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A poison is any substance which, when relatively small amounts are ingested, inhaled, or absorbed, will cause illness or death. Ancient cultures must have first learned of such harmful substances in their efforts to find edible plants. Poisonous plants would have been quickly identified and knowledge of them entered into the shared information of the culture .1 Knowledge of poisonous animals and minerals would also have been important. Poisons can have medicinal and social uses. Some substances that may cause illness and death in larger doses may have therapeutic roles in lower doses. Poisons may be used for revenge, to gain social advantage, or to commit suicide. The list of poisonous substances is very long; this chapter will discuss only those that may have been responsible for illnesses described in ancient Mesopotamian texts. Parasympathetic Nerve Poisons The parasympathetic nervous system has many roles in controlling day-to-day bodily functions such as heart rate, breathing, and intestinal movement. There are two major classes of plant toxins with opposing effects on this system: belladonna drugs (atropine and scopolamine) and muscarinic drugs. Belladonna drugs inhibit parasympathetic nerves, whereas muscarinic drugs stimulate them. Plants containing belladonna drugs are widely distributed in nature, especially the Solanaceae plants (deadly nightshade, jimson weed, and henbane). Both atropine and scopolamine have significant central nervous system effects. Atropine causes restlessness, chapter 15 Poisons That person has been fed (something) in bread, been given (something) to drink in beer, been rubbed (with something) in oil. —BAM 232 i 20⬘ irritability, disorientation, hallucinations, and delirium, while scopolamine leads to drowsiness , amnesia, fatigue, and dreamless sleep. These drugs otherwise have similar physiologic actions including cutaneous (skin) flushing and decreased sweating, dry nose and mouth causing difficulty swallowing, rapid heart rate with intermittent slowing, decreased intestinal and bladder contraction, and fever. These same physiologic actions can make this class of drugs useful as therapeutic agents when used in small doses to counteract excessive parasympathetic activity. Certain mushrooms such as Amanita muscaria produce muscarinic drugs while others including Amanita phalloides produce other toxins that can cause fatality due to gastrointestinal , liver, and kidney damage. Muscarinic drugs cause increased salivation and lacrimation (tearing), headache, visual disturbance, nausea and vomiting, diarrhea, abdominal colic, bronchospasm, slow heart rate, low blood pressure, and shock. Amanita muscaria has other toxins including atropine-like compounds that can cause irritability, restlessness, unsteady gait (ataxia), hallucinations, delirium, drowsiness, and sedation. Mesopotamian physicians were well versed in the uses of plants in both their toxic and therapeutic functions. From some of the references listed below, it is quite evident that the toxins were ingested, but the physicians were also aware that the toxins in some cases could be absorbed transdermally since there is reference to substances in oil rubbed on the patient’s skin that caused illness. Although the poisoning may in some cases have been accidental or due to suicide attempts, clearly the physicians were aware that it was often related to attempted murder. belladonna drugs There are three references listed below that have many similar signs and symptoms as well as being attributed to the combined effects of pursuing ghosts and the Babylonian god Marduk (otherwise responsible for angina). Included in the complaints are dry mouth, mental status changes (confusion, disorientation, forgetfulness, and hallucinations), pains in back, neck, breast, and shoulders, nausea and vomiting, and fever. This illness is likely to be due to belladonna drugs. It is evident that ancient physicians believed that the poisoning could be intentional. Since belladonna drugs, used in conjunction with ergotamine, are an appropriate treatment for some of the ailments attributed to ghosts (such as migraine headaches), it is possible that some of the poisonings arose accidentally through attempted self-medication. 15.1 DISH NA MURUB4 UGU-shú {SAG}.KI.MESH-shú TAG.TAG-s[u] GESHTUII-s hú i-shag-guma liq pi-s hú i-ta-na-b[al ] shim-ma-tú ri-mu-tú TUKU.TUKU-s hi GABA.MESH-s hú KÚ.MESH-{shú} ZI-shú ik-ta-nàr-rù SÍG UGU-s hú GUB.GUB-az hrur-ba-shú SHUB.SHUB-su mi-na-tu-shú i-sham-mama -shú hru-us. GAZ SHÀ-bi TUKU.TUKU-shi a-s hu-ush-tum SHUB.SHUB-su bi-bil SHÀ-bi TUKU-{ma} NU KÚ {la} ina-ahr [ur-r]a u [GI6 i]-ár-ru LÚ BI GID[IM mu]r-tap-pi-du DIB-su ù lu-ba-t.ù {SHUII} dAMAR.UT[U] ana...

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