Dichroa febrifuga 常山

POISONOUS PARTS

Whole plant.^2,4

TOXICITY

• Toxic Constituents

  Dichroine.^2,4,5

• Toxic Dose

  10 g dried roots can be toxic.^4,6

• Mechanism

  Dichroine stimulates vagal and sympathetic nerve endings, causing gastrointestinal upsets. It also causes mucosal damage, leading to gastrointestinal bleeding.⁵

• Poisoning Features

  Nausea, vomiting, diarrhoea, abdominal pain, haematemesis and melaena. Palpitation, arrhythmias, hypotension, circulatory failure and even death in severe cases.^2,4–6

• Poisoning Events

  A suspected fatal case of D. febrifuga poisoning has been reported in China. The patient had a history of rheumatic heart disease. She developed nausea and repeated vomiting after consuming 10 g of dried roots as TCM. She later developed cardiogenic shock and succumbed despite supportive treatment.⁶

CLINICAL MANAGEMENT

Supportive treatment.

IDENTIFICATION FEATURES

Shrubs, 1–2 m tall. Branchlets often fleshy, terete or slightly 4-angular, usually purplish. Leaf blades papery, 6–25 × 2–10 cm, margin denticulate or serrulate. Corymbose panicles terminal, 3–20 cm long. Flowers bluish, about 8 mm in diameter; calyx lobes 4–6; petals 4–6. Stamens 10–20; styles 4–6. Berries 3–7 mm in diameter, blue when ripe.⁷

MEDICINAL USES

Roots used in TCM: induce vomiting of phlegm and slobber, remove heat, control malaria. Recommended dose: 5–9 g.^2,8–11

LABORATORY ANALYSIS

Dichroine can be detected by HPLC-DAD.¹²