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PLANTS-FAGUS

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Classification   |    Detailed evidence-based information

Substances Included Synonyms

Therapeutic Toxic Class

    A) Fagus species are members of the beechnut family. The nut of the American beech (Fagus grandifolia) is edible. Toxicity has been reported in both man and animals after ingestion of nuts from the European beech (F. Sylvatica).
    B) Beechnuts are used as a food source, but gastroenteritis and dermatitis have occasionally been reported after ingestion of the European beechnut.
    C) Animal poisonings occur due to grazing on the nuts or after ingesting a feedcake derived from the husks and nuts.

Specific Substances

    A) Fagus crenata (Blume)
    1) Japanese Beech
    2) Fagus Sieboldii (Endl)
    3) FAGUS (PLANT)
    Fagus grandiflora (Ehrh)
    1) American Beech
    2) Fagus americana (Sweet)
    3) Fagus ferruginea (Ait)
    4) Fagus longipetiolata (Seemen)
    5) Fagus sinensis
    Fagus orientalis (Lipsky)
    1) Fagus macrophylla (DC)
    Fagus sylvatica (L)
    1) Beechmast
    2) European Beech

Available Forms Sources

    A) FORMS
    1) Beech trees are ornamental trees commonly found around cities, and in rich woods and ravines. In the United States they are commonly found in deciduous forests (Hardin & Arena, 1974).
    B) USES
    1) Beechnuts, from both the American and European beech, have been used for food and are said to have a sweet taste. The American beechnuts are eaten raw or cooked, the European beechnuts are usually roasted (Duke, 1989). Nutmeats (in small quantities) are edible raw or cooked. They may be roasted and ground for a coffee substitute (Tech Info, 2001).
    2) The cake left after extraction of the oil was used as animal feed, resulting in poisoning. This cake was especially toxic if residue from the husk was included (Cornevin, 1887). It is unclear whether boiling the cake, and discarding the water renders the cake as nontoxic. There have been conflicting reports on the toxicity of this material (Cooper & Johnson, 1984).
    3) Wildlife are known to eat the mature seeds (Westbrooks & Preacher, 1986).
    4) Indians were thought to use the nuts as a treatment for kidney ailments, worms, frostbite, burns, and poison ivy (Duke, 1989; Angier, 1978).
    5) The pioneers prepared decoctions of American beech leaves (either fresh or dried) for treatment of burns, scalds, and frostbite (Lewis & Elvin-Lewis, 1977).
    6) The bark and leaves are astringent and antiseptic. A tonic was used to treat bladder and kidney ailments. The oil was used as an anthelminthic (Bolyard, 1981).

Overview

Life Support

    A) This overview assumes that basic life support measures have been instituted.

Clinical Effects

    0.2.1) SUMMARY OF EXPOSURE
    A) DESCRIPTION: Fagus species are members of the beechnut family. Beechnuts, from both the American and European beech, have been used for food and are said to have a sweet taste. The American beechnuts are eaten raw or cooked, the European beechnuts are usually roasted.
    B) TOXICOKINETICS: The specific toxin in beechnuts has not been established, but has been attributed to a saponin compound. Other possible considerations may be thiaminase or an alkaloid called fagin.
    C) EPIDEMIOLOGY: Exposure is not common.
    D) WITH THERAPEUTIC USE
    1) ADVERSE EFFECTS: Beechnuts are used as a food source, but gastroenteritis and dermatitis have occasionally been reported after ingestion of the European beechnut.
    E) WITH POISONING/EXPOSURE
    1) TOXICITY: Toxicity has been reported in both man and animals after ingestion of nuts from the European beech (F. Sylvatica). The primary effects in humans following a large ingestion of European beechnuts include a sore mouth, dizziness, pallor, headache, elevated body temperature, nausea, vomiting, diarrhea, fatigue and abdominal pain.
    2) ONSET: Usually occurs within an hour of eating nuts; duration may be as long as 5 hours.
    3) ANIMAL DATA: Animals may experience severe colic, paralysis, coma, suffocation and death.
    0.2.3) VITAL SIGNS
    A) Fever may occur after the ingestion of large numbers of European nuts.
    0.2.4) HEENT
    A) Beech wood is not particularly irritating to animal eyes.
    0.2.6) RESPIRATORY
    A) Asthma has been reported in woodworkers.
    0.2.7) NEUROLOGIC
    A) Dizziness, extreme fatigue, and headache may be seen after ingestion of large amounts of European beechnuts.
    0.2.8) GASTROINTESTINAL
    A) The primary effects after ingesting large numbers of European beechnuts (especially raw beechnuts) are nausea, vomiting, diarrhea, and abdominal pain.
    B) Irritation of the mouth and throat may also occur.
    0.2.14) DERMATOLOGIC
    A) Pallor may be seen after ingestion of substantial amounts.
    B) Dermatitis has been reported in woodworkers who handle beech wood.
    0.2.19) IMMUNOLOGIC
    A) The pollen of beech trees may produce hayfever and asthma in susceptible individuals.
    0.2.20) REPRODUCTIVE
    A) At the time of this review, no data were available to assess the teratogenic potential of this agent.
    B) At the time of this review, no data were available to assess the potential effects of exposure to this agent during pregnancy or lactation.
    C) Administration of beech wood creosote to mice produced changes in reproductive tissue.
    0.2.21) CARCINOGENICITY
    A) Adenocarcinoma of the nasal cavities and paranasal sinuses is clearly associated with occupational exposure to hardwood dust.

Laboratory Monitoring

    A) No specific laboratory measures are indicated.
    B) Patients developing significant, persistent vomiting and/or diarrhea should be monitored for fluid loss and electrolyte abnormalities.

Treatment Overview

    0.4.2) ORAL/PARENTERAL EXPOSURE
    A) MANAGEMENT OF MILD TO MODERATE TOXICITY
    1) Treatment is symptomatic and supportive. Patients with significant persistent vomiting and/or diarrhea should be monitored for fluid loss and electrolyte abnormalities and treated as clinically necessary. Symptoms typically develop within the first hour after ingestion; resolving over the subsequent 5 hours.
    B) MANAGEMENT OF SEVERE TOXICITY
    1) Treatment is symptomatic and supportive. Limited information. Severe toxicity has not been reported and is not anticipated with this plant.
    C) DECONTAMINATION
    1) PREHOSPITAL: In most cases, gastrointestinal decontamination is not necessary. Individuals can ingest a small amount of nuts as an edible food stuff. However, ingestion of large amounts of European beechnuts (more than 50) can stimulate emesis.
    2) HOSPITAL: Activated charcoal may be considered if large amounts (greater than 50) of European beechnuts have been ingested. If spontaneous emesis has occurred, administer activated charcoal with caution.
    D) AIRWAY MANAGEMENT
    1) Airway support is unlikely to be necessary following a minor or taste exposure.
    E) ANTIDOTE
    1) There is no known antidote.
    F) PATIENT DISPOSITION
    1) HOME CRITERIA: Asymptomatic children with a minor ingestion of beechnuts or a "taste" ingestion of the plant material can be monitored at home with adult supervision. Following dermal contact, remove exposed clothing and rinse skin with water and flush eyes with copious amounts of water as needed.
    2) OBSERVATION CRITERIA: Observation in the emergency department may be indicated following the ingestion of more than 50 uncooked nuts from the European beech or as indicated. The onset of effects are anticipated to occur within 1 hour and usually last 5 hours.
    3) ADMISSION CRITERIA: Based on limited information, hospital admission is not anticipated to be necessary.
    4) CONSULT CRITERIA: Consult a toxicologist or poison center if the diagnosis is unclear.
    0.4.5) DERMAL EXPOSURE
    A) OVERVIEW
    1) Dermatitis has been reported in woodworkers. Treatment includes termination of the exposure, and symptomatic and supportive care.

Range Of Toxicity

    A) TOXICITY: A minimum lethal human dose has not been delineated for this plant. It is estimated that 50 or more European beechnuts may cause symptoms in susceptible individuals.

Clinical Effects

Summary Of Exposure

    A) DESCRIPTION: Fagus species are members of the beechnut family. Beechnuts, from both the American and European beech, have been used for food and are said to have a sweet taste. The American beechnuts are eaten raw or cooked, the European beechnuts are usually roasted.
    B) TOXICOKINETICS: The specific toxin in beechnuts has not been established, but has been attributed to a saponin compound. Other possible considerations may be thiaminase or an alkaloid called fagin.
    C) EPIDEMIOLOGY: Exposure is not common.
    D) WITH THERAPEUTIC USE
    1) ADVERSE EFFECTS: Beechnuts are used as a food source, but gastroenteritis and dermatitis have occasionally been reported after ingestion of the European beechnut.
    E) WITH POISONING/EXPOSURE
    1) TOXICITY: Toxicity has been reported in both man and animals after ingestion of nuts from the European beech (F. Sylvatica). The primary effects in humans following a large ingestion of European beechnuts include a sore mouth, dizziness, pallor, headache, elevated body temperature, nausea, vomiting, diarrhea, fatigue and abdominal pain.
    2) ONSET: Usually occurs within an hour of eating nuts; duration may be as long as 5 hours.
    3) ANIMAL DATA: Animals may experience severe colic, paralysis, coma, suffocation and death.

Vital Signs

    3.3.1) SUMMARY
    A) Fever may occur after the ingestion of large numbers of European nuts.
    3.3.3) TEMPERATURE
    A) Elevated body temperature may be seen after ingestion of a large number of nuts (50 or more) (Cooper & Johnson, 1984).

Heent

    3.4.1) SUMMARY
    A) Beech wood is not particularly irritating to animal eyes.
    3.4.3) EYES
    A) ANIMALS: Beech wood has been tested in rabbit eyes and has not been shown to be particularly irritating (Grant & Schuman, 1993).

Respiratory

    3.6.1) SUMMARY
    A) Asthma has been reported in woodworkers.
    3.6.2) CLINICAL EFFECTS
    A) BRONCHOSPASM
    1) WITH POISONING/EXPOSURE
    a) Asthma has been reported in woodworkers (Hausen, 1973).

Neurologic

    3.7.1) SUMMARY
    A) Dizziness, extreme fatigue, and headache may be seen after ingestion of large amounts of European beechnuts.
    3.7.2) CLINICAL EFFECTS
    A) HEADACHE
    1) WITH POISONING/EXPOSURE
    a) Headache may be seen after ingestion of a large number of nuts (50 or more) (Cooper & Johnson, 1984).
    B) DIZZINESS
    1) WITH POISONING/EXPOSURE
    a) Vertigo may be seen after ingestion of a large number of nuts (50 or more) (Cooper & Johnson, 1984; Cooper, 1974).
    C) FATIGUE
    1) WITH POISONING/EXPOSURE
    a) Extreme fatigue may be seen after ingestion of a large number of nuts (Cooper & Johnson, 1984).
    D) SYNCOPE
    1) WITH POISONING/EXPOSURE
    a) Fainting may be seen after ingestion of a large number of nuts (Cooper & Johnson, 1984).

Gastrointestinal

    3.8.1) SUMMARY
    A) The primary effects after ingesting large numbers of European beechnuts (especially raw beechnuts) are nausea, vomiting, diarrhea, and abdominal pain.
    B) Irritation of the mouth and throat may also occur.
    3.8.2) CLINICAL EFFECTS
    A) GASTROENTERITIS
    1) WITH POISONING/EXPOSURE
    a) Gastroenteritis has been reported from ingesting the seeds, especially of F. sylvatica (European beech). Although not scientifically studied, case reports would indicate that F. grandifolia (American beech) is less likely to cause the gastroenteritis, but even these seeds should not be eaten raw (Tech Info, 2001) (Hardin & Arena, 1974).
    b) There appears to be a saponin-like compound which causes nausea, diarrhea, and abdominal pain (Tampion, 1977). The effects differ with various individuals, some people may eat the nuts with little or no effect (Tampion, 1977).
    B) INFLAMMATORY DISEASE OF MUCOUS MEMBRANE
    1) Eating beechnuts, especially in quantity, may produce soreness of the mouth and throat (Cooper & Johnson, 1984).

Dermatologic

    3.14.1) SUMMARY
    A) Pallor may be seen after ingestion of substantial amounts.
    B) Dermatitis has been reported in woodworkers who handle beech wood.
    3.14.2) CLINICAL EFFECTS
    A) DERMATITIS
    1) WITH POISONING/EXPOSURE
    a) Dermatitis has been reported in wood workers after exposure to beech trees (Howes, 1951; Jones, 1946). Some of the dermatitis cases may actually be due to lichens and liverworts found on the bark of trees (Mitchell & Rook, 1979).
    B) PALE COMPLEXION
    1) WITH POISONING/EXPOSURE
    a) Pallor may be seen after ingestion of large number of nuts (50 or more) (Cooper & Johnson, 1984).

Immunologic

    3.19.1) SUMMARY
    A) The pollen of beech trees may produce hayfever and asthma in susceptible individuals.
    3.19.2) CLINICAL EFFECTS
    A) ACUTE ALLERGIC REACTION
    1) WITH POISONING/EXPOSURE
    a) Beech pollen may trigger attacks of hayfever (Helbling et al, 1985; James, 1973). Beech pollen is known to contain 32 antigens (Wiebicke et al, 1987).
    b) Asthma has been reported in woodworkers (Hausen, 1973). Occupational exposure to beech wood dust may produce bronchial asthma, rhinitis, alveolitis, bronchitis, or conjunctivitis (Maciejewska et al, 1993).

Reproductive

    3.20.1) SUMMARY
    A) At the time of this review, no data were available to assess the teratogenic potential of this agent.
    B) At the time of this review, no data were available to assess the potential effects of exposure to this agent during pregnancy or lactation.
    C) Administration of beech wood creosote to mice produced changes in reproductive tissue.
    3.20.3) EFFECTS IN PREGNANCY
    A) LACK OF INFORMATION
    1) At the time of this review, no data were available to assess the potential effects of exposure to this agent during pregnancy or lactation.
    B) ANIMAL STUDIES
    1) Administration of beech wood creosote to female mice produced changes in maternal ovaries and fallopian tubes (Lewis, 1991).
    2) Administration of beech wood creosote to male mice produced changes in paternal testes/sperm ducts and epidymis (Lewis, 1991).

Carcinogenicity

    3.21.2) SUMMARY/HUMAN
    A) Adenocarcinoma of the nasal cavities and paranasal sinuses is clearly associated with occupational exposure to hardwood dust.
    3.21.3) HUMAN STUDIES
    A) HUMANS
    1) Adenocarcinoma of the nasal cavities and paranasal sinuses is clearly associated with occupational exposure to hardwood dusts in many cohort and case-controlled studies (IARC, 1995). Beech wood dust is included in this evaluation, and along with oak wood dust seems to be among the most carcinogenic of the hardwood dusts (Zhou et al, 1995; (Maciejewska et al, 1993). Testing has shown that the genotoxic agents in beech are soluble in both ethanol and cyclohexane (Wolf et al, 1998).

Genotoxicity

    A) Untreated samples of beech wood were found to be mutagenic in the Salmonella/mammalian microsome assay. Base-pair substitution mutagens were isolated from the beech wood dust. These compounds reverted Salmonella typhimurium his-TA 100 in the presence of Aroclor-induced rat S9 (Mohtashamipur et al, 1986).

Laboratory Monitoring

Monitoring Parameters Levels

    4.1.1) SUMMARY
    A) No specific laboratory measures are indicated.
    B) Patients developing significant, persistent vomiting and/or diarrhea should be monitored for fluid loss and electrolyte abnormalities.

Treatment

Life Support

    A) Support respiratory and cardiovascular function.

Patient Disposition

    6.3.1) DISPOSITION/ORAL EXPOSURE
    6.3.1.1) ADMISSION CRITERIA/ORAL
    A) Based on limited information, hospital admission is not anticipated to be necessary.
    6.3.1.2) HOME CRITERIA/ORAL
    A) Asymptomatic children with a minor ingestion of beechnuts or a "taste" ingestion of the plant material can be monitored at home with adult supervision. Following dermal contact, remove exposed clothing and rinse skin with water and flush eyes with copious amounts of water as needed.
    6.3.1.3) CONSULT CRITERIA/ORAL
    A) Consult a toxicologist or poison center if the diagnosis is unclear.
    6.3.1.5) OBSERVATION CRITERIA/ORAL
    A) Observation in the emergency department may be indicated following the ingestion of more than 50 uncooked nuts from the European beech or as indicated. The onset of effects are anticipated to occur within 1 hour and usually lasts 5 hours.

Monitoring

    A) No specific laboratory measures are indicated.
    B) Patients developing significant, persistent vomiting and/or diarrhea should be monitored for fluid loss and electrolyte abnormalities.

Oral Exposure

    6.5.1) PREVENTION OF ABSORPTION/PREHOSPITAL
    A) SUMMARY
    1) In most cases, gastrointestinal decontamination is not necessary. Individuals can ingest a small amount of nuts as an edible food stuff. However, ingestion of large amounts of European beechnuts (more than 50) can stimulate emesis.
    B) ACTIVATED CHARCOAL
    1) May be indicated if large amounts (over 50) of European beechnuts have been ingested. If spontaneous emesis has occurred, administer activated charcoal with caution to prevent possible aspiration.
    2) PREHOSPITAL ACTIVATED CHARCOAL ADMINISTRATION
    a) Consider prehospital administration of activated charcoal as an aqueous slurry in patients with a potentially toxic ingestion who are awake and able to protect their airway. Activated charcoal is most effective when administered within one hour of ingestion. Administration in the prehospital setting has the potential to significantly decrease the time from toxin ingestion to activated charcoal administration, although it has not been shown to affect outcome (Alaspaa et al, 2005; Thakore & Murphy, 2002; Spiller & Rogers, 2002).
    1) In patients who are at risk for the abrupt onset of seizures or mental status depression, activated charcoal should not be administered in the prehospital setting, due to the risk of aspiration in the event of spontaneous emesis.
    2) The addition of flavoring agents (cola drinks, chocolate milk, cherry syrup) to activated charcoal improves the palatability for children and may facilitate successful administration (Guenther Skokan et al, 2001; Dagnone et al, 2002).
    3) CHARCOAL DOSE
    a) Use a minimum of 240 milliliters of water per 30 grams charcoal (FDA, 1985). Optimum dose not established; usual dose is 25 to 100 grams in adults and adolescents; 25 to 50 grams in children aged 1 to 12 years (or 0.5 to 1 gram/kilogram body weight) ; and 0.5 to 1 gram/kilogram in infants up to 1 year old (Chyka et al, 2005).
    1) Routine use of a cathartic with activated charcoal is NOT recommended as there is no evidence that cathartics reduce drug absorption and cathartics are known to cause adverse effects such as nausea, vomiting, abdominal cramps, electrolyte imbalances and occasionally hypotension (None Listed, 2004).
    b) ADVERSE EFFECTS/CONTRAINDICATIONS
    1) Complications: emesis, aspiration (Chyka et al, 2005). Aspiration may be complicated by acute respiratory failure, ARDS, bronchiolitis obliterans or chronic lung disease (Golej et al, 2001; Graff et al, 2002; Pollack et al, 1981; Harris & Filandrinos, 1993; Elliot et al, 1989; Rau et al, 1988; Golej et al, 2001; Graff et al, 2002). Refer to the ACTIVATED CHARCOAL/TREATMENT management for further information.
    2) Contraindications: unprotected airway (increases risk/severity of aspiration) , nonfunctioning gastrointestinal tract, uncontrolled vomiting, and ingestion of most hydrocarbons (Chyka et al, 2005).
    6.5.2) PREVENTION OF ABSORPTION
    A) ACTIVATED CHARCOAL
    1) May be indicated if large amounts (over 50) of European beechnuts have been ingested. If spontaneous emesis has occurred, administer activated charcoal with caution to prevent possible aspiration.
    2) CHARCOAL ADMINISTRATION
    a) Consider administration of activated charcoal after a potentially toxic ingestion (Chyka et al, 2005). Administer charcoal as an aqueous slurry; most effective when administered within one hour of ingestion.
    3) CHARCOAL DOSE
    a) Use a minimum of 240 milliliters of water per 30 grams charcoal (FDA, 1985). Optimum dose not established; usual dose is 25 to 100 grams in adults and adolescents; 25 to 50 grams in children aged 1 to 12 years (or 0.5 to 1 gram/kilogram body weight) ; and 0.5 to 1 gram/kilogram in infants up to 1 year old (Chyka et al, 2005).
    1) Routine use of a cathartic with activated charcoal is NOT recommended as there is no evidence that cathartics reduce drug absorption and cathartics are known to cause adverse effects such as nausea, vomiting, abdominal cramps, electrolyte imbalances and occasionally hypotension (None Listed, 2004).
    b) ADVERSE EFFECTS/CONTRAINDICATIONS
    1) Complications: emesis, aspiration (Chyka et al, 2005). Aspiration may be complicated by acute respiratory failure, ARDS, bronchiolitis obliterans or chronic lung disease (Golej et al, 2001; Graff et al, 2002; Pollack et al, 1981; Harris & Filandrinos, 1993; Elliot et al, 1989; Rau et al, 1988; Golej et al, 2001; Graff et al, 2002). Refer to the ACTIVATED CHARCOAL/TREATMENT management for further information.
    2) Contraindications: unprotected airway (increases risk/severity of aspiration) , nonfunctioning gastrointestinal tract, uncontrolled vomiting, and ingestion of most hydrocarbons (Chyka et al, 2005).
    6.5.3) TREATMENT
    A) SUPPORT
    1) MANAGEMENT OF MILD TO MODERATE TOXICITY
    a) Treatment is symptomatic and supportive. Patients with significant, persistent vomiting and/or diarrhea should be monitored for fluid loss and electrolyte abnormalities and treated as clinically necessary. Symptoms typically develop within the first hour after ingestion; resolving over the subsequent 5 hours.
    2) MANAGEMENT OF SEVERE TOXICITY
    a) Treatment is symptomatic and supportive. Limited information. Severe toxicity has not been reported and is not anticipated with this plant.
    B) MONITORING OF PATIENT
    1) No specific laboratory measures are indicated. Patients with persistent vomiting and/or diarrhea should be monitored for fluid loss and electrolyte abnormalities.

Eye Exposure

    6.8.1) DECONTAMINATION
    A) EYE IRRIGATION, ROUTINE: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, an ophthalmologic examination should be performed (Peate, 2007; Naradzay & Barish, 2006).

Dermal Exposure

    6.9.1) DECONTAMINATION
    A) DERMAL DECONTAMINATION
    1) DECONTAMINATION: Remove contaminated clothing and wash exposed area thoroughly with soap and water for 10 to 15 minutes. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).
    6.9.2) TREATMENT
    A) SUPPORT
    1) Dermatitis has been reported in woodworkers. The only treatment is to terminate exposure to the offending wood. Reactions are usually of mild to moderate severity and may be treated symptomatically.
    B) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Enhanced Elimination

    A) SUMMARY
    1) No studies have addressed the utilization of extracorporeal elimination techniques with this plant.

Range Of Toxicity

Summary

    A) TOXICITY: A minimum lethal human dose has not been delineated for this plant. It is estimated that 50 or more European beechnuts may cause symptoms in susceptible individuals.

Minimum Lethal Exposure

    A) SUMMARY
    1) A minimum lethal human dose has not been delineated for this plant.

Maximum Tolerated Exposure

    A) SUMMARY
    1) Ingestion of 50 or more nuts from the European beech by humans may cause gastroenteritis, irritation of the mouth and throat, fever, headache, dizziness, pallor, and fatigue (Duke, 1989; Cooper & Johnson, 1984; Cooper, 1974).
    2) The oil expressed from the nuts, does not appear to be toxic (Kingsbury, 1964).
    3) The nuts of the American beech are considered edible (Dirr, 1990).

Pharmacology Toxicology

Toxicologic Mechanism

    A) The specific toxin in beechnuts has not been established, but it is often attributed to a saponin compound (Frohne & Pfander, 1984; Volker, 1950; Cornevin, 1887). The toxic principle may also be thiaminase (Beckman & Manz, 1950) or an alkaloid called fagin (Cooper & Johnson, 1984).
    B) The nuts contain oxalic acid, 0.54% soluble oxalates and 2.41% insoluble oxalates (Frohne & Pfander, 1984).

Animal Toxicology

Clinical Effects

    11.1.2) BOVINE/CATTLE
    A) Beech poisoning has occurred commonly in cattle. Animals may become critically ill. Initial effects are burning and local irritation which progresses to severe abdominal pain, cramping, staggering, periods of severe paralysis, collapse, and coma (Cooper & Johnson, 1984; Bohosiewicz, 1970; Volker, 1950).
    B) Death usually results from asphyxia, occurring 12 hours into the intoxication. If the animal survives this period, it usually recovers (Cooper & Johnson, 1984).
    C) Postmortem findings are unremarkable. There may be signs of suffocation, brain or spinal cord edema, or intestinal inflammation (Cooper & Johnson, 1984).
    11.1.5) EQUINE/HORSE
    A) Horses appear to be especially susceptible to the effects of beechnuts or cake. As little as 300 to 500 grams of the cake may be fatal (Bohosiewicz, 1970).
    B) CASE REPORTS -
    1) Rigid extensor spasms of the hindlimbs, convulsive paddling of the forelimbs, extreme pain, colic, dilated pupils, and dark gray/blue mucous membranes were seen in a pony that ingested Fagus sylvatica. The respiratory rate was 75 per minute and irregular, with expiratory grunts and harsh respiratory sounds (Wilkens & Cranwell, 1990).
    a) The pulse was rapid and almost imperceptible. The pony was eventually euthanized.
    b) Another horse which had used the same grazing areas developed marked muscular vesiculation over the hindquarters, dilated pupils, and absence of gut sounds. The pulse was 80 and irregular and thready, the respiratory rate was 40 per minute. The animal became very excited, the respiratory rate increased to 90 per minute, and the animal finally needed to be euthanized.
    c) Postmortem examination of these animals showed numerous petechiae over both the serosal and mucosal surfaces of the stomach, duodenum, and proximal small intestine. Beechnuts were found in the stomach.
    2) Beechnut poisoning was suspected in another horse who was profusely sweating, had muscular fasciculations, a high respiratory rate, dilated pupils, and a regurgitation reflex. The horse appeared to be hallucinating. The cause of the intoxication was never proven (Hayes & Turner, 1990).

Range Of Toxicity

    11.3.2) MINIMAL TOXIC DOSE
    A) HORSE
    1) Horses appear to be especially susceptible to the effects of beechnuts or cake. As little as 300 to 500 grams of the cake may be fatal (Bohosiewicz, 1970).

Sources

    A) GENERAL
    1) The cake left over after extraction of the oil used to be used as animal feed, resulting in poisoning. This cake was especially toxic if residue from the husk was included (Cornevin, 1887). It is unclear whether boiling the cake and discarding the water renders the cake nontoxic. There have been conflicting reports on the toxicity of this material (Cooper & Johnson, 1984).

References

General Bibliography

    1) Alaspaa AO, Kuisma MJ, Hoppu K, et al: Out-of-hospital administration of activated charcoal by emergency medical services. Ann Emerg Med 2005; 45:207-12.
    2) Angier B: Field Guide to Medicinal Plants, Stackpole Books, Harrisburg, PA, 1978.
    3) Bailey LH & Bailey EZ: Hortus Third, MacMillan Publishing Co, Inc, New York, NY, 1976.
    4) Bohosiewicz M: (Veterinary toxicology), Panstwowe Wydawnictwo Rolnicze i Lesne, Warsaw, Poland, 1970, pp 214.
    5) Bolyard JL: Medicinal Plants and Home Remedies of Appalachia, Charles C Thomas Publishing, Springfield, IL, 1981.
    6) Burgess JL, Kirk M, Borron SW, et al: Emergency department hazardous materials protocol for contaminated patients. Ann Emerg Med 1999; 34(2):205-212.
    7) CH Tubbs : US Forest Service Manual. U.S. Forest Service, Northeastern Area. Newtown Square, PA. 2001. Available from URL: http://www.na.fs.fed.us/spfo/.
    8) Chyka PA, Seger D, Krenzelok EP, et al: Position paper: Single-dose activated charcoal. Clin Toxicol (Phila) 2005; 43(2):61-87.
    9) Cooper MR & Johnson AW: Poisonous Plants in Britain. Ministry of Agriculture Fisheries and Food. Ref Book 161, Her Majesty's Stationery Office, Norwich, UK, 1984.
    10) Cooper P: Poisoning by Drugs and Chemicals, Plants and Animals, 3rd edition, Alchemist Publications, London, UK, 1974, pp 102.
    11) Cornevin C: Des Plantes Veneneuses, Librairie de Firmin-Diodot, Paris, France, 1887, pp 137.
    12) Dagnone D, Matsui D, & Rieder MJ: Assessment of the palatability of vehicles for activated charcoal in pediatric volunteers. Pediatr Emerg Care 2002; 18:19-21.
    13) Dirr MA: Manual of Woody and Herbaceous Plants: Their Identification Ornamental Characteristics, Culture, Propagation, and uses, Stipes Publishing, Champaign, IL, 1990.
    14) Duke JA: Handbook of Nuts, CRC Press, Boca Raton, FL, 1989.
    15) Elliot CG, Colby TV, & Kelly TM: Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal. Chest 1989; 96:672-674.
    16) FDA: Poison treatment drug product for over-the-counter human use; tentative final monograph. FDA: Fed Register 1985; 50:2244-2262.
    17) Frohne D & Pfander HJ: A Colour Atlas of Poisonous Plants, Wolfe Publishing Ltd, London, England, 1984.
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