lathyrism historical notes stockman 1932

7/29/2019 Lathyrism Historical Notes Stockman 1932

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HISTORICAL NOTESON POISONING BY LEGUMINOUS FOODS

BY

RALP H S TOCKMAN, M.D. ,Professor of Materia Medica and Therapeutics, University of Glasgow.

In a rece ntly published research ') I have shown th at thevetchlings Lathyrus sativus and L. cicera and the bitter-vetch(Ervum ervilia) owe their well-known poisonous actions on thenervous system of man and animals to the presence of anorganic acid. Further investigation revealed the hitherto unsuspectedfact that such co mmonly used pulses as lentils (Ervum Lens),the common cultivated pea (Pisum sativum), the soya bean(Soya hispida), the pigeon pea (Cajanus indicus) and tares (Viciasativa) possess similar poisonous properties and that the activeprinciple is probably the same in all of them. Feeding experimentswith these pulses and hypoderm ic administration of the activesubstance caused in monkeys and other animals extensive degene-ration of the central nervous system leading to paralysis andsometimes to death, results which are not due to dietetic causesor vitamin deficiency but to a poison p resent in the seeds ').That the excessive consumption of peas and beans ordinarilyused by mankind as everyday articles of food may occasionparalysis is no new observation as it has been known since Hippo-cratic times. In the Epidemics the first historical outbreak of thekind is recorded briefly but very clearly : 'Ev AivccUV%/O, y\eixi Kpveve,


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l8 2to its special mention in the account of the Hippocratic epidemicand to its being known to cause poisoning among farm animalsclassical and mediaeval and modern authors have directed moreattention to it than its importance might seem to demand. Thepeas are small and wedge-shaped and have a quite distinct butnot very pronounced bitter taste which is imparted to water.Galen's account of it (second century) reads ; In our countryand among many other peoples, cattle are fed on bitter vetchesafter they have been sweetened in water, but men abstain fromthe seeds for they are sour and of a bad flavour. When theyhave been washed twice and sweetened frequently in water theylose their unpleasantness and with their unpleasantness theircutting and cathartic power so that the earthy element of theirbitterness becomes a dish of a certain parching quality" '). Healludes also to its mention in the Hippocratic writings as causingparalysis but states that it is eaten only under constraint of famine.Dioscorides (first century) says that boiled or well soaked in

water it is used as fodder for cattle. Columella 2) (first century)enumerates it among the most valuable forage plants but doesnot mention it in a considerable list of those employed for humanfood. He adds that farmers say that a crop sown in March isharmful to cattle and renders them violent after eating it, andPalladius 3) (fourth century) advises that it should be sown inFebruary for this reason.Pliny (first century) says of it 4 ): As a food is unsuitable, itcauses vomiting and disturbs the bowels and is heavy on thehead and stomach. It weakens the knees also. But soaked inwater for several days it is very useful for oxen and draughtanimals."Ramazzini 5) mentions an epidemic in the Duchy of Modenain 1691, when paralysis of the legs occurred ob usum leguminumac ervi praesertim" and identifies it with the Hippocratic description.

1) %tpi Ttov ev T/ rpotyoci Svvxfiiuv. B K . I .2) De re rustica, Lib. II, XI. Ibid VII.3 ) De re rus t ica , L ib . I l l , T i t . Vil .4 ) L ib . XXII, Cap . 73 .5) Conslkutio epidmica anni 1691. Modena.

183Valisnieri1 ) (1720) describes weakness of the legs as occurringin persons who ate bread made from the seeds and in horsesafter eating the plant, and Rossi 2) (1762) states that the seedspoison pigs and hens but fatten cattle.Bourlier 3) (1882) relates that on a farm in Algiers fifty pigswere fed on the seeds in the evening and next morning thirty-

seven of them were found dead, and similar occurrences havebeen recorded by others.In England Southall 4), having occasion to determine the causeof death in certain pigs which died after being fed on peas im-ported from Turkey, grew the seeds and identified the resultingplant as the bitter-vetch.Proust5) (1883) says it is still used as food by the Kabylesand is one of the plants responsible among them for causinglathyrism".We have thus a long and fairly continuous although somewhatscanty record of poisoning by the bitter-vetch, but only whenit was eaten in immoderate quantity or over a long period. Itseems never to have been popular as human food and probablywas used as such only by the poor or in hard times. At thepresent day it must be scarcely used in any part of the worldexcept as cattle fodder. It is interesting that from a very earlyperiod it has been recognised by farmers and recorded by writersthat its poisonous properties could be got rid of by soaking itin water and this seems to have been the common practiceamong agriculturists and when it was used for human food.The Vetchlings. Lathyrus.

Lathyrus sativus (the chickling vetch) is described as growingwild from the Southern Caucasus to Northern India but it hasbeen cultivated in India, Southern Europe and North Africa from1) Esperion/e cd osscrvaiione speltanti all' is toiia medica c naturalc. Venezia 1720.2) De nonnullis plantis quae pro venenatis habentur observationes et experimenta.

Pisa 1762.3) Gaz. md. de l'Algrie, XVII, 139, 1882.4 ) Pharmaceu t . Journ . 1879 , X, 481 .5) Bull. Acad. Md. XII. 829, 1883.the cited work by Bourlier does not haveany comment about V. ervilia and pigs


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184 185time immemorial partly and largely for human food and partlyfor fodder. Its peas along with those of L. cicera (the flat-poddedvetch) and L. clymenum (Spanish vetch) have long had an un-enviable reputation as apt to cause paralysis in man and allkinds of farm animals. Today as found in commerce the peasdiffer a good deal in size and appearance. Careful cultivationand selection in Europe have produced in L. sativus large whitefleshy seeds, wedge-shaped and having a distinct resemblance todogs ' teeth (the dog-tooth pea). In India it occurs in two sizes,one about half the size of the European pea, with a brown seed-coat and wedge-shaped, the other much smaller, darker andmeaner looking. Those grown in Algiers resemble the Indianvariety. L. cicera peas grown in France are hardly distinguishablefrom the larger Indian kind of L. sativus while those of L. cly-menum are smaller. All seem to be equally poisonous.The Greek name for vetchlings was Xxupo and Galen says ofthem In their substance the vetchlings are like pulse (xpoi) andkidney beans {(pxvyXoi) and countrymen in our part of Asiachiefly use them and most of all the men in Mysia and Phrygia,not only in the fashion in which the inhabitants of Alexandriaand many other cities use pulse and kidney beans but also byprepar ing them like bruised lentils ." The R oman name was cicera(L . cicera) and cicrcula (L. sativus). Columella says they werehighly prized in Hispania Baetica (Andalusia) as fodder for cattleand that they are not useless for human food nor unpleasant tothe taste.Dioscorides does not mention lathyrus but possibly he did notdistinguish it from certain other peas. In the early days of botanyand for long afterwards the classification of plants rested on veryuncertain and variable features, hence the species and varietiesof peas were very indefinitely differentiated both by botanistsand medical writers. The current popular names were appliedvery loosely and often to different peas, so that it is sometimesdifficult and even impossible to determ ine which is meant, adifficulty which has continued to this day (in Franc e). Theo phrast us l)(fourth century B. C.) in discussing the differences between pulses

1) E nquiry into Plants. The Loeb Classical Library 1916. Trans, by Horst. VIII, V, 1.

says : In pulses we cannot find such differences whether forwant of careful enquiry or because there is less diversity in theseplants. For apart from chick pea (psivooc), lentil (cpctKog), and toa certain extent bean (KVX(OC) and vetch (pooc) in so far as inthese we find differences of colour and taste, among the rest nodistinct forms are recognised." Galen also says that Arachos hasa seed very similar to that of vetchlings and that it is consideredby many to be in no way different from them. In later timesthe bitter-vetch, lathyrus (sativus and cicera) and the chick pea(cicer) continued to be confused with each other. Eliny speaks ofcicrcula when he evidently means cicer, while in the sixteenth cen-tury Matthiolus accuses and convicts Brasauolus ') and the celebratedbotanist Fuchs 2) of somewhat similar irregularities. Fuchs, forinstance, regarded L. sativus as the cultivated form of the bitter-vetch. An enquiry carried out in France by Lunier3) in 1883revealed that neither botanists nor the country people were agreedas to the popular names of these peas, nor as to the exactrelationship of popular and botanical nomenclature. It was foundthat the names gesse, jarosse, jarat, besides other more localterms, were used indiscrim inately for L. cicera, L. sativus, E rvumervilia, and sometimes for tares and other vetches, and that theywere often applied to different plants in districts quite close toeach other. And the most eminent modern French botanists differas much as the country people 4).The whole matter is not of much importance from the toxi-cological point of view as these plants have now been shown topossess similar poisonous properties.The earliest authentic account of a pandemic of paralysis duesolely to lathyrus we owe to Joh. Nie. Binninger

3) (1673) who

1) Examen omnium simplicium medicam entorum quorum in officinis usus est.Lugduni 1543.2) De historia stirpium. Lugduni 1549.3) Bull. Acad. Md. XII, 910, 1883.4) Conf. Billon, Diction, de Botanique 1886: Moquin-Tandon, Elements deBotanique M dicale, Paris 1861 : Le Maout et Decaisne, Trait gn. de Bot.,Paris 1868 : Lam arck & Decandolle. Flore Franaise IV, 1815: Diet, encyclop. Se.Md. Article Gesse.5) Observationum et curationum medicinalium Centuriae Quinqu. Montisbeligard1673. Obs. 70, p. 571.


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186calls it a new and unheard of disease". It occurred in the neigh-bourhood of Montbliard, a town in the department of Doubson the Swiss frontier of France , bu t at that time part of thedominions of the House of Wrttemberg. Probably he was nogreat botanist and misled by consulting Matthiolus he calls theplant Ervuw. His description of the peas, however, leaves nodoubt that it was lathyrus, and Du vernoy who described a similaroutbreak in the same district a hundred years later shows Bin-ninger to have been mistaken and adds that the bitter vetchis not grown in this region. The plant had been introduced tenyears previously by a local farmer and owing to its luxuriantgrowth his neighbours had also cultivated it extensively andused it to feed their cattle and horses and to make bread forthemselves. Only the country people were affected, the town-dwellers escaped, and with admirable acumen Binninger tracedthe disease to the bread. His strikingly graphic and accuratedescription of the symptoms and gait along with his identifi-cation of it as a disease of the nervous system stamp him as anoutstanding clinician. He gives a list of his patients of whomnone were relieved, none cured, none died." Horses fed on thewhole plant suffered from paralysis and tremors and it requiredthis to convince the inhabitants that Binninger's explanation ofthe cause of their own misfortunes was the correct one. Its cul-ture was prohibited by solemn ducal edict in 1672 but as theedict was renewed in 1705 and again in 1714 it is unlikely thatit was effective.Duvernoy ') (1770) devotes much space and attention to thebotany of lathyrus and in his clinical account notes for the firsttime that women are much less often affected than men, wivesthan their husbands, although living on the same food. Horsesfed on it became weak in the legs, and pigs affected in the sameway lay down a great deal and were apt to become very fat.This, he adds, is hard to understand as cattle in certain partsof Switzerland devour it and are not injured.In 1784 in consequence of a failure of the crops in Tuscany

i) Dissertatio inauguralis medica de Lathyri quadam venenata specie in ComitatuMontbelgardensi culta. Basileae 1770.

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peas were imported from Tunis to make bread and as a resultmany cases of paralysis of the legs occurred. This outbreak hasbeen described by Targioni Tozzetti ') who grew the peas andidentified the plant as L. sativus.Matthiolus (sixteenth century) says that L. sativus (cicrcula)was largely eaten in Italy in his time and there is little doubtthat the same was true of France and Spain and the Mediter-ranean countries generally. L. cicera was also grown extensivelyand used as food, and under such names as crurum exsolutio,crurum imbecillitas, crurum impotentia the disease which waslater called lathyrism by Cantani (Naples, 1873) seems to havebeen very familiar to the physicians of those days.During the nineteenth and twentieth centuries much interesthas been taken in the subject both by governments (India, France)and by individual investigators, and many outbreaks have beencarefully studied and recorded in India, France, Italy and Algeria.Since 1820 when the Ve terina ry School at Alfort (Paris) published awarning to horse-owners against the use of L. cicera as a feeding-stuff there has accumulated an extensive veterinary literatureregarding poisoning in horses, cattle, pigs, sheep and poultry.Many agriculturists have stated as their own personal experiencethat they have never seen any ill-effects from feeding stock onlathyrus either the whole plant or peas but the evidenceon the other side is overwhelming and Cornevin gives a mostinteresting and conclusive account of it 2). The explanation is, asI have shown elsewhere, that different samples of lathyrus peasvary greatly in their content of the toxic substance. Proust saysthat in Algeria a crop sown in March (instead of April) is believedto be especially poisonous and the influence of soil and weatherhas to taken into account as factors determining the degree ortoxicity at different times and places. But in all cases in whichpoisoning has occurred the amount consumed must be regardedas having been excessive 3).

1) Memoric sullc Cicherchie. Firenze 1793.2) Plantes vnneuses. Paris 1887. . /3) The literature of lathyrism is fully given by Schuch ardt, Deutsch. Archiv, klin. j1Med., XL, 312, 1887 & Stockman, Edin. Med. Journ., Nov. 1917 & Journ. of j Pharmac. & Exper. Thera p. XXX VII, 1929. l'[


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i 8 8Pigeon Pea. Cajanns indicus.

The pigeon pea is largely eaten in the East and West Indies.The Indian names are arhar, urhur, toar. Kinloch Kirk ') says itcauses chronic poisoning, the symptoms being urticaria, heat in thestomach, redness of the oral mucosa, discoloration and cracks ofthe skin, a burning feeling in the hands and feet, rheumaticpains and thickening of the periosteum. It is also said that thephysical powers and moral sense deteriorate and that womenbecome barren 2). This description is reminiscent of what is seenin pellagra, but such effects seem to be unknown to medicalmen either native or British with experience of Indian practice.Kirk however had a very expert knowledge of leguminous foodsand was a reliable observer.The peas of Dolichos pilosus, a dal known as oordh or maash,are also said by Kirk to have similar effects.

Vicia sativa var. angustifoliaVernacular, akta, akri.Anderson, Howard and Simonsen 3) have described a series ofexperiments on animals which shows that the seeds of this vetchhave an action similar to that of lathyrus. It is a weed whichgrows very plentifully in the fields in India and is not used forhuman food. I have found that the seeds of the cultivated Viciasativa (tares) grown in Europe and largely used as feeding-stuffproduce similar poisonous effects 4).

Chickpea. Cicer arietinum,Galen's account of it is that it is largely used as a food madeinto soup, boiled with milk, boiled and eaten with salt, or sprinkledwith powdered cheese. It is also eaten green. He continues: Itis believed to kindle sexual desire and at the same time to1) Indian Annals of Med. Science, VII, 144, 1861.2) Journal of Trop. Med., I, 1899.3) Ind. Journ. Med. Research XII, 613, 18245. McCombie Young, Inp. Journ.Med. Research, XV, 453, 1927 & Transact, of the F.E.A.T.M., Vol. Ill, 444, Calcutta1929. Acton & Chopra. Ibid.4) Jour, of Hygiene XXXI, 1931.

189produce sexual power so that for this reason it is given tostallions to eat".Paul of Aegineta says: Cicera instant, abstergunt, gnitalesemen augent, venerem stimulant, calculum terent."It is a very considerable article of food in India, Spain andother c ountries and in India (A nglo-Indian gram) is the chiefgrain used for feeding horses. No experimental examination ofits action on animals has ever been made and there is no indicationin the literature of any deleterious effects when used as a foodeither for man or horses.From the foregoing account it is evident that during the longages that leguminous plants have been used by mankind for foodonly a very insignificant number of them have aroused anysuspicion that they might be poisonous. This is due to the cir-cumstance that their consumption has usually been kept withinthe limits of safety and in consequence there have been noharmful effects which might have attracted attention. Very fewof them have hitherto been subjected to careful pharmacologicalinvestigation but now tha t a beginning has been made ') it willprobably be found that others, and probably all of them, containa poisonous substance capable of damaging the nervous systemand that their shortcomings as foods are due to this and not todeficiency of vitamins or amino-acids as has been sometimesassumed.

l) Jour. Hygiene loc. cit.


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JANUSA r c h i v e s i n t e r n a t i o n a l e s p o u r l ' H i s t o i r e d e la M d e c i n s et la G o g r a p h i e M d i c a l e .(Organe de la Socit historique nerlandaise des Sciences mdicales, exactes et naturelles. )

RDACTEURS.Dr. AOYAMA, Prof., Tokyo; Dr. D. A. FERNANDEZ-CARO Y NOUVILAS, Madrid; Dr. A. CAL-METTE, Dir. del'Iust. Pasteur, Lille; Dr. ERNST COHEN, Prof., Utrech t; Dr. Cn. CUEICTON,Londres; Dr. A. CORSINI, Prof., Florence; Dr. A. DAVIDSON, Prof., Edinbourg; Dr. P. DOKVEAUX,Bibliothcaire, Paris; Dr. F.M. G.DE FEYFER, Geldermalsen-, Dr. A.FON AHN, Kristiania;Dr. J.HEMMETER, Prof., Baltimore; Dr. A. JOHANNESSEN, Prof., Christiania; Dr. J.KERMOKGANT,Insp. du serv. md. des colonies franaises, Paris; Dr. KITASATO, Prof., Tokyo; Dr. J. P. KLEIWKOD E ZVVAAN, Prof., Amsterdam; Prof. Dr. A. B.LUCIIHARDT, Chicago ; Dr. J. E. MONJAKAS,Saint-Louis-Potosi, Mexique; Dr. VA N SCHEVENSTEEN, Anvers ; Dr. C. SINOER, Prof., London;Dr. K. SUDHOFF, Prof., Leipzig; Dr. C. J.S. THOMPSON, Stanmore ;Dr. G. F. TREIM.K, Insp. K.II. du Serv. Md. des Colonies, Vichy; Dr. E.WICKERSHEIMER Strasbourg.

Trente et Sixime Anne.

LEYDE. E . J. B R I L L , S. A.c.1932.

lathyrism historical notes stockman 1932

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