Croton tiglium 巴豆

POISONOUS PARTS

Whole plant, especially the seeds.²

TOXICITY

• Toxic Constituents

  Phorbol, phorbol esters and crotin.^3,4

• Toxic Dose

  1 fruit can be toxic. Seeds contain 34–57% croton oil. Half a drop of croton oil can be toxic; 20 drops can be lethal.^2,5

• Mechanism

  Phorbol esters have purgative effect. Crotin inhibits protein synthesis, induces haemolysis and causes local cell necrosis.^2,6

• Poisoning Features

  Skin contact: contact dermatitis and blistering. Eye contact: keratoconjunctivitis. Ingestion: burning sensation of the oral cavity, vomiting, diarrhoea, abdominal pain, oliguria, proteinuria, dizziness, headache, delirium and convulsion.^7–9

• Poisoning Events

  Poisoning outbreak due to malicious addition of C. tiglium in food, affecting 26 cases with mainly gastrointestinal tract symptoms, has been reported in China. All patients recovered uneventfully with supportive management.¹⁰

CLINICAL MANAGEMENT

Supportive treatment. Correction of fluid and electrolyte disturbances in patients with severe gastrointestinal symptoms.¹⁰

IDENTIFICATION FEATURES

Treelets, 3–7 m tall; young branches sparsely stellate-hairy. Leaves papery, biglandular at the base; leaf blades 5–15 × 2–7 cm, basal veins 3–5. Racemes terminal, 8–20 cm long. Male flowers: pedicels 5–9 mm long, calyx-lobes 2–3 mm long, stamens 16–17. Female flowers: pedicels 3–4 mm long, calyx-lobes about 2.5 mm long, styles biparted. Capsules 1–2 × 1–2 cm. Seeds 8–12 × 6–7 mm, grey-brown.¹¹

MEDICINAL USES

Highly toxic; use with caution. Seeds used in TCM: induce purgation and relieve accumulation, induce diuresis to abate oedema, dispel phlegm to soothe the throat, debride furuncles and kill parasites. Recommended dose: processed seed oil 0.1–0.3 g.^2,12–14

LABORATORY ANALYSIS

Phorbol esters can be detected by LC-MS/MS.¹⁵