Skip to main content
SpringerLink
Log in

Water Hemlock Poisoning

  • Living reference work entry
  • First Online:
Critical Care Toxicology

  • 745 Accesses

Abstract

Water hemlock belongs to the family Apiaceae (Umbelliferae). The genus Cicuta includes the species spotted water hemlock (C. maculata), Western water hemlock (C. douglasii), and northern water hemlock also known as European water hemlock (C. virosa), C. bolanderi, C. bulbifera, C. californica, C. curtissii, C. mackenziana, C. occidentalis, and C. vagans (Figs. 1, 2, and 3). The active toxic compound in water hemlock is cicutoxin. The hemlock water dropwort (Oenanthe crocata) belongs to the family Apiaceae (Umbelliferae), genus . It is native to Europe but has been introduced to some parts of the United States. It lacks the chambered root of the Cicuta spp. and produces oenanthotoxin, a constitutional isomer (a compound that has the same molecular formula but a different structural formula) of cicutoxin.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Kingsbury JM. Poisonous plants of the United States. Englewood Cliffs: Prentice-Hall; 1964.

    Google Scholar 

  2. Stratton MR. Water hemlock poisoning. Colo Med. 1919;16:104–11.

    Google Scholar 

  3. Mitchell MI, Routledge PA. Poisoning by hemlock water dropwort. Lancet. 1977;1(800):423–4.

    Article  CAS  PubMed  Google Scholar 

  4. Mitchell MI, Routledge PA. Hemlock water dropwort poisoning – a review. Clin Toxicol. 1978;12(4):417–26.

    Article  CAS  PubMed  Google Scholar 

  5. Carlton BE, Tufts E, Girard DE. Water hemlock poisoning complicated by rhabdomyolysis and renal failure. Clin Toxicol. 1979;14(1):87–92.

    Article  CAS  PubMed  Google Scholar 

  6. Costanza DJ, Hoversten VW. Accidental ingestion of water hemlock. Calif Med. 1973;119(2):78–82.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Egdahl A. A case of poisoning due to eating poison-hemlock (Cicuta maculata). Arch Int Med. 1911;7:348–56.

    Article  Google Scholar 

  8. Furbee B, Wermuth M. Life-threatening plant poisoning. Crit Care Clin NA. 1997;13(4):849–88.

    Article  CAS  Google Scholar 

  9. Gompertz LM. Poisoing with water hemlock (Cicuta maculata). JAMA. 1911;87(16):1277–8.

    Article  Google Scholar 

  10. Haggarty DR, Conway JA. Report of poisoning by Cicuta maculata. NY State J Med. 1936;36:1511–4.

    Google Scholar 

  11. Heath KB. A fatal case of water hemlock poisoning. Vet Hum Toxicol. 2001;43(1):35–6.

    CAS  PubMed  Google Scholar 

  12. Knutsen OH, Paszkowski P. New aspects in the treatment of water hemlock poisoning. Clin Toxicol. 1984;22(2):157–66.

    CAS  Google Scholar 

  13. Landers D, Seppi K, Blauer W. Seizures and death on a white river float trip. West J Med. 1985;142:637–40.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Mulligan GB, Munro DB. The biology of Canadian weeds. 48. Cicuta maculata L. C. douglasii (DC.) Coult. & Rose and C. virosa L. Can J Plant Sci. 1981;61:93–105

    Google Scholar 

  15. Robson P. Water hemlock poisoning. Lancet. 1965;2(7425):1274–5.

    Article  CAS  PubMed  Google Scholar 

  16. Rork LE. Plant poisoning in a child. Rocky Mt Med J. 1969;66(2):47–9.

    CAS  PubMed  Google Scholar 

  17. Campell EW. Plant poisoning umbelliferae (parsley family). J Maine Med Assoc. 1966;57:40–1.

    Google Scholar 

  18. Sweeney K, Gensheimer KF, Knowlton-Field J, et al. Water hemlock poisoning – Maine, 1992. MMWR. 1994;43(13):229–31.

    Google Scholar 

  19. French LK, Hendrickson RG. Carpe Philon – an unhappy camper with vomiting and seizures. Ped Emerg Care. 2010;26:938–41.

    Article  Google Scholar 

  20. Uwai K, Ohashi K, Takaya Y, et al. Exploring the structural basis of neurotoxicity in C17-polyacetylenes isolated from water hemlock. J Med Chem. 2000;43:4508–15.

    Article  CAS  PubMed  Google Scholar 

  21. Boehm R. Arch Exp Pathol Phamakologie. 1876;5(4–5):279–310. as referenced by Stratton.28

    Article  Google Scholar 

  22. Anet EFLJ, Lythgoe B, Silk MH, et al. Oenanthotoxin and cicutoxin. Isolation and structure. J Chem Soc. 1953;62:355–64.

    Google Scholar 

  23. Ohta T, Uwai K, Nozoe S, et al. Absolute stereochemistry of cicutoxin and related toxic polyacetylenic alcohols from Cicuta virosa. Tetrahedron. 1999;55:12087–98.

    Article  CAS  Google Scholar 

  24. Uwai K, Oshima Y. Syntheses and stereochemical assignment of toxic C17-polyacetylenic alcohols virols A, B, and C, isolated from water hemlock (Cicuta virosa). Tetrahedron. 1999;55:9469–80.

    Article  CAS  Google Scholar 

  25. Schep LJ, Slaughter RJ, Becket G, et al. Poisoning due to water hemlock. Clin Toxicol (Phila). 2009;47:270–8.

    Article  CAS  Google Scholar 

  26. Starrveld E, Hope CE. Cicutoxin poisoning (water hemlock). Neurology. 1975;25:730–4.

    Article  Google Scholar 

  27. Ball MJ, Flather ML, Forfar JC. Hemlock water dropwort poisoning. Postgrad Med J. 1987;63:363–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. King LA, Lewis MJ, Parry D, et al. Identification of oenanthotoxin and related compounds in hemlock water dropwort poisoning. Hum Toxicol. 1985;4:355–64.

    Article  CAS  PubMed  Google Scholar 

  29. Grundy HF, Howarth F. Pharmacological studies on hemlock water dropwort. Br J Pharmacol. 1956;11:225–30.

    CAS  Google Scholar 

  30. Akaike N, Hattori K, Oomura Y, et al. Bicucilline and picrotoxin block gamma-aminobutyric acid-gated Cl− conductance by different mechanisms. Experimentia. 1985;41:70–1.

    Article  CAS  Google Scholar 

  31. Nelson RB, Cole FR. The convulsive profile of Cicuta douglasii (water hemlock). Proc West Pharmacol Soc. 1976;19:193–7.

    CAS  PubMed  Google Scholar 

  32. Chen L, Durkin KA, Casida JE. Structural model for gamma-aminobutyric acid receptor noncompetitive antagonist binding: widely diverse structures fit the same site. Proc Natl Acad Sci U S A. 2006;103:5185–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Chen L, Xue L, Giacomini KM, et al. GABAA receptor open-state conformation determines non-competitive antagonist binding. Toxicol Appl Pharmacol. 2011;250:221–8.

    Article  CAS  PubMed  Google Scholar 

  34. Olsen RW. Picrotoxin elike channel blockers of GABAA receptors. Proc Natl Acad Sci U S A. 2006;103:6081–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Ratra GS, Kamita SG, Casida JE. Role of human GABA(A) receptor beta 3 subunit in insecticide toxicity. Toxicol Appl Pharmacol. 2001;172:233–40.

    Article  CAS  PubMed  Google Scholar 

  36. Green BT, Goulart C, Welch KD, et al. The non-competitive blockage GABAA receptors by an aqueous extract of water hemlock (Cicuta douglasii) tubers. Toxicology. 2015;108:11–4.

    CAS  Google Scholar 

  37. Uwai K, Ohashi K, Takaya Y, et al. Virol A, a trans-polyacetylenic alcohol of Cicuta virosa, selectively inhibits the GABA-induced Cl- current in acutely dissociated rat hippocampal CA1 neurons. Brain Res. 2001;889:174–80.

    Article  CAS  PubMed  Google Scholar 

  38. Withers LM, Cole FR, Nelson RB. Water hemlock poisoning. N Engl J Med. 1969;281(10):566–7.

    CAS  PubMed  Google Scholar 

  39. Konoshima T, Kuo-Hsiung L. Antitumor agents, 85. Cicutoxin, an antileukemic principle from Cicuta maculata, and the cytotoxicity of the related derivatives. J Nat Prod. 1986;49(6):1117–21.

    Article  CAS  PubMed  Google Scholar 

  40. Strauss U, Wittstock U, Schubert R, et al. Cicutoxin from Cicuta virosa – a new and potent potassium channel blocker in T lymphocytes. Biochem Biophys Res Commun. 1996;219:332–6.

    Article  CAS  PubMed  Google Scholar 

  41. Wepfer JJ. Cicutae Aquatica historia et noxae. SM 4o Basiloe, JR Konig, 1679, as referenced by Costanza5.

    Google Scholar 

  42. Stockbridge J. Account of the effects of a poisonous plant called Cicuta maculata. Boston Med Surg J. 1814;3:334–7.

    Google Scholar 

  43. Frazer E. Poisoning by hemlock. Lancet. 1888;446.

    Google Scholar 

  44. Downs C, Phillips J, Ranger A, et al. A hemlock water dropwort curry: a case of multiple poisoning. Emerg Med J. 2002;19:472–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Miller MM. Water hemlock poisoning. JAMA. 1933;101(11):852–3.

    Article  Google Scholar 

  46. Nelson RB, North DS, Kaneriya M, et al. The influence of biperiden, benztropine, physostigmine and diazepam on the convulsive effects of Cicuta douglasii. Proc West Pharmacol Soc. 1978;21:137–9.

    CAS  PubMed  Google Scholar 

  47. North DS, Nelson RB. Anticholinergic agents in cicutoxin poisoning. West J Med. 1985;143:250.

    CAS  PubMed  PubMed Central  Google Scholar 

  48. Panter KE, Baker DC, Kechele PO. Water hemlock (Cicuta douglasii) toxicoses in sheep: pathologic description and prevention of lesions and death. J Vet Diagn Invest. 1996;8:474–80.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine, Division of Clinical Pharmacology and Toxicology, University of Colorado - Denver, Aurora, CO, USA

    Edward W. Cetaruk

Authors
  1. Edward W. Cetaruk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Edward W. Cetaruk .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies, and case reports, or reports of expert committees.

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing AG

About this entry

Cite this entry

Cetaruk, E.W. (2016). Water Hemlock Poisoning. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_85-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-20790-2_85-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-20790-2

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

Publish with us

Policies and ethics

Search

Navigation