Chemists tested blood and urine samples as well as the tea itself to confirm that it was aconitine, using mass spectrometry to identify the molecule’s structure.Īconitine causes arrhythmia by interfering with the structures that pump sodium ions in and out of specialized cells in your heart.
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“These types of abnormal heartbeats that really aren’t responding to any medication at all kind of points in the direction of aconite,” says Smollin. The key for Smollin-and one of the scariest things about aconitine-was that the drugs that typically fix arrhythmia weren’t working. Soon, the patient started to lose consciousness, and their heart went into arrhythmia, an abnormal heartbeat rhythm. Fortunately, that person also told doctors they’d just made some tea. Nausea, vomiting, tingling and numbness in the face and extremities are all common early signs of aconite poisoning. “The only way you’re going to make this diagnosis is to know some of the history,” says Craig Smollin, medical director of SF’s poison control center. The first patient who came to the emergency room in this case thought they might be having a stroke. It can be difficult to diagnose and even harder to treat. These two most recent victims are probably lucky they got sick in San Francisco. There have been some notable deliberate aconitine poisonings, like this case of a jealous lover in London in 2009. But if the root is merely steeped, not boiled, that only serves to leach more of the poison into the victim’s tea. Typically, the patient is advised to boil the root for about half an hour to finish the preparation started by the herbalist and further reduce aconite’s toxicity. But that part is easy to mess up, explains Boyer. Processing can convert the deadly cardiotoxin into a fairly effective non-steroid anti-inflammatory drug, according to Boyer.
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That tuber, carefully prepared, is used in traditional Chinese and Hindu medicine. She referred to the toxin as a contaminant, although from my conversation with doctors it seems likely the victims sought out aconitine. A DPH spokeswoman says the store’s proprietor is fully cooperating with the department to help determine why the poisonings happened.