Toxicity of puffer fish: it contains tetrodotoxin, tetrodonic acid, ovotoxin and hepatotoxin. Tetrodotoxin is a non-protein strong neurotoxin, which was firstly isolated by Dr. Tahara of Japan from the ovaries of puffer fish, so it is called Tetrodotoxin (Tetrodotoxin). It is a polyhydroquinazoline compound alkaloid, and its toxicity is 1000 times greater than that of sodium cyanide. It is generally most toxic in the spring and summer and during the ovarian gestation stage. Ovaries, testes and liver are the main toxic parts, followed by intestines, blood, gills, kidneys and skin, etc. Muscle and blood also contain toxin. Tetrodotoxin is stable in nature, and heating, salting and high-temperature cooking cannot destroy it; it is now known that some animals, such as salamanders, octopuses, shellfish, crabs, etc., contain tetrodotoxin in more than 50 kinds of marine animals, belonging to different families.

After eating poisonous tetrodotoxin for half an hour to a few hours, there will be numbness or tingling in the fingers, lips and tongue, and then there will be thirst, nausea, vomiting, diarrhea, watery stools, or blood in the stools in the worst cases. There is also weakness of the limbs, paralysis of the lips, tongue and limbs, followed by general paralysis, or even general paralysis. It shows uncoordinated movement, drunkenness, drooping eyelids, weakness and paralysis of limbs, and in severe cases, slurred speech, respiratory difficulties, dilated pupils, and even respiratory paralysis, slow pulse, drop in blood pressure, and cardiac arrhythmia. The death rate is as high as 40-60%. Generally speaking, death occurs 6~24 hours after consumption; if the patient is still alive after 24 hours of consumption, and no complications, the mortality rate is greatly reduced after 24 hours of danger, the prognosis is better, and more can be fully recovered.

After eating tetrodotoxin, it is necessary to take oral emetic drugs immediately, or stimulate the root of the tongue and pharynx to induce vomiting artificially; however, it is important to note that tetrodotoxin can cause muscle paralysis in a very short period of time, so don't induce vomiting after the emergence of the symptoms, because it is easy to induce vomiting in this case to cause asphyxiation, which can be dangerous to the patient's life. The most important thing is to pay close attention to the patient's respiratory situation, immediately sent to a nearby hospital, given gastric lavage and activated charcoal; the application of vitamin B1, B6, B12, etc. to treat neuromuscular paralysis; if necessary, but also need to respiratory assisted respiration, monitor the patient's blood pressure. At present, there is no specific antidote for tetrodotoxin poisoning. Animal experiments show that cysteine can react with tetrodotoxin to form a non-toxic substance under neutral conditions, but it has not been widely used in clinics.

The most fundamental measure to prevent tetrodotoxin poisoning is that fishermen must cull it out when they catch it, and not allow it to reach the market; the sale, processing, and marketing of tetrodotoxin is strictly prohibited; and publicity is also strengthened to improve the public's ability to recognize tetrodotoxin in areas of high incidence.