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Mandragora officinarum L. is one of the traditional drug recorded in Uigurian document, but Uigurian doctors mistake Panax ginseng C. A. Mey. for Mandragora officinarum L. By herbal study and research of systematic botany for Uigurian drug Mandragora officinarum L., this paper considers that is doesn't substitute Panax ginseng C. A. Mey. for Mandragora officinarum L.
Anticholinergic syndrome (AS) due to accidental poisoning is exceptional. Mandragora contains a high concentration of atropine, hiosciamine and scopolamine. We have evaluated 15 patients with AS due to poisoning by Mandragora autumnalis, distributed in two family groups. The latency period since the ingestion was 1-4 hours (Means = 2.7 +/- 0.9). The clinical features corresponded to an AS of variable severity. All patients had blurred vision and dryness of mouth, nine (60%) had difficult micturition, nine dizziness, nine headache, eight (53%) vomit, two difficult swallowing and two abdominal pain. There was no correlation between the latency period and the clinical severity. Blushing, areactive mydriasis and tachycardia were found in all, dry skin and mucosae in 14 (93%), hyperactivity/hallucination in 14 and agitation/delirium in nine (60%). One patient developed a florid psychotic episode. Prostigmine (2-6 mg) was administered to 11 patients and physostigmine (0.5-2 mg) to six. The time until a definite response was observed was variable (3-36 hours). The patients treated with physostigmine had a better reversal of the psychoneurological symptoms. Mandragora was identified intermingled with chard [correction of stalwort] (Beta vulgaris) and spinach (Spinacia oleracea) leaves, and atropine and hiosciamine were identified.
After mentioning the botanic characteristics of mandragora, its territorial distribution, morphological characteristics and the toxicological properties of its alkaloids, a clinical case of accidental mandragora poisoning is reported. The case was successfully treated with atropinic block antagonists, namely cholinesterase inhibitors. Apart from its serious symptomatology, mandragora poisoning also involves considerable metabolic commitment of liver and kidney, which present evident signs of disturbance. Information about these and other insidious plants should be spread to prevent such cases of poisoning, whose gravity is enhanced by the fact that they are exceptional and not often encountered in clinical practice.
The present state of knowledge in the chemistry of mandragora plant is reviewed. Isolations and identifications of the compounds were done from all parts of this plant. Up-to-date more than 80 substances were identified in different species of the genus Mandragora.
A multiple case of Mandragora autumnalis poisoning is described. Mandragora autumnalis, a solanaceous plant that is common in the Sicilian countryside, contains a variable concentration of solanum alkaloids, which cause gastrointestinal irritation, and tropane alkaloids, which have anticholinergic properties and produce typical and sometimes severe atropine-like symptoms. Vital function support, decontamination, symptomatic treatment and, in severe cases, antidote therapy with physostigmine are useful to control acute poisoning.
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Pedanius Dioscorides of Anazarba in Cilicia lived in the first century. He was a Greek physician who served as a surgeon in Neròs army. He wrote several books on materia medica. One of his manuscripts with drawings of medicinal herbs was copied down in the fifth century. In this book on Greek Herbal, still kept in the National Library of Vienna, Dioscorides gave a detailed description of mandragora (mandrake). Over the ages, the mandrake has been endowed with a wonderful and mystical aura. Examples are superstitions regarding harvesting of the plant. While being torn from the ground, the mandrake would emit a horrible shriek, that would be fatal to the harvester who hears it. So, if someone simply pulled the plant, they would either die or go mad. To avoid that fate, the plant could be partially dug with a few remaining roots staying in the ground. Then a starved black dog was tied to the mandrake with a rope. The harvester, with plugged ears, would throw some scraps to the hungry dog. When the unsospecting animal lunged for food, the mandrake would be completely unrooted and the ensuing shriek would kill the dog and spare the man. According to different legends quoted by Theophrastus and Pliny the Elder, other dire consequences of unrooting a mandrake could be avoided by making circles around the plant on the ground with a sword and then facing west while digging. If there were a true Anaesthetic of Antiquity it would have been mandragora. Dioscorides describes how the wine made from mandragora produces anaesthesia: Using a cyathus of it on those who cannot sleep, or are grievously pained, or are being cut, or cauterized they will not feel pain. Here Dioscorides used for the first time the word anaesthesia as absence of sensation as we mean it today.
We describe a case of Mandragora autumnalis poisoning which occurred in a 72-year-old female patient who had eaten the venenous M. Autumnalis, picked near her home, mistaking it for the edible Borago Officinalis. M. Autumnalis is a solanaceous plant, common in the Sicilian countryside, which contains a variable concentration of solanum alkaloids, causing gastrointestinal irritation, and tropane alkaloids, with anticholinergic properties. Unluckily, M. Autumnalis is often mistaken for the edible B. Officinalis, likewise widespread in Sicilian countryside. The diagnosis of Mandragora poisoning was made on the basis of clinical symptoms and signs of anticholinergic syndrome associated with a history of vegetable meal of uncontrolled origin, moreover analysing the vegetable obtained from gastric lavage. Decontamination and symptomatic treatment were useful in our patient to control acute poisoning.