brugmansia...
. . .

The arutam seeker is watched over by men not taking the maikua, in order to protect him from accidents or self-inflicted harm that might occur during the initial violent stages when the drug is taking effect. If the boy is fortunate, the arutam will appear to him, usually in the form of a pair of large creatures, often animals such as jaguars or anacondas.

In more recent times, the street drug 'burundanga' has been used by criminals to incapacitate potential victims, as Vaughan Bell has explained.

So the question arises, with such a long and distinguished literature, why was a new case study of Brugmansia poisoning published? Obviously, there are vast cultural differences between indigenous South American peoples, curious German and Australian youth, and elderly Korean women.

Heungmi kkotjeon (Pan-fried Sweet Black Rice Cake with Flower Petals)

The beautiful Korean dish above is made with non-toxic edible flowers. Another (similar?) dish is hwajeon, or "flower cake". Might this lead to a greater danger in accidentally eating toxic flowers? Kim et al. conclude:
This case is unique in that AT was ingested as an ingredient of a traditional Korean dish.  ...  Considering the fact that one can purchase it from virtually any florist without much difficulty, and that the number of adolescent recreational drug users is increasing, AT could be misused in the near future. The flowers of AT are occasionally used to garnish foods, so raising the awareness of the toxicities of this plant to the general public is important.

Further Reading

The tree of drunkeness

Hallucinations and hospitalizations: Angel’s Trumpet

The plant of human puppets

Cultural Chemistry - the plant that robs you of your free will?

Is free will spent by a knock-out drug?

Mind controller: What is the 'burundanga' drug?

If you must, 23 Recipes That Will Feed Your Inner Flower Child at Buzzfeed


Andreola B, Piovan A, Da Dalt L, Filippini R, Cappelletti E. (2008). Unilateral mydriasis due to Angel's trumpet. Clin Toxicol (Phila). 46(4):329-31.

Isbister, G., Oakley, P., Dawson, A., & Whyte, I. (2003). Presumed Angel's trumpet (Brugmansia) poisoning: Clinical effects and epidemiology. Emergency Medicine Australasia, 15 (4), 376-382 DOI: 10.1046/j.1442-2026.2003.00477.x

Kim, Y., Kim, J., Kim, O., & Kim, W. (2014). Intoxication by angel’s trumpet: case report and literature review. BMC Research Notes, 7 (1) DOI: 10.1186/1756-0500-7-553

Tommie Lee Lockwood, summarized by Evans Schultes, R., & Plowman, T. (1979). The ethnobotany of Brugmansia. Journal of Ethnopharmacology, 1 (2), 147-164 DOI: 10.1016/0378-8741(79)90004-7

Marneros A, Gutmann P, Uhlmann F. (2006). Self-amputation of penis and tongue after use of Angel's Trumpet. Eur Arch Psychiatry Clin Neurosci. 256(7):458-9.

More Photo credits: Bibimbop by Agnes Ly, via Wikimedia Commons and Brugmansia (angel’s trumpet) by Asit K. Ghosh Thaumaturgist, via Wikimedia Commons. Neurocritic Remix CC BY-SA 3.0.

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At September 09, 2014 6:46 AM, Anonymous Em said...

Well atropine is reportedly the plant's "defense" against herbivores (which is a theory that makes no sense to me - if it's a delayed reaction, unless it straight up kills the animal how does it protect the plants from being eaten?) so one wonders if it's become an ornamental has it been hybridized or otherwise changed somehow to have a new chemical profile. I write lots about mistakes with foraged edibles (and wrote recently about poison vs toxins) so nice to see more posts about it.

At September 11, 2014 12:21 PM, Anonymous Anonymous said...

I am a retired florist and have witnessed several cases instances that could lead to trouble. I did some flowers for a wedding and saw the bride's friends (who provided cupcakes at the reception) place hydrangea petals on each cupcake. Hydrangeas are poison I told them. Did they listen? No. Then I told the bride the problem. She shut me down. Another bride wanted Lily of the Valley on her cake. No way I told her--that plant is deadly. With the exception of pansies and violas it is best not to eat blue flowers.

Jennifer in San Jose, CA

At September 15, 2014 11:50 AM, Anonymous Anonymous said...

Holy smokes! Glad I did not eat the pink flowers that that came with my fish cakes at the Thai place last night!


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