or their equivalents, are now artificially synthesized. Brugmansia species have also traditionally been used in many South American indigenous cultures in medical preparations and as an entheogen in religious and spiritual ceremonies. Medicinally, they have mostly been used externally as part of a poultice, tincture, ointment, or where the leaves are directly applied transdermally to the skin. Traditional external uses have included the treating of aches and pains, dermatitis, orchitis, arthritis, rheumatism, headaches, infections, and as an anti-inflammatory. They have been used internally much more rarely due to the inherent dangers of ingestion. Internal uses, in highly diluted preparations, and often as a portion of a larger mix, have included treatments for stomach and muscle ailments, as a decongestant, to induce vomiting, to expel worms and parasites, and as a sedative. Several South American cultures have used Brugmansia species as a treatment for unruly children, so that they might be admonished directly by their ancestors in the spirit world, and thereby become more compliant. Mixed with maize beer and tobacco leaves, it has been used to drug wives and slaves before they were buried alive with their dead lord. In the Northern Peruvian Andes, shamans (curanderos) traditionally used Brugmansia species for initiation, divination, and black magic rituals. In some Latin American countries such as Colombia and Peru, members of the genus Brugmansia are reportedly used by malevolent sorcerers or "bad shamans" in some ayahuasca brews in attempt to take advantage of tourists. The species that are typically used for these purposes include Brugmansia suaveolens and Brugmansia arborea among others. Toxicity All parts of Brugmansia are potentially poisonous, with the seeds and leaves being especially dangerous. Brugmansia are rich in scopolamine (hyoscine), hyoscyamine, and several other tropane alkaloids which can lead to anticholinergic toxidrome and delirium. Effects of ingestion can include paralysis of smooth muscles, confusion, tachycardia, dry mouth, constipation, tremors, migraine headaches, poor coordination, delusions, visual and auditory hallucinations, mydriasis, rapid onset cycloplegia, and death. The hallucinogenic effects of Brugmansia were described in the journal Pathology as "terrifying rather than pleasurable". The author Christina Pratt, in An Encyclopedia of Shamanism, says that "Brugmansia induces a powerful trance with violent and unpleasant effects, sickening after effects, and at times temporary insanity". These hallucinations are often characterized by complete loss of awareness that one is hallucinating, disconnection from reality (psychosis), and amnesia of the episode, such as one example reported in European