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Wednesday, February 10, 2010

How Not to Cook Stew

Foraging herbs and mushrooms and other stuff from the wilds for dinner is a great idea. Except when it's not, as a Maryland family found out the hard way. See, I subscribe to a tasty little electronic newsletter known as MMWR Weekly. That's short for the Morbidity and Mortality Weekly Report (yes, there's a redundancy in there somewhere) from the Centers for Disease Control, and it's chock full of good stuff about diseases and death and other things to ponder when you're feeling a bit too happy. Last week had a great little nugget buried among HIV stats and the like: A full account of a family who accidentally prepared a jimsonweed stew. Then ate it.

For those of you not familiar with jimsoonweed, a.k.a. Sacred datura, it's a bushy plant, with dark green leaves and big, white, trumpet-shaped flowers. It grows in the desert, where it's sultry appearance seems wildly out of place. Georgia O'Keefe has a few famous paintings of datura. Adding to its allure is its danger: It's an hallucinogen, one of many written about by Carlos Castanada. And, as follows, it's also poisonous (kids looking for an easy trip sometimes brew a tea out of this stuff; it can take several days for the resulting visions to recede). So, you probably shouldn't make stew out of it lest this happen:

In the early morning hours of July 9, 2008, six adult family members were admitted to a hospital emergency department in Maryland with hallucinations, confusion, mydriasis, and tachycardia of approximately 3--4 hours duration.

The six affected persons came from one family and included three men and three women ranging in age from 38 to 80 years (median age: 42 years). All six shared a meal of homemade stew and bread at approximately 9:00 p.m. on July 8, 2008. No one else was at the home when the meal was eaten. Approximately 1 hour later, another relative arrived at the home and discovered the six affected family members laughing, confused, and complaining of hallucinations, dizziness, and thirst.
During the next 6 hours in the emergency department, the six patients continued to experience tachycardia, mydriasis, and altered mental status. One remained unconscious. The others demonstrated confusion, aggression, agitation, disorganized speech, incoherence, and hallucinations. All six were admitted to the hospital, five to the intensive-care unit. The unaffected relative reported to providers that pesticides had been sprayed on mint leaves that might have been incorporated into the stew.
Ahhh.... no. That's not it!

Over the course of their hospitalizations, the patients' signs and symptoms of anticholinergic toxicity fluctuated. In addition to tachycardia, mydriasis, and altered mental status, two patients experienced urinary retention, and one had a small pleural effusion identified by computed tomography scan (Table). The patients received supportive care, including cardiac monitoring and intravenous fluids. Four of six patients were administered lorazepam to control agitation. None were administered physostigmine. Their neurologic statuses improved during hospitalization and were normal by the time of discharge. Four were discharged on the third hospital day, one on the fourth hospital day, and one on the fifth hospital day, each with a final diagnosis of altered mental status secondary to food poisoning. The patient reported to have eaten the most stew was the slowest to recover and had the longest stay. All patients fully recovered.

And that's when they were able to remember what they ate: A stew with potatoes, garlic, onion, tomatoes, curry powder and the leaves from some plant out in the yard. Bingo.