Monday, August 8, 2016

World's worst hickeys: Cupping is weird and potentially dangerous

In an effort to reduce pain or fix other health problems, some people will submit to having suction temporarily applied to various regions of their skin, usually the neck, shoulders, and back, via a collection of plastic or glass cups.

This is known as cupping, and is a great way to embrace your inner Polkaroo.

Thanks to the many sore athletes taking part in the Rio Olympics, cupping is having a bit of a moment right now. You've got swimmers and gymnasts with weird circular marks all over their torsos. The marks are some combination of erythema, petechiae, purpura, and ecchymosis. In other words, a bunch of blood ending up near the surface of the skin, the results of suction tearing open a bunch of tiny blood vessels.

Just a run-of-the-mill cupping mark (Source)

Setting aside whether or not cupping actually does anything useful (I'm betting on placebo), it turns out there are at least a couple of dangers associated with it.

First off, the traditional approach to cupping involves placing cotton doused in alcohol at the base of the cup, then lighting it to heat up the air inside. The cup is then cooled, resulting in suction as the pressure inside the cup is lowered. It might not surprise you to learn people occasionally are burned during a traditional cupping session. Nothing like hot glass on skin, eh? Modern cupping has eliminated this issue, as it involves the use of a hand pump to achieve suction.

One of the freakier ways of being hurt by cupping is having it done while flying. One case report I found told the story of a middle aged dude who ended up in emerge after being cupped while aboard his private airplane. Multiple blisters developed on the spots where the cups had been applied, each of which had to be drained with a needle. It's thought that a fairly rapid descent of the plane during the flight ended up increasing the suction inside the cups to the point at which skin begins to pop.

Problems can arise when cupping is carried out alongside acupuncture. In one reported case, an individual ended up with an abscess in their spinal cord. In other, the patient contracted herpes. It's clearly important to use clean equipment in order to avoid infection. Cupping and acupuncture can also cause serious issues for people with eczema. We're talking deep ulcers and intravenous antibiotics levels of serious.

In addition to injuries, cupping can mess with the efforts of forensic investigators. An article published last year in the Journal of Forensic and Legal Medicine warned that cupping-related skin damage could be misinterpreted during an autopsy as blunt trauma. There's also the possibility that a doctor might mistake cupping damage as evidence of a disease process and misdiagnose a patient.


Hon KL, Luk DC, Leong KF, Leung AK. 2013. Cupping therapy may be harmful for eczema: A PubMed search. Case Reports in Pediatrics 605829. [Full text]

Lin CW, Wang JT, Choy CS, Tung HH. 2009. Iatrogenic bullae following cupping therapy. Journal of Alternative and Complementary Medicine 15(11):1243-1245.

Tuesday, July 26, 2016

Fungi found flourishing following fire

Morels and several other fungi (all members of the order Pezizales) are known to produce their mushrooms in recently burned soil, whether it's the result of a nice little campfire or an entire forest going up in smoke. The fire creates the right conditions for the fungus, which lies beneath the ground and so protected from flames and heat, to send up mushrooms. These mushrooms release spores into the environment, and the circle of life continues ever onward.

In the case of morels, it's thought a forest fire does two things. Firstly, it damages or kills the trees the fungus obtains food from while growing underground, which is thought to signal mushroom production. Secondly, it helps to clear out the plant litter (leaves, twigs, etc.) covering the forest floor, giving the mushrooms an easier path to the surface. The cup fungus Geopyxis carbonaria tends to show up in the same fire-damaged forests as morels. It appears earlier, so it might be a useful guide for where morels (one of the major products of North American forests - hundreds of tonnes are harvested each year) can be found.

Here are a couple of cool photos I found on Flickr:

Morels growing in a burned out stump hole (Source)

Cup fungus growing where a campfire once burned (Source)

Peziza pseudoviolacea growing at a recently burned site (Source)

Rhizina undulata growing on a tree root in a recently burned forest (Source)


Greene DF, Hesketh M, Pounden E. 2010. Emergence of morel (Morchella) and pixie cup (Geopyxis carbonaria) ascocarps in response to the intensity of forest floor combustion during a wildfire. Mycologia 102(4):766-773. [Full text]

Monday, July 18, 2016

The Internet asks me about smelly things

Whenever I'm working on a new post, I like to take a bit of time to check in on the stats for this blog. I'm particularly interested in what people are typing into their search engines to find their way here. For whatever reason, a post I wrote about what poisons smell like is very popular among users of the Internet. I'm taking this as a sign that people like to read about smells, so I thought I'd look into a couple of odour-related search queries via which people have found this blog.

'type of algae has strong garlic like odour'

Members of the genus Chara are plant-like green algae found in lakes, rivers, and ponds all over the world. They have fun names like muskgrass or skunkweed on account of their intense unpleasant odour, which has been described as vaguely resembling that of garlic. Many sulfur-containing organic molecules (take for example, diallyl disulfide) tend to smell like garlic. Chara globularis is known to produce at least two organosulfur compounds, 4-methylthio-l,2-dithiolane and 5-methylthio-l,2,3-trithiane. Both can inhibit photosynthesis, so I'm guessing they're produced by the algae to help it compete with other sun-using aquatic organisms.

'are there pesticides smell like fish?'

Yes, at least one pesticide does indeed smell like fish. 2,4-D is herbicide discovered by the Allies during WII (fruit of their efforts to develop new chemical weapons) and used by the US during the Vietnam War (as an ingredient in Agent Orange). What makes 2,4-D so useful is it's way less toxic to grasses compared to other plants, meaning it can be applied to lawns and cereal crops in order to selectively disrupt the growth of their competitors (AKA weeds). While it's good at what it does, 2,4-D does not dissolve well in water. To fix this, chemists have played around with it a bit over the years. One of the more successful modifications was a salt, 2,4-D dimethylamine. It's very good at dissolving in water, but has an intense fishy odour because it contains a small amine. Amines are derivatives of ammonia found in, among other things, raw fish.

'why do some toxic chemicals smell sweet?'

Toxic chemicals with a sweet odour include benzene, carbon tetrachloride, chloropicrin, cyclosarin, and diborane. From a structural standpoint, they don't appear to have much in common:
  • Benzene is an electron-rich ring of six carbon atoms
  • Cyclosarin consists of a phosphorus atom attached to atoms of carbon, oxygen, and fluorine, as well as a ring of carbon atoms.
  • Carbon tetrachloride and chloropicrin have no rings but contain a bunch of chlorine atoms.
  • Diborane consists only of boron and hydrogen.
Smelling is complicated. We sense odours via the activation of receptors inside our nose, which transmit signals to our brain. Sounds pretty straightforward right? Problem is, there are hundreds of receptor types, and the signals they produce interact with one another in specific ways to form the information passed on to the brain. It's not uncommon for molecules with very different chemical structures to have similar odours, and for similarly structured molecules to have very different odours.


Sell CS. 2006. On the unpredictability of odor. Angewandte Chemie International Edition 45(38):6254-6261. [Full text]

Stonard RJ, Miller-Wideman MA. 1994. Herbicides and plant growth regulators. In: Agrochemicals from Natural Products, Ed. CRA Godfrey. CRC Press. [Link]

Volgas GC, Mack RE, Roberts JR. 2005. Benefits of a 2,4-D acid herbicide formulation. In: Pesticide Formulations and Delivery Systems, Ed. GR Goss. ASTM International. [Link]

Thursday, July 14, 2016

Weird stuff found in recreational drugs: Cocaine edition

This is the fifth and final post in a series on strange substances accidentally or intentionally added to street drugs. When you're done here, check out the posts on alcohol, meth, opioids, and pot/LSD.

If a drug is being sold illegally, chances are its sellers have added crap to it in order to make more money. Cocaine is no exception to this deception. Substances added to nose candy because they resemble the drug but otherwise don't mimic or influence its effects include talc powder, flour, cornstarch, inositol and other sugar alcohols, various salts, boric acid, and microcrystalline cellulose. Snorting any of talc, starch, or cellulose into your lungs can result in an inflammation that disrupts your ability to breathe normally.

A decidedly artsy photo of talc powder between two brushes (Source)

There are also a bunch of drugs known to be mixed in with cocaine to dupe a buyer into believing they're purchasing a higher quality product. Caffeine is used in this capacity because it's cheap and is a stimulant (it perks you up) like cocaine, albeit a way less intense one. Several relatives of cocaine, including procaine, lidocaine, and benzocaine, are used as local anesthetics to do things like numb your mouth at the dentist before the drilling commences. Cocaine also causes mouth numbness, so adding these other drugs to it can trick customers into thinking they're getting a higher quality product.

One of the stranger yet very common additions to cocaine is a drug called levamisole. It's good at killing parasitic worms and also appears to be able to influence the immune system in useful ways. Unfortunately, it also has a tendency to ruin bone marrow and cause a serious dip in the number of white blood cells being made there (agranulocytosis), which is a fantastic way to catch a life-threatening infection. Snorting cocaine contaminated with levamisole can also damage blood vessels in the arms and legs via vasculitis. The role of levamisole as a cocaine adulterant is a bit of a mystery. It's apparently transformed into aminorex, an amphetamine-like drug, when given to racehorses, suggesting it can enhance the effects of cocaine. There's also some evidence that levamisole can act on receptors in the brain to enhance how good cocaine makes you feel. Alternatively, it may simply be added because it's cheap, resembles cocaine, and is often easy to acquire since it's sold as a veterinary medication.

Our tour of drug additions to cocaine ends with diltiazem. This drug acts to block the movement of calcium through channels in the outer membranes of heart cells, permitting it to be used to help control an erratic heartbeat (arrhythmia) and other heart issues. It's been suggested that some distributors decided to add diltiazem to their cocaine in order to negate the negative effects it can have on the heart, which happen to include arrhythmias. Even so, there isn't any evidence diltiazem can provide a protective effect. If anything, it might actually make things worse.


Brunt TM, Rigter S, Hoek J, Vogels N, van Dijk P, Niesink RJ. 2009. An analysis of cocaine powder in the Netherlands: Content and health hazards due to adulterants. Addiction 104(5):798-805.

Cole C, Jones L, McVeigh J, Kicman A, Syed Q, Bellis M. 2011. Adulterants in illicit drugs: A review of empirical evidence. Drug Testing and Analysis 3(2):89-96.

Tallarida CS, Tallarida RJ, Rawls SM. 2015. Levamisole enhances the rewarding and locomotor-activating effects of cocaine in rats. Drug and Alcohol Dependence 149:145-150. [Full text]

Thursday, June 23, 2016

Weird stuff found in recreational drugs: Pot/LSD edition

This is the fourth post in a series on strange substances accidentally or intentionally added to street drugs. When you're done here, check out the posts on alcohol, meth, opioids, and cocaine.

In the autumn of 2007, hospitals near Leipzig, Germany admitted 29 people after they inadvertently smoked weed contaminated with lead. Yep, some dealer or grower decided it was a good idea to drop a bunch of small lead particles into the marijuana they were selling, presumably to increase its weight (lead is super dense) and thus make mad bank. The average lead content of stashes recovered from the poisoned individuals was 10% by weight, translating into an additional ~$1500 per kg of pot sold.

It turns out the center of a lit joint can reach temperatures up to 1200°C, sufficient to ensure a bunch of lead particles will end up in the inhaled smoke and so be absorbed via the lungs (particularly if the inhaled smoke is being held in to maximize absorption of non-lead stuff like THC). Those with lead poisoning showed up to the hospitals with stomach cramps, feeling like they were going to barf, lacking sufficient numbers of red blood cells (anemia), and being unreasonably tired. Most had basophilic stippling and exhibited Burton's line (here's a gross photo), which are classic indicators of lead poisoning. One particularly unfortunate person also had their nervous system seriously damaged by lead. In addition to experiencing hallucinations, this individual exhibited wrist drop because a nerve connecting their spine with their arms stopped working properly.

Aluminum and small bits of glass have also been found in marijuana sold on the street. The aluminum was attributed to using unreasonably dirty water to grow the plants, while the glass was thought to be intentionally added to make the pot look better (like it has lots of crystals) and increase its weight. Inhaling hot glass fumes isn't pleasant since they can severely burn your mouth and lungs.

Claviceps purpurea fungus growing on grain (Source)

Very rarely, dropping acid (LSD) can result in ergot poisoning, which is probably one of the worst possible outcomes for a trip. If the LSD is synthesized from lysergic acid obtained from the ergot fungus (Claviceps purpurea), it may be contaminated with other toxic fungal alkaloids. Ergot poisoning (aka St. Anthony’s fire) has been around since we first began harvesting rye and other grains to eat. The fungus grows on these plants, producing a bunch of compounds that aren't very nice to the human body. They act on the intestines to produce diarrhea and on the nervous system to produce seizures. Ergot alkaloids also cause blood vessels to constrict, reducing blood (and thus oxygen) flow to the arms and legs (aka limb ischemia, usually accompanied by burning pain). In severe cases, the reduced blood flow can lead to gangrene, where the ends of one's fingers and toes to die, turn black, and eventually fall off.


Busse F, Omidi L, Timper K, Leichtle A, Windgassen M, Kluge E, Stumvoll M. 2008. Lead poisoning due to adulterated marijuana. New England Journal of Medicine 358(15):1641-1642. [Full text]

Cole C, Jones L, McVeigh J, Kicman A, Syed Q, Bellis M. 2011. Adulterants in illicit drugs: A review of empirical evidence. Drug Testing and Analysis 3(2):89-96.

Raval MV, Gaba RC, Brown K, Sato KT, Eskandari MK. 2008. Percutaneous transluminal angioplasty in the treatment of extensive LSD-induced lower extremity vasospasm refractory to pharmacologic therapy. Journal of Vascular and Interventional Radiology 19(8):1227-1230.