or other ‘natural’ remedies is an area of especial concern. Whilst most, but by no means all, herbal preparations are innocuous (Belsey & Karch, 2015; Byeon et al., 2019), adulteration or contamination with dust, pollens, insects, rodents, parasites, microbes, fungi, mould, toxins, pesticides, toxic metals, and/or prescription drugs, is not uncommon (Byard, 2010; Posadzki et al., 2013; Steyn et al., 2018). This adds to the difficulty of diagnosing poisoning with these agents, each of which many contain dozens if not hundreds of different compounds, all at relatively low concentrations.
One area that has been neglected somewhat is that of food-derived poisons. Botulinum toxin and other toxins of microbiological origin are usually considered together with food poisoning. Poisoning from other naturally occurring substances, which include atropine from Atropa belladonna, solanine from potatoes, and cyanide from Cassava and from apple pips, also occurs, sometimes with homicidal intent (Bonnici et al., 2010). Here analysis of the foodstuff rather than biological samples can be more helpful in establishing the diagnosis in individual patients. Acute pesticide poisoning sometimes occurs after ingestion of contaminated produce and again analysis of the foodstuff can be helpful (Nasreddine & Parent-Massin, 2002).
1.5 Summary
It is impossible to divorce the study of the analytical methods used in performing toxicological analysis on biological and related samples from the study of toxicology itself, especially clinical and forensic toxicology. By the same token, the laboratory can do nothing to help in the diagnostic process unless someone, be it a clinician, pathologist, or some other person, first suspects poisoning and ensures that specimens are collected and sent for analysis. However, appropriate sample collection and handling is not always straightforward and indeed is a subject in its own right.
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