And Injurious Plants

Michael J. Balick, Ph.D.


ISBN-10: 0-387-31268-4 e-ISBN-10: 0-387-33817-9

ISBN-13: 978-0387-31268-2 e-ISBN-13: 978-0387-33817-0

Printed on acid-free paper.

in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dis-

Foreword by Lewis R. Goldfrank vii

Authors' Note xv

Botanical Nomenclature 3 Section 2. Poisons, Poisoning Syndromes, and Their Clinical

Photographers' Credits 307

quality botany, pharmacognosy, fine graphics, and a limited amount of clinical medicine. The first edition's authors, Kenneth Lampe and Mary Ann McCann,

Their vision, the increasing societal use of herbal preparations, and the investi-

ments have led to the dramatic intellectual, organizational, and photographic advances seen in this second edition.

both Poison Control Centers and emergency departments have dramatically soning caused by plant exposure. The staff of emergency departments and poison control centers have developed close working relationships that have had out the world.

The authors of this second edition represent a fusion of clinical and botanical worlds. Drs. Lewis Nelson and Richard Shih are both physicians educated in emergency medicine and medical toxicology, and Dr. Michael Balick is a botanist trained in the study of useful and harmful plants. Their collaborative efforts have created a handbook that meets the clinician's needs. This text has clinical medicine. This second edition is created to assist the clinician in addressing the needs of a poisoned child or adult. The authors have created a rigorous approach that starts with the physician addressing the patient's signs and symp-

plants that might lead to the development of the symptom complex and describes the mechanisms of action of the implicated toxin, additional clinical manifestations, and specific therapeutics for each presentation. The photographs of frequently encountered and clinically important plants are elegantly presented to permit the clinician to assist in the evaluation of potential toxic plant ingestions.

ignorance about plant ingestions are substantially alleviated. The authors'

Lewis R. Goldfrank, M.D. Department of Emergency Medicine

Bellevue Hospital/NYU Hospitals/VA Medical Center book of Poisonous and Injurious Plants. Several years ago, that organization and organize the photographs and drawings that appear in the book. The United States National Herbarium at the National Museum of Natural History lection of the late Harvard Professor Richard A. Howard, noted international authority on the botany of toxic plants, in order that they be available for this book. We thank George F. Russell of the NMNH for collaboration in that and it was through her patient and capable labors that we were able to work based on information from Steven Foster and Roger Caras's book Venomous

Staff of the Liberty Hyde Bailey Hortorium, Macmillian Publishing Co., New

(, IPNIā€”The International Plant Garden Virtual Herbarium ( necessary.

Richard A. Howard, as well as the third author; this group collectively con-Edition, making it much more user friendly. We are grateful for Bobbi Angell's

Marie Long, for their patient assistance in our search for appropriate illustra-

photographic images from its collections. The New York Botanical Garden's living collections were an important resource for illustrating this book and for understanding the plants we discuss herein, and we are grateful to Carlo Bal-

Scott Mori, and Michael Nee were kind enough to provide their insight on some

Rican farm, Luna Nueva, available to us for photographing.

bring to our workplace examples of poisonous plants that he found in his

Finally, we thank our families for their patience and support during the

Laura, Catherine, Randy, Anne, Helen, and Chi Kai. Lewis Nelson is grateful to Laura, Daniel, Adina, and Benjamin as well as Myrna and Irwin. Michael Balick thanks Daniel and Tammy Balick and Roberta Lee. They have each given us the

Michael J. Balick, Ph.D.

I studied botany before I studied medicine, having had the good fortune to pursue an undergraduate degree under the direction of the late Dr. Richard Evans Schultes, longtime director of the Harvard Botanical Museum and god-

plants, especially of the New World tropics. Initially, through his stories of the indigenous lifestyle of Amazonian peoples, and later by helping me undertake plants that led me to become first an investigator and later a practitioner of botanical medicine.

When I moved on to Harvard Medical School, I was dismayed to find that none of my teachers, even of pharmacology, had firsthand knowledge of the plant sources of drugs. Since then I have been continually struck by the lack of awareness of the medicinal and toxic properties of plants in our culture. Examples are unfounded fears of poisoning by common ornamentals such as the poinsettia, exaggerated fears of herbal remedies such as Chinese ephedra, ignorance of the vast medicinal importance of such spices as turmeric and ginger, and lack of awareness of the toxic and psychoactive properties of other spices, for example, nutmeg and mace.

At the root of this problem is the distance that exists between plant scientists and health scientists. Because I am trained in both worlds, I have been very conscious of it all my professional life. This intellectual gap creates difficulties for botanists who want to learn the medical significance of plants with pharmacological effects and for physicians, nurses, and pharmacists who want to

By bringing together specialists from both sides of this divide, the present book does a great service. It gives different perspectives on poisonous and inju-

nobotany. I wish it had been available when I was first practicing medicine and, because of my background in botany, was often asked questions about the harmful potentials of plants and products derived from them.

I meet many people who imagine that most wild plants are dangerous, who think that if you pick and eat plants at random in the backyard or woods you will die. In fact, the percentage of plants that are really harmful is quite small, as is the percentage that are really beneficial. If you wish to get to know plants, a good place to start is to learn about those that can kill or cause

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