Volume 26 Number 2



By Frank Hubbell, DO



There are quite a few foods that we commonly eat that contain potentially lethal toxins. Fortunately, they are in trace quantities, and our liver is generally able to detoxify them before they can cause us any harm.



One particular toxin that is found in a variety of foods is amygdalin, a cyanogenic glycoside that is metabolized into hydrogen cyanide (HCN). Egads! CYANIDE– that could kill you!




Cyanide can be found in the following seeds and foods:


Apple seeds                            Cherry pits


Peach pits                              Apricot pits


Plums                                       Pears


Almonds                                Lima beans


Nectarines                            Barley


Cabbage                                Sorghum


Broccoli                                Cauliflower


Flaxseed                                Bamboo


White Clover


Cassava root = tapioca, manioc, yuca



The questions are where does the cyanide come from, and why it is in these seeds, fruits, or vegetables?



Some plants have the ability to fix nitrogen to carbon with a triple bond, making hydrogen cyanide = HCN, one hydrogen atom, one carbon atom, and one nitrogen atom.  Of course at this point, you’re wondering why aren’t all plants potentially cyanide carriers.  The plants have to have the enzymes necessary to carry out these chemical reactions and it has to be able to store the hydrogen cyanide without harming itself.


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Indo-Pacific Lionfish

March/April 2012  ISSN-1059-6518  Volume 25 Number 2

The INVASIVE Indo-Pacific Lionfish

 By Frank Hubbell, DO

Illustration by T.B.R. Walsh


While recently in the Caribbean, we became acutely aware of a major problem for the spectacular underwater world of the Caribbean Sea – the invasive Lionfish.


The problem is that Lionfish do not belong in the Atlantic Ocean or the Caribbean Sea. They are an Indo-Pacific predatory fish, and that is exactly where they belong – in the Indian and Pacific Oceans.


In the 1990’s, they were unintentionally introduced into the Atlantic, probably in the bilge water of ships returning to the Atlantic side of the world from the Indo-Pacific side. Today they have spread, as an invasive species, along the East Coast of the USA.  In addition, they can be found in the Mesoamerican Barrier Reef System and the wider Caribbean Sea.


A highly invasive species, they do not have any natural predators in these waters. In fact, in these marine environs, their only predator is we humans.




Pterois volitans and Pterois miles are the two species, out of nine, of Lionfish that have invaded the Atlantic Ocean and Caribbean Sea. They have multiple spines in their fins containing toxic barbs.


The toxin in these barbs is a complex protein mixture of neuromuscular toxins and a neurotransmitter, acetylcholine. It is the acetylcholine that causes the untoward effects on the heart.


Hazard to Humans


Because they are not an aggressive fish, they will not attack you. However, they still present a hazard to humans who handle a caught fish or step on a fish and are impaled by the toxic spines in the fins.


Injuries are not uncommon in the Indo-Pacific Oceans, with about 30,000 – 40,000 injuries beings reported annually. But, the envenomation is rarely lethal.

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Chest Trauma and the Lungs

IN the last edition of the Wilderness Medicine Newsletter, we discussed the anatomy and physiology of the respiratory system and respiratory medical emergencies. In this issue, we will continue our discussion by focusing on chest trauma.  Some traumatic injuries to the chest, such as a flail chest or traumatic asphyxia, though uncommon, are life-threatening. While others, like a fractured clavicle or rib, are very common, yet can still be very serious or even life-threatening. Any traumatic injury to the chest cavity should be considered serious until proven otherwise.


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Asthma and Rescue Inhalers

September/October 2008  ISSN-1059-6518  Volume 21 Number 5

By Frank Hubbell, DO

Illustrations by T.B.R. Walsh

As described in the feature article, asthma is recurrent (not progressive) and reversible. An asthma attack is caused by allergens that have been inhaled into the airway causing swelling, bronchospasm, and increased mucous production by the bronchioles. This will cause the bronchioles to narrow, producing expiratory wheezing (wheezing on exhalation), which will then cause air to become trapped in the alveoli. Due to the decrease in air movement, and air trapping, asthma patients will complain of a worsening sensation of shortness of breath (SOB)—dyspnea.

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