Cardiovascular manifestations in Argemone mexicana poisoning (epidemic dropsy).

THE SYNDROME of epidemic dropsy is characterized by edema, its other chief manifestations being diarrhea, pyrexia, anemia, dyspnea, tachyeardia, and elevated erythrocyte sedimentation rate. It was earlier believed to be a toxic syndrome eaused by ingestion of poisonous bases formed in rice under certain conditions.' That the disease is due to argemone poisoning has since been shown by the finding of argemnone oil contamination in ingested mustard oil2' 3 and experimental production of the disease in animals and human beings by administration of argemone oil.4-7 While outbreaks, some of them with a high incidence of mortality, have been reported mostly from Iindia, the disease has also been reported from Fiji, Burma, and Africa.5'2 Mustard oil expressed from mustard seeds is used extensively in many states in India, particularly in Benigal and Assain, as a medium for cooking or frying vegetables and other food articles in place of butter, margarine, or other edible fats used in western countries. Acton and Chopra13 first reported that pathologic changes in this disease are characterized by dilatation of the capillaries, and changes in the heart consist of increased vascularity, gross capillary dilatation, and edenma separating the muscle fibers, which are otherwise normal. Shanks and De14 confirmed these changes and noted that both ventricles are equally involved. Though mention was made in the earlier literature of cardiac dilatation, murmurs, and failure, cardiovascular manifestations in epidemic dropsy were first stressed by Chopra and Basu15 and Chopra and Bose16 and have since been described in several reports.17 21 There has, however, been no comprehensive study, and the findings have often not been substantiated by sufficient laboratory data. The purpose of this paper is to report a study