Q: My hero knows the villain, a werewolf, is extremely allergic to silver. He has to introduce a sufficient amount into the villain’s system to put him out of action permanently. He doesn’t have to die but no longer be a threat. A vegetative state would be okay.
They are at a party to raise money to rebuild a church. The villain is a member of the church council so will be greeting the guests. The hero and villain have never met before.
The hero cannot be a suspect in the villain’s poisoning so he can’t offer him any food or drink with silver in it. If he gave the villain a check with silver powder sprinkled on it would it be enough to bring on a reaction? How soon would the reaction occur and what would be the symptoms? The party’s host’s son is a doctor. What actions would he take to save the villain?
A: What a wild plot. If I remember correctly from my childhood visits to the Saturday morning “Creature Features” at the local theater, a werewolf can be killed with a silver bullet to the heart. But, silver powder would work too if the werewolf was allergic to it.
A severe allergy to virtually anything can kill the allergic person. From peanuts to penicillin and everything in between. And yes, sliver, too. Particularly in the world of werewolves and other fantasy situations. If the victim is severely allergic, skin contact of a metal such as silver might very well produce a sudden and deadly allergic reaction. This would be called an anaphylactic reaction or anaphylaxis.
Our immune system is critical to our survival. We are constantly bombarded by potential antigens all the time, usually in the form or bacteria and viruses. The body recognizes the antigen (virus, etc.) as foreign and builds antibodies that will recognize and attach to the virus. This reaction attracts white blood cells (WBCS), which release chemicals that kill or harm the virus, which is then consumed by the WBCs and destroyed. This process is essential for each of us to survive in our bacteria and virus-filled world.
So far, so good.
But, in allergic individuals, this reaction can be rapid and massive and can cause the release of large amounts of the chemicals from the WBCs. This is the reaction we call anaphylaxis. In excessive amounts these chemicals cause dilatation (opening up) of the blood vessels, which leads to a drop in blood pressure (BP) and shock. They cause the bronchial tubes (airways) to constrict (narrow), which leads to shortness of breath, wheezing, and cough. This is basically a severe asthmatic attack and prevents adequate air intake and the oxygen level in the blood drops rapidly. The chemicals also cause what is known as capillary leak, where the microscopic blood vessels in the tissues leak fluids into the tissues. This leads to swelling. In the skin this is manifested as hives and rashes. In the lungs it causes swelling of the airways, which along with the constriction of the airways, prevents air intake. In the tissues it causes swelling of the hands, face, eyes, and lips. The net result of an anaphylactic reaction is a dramatic fall in BP, severe wheezing, swelling and hives, shock (basically respiratory and cardiac failure), and death.
So, anaphylaxis is a rapid and profound reaction to some antigen. These antigens are typically foods, drugs, or insect venoms. Common foods are peanuts and shellfish, common drugs are penicillin and iodine, which is found in many radiographic dyes, and common insects are bees. There a myriad other foods, drugs, and bugs that can cause anaphylaxis in the allergic person. And in your scenario, silver would work.
Usually anaphylaxis onsets within minutes (10 to 20) after contact with the chemical, but sometimes, particularly with ingested foods, it may be delayed for hours—even up to 24 hours. In your scenario it would take from 10 to 30 or so minutes to begin and your werewolf would then develop all the above symptoms and signs. He would become very short of breath and develop hives and a rash. He might wheeze and gasp for breath. Finally he might clutch his chest and collapse into shock and die.
Untreated anaphylaxis leads to death in anywhere from a very few minutes to an hour or more, depending upon the severity of the reaction and the overall health of the victim. Treatment consists of blood pressure (BP) and respiratory support, while giving drugs that counter the allergic reaction. BP support may come from intravenous (IV) drips of drugs called vasopressors. The most common would be Dopamine, Dobutamine, epinephrine, and neosynephrine. Respiratory support may require the placement of an endotracheal (ET) tube and artificial ventilation. The victim would immediately be given epinephrine IV or subcutaneously (SubQ) and IV Benadryl and steroids. Common steroids would be Medrol, Solumedrol, and Decadron. These drugs work at different areas of the overall allergic reaction and reverse many of its consequences. The victim could survive these interventions. Or not. Your call. And if he survived he could easily suffer permanent brain damage and be in a vegetative state.