AMARYLLIDACEAE

(Amaryllis or Daffodil family)

• Medicinal / Folk-medicinal aspects:  •
• Adverse effects: Many reports describe skin irritation following contact with members of this family. Primary skin irritation may be caused in part by minute needle-like crystals of calcium oxalate, known as raphides, and in part by alkaloids present in the sap. Some of the alkaloids are also sensitisers. Members of the genus Allium have often been reported to have irritant and allergenic properties on skin contact. Although farmers and gardeners may frequently be exposed to Allium species, the most intimate and prolonged contact is liable to occur in cooks, housewives, and other food handlers. The chemicals responsible appear to be the volatile sulfur-containing oils that are released when the plant material is damaged. The more familiar lachrymatory effect that is experienced when peeling or chopping the onion (Allium cepa L.) is caused by the release of thiopropanal S-oxide. •
• Veterinary aspects: •

Now including genera formerly classified in the Agapanthaceae and Alliaceae (Angiosperm Phylogeny Group 2009), this family comprises 1825 species belonging to 72 genera largely native to the tropics and sub-tropics, with some species occurring naturally in temperate regions. Many of the plants are bulbous; others have rhizomes (Mabberley 2017).

The largest and most important genus is Allium L., the 1077 species of which are widely distributed in the Northern Hemisphere but also in South Africa, and widely introduced elsewhere.^a The onion (Allium cepa L.), chives (Allium schoenoprasum L.), shallot ("Allium ascalonicum"), and leek (Allium porrum L.) are very widely grown for culinary use.

Many species in several genera are widely cultivated for their attractive flowers. These include species of Allium L., Boophone Herb., Crinum L., Haemanthus L., and Pancratium L. The genus Narcissus L., which includes the popular daffodils, narcissi, and jonquils, is very extensively cultivated. This results in frequent and prolonged contact by workers in the bulb and cut flower industries, and to a lesser extent by amateur gardeners and housewives. Somewhat less commonly encountered by gardeners, florists, and the like are various large flowered cultivars belonging to the genus Hippeastrum Herb. The snowdrop (Galanthus nivalis L.) is also included in this family. Some, such as Allium triquetrum L., have become abundant and troublesome weeds.

The bulbs of Boophone, Crinum, Hippeastrum, Narcissus and of other genera are poisonous on ingestion (Watt & Breyer-Brandwijk 1962, Lewis & Elvin-Lewis 1977). This is probably the case for most species in this family, and is attributable to their content of alkaloids (Fuganti 1975).

^a https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:30000901-2; accessed January 2025

Agapanthus praecox Willd.

[syns Agapanthus orientalis F.M.Leight., Agapanthus praecox subsp. orientalis (F.M.Leight.) F.M.Leight.]

African Blue Lily

The sticky acrid sap in the leaves of Agapanthus orientalis can cause severe ulceration of the mouth (Francis & Southcott 1967).

Allium ampeloprasum var. bulbilliferum Lloyd

Great-Headed Garlic, Carambole, Poireau d'Été, Pferdknoblauch

Boscher et al. (1996) reported the presence of S-2-propenyl-L-cysteine sulfoxide in quantities similar to those found in cultivated garlic [see Allium sativum L. below] in the bulbs of this cultivated variety found on the Ile d'Yeu in France.

Allium cepa L.

Onion, Shallot, Egyptian Onion, Tree Onion

The botanical name Allium cepa now refers to a diverse collection of cultigens that can be segregated into three groups, namely the Cepa, Aggregatum, and Proliferum groups. The Cepa group comprises the various single-bulb onions that do not produce bulbils in their inflorescences; the Aggregatum group comprises the shallots, which form a number of lateral bulbs and no bulbils in their inflorescences; the Proliferum group, comprising the Egyptian or tree onions, is characterised by the formation of bulbils in their inflorescences from which the plants may be propagated. The Proliferum group is possibly of hybrid origin involving Allium fistulosum L., the Welsh or Japanese bunching onion. Shallots were formerly considered to be a distinct species, namely Allium ascalonicum L. (Mabberley 1997).

In NW Moroccan traditional medicine, the juice from the onion bulb is applied onto eyes for ocular infections; an infusion made from the bulb is applied externally to treat haemorrhoids; and the bulb is warmed in oil and applied to skin abscesses (Merzouki et al. 2000).

In traditional Chinese medicine, the shallot is known as hsieh. A preparation of the bulb combined with honey is said to be a useful application in burns (Stuart 1911).

Onions release thiopropanal S-oxide when damaged, which is lachrymatory (Brodnitz & Pascale 1971, Freeman & Whenham 1976a). Also released is a complex mixture of sulfur-containing oils together with sulfur-free aldehydes and ammonia, all of which are more or less volatile and contribute to the odour of freshly cut onion (Boelens et al. 1971). The thiopropanal S-oxide, the volatile aldehydes, the sulfur-containing oils, etc. are produced by the onion from non-volatile precursors as a response to damage. Their principal biosynthetic precursor has been identified as S-1-propenyl-L-cysteine sulfoxide (Virtanen 1965), a sulfur-containing amino acid. This compound is almost identical with alliin, the principal flavour precursor of garlic (Allium sativum L.), which is 2-propenyl cysteine sulfoxide.

According to Vohora et al. (1973), onion applied externally acts as a rubefacient. Handling dehydrated onions has been held responsible for an irritant dermatitis (Schwartz et al. 1957). The pungent and irritant sulfur-containing oils are thought to be the causative agents (Watt & Breyer-Brandwijk 1962). Neves (1964) described a 50-year old female with eczema of the hands associated with handling onion and garlic. Patch tests with both garlic and onion showed 2+ reactions at 48 hours and 96 hours. Tests in controls were not reported.

Parasitic thrips that inhabit onion beds can attack man (Bailey 1936).

Allium chinense G.Don

[syn. Allium bakeri Regel]

Chinese Onion, Oriental Onion, Japanische Lauchzwiebel, Rakkyo

This species yields the lachrymatory thiopropanal-S-oxide from its biosynthetic precursor S-1-propenyl-L-cysteine sulfoxide when damaged (Freeman & Whenham 1976b). It is cultivated for culinary use.

Allium fistulosum L.

Fistular Onion, Japanese Bunching Onion, Rock Onion, Welsh Onion, Frühlingszwiebel, Zwiebel Winterhecke, Ciboule

In traditional Chinese medicine, this onion is known as tsung pai or as Allii Fistulosi Bulbus. Stuart (1911) noted that buboes and abscesses are poulticed with the bulb.

This species yield the lachrymatory thiopropanal-S-oxide from its biosynthetic precursor S-1-propenyl-L-cysteine sulfoxide when damaged (Freeman & Whenham 1976b).

Allium porrum L.

[syn. Allium ampeloprasum var. porrum (L.) J.Gay]

Common Leek, Garden Leek, Leek, Spanischer Lauch, Poireau, Porreau

This species yields the lachrymatory thiopropanal-S-oxide from its biosynthetic precursor S-1-propenyl-L-cysteine sulfoxide when damaged (Freeman & Whenham 1976b). It is widely cultivated for culinary use.

Allium sativum L.

Garlic

Garlic oil has been reported to induce irritation and vesication of the skin (White 1887, Burkill 1935). Nadkarni (1976) noted that the juice from garlic cloves may be used as a rubefacient liniment. Garlic juice produces superficial irritation of the skin which, although it results in rubefaction and vesication, does not penetrate the underlying tissues (Watt & Breyer-Brandwijk 1962). Vohora et al. (1973) also report that garlic applied externally acts as a rubefacient. In NW Moroccan traditional medicine, fresh cloves of garlic are used externally by friction to treat dermatitis (Merzouki et al. 2000).

Strobel et al. (1978) describe dermatitis produced by a poultice containing garlic. Neves (1964) and Martinescu (1981) have also reported contact dermatitis from the plant. In Mexico, garlic appeared to cause photosensitisation after it had been applied to a variety of dermatoses including lichen simplex and acne (Cueva & Duran 1955, Saul 1972). Lesions developed on sun-exposed sites including some to which garlic had not been deliberately applied. The clinical syndrome most commonly reported as a result of contact with garlic has been a circumscribed irritable hyperkeratotic eczema of one or both hands — often the left hand which is used to grasp the bulb firmly whilst a knife is held in the right hand (Borda & Bozolla 1961, Burks 1954, Burgess 1952). The sudden onset of eczema of this distribution has been observed in a male cook who had regularly handled garlic with impunity for over 20 years (Rook 1974). Less distinct patterns of eczema on the hands or forearms have been attributed to garlic in a 12-year old girl (Sepulveda R. 1938), and also in workers at a potato crisp factory (Inman 1965), and in a meat grinder (Edelstein 1950).

Garlic as well as onion, leek, chives, etc. produce positive patch test reactions in a high proportion of controls because of irritancy (Bleumink et al. 1972, Hjorth & Roed-Petersen 1976, Sinha et al. 1977, Pasricha & Guru 1979, Yoshikawa et al. 1979, Mitchell 1980). This complicates patch testing and renders results unreliable. Problems in patch testing were discussed by Mitchell (1980).

Garlic leaves and bulbs contain S-2-propenyl-L-cysteine sulfoxide, otherwise known as alliin (Boscher et al. 1996). Damage to the plant results in the breakdown of alliin by the co-occurring enzyme alliinase to produce allicin. The allicin then undergoes a series of disproportionation reactions and also enzymatically catalysed reductions to produce various sulfur-containing oils and allyl alcohol. These products are more or less volatile and are responsible in part for the odour of garlic (Brodnitz et al. 1971, Freeman & Whenham 1976b). Diallyl di- and tri- sulfides are the principal constituents of the resulting oil.

The allergens of garlic appear to be present in ether, ethanol, acetone, and water extracts (Burks 1954, Bleumink & Nater 1972, Hjorth & Roed-Petersen 1976, Sinha et al. 1977, van Ketel & de Haan 1978), whereas the ethanol extract but not the acetone or water extracts of onion produced a positive patch test response in a sensitised individual (van Ketel & de Haan 1978). Diallyl disulfide is considered to be the major allergen of garlic oil (Hjorth & Roed-Petersen 1976).

The way in which the plant material is prepared for patch testing also has an effect on the outcome of patch tests. This is because formation of the sulfur-containing oils and the degradation of the precursor compounds occurs only after damaging the plant material. Thus, the time allowed between cutting up or crushing the plant material and adding the chosen solvent will affect the composition of the final extract. Also of significance is the choice of solvent. Alcohol can be expected either to precipitate or to denature the enzymes involved in the breakdown of precursor compounds, thus affecting the progress of the reaction. Water, as a solvent, will also affect the progress of the reactions by diluting the reactants, but the reaction will not necessarily stop. Acetone tends not to denature enzymes but nevertheless can be expected to affect their activity by precipitating them. Of course, if the nature of the allergen is also unknown, then its solubility in the chosen solvent will be a further unknown variable.

An alternative method to solvent extraction is steam distillation. Sinha et al. (1977) suggest the use of steam distilled oils of garlic and onion because of their decreased irritancies. However, the steam distilled oils is not identical in composition with the freshly produced natural oil (Brodnitz et al. 1971, Boelens et al. 1971), and almost certainly does not contain the precursor compounds such as alliin and allicin.

When considered with the likelihood of natural variation in the levels of phytochemicals in the plant material, it is not difficult to understand the problems in producing a standardised preparation for patch testing. A filtered aqueous extract 10% in ethanol has been recommended (Yoshikawa et al. 1979, Mitchell 1980). However, controls must be tested for irritancy which is frequently observed even at this concentration.

Neves (1964) tested a 1:100 aqueous extract of garlic in a patient with eczema associated with handling garlic and onions, and observed erythema and microvesiculation as a result. Because of this he considered that alliin, since it is water soluble, was responsible for the skin reaction. Hjorth & Roed-Petersen (1976) consider the major allergen of garlic oil to be diallyl disulfide which provoked positive patch test reactions (5% in petrolatum) when applied to the skin of patients sensitised to garlic. Campolmi et al. 1982 described a 34-year old male cook who reacted to patch tests with 5% diallyl disulfide in petrolatum and with an alcoholic extract of garlic, but the reactions on controls were not reported. Bleumink & Nater (1972) prepared ethanolic and aqueous extracts of garlic and patch tested 125 persons; six reacted to the ethanolic extract, ten reacted to the aqueous extract. All of these ten subjects were women of average age 58 and all had been exposed to garlic during food preparation. A latent subclinical sensitivity was postulated.

A consideration of the phytochemistry of the two species could well serve to confirm that immunologically related substances are present in garlic and onion. However, cross reactions with onion are inconstant: Burks (1954) reported 4 from 8; Bleumink & Nater (1972) reported 0 from 1; Yoshikawa et al. (1979) reported 1 from 4; van Ketel & de Haan (1978) reported 1 from 3. The results are probably unreliable because of the frequent occurrence of irritancy.

Bleumink & Nater (1973) found sensitivity to garlic, onion, and Tulipa L., but van Ketel & de Haan (1978) could not demonstrate cross-sensitivity between tulipalin A (α-methylene-γ-butyrolactone) and garlic or onion. Cross-sensitivity between garlic and chives, onion, leek, and chicory (Cichorium intybus L., fam. Compositae) was noted by Hjorth & Roed-Petersen (1976), who also described one patient with a positive scratch test reaction to garlic indicating immediate-type hypersensitivity. Lybarger et al. (1982) investigated a male patient with asthma associated with the inhalation of garlic dust at his place of work. He also developed dyspnoea and wheezing following ingestion of garlic-containing foods. An aqueous extract of garlic gave positive scratch test reactions; the responses of 7 controls were negative. A RAST inhibition experiment with the patient's serum showed cross-allergenicity between garlic, onions, chives, and asparagus (Asparagus officinalis L., fam. Asparagaceae). Immediate hypersensitivity to garlic was also reported by Campolmi et al. (1982) who described a male cook with positive intradermal and RAST tests to garlic.

A self-inflicted bullous eruption on the shins produced by garlic in a malingerer resembled pemphigus both histologically and cytologically (Pirogova & Katyukhina 1970).

Inhibition of platelet aggregation has been shown to occur following ingestion of fresh garlic cloves (Boullin 1981). This property has been found to be associated with methylallyltrisulfide, a minor constituent of garlic oil (Ariga et al. 1981).

Allium scorodoprasum L.

Sand Leek, Giant Garlic, Rocambole, Spanish Garlic, Knoblauchartiger Lauch, Ail Rocambole

This species yields the lachrymatory thiopropanal S-oxide from its biosynthetic precursor S-1-propenyl-L-cysteine sulfoxide when damaged (Freeman & Whenham 1976b).

Allium schoenoprasum L.

Chives, Schnittlauch, Ail Civette, Ciboulette

This species yields the lachrymatory thiopropanal S-oxide from its biosynthetic precursor S-1-propenyl-L-cysteine sulfoxide when damaged (Freeman & Whenham 1976b). An ointment prepared from chives has caused dermatitis in Japan.

Allium triquetrum L.

Triangle Onion, Triangular-Stalked Garlic, Dreikantiger Lauch, Ail à Tige Triquètre

A single case report of facial oedema, coughing, sneezing, and lachrymation one or two hours after handling Allium triquetrum has been reported by Black (1972). Subsequent consumption of onions (Allium cepa L.) was followed almost immediately by wheezing and a feeling of constriction in the throat. Tests for immediate-type hypersensitivity were negative, and patch tests were positive at 96 hours but not at 48 hours.

Allium tuberosum Rottler ex Spreng.

[syns Allium chinense Maxim., Allium roxburghii Kunth]

Chinese Chives, Chinese Onion, Garlic Chives, Oriental Garlic, Chinesischer Schnittlauch, Orientalischer Knoblauch, Ail Tubéreux, Ciboule de Chine

Freeman & Whenham (1976b) classified this species in a group including Allium sativum L. [see above] characterised by a high content of S-2-propenyl-L-cysteine sulfoxide, the precursor of allicin and diallyl disulfide.

Allium ursinum L.

Ramsons, Broad-leaved Garlic, Wild Garlic, Wood Garlic

Freeman & Whenham (1976b) classified this species in a group including Allium sativum L. [see above] characterised by a high content of S-2-propenyl-L-cysteine sulfoxide, the precursor of allicin and diallyl disulfide. Boscher et al. (1996) also reported the presence of S-2-propenyl-L-cysteine sulfoxide in the plant.

When applied to the skin, this species is rubefacient. Externally, the bruised leaves may be applied to abscesses and boils (Flück & Jaspersen-Schib 1976).

Allium vineale L.

Crow Garlic, Field Garlic, Wild Garlic, Wild Onion, Vineyard Onion, Weinberg-Lauch, Ail des Vignes

Boscher et al. (1996) reported the presence of S-2-propenyl-L-cysteine sulfoxide in the bulbs, inflorescential bulblets, and leaves of this species in quantities similar to those found in cultivated garlic [Allium sativum L., see above]. The release of disulfides bearing allyl and methyl moieties was also demonstrated. Further, the leaves were found to contain S-1-propenyl-L-cysteine sulfoxide, the precursor of the lachrymatory principle released by onions [see Allium cepa L. above]. These findings are consistent with those made earlier by Freeman & Whenham (1976b) that this species exhibits weak lachrymatory activity and that it may be classified in a group including Allium sativum L. characterised by a high content of S-2-propenyl-L-cysteine sulfoxide.

Amaryllis belladonna L.

[syns Amaryllis rosea Lam., Brunsvigia rosea (Lam.) L.S.Hannibal, Callicore rosea (Lam.) Link, Leopoldia belladonna (L.) M.Roem.]

Amaryllis, Belladonna Lily, Jersey Lily, Naked Ladies

This species occurs naturally in southern Africa but is widely cultivated. The genus is considered to be monotypic by Willis (1973); more recent treatments recognise 2 species (Mabberley 2008).

The common name amaryllis is also applied to various large flowered cultivars belonging to the genus Hippeastrum Herb., and to a lesser extent to Sprekelia formosissima (L.) Herb., to Cyrtanthus elatus (Jacq.) Traub (syns Vallota purpurea Herb., Vallota speciosa (L.f.) T.Durand & Schinz), and to certain species of Brunsvigia Heist., Crinum L., Lycoris Herb., Nerine Herb., Sternbergia Waldst. & Kit., and Zephyranthes Herb.

Gardner & Bennetts (1956) include "Amaryllis species" in a list of plants known or suspected of causing dermatitis.

Boophone disticha (L.f.) Herb.

[syns Amaryllis disticha L.f., Boophone toxicaria (L.f. ex Aiton) Herb.]

Cape Poison Bulb, Century Plant, Fan Leaved Boophane, Kaffir Onion, Oxkiller Fan, Sore-Eye Flower, Tumbleweed, Windball

The native range of this species is South-East Sudan to South Africa,^a but the plant may occasionally be found elsewhere in cultivation as an ornamental.

William Herbert originally in 1821 spelled the name of the genus as Boophane but then in subsequent publications used the orthographical variants Buphane and Buphone. In 1939, the name was corrected to take into account the etymology provided in 1837 by Herbert himself, and thus became Boophone [from the Greek bous (βους; an ox) and phone (φονε; kill), an allusion to the toxicity of the plant]. This corrected orthographic variant has come into common use and, in accordance with a proposal by Archer et al. (2001), is now conserved. However, all combinations of these orthographic variants with the species name are to be found in the literature.

This is the most common member of the Amaryllidaceae to have found extensive use in the traditional medicine of the various indigenous South African population groups. Nair & Van Staden (2014) reviewed this traditional usage, and the phytochemistry and pharmacology, identifying 16 categories of usage, associating these usages with the crinane and other alkaloids found in the bulbs and leaves. Thus, citing earlier sources, these authors noted that the bulbs have been used by most tribes of South Africa (as well as by early European settlers to the Cape) for rashes, bruises, burns, cuts, wounds, boils and swelling, adding that the treatment is thought to relieve pain as well as to draw out pus. They further noted that the leaves are used to stop bleeding; that bulb decoctions are applied for muscle pain and stiffness; and that bulb preparations are applied for eye conditions as well as for healing infected scars [?]. Watt & Breyer-Brandwijk (1962) had earlier recorded that the Xhosa in southern Africa used the dry scale of the bulb as an outer dressing after circumcision and as an application to boils; that the dry scale moistened has been used by the European as a dressing on boils, sores, whitlows, and septic cuts; and that the fresh leaf has been used by the European as a styptic application to cuts and in the treatment of septic cuts whilst the dried leaf moistened with milk or oil has been used for the treatment of [unspecified] skin diseases and of varicose ulcers.

Nair & Van Staden (2014) also reviewed the literature on the toxicology of the plant, which is known to be one of several highly toxic species of the Amaryllidaceae, and which has been associated with a number of human and animal poisonings. The bulbs have been used as arrow and dart poisons, and have caused death by suicide. The toxic effects produced include nausea, coma, muscular flaccidity, visual impairment, stertorous breathing, respiratory paralysis, feeble or increased pulse, dyspnoea, and hyperaemia and oedema of the lungs. Quattrocchi (2012) additionally noted, but without citing a source for this information and without further elaboration, that the plant is irritant to the skin. And there is also reason to believe that a toxic principle can become airborne: the name sore-eye flower refers to the fact that exposure to the open flowers in a confined space may lead to sore eyes and even to a headache.^b

^a https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:60455694-2; accessed January 2023
^a https://pza.sanbi.org/boophone-disticha; accessed January 2023

Crinum bulbispermum (Burm.f.) Milne-Redh. & Schweick.

[syns Amaryllis bulbisperma Burm.f., Crinum capense Herb., Crinum viviparum (Lam.) R.Ansari & V.J.Nair]

Cape Lily, Hardy Swamplily

Crinum latifolium L.

The roasted bulb has been used in India as a rubefacient (Watt & Breyer-Brandwijk 1962, Quisumbing 1951).

Crinum zeylanicum (L.) L.

[syn. Amaryllis zeylanica L.]

Ceylon Swamp Lily, Milk And Wine Lily

The bulbs will reportedly blister the skin of cattle (Hurst 1942).

Galanthus nivalis L.

Snowdrop

An aqueous extract of the leaves has produced a positive patch test reaction in a gardener (Bleumink & Nater 1974a).

Hippeastrum Herb.

Amaryllis, Royal Dutch Amaryllis

At least some species are irritant (Burkill 1935). The positive patch test reported by Agrup (1969) to the leaf of an unnamed cultivar is difficult to interpret.

Hymenocallis caribaea (L.) Herb.

[syns Hymenocallis declinata (Jacq.) Sweet, Pancratium caribaeum L.]

Caribbean Spider Lily

von Reis Altschul (1973) found an herbarium note stating that Hymenocallis declinata has been reported as very irritating to the skin.

Narcissus L.

Daffodil

Narcissus species have been cultivated for over 300 years, as have a number of naturally occurring hybrids. Deliberate hybridisation was started in the 19th Century by English gardeners and has since been carried out on such a large scale that the parentage of many popular cultivars is uncertain (Gorer 1970).

The vernacular nomenclature of the various species is confusing. The term daffodil is commonly used for trumpet narcissi, especially Narcissus pseudonarcissus L.; the term narcissus is used for the remainder, but without consistency. The term jonquil is applied just as inconsistently to Narcissus jonquilla L., and to a number of wild daffodils, and to others thought to resemble them.

Walsh (1910) suggested that the irritant properties of the bulbs could be ascribed to the needle-like crystals of calcium oxalate found in many of the species. The leaves and stems are also mildly irritant.

Many authors refer loosely to "daffodils" and "narcissi" and thus little information is available concerning the sensitising capacity of the different species. However, N. jonquilla as well as N. poeticus and N. tazetta can sensitise (Stryker 1936, Agrup 1969). According to Klaschka et al. (1964), dermatitis from Narcissus is probably always caused partly by an allergic mechanism and partly by irritant effects, the clinical picture depending on the predominance of one or other mechanism and on the mode of exposure. Walsh (1910) noted that dogs also are sometimes affected when running amongst the flowers.

Nurserymen and pickers have repeatedly noted that some cultivars provoke dermatitis more readily than others. The cultivars Camparelle, Ornatus, Gloriosa, Scilly White, Grande Monarque (Walsh 1910), and Actaea and Princeps (Rook 1961b) have proved particularly troublesome. Only a large and experienced grower can advise on the relative sensitising capacities of the cultivars in favour at a particular time and place.

The nature of the allergen is unknown (Hjorth & Wilkinson 1968). It is not present in an ether extract but is present in ethanol, acetone, and water extracts (Staines 1958, Bleumink & Nater 1974a).

Narcissus absolute, a fragrance raw material prepared from the flowers of various Narcissus species (notably N. poeticus and N. tazetta), was found to be slightly irritating to the skin of mice and swine when applied under occlusion for 24 hours. When applied to human skin at a concentration of 2% in petrolatum, it was found to be non irritant following a 48 hour closed-patch test, and was not found to be a sensitiser in 25 human volunteers (Opdyke 1978). Narcissus absolute is prepared by extraction of the flowers with petroleum ether which is evaporated to produce a "concrete", and this is then extracted to produce the "absolute". The absolute contains linalool, benzyl acetate, benzyl alcohol, terpineol, cineol, phenylpropyl and phenylethyl alcohols and their acetates, n-heptanol, n-nonanal, etc.

Narcissus pseudonarcissus L.

Daffodil, Trumpet Narcissus

Aplin (1966) noted that the sap from the cut stems of this species can cause dermatitis. However, he was probably referring to cultivated daffodils rather than to the wild species.

Narcissus tazetta L.

Bunch-Flowered Narcissus, Chinese Sacred Lily, Cream Narcissus, Joss Flower

In traditional Chinese medicine, the bulbs of this narcissus (which is known as shui hsien) are used medicinally as a poultice to swellings (Stuart 1911). The name shui hsien is also used to describe an oolong tea that has a narcissus-like fragrance.

Pancratium zeylanicum L.

The roots of this and possibly other species are irritant (Burkill 1935).

Scadoxus multiflorus (Martyn) Raf.

[syns Amaryllis multiflora (Martyn) Tratt., Haemanthus multiflorus Martyn, Nerissa multiflorus (Martyn) Salisb.]

Blood Lily, Fireball Lily, Powderpuff Lily, Ail Rouge

The juice of Haemanthus multiflorus is supposed to produce dangerous swelling of the lips and tongue (Watt & Breyer-Brandwijk 1962).

Morton (1962a) noted that the bulb of Haemanthus multiflorus has been used to prepare an ointment for ulcers.

Tulbaghia alliacea L.f.

Tulbaghia leucantha Baker

[syn. Tulbaghia dieterlenii E.Phillips]

All parts of the plants, when bruised, have a strong odour of garlic (Watt & Breyer-Brandwijk 1962).

DERMATOLOGY

In the bulb and cut flower industries, those who pick and pack Narcissus species and cultivars are most heavily at risk. It has been estimated that up to 20% of workers may be affected (Schwartz et al. 1957). An expert picker may gather in a day up to 2000 bunches, each of 12 blooms. The skin of the hands and forearms becomes macerated and abraded, and if sensitisation develops, eczematous dermatitis affects mainly the fingers, hands, and forearms, but not uncommonly also affects the thighs and genitalia, and may even be generalised (Walsh 1910, Palmer & Freeman 1934). If warmer weather allows more scanty clothing to be worn, the principal sites affected may be the left forearm and abdominal wall (Marshall 1967).

Heyl (1961) in South Africa described the distribution of daffodil-induced occupational dermatitis in those who picked the flowers; positive patch test reactions were obtained to the stem sap but not the pollen or flower itself. Bleumink & Nater (1974a) obtained positive patch test reactions with the flower and leaf in a gardener who developed contact dermatitis of the hands from cutting and bunching daffodils. An aqueous extract of the leaves of snowdrops (Galanthus nivalis L.) also produced a positive but weak reaction.

Bulb handlers may develop dermatitis of the fingers (van der Werff 1959) resembling tulip fingers (see Alstroemeria, fam. Alstroemeriaceae and Tulipa, fam. Liliaceae), but usually less severe.

The dermatitis problem in both the cut flower and bulb producing sections of the industry has on occasion "caused serious dislocation" (Palmer & Freeman 1934).

In florists, dermatitis from Narcissus is less common and is often confined to the hands but may involve the face.

Although the authors (J.M. & A.R.) have not seen irritant effects from patch tests with leaves, it is a wise precaution always to test some control subjects.

References

• Agrup G (1969) Hand eczema and other hand dermatoses in South Sweden. Acta Dermato-Venereologica 49(Suppl 61): 1-91
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• Aplin TEH (1966) Poison plants in the garden. Journal of Agriculture of Western Australia 7(1): 23-27 [url] [url-2]
• Archer RH, Snijman DA, Brummitt RK (2001) (1478) Proposal to conserve the name Boophone Herbert with that spelling (Amaryllidaceae). Taxon 50(2): 569-571 [doi] [doi-2] [url] [url-2]
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