Veratrum album is a poisonous plant that can easily be mistaken for the yellow gentian, Gentiana lutea, used in beverages. Two adult men were brought to the emergency department six hours after drinking gentian spirit. Each presented with nausea and vomiting, preceded by a headache, developed within one hour after ingestion and followed by diarrhea in one of the patients. Vital signs were normal except for heart rates of 42 and 45 beats per minute in the two patients, respectively. Laboratory findings were unremarkable. Electrocardiograms revealed sinus bradycardia. Activated charcoal and antiemetics were given and the patients were admitted for observation of signs of toxicity. The further clinical course was uneventful. Heart rates returned to normal within eight hours after admission. Retrospective investigation of the gentian beverage confirmed that V. album was mistaken for G. lutea. Patients with clinical toxicity following unintentional ingestion of V. album should be kept under observation and generally recover with supportive care.
Veratrum species contain more than 200 different alkaloids, which are the principal toxins and are responsible for most clinical symptoms. There are likely multiple mechanisms of toxicity and some of them are only partially understood. The opening of voltage-gated sodium channels is probably one of the most relevant pathophysiological mechanisms.
Veratrum album intoxication in children demonstrated the same clinical course as observed in adults. Accidental ingestion of a low dose of the plant had a favorable outcome with supportive care.
Uses / Indications of Veratrum Album
- Angina pectoris
- Cholera Asiatica
- A headache, sick, nervous
- Intermittent fever
- Labor, constipation after
- Liver, hyperemia of Meningitis
- Menstruation, nausea before, diarrhea before.
- Neuralgia, palpebral
- Pernicious fevers Plica Polonica. Pneumonia
- A toothache
- Typhoid fever
The Dosage of Veratrum Album
- Adults and children: Dissolve 5 pellets in the mouth 3 times a day until symptoms are relieved or as directed by a physician.
- Adults: Dissolve 4 tablets under tongue 4 times a day. Children: 2 tablets as above