POISONOUS PARTS
Whole plant, especially the roots.2
TOXICITY
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Toxic Constituents
Veratrum alkaloids such as jervine and veratramine.3–5
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Toxic Dose
100 g of the plant can be toxic.6
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Mechanism
Veratrum alkaloids bind to selected sodium channels and impair the generation of action potentials, hence affecting signal conduction in skeletal muscle, nerve and cardiac cells. Veratrum alkaloids also have strong emetic effect.3,5
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Poisoning Features
Nausea, vomiting, abdominal pain, paraesthesia, numbness, headache, sweating, salivation and weakness. Bradycardia , hypotension and heart block in severe cases.3
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Poisoning Events
Multiple cases of Veratrum species poisoning, due to ingestion of the roots, leaves or seeds, as a result of misidentification as edible species, have been reported in Europe. Most patients recovered uneventfully with supportive treatment.3,6,7
CLINICAL MANAGEMENT
Supportive treatment. Correction of fluid and electrolyte disturbances in patients with severe gastrointestinal symptoms. Activated charcoal therapy has been used for gastrointestinal decontamination in Veratrum species poisoning.3
IDENTIFICATION FEATURES
Perennial herbs, up to 1 m tall. Stems simple, erect. Leaves basal and alternate; leaf blades 15–30 × 2–6(–10) cm, strongly plicate-veined. Panicles variable in length; rachis and pedicels greywhite woolly. Perianth segments 6, yellowish green, greenish white or brownish, 5–8 × 2–3 mm. Capsules 1–2 × about 1 cm, erect. Seeds flattened, winged, black.8
MEDICINAL USES
Roots and rhizomes used in TCM: dispel wind-phlegm, kill parasites, relieve itching. Recommended dose: 0.3–0.6 g.2,9–11
LABORATORY ANALYSIS
Jervine and veratramine can be detected by LC-MS and LC-MS/MS.12,13
