Plant Poison

Poison Ivy, Poison Oak, Poison Sumac, Poison Vine by GEORGE H. HEALD, M. D.

ONE of the severest afflictions that can come to a visitor to the country is a dermatitis — skin inflammation — caused by coming in contact with certain poisonous plants, variously known as poison ivy, poison oak (two or three varieties of this), poison sumac, poison vine, etc. These are different but closely related plants (Rhus), and contain a very irritant oil; so irritant, in fact, is this oil, that the minutest quantity, penetrating the skin, is sufficient to set up a violent reaction. The plants in one form or another are widely scattered over the entire area of the United States, except at high altitudes. Some persons apparently are immune to the effects of this poison and can handle the plants without fear. But as sometimes happens, this immunity is only apparent or relative. Occasionally a per­son who has been repeatedly ex­posed to certain of these plants without ill effect is finally taken down with a severe case of poison­ing.

After exposure a person may be­gin to feel the effects within a few hours, or not for several days. The oil is slow in penetrating the skin, and in addition it may have been transferred from the plant to the clothing or the shoes or to some im­plement, and later from there to the skin. Whether any one is ab­solutely immune to the poison when it penetrates the skin, is not known.

The writer, when a little child, was badly poisoned with oak (Rhus diversiloba). Later in his boyhood he found the poison oak apparently harmless to him. Whether or not this was due to the fact that he, with other boys, chewed some poi­son oak twigs, he is unable to say. He had heard that such a practice would act as a preventive of poisoning, and, boylike, he tried it. Since he has arrived at the age of discretion, he has never had sufficient confidence in the method to recommend it to others. Still, from what we know of the value of using minute doses of certain proteins to desensitize, or render immune, patients suffering from asthma and hay fever, it would seem that the principle of preventive inoculation for the Rhus poison is a sound one. The danger is that the dose by mouth might possibly produce a worse condi­tion than a skin exposure. In immunizing a hay fever or an asthma case, an overdose of the offending protein would be disastrous. So the writer has no burden to advise others to chew poison oak or poison ivy in order to acquire

immunity.

Symptoms of Plant Poisoning

The first evidence of poisoning may be a slight itching, gradually becoming more severe, and finally almost unbearable, so that sleep is impossible. Though scratching af­fords temporary relief, it spreads the trouble, and makes it more se­vere. The scratching may also be the means of causing an infection by pus germs, thus increasing the inflammation and pain.

The appearance of the affected area may vary within wide limits. There may be merely a red, angry surface, or small water blisters, or large blisters with considerable leakage, or there may be pustules and pus pockets (germ infection through scratching); and in the later stages the formation of scabs, and later a scaling off or peeling of the affected area, which may be scarcely noticeable, or in severe cases may be very marked.

The affected parts, especially around the eyes, are likely to swell; and somtimes the patient with both eyes swollen shut is a pitiable-look­ing object, whom his best friends would fail to recognize.

Though the pus-germ invasion may affect neighboring glands and ulcerations may persist for some poisoning terminates about as quickly as it began, leaving the skin in practically its normal condition.

In some cases where, on account of the na­ture of one's work, exposure to Rhus poisoning is frequently repeated, there develops a chronic eczema-like form which the patient may not rec­ognize as Rhus poisoning.

Prevention of Plant Poisoning

The most efficient preventive measure would be thorough eradication of all Rhus plants. But as this is not a condition that can be hoped for in the near future, the most practical preventive measures are:

1. Learning to recognize and avoid the Rhus plants.

2. Protecting the skin from contact with the poisonous oil:

a. By the use of rubber gloves.

b. By thorough washing after any suspected exposure.

c. By preventing poisoning from clothing, shoes, utensils, etc.

Where one is going through or is handling underbrush, rubber gloves may be a great pro­tection ; but they should be thoroughly washed in soap and water when they are removed after the trip.

On returning from a trip where one may have been exposed to Rhus poisoning, it is advisable to wash the exposed parts well with soap and hot water. In order to remove the least vestige of oil, they should be washed repeatedly in a series of soapy waters.

Owing to the fact that it takes some time for the oil to penetrate the skin, this measure will usually prove efficient — provided the clothing is changed; for there is a possibility that some of the oil is clinging to clothing or shoes, and may be transferred to the skin after one has gone through this washing process.

While it may not be feasible to eliminate all Rhus plants, yet those who own land infested with these plants will be doing missionary work if they will root it up or kill it around their own property. If each property owner would do " his bit" in this matter, there would not be nearly so many cases of Rhus poisoning.

The plants may be killed by a solution of sodium arsenite, picpared by dissolving a pound of sodium arsenite in five to ten gallons of water. This solution applied to the plants will kill them, but it is a poison that may kill other plants, and also live stock, so it must be used with due caution.

Treatment of Plant Poison

" Accidents," we are told, " may happen in the best-regulated families; " and with the best of preventive care there is a possibility that sometime one will get a dose of Rhus poison.

Some experienced physicians who have had much to do with the treatment of Rhus poison have expressed the opinion that time is the only reliable factor in the treatment of this condition; in other words, that it runs its course notwithstanding the best of treatment, and gets well itself when the proper time arrives. Per­haps they are fight. Still, there are remedies that have seemed to work so quickly and so graciously that they are advocated with confi­dence by their sponsors.

Hot fomentations or compresses afford tem­porary relief to the itching, but probably do not lessen the duration of the attack.

Potassium permanganate, in 2-per-cent strength (ten grains to one ounce of water) if the skin is unbroken, or half this strength if the skin is broken, seems to antagonize the poison. It gives prompt results. Unfortunately it dark­ens or stains the skin. It is best applied by means of compresses. Following the permanga­nate compress with another compress wet with a 10-per-cent solution of sodium hyposulphite (48 grams to an ounce of water), will serve the double purpose of discoloring the permanganate and neutralizing the Rhus poison. Some per­sons use only the hyposulphite.

Some of the sulphates also act well. A 10- per-cent solution of magnesium sulphate (Ep­som salts), applied hot by means of compresses, covered with oiled silk, and renewed three or four times a day, has its enthusiastic advocates.

But the writer has had best success with zinc sulphate, ten grains to one ounce of water. If this is applied within twenty-four hours, or within ten hours of the formation of blisters, it seems to abort the trouble — " dry it up," as it were. Even if applied later it acts well, though more slowly. Where the skin is broken, it should be applied half strength to treat plant poison