This family of about 1100 species belonging to 85 genera is largely native to the tropics and sub-tropics, but some species occur naturally in temperate regions. Many of the plants are bulbous; others have rhizomes.
A large number of species in several genera are widely cultivated for their attractive flowers. These include species of 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.
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 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).
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.
The sticky acrid sap in the leaves of Agapanthus orientalis can cause severe ulceration of the mouth (Francis & Southcott 1967).
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.
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
The roasted bulb has been used in India as a rubefacient (Watt & Breyer-Brandwijk 1962, Quisumbing 1951).
The bulbs will reportedly blister the skin of cattle (Hurst 1942).
An aqueous extract of the leaves has produced a positive patch test reaction in a gardener (Bleumink & Nater 1974a).
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.
von Reis Altschul (1973) found an herbarium note stating that Hymenocallis declinata has been reported as very irritating to the skin.
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.
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.
The roots of this and possibly other species are irritant (Burkill 1935).
The juice of Haemanthus multiflorus is supposed to produce dangerous swelling of the lips and tongue (Watt & Breyer-Brandwijk 1962).
[Further information available but not yet included in database]
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.