FLAG THAT IRIS

In the hands of two medical doctors and a noted ethnobotanist the new edition of the A.M.A. Handbook is a welcomed improvement on the original. It is still not without error. I question the need to include plants that should only concern a farmer and a large- animal veterinary surgeon.

When a caring mother sees Tall Bearded Iris included as a poisonous plant but does not read the text thoroughly and critically, she might think it necessary to get rid of her garden plants for the safety of her child.

Tall Bearded Iris, Iris germanica are very hardy, easily cared for, long-lived perennials that deserve a spot in any sunny garden. It would be a shame if you couldn't do so on doctor's orders.

. The other Iris that they cite is the Yellow Flag, Iris pseudacorus which is usually container- grown as a water plant. It is European but is now well established in our wetlands.
Sweet Flag is Acorus calamus and not an Iris; as far as I can see it has a spotless record and no outstanding warrants. One very old Cree claimed to know something about Sweet Flag but he would not say what it was.

When you read the text that surrounds a photograph of Iris germanica , you are told that the roots and leaves are toxic although the toxin is not known. Often accused as causing stomach irritation yet human cases have never been reported .
A competent Crown Prosecuter would never let this case go to trial.
Nothing further is said regarding the Yellow Flag, perhaps it could be a problem for farmers.   It is not clear.
Blue Flag Iris, Iris versicolor which may be the stylized floral heraldic on the Quebec flag, (speaking of flags) is not mentioned in the Handbook. It does get a mention occassionally by other writers, as causing harm to calves or year- olds. Well, I have only heard of one case but that would be more than enough for Sick Kids' et al. They condemn all Iris.
.

Yellow Flag                              Blue Flag

HORSE SHIT

HORSE CHESTNUTS ARE NOT POISONOUS.
Read many books or use any search engine and you might believe that they were. They are rarely eaten and do not compare with Sweet Chestnuts that the French call Marron; famously in marron glacé. American Sweet Chestnuts are known for 'roasting o'er an open fire' when Jack Frost is nippin' at your nose.

     The genus name for Horse Chestnut and for the Buckeyes is Aesculus. At the family level it is kin to citrus, mangoe, maple and mahogany.
 Sweet Chestnut is Castanea and related to beech and oak.
 The nuts of Horse Chestnut are scarcely edible and would probably never be eaten unless in times of famine. They are less than choice as a food item but they are not poisonous. Children playing the ancient game of 'conkers' don't have the dentition to chomp chestnuts unless they have already mastered the art of chewing marbles.

Native Americans ate the nuts of Ohio Buckeye, Aesculus glabra once the nuts were cooked. They would roast and peel them, mashing the flesh into a nutritional meal called Hetuk.

American farmers believe that Buckeyes are poisonous to cattle. Maybe so, since cows have no one to cook for them. If I was a farmer I too would be concerned about Buckeye nuts. These animals are expensive. Prices vary, but the last I checked a beef cow was worth around $1,500 and a dairy cow of good breeding could cost you between $1.800 and $3.000.   
Humans on the hoof are in over-supply and worth very little, if anything.

   Around the year 1900 a foreign fungus entered North America and within 40 years many millions of American Chestnut were gone, almost to extinction. Almost but not quite. Not yet.
 Mel Tormé's favourite chestnut is now 'off the menu' and has been replaced by Spanish and Chinese Chestnuts.

First we lost the American Chestnut then the American Elm and now we are losing the Ash to the Emerald Ash Borer. The 'Starry Night' Long Horn Beetle is a threat to many tree species. It is regretable that the public appear to know only a few familiar names such as, Crimson King Maple, Austrian Pine and  Colorado Spruce when there are so many handsome trees to choose from. As we begin to replace the Ash and more we must diversify and plant as many different genera and species as possible and avoid a monoculture that could all fall victim to the next plague that visits us.

Now that you know that the Horse Chestnut is not poisonous and that humans at least have nothing to fear from Buckeyes you can now consider them in your selectiion. They merit your attention.

Aesculus glabra
Ohio Buckeye



Aesculus pavia
Don't know why the Red Buckeye is called the Friday Flower
I'll take it any day of the week

THE CASE OF THE DORSET BOY

     In seeking a genuine case of a child being poisoned by Foxglove, I did not pursue any that mentioned Digoxin or Digitoxin as I believed that those would only concern the pharmaceutical tablet or the pediatric liquid.
  This was not what I was looking for; I wanted to learn of a poisonous interaction between a child and a plant in the garden. In many instances even when refered to as Digitalis it would once again be the pharmaceutical.
   Until I discovered the case of the Dorset boy. The scientific paper that was written on this case had a title that was perfectly clear.    
     "Digitalis Poisoning Due to the Accidental Ingestion of Foxglove Leaves"
(Therapeutic Drug Monitoring 5:217 (1983) Raven Press N.Y. )
Michael Simpkiss, pediatrician. Poole General Hospital, Dorset UK
and David Holt, Poison Unit, Guy's Hospital.  London UK

     It is not a pretty story, although I will say at once that given the circumstances it has a reasonably happy ending. The boy was fine.

   The 7 year old child is described as being severely mentally retarded.
He was diagnosed as having a genetic disorder termed epiloia or tuberous sclerosis that causes small benign tumours to form on various body organs.

   He was epileptic for which he received two different drugs three times a day.
He had pica.  The word pica was entirely new to me and since it may be new to you I will explain.
   PICA :  A pattern of behavior distinguished by the ingestion of non-food items such as dirt, sand, animal faeces, flaking paint or wallpaper and other papers. The word refers to Pica pica the European Magpie.

   The boy had been left unattended in the garden. When he was next observed he was producing green vomit and continued do so for 24 hours before he was taken to a hospital. His pulse rate was a low 48 beats a minute compared to
70/80 beats on previous admissions. The symptoms all suggested Foxglove ingestion which was confirmed by testing for digitoxin levels in the blood plasma. He had stopped vomiting after 48 hours and began to make a steady recovery. Tests had shown the presence of extremely high quantities of Digitalis indicating that a considerable amount of Foxglove had been consumed.
 Digitalis slows the heart and when it slows to an extreme you're dead.

     Have I been wise in relating these facts ? I am not sure. I do believe that silence can be the very worse kind of lie. The Case of the Dorset Boy is an extreme and very rare event. It is not something that will happen to your healthy child finding delight in a beautiful flower.
    A child who explores the taste of Foxglove will find that the leaves are furry and extremely bitter with nothing to appeal. A happy child would simply spit it out. Garden centres can continue to sell  Foxgloves with clear conscience and gardeners can take pride in their  plants.
We should be so lucky as to live where Foxgloves are a prominent feature of the countryside.


  

CAUTIONARY TALES

We are repeatedly told that children have died from contact with Foxglove, Digitalis purpurea and I cannot imagine something more tragic. With each retelling the stories become more frightening. Like the Broken Telephone game where a child's puke becomes a poisoning, morphing into a fatality, as each writer strives to be readable and avoids obvious plagiarism by putting the story into their own words. With each repetition the story gets worse and worse.

I have tried to follow such tales to the original case, only to see them disappear just as I thought that I was getting close. We are told many times of fatalities where children supposedly drank water from a vase of Foxglove flowers. I thought that this story would be validated in a paper that was published in the highly respected Pediatrics. (1974;54;374) by none other than Kenneth F. Lampe co-author of the A.M.A. Handbook of Poisonous and Injurious Plants. (1985)

The article, Systematic Plant Poisoning in Children is most disappointing since once again no actual case is cited. He avers that children have been fataly poisoned by drinking water from a flower vase. He does not tell us who the children were or if they were babies, toddlers or older infants. I want much more than that. Where and when did this happen ? Were the plants correctly identified ? Who was the attending physician ? Were remedies attempted ? What was the cause of death as declared on the Death Certificate ? He answers none of these questions. He is the famous doctor (Ph.D) and toxology expert and we are expected to take his word for it.

In fact there was no vase of flower water. It is a notional vase in which he not only imagines Foxglove but Oleander and Lily of the Valley too. We are being told a cautionary tale and being taught by parable. Now the story is being repeated and elaborated on by every Poison Centre in the English-speaking world and unthinking writers everywhere.

QUACK QUACK

HOLLY: The Genus Ilex.
If my workplace colleagues had known what was coming they might have warned, "Don't get him started." I had been overheard telling people that Holly berries were not poisonous and was soon visited by someone saying, " I think you were a bit fast there Tom when you were asked about Holly berries; they are poisonous"... and presented me with the Sick Kids' Hospital slanderous list.
 I went ballistic, as my colleagues knew I would. "Holly berries are NOT poisonous" I sputtered. " The folks at Sick Kids' Hospital are wrong."
 "Oh sure, you're right and everyone else is wrong. Who are people going to believe ?" He was right about that of course; people would take the word of a world-famous hospital over that of a mere garden centre employee. I'm still furious.

The book in my own quite extensive library that I depended on was Poisonous Plants of the United States and Canada (1964) by John M. Kingsbury professor of botany and lecturer in poisonous plants at Cornell University, N.Y. In this text written for students of medical and veterinary science, Holly is never mentioned or referred to: not once.

The American Medical Association Handbook of Poisonous and Injurious Plants (1985) states that the fruit is poisonous and gives as a reference a paper by Rodrigues TD et al: Holly berry ingestion: Case report. Journal of Veterinary and Human Toxicology, 1984.

Poisonous Plants of Canada (1990) tells us that the only documented case of poisoning was a mild one that occured after two young children ate "a handful" of berries (Rodrigues et al.1984)

Subsequent texts that came my way all refer me to Rodrigues et al.

Identical twin two year old girls were found eating berries from American Holly, Ilex opaca. We are not told by whom but presumably their mother who, believing that the berries were poisonous gave both girls a teaspoon of Syrup of Ipecac and a drink of water. ( Rodrigues says 15 ml of Ipecac and 120 ml of water. That sounds more clinical and impressive in a scientific paper.)

It was much as I had previously imagined. This was not a case of holly berry poisoning at all, and the papers' title should have been Ipecac poisoning : Case report.

Both girls continued to vomit, voiding loose stools that progressed to watery diarrhea and one became drowsy. Of course they did, they had both been given Ipecac syrup. As this very paper clearly states, "Because drowsiness is so common following Ipecac-induced emesis, however, we cannot confirm a definite causal relationship to the holly ingestion". The girl who became drowsy was taken to her pediatrician who said she was fine and sent her back home.

A second edition of the A.M.A. Handbook was released in 2007 to replace the original version whose cover was no longer appropriate. The book's back cover carried a strong endorsement for Syrup of Ipecac with instructions for its' use. Now, in a complete reversal of policy the emetic is no longer recommended. Where mothers might once have been rebuked by their pediatrician if Ipecac was not in the family medicine chest, are now told that it should not be used and should not be kept at home.

(I don't think that you will be able to buy it at the pharmacy today.)

The new edition of the Handbook was a perfect opportunity for the A.M.A. to repudiate the Rodrigues paper as they repudiated Syrup of Ipecac but they still give it as a reference. However, to make matters worse Oregon Holly is now included under Ilex. Adding the N.Y. Botanical Garden to the publishing roster has not helped the fact checking. Oregon Holly or Oregon Grape Holly is not even in the same family. It is not poisonous either. The blue berries are eaten fresh or used in jellies.

The Rodrigues paper has all the hallmarks of a scientific paper.

It has two well-qualified co-authors. It was published in a prestigious and appropriate journal where it was available for peer review.

It talks like a scientific paper. It walks like a scientific paper : but it is a canard.

If the mother of the twins had not been taught that holly berries were poisonous then this unfortunate incident would never have happened.

GLAD' TIDINGS

The Toronto Sick Kids' publication Information for Families-Plant Safety says that Gladiola are 'known to be poisonous to humans'. I don't know why.

   I do know that it should be Gladiolus. It could just be that the list maker has been eating the Alihotsy leaves and confused Gladioli with the Bouncing Bulb or the Bubotuber (http://hp-lexicon.org/magic/herbology.html)                     See J.K.Rowling The Harry Potter Lexicon : Magical and Mundane Plants
 She is a self-proclaimed plant hater.

WITHERING HEIGHTS

William Withering trained as a physician at the University of Edinburgh, probably the most important medical school in the world when he got his M.D. in 1776. As a well-tutored man he studied and published scientific papers on minerology and chemistry and was a first class botanist.   His intellectual life was exercised and enriched by  membership in the Lunar Society of Birmingham where he would wine and dine and exchange views on current science with the likes of Joseph Priestley who first (according to the British) isolated oxygen. Other famous members of the club included James Watt, improving and manufacturing the steam engine, Josiah Wedgwood who made porcelain and Erasmus Darwin, physician and grandfather to Charles.
   In 1775 Withering's opinion was sought regarding a herbal mixture that was being used by 'an old woman in Shropshire' to successfully treat 'dropsy' or congestive heart failure. Her mixture contained over twenty ingredients; but, said the doctor, "It was not difficult for me to perceive that the active herb could be no other than the Foxglove". For the next ten years until he published "An Account of the Foxglove" in 1786, he set about quite scientifically to discover how best to use the 'beautiful green powder'. He admitted that at first he was using a too strong dosage that produced a violent vomiting. He needed to find the amount that would slow the pulse rate and produce a stronger pumping action from the failing heart with less of the emetic side effect.
   So the eminent doctor had taken a folk medicine and gave us our first modern 'wonder drug'.

     Purple Foxglove, Digitalis purpurea is a much admired wayside wild flower that was welcomed into the English "cottage garden'. I would love to see it invade Ontario as it is one of very few shade tolerant plants that is tall growing. Unfortunately this biennial's first year foliage rosette rarely overwinters. (It does very well in British Columbia.) Remembering the shabby treatment accorded the beautiful Purple Loosestrife, perhaps we don't deserve it.
   Children and Foxglove have gotten along wonderfully well for generations before Withering and in the two hundred years since his great achievement. Now we have the overly anxious spoiling this idyll. We are told that children must not drink rainwater out of the flowers for fear of poisoning. Why do people say such things ? A Foxglove flower would make a better lampshade than a tumbler. They hang down. They don't collect water. Even if a bloom is detached and used as a drinking glass, the drug dose would be safely homeopathic.
   It is perfectly obvious that despite Foxglove being so medicinally potent, that in fact, children are not poisoned. The leaves of Digitalis are bitter. If a child chewed a leaf it would be spat out. In the highly unlikely case where a leaf is actually swallowed, it would immediately be ejected by vomiting.
   I neither want to make light of foxgloves toxicity nor have people be fearful of a desirable flower; I wish only to make the point that in real life children are not harmed. It does not happen.