Handbook of Poisonous and Injurious Plants, 3rd ed., by Lewis S. Nelson and Michael J. Balick. New York, NY: New York Botanical Garden and Springer; 2020. Hardcover, 336 pages. ISBN-978-1-4939-8924-9. $59.99.

I firmly believe that a collaboration across disciplines can produce a richness not obtained from authors of one discipline. The third edition of Handbook of Poisonous and Injurious Plants exemplifies this. It is a collaboration between Lewis Nelson, MD, an academic emergency physician with a background in toxicology, and Michael Balick, PhD, a botanist with expertise in ethnobotany and toxic plants. This book combines Nelson’s experience in the clinical management of potential poisonings with Balick’s solid foundation of botanical knowledge to discuss and identify the plants.

The first edition of this book was published in 1985 by the American Medical Association and written by Kenneth F. Lampe, PhD, and Mary Ann McCann. The second edition was published as a partnership between Springer and the New York Botanical Garden, where Balick is the research and training director and philecology curator at the Institute of Economic Botany. This arrangement was continued with this third edition. The first edition included information on poisonous fungi. According to the authors, this information was dropped for the second and third editions, as that is covered more adequately in other texts.

Handbook of Poisonous and Injurious Plants is an excellent reference book for clinicians, botanists, and anyone with an interest in plants. The book begins with background on botanical nomenclature and terminology. The botanical terms are accompanied by illustrations that help immensely with interpreting the definitions. The botanical section is extremely important, as the first step of working with plants is to identify them by their Latin binomial.

The book proceeds with a section on the clinical symptoms and management of poisonings. Plants are grouped into categories according to the mechanism of poisoning and/or chemical constituents known to have harmful effects: anticholinergics, calcium oxalate crystals, cardioactive glycosides, convulsants, cyanogenic compounds, gastrointestinal toxins, mitotic inhibitors, nicotine-like alkaloids, pyrrolizidine alkaloids, sodium channel activators, and toxic albumins. There are also expanded sections on plant-induced dermatitis and gastrointestinal decontamination.

The book includes tables with lists of plants associated with dermatological irritations that would be useful for looking for a potential causative agent. One comment that struck me in particular was that children tend to ingest poisonous plants accidentally, whereas it is often intentional with adults — either for therapeutic, injurious, or psychoactive purposes. Another table I found particularly interesting was a listing of the top 10 plant exposures reported by US poison control centers in 2018. At the top was Capsicum (Solanaceae) species (chili peppers).

The bulk of the book is devoted to a catalog of individual plants arranged according to genus. Each listing includes Latin binomials, common names, botanical descriptions, geographical distributions, the toxic plant parts, and the chemical toxins, along with the clinical symptoms and suggested management of those symptoms. Each plant is beautifully illustrated with photographs, many of them provided by noted botanist, author, and photographer Steven Foster. Finally, each plant section is accompanied by references, which allow for further investigation.

I suggest updating the plant family names to those currently recognized by taxonomists. While the old family names, such as Compositae and Leguminosae, are comforting and familiar, using the more recent names, such as Asteraceae and Fabaceae, respectively, would make the plant listings current. In future revisions, a reference to the American Herbal Products Association’s lists of standardized common names for plants in commerce in the United States might be useful for investigating adverse effects from dietary supplements. Another suggestion for future revisions, which I acknowledge might be challenging, would be to include more information about dosages. The authors note that “the dose makes the poison” and that most plant exposures do not result in toxicities. This makes it difficult for professionals and consumers to put plant exposures into context. These suggestions are minor and do not detract in any way from the value of the book.

I highly recommend this beautiful and well-laid-out reference book to anyone with an interest in potentially poisonous or injurious plants.

Marilyn Barrett, PhD, is a consulting pharmacognosist and a long-time member of the ABC Advisory Board.