The Socrates Project: Explosion of Accidental Poisonings Prompts New Guidance

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Alfred Goossens with a wild cherry, parts of which are poisonous. Photo: Malcolm Andrews.

There are imposters masquerading as free food in our fields and woods, and some of them contain toxins likely to cause sickness and even death. Poisoning from intentionally foraged plants is usually more serious than the accidental ingestion of brightly-colored berries or a flower or two by children.  Chris Holstege, M.D.,the medical toxicologist who directs the Blue Ridge Poison Center at U.Va., explained why.

“Children or even adults may grab a poisonous berry or a leaf out of curiosity, but chances are they won’t eat much,” Holstege said, “but when they’ve specifically gathered a bunch of wild leaves or roots for food, they’re likely to eat a lot more.” 

Every year, Holstege said, he sees a couple of examples of foragers poisoned by their dinner, but this year the number has increased dramatically. “There were four cases just recently of people foraging for ramps in central Virginia who instead gathered false hellebore,” he said. In one earlier case, one of the diners tasted something awry in the spaghetti sauce and put down his fork; the other ate with gusto and became very sick. 

Mountain Laurel is lovely to look at but sickening to swallow. Photo: Malcolm Andrews.

The sharp uptick in unintentional poisoning is a national trend, Holstege said. He believes that people searching for outdoor adventures during the pandemic took to the woods in much larger numbers and are sometimes less informed than the veteran foragers who have been doing it all along. Meanwhile, the humble ramp has been enjoying a bit of a moment, as foodies rave about its mild, leek-like flavor and share recipes online. “Most of the cases we’ve seen here have been from the false hellebore (a ramp look-alike),” he said. “This very alkaline plant can open up sodium channels and cause serious heart problems.”

Holstege said that foraging with just a photo guide to edible plants can be misleading: “Plants change their appearance as the season progresses,” he said. “So, you may have a photo of mature leaves that look like the young leaves of another plant.”

Holstege said he respects the knowledge of rural elders about folk medicine, but sometimes their younger relatives remember their advice wrong, or try to follow it without having any experience with the plants involved. He related the case of a man not feeling well who remembered the old folks taking milkweed tea, a brew best left to those very experienced in working with natural medicines. In his case, the tea made the sick man much sicker. The old-timers knew to boil the plant in several changes of water before administering it.

The surge in people calling the Virginia poison hotline and hospitalizations of would-be foragers prompted the expansion of a booklet developed by the Old Rag Master Naturalists and published in 2018, when they realized the extent of poisonous plants in the Central Virginia wild, and even in local gardens. They re-issued the booklet in a collaboration between the Virginia Master Naturalists Program, the Blue Ridge Poison Center at the University of Virginia Health System and the U.Va. School of Medicine’s Division of Medical Toxicology.

Beautiful but deadly: the cover of The Socrates Project, created by Trisha Crowe, illustrates parts of several poisonous plants found locally.

The man behind the original booklet is Alfred Goossens, a master naturalist with the Old Rag group. He has since moved near Charlottesville. The book’s editors called the original guide and its more recent edition, “The Socrates Project,” after the famous forced suicide of Socrates in 399 B.C. using this common wild plant. The hemlock that surrounds us in Central Virginia is probably the same as the hemlock that Socrates was condemned to drink after his trial in Athens, and is equally poisonous, Goossens said, so it was a good choice for a title. Like the lovely Queen Anne’s lace, the wild parsnip and the carrots we put in our soup, hemlock is a member of the carrot family, as is the dreaded giant hogweed. “That’s the worst,” Goossens said. “It’s easily identified, though, because of its size.” He said the blooms could be as wide as 5 feet, with the foliage towering overhead.

Goossens is a retired flavor chemist, and his profession, plus his interest in wild plants, plus his original degree in agriculture made him well qualified to lead the Socrates Project through its first publication, and then to join forces with the UVa poison center to expand it into the current edition, which adds 14 more poisonous plants commonly found in Virginia. Goossens is quick to acknowledge the work of his fellow master naturalists, all of whom are mentioned in the new guide; the work of Margaret Clifton, the editor, and the stunning artwork of Trish Crowe on the cover. The Socrates Project booklet will go to every county in Virginia, with emphasis on school nurses, EMTs and educators. Goossens said each state park would also get a copy, to guide staff who come across a suspected poisoning.

Wild cherry fruit. Photo: Malcolm Andrews.

“The Socrates Project” depicts the poisonous plant rather than its edible look-alike, with several different views, and it clearly explains what parts are poisonous and why. Both Holstege and Goossens want readers to increase their knowledge of the fascinating plants around us in Virginia and continue to get outdoors. Some key points from our conversations:

Just because a plant is poisonous doesn’t mean it should be eradicated. The same milkweed that sickened one man is crucial for the survival of monarch butterflies.

Some poisonings are intentional, though misguided. “This is a problem mostly confined to adolescent males in groups,” Holstege said. “They’ll believe they’ll get high from jimson weed, or some other plant, and end up hospitalized.”

Plants can be poisonous to touch as well as to swallow. Many plants have poisonous sap, Goossens said. We’re familiar with poison ivy, but other plants can cause irritation too. “The sap of the Giant Hogweed is so toxic that if you rub your eyes after touching it, it can cause blindness.”

Even veterans can make mistakes. Holstege recalled a farmer who was familiar with the wild plants around his homestead, but still made the mistake of biting into a pokeweed tuber while investigating yams in his field. This case was a life-saving collaboration between the Poison Center and the master naturalists. The farmer had the presence of mind to save a portion of the plant he ate. Holstege sent a photo to Goossens, who in turn sent it to a number of master naturalists. “The farmer was extremely sick,” Goossens recalled, and quickly losing kidney function. Within a few minutes, several of the naturalists had identified the poisonous tuber, which gave Holstege and his staff guidance on how to treat it, ultimately saving the man’s life.

Be extra careful with mushrooms. Holstege said he’s seen hundreds of cases of accidental poisoning over the years from foraged food, with many hospitalizations but few deaths, with one exception. “Almost all the deaths were from mushrooms,” he said. Like ramps, morels are sought after by foragers and there’s a “false morel” that causes seizures, Goossens said. Although mushrooms are not included in “The Socrates Project,” there are plenty of online sources that devoted to poisonous mushrooms. 

The book can be downloaded free of charge by visiting med.virginia.edu/brpc/Socrates. If you believe you may have consumed a poisonous plant, call the Poison Center at (800) 222-1222 for medical advice. 

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