POISONOUS PARTS
Latex, bark and twigs.3,4
TOXICITY
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Toxic Constituents
A group of daphnane diterpene esters named as excoecariatoxins.4–6
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Mechanism
Excoecariatoxins are strong irritants to skin, eyes and mucosal surface.4–6
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Poisoning Features
Skin contact: irritant contact dermatitis. Eye contact: keratoconjunctivitis, blindness in severe cases. Ingestion: vomiting, diarrhoea.7,8
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Poisoning Events
A 13-year-old boy in Sri Lanka was splashed with the latex of the plant over his right eye, face, trunk and limbs while cutting the branches. He developed keratoconjunctivitis and irritant contact dermatitis with superficial burn. He recovered with minor skin scarring.9
CLINICAL MANAGEMENT
Supportive treatment. For skin and ocular exposure, affected area could be irrigated with water.7,8
IDENTIFICATION FEATURES
Evergreen trees, 2–5 m tall, with milky sap. Leaves alternate, papery to sub-leathery; leaf blades 4.5–10 × 3–5 cm, margin entire or crenulate. Plant dioecious; racemes axillary, the male 3–4.5 cm long, the female 2–3 cm long. Flowers without petals; bracts fleshy, broad-ovate. Capsules 0.7–0.8 × about 1 cm, globose, trisulcate.10
MEDICINAL USES
Whole plant used in TCM: induce purgation, expel toxin. Recommended dose: 0.5–1.5 g.2
LABORATORY ANALYSIS
Excoecariatoxins can be detected by NMR.6
