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Pontifications on Poison

Being some ramblings on events associated with poisonous plants.

Sunday 4th December 2011 

After a couple of days of fairly serious stuff I thought I’d scout around for something a little more light-hearted. Instead, I found myself looking into self-harming by poisoning.

It began with someone quoting Frohne & Pfander’s ‘A Colour Atlas of Poisonous Plants’ as a source for the number of deaths caused by plants in the Datura genus in India. Since I have that book I went to look up the information given and found that Frohne & Pfander are only, themselves, quoting a figure from another source.

The information given is that between 1950 and 1965 there were 2,728 fatal Datura poisonings investigated by the State Chemical Laboratory in Agra. Frohne & Pfander say this figure comes from a 1967 paper, in German, whose title (translated with the help of Google) is ‘Forensic-toxicological isolation, identification and micro determination of Datura alkaloids with the aid of paper chromatography’. So, clearly not a statistical study of reported incidents.

I found a brief summary of this paper, also in German, and it makes me think that the 2,728 deaths was one of those things scientists mention in their introduction to explain why their work is necessary. In other words, my suspicion is that the author, S. N. Tewari, relied on another source for that number of deaths.

Almost all the information seems to suggest that deliberate self-harming is the major cause of poisoning in the Indian sub-continent. Discussing suicide, whether attempted or successful, online is a tricky business because you can’t rely on someone in despair following the ‘Don’t try this at home’ warning. In the past, there has been a lot of criticism of media reports of suicide that have contained enough information to amount to a ‘do it yourself’ guide.

But, when it comes to plant poisonings it does seem that ‘don’t try this at home’ can be followed by ‘because you’ll probably be unsuccessful’. one paper on plant poisoning in Sri Lanka, for example, found that only 8 deaths, out of 4,556 cases of poisoning, of which there is official awareness, were due to plants or mushrooms.

‘Of which there is official awareness’ is an important qualification. Many minor cases of poisoning may never get recorded. And that doesn’t just apply in countries like India where recording systems may be less sophisticated. I’ve said before that daffodils may well cause more poisoning incidents each year in the UK than any other plant but, because the problems caused are minor and gone within a couple of days at most, very few end up being referred to healthcare services and, thus, go unrecorded.

As illustration of this problem comes in this factsheet from the National Institute of Mental Health and Neuro Sciences in India This says that, in 2007, there were 25,447 deaths from all forms of poisoning and 4,987 serious injuries. This is, clearly, a gross understatement of the non-fatal exposures. In the USA, for example, in 2008 there were 718 deaths from poisoning and 9,609 ‘major’ non-fatal poisonings.

Remember these are figures for all poisonings. It is not possible for me to separate them by substance or pick out accident from deliberate self-harm with any accuracy, not least because the detailed statistics are behind yet another paywall.

What may be said with some certainty is that poisoning is, clearly, a much bigger problem in India than the USA. In the roundest of terms, the population of India is four times that of the USA so India ‘should’ have about 2,900 poisoning deaths a year not the 25,000 plus it actually has.

Though poisoning is a greater problem it would be wrong to conclude that this means suicide is a greater problem. In fact, at 10 per 100,000 of population committing suicide each year in India, the overall rate is lower than the USA’s 11.1 per 100,000. Americans, it would seem, use other methods.

With the caveat of non-fatal data in India being much more unreliable, it appears that there is very little difference between the ‘success’ rates in the two countries. Only around one in ten reported suicide attempts results in death.