Punica granatum 安石榴

POISONOUS PARTS

Roots, bark and peels.³

TOXICITY

• Toxic Constituents

  Pelletierine, isopelletierine and pseudopelletierine.³

• Toxic Dose

  Reported lethal dose: 40 g bark.⁴

• Poisoning Features

  Nausea, vomiting, diarrhoea, abdominal pain, dizziness, weakness, mydriasis, blurred vision, headache, hyperreflexia, convulsion and hypertension. Hypotension, respiratory depression and even death in severe cases.^2–5

• Poisoning Events

  A young man who consumed a decoction made with 40 g bark was admitted with headache, dizziness, nausea, vomiting and weakness. He was found to have complete heart block and left heart failure. He succumbed 12 hours after admission despite resuscitation.⁴

CLINICAL MANAGEMENT

Supportive treatment.

IDENTIFICATION FEATURES

Shrubs or small trees, 3–5(–10) m tall. Branchlets with many axillary leafless or leafy spurs, often spine-tipped. Leaves opposite, papery; leaf blades 2–9 × 1–2 cm. Flowers 1–5-fasciculate at branch apex, fleshy. Petals bright red, 1.5–3 × 1–2 cm, crumpled. Fruits 5–12 cm in diameter, yellowish green, white or reddish, crowned by the persistent calyx. Seeds red, pink or yellowish white.⁶

MEDICINAL USES

Uses in TCM—peels: astringe the intestines to stop diarrhoea, stanch bleeding, remove toxin, kill parasites; flowers: cool blood, stanch bleeding; leaves: stop diarrhoea, remove toxin and kill parasites; roots or root bark: kill parasites, astringe the intestines, reduce vaginal discharge. Recommended dose: peels 3–9 g, flowers 3–6 g, leaves 15–30 g, roots or root bark 6–12 g.^2,5,7–9

LABORATORY ANALYSIS

Pelletierine and pseudopelletierine can be detected by GC-MS and HR-MS.^10,11