Atropa belladonna, commonly known as Belladonna or Deadly Nightshade, is a perennial herbaceous plant of the family Solanaceae, native to Europe, North Africa, and Western Asia. The foliage and berries are extremely toxic, containing tropane alkaloids. The drug atropine is derived from this plant. Random right?
In Italian, the word belladonna literally means “beautiful lady”. In the old days in Italy, they used belladonna extracts to dilate the pupils (the black dot at the centre of the coloured ring in your eye) of women, because that’s what - in those days - was considered beautiful. Prolonged usage caused blindness, and that probably had something to do with it going out of fashion.
Belladonna was also used for letters. If in the 18th or whatever century it was, you wanted to send a written letter by hand, but needed to make sure it was kept a secret, you had a little problem. You could either trust that your messenger won’t open it; or you could lace the letter with extract of belladonna.
The moment the messenger lays his eyes on the belladonna laced letter, his pupils would dilate because of its fumes. The normal reflex of the human eyes is to constrict the pupils in response to excess light (ie. a lit lantern). If this does not happen, the recepient would know that the letter has been read, and the promised privacy has been compromised.
If the treacherous messenger hadn't kept to his word, he would soon find that on delivering the precious letter to the correct address, he would be greeted by a bright lantern to light his face. The recipient would take the letter from his hand, fold it in his pocket; and in exeunt, slash his throat before fading into the darkness.
The other day, dad was telling me about a case he was treating in the early years of his training. He was a junior resident then. They had just finished operating on a woman, but she had lost so much blood that she went into severe hypotension. Hypotension is basically low blood pressure. The reason why blood pressure is so important, is because without it, the brain wont get enough blood, and consequently the patient can die. So despite huge doses of norepinephrine and atropine, the patient still lay still.
The way it works is that after a long period of low blood supply to the brain, parts of it necessary for human survival can die. While you may still be able to keep the patients heart rate, respiratory rate etc up to normal levels by artifical means; the patient herself is already dead, and nothing more can be done. There is no brain activity, and no reflex response. Thats brain death for you in simple, non-legal terms.
So the doctors frantically asked her to respond to their commands “wink if you can hear us” “Show us your tongue”. No response. They The doctors then looked at her pupils and shone bright light into them; they were both wide open. No light reflex. They all agreed that the patient is brain dead It was upto my dad to inform the relatives of the bad news. He told her nephew in as calm a voice as he could “She’s already gone, her heart is beating but her brain has died.”
The nephew was broken; the family cried for an hour, and cursed the hospital for another. Until finally, the newpew came to her bedside and slowly wept in his native tounge “Please blink”…
The patient blinked.
The doctors swerved back, and huddled around her bed. They looked at each other in disbelief. How could doctors, all trained in the hallowed grounds of the All India Institude of Medical Sciences, possibly declare a patient brain dead when she was alive and well? The problem was almost comical…
We all know the effects of belladonna on the eyes of women; and since Atropine is derived from the same plant, all you need to do is connect the dots.
For those who care: Atropine blocks the Acetylcholine receptors in the myocardium, thus reducing parasympathetic stimulation via the Vagus nerve. The decreased parasympathetic stimulation is what causes an increased heart rate. Thats why it’s used in conjunction with norepinephrine and epinephrine to manage hypovolaemic shock.
Anyway, back to the story. First off, the patient did not understand hindi or english, so she didn’t know what the doctors wanted from her when they asked her to do something. And secondly, because of the high doses of atropine she had been given, her pupils remained dilated. Brain death is a complex and highly debated condition even today, let alone 25 years ago. Two hallmark criteria for braindeath are: lack of auditory and motor responses, and lack of pupil light reflex. Death by belladonna they said, and the rest is history…
In summary, dearest readers, always remember the Atropine. And always remember to keep exploring the world around you. You never know which random piece of information might just save someone’s aunt.