Substance
The apiol is an organic chemical compound, a phenylpropanoid extracted from the seeds and leaves of parsley (Petrosileum hortense).
Even in the ancient Greece, Hippocrates knew that parsley had abortive effects. Plants containing apiol were also used by women in the Middle Ages to terminate pregnancies. When in 1849 was held in Paris a prize in chemistry for the best substance to replace quininein, two doctors presented the apiol. Coincidentally, some patients, sicked with malaria and treated with apiol, suffered of amenorrhea. It was thus discovered that, among the side effects, apiol regularizes menstruation: it was discovered a new emmenagogue. The apiol began to be sold by many pharmaceutical companies under different names (Ergapiol, Apergol, Salutol) without prescription. The widespread was impressive, probably one half of volontary abortions was due to the use of this substance. We can find a lot of medical publication in which apiol’s toxicity is underlined.
“There is no justification for the prolonged use and availability of such preparations. Apiol’s preparations have no legitimate use of importance in therapeutic and the danger associated with their employment, especially the haphazard and unrestricted dosages of attempts at abortion, have provoked legislation making such preparation available for sale on prescription only.”
(
"Apiol Poisoning,1958")
Eventually it was retired from trade during the 60’.
Nowadays, the apiol is the forerunner of the most important chemical abortive.
The liberalization of abortion laws and new researches give woman the legal justification to perform abortion, new methodics more safe. Even though the use of plants to induce abortion is still a significant concern in many part of the world. The purpose of this report is to describe abortive effects of the apiol and to enhance awareness and understanding of their toxicity.
Source
(
"Wikipedia Apiolo")
(
"Herbal Infusions Used for Induced Abortion, 2003")
(
"Aborto.Una storia dimenticata, 1997")
Abortive effects
The circumstances surrounding an induced abortion involve complex, legal, ethical, and social aspects. For the toxicologist, complexity is increased by two main problems. First, the patient usually denies the ingestion of any abortive substances,and secondary, standard medical training does not provide the pharmacological information to treat patient.
Apiol increases the tone and strength of miometral contraction, reduces the tone of vessels and causes necrosis of placental tissue. This chemical abortive is a not cruent method that allows to avoid perforation and infection, but is very poisonous.
The lowest dose of apiol that seems to be necessary to induce abortion is 0.9 g taken for 8 consecutive days.
Source
(
"Herbal Infusions Used for Induced Abortion, 2003")
(
"Essential oil safety, 1995")
Toxic effects
In the past there have been numerous cases of severe poisoning, often fatal, due to the empirical practice to use concentrated decoction of parsey seeds and / or leaves to induce abortion.
The toxic dose is difficult to define, because it depends on the mode of preparation and on the association with other substances that can enhance the toxicity of the product. But the facts that patient ingestes an excedingly large dose of the drug in a short period of time may help to enhance the severity of the symptoms.
1.He reacts with cell membrane dissolving the latter;
2.Patients show a bleeding tendency associated to trombocytopenia and an anemia partly due to blood loss and partly on a hemolytic basis.
3.Ematuria
4.Fatty liver and necrosis
5.Demielinization of peripheral nerves. All the cases reported would tend to show that the process is limitated to the peripheral nerves and there is no involvement of the SNC.
| Symptoms |
Parsley n=13 |
| Abdominal pain |
3 |
| Vomiting |
6 |
| Genital hemorrhage |
7 |
| Abortion |
7 |
| Anemia |
8 |
| Jaundice |
6 |
| Liver enlargement |
3 |
Symptoms and signs noted by the Montevideo Poison Centre between 1986 and 1999 concerning the ingestion of apiol with abortive intent (n=13)
Source
(
"Herbal Infusions Used for Induced Abortion, 2003")
(
"Apiolo,enciclopedia")
(
"Cerebral damage in a case of fatal poisoning due to a compound of ergot and apiol (Ergoapiol), 1938")
Symptoms
In relation to the mode of intoxication (abortion attempt), most of the subjects reach hospital at a distance of 12-24 hours or more after ingestion of the toxin.The symptoms are: nausea,vomiting, abdominal distress and diarrhea particularly in the early stages, a state of shock, massive hematuria, metroraggia, cutaneous petechiae and other signs of severe coagulation’s alteration. Frequently is observed hyperthermia and rapid progression to coma associated with brain damage. This syndrome has usually a rapid progression and ends with a fatal outcome. In the case of survival, the resolution of the coma and liver damage and kidney is slow.
Source
(
"Apiolo,enciclopedia")
(
"Apiol polyneuritis, 1935"))
Therapy
Within a few hours of ingestion, it must be done gastric lavage.
If the most of the toxic has already been absorbed, it is necessary to follow very frequently the coagulative parameters and proceeds to the factor’s correction.
In the presence of metroraggia, hysterectomy is deemed necessary. Finally it’s necessary to make dialysis for compensating the kidney failure. If the hemolysis is massive, the clinical can choose to performe plasmapheresis to remove free hemoglobin and prevent kidney failure or exsanguigno tranfusion.
Source
(
"Le difese tossicologiche naturali: aspetti medico legali, 2007")
