Get Involved
About Us
Our Members
Handbook of Poisonous and Injurious Plants

Handbook of Poisonous and Injurious Plants, 2nd ed., by Lewis S. Nelson, Richard D. Shih, and Michael J. Balick. New York, NY: Springer/The New York Botanical Garden; 2007. Paperback; 340 pages. ISBN-13: 978-0387312682. $39.95.

This book is a significant revision of the 1985 publication from the American Medical Association titled The AMA Handbook of Poisonous and Injurious Plants, by Kenneth Lampe, Mary Ann McCann, and the American Medical Association. With 434 four-color photos and illustrations throughout, it is almost a field guide to poisonous plants.

The authors are 2 physicians with active practices in medical toxicology and emergency medicine plus a leading ethnobotanist: Lewis S. Nelson, MD, of the New York University School of Medicine; Richard D. Shih, MD, of the Morristown Memorial Hospital in Morristown, New Jersey; and Michael J. Balick, PhD, director of the Institute of Economic Botany at The New York Botanical Garden. Dr. Balick is also a member of the Board of Trustees of the American Botanical Council.

The combination of experienced medical practice and 3 decades of ethnobotany have produced a book that is highly authoritative in scope and depth.

The brief introduction by Andrew T. Weil, MD, noted author and pioneering proponent of integrative medicine and the rational use of medicinal plants, applauds the integration of medical experts and an experienced botanist to create this volume. A trained botanist before studying medicine, Dr. Weil has a commanding perspective on beneficial and injurious plants.

Plant-related toxicities account for about 10% of all reports to poison control centers. More than 57,000 calls related to exposures to plants were made to poison control centers in 2003, 85% of which involved children under the age of 6 years—comprising the 7th most common form of reported toxic exposures in children. The authors hasten to clarify that most of these exposures did not result in toxicity; they were merely exposures, not incidents of adverse events. Nevertheless, there are numerous toxic and injurious plants in home gardens, public parks, roadsides, vacant lots, wilderness areas, etc. Health professionals and consumers need information on the proper identification of these plants, their toxic parts, and their appropriate management if a toxic event occurs.

The first section of the book wisely provides a brief primer on botanical nomenclature, some of which has changed since the publication of the first volume, e.g., family names for plants (Apiaceae is preferred for Umbelliferae; Asteraceae is preferred for Compositae; etc.).

The second section deals with poisonings, poisoning syndromes, and their clinical management. This section includes chapters dealing with various types of plant poisons: plants with anticholinergic (antimuscarinic) poisons (i.e., plants with tropane alkaloids, e.g., Atropa, Datura, Hyoscyamus, et al.); calcium oxalate crystals (Philodendron, et al.); cardioactive steroids/cardiac glycosides (Convallaria, Digitalis, Strophanthus, et al.); convulsant poisons (Lobelia, Nicotiana, Conium, Strychnos, et al.); cyanogenic compounds (Prunus, Sambucus, et al.); gastrointestinal toxins; mitotic inhibitors (Catharanthus, Colchicum, Podophyllum, et al.); nicotinelike alkaloids (Baptisia, Lobelia, Nicotiana, Sophora, et al.); pyrrolizidine alkaloids (Crotolaria, Heliotropum, Senecio, et al.); sodium channel blockers (Aconitum, Kalmia, Veratrum, et al.); and toxalbumins (Jatropha, Momordica, et al.). (Note that some of these genera contain plant species sometimes used in herbal medicine, usually in clinical practice, not in generally-available herbal teas or dietary supplements.)

One of the most common forms of plantrelated injuries is plant-induced dermatitis—irritation to skin. The third section contains 6 tables listing plants that are toxic to skin, including those that have mechano-chemical toxicity (e.g., the acetylcholine-formic acid-serotonin-filled stinging hairs in nettles [Urtica spp., Urticaceae]), allergens, and phototoxins (e.g., wild carrot [Daucus carota, Apiaceae]).

The fourth part provides methods for gastrointestinal decontamination, including the use of syrup of ipecac (Cephaelis ipecacuanha, Rubiaceae—the Latin binomial is curiously omitted from the paragraph on this standby herbal remedy), orogastric lavage, activated charcoal, and whole bowel irrigation.

The main part consists of the profiles on over 150 individual plants. Each profile contains the following: plant family, Latin binomial(s), common names, botanical description, distribution, toxic part(s), toxin, clinical findings, clinical management, and references. Included are usually 1–2 color photos and/or a color painting on each plant.

Physicians and other healthcare professionals (including veterinarians), herbalists, hikers, naturalists, gardeners, horticulturists, parents of small children, pet owners, and all those who interact with plants and the landscapes (both indoors and outdoors), would find this book of great value. It is well worth the investment.

—Mark Blumenthal