Datura Poisoning

 

Datura

Two varieties:

(i) Datura Alba—White flowers

(ii)Datura Niger—Black or deep purple flowers.

The fruits are spherical with sharp spines—Thorn apple and contains yellowish

 brown seeds.  All parts of the plant are poi­so­nous, but the fruit and seeds are most

 poisonous.

Active Principles: (i) Hyoscine (ii) Hyoscya­mine (iii) Traces of atropine.

Mechanism of action: The symptoms are due to the blockade of peripheral

 muscarinic receptors that innervate exocrine glands, smooth muscle, and cardiac

 tissue. Therefore, the primary toxic manifestations include mydriasis, which is due

 to the blockade of papillary sphincter muscle and iris muscle; dry mouth,

 secondary to parasympathetic blockade of salivary secretion; tachycardia, caused

 by competition at muscarinic receptors in postganglionic parasympathetic neurons

 and blockade of receptors in the SA node; and fever and erythema, because of

 vasodilation and inhibition of sweating.  

Gardener’s eye and cornpickers eye: When the sap or dried plant material

 from a member of the Datura species enters the eye directly, the papillary

 sphincter and ciliary muscles are affected resulting in mydriasis and cycloplegia.

 Pupil dilation is sudden in onset and often profound. The mydriasis can be

 bilateral, but most commonly it is unilateral.

Signs and Symptoms

(i) Contact with the leaves and flowers cause dermatitis in sensitive patients

(ii) When the seeds are ingested, the symptoms appear within half an hour

(iii) At times vomiting occurs immediately after taking the seeds when crushed due to gastric irritation

(iv) Bitter taste and dryness of mouth and throat

(v) Burning pain in the stomach

(vi) Dysphagia and difficulty in talking

(vii) Headache followed by giddiness

viii) Staggering gait and incoordination of muscles

(ix) Flushing of face

(x) Dry and hot skin with rise in body temperature to 107-108 oF

(xi) Pupils are dilated and there is photophobia

(xii) There is loss of accommodation for near vision

(xiii) Conjunctiva is red and injected

(xiv) There is inability to pass urine

(xv) Drowsiness 

(xvi) At times scarlentiniform rashes or exfoliation of skin are seen over most of the body 

(xvii) Pulse is full and bounding, later it is weak, irregular and intermittent 

(xviii) Respiration is increased 

(xix) Muscle tone and deep reflexes are increased; muscular spasm is present at times 

(xx) Delirium is restless and purposeless. He is silent or mutters indistinct or

 inaudible words, but usually he is noisy, tries to run up away from his bed, picks

 bed clothes, tries to pull imaginary threads from the tips of his fingers, threads

 imaginary needles (pin rolling movements).

Muttering Delirium: It is a type of delirium in which an individual's speech is

 marked by low utterances, slurring, dysarthria or any combination of these.

 Typically, the individual's movements are dominated by restlessness and

 trembling.

(xxi) Dreadful hallucina­tions of sight and hearing is present 

(xxii) Delusions are present.

The signs and symptoms of acute Dhatura poisoning can be summarized by 10 D’s:

(i) Dysphagia (ii) Delusions (iii) Dermatitis (iv) Delirium (v) Drowsiness (vi) Dry

 skin and mucous membrane (vii) Dilated pupil (viii) Dreadful hallucinations (ix)

 Dysuria (x) Dysarthria.

The signs and symptoms can also be remem­bered as:

(i) Hot as a hare (increased temperature) (ii) Blind as a bat (disturbed vision) (iii)

 Dry as a bone (intense thirst) (iv) Mad as a hen (mental symp­toms—Delirium,

 hallucination, delusion, rest­less­ness) (v) Red as a beet (flushing of the face).

Fatal Dose: 100-125 seeds

Fatal Period: 1 day

Autopsy Findings

(i) Postmortem findings are not characteristic, but signs of asphyxia are there

(ii) Seeds or their fragments may be found in the stomach or intestine

(iii) Stomach may show slight inflam­mation

(iv) Lungs are congested and oedematous

(v) All the organs are congested.

Medico legal aspects

(i) Dhatura is used mostly for criminal purposes. It is used to stupefy travelers for

 the purpose of rob­bery, rape and theft. It is also called Road Poison seeds that are

 mixed with rice, dal, coffee, and sweets. Seeds and leaves are mixed with tobacco or

ganja and smoked in Chillum (pipe).

(ii) Dhatura seeds resist putrefaction for a long time but mydriatic principle

 contained in them is destroyed by putre­faction. It can be chemically detected even

 after a long time

(iii) Dhatura is sometimes used for homi­cidal purposes.

(iv) Medicinal use of Dhatura: dried leaves mixed with cannabis in the form of

 cigarettes are used for the treatment of asthma.

 

Differences between Chilli and Dhatura seeds
Features	Chilli seeds	Dhatura seeds
Size	Smaller	Larger
Shape	Round	Kidney shape
Surface	Smooth	Finely pitted
Colour	Yellowish	Brownish
Smell	Pungent	Odourless
Convex border	Single edged	Double edged
On section	The embryo curved inwards	Curved outwards

 

 #datura #poisoning